We construct the Lorentz-invariant chiral Lagrangians up to the order O(p 4 ) by including ∆(1232) as an explicit degree of freedom. A full one-loop investigation on processes involving ∆(1232) can be performed with them. For the π∆∆ Lagrangian, one obtains 38 independent terms at the order O(p 3 ) and 318 independent terms at the order O(p 4 ). For the πN ∆ Lagrangian, we get 33 independent terms at the order O(p 3 ) and 218 independent terms at the order O(p 4 ). The heavy baryon projection is also briefly discussed.

Background Whether anesthesia type is associated with the surgical outcome of Hepatocellular carcinoma (HCC) patients with portal vein tumor thrombus (PVTT) remains to be determined. This study aims to investigate the impact of volatile inhalational anesthesia (INHA) versus total IV anesthesia (TIVA) on the survival outcomes in HCC patients with PVTT. Methods A cohort of in-patients whom were diagnosed of HCC with PVTT in Eastern Hepatobiliary Surgery Hospital, Shanghai, China, from January 1, 2008 to December 24, 2012 were identified. Surgical patients receiving the INHA and TIVA were screened out. The overall survival (OS), recurrence-free survival (RFS) and several postoperative adverse events were compared according to anesthesia types. Results A total of 1513 patients were included in this study. After exclusions are applied, 263 patients remain in the INHA group and 208 in the TIVA group. Patients receiving INHA have a lower 5-year overall survival rate than that of patients receiving TIVA [12.6% (95% CI, 9.0 to 17.3) vs. 17.7% (95% CI, 11.3 to 20.8), P = 0.024]. Results of multivariable Cox-regression analysis also identify that INHA anesthesia is significantly associated with mortality and cancer recurrence after surgery compare to TIVA, with HR (95%CI) of 1.303 (1.065, 1.595) and 1.265 (1.040, 1.539), respectively. Subgroup analysis suggested that in more severe cancer patients, the worse outcome related to INHA might be more significant. Conclusion This retrospective analysis identifies that TIVA is associated with better outcomes compared with INHA. Future prospective studies clinical and translational studies are required to verify this difference and investigate underlying pathophysiology.

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Background This multicenter clinical trial was designed to evaluate the efficacy and safety of thalidomide (THD) in preventing oral mucositis (OM) in patients with nasopharyngeal carcinoma (NPC) undergoing concurrent chemoradiotherapy (CCRT). Methods Patients with locally advanced NPC were randomly assigned to either a THD group or a control group. All 160 patients received radical intensity‐modulated radiotherapy plus cisplatin‐based concurrent chemotherapy and basic oral hygiene guidance. Patients in the THD group received additional THD at the beginning of CCRT. The primary end points were the latency period and the incidence of OM. The secondary end points were mouth and throat soreness (MTS), weight loss, short‐term efficacy, and adverse events. Results The median latency period of OM was 30 and 14 days in the THD and control groups, respectively (hazard ratio, 0.32; 95% confidence interval, 0.23‐0.35; P < .0001). The incidence of OM and severe OM (World Health Organization grade 3 or higher) was significantly lower in the THD group than the control group (87.5% vs 97.5% [P = .016] and 27.5% vs 46.3% [P = .014], respectively). THD treatment also remarkably reduced the intensity of MTS and the degree of weight loss. In comparison with the control group, the incidence of nausea, vomiting, and insomnia was significantly decreased, whereas the incidence of dizziness and constipation was obviously increased in the THD group. The objective response rates 3 months after CCRT were similar between the groups. Conclusions THD prolonged the latency period, reduced the incidence of OM, and did not affect the short‐term efficacy of CCRT in patients with NPC. Lay Summary Oral mucositis is the most common complication of nasopharyngeal carcinoma during chemoradiotherapy; it decreases the patient's quality of life, and ideal mucosal protective agents are lacking. A few basic research and preclinical studies have shown that thalidomide may be an approach to ameliorating oral mucositis. The results of the current study confirm that thalidomide has a protective effect against oral mucositis in patients who have received chemoradiotherapy for nasopharyngeal carcinoma.

We construct the relativistic chiral Lagrangians with decuplet baryons up to the order Oðp 4 Þ (one loop). For the meson-decuplet-decuplet couplings, there are 1, 13, 55, and 548 terms in the Oðp 1 Þ − Oðp 4 Þ order Lagrangians, respectively. For the meson-octet-decuplet Lagrangians, the number of independent terms from Oðp 1 Þ to Oðp 4 Þ is 1, 5, 67, and 611, respectively. For convenience of application, the πΔΔ and πNΔ chiral Lagrangians are picked out. This new form of Δ Lagrangians is equivalent to the original isovectorisospinor one, and we establish relations between these two forms.