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Background Gastrointestinal symptoms in gastric cancer patients treated with postoperative chemotherapy are diverse and interconnected, without effective intervention targets. In recent years, network analysis has emerged as a prominent approach to identify intervention targets. Objective To construct a network of gastrointestinal symptoms in gastric cancer patients treated with postoperative chemotherapy, identify core symptoms and analyze the factors influencing core symptoms, so as to provide a reference for precise symptom management. Methods Postoperative chemotherapy patients with gastric cancer were selected in the medical oncology and surgical oncology department of four tertiary A-level Chinese medicine hospitals (Jiangsu Provincial Hospital of Traditional Chinese Medicine, Suzhou Hospital of Traditional Chinese Medicine, Wuxi Hospital of Traditional Chinese Medicine, and Xuzhou Hospital of Traditional Chinese Medicine) in South, Central, and North of Jiangsu Province, from March to December 2022 via convenience sampling method, as the study subjects. The MD Anderson Symptom Inventory Gastrointestinal Cancer (MDASI-GI) was used for evaluating gastrointestinal symptoms and their severity among patients receiving postoperative chemotherapy for gastric cancer, as well as assessing the classification of traditional Chinese medicine constitution among patients. The network of gastrointestinal symptoms was constructed using an R package to identify the centrality indexes. The univariate analysis and multiple linear regression analysis were conducted to investigate factors influencing core gastrointestinal symptoms in patients undergoing postoperative chemotherapy for gastric cancer. Results A total of 362 electronic questionnaires were collected, 355 were valid, with a valid recovery rate of 98.1%. The highest incidence of gastrointestinal symptoms in patients with postoperative chemotherapy for gastric cancer was lack of appetite (83.1%), taste alteration (81.7%) and nausea (71.0%), and the top three in terms of severity were lack of appetite (2.77 points), taste alteration (2.50 points) and nausea (2.27 points). Network analysis showed that taste alteration had the highest intensity (rS=1.27) and the highest tight centrality (rC=1.50) ; vomiting had the highest betweenness centrality (rB=1.76). The results of multiple linear regression analysis showed that gender (B=0.809, 95%CI=0.319-1.298), smoking history (B=0.706, 95%CI=0.185-1.228) and phlegm-damp constitution (B=1.703, 95%CI=0.538-2.868) were the factors influencing the severity of taste alteration symptoms in patients with gastric cancer after chemotherapy (P

The objective of this study is to investigate the effects of salt stress on seed yield, quality, and physiological processes in rapeseed. During rapeseed growing season from 2020 to 2022, two different soil salinity levels of low soil salinity (LS) and high soil salinity (HS) were conducted for rapeseed planting in Dafeng city, Jiangsu province, China (33°24'N, 120°35'E). The results indicated that, compared with LS treatment, the biomass accumulation under HS treatment was decreased by 18.46%-35.67% at the early flowering stage, and 20.92%-46.03% at maturity stage, respectively. HS treatment increased the proportion of dry biomass distribution in roots and leaves and decreased the proportion of stem and branch distribution at the early flowering stage, and increased the proportion of root, stem, and branch distribution and decreased the proportion of pod and seed distribution at maturity stage. Moreover, compared with LS treatment, HS treatment decreased the accumulations of carbon (C) and nitrogen (N) in various organs at both early flowering and maturity stages, and decreased the efficiency of C and N translocation in stems, branches, and leaves at reproductive stage, indicating that salt stress inhibited C and N assimilation and translocation, and ultimately led to a decrease in seed yield. Besides, C/N in all organs under HS treatment was lower than that under LS treatment, indicating that the adverse effects of salt stress on C assimilation were more intensive than those on N assimilation, which resulted in the increased seed protein content by 8.23% and decreased oil content by 4.42%. In addition, compared with LS treatment, HS treatment decreased net photosynthetic rate (Pn), stomatal conductance (Gs), transpiration rate (Tr), and instantaneous carboxylation efficiency (CE); however, it increased intercellular CO2 concentration (Ci) and water use efficiency (WUE), which indicating that the effects of salt stress on rapeseed photosynthesis were mainly attributed to the non-stomatal factors. HS treatment increased peroxide (H2O2) and malondialdehyde (MDA) content by 27.41% and 42.33% compared with LS treatment. The superoxide (SOD) activity, catalase (CAT) activity, ascorbic acid (AsA) content, soluble protein content, and soluble sugar content under HS treatment were increased by 65.54%, 22.85%, 29.68%, 9.75%, and 16.84%, compared with LS treatment, respectively. In conclusion, salt stress decreased the yield and changed quality by inhibiting C and N assimilation and photosynthesis in rapeseed, which could improve the antioxidants and osmotic regulation ability to adapt to salt stress environment. [ABSTRACT FROM AUTHOR]

Objectives: The time for posttreatment tumor progression differs between nasopharyngeal carcinoma (NPC) patients. Herein, we established effective nomograms for predicting early tumor progression (ETP) and late tumor progression (LTP) in NPC patients. Methods: We retrospectively enrolled 8292 NPC patients (training cohort: n = 6219; validation cohort: n = 2073). The ELP and LTP were defined as the time to tumor progression ≤24 and >24 months after treatment, respectively. Results: The ETP and LTP accounted for 52.6 and 47.4% of the total patient cohort, respectively. Patients who developed ETP had markedly worse overall survival (OS) versus patients who suffered from LTP (5‐year OS: 26.2% vs. 59.7%, p < 0.001). Further, we identified 10/6 predictive factors significantly associated with ETP/LTP via logistic regression analyses. These indicators were used separately to construct two predictive nomograms for ETP and LTP. In the training group, the ETP nomogram [Harrell Concordance Index (C‐index) value: 0.711 vs. 0.618; p < 0.001] and LTP nomogram (C‐index value: 0.701 vs. 0.612; p < 0.001) were significantly superior for risk stratification than the TNM staging. These results were supported in the validation group with a C‐index value of 0.753 and 0.738 for the ETP and LTP nomograms, respectively. High‐risk patients defined by ETP/LTP nomograms had shorter progression‐free survival than low‐risk patients (all p < 0.001). Conclusion: The established nomograms can help in ELP or LTP risk stratification for NPC patients. Our current results might also provide insights into individualized treatment decisions and designing surveillance strategies for NPC patients. [ABSTRACT FROM AUTHOR]

Abstract Background The association of single nucleotide polymorphisms (SNPs) in the apolipoprotein (Apo) A1/C3/A4/A5 gene cluster and serum lipid profiles is inconsistent. The present study was undertaken to detect the association between the ApoA1/C3/A5 gene polymorphisms and their haplotypes with serum lipid levels in the general Chinese population. Methods A total of 1030 unrelated subjects (492 males and 538 females) aged 15-89 were randomly selected from our previous stratified randomized cluster samples. Genotyping of the ApoA1 -75 bp G>A, ApoC3 3238C>G, ApoA5 -1131T>C, ApoA5 c.553G>T and ApoA5 c.457G>A was performed by polymerse chain reaction and restriction fragment length polymorphism combined with gel electrophoresis, and then confirmed by direct sequencing. Pair-wise linkage disequilibria and haplotype analysis among the five SNPs were estimated. Results The levels of high-density lipoprotein cholesterol (HDL-C) and ApoA1 were lower in males than in femailes (P < 0.05 for each). The allelic and genotypic frequencies of the SNPs were no significant difference between males and females except ApoC3 3238C>G. There were 11 haplotypes with a frequency >1% identified in the cluster in our population. At the global level, the haplotypes comprised of all five SNPs were significantly associated with all seven lipid traits. In particular, haplotype G-G-C-C-A (6%; in the order of ApoA5 c.553G>T, ApoA5 c.457G>A, ApoA5 -1131T>C, ApoC3 3238C>G, and ApoA1 -75bp G>A) and G-A-T-C-G (4%) showed consistent association with total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), ApoA1, ApoB, and the ApoA1/ApoB ratio. In addition, carriers of haplotype G-G-T-C-G (26%) had increased serum concentration of HDL-C and ApoA1, whereas carriers of G-G-C-G-G (15%) had high concentrations of TC, triglyceride (TG) and ApoB. We also found that haplotypes with five SNPs explain much more serum lipid variation than any single SNP alone, especially for TG (4.4% for haplotype vs. 2.4% for -1131T>C max based on R-square) and HDL-C (5.1% for haplotype vs. 0.9% for c.553G>T based on R-square). Serum lipid parameters were also correlated with genotypes and several environment factors. Conclusions Several common SNPs and their haplotypes in the ApoA1/C3/A5 gene cluster are closely associated with modifications of serum lipid parameters in the general Chinese population.

Background: The optimal treatment for the rare subtype of non‐Hodgkin lymphoma, extranodal natural killer/T‐cell lymphoma (ENKTL), nasal‐type, has not been clearly defined. The purpose of the study was to investigate the efficacy of sequential and "Sandwich" chemotherapy and extended involved‐field intensity‐modulated radiotherapy (IMRT) in patients with stage IE/IIE extranodal ENKTL, nasal‐type. Methods: One hundred and fifty‐five patients with stage IE/IIE nasal‐type ENKTL were enrolled in the study, including 99 patients treated with sequential chemotherapy and extended involved‐field IMRT (SCRT) and 56 patients with "Sandwich" chemotherapy and extended involved‐field IMRT and chemotherapy (SCRCT). All patients were treated with extended involved‐field IMRT with median dose of 54.6 Gy to the primary tumor and positive lymph nodes. Ninety‐four patients had Ann Arbor stage IE disease, and 61 patients had stage IIE disease. Results: The 5‐year rates of loco‐regional recurrence (LRR), progression‐free survival (PFS), and overall survival (OS) were 17.0%, 78.5%, and 84.7%, respectively. Univariate analysis revealed that EBV DNA copy after treatment (normal vs elevated level) was significant prognostic factor for LRR, PFS, and OS (P < 0.001); therapeutic method (SCRT vs SCRCT) was significant prognostic factor for PFS (71.0% vs 91.8%, P = 0.011), but there was no significant effect on 5‐year LRR and OS (22.2% vs 8.2%, P = 0.051 for LRR; 80.9% vs 91.8%, P = 0.199 for OS). Conclusions: Compared with SCRT, SCRCT was significantly associated with higher PFS rates and showed a trend toward improved loco‐regional control. EBV DNA copy after treatment is a good index for recurrence and prognosis for stage IE/IIE ENKTL patients. Compared with sequential chemotherapy (Ch) and extended involved‐field intensity‐modulated radiotherapy (EIF‐IMRT), "Sandwich" Ch and EIF‐IMRT and Ch were significantly associated with higher PFS rates and showed a trend toward improved loco‐regional control. EBV DNA copy after treatment is a good index for recurrence and prognosis for stage IE/IIE ENKTL patients. [ABSTRACT FROM AUTHOR]

Background: The optimal treatment for the rare subtype of non-Hodgkin lymphoma, extranodal natural killer/T-cell lymphoma (ENKTL), nasal-type, has not been clearly defined. The purpose of the study was to investigate the efficacy of sequential and "Sandwich" chemotherapy and extended involved-field intensity-modulated radiotherapy (IMRT) in patients with stage I E /II E extranodal ENKTL, nasal-type., Methods: One hundred and fifty-five patients with stage I E /II E nasal-type ENKTL were enrolled in the study, including 99 patients treated with sequential chemotherapy and extended involved-field IMRT (SCRT) and 56 patients with "Sandwich" chemotherapy and extended involved-field IMRT and chemotherapy (SCRCT). All patients were treated with extended involved-field IMRT with median dose of 54.6 Gy to the primary tumor and positive lymph nodes. Ninety-four patients had Ann Arbor stage I E disease, and 61 patients had stage II E disease., Results: The 5-year rates of loco-regional recurrence (LRR), progression-free survival (PFS), and overall survival (OS) were 17.0%, 78.5%, and 84.7%, respectively. Univariate analysis revealed that EBV DNA copy after treatment (normal vs elevated level) was significant prognostic factor for LRR, PFS, and OS (P < 0.001); therapeutic method (SCRT vs SCRCT) was significant prognostic factor for PFS (71.0% vs 91.8%, P = 0.011), but there was no significant effect on 5-year LRR and OS (22.2% vs 8.2%, P = 0.051 for LRR; 80.9% vs 91.8%, P = 0.199 for OS)., Conclusions: Compared with SCRT, SCRCT was significantly associated with higher PFS rates and showed a trend toward improved loco-regional control. EBV DNA copy after treatment is a good index for recurrence and prognosis for stage I E /II E ENKTL patients., (© 2018 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)

This study retrospectively investigated asparaginase-based chemotherapy treatment outcomes with or without radiotherapy in 143 patients with stage IE-IIE extranodal natural killer/T cell lymphoma (ENKTCL). All patients received a median of three cycles of asparaginase-based chemotherapy, while 121 patients received radiotherapy following the chemotherapy. The complete remission (CR) rate for all patients post-chemotherapy was 58.7%, and rose to 73.4% by the end of treatment. Patients who received radiotherapy achieved better survival outcomes than those who did not (89.7% vs. 49.0% for 2-year overall survival (OS), P<0.001; 86.8% vs. 37.4% for 2-year progression-free survival (PFS), P<0.001). Additionally, even patients who achieved CR post-chemotherapy exhibited differential survival rates with or without radiotherapy (90.8% vs. 60% for 2-year OS, P=0.006; 86.1% vs. 60% for 2-year PFS, P=0.044). Multivariate analysis revealed that radiotherapy was an independent factor favoring OS (HR=0.098, 95%CI=0.031-0.314, P=0.001) and PFS (HR=0.156, 95%CI=0.062-0.396, P=0.001). Thus, radiotherapy is recommended for stage IE-IIE ENKTCL patients treated with asparaginase-based chemotherapy, even in cases of CR following chemotherapy.

Objective: The roles of the transmembrane and secreted forms of tumor necrosis factor alpha (TNFalpha) in rheumatoid arthritis (RA) remain unclear. Agents used to inhibit TNFalpha have shown varying efficacy in RA patients, suggesting that anti-TNFalpha agents possess dissimilar mechanisms of action, including the ability to neutralize transmembrane (tmTNFalpha) and secreted TNFalpha. In this study, TNFalpha-knockout (TNFalpha-KO) mice that were genetically altered to express elevated levels of tmTNFalpha were constructed to further understand the roles of the 17-kd secreted, trimeric, and 26-kd transmembrane forms of TNFalpha., Methods: A speed-congenic mating scheme was used to generate 3 unique strains of mice: 1) transgenic tmTgA86 mice overexpressing 26-kd tmTNFalpha and also secreting 17-kd trimeric TNFalpha (tmTNFalpha-transgenic), 2) TNFalpha-/- mice (TNFalpha-KO), and 3) transgenic mice overexpressing tmTNFalpha backcrossed to TNFalpha-KO mice (tmTNFalpha-transgenic/TNFalpha-KO). Mice were treated with phosphate buffered saline (as vehicle control), dexamethasone (as positive control), or modified recombinant human soluble TNF receptor (sTNFR) p55 or p75, and were assessed clinically and histopathologically for signs of inflammation and development of arthritis., Results: The tmTNFalpha-transgenic/TNFalpha-KO mice were born with crinkled tails and spinal deformities similar to those in ankylosing spondylitis. By 2-4 weeks, these mice developed symmetric inflammatory arthritis, characterized by tissue swelling, pannus formation, and bone deformities. The tmTNFalpha-transgenic mice also developed spontaneous-onset arthritis, but at a slower rate (100% incidence by 10-12 weeks). Clinical and histologic progression of arthritis in the tmTNFalpha-transgenic/TNFalpha-KO mice was reduced by treatment with dexamethasone or with the p55 or p75 sTNFR (69% and 63% reduction in total histologic score, respectively)., Conclusion: These data show that arthritis is sufficiently initiated and maintained in tmTNFalpha-transgenic/TNFalpha-KO mice, and that it can be neutralized by recombinant human p55 or p75 sTNFR, resulting in amelioration of the biologic and subsequent histologic destructive effects of tmTNFalpha.