Synergistic Effect of P and Co Dual Doping Endows CuNi with High-Performance Hydrogen Evolution Reaction.

The rational design of highly active and durable non-noble electrocatalysts for hydrogen evolution reaction (HER) is significantly important but technically challenging. Herein, a phosphor and cobalt dual doped copper-nickel alloy (P, Co-CuNi) electrocatalyst with high-efficient HER performance is prepared by one-step electrodeposition method and reported for the first time. As a result, P, Co-CuNi only requires an ultralow overpotential of 56 mV to drive the current density of 10 mA cm-2, with remarkable stability for over 360 h, surpassing most previously reported transition metal-based materials. It is discovered that the P doping can simultaneously increase the electrical conductivity and enhance the corrosion resistance, while the introduction of Co can precisely modulate the sub-nanosheets morphology to expose more accessible active sites. Moreover, XPS, UPS, and DFT calculations reveal that the synergistic effect of different dopants can achieve the most optimal electronic structure around Cu and Ni, causing a down-shifted d-band center, which reduces the hydrogen desorption free energy of the rate-determining step (H2O + e- + H* → H2 + OH-) and consequently enhances the intrinsic activity. This work provides a new cognition toward the development of excellent activity and stability HER electrocatalysts and spurs future study for other NiCu-based alloy materials.

Effects of early nutritional intervention on oral mucositis and basic conditions in patients receiving radiotherapy for head and neck cancer: Randomized controlled trial (ChiCTR2000031418).

BACKGROUND & AIMS: This study aims to observe the effects of early nutritional intervention on radiation-induced oral mucositis (OM) and the nutritional status of patients with head and neck cancer (HNC) receiving radiotherapy. METHODS: Eligible patients receiving radiotherapy for HNC were randomly divided into an early nutritional intervention group (enteral nutritional intervention was administered at the beginning of radiotherapy) and a late nutritional intervention group (enteral nutritional intervention was administered at the beginning of eating restriction) in a 1:1 ratio. The primary endpoint was radiation-induced OM. Secondary endpoints included nutrition-related indicators, immune function, overall survival (OS), progression-free survival (PFS), quality of life, and other radiotherapy-induced adverse effects. RESULTS: A total of 100 patients were enrolled between 2020 and 2021, including 50 each in the early nutritional intervention group and in the late group. The incidence of Grade-III/IV OM was lower in the early treatment group than in the late treatment group (2% vs 14%, P = 0.059). By week 7 weight loss was significantly lower in the early group than in the late group (1.08 kg, 95% CI: 0.08-2.09, P = 0.035). Regarding the PG-SGA scores after receiving radiotherapy, the early group comprised more well-nourished and fewer malnourished patients than those in the late group (P = 0.002). The scores of the immune function indices of T cell CD3+, CD4+/CD8+, and B cell CD19+ were slightly higher in the early group than in the late group; however, the difference was not statistically significant (all P > 0.05). PFS and OS were better in the early group than in the late group; however, the differences were not statistically significant (P > 0.05). CONCLUSIONS: Early nutritional intervention can effectively improve the nutritional status and reduce the incidence of high-grade OM in patients with HNC receiving radiotherapy. TRIAL REGISTRATION: Chinese Clinical Trials Registry (http://www.chictr.org.cn). CHICTR-ID: ChiCTR2000031418.

Weight-adaptive joint mixed-precision quantization and pruning for neural network-based equalization in short-reach direct detection links.

Neural network (NN)-based equalizers have been widely applied for dealing with nonlinear impairments in intensity-modulated direct detection (IM/DD) systems due to their excellent performance. However, the computational complexity (CC) is a major concern that limits the real-time application of NN-based receivers. In this Letter, we propose, to our knowledge, a novel weight-adaptive joint mixed-precision quantization and pruning approach to reduce the CC of NN-based equalizers, where only integer arithmetic is taken into account instead of floating-point operations. The NN connections are either directly cutoff or represented by a proper number of quantization bits by weight partitioning, leading to a hybrid compressed sparse network that computes much faster and consumes less hardware resources. The proposed approach is verified in a 50-Gb/s 25-km pulse amplitude modulation (PAM)-4 IM/DD link using a directly modulated laser (DML) in the C-band. Compared with the traditional fully connected NN-based equalizer operated with standard floating-point arithmetic, about 80% memory can be saved at a minimum network size without degrading the system performance. Quantization is also shown to be more suitable to over-parameterized NN-based equalizers compared with NNs selected at a minimum size.

Multiplication-free and hardware-efficient baud-rate timing error detector for Nyquist and faster than Nyquist optical IM/DD systems.

Clock recovery (CR) algorithms that support higher baud rates and advanced modulation formats are crucial for short-distance optical interconnections, and it is desirable to push CR to operate at baud rate with minimal computing resources and power. In this Letter, we proposed a hardware-efficient and multiplication operation-free baud-rate timing error detector (TED) as a solution to meet these demands. Our approach involves employing both the absolute value of samples and the nonlinear sign operation to emphasize the clock tone, which is deteriorated by severe bandwidth limitation in Nyquist and faster than Nyquist (FTN) systems. Through experimental investigations based on a transceiver system with a 3 dB bandwidth of 30 GHz, the proposed baud-rate TED exhibits excellent performance. The proposed scheme successfully achieves clock synchronization of the received signals with the transmitted signals, including 50 GBaud PAM4/8, 80 GBaud PAM4, and up to 120 GBaud PAM4 FTN signals. To the best of our knowledge, the CR based on the proposed baud-rate TED is the most optimal solution for ultrahigh-speed short-reach IM/DD transmission, comprehensively considering the timing jitter, bit error rate (BER), and implementation complexity.

Gradient-descent noise whitening techniques for short-reach IM-DD optical interconnects with severe bandwidth limitation.

Bandwidth limitation in optoelectrical components and the chromatic dispersion-induced power fading phenomenon cause severe inter-symbol interference (ISI) in high-speed intensity modulation and direct detection (IM-DD) optical interconnects. While the equalizer implemented in the receiver's digital signal processing procedure can mitigate ISI, it also inevitably enhances the noise located in the decayed frequency region, known as equalization-enhanced colored noise (EECN). Additionally, the nonlinear impairments of the modulator and photodetector also deteriorate the performance of the IM-DD system, especially for high-order modulation formats. In this work, we propose a gradient-descent noise whitening (GD-NW) algorithm to address EECN and extend it by introducing nonlinear kernels to simultaneously mitigate EECN and nonlinear impairments. The proposed algorithms are compared with conventional counterparts in terms of the achievable baud rate and the receiver optical power sensitivity. As a proof-of-concept experiment, we validate the principles of the proposed algorithms by successfully transmitting 360-GBd on-off-keying (OOK) and 180-GBd 4-level pulse-amplitude-modulation (PAM-4) signals in the back-to-back case under a 62-GHz brick-wall bandwidth limitation. 280-GBd OOK and 150-GBd PAM-4 transmissions are also demonstrated over 1-km standard single-mode fiber with a bit error rate below 7% hard-decision forward error correction aided by the proposed approach.

An open, multicenter, exploratory study of apatinib mesylate maintenance therapy for recurrent/metastatic head and neck squamous cell carcinoma (ChiCTR1800019375).

BACKGROUND: This study evaluated the efficacy of apatinib in maintenance therapy in patients with recurrent/metastatic head and neck squamous cell carcinoma (R/M HNSCC). METHODS: Twenty-six patients from three centers were enrolled from November 2018 to September 2021. These patients received 2 weeks apatinib, administered at 250 mg qd. Then apatinib dose may be administered to 500 mg qd continuous in 4 weeks cycle if no patients experienced adverse reaction. Enrolled patients can receive a combination of radiotherapy or chemotherapy. The primary endpoints were progression-free survival (PFS), and secondary endpoints included overall survival (OS), disease control rate (DCR), objective response rate (ORR), quality of life (QOL) score, and adverse drug reactions. RESULTS: Median PFS of all patients was 3.2 months (95% CI: 2.06-4.33). Median OS of all patients was 7.3 months (95% CI: 2.14-12.46). The DCR was 92.3%. The ORR was 30.8%. In univariate analysis, the results showed that ECOG score 0-1 (HR = 0.31, p = 0.006) and treated with apatinib for more than 60 days (HR = 0.31, p = 0.003) were independent prognostic indicators affecting PFS, and ECOG score 0-1 (HR = 0.40, p = 0.027) and moderately differentiated or highly differentiated (HR = 0.38, p = 0.048) were independent prognostic indicators of OS. The most common adverse events among treated subjects included hypertension (46.1%), fatigue (42.3%), and hand-foot syndrome (23.1%). There were only two cases (7.7%) of Grade III or above adverse reactions. CONCLUSIONS: Maintenance therapy with apatinib is an effective and well-tolerated regimen in patients with R/M HNSCC.

Fast polarization state tracking for dual-polarization direct detection with Jones-space field recovery.

Direct detection system is expected to possess the phase and polarization diversity in order to achieve high spectral efficiency and fiber impairment compensation such as chromatic dispersion and polarization rotation. In this Letter, we theoretically extend the concept of the proposed Jones-space field recovery (JSFR) to include a dynamic polarization rotation matrix and experimentally demonstrate the rapid polarization state tracking ability of the JSFR receiver based on a 3 × 3 optical coupler. Under a rotation of the state of polarization at a rate of 1 Mrad/s, we successfully transmit 59-GBd dual-polarization 16-ary quadrature-amplitude-modulation signals over an 80-km standard single-mode fiber based on a decision-directed least mean square (DD-LMS) or a recursive least square (DD-RLS), with a bit-error rate below the 14% hard-decision forward error correction threshold of 1 × 10-2. The experimental results indicate that the legacy polarization tracking algorithms designed for coherent optical communication are also applicable for this direct detection scheme. To our best knowledge, this work demonstrates the first polarization rotation-tolerant direct detection system with phase and polarization diversity, providing a low-cost and high-speed solution for short-reach communications.

Overcoming acquired resistance to cancer immune checkpoint therapy: potential strategies based on molecular mechanisms.

Immune checkpoint inhibitors (ICIs) targeting CTLA-4 and PD-1/PD-L1 to boost tumor-specific T lymphocyte immunity have opened up new avenues for the treatment of various histological types of malignancies, with the possibility of durable responses and improved survival. However, the development of acquired resistance to ICI therapy over time after an initial response remains a major obstacle in cancer therapeutics. The potential mechanisms of acquired resistance to ICI therapy are still ambiguous. In this review, we focused on the current understanding of the mechanisms of acquired resistance to ICIs, including the lack of neoantigens and effective antigen presentation, mutations of IFN-γ/JAK signaling, and activation of alternate inhibitory immune checkpoints, immunosuppressive tumor microenvironment, epigenetic modification, and dysbiosis of the gut microbiome. Further, based on these mechanisms, potential therapeutic strategies to reverse the resistance to ICIs, which could provide clinical benefits to cancer patients, are also briefly discussed.

Mesenchymal stem cells in radiation-induced lung injury: From mechanisms to therapeutic potential.

Radiotherapy (RT) is an effective treatment option for multiple thoracic malignant tumors, including lung cancers, thymic cancers, and tracheal cancers. Radiation-induced lung injury (RILI) is a serious complication of radiotherapy. Radiation causes damage to the pulmonary cells and tissues. Multiple factors contribute to the progression of Radiation-induced lung injury, including genetic alterations, oxidative stress, and inflammatory responses. Especially, radiation sources contribute to oxidative stress occurrence by direct excitation and ionization of water molecules, which leads to the decomposition of water molecules and the generation of reactive oxygen species (ROS), reactive nitrogen species (RNS). Subsequently, reactive oxygen species and reactive nitrogen species overproduction can induce oxidative DNA damage. Immune cells and multiple signaling molecules play a major role in the entire process. Mesenchymal stem cells (MSCs) are pluripotent stem cells with multiple differentiation potentials, which are under investigation to treat radiation-induced lung injury. Mesenchymal stem cells can protect normal pulmonary cells from injury by targeting multiple signaling molecules to regulate immune cells and to control balance between antioxidants and prooxidants, thereby inhibiting inflammation and fibrosis. Genetically modified mesenchymal stem cells can improve the natural function of mesenchymal stem cells, including cellular survival, tissue regeneration, and homing. These reprogrammed mesenchymal stem cells can produce the desired products, including cytokines, receptors, and enzymes, which can contribute to further advances in the therapeutic application of mesenchymal stem cells. Here, we review the molecular mechanisms of radiation-induced lung injury and discuss the potential of Mesenchymal stem cells for the prevention and treatment of radiation-induced lung injury. Clarification of these key issues will make mesenchymal stem cells a more fantastic novel therapeutic strategy for radiation-induced lung injury in clinics, and the readers can have a comprehensive understanding in this fields.

Sulforaphane regulates Nrf2-mediated antioxidant activity and downregulates TGF-ß1/Smad pathways to prevent radiation-induced muscle fibrosis.

AIMS: This study aimed to examine the efficacy of sulforaphane (SFN) in preventing radiation-induced muscle fibrosis (RIMF) and the potential role in nuclear factor erythroid 2-related factor 2 (Nrf2)-mediated antioxidant stress. MAIN METHODS: The RIMF model was established by a single irradiation of the left thigh of C57BL/6 J mice, and the mice were then randomly divided into control, SFN, irradiation (IR), and IR + SFN (IR/SFN) groups. The serum and skeletal muscle were collected eight weeks after irradiation, and changes in oxidative stress and muscle fibrosis were detected. KEY FINDINGS: The IR group showed a more obvious skeletal muscle fiber atrophy, significantly higher number of collagen fibers, and higher inflammatory cell infiltration compared to control group. Compared to the IR group, the IR/SFN group had orderly arranged muscle fibers, decreased collagen fibers, and infiltration of inflammatory cells. In addition, compared with the control group, the expression of oxidative stress-related indexes was significantly increased, accompanied by activation of the transforming growth factor (TGF-ß)/Smad pathway and its downstream fibrogenic molecules in the skeletal muscle of the IR group. After SFN intervention, the above indices were significantly restored. Furthermore, SFN induced the upregulation of Nrf2, activation of AKT, and inhibition of GSK-3ß and Fyn accumulation. SIGNIFICANCE: These results revealed that Nrf2 plays a central role in protecting against RIMF. Furthermore, SFN prevents RIMF by activating Nrf2 via the AKT/GSK-3ß/Fyn pathway.

CNTs support 2D NiMOF nanosheets for asymmetric supercapacitors with high energy density.

In addition to complex preparation and low-yield syntheses, attaining high energy density while maintaining high power density remains a significant challenge for supercapacitor applications in the field of energy storage. Herein, two-dimensional (2D) nickel-based metal-organic framework (NiMOF) nanosheets are grown around carbon nanotubes (CNTs) to form NiMOF/CNTs composite, which is synthesized via a one-step solvothermal method at various temperatures. Thereinto, the NiMOF/CNTs composite synthesized at 180 °C (NiMOF/CNTs 180) exhibits enhanced electrical conductivity for ion and electron transport due to the addition of the CNTs, as well as the highest specific capacitance due to the unique 3D vine-like structure, which provides abundant active sites for electrochemical reactions. Specifically, the NiMOF/CNTs 180 composite demonstrates outstanding electrochemical performance with high specific capacitance (1855.0 F g-1 at 1 A g-1) and an excellent capacitance retention of 87.7% at 10 A g-1, indicating a favorable rate performance. The NiMOF/CNTs 180//AC asymmetric supercapacitors (ASCs) device assembled with NiMOF/CNTs 180 and activated carbon (AC) has a high specific capacitance of 320.0 F g-1 at 1 A g-1 and a maximum energy density of 113.8 W h kg-1 at 800.0 W kg-1. Therefore, the present work provides a handy and efficient synthesis strategy for supercapacitor devices with high energy density.

ARTS, an unusual septin, regulates tumorigenesis by promoting apoptosis.

Apoptosis plays particularly important roles in tumorigenesis through various mechanisms. Apoptosis can be initiated by both extrinsic and intrinsic signals centered in and coming from the mitochondria. Antiapoptotic proteins promote tumor progression, and the occurrence and progression of tumors are closely related to antiapoptotic protein expression. As the only member of the septin gene family with proapoptotic function, apoptosis-related proteins in the TGF-ß signaling pathway (ARTS) has received extensive attention for its unique structure. In contrast, unlike other known inhibitors of apoptosis protein (IAP) antagonists, ARTS exhibits a stronger tumor suppressor potential. Recent research has shown that ARTS can bind and inhibit XIAP and Bcl-2 directly or assist p53 in the degradation of Bcl-XL. Here, we review recent advances in the molecular mechanisms by which the proapoptotic protein ARTS, with its unique structure, inhibits tumorigenesis. We also discuss the possibility of mimicking ARTS to develop small-molecule drugs.

Effective handling of nonlinear distortions in CO-OFDM using affinity propagation clustering.

We experimentally demonstrate a system-agnostic and training-data-free nonlinearity compensator, using affinity propagation (AP) clustering in single- and multi-channel coherent optical OFDM (CO-OFDM) for up to 3200 km transmission. We show that AP outperforms benchmark deterministic and clustering algorithms by effectively tackling stochastic nonlinear distortions and inter-channel nonlinearities. AP offers up to almost 4 dB power margin extension over linear equalization in single-channel 16-quadrature amplitude-modulated CO-OFDM and a 1.4 dB increase in Q-factor over digital back-propagation in multi-channel quaternary phase-shift keying CO-OFDM. Simulated results indicate transparency to higher modulation format orders and better efficiency when a multi-carrier structure is considered.

Two-step facile synthesis of Co3O4@C reinforced PbO2 coated electrode to promote efficient oxygen evolution reaction for zinc electrowinning.

The conventional Pb-Ag alloy possesses a high oxygen evolution reaction overpotential, poor stability, and short service life in acidic solutions, making it an unsuitable sort of anode material for the zinc electrowinning process. Therefore, a layered carbon-covered cobalt tetroxide (Co3O4@C)-reinforced PbO2-coated electrode is fabricated via a facile two-step pyrolysis-oxidation and subsequent electrodeposition process. As a result, the reinforced PbO2-coated electrode exhibits a low OER overpotential of 517 mV at 500 A m-2 and a Tafel slope of 0.152 V per decade in a zinc electrowinning simulation solution (0.3 M ZnSO4 and 1.53 M H2SO4). The reduced overpotential of 431 mV at 500 A m-2 compared to traditional Pb-0.76%Ag alloy leads to improved energy savings, which is attributable to the presence of Co3O4@C to refine the grain size and thus increase the effective contact area. Moreover, the reinforced PbO2-coated electrode has a prolonged service life of 93 h at 20 000 A m-2 in 1.53 M H2SO4. Therefore, an accessible and efficient strategy for preparing a coated electrode to improve OER performance for zinc electrowinning is presented in this research.

Facile synthesis MnCo2O4.5@C nanospheres modifying PbO2 energy-saving electrode for zinc electrowinning.

The oxygen evolution reaction kinetics in industrial zinc electrowinning is sluggish, resulting in low electrocatalytic activity and substantial energy expenditure (about one-third of energy was wasted due to the strong polarization effect). Herein, the paper described a core-shell structured MnCo2O4.5@C modified PbO2 electrode through the pyrolysis and co-electrodeposition as a promising candidate for zinc electrowinning. As a result, the obtained Pb-0.2%Ag/α-PbO2/ß-PbO2-MnCo2O4.5@C composite electrode showed a sandwich-like structure, where Pb-0.2%Ag as a core, α-PbO2 as a mid-layer, and ß-PbO2-MnCo2O4.5@C served as an electrocatalytic layer. It also possessed improved OER catalytic activity, only required 680 mV to achieve a current density of 50 mA cm-2 and a Tafel slope of 216.04 mV dec-1 in an acidic solution containing 50 g L-1 Zn2+ and 150 g L-1 H2SO4. The current efficiency increased by 0.7% and the cell voltage reduced by 360 mV as compared to a conventional Pb-0.76%Ag alloy electrode, leading to a remarkable energy-consumption reduction of 283.5 kW h for producing per ton metallic zinc. Furthermore, Pb-0.2%Ag/α-PbO2/ß-PbO2-MnCo2O4.5@C exhibited a prolonged service life, which worked about 44 h under an ultra-high current density of 2 A cm-2. Hence, this paper provides the strategy to design and construct non-precious, high-performance catalyst for electrolysis and other applications.

Research progress on mechanism and imaging of temporal lobe injury induced by radiotherapy for head and neck cancer.

Radiotherapy (RT) is an effective treatment for head and neck cancer (HNC). Radiation-induced temporal lobe injury (TLI) is a serious complication of RT. Late symptoms of radiation-induced TLI are irreversible and manifest as memory loss, cognitive impairment, and even temporal lobe necrosis (TLN). It is currently believed that the mechanism of radiation-induced TLI involves microvascular injury, neuron and neural stem cell injury, glial cell damage, inflammation, and the production of free radicals. Significant RT-related structural changes and dose-dependent changes in gray matter (GM) and white matter (WM) volume and morphology were observed through computed tomography (CT) and magnetic resonance imaging (MRI) which were common imaging assessment tools. Diffusion tensor imaging (DTI), dispersion kurtosis imaging (DKI), susceptibility-weighted imaging (SWI), resting-state functional magnetic resonance (rs-fMRI), magnetic resonance spectroscopy (MRS), and positron emission tomography (PET) can be used for early diagnosis and prognosis evaluation according to functional, molecular, and cellular processes of TLI. Early diagnosis of TLI is helpful to reduce the incidence of TLN and its related complications. This review summarizes the clinical features, mechanisms, and imaging of radiation-induced TLI in HNC patients. KEY POINTS: • Radiation-induced temporal lobe injury (TLI) is a clinical complication and its symptoms mainly include memory impairment, headache, and cognitive impairment. • The mechanisms of TLI include microvascular injury, cell injury, and inflammatory and free radical injury. Significant RT-related structural changes and dose-dependent changes in TL volume and morphology were observed through CT and MRI. • SWI, MRS, DTI, and DKI and other imaging examinations can detect anatomical and functional, molecular, and cellular changes of TLI.

Sulforaphane-Mediated Nrf2 Activation Prevents Radiation-Induced Skin Injury through Inhibiting the Oxidative-Stress-Activated DNA Damage and NLRP3 Inflammasome.

This article mainly observed the protective effect of sulforaphane (SFN) on radiation-induced skin injury (RISI). In addition, we will discuss the mechanism of SFN's protection on RISI. The RISI model was established by the irradiation of the left thigh under intravenous anesthesia. Thirty-two C57/BL6 mice were randomly divided into control group (CON), SFN group, irradiation (IR) group, and IR plus SFN (IR/SFN) group. At eight weeks after irradiation, the morphological changes of mouse skin tissues were detected by H&E staining. Then, the oxidative stress and inflammatory response indexes in mouse skin tissues, as well as the expression of Nrf2 and its downstream antioxidant genes, were evaluated by ELISA, real-time PCR, and Western blotting. The H&E staining showed the hyperplasia of fibrous tissue in the mouse dermis and hypodermis of the IR group. Western blotting and ELISA results showed that the inflammasome of NLRP3, caspase-1, and IL-1ß, as well as oxidative stress damage indicators ROS, 4-HNE, and 3-NT, in the skin tissues of mice in the IR group were significantly higher than those in the control group (p < 0.05). However, the above pathological changes declined sharply after SFN treatment (p < 0.05). In addition, the expressions of Nrf2 and its regulated antioxidant enzymes, including CAT and HO-1, were higher in the skin tissues of SFN and IR/SFN groups, but lower in the control and IR groups (p < 0.05). SFN may be able to suppress the oxidative stress by upregulating the expression and function of Nrf2, and subsequently inhibiting the activation of NLRP3 inflammasome and DNA damage, so as to prevent and alleviate the RISI.

Reference values of urine protein/creatinine ratio in healthy Dalian adults.

BACKGROUND: The urine protein/creatinine ratio (UPCR) is commonly used in current clinical practice. However, there are only few published clinical data on UPCR from large cohorts of Chinese adults. This study aimed to determine the overall and age- and sex-specific UPCR reference values for healthy Dalian adults. METHODS: According to the Clinical & Laboratory Standards Institute EP28-A3c guidelines, 1321 healthy Dalian adults (646 men and 675 women) aged 20-69 years were enrolled. Urine protein and creatinine levels were analyzed in the random morning spot urine samples, and UPCR was calculated. The 95th percentile of the UPCR was used as the normal upper limit. The Mann-Whitney U test was used to test differences among groups. RESULTS: The UPCR reference value was 141.7 mg/g for the entire cohort, 128.7 mg/g for men, and 150.8 mg/g for women. In addition, women had relatively higher UPCR values than men in the same age group. We also compared the UPCR reference values between different estimated glomerular filtration rate (eGFR) groups and found that women had significantly higher UPCR values than men in the normal eGFR groups. CONCLUSIONS: This study provides the overall and age- and sex-specific UPCR reference values for healthy Dalian adults.

Efficacy and safety of systemic treatments for patients with recurrent/metastatic head and neck squamous cell carcinoma: A systematic review and network meta-analysis.

A variety of systemic chemotherapy regimens have been used for recurrent/metastatic head and neck squamous cell carcinoma (R/M HNSCC). However, most guidelines have been derived from a single clinical trial, and no studies have comprehensively compared their efficacy and safety. We systematically searched PubMed, Embase, Web of Science, and Cochrane Library databases. Eligible studies reported overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and ≥ 3 adverse events rate (AEs). Eighteen eligible trials involving 4930 patients and 15 treatment regimens were included. The results suggest that patients with R/M HNSCC exhibit better tumor response with the cetuximab/platinum/5-FU, pembrolizumab/platinum/5-FU or pembrolizumab alone, accompanied by a low AE rate. Nivolumab also showed better efficacy than other single agents. Immunotherapy has achieved better efficacy.

A Bioadhesive Barrier-Forming Oral Liquid Gel Improved Oral Mucositis and Nutritional Status in Patients With Head and Neck Cancers Undergoing Radiotherapy: A Retrospective Single Center Study.

BACKGROUND: Episil® is a bioadhesive barrier-forming oral liquid gel that can relieve oral mucositis (OM) caused by radiotherapy (RT) and hence relieves pain effectively. In this study, we observed the effects of Episil® on the OM and nutritional status of patients with head and neck cancers (HNCs) undergoing RT. METHODS: A total of 50 HNC patients were divided into the Episil® (25 patients) and control (25 patients) groups. Patients in the Episil® group were sprayed with Episil®. In the control group, the kangfuxin solution or Kangsu™ oral gargle was used. Medical staff assessed the OM extent and timing as well as the nutritional status during treatment and recorded adverse reactions other than OM. The nutritional status assessment included the following indicators: Patient Generated-Subjective Global Assessment (PG-SGA) score, body mass index (BMI), body weight, albumin levels, and other hematological indicators. RESULTS: The incidence of high-level OM (III-IV) after RT was lower in the Episil® group than in the control group (P < 0.05). Nutritional status assessments showed that the Episil® group had a lower percentage of weight loss than the control group at weeks 4 and 7 after RT. Similar results were also obtained for BMI and albumin levels (P < 0.05). Moreover, according to PG-SGA scores, fewer patients in the Episil® group were malnourished and more patients were well-nourished (P < 0.05) compared with the control group. CONCLUSION: Episil® effectively improved OM and malnutrition in HNC patients who received RT and has a good clinical application value.