Locoregional radiotherapy improves survival outcomes in de novo metastatic nasopharyngeal carcinoma treated with chemoimmunotherapy.

BACKGROUND: We aimed to investigate the efficacy of locoregional radiotherapy (LRRT) in patients with de novo metastatic nasopharyngeal carcinoma (dmNPC) receiving chemotherapy combined with anti-programmed cell death receptor-1 monoclonal antibodies (anti-PD-1 mAbs) as first-line treatment and identify optimal candidates for LRRT. MATERIALS AND METHODS: We enrolled patients with dmNPC receiving platinum-based palliative chemotherapy and anti-PD-1 mAbs followed or not followed by LRRT from four centers. The endpoints were progression-free survival (PFS), objective response rate (ORR), and overall survival (OS). We used the inverse probability of treatment weighting (IPTW) to balance the baseline characteristics of the LRRT and non-LRRT groups to minimize selection bias before comparative analyses. Multivariate analyses were carried out using the Cox proportional hazards model. RESULTS: We included 163 patients with dmNPC (median follow-up: 22 months). The median PFS was 20 months, and the ORR was 92.0%; the median OS was not achieved. After IPTW adjustments, patients who received LRRT had a significant survival benefit over those not receiving LRRT (median PFS: 28 versus 15 months, P < 0.001). The Epstein-Barr virus DNA (EBV DNA) level after four to six cycles of anti-PD-1 mAbs [weighted hazard ratio (HR): 2.19, 95% confidence interval (CI) 1.22-3.92, P = 0.008] and LRRT (weighted HR: 0.58, 95% CI 0.34-0.99, P = 0.04) were independent prognostic factors. Patients with undetectable EBV DNA levels after four to six cycles of anti-PD-1 mAbs (early EBV DNA clearance) benefitted from LRRT (HR: 0.41, 95% CI 0.22-0.79, P = 0.008), whereas those with detectable levels did not (HR: 1.30, 95% CI 0.59-2.87, P = 0.51). CONCLUSIONS: Palliative chemotherapy combined with anti-PD-1 mAbs followed by LRRT was associated with improved PFS in patients with dmNPC, especially for patients with early EBV DNA clearance.

High sensitivity of spontaneous spike frequency to sodium leak current in a Lymnaea pacemaker neuron.

The spontaneous rhythmic firing of action potentials in pacemaker neurons depends on the biophysical properties of voltage-gated ion channels and background leak currents. The background leak current includes a large K+ and a small Na+ component. We previously reported that a Na+ -leak current via U-type channels is required to generate spontaneous action potential firing in the identified respiratory pacemaker neuron, RPeD1, in the freshwater pond snail Lymnaea stagnalis. We further investigated the functional significance of the background Na+ current in rhythmic spiking of RPeD1 neurons. Whole-cell patch-clamp recording and computational modeling approaches were carried out in isolated RPeD1 neurons. The whole-cell current of the major ion channel components in RPeD1 neurons were characterized, and a conductance-based computational model of the rhythmic pacemaker activity was simulated with the experimental measurements. We found that the spiking rate is more sensitive to changes in the Na+ leak current as compared to the K+ leak current, suggesting a robust function of Na+ leak current in regulating spontaneous neuronal firing activity. Our study provides new insight into our current understanding of the role of Na+ leak current in intrinsic properties of pacemaker neurons.

Neural phosphoproteomics of a chronic hypoxia model--Lymnaea stagnalis.

Chronic hypoxia is a common clinical event that induces adaptive responses and can result in behavioral deterioration. The reduction of metabolic rate during hypoxia may limit overall protein phosphorylation owing to the lack of high energy phosphate. However, the hypoxia-induced regulation of phosphoproteins is poorly understood. Here, we characterized the CNS phosphoproteome of Lymnaea stagnalis, a freshwater snail that has been used as a model to study chronic hypoxia-induced neural depression. After hypoxia treatment for 4 days, the motor behavior of the snail was suppressed. Electrophysiological measurements from Pedal A (PeA) interneurons showed that hypoxia increased the frequency of spontaneous postsynaptic excitatory potentials (sEPSPs), but reduced the firing frequency, the amplitude, and the half-width duration (APD(50)) of spontaneous action potentials. Imaging with a fluorescent phosphate label, Pro-Q Diamond, revealed that the neuronal phosphoprotein level was reduced after the hypoxia treatment. The hypoxia-induced changes in the phosphoproteome of the central ganglia were quantified using one-dimensional gel-electrophoresis by comparing the fluorescence intensity ratio of phospholabeled phosphoproteins versus total proteins between the hypoxia and control groups. We analyzed 16 protein bands: eight showed decreased phosphorylation levels after hypoxia treatment, and eight did not change. Using mass spectrometry analysis and protein database matching we found three phosphoproteins that may be associated with chronic hypoxia-induced neuronal adaptive response of the snail. This is the first proteomic screening for neural phosphoproteins in chronic hypoxia.

Hepatic cavernous hemangioma. CT findings and pathological basis.

CT findings in 113 cases of hepatic hemangioma confirmed pathologically including 52 resected specimens and 8 autopsies were studied in correlation with the typical CT scan of 506 cases of the same disease. Mottling enhancement in the surrounding hepatic parenchyma of hemangioma which never appeared in other kinds of tumor was considered as a pathognomonic sign for diagnosis. It was correlated with the presence of dilated vascular spaces or sinusoids communicating with the tumor itself in the surrounding tissue. The thick wall and thin wall types of hemangioma were discussed.