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High diversity of fish myxosporeans was reported in China, but less concerns in species from marine environment, especially in South China Sea. Increasing myxosporidiosis of cultured marine fish expedite us to initiate a project of investigating the myxosporean diversity of marine fish in China. As a part of this project, a new myxosporean species, named as Henneguya ovata n. sp. was described here which intensively infected the internal wall of intestinal tract of net-cage-cultured ovate pompano, Trachinotus ovatus Linnaeus (1758) (Perciformes: Carangidae) off the coast of Huidong country, Guangdong Province, South China. The parasite generally produced white and usually round plasmodia, up to 3 mm in diameter. Mature spores with a bifurcated equal caudal appendage were elongated ellipsoidal in frontal view, with blunted round anterior end, measuring 15.8 +/- 0.9 (14.7-17.1) mu m in total spore length, 6.9 +/- 0.3 (6.1-7.1) mu m in spore body length, 3.3 +/- 0.2 (2.9-4.1) mu m in width, 2.9 +/- 0.1 (2.8-3.3) mu m in thickness. The caudal appendages were 8.9 +/- 0.3 (8.1-9.6) mu m in length. Two equal pyriform polar capsules situated in the plane of the suture line at the anterior end of spores, measuring 2.7 +/- 0.1 (2.6-2.9) mu m in length and 1.2 +/- 0.1 (0.9-1.3) mu m in width and occupied about half of the spore body length. Polar filaments wounded in 3 to 4 coils and situated perpendicularly of the longitudinal axis of the polar capsules. Morphological comparisons showed that the present species was smaller than most of reported Henneguya species. Under ultrastructural observations, numerous projections could be seen in the plasmodial wall toward host tissue. The obtained partial 18S rDNA gene sequences, 1675 bp in length, did not match any of myxosporeans available in the GenBank, but was most similar to two Trachinotus-infecting Henneguya species (about 91%). Phylogenetic analysis revealed that the parasite clustered within the marine Henneguya-Myxobolus clade infecting fish of the order Perciformes. Therefore, our results strengthened again the contention that the host affinity was the strongest among evolutionary signals to infer the phylogeny of myxosporeans of the family Myxobolidae. However, spore morphology and tissue tropism could represent well phylogenetic relationships among species of myxobolid group of within a short evolutionary history. Taking into account the high infection intensity and caused remarkable thin and transparent intestinal wall, the detrimental effects of infection of this myxosporean on cultured T. ovatus deserve more attentions in future.

A suspected new enteric Sphaerospora species was believed to be directly associated with the mass mortality of yearling groupers of Epinephelus spp. in South China. The epizootic generally emerged from late September to late April of the following year. The infection prevalence and mortality rate were significantly negatively correlated with fish size. Clinical signs included anorexia, cachexia and extrusion of white pulp-like substance from anus after gentle pressure on the abdomen. Upon necropsy, severe intestinal oedema, thin and transparent intestinal wall, swollen spleen, kidney and gall bladder could be observed. Wet preparation of the infected samples showed large amount of typical disporous plasmodia of the genus Sphaerospora, but no mature spores were observed. Epidemiological investigation showed that this parasite exclusively infected Epinephelus groupers. Histopathologically, this species mainly infected the epithelium of intestine and kidney tubules and caused severe epithelia sloughing and the collapse of intestinal villus. Interestingly, this enteric myxosporidiosis did not cause severe emaciation of infected fish for mass mortality usually emerged within 2-3 days after appearance of clinical signs. The species was most genetically related to Sphaerospora fugu (89% sequence identity) and phylogenetically positioned within marine Sphaerospora lineage. This is the first report of enteric sphaerosporosis of groupers.

This Systematic Review summarizes the literatures of clinical trials on the efficacy and safety of carbon ion therapy for gynecological carcinomas. The protocol is detailed in the online PROSPERO database, registration no. CRD42019121424, and a final set of eight studies were included. In the treatment of cervical carcinomas, both carbon ion therapy alone and carbon ion therapy concurrent chemotherapy have presented good efficacy. Besides, the efficacy of inoperable endometrial carcinomas and gynecological melanoma are similar to that of surgical treatment. In terms of safety, gastrointestinal and genitourinary toxicities are low and could be controlled by limiting the volume and dose of intestinal tract and bladder. Carbon ion radiotherapy could be considered a safe, effective and feasible therapy for gynecological carcinomas.

Non-small cell lung cancer (NSCLC) exhibits radioresistance to conventional rays, due to its DNA damage repair systems. NSCLC may potentially be sensitized to radiation treatment by reducing those factors that continuously enhance the repair of damaged DNA. In the present study, normal lung fibroblast MRC-5 and lung cancer A549 cells were treated with NU7026 and CGK733, which are inhibitors of the DNA-dependent protein kinase catalytic subunit (PKcs) and ataxia telangiectasia mutated (ATM) and ataxia telangiectasia and Rad3-related (ATR), respectively, followed by exposure to X-rays and carbon ion irradiation. The cytotoxic activity, cell survival rate, DNA damage repair ability, cell cycle arrest and apoptosis rate of the treated cells were analyzed with MTT assay, colony formation assay, immunofluorescence and flow cytometry, respectively. The transcription and translation levels of the ATM, ATR and DNA-PKcs genes were detected by reverse transcription-quantitative polymerase chain reaction and western blotting, respectively. The results indicated that the radiosensitivity and DNA repair ability of A549 cells were reduced, and the percentages of apoptotic cells and those arrested at the G2/M phase of the cell cycle were significantly increased, following ionizing radiation with inhibitor-pretreatment. The expression levels of ATM, ATR, DNA-PKcs and phosphorylated histone H2AX, a biomarker for DNA double-strand breaks, were all upregulated at the transcriptional or translational level in A549 cells treated with carbon ion irradiation, compared with the control and X-rays-treated cells. In addition, the treatment with 5–50 µM NU7026 or CGK733 did not produce any obvious cytotoxicity in MRC-5 cells, and the effect of the DNA-PKcs-inhibitor on enhancing the radiosensitivity of A549 cells was stronger than that observed for the ATM and ATR-inhibitor. These findings demonstrated a minor role for ATM and ATR in radiation-induced cell death, since the upregulation of ATM and ATR did not rescue the A549 cells subjected to ionizing irradiation. Therefore, future studies on DNA-PKcs, ATM and ATR may lead to novel specific therapies that supplement general radiotherapy for the treatment of lung cancer.

Background: Preclinical in vitro experiments demonstrated that epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) might have synergistic effect in combination with radiotherapy on Non-small cell lung cancer (NSCLC), but the clinical trials showed inconsistence results in NSCLC patients with EGFR status unknow or mutations. This study aimed to determine if added TKIs to Thoracic radiotherapy (TRT) improve primary disease response rate (RR) and survival outcomes in advanced or metastatic NSCLC. Methods: We searched MEDLINE, EMBASE, and Cochrane Library from January 2000 to December 2017 for eligible studies where patients received concurrent EGFR TKIs and TRT or CRT. Concerned outcomes were primary tumor RR, overall survival (OS), and adverse events (AEs). The meta-analysis was performed using Stata software (version 12.0). Random effects models were used to pool outcomes across studies. Sensitivity analysis was performed to determine if the results would be different. Results: We found 16 prospective clinical trials with mature results for meta-analyses. Twelve studies including 446 patients reported the RR and survival outcomes of TRT combined TKIs. The CR, PR, SD, and PD, respectively, were 0.06 (95% CI 0.03–0.09, I2 = 0%), 0.44 (95% CI 0.38–0.49, I2 = 64.9%), 0.29 (95% CI 0.24–0.34, I2 = 78.4%), and 0.15 (95% CI 0.11–0.19, I2 = 84.2%). One- and 2-year OS, respectively, were 0.52 (95% CI 0.44–0.60, I2 = 38.8%) and 0.26 (95% CI 0.18–0.33, I2 = 0%). Four studies including 182 patients reported the RR and survival outcomes of CRT combined TKIs. The pooled CR, PR, SD, and PD, respectively, were 0.12 (95% CI 0.02–0.22, I2 = 69.1%), 0.41 (95% CI 0.27–0.55, I2 = 71.6%), 0.31 (95% CI 0.16–0.46, I2 = 79%), and 0.14 (95% CI −0.01–0.30, I2 = 87.8%). Only 1 study reported the survival event rate, 1- and 2-year OS, respectively, were 0.83 (95% CI 0.71–0.94) and 0.67 (95% CI 0.54–0.81). There were not severe adverse events (SAEs) reported either TRT combined TKIs or CRT combined TKIs. Conclusion: There is evidence, albeit of low quality, that added the TKIs to TRT or CRT may improve RR and survival outcomes in patients with EGFR mutant status unknown advanced or metastatic NSCLC relative to other studies of TKIs alone, TRT alone or CRT.

We carried out a meta-analysis to assess the effectiveness and safety of radiotherapy combined with surgery for gastric cancer. Randomized Clinical Trials (RCTs) in which radiotherapy (preoperative, intraoperative and postoperative), was compared with surgery alone in resectable gastric cancer were identified by searching Cochrane Library (Issue 2, 2009), PubMed (Jan 1966–Jun 2009), EMBASE (Jan 1974–Jun 2009), Chinese Biomedical Literature Database (Jan 1978–Jun 2009), Chinese Science and Technology Periodicals Database (Jan 1989–Jun 2009), China National Knowledge Infrastructure (Jan 1994–Jun 2009) and Wanfang database (Jan 1997–Jun 2009) in English and Chinese languang. Two researchers assessed the quality of included randomized controlled trials (RCT) extracted data independently. The RevMan 5.0 software was used for meta-analysis. Our researchers assessed the quality of included randomized controlled trials (RCT) extracted data independently. The RevMan 5.0 software was used for meta-analysis. Nine randomized controlled trials of 1 548 patients were selected for meta-analysis. Five randomized controlled trials were related with comparison of preoperative radiotherapy plus surgery with single surgery. Two randomized controlled trials were the comparative studies between surgery plus postoperative and single surgery. The meta-analysis results showed that: (1) compared with surgery alone, preoperative radiotherapy combined with surgery can increase 3 years (OR = 1.78; 95% CI 1.14–2.78, P = 0.01), 5 years (OR = 1.67; 95% CI 1.22–2.29, P = 0.001), 10 years (OR = 1.64; 95% CI 1.03–2.60, P = 0.04) survival rate and resection rate (OR = 2.15; 95% CI 1.31–3.54, P = 0.003); reduce the of tumor recurrence rate (OR = 0.59; 95% CI 0.37–0.92, P = 0.02) and metastasis rate (OR = 0.44; 95% CI 0.27–0.73, P = 0.001); (2) The tumor recurrent rates (OR = 0.19, 95% CI 0.03–1.14, P = 0.07) and tumor metastasis rate (OR = 0.09; 95% CI 0.00–1.77, P = 0.11) had no difference between single surgery group and peri-operative radiotherapy plus surgery group; (3) Postoperative radiotherapy compared with surgery alone had no significant effects on 1 year (OR = 0.83; 95% CI 0.60–1.15, P = 0.26) and 3 years (OR = 0.75; 95% CI 0.51–1.11, P = 0.15) survival rate compared with single surgery, but the 5-year survival rates (OR = 0.57; 95% CI 0.34–0.95, P = 0.03) of the patients who received surgery alone was higher than those who received combined therapy. No difference of the tumor recurrence rate (OR = 0.59; 95% CI 0.33-1.05, P = 0.07), tumor metestasis rate (OR = 0.90; 95% CI 0.51–1.59, P = 0.71) and anastomotic leak (OR = 0.98; 95% CI 0.25–3.65, P = 0.98) were observed between the two groups. Preoperative radiotherapy combined surgery is more rational and effective than surgery alone of gastric cancer. However, in terms of the clinical effects of perioperarive or postoperative radoiotherapy combined with surgery, much multicenter, largescale, high-quality, double-blind and rigorously designed studies would be needed than currently available in the future.

Objective The aim of this study was to assess the long-term effect of breast conservation with breast intensity-modulated radiotherapy (IMRT) for early-stage breast cancers.

The objective of this study was to assess the clinical efficacy and safety of concomitant or adjuvant tomozolomide with whole-brain irradiation (WBI) in patients with brain metastases. MEDLINE, EMBASE, Cochrane Library, Chinese Biomedical Literature Database were searched to identify relevant original published trails, and the references of eligible studies were manually screened. Randomized controlled trails reported in any language, comparing concomitant or adjuvant temozolomide (TMZ) and WBI with WBI alone in patients with brain metastases, were eligible for inclusion. Two investigators independently assessed the quality of included trials and extracted data. The RevMan 5 software was used for statistical analysis. Four trials involving 280 patients were included. The result showed that the group TMZ+WBI was superior to group WBI in partial response, stable disease, progressive disease, and objective response with the pooled risk ratio value and 95% confidence interval, respectively, 1.89 (1.19-3.02), 0.82 (0.45-1.50), 0.29 (0.10-0.78), and 1.72 (1.32-2.24). The incidence of gastrointestinal symptoms and > or =grade 3 myelosuppression presented statistical difference, TMZ+WBI group is higher than WBI group, the pooled risk ratio value and 95% confidence interval were 3.75 (1.04-13.44) and 13 (1.75-96.79), respectively. The currently available evidence showed that the combination of TMZ and WBI may moderately improve the response rate, but accordingly increase the incidence of gastrointestinal symptoms and myelosuppression. Future large-scale, high-quality, placebo-controlled, double-blind trials are needed.

Radiotherapy for the management of keloids was first introduced in 1906, yet 107 years later optimal protocol has not yet been established. Most studies have been conducted using x-ray, β-ray, or γ-ray. However, for high linear energy transfer radiation, clinical data are scarce. The aim of this study was to examine the efficacy and safety of postoperative carbon ion radiotherapy for keloids.Case records of 16 patients with 20 keloids, who were given postoperative carbon ion radiotherapy with 16GyE/8 fractions in the therapy terminal at the Heavy Ion Research Facility in Lanzhou at the Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou, China, were retrospectively reviewed.In a mean follow-up period of 29.7 months (range 24.3-35.3 months), overall survival and 95% success rates were achieved. No grade 3 or higher toxicity and complication occurred, and none of the 16 patients presented with local or systemic malignancy during the follow-up period.Here, the first evidence of postoperative carbon ion radiotherapy for keloids is provided. Surgical excision and immediate postoperative carbon ion radiotherapy is well tolerated and should be considered as a potential curative treatment modality of keloids in certain cases.