ABSTRACT
Objective@#To examine outcomes in a modern treatment era for stage III uterine serous carcinoma (USC). @*Methods@#Fifty women were retrospectively identified as 2009 International Federation of Gynecology and Obstetrics stage III USC patients who received radiotherapy (RT) at our institution between 1/2003–5/2018. The patients were divided into 2 cohorts: 20 in the early era (2003–2010) and 30 in the modern era (2011–2018). Patient characteristics were compared using χ 2 tests for categorical variables and t-tests for continuous variables. Recurrence free survival (RFS) and overall survival (OS) were analyzed with Kaplan-Meier estimates, the logrank test, and Cox proportional hazards. @*Results@#The modern era differed from the early era in the increased use of volume-directed external beam RT (EBRT) as opposed to vaginal brachytherapy (VB) alone (33.3% vs 5.0%, p=0.048), minimally invasive surgery (56.7% vs. 25%, p=0.027), sentinel node sampling (26.7% vs. 0%, p=0.012), computed tomography imaging in the perioperative period (63.3% vs. 30%, p=0.044), and human epidermal growth factor receptor 2eu testing (96.7% vs.55%, p=0.001). Median follow-up for early and modern eras was 37.27 and 33.23 months, respectively. The early vs. modern 3-year RFS was 33% and 64% (p=0.039), respectively, while the 3-year OS was 55% and 90% (p=0.034). Regional nodal recurrence more common among the patients who received VB only (p=0.048). @*Conclusion@#Modern era treatment was associated with improved RFS and OS in patients with stage III USC. Regional nodal recurrences were significantly reduced in patients who received EBRT.
ABSTRACT
Objective@#To examine outcomes in a modern treatment era for stage III uterine serous carcinoma (USC). @*Methods@#Fifty women were retrospectively identified as 2009 International Federation of Gynecology and Obstetrics stage III USC patients who received radiotherapy (RT) at our institution between 1/2003–5/2018. The patients were divided into 2 cohorts: 20 in the early era (2003–2010) and 30 in the modern era (2011–2018). Patient characteristics were compared using χ 2 tests for categorical variables and t-tests for continuous variables. Recurrence free survival (RFS) and overall survival (OS) were analyzed with Kaplan-Meier estimates, the logrank test, and Cox proportional hazards. @*Results@#The modern era differed from the early era in the increased use of volume-directed external beam RT (EBRT) as opposed to vaginal brachytherapy (VB) alone (33.3% vs 5.0%, p=0.048), minimally invasive surgery (56.7% vs. 25%, p=0.027), sentinel node sampling (26.7% vs. 0%, p=0.012), computed tomography imaging in the perioperative period (63.3% vs. 30%, p=0.044), and human epidermal growth factor receptor 2eu testing (96.7% vs.55%, p=0.001). Median follow-up for early and modern eras was 37.27 and 33.23 months, respectively. The early vs. modern 3-year RFS was 33% and 64% (p=0.039), respectively, while the 3-year OS was 55% and 90% (p=0.034). Regional nodal recurrence more common among the patients who received VB only (p=0.048). @*Conclusion@#Modern era treatment was associated with improved RFS and OS in patients with stage III USC. Regional nodal recurrences were significantly reduced in patients who received EBRT.
ABSTRACT
Nonalcoholic fatty liver disease (NAFLD) is a common complication of type 2 diabetes mellitus (T2DM) and can progress to liver cirrhosis and even hepatocellular carcinoma, but there are still no effective pharmacotherapies for NAFLD at present. Sodium-glucose co-transporter 2 inhibitor (SGLT-2i) is a newly approved oral hypoglycemic agent and can effectively reduce blood glucose. Meanwhile, SGLT-2i can improve NAFLD by improving lipid accumulation and insulin resistance, exerting anti-inflammatory and anti-oxidative stress effects, reducing liver fibrosis degree, and delaying the progression to hepatocellular carcinoma. SGLT-2i also helps with the prevention of NAFLD by reducing the toxicity of high glucose, body weight, and blood uric acid and improving liver dysfunction. This article reviews the current status of T2DM with NAFLD, the mechanism of action of SGLT-2i, the effect of SGLT-2i in preventing T2DM with NAFLD, and the safety of SGLT-2i.
ABSTRACT
Background: to compare the following techniques for hypofractionated whole-breast irradiation [WBI] with simultaneous integrated boost [SIB] after breast-conserving surgery [BCS]: three-dimensional conformal radiation therapy plus electron boost [3DCRT-EB], intensity-modulated radiation therapy [IMRT] plus EB [IMRT-EB], field-in-field IMRT plus EB [FIF-IMRT-EB], FIF-IMRT plus IMRT boost [FIF-IMRT-IB], IMRT plus IMRT boost [IMRT-IB], and volumetric-modulated arc therapy [VMAT] plus VMAT boost [VMAT-VB]
Materials and Methods: twenty patients with left breast cancer were enrolled. The prescribed dose was 40.05 Gy in 15 fractions to the whole breast and an SIB to the tumor bed of 3.2 Gy/fraction [total, 48 Gy]. Target-volume coverage, dose-conformity index, homogeneity index [HI], doses to organs at risk [OAR], and costs were compared
Results: FIF-IMRT-EB performed the best, while FIF-IMRT-IB, IMRT-IB, and VMAT-VB performed the worst. The mean dose to the planning target volume for breast evaluation [PTV Eval-breast] was significantly lower for IMRT-EB and FIF-IMRT-EB than for the other plans. For both PTV Eval-breast and PTV Eval-boost, VMAT-VB had the lowest target-volume coverage for 95% of the prescription dose and the highest target-volume coverage for >105% of the prescription dose. Among the six plans, VMAT-VB had the best HI for PTV Eval-boost and the highest doses to all OAR, except the coronary artery. Plans with EBs had lower mean doses for the contralateral lung and contralateral breast than plans with IMRT boosts. FIF-IMRT-EB had a low cost; plans with IMRT boosts had the highest costs
Conclusion: FIF-IMRT-EB may be the most suitable irradiation technique for hypofractionated WBI with SIB after BCS
ABSTRACT
Background: We used a MapCHECK software-based dimensional dose distribution comparison method capable of evaluating point-to-point geometrical dose differences in volume to determine whether doses obtained from an enhanced computed tomography [CT]-based treatment plan, which better defines the target regions and organs at risk, differs from doses obtained from plain CT and then evaluated the feasibility of treatment planning via enhanced CT
Materials and Methods: Forty-three randomly selected patients underwent plain and subsequent enhanced CT with the same settings. Treatment plans developed for the two scans were identical in terms of planning parameters [e.g., isocentre, gantry angle, segments] and monitor units [MU] used for dose calculation. Horizontal and vertical dose distribution planes across the same isocentre were selected from two types of plan; a two-dimensional dose distribution analysis was used to determine the Distance-To-Agree [DTA] pass ratios of corresponding dose distribution planes
Results: Obtained doses at the head and neck [H and N] and pelvic sites did not differ greatly between enhanced and plain CT. However, enhanced CT significantly influenced doses to the lower thoracic oesophagus. A corrected pass ratio that was achieved by non-pass points in lower isodose areas excluded from the statistical analysis had better clinical outcome
Conclusion: Radiation plans with multi-fields and multi-angles can reduce the influence of enhanced CT on torso cases and may even negate its influence on H and N cases. Enhanced CT can be directly used for planning unless the target region contains the lower oesophagus and its surrounding blood vessel whose high density requires correction
ABSTRACT
Background: The activity concentrations of [226]Ra, [232]Th and [40]K in sand used as building material in Weifang of China were investigated for evaluating the radiation hazard
Materials and Methods: Sand samples were collected from Weifang and their radioactivity levels were measured using gamma-ray spectrometry. The radiation hazard for residents was assessed by radium equivalent activity [Raeq], indoor air absorbed dose rate [D], annual effective dose [AED] and excess lifetime cancer risk [ELCR]
Results: The activity concentrations of [226]Ra, [232]Th and [40]K ranged from 11.7 to 23.0, 33.6 to 126.1 and 353.2 to 924.8 Bq kg[?1] with averages of 15.5, 70.3 and 802.9 Bq kg[-1], respectively. All Raeq values were lower than the limit of 370 Bq kg[-1]. The mean value of D was higher than the world population-weighted average of 84 nGy h[-1], while the mean AED and ELCR values were below the internationally accepted values
Conclusions: The use of sand in construction of dwellings is considered to be safe for inhabitants
ABSTRACT
Adipose tissue is a central metabolic organ that controls energy homeostasis of the whole body. White adipose tissue (WAT) stores excess energy in the form of triglycerides, whereas brown adipose tissue (BAT) dissipates energy in the form of heat through mitochondrial uncoupling protein 1 (Ucp1). A newly identified adipose tissue called ‘beige fat’ (BAT-like) is produced through a process called WAT browning. This tissue mainly resides in WAT depots and displays intermediate characteristics of both WAT and BAT. Since the recent discovery of BAT in the human body, along with the identification of molecular targets for BAT activation, stimulating energy expenditure has been considered as a great strategy to treat human obesity and metabolic diseases. Here we summarize recent findings regarding molecular targets and thermogenic small molecules that can stimulate BAT and increase energy expenditure, with an emphasis on possible therapeutic applications in humans.
Subject(s)
Humans , Adipocytes , Adipose Tissue , Adipose Tissue, Brown , Adipose Tissue, White , Energy Metabolism , Homeostasis , Hot Temperature , Human Body , Metabolic Diseases , Obesity , TriglyceridesABSTRACT
Objective To record the drilling feed force on different layers of fresh porcine femur, so as to provide reference for collecting and outputting the feedback signals of drilling feed force for orthopedic virtual surgery system. Methods The biological bone drilling feed force testing system was established by modifying the universal material testing machine and adjustable speed electric drill (drill bit Φ5.0 mm). The feed forces on 6 fresh porcine femoral shafts with a total of 162 drilling markers were collected at 3 different rotate speeds (n＝500, 800, 1 200 r/min) and 3 feed speeds (v＝30, 50, 70 mm/min), and their variation with corresponding tissues and locations were also analyzed. Results At the same drill marker of the fresh porcine femur, the drilling feed force on bilateral cortical bone was the largest (fmax＝103.63~142.59 N), while that on marrow cavity was the smallest, which was almost close to zero, and the drilling feed force on the middle part (f4,5,6＝124.69 N) was larger than that at two ends (f1,2,3,7,8,9＝121.84 N); the drilling feed force was smallest (f＝106.04 N) at v＝30 mm/min, n＝1 200 r/min, while the largest drilling feed force (fmax＝139.84 N) appeared at v＝70 mm/min、n＝500 r/min. Conclusions The modified drilling feed force testing system could efficiently collect the biological bone drilling data. The drilling feed force had a close relationship with bone structure, feed speed and rotate speed of electric drill as well. A larger bone density, smaller rotate speed of electric drill and higher feeding speed would lead to a larger drilling feed force, and vice versa. The accurate drilling feed force data and its variation tendency on porcine femoral obtained in this experiment could provide a reliable basis for force-feedback signal output in the virtual orthopedic surgery system.
ABSTRACT
Hexavalent chromium is mobile and hazardous in the environment. Electrokinetic remediation of chromium [IV]-contaminated soils is intended either to remove or to reduce Cr [VI] to Cr [III]. This study examines the effectiveness of utilizing EDTA and acetic acid solutions as alternative electrolytes in the electrokinetic [EK] process, with coupled nano-scale zero-valent iron [nZVI] as a barrier for the remediation of Cr [VI]-contaminated clay. An nZVI barrier was installed adjacent to the anode, and different electrolyte solutions [0.1 M EDTA and 1 M acetic acid] were used to investigate the effect of both on the electrokinetic remediation efficiency. Soil was contaminated to 300 ppm of Cr [IV], and a constant DC voltage gradient of 1 V/cm was applied to the soil sample for 72 h. It was found that an nZVI permeable reactive barrier [PRB] could improve the Cr [VI] remediation efficiency and reduce electrical energy consumption. Results also showed that acetic acid as electrolyte promoted the reduction of Cr [VI] to Cr [III], while EDTA application as electrolyte led to more chromium removal and reduction than an EK-nZVI barrier
Subject(s)
Chromium , Electrolytes , Edetic Acid , Environmental PollutionABSTRACT
This study investigated the impact of internal nitrogen and phosphorus loading on water quality of Lake Chaohu, China. Results showed that the overall mean concentration of TN and TP in lake water was 1.09 +/- 0.84 and 0.15 +/- 0.84 [SD] mg/L, respectively, indicating Lake Chaohu was highly eutrophic during the study period. Mean benthic flux of NH[4+], NO[3-], and PO[43-] were 3.56 +/- 1.52 mg N/m[2]/d, -0.14 +/- 0.40 mg N/m[2]/ d, and -1.54 +/- 21.94 micro g P/m[2]/d in summer and were 3.16 +/- 1.83 mg N/m[2]/d, -0.03 +/- 0.30 mg N/m[2]/d, and - 0.11 +/- 2.58 micro g P/m[2]/d in fall, respectively. In this study, lake sediments acted as both a source of NH[4+] and a sink of PO[4][3-]. A scenario was used to understand the role of sediments on lake water quality. Results showed that Lake Chaohu would be eutrophic within a month under the impact of internal NH[4+] loading when water was diverted to the lake. This indicates that an integrated project combining both a diversion project and dredging of sediments would be necessary for future lake restoration
Subject(s)
Phosphorus/chemistry , Water Pollutants, Chemical , Geologic Sediments , Nitrogen/chemistryABSTRACT
Objective To evaluate the associations of oral contraceptives (OC) exposure,angiotensin-converting enzyme(ACE) gene polymorphism and their joint actions with the risk of stroke in Chinese women.Methods A case-control study,based on a set cohort,was carried out.Incident cases of stroke identified between July 1 1997 and June 30 2009 were enrolled.One hospital control and healthy community control were matched on region and age ( ± 3 years).A total of 453women with stroke and 919 controls were recruited.I/D genepolymorphism was detected by polymerase chain reaction (PCR) and amplification fragment length polymorphism (AFLP),A-240T polymorphism were detected by TagMan.Results ( 1 ) The risk of stroke gradually increased with the cumulative time of OC being used in women (P＜0.0001).Compared with non-users,the risk of stroke significantly increased among those with cumulative time of using OC longer than 20 years (adjusted OR was 2.07,with 95％ CI as 1.30-3.29).(2) ID/DD genotype of I/D locus indicated significantly an increased risk of hemorrhagic stroke (adjusted OR,2.37; 95％CI,1.46-3.84).(3)Women with ID/DD genotype of I/D locus or with TA/TT genotype of A-240T locus and using OC could significantly increase the risk of hemorrhagic stroke (adjusted OR was 4.59; with 95％ CI as 2.21-9.51 and OR was 2.50; with 95％CI as 1.42-4.38).(4) Data from multivariate analyses showed that both OC and ID/DD genotypes were important risk factors for hemorrhagic stroke.Conclusion ID/DD and TA/TT genotypes of ACE gene,OC and their joint action might increase the risk of stroke,especially on hemorrhagic stroke in Chinese women.
ABSTRACT
Human health is closely related with the quality of drinking water. Various chemical pollutants in the drinking water can cause great risk to human health. Shizuishan city is an important coal-based industrial city where residents mainly rely on groundwater. In order to protect the safety of water supply, based on the sample survey, health risk assessment model recommended by the Unites States Environmental Protection Agency was adopted to assess the health risks of groundwater in the region. During the study, total 25 groundwater samples were colleted from drinking water supply wells and many parameters such as Cr[6+], fluoride, arsenide, volatile phenol and cyanide were examined according to standard procedures recommended by Chinese Ministry of Water Resources. Evaluation results showed that the greatest risk value due to non-carcinogenic pollutants was caused by fluoride, while the greatest health risk due to chemical carcinogenic pollutants was primarily caused by Cr[6+], the second was arsenide. The health risk due to chemical carcinogens was 3 magnitudes larger than that caused by noncarcinogenic pollutants, which indicated that chemical carcinogens were the primary pollutants in the drinking groundwater. The total health risk level was within the acceptable level proposed by Unites States Environmental Protection Agency, but exceeded the acceptable level recommended by International Commission on Radiologic Protection which meant that the groundwater needs pretreatment before consumption
Subject(s)
Drinking Water , Water Resources , Water Quality , Risk Assessment , Health Status Indicators , GroundwaterABSTRACT
The purpose of this work is to develop robust and interpretable quantitative structure "activity relationship [QSAR] odels for assessing the aquatic toxicity of phenols using a combined set of descriptors encompassing the logP and recently developed variables [Monconn-Z variables]. The used dataset consists of 250 chemicals with toxicity data to the ciliate Tetrahymena pyriformis. For each compound, a total of 197 physico-chemical descriptors including logP and Molconn-Z descriptors were calculated. Multiple linear regression [LR] and Partial least squares [PLS] were used to obtain QSARs and the predictive performance of the proposed models were verified using external statistical validations. The results of stepwise-MLR analysis reveal that the AlogP, MlogP and ClogP models were not successful for the prediction of aquatic toxicity for all the compounds. And by using the logP [AlogP and MlogP] with Molconn-Z descriptors, the obtained QSARs were not successful enough until removal of some outliers. Two optimal QSARs were built with R[2] of 0.71 and 0.70 for the training sets and the external validation Q[2] of 0.69 and 0.68 respectively. All these selected descriptors in the best models account for the hydrophobic [AlogP, MlogP] and other electrotopological properties like SHCsatu, Scarboxylicacid, SHBa, gmax and nelem. PLS produces a good model using all the calculated descriptors with R[2] of 0.78 and Q[2] of 0.64, and hydrophobic and electrotopological descriptors show importance for the prediction of phenolic toxicity
Subject(s)
Tetrahymena pyriformis , Linear Models , ForecastingABSTRACT
To investigate the current prevalence of anemia among pregnant women in different areas of China and the association with birth weight and educational level. A total of 6,413 women aged 24-37 in the third trimester of pregnancy from five areas were randomly selected from all gravidas who gave birth in the hospitals from 1999 to 2003. blood hemoglobin concentration [Hb] was measured by the cyanomethemoglobin method; Hb<110 g/l was considered as anemia. The overall prevalence of anemia was 58.6%, ranging from 48.1 to 70.5% in the five areas. There was a significant difference in the prevalence of anemia between women who have mental jobs and those who have physical jobs [52.3 vs. 61.1%, p<0.01]. The prevalence of anemia depended on the level of education: with 52.9, 62.4 and 66.5%, for college, secondary school and primary education, respectively, and the difference was statistically significant [p=0.005]. results showed that higher birth weight was associated with Hb concentrations ranging from 90 to 140 g/l, whereas lower birth weight occurred below 80 g/l and above 140 g/l Hb. The prevalence of anemia in Chinese pregnant women was high both in rural areas and towns. Area of residence, education level and type of job influenced the prevalence of anemia. Low maternal Hb concentrations influenced birth weight
Subject(s)
Humans , Female , Prevalence , Pregnant Women , Pregnancy , Birth Weight , Education , Educational StatusABSTRACT
The indoor environmental quality parameters, including temperature, relative humidity, air velocity, particulate matter concentration, illumination level, sound level, carbon dioxide concentration and ventilation rate in two computer classrooms and one general classroom were evaluated. Analytical results reveal average carbon dioxide concentration in the three classrooms during daytime classes was 785"1681 ppm. These values exceeded the exposure limits for indoor air quality suggested by the Environmental Protection Administration of the Republic of China, Taiwan [ROCEPA]. The particulate matter concentration in the general classroom was 0.087 mg/m[3], which exceeded the indoor air quality exposure limit for Type-1 venues recommended by the ROCEPA. Illumination level in the two computer classrooms was 386 and 176 Lux; these values are far lower than the illumination level for school classrooms suggested by Ministry of Education, Taiwan. Indoor sound levels in the three classrooms during non-class [51.4"61.9 dB[A] and class times [61.0"73.6 dBA exceeded the limit recommended by the Ministry of Education, Japan. The ventilation rates for the three classrooms were 0.41"0.65 h[-1]; such low ventilation rates were likely responsible for the very high indoor carbon dioxide concentrations in the three classroom during class periods. These analytical results indicate schools should examine the efficacy of air-conditioning equipment in classrooms, particularly computer classrooms. Schools should also pay attention to ventilation rates and sound levels. Due to the poor ventilation rates in computer classrooms, this study suggests that problems arisen from the accumulation of specific toxicants dispersed by computer equipment, such as polybrominated diphenyl ethers, need further investigations