The long-term survival of patients with III-IVb stage nasopharyngeal carcinoma treated with IMRT with or without Nimotuzumab: a propensity score-matched analysis.

BACKGROUND: To assess the efficacy of Nimotuzumab in combination with first-line chemoradiotherapy treatment in Chinese patients with primary III-IVb stage nasopharyngeal carcinoma. METHODS: Patients with primary locoregionally advanced nasopharyngeal carcinoma who were treated with intensity-modulated radiotherapy (IMRT) and concurrent cisplatin-based chemotherapy between January 2008 and December 2013 at a single institution were retrospectively reviewed. Group A received at least 6 doses of Nimotuzumab, while Group B did not receive Nimotuzumab. A propensity score matching method was used to match patients from each group in a 1:3 ratio. RESULTS: In total, 730 eligible patients were propensity matched, with 184 patients in Group A and 546 patients in Group B. Significant differences were not observed in the patient and tumor characteristics between Group A and Group B. At a median follow-up of 74.78 months (range 3.53-117.83 months), locoregional recurrence, distant failure and death were observed in 10.68, 11.10 and 16.03% of all patients, respectively. The estimated 5-year locoregional relapse-free survival, distant metastasis-free survival, progression-free survival and overall survival in the Group A versus Group B were 85.34% versus 89.79% (P = 0.156), 93.09% versus 85.61% (P = 0.012), 79.96% versus 77.99% (P = 0.117) and 88.91% versus 78.30% (P = 0.006), respectively. CONCLUSIONS: This nimotuzumab-containing regimen resulted in improved long-term survival of III-IVb stage NPC patients and warrants further prospective evaluation.

Simulation and control strategy for the variational influent of WWTP.

With the development of activated sludge model, the simulation software for the design and operation of wastewater treatment plant (WWTP) was produced and has been widely used. The dynamic change of the quality and flow of influent are major factors causing the unstable operation of wastewater treatment process. As a basic model, ASM1 model was used for the simulation of activated sludge process, and double exponential model was selected for the simulation of secondary sedimentation tank. The influences of influent change to the aeration tank and secondary sedimentation tank were investigated, and the relationship among influent change, the quality of effluent and the level of sludge blanket in secondary sedimentation tank was established. On the basis of the simulation results, the operation of the WWTP could be adjusted under the dynamic change of the influent. Furthermore, the controlling strategy combined the feed-forward on the influent flow and the feedback on the level of sludge blanket in the secondary sedimentation tank was studied.

Establishment of soft-tissue-injury model of high-voltage electrical burn and observation of its pathological changes.

A realistic model is very useful in laying the foundation for clinical treatment and further study of high-voltage electrical burns. We therefore established a soft-tissue-injury model of high-voltage electrical burn in rabbits using the highest voltage alternating current reported. Twenty-five healthy big-ear white rabbits were randomly divided into five groups (five in each group): control group (C group) before injury and 0.5-h, 24-h, 48-h and 72-h groups after injury. Except for the control group, the rabbits in the other four groups were anaesthetised with ketamine and the electrodes were placed in their left limbs. Electric shock was administered from a distance of 7 cm at 3000 V output voltage for 0.1s to observe the skin temperature, electric resistance, wound morphology, histological change and to measure the level of muscle viability and serum myocardial enzymes, among others. Instant current application reached 3-5A (mean: 4.1+/-0.8A), and electric shock voltage was fixed at 3000 V. The resistance between the two electrodes in the left limb decreased from between 1500 and 3600 Omega (mean: 2590.3+/-812.9 Omega) to 921.5+/-528.7 Omega after the electric shock. The skin temperature of the control group was 30.1+/-2.5 degrees C, which elevated to 50.3+/-4.5 degrees C after the electric shock. Muscle necrosis occurred progressively 24-72 h after the injury with obvious acute inflammation. Electron microscopic examination revealed a bilaminar sarolemma membrane structure, multiple mitochondria between muscle bundles and disappearance of shortened mitochondrial crista 48 h after injury. Additionally, the muscle viability index decreased gradually to 0.376+/-0.071 72 h after the injury, while in the control group it was 1.354+/-0.117. The skin, arterial walls, and peripheral nerves showed obvious degeneration and necrosis. Moreover, pathological changes were found in vital organs distal to the electric shock sites, such as the heart, liver, lung and kidney, indicating systemic injuries. The level of serum myocardial enzymes was significantly elevated, especially 24h after injury. Thus, electric shock at 3000 V output electric voltage for 0.1s can cause severe, focal, soft-tissue injury and pathological changes in the vital organs such as heart, liver, kidney and lung with the characteristics similar to those of high-voltage-electrical-burn patients.