Simultaneous separation and determination of several chiral antidepressants and their enantiomers in wastewater by online heart-cutting two-dimensional liquid chromatography.

A novel method for simultaneous separation and detection of the racemates and the enantiomers of common chiral antidepressants in wastewater matrix was developed by online heart-cutting two-dimensional liquid chromatography (2D-LC) coupled to solid-phase extraction (SPE). Screening of chiral stationary phases (CSPs) and chromatographic conditions was investigated for complete enantioseparation to be compatible with RP-HPLC in 1st D-LC. Using methanol-0.1 % (v/v) ammonia solution as mobile phase, a 2D-LC system was configured by reversed mode with a combination of C18 column and the serially CPS columns as 2D-LC stationary phases respectively. The target analytes could achieve satisfactory transformation between 2D-LCs with transfer rate of 90.57-98.58 %. By means of freeze-drying and SPE, three antidepressants in wastewater were greatly preconcentrated under the optimized conditions, improving the method performance. The racemates and the enantiomers of mirtazapine, bupropion and fluoxetine exhibited good linearity in the range of 0.10-30.00 ng/mL (R2≥0.9986), and LODs and LOQs ranged in 0.0183-0.0549 ng/mL and 0.0661-0.1831 ng/mL, respectively. By this way, the method was successfully applied to simultaneous determination of the racemates and the enantiomers of mirtazapine, bupropion and fluoxetine in wastewater samples. Among them, three samples contained bupropion at level of 0.401-0.822 ng/mL, and mirtazapine at level of 0.328 and fluoxetine at level of 0.381 ng/mL were detected respectively in the other two samples. The enantiomers were at level of 0.140-0.189 ng/mL for mirtazapine, 0.182-0.419 ng/mL for bupropion and 0.179-0.204 ng/mL for fluoxetine, respectively. The proposed method providing an efficient approach to monitoring chiral drugs and their enantiomers in wastewater, facilitating to pollution assessment of chiral drugs in the environment and regional survey of illicit abuse in drug control.

Analysis of the amplitude changes and baseline shifts of respiratory motion using intra-fractional CBCT in liver stereotactic body radiation therapy.

PURPOSE: Using intra-fractional cone-beam CT (CBCT) to evaluate the amplitude changes and baseline shifts of respiratory motion in liver stereotactic body radiation therapy (SBRT). METHODS: The amplitude changes and baseline shifts of respiratory motion for 24 liver patients were evaluated by the four-dimensional (4D) CT, inter- and intra-fractional CBCT. The difference of the average liver position errors among all treatment fractions and the 4D CT representthe baseline shifts. According to the baseline shifts, the ITV to PTV margin was recalculated and the plan was re-designed to compare the dosimetric variation. RESULTS: The systematic and random errors of the baseline shifts for intra-fractional CBCT in the left-right (LR), superior-inferior (SI), and anterior-posterior (AP) directions were 0.99/1.60 mm, 2.03/2.46 mm, and 1.02/2.07 mm, respectively. The new ITV to PTV margins should be 4.0 mm, 7.0 mm, and 4.0 mm, respectively. The amplitude change of motion between the 4D CT and the intra-fractional CBCT was 1.03 ± 4.35 mm, with 31% of fractions exceeding 5 mm. To achieve the same dose coverage of the new PTV, the Dmean, V50, V40, V30, V25 of normal liver and maximum dose of the duodenum were significantly different. CONCLUSIONS: Significant amplitude changes and baseline shifts of motion occurred during dose delivery compared with those in 4D CT. Using the ITV to PTV margin of 4.0 mm (LR), 7.0 mm (SI), and 4.0 mm (AP) can ensure the target dose coverage and keep the dose constrain of normal tissues at an acceptable level.

Analysis of local setup errors of sub-regions in cone-beam CT-guided post-mastectomy radiation therapy.

The purpose of the study was to quantify local setup errors and evaluate the planning target volume (PTV) margins for sub-regions in cone-beam computed tomography (CBCT)-guided post-mastectomy radiation therapy (PMRT). The local setup errors of 20 patients undergoing CBCT-guided PMRT were analysed retrospectively. Image registration between CBCT and planning CT was performed using four sub-regions of interest (ROIs): the supraclavicular area (SROI), ipsilateral chest wall region (CROI), ipsilateral chest wall plus supraclavicular region (SROI + CROI) and vertebral region (TROI). Bland-Altman analysis, correlation, local setup errors and PTV margins among these ROIs were evaluated. There was no significant consistency or correlation for registration results between the TROI and the CROI or SROI regions on any translational axis. When using the SROI + CROI as the ROI, the systematic error (Σ) and random error (σ) of the local setup errors for the CROI region were 1.81, 1.19 and 1.76 mm and 1.84, 2.64 and 3.00 mm along the medial-lateral (ML), superior-inferior (SI) and anterior-posterior (AP) directions, respectively. The PTV margins for the CROI region were 5.80, 4.82 and 6.50 mm. The Σ and σ of the local setup errors for the SROI region were 1.29, 1.15 and 0.77 mm and 1.96, 2.65 and 2.2 mm, respectively, and the PTV margins were 4.59, 4.73 and 3.47 mm. Large setup errors and local setup errors occur in PMRT. The vertebral body should not be a position surrogate for the supraclavicular region or chest wall. To compensate for the local setup errors, different PTV margins are required, even with CBCT guidance.

Design of a new breast vacuum bag to reduce the global and local setup errors and to reduce PTV margin in post-mastectomy radiation therapy.

To design a new breast vacuum bag to reduce global and local setup errors in post-mastectomy radiation therapy (PMRT). A total of 24 PMRT patients were immobilized with an old vacuum bag and 26 PMRT patients were immobilized with a new vacuum bag. The registration results were analysed using four regions of interest (ROI): the global ROI [including the whole region of the planning target volume (PTV), GROI], the supraclavicular area (SROI), the ipsilateral chest wall region (CROI) and the ipsilateral arm region (AROI). The global and local setup errors of the two groups were compared. The global setup errors of the new vacuum group were significantly smaller than those in the old vacuum group with the exception of yaw axes (P < 0.05). The systematic error (Σ) and random error (σ) ranged from 1.21 to 2.13 mm. In the new vacuum group, the local setup errors in the medial-lateral (ML) direction and roll axes for CROI (the Σ and σ ranged from 0.65 to 1.35 mm), and the local setup errors in ML and superior-inferior (SI) directions for SROI were significantly smaller than those in the old vacuum group. The total required PTV margins for the chest wall in ML, SI, and anterior-posterior (AP) were 4.40, 3.12 and 3.77 mm respectively. The new vacuum bag can significantly reduce the global setup errors and local setup errors in PMRT. The respiratory motion of the chest wall was negligible, and the 5 mm PTV margin could cover the local setup errors in PMRT using the new vacuum bag with cone beam CT (CBCT) correction.

Home enteral nutrition may prevent myelosuppression of patients with nasopharyngeal carcinoma treated by concurrent chemoradiotherapy.

BACKGROUND: The aim of this study is to assess the effect of home enteral nutrition (HEN) on the myelosuppression of patients with nasopharyngeal cancer (NPC) during the course of concurrent chemoradiotherapy (CCRT). METHODS: A total of 18 outpatients with NPC administered oral nutritional supplementation intervention at home during the course of CCRT were designated as the HEN group, whereas 36 patients with NPC who had previously completed CCRT were retrospectively included as the control group. Patient Generated Subjective Global Assessment, body mass index (BMI), and blood test were evaluated prior to CCRT. During the course of CCRT, blood test was assessed every 2 weeks. RESULTS: In male patients, hemoglobin (HB) and red blood cell were decreased (P < .05) in both HEN and control group after CCRT, whereas white blood cell (WBC) started to decrease since week 2 of CCRT in the control group but maintained in the HEN group which was significantly higher than the control (5.05 ± 1.29 vs 3.77 ± 1.5, P < .05). In female patients, HB and WBC were reduced in control group during CCRT, whereas these indicators also maintained in the HEN group. Surprisingly, all patients with lower BMI (<24 kg/m2 ) had a significant increase in platelet (PLT) after CCRT (200.78 ± 58.03 vs 253.00 ± 69.82, P < .05), while had steady HB and WBC values in the HEN group. At the end of CCRT, WBC and PLT of the HEN group were both higher than those in the control group (5.21 ± 1.07 vs 3.37 ± 1.52), (253.00 ± 69.82 vs 165.57 ± 59.56) (P < .05 for both). Our findings suggest that HEN is effective in preventing myelosuppression during CCRT for patients with NPC. CONCLUSION: Our findings suggest that HEN is effective in preventing myelosuppression during CCRT for patients with NPC.

Analysis of which local set-up errors can be covered by a 5-mm margin for cone beam CT-guided radiotherapy for nasopharyngeal carcinoma.

OBJECTIVE: To analyse which local set-up errors can be covered by a 5-mm margin for cone beam computed tomography (CBCT)-guided radiotherapy in nasopharyngeal carcinoma (NPC). METHODS: 11 regions of interest (ROIs) were registered for 24 NPC patients, with a total of 323 CBCT scans. According to the registration results, clinical target volume-planning target volume (CTV-PTV)/organs at risk-planning risk volume (OAR-PRV) margin analysis; Pearson correlation analysis; Bland-Altman plots; and a receiver operating characteristic (ROC) analysis were used to investigate which local set-up errors of substructure can be represented by the PTVROI. RESULTS: The clinical target volume-PTV/OAR-planning risk volume margins were less than 5 mm for C1ROI-C4ROI, mandible (MROI), and sphenoid sinus (SROI) with respect to PTVROI. C1ROI-C4ROI, MROI, and SROI exhibited significant correlations and consistencies in the mediolateral, superior-inferior, and anteroposterior (AP) directions and significant receiver operating characteristic analysis results in the anteroposterior direction. CONCLUSION: Only the upper local set-up error of C1ROI-C4ROI, MROI, and SROI can be covered by a 5-mm margin for CBCT-guided NPC radiotherapy with a large ROI. Using these ROIs as an integral reference ROI is better than individual bony landmark. Advances in knowledge: This report is helpful to CBCT registration for NPC radiotherapy in clinical practice.

Transcription factor C/EBPß promotes the transcription of the porcine GPR120 gene.

G protein-coupled receptor 120 (GPR120), an adipogenic receptor critical for the differentiation and maturation of adipocytes, plays an important role in controlling obesity in both humans and rodents and, thus, is an attractive target of obesity treatment studies. However, the mechanisms that regulate the expression of porcine GPR120 remain unclear. In this study, electrophoretic mobility shift assay (EMSA) and chromatin immunoprecipitation (ChIP) techniques were used to analyze and identify the binding of C/EBPß (transcription factor CCAAT/enhancer binding protein beta) to the GPR120 promoter. C/EBPß overexpression and RNA interference studies showed that C/EBPß regulated GPR120 promoter activity and endogenous GPR120 expression. The binding site of C/EBPß in the GPR120 promoter region from -101 to -87 was identified by promoter deletion analysis and site-directed mutagenesis. Overexpression of C/EBPß increased endogenous GPR120 expression in pig kidney cells (PK). Furthermore, when endogenous C/EBPß was knocked down, GPR120 mRNA and protein levels were decreased. The stimulatory effect of C/EBPß on GPR120 transcription and its ability to bind the transcription factor-binding site were confirmed by luciferase, ChIP, and EMSA. Moreover, the mRNA and protein expression levels of C/EBPß were induced by high fat diet feeding. Taken together, it can be concluded that C/EBPß plays a vital role in regulating GPR120 transcription and suggests HFD-feeding induces GPR120 transcription by influencing C/EBPß expression.

Implementation of single-breath-hold cone beam CT guided hypofraction radiotherapy for lung cancer.

BACKGROUND: To analyze the feasibility of active breath control (ABC), the lung tumor reproducibility and the rationale for single-breath-hold cone beam CT (CBCT)-guided hypofraction radiotherapy. METHODS: Single-breath-hold CBCT images were acquired using ABC in a cohort of 83 lung cancer patients (95 tumors) treated with hypofraction radiotherapy. For all alignments between the reference CT and CBCT images (including the pre-correction, post-correction and post-treatment CBCT images), the tumor reproducibility was evaluated via online manual alignment of the tumors, and the vertebral bone uncertainties were evaluated via offline manual alignment of the vertebral bones. The difference between the tumor reproducibility and the vertebral bone uncertainty represents the change in the tumor position relative to the vertebral bone. The relative tumor positions along the coronal, sagittal and transverse axes were measured based on the reference CT image. The correlations between the vertebral bone uncertainty, the relative tumor position, the total treatment time and the tumor reproducibility were evaluated using the Pearson correlations. RESULTS: Pre-correction, the systematic/random errors of tumor reproducibility were 4.5/2.6 (medial-lateral, ML), 5.1/4.8 (cranial-caudal, CC) and 4.0/3.6 mm (anterior-posterior, AP). These errors were significantly decreased to within 3 mm, both post-correction and post-treatment. The corresponding PTV margins were 4.7 (ML), 7.4 (CC) and 5.4 (AP) mm. The changes in the tumor position relative to the vertebral bone displayed systematic/random errors of 2.2/2.0 (ML), 4.1/4.4 (CC) and 3.1/3.3 (AP) mm. The uncertainty of the vertebral bone significantly correlated to the reproducibility of the tumor position (P<0.05), except in the CC direction post-treatment. However, no significant correlation was detected between the relative tumor position, the total treatment time and the tumor reproducibility (P>0.05). CONCLUSIONS: Using ABC for single-breath-hold CBCT guidance is an effective method to reduce the PTV margin of hypofraction radiotherapy for lung cancer. Using ABC, the tumor position was significantly altered relative to the vertebral position. The reproducibility of the tumor position was affected by the vertebral bone but not by the relative tumor position or the total treatment time.