Distribution of Microbiota in Fine Particulate Matter Particles in Guangzhou, China.

OBJECTIVE: High PM 2.5 concentration is the main feature of increasing haze in developing states, but information on its microbial composition remains very limited. This study aimed to determine the composition of microbiota in PM 2.5 in Guangzhou, a city located in the tropics in China. METHODS: In Guangzhou, from March 5 th to 10 th, 2016, PM 2.5 was collected in middle volume air samplers for 23 h daily. The 16S rDNA V4 region of the PM 2.5 sample extracted DNA was investigated using high-throughput sequence. RESULTS: Among the Guangzhou samples, Proteobacteria, Bacteroidetes, Firmicutes, Cyanobacteria, and Actinobacteria were the dominant microbiota accounting for more than 90% of the total microbiota, and Stenotrophomonas was the dominant gram-negative bacteria, accounting for 21.30%-23.57%. We examined the difference in bacterial distribution of PM 2.5 between Beijing and Guangzhou at the genus level; Stenotrophomonas was found in both studies, but Escherichia was only detected in Guangzhou. CONCLUSION: In conclusion, the diversity and specificity of microbial components in Guangzhou PM 2.5 were studied, which may provide a basis for future pathogenicity research in the tropics.

Celiac Plexus Block After Stereotactic Body Radiotherapy Improves Pain Relief in Locally Advanced Pancreatic Cancer.

PURPOSE: This study evaluated the analgesic effect of stereotactic body radiotherapy (SBRT) in combination with celiac plexus block (CPB), relative to SBRT alone, in locally advanced pancreatic cancer (LAPC) patients. PATIENTS AND METHODS: We reviewed medical records of all patients with LAPC, who received SBRT between 1 January 2017 to 31 August 2019 at our center. The average numeric rating scale (NRS) of ≥3 was used in all patients at admission. We recorded average and worst NRS in a 24-hour period, and daily narcotic doses before SBRT, followed by weekly for 1 month and monthly for 3 months. RESULTS: A total of 23 patients in the SBRT group and 12 under SBRT+CPB who met the inclusion criteria were enrolled. All patients in the SBRT+CPB group received CPB within 10 days after SBRT. Pain intensity and narcotic consumption were comparable in both groups at initial assessment. However, a significant decrease (P < 0.05) in average NRS was recorded in the SBRT+CPB group relative to SBRT at 2, 3 and 4 weeks after SBRT. A comparison of daily narcotic consumption with baseline values showed a significant decrease in the SBRT+CPB group at 3 and 4 weeks after SBRT (P < 0.05), while no significant differences were observed in the SBRT group. CONCLUSION: CPB after SBRT appears to be an effective therapeutic option in patients with LAPC and warrants further evaluation with increased number of patients in prospective clinical trials.

Contribution of Opiate Analgesics to the Development of Infections in Advanced Cancer Patients.

OBJECTIVES: Literature is limited on the relationship between opiate analgesics and the development of infections in cancer patients. This study aimed to determine whether opiate analgesics contribute to the advancement of infections and how infection rates differ among the various opiates used for cancer management. MATERIALS AND METHODS: From January 2013 to October 2014, we analyzed retrospectively 642 consecutive advanced cancer patients who received single types of opiates, including morphine, oxycodone, or fentanyl, or a combination of these drugs, continuously for >14 days. Binominal logistic regression analysis was used to analyze the factors that may promote the development of infections. RESULTS: A total of 303 patients were included in the final analysis. Of these patients, 85, 41, and 68 patients received only morphine, oxycodone, and fentanyl, respectively. Altogether, 87 (28.7%) patients developed infections; 20 (23.5%), 10 (24.4%), and 14 (20.6%) patients developed infections in the groups that received only morphine, oxycodone, and fentanyl, respectively (P>0.05). Logistic regression analysis found that the daily oral morphine equivalent (OME) is the an independent factor that influences the development of infection in the single-opiate group (odds ratio=1.002, P<0.01). The risk for developing infection increased by 2% per 10 mg increase in the daily OME. CONCLUSIONS: Our clinical results did not display any difference among the single-opiate groups in the development of infections. However, the increase in daily OME may serve as a risk factor for the development of infections in advanced cancer patients using one opiate type for pain management.

Nonpain Symptom Prevalence and Intensity of Inpatients With Moderate to Severe Cancer Pain in China.

OBJECTIVES: To identify prevalence and severity of nonpain symptoms and to clarify possible influences on each nonpain symptom. METHODS: The study used a descriptive survey design. Chinese version of the Edmonton Symptom Assessment System was used. Patients' demographic and pain characteristics were collected. RESULTS: The most common symptoms reported were loss of appetite (94.3%) followed by insomnia (93.3%), and tiredness (91.6%). Prevalence rates of nonpain symptom were all above 70% except "thinking clearly." Prevalence and severity of nonpain symptoms varied by gender, age, primary cancer, and pain characteristics, especially intensity, number of breakthrough pain episodes per day, and number of pain sites. CONCLUSIONS: Most inpatients with cancer pain experienced concurrent nonpain symptoms. Comprehensive symptom assessment and intervention managing multiple symptoms are essential for these inpatients.

[Concurrent chemoradiotherapy for stage III non-small cell lung cancer].

OBJECTIVE: To evaluate the immediate efficacy and acute toxicity of cisplatin-based induction chemotherapy followed by weekly concomitant chemoradiotherapy and concomitant chemoradiotherapy followed by consolidation chemotherapy in unresectable stage III NSCLC. METHODS: A total of 118 patients were pathologically diagnosed as stage III N SCLC. Among them, 77 patients (A group) received two cycles of cisplatin-based induction chemotherapy, followed by 6 weekly cycles of paclitaxel 45 mg/m(2) (n = 45) and gemcitabine 350 mg/m(2) (n = 32) in combination with thoracic radiotherapy; 41 patients (B group) received concomitant chemoradiotherapy (cisplatin 50 mg/m(2), d1, 8, 29, 36/etoposide 50 mg/m(2), d1-5, 29-33, n = 18, paclitaxel 45 mg/m(2)/weekly × 6/carboplatin AUC = 2/weekly × 6, n = 23) followed by consolidation chemotherapy. All thoracic radiotherapy dose are 2 Gy per fraction and day to a total dose of 58-60 Gy. RESULTS: The total response rate of A and B groups was 80.5% and 75.6% respectively (P = 0.534). According to subgroup analyses, no statistically significant differences existed according to chemotherapy (P = 0.557). The main side-effects were neutropenia, radiation esophagitis, radiation pneumonitis and nausea/vomiting. The gemcitabine group was statistically significant different in neutropenia. CONCLUSION: Different chemotherapeutic agents in combination with thoracic radiotherapy are clinically feasible with a moderate toxicity. Their profiles of efficacy and toxicity are comparable to each other.