The purpose of this study is to assess the long-term effect of sensorineural hearing loss (SNHL) resulted from radiotherapy (RT) alone versus chemoradiotherapy in nasopharyngeal carcinoma patients (NPC). Seventy-two patients initially diagnosed with NPC were enrolled from Shandong Tumor Hospital between March 2003 and May 2007. They were assigned into two groups: RT alone and chemoradiotherapy according to the different treatment regimens. Intensity-modulated radiation therapy was applied for both groups, concurrent and adjuvant cisplatin were administered for chemoradiotherapy group additionally. Hearing threshold test was performed at various time periods after completion of RT. Mean radiation dose to the cochlea in each ear was calculated to determine the correlation between cochlear dose and SNHL. We found that the hearing loss is more severe in the chemoradiotherapy group compared with RT group, from completion of RT up to the 5 years of follow-up period. This is especially obvious in the high frequency range. Hearing level is seriously damaged when cochlea dose exceeds 46 GY. We concluded that concurrent/adjuvant chemotherapy plus RT aggravates SNHL in NPC patients than RT alone and thus inner ear tissue tolerance should be redefined in those patients.

BackgroundThis study was designed to compare toxicities, disease control, and survival outcomes for limited disease small-cell lung cancer (LD-SCLC) treated with once daily (QD) versus twice daily (BID) radiotherapy.MethodsAll of the patients received four to six cycles of platinum plus etoposide. In the QD group, irradiation was given via conventional radiotherapy with a dose of 60 Gy at 2 Gy per once-daily fraction. In the BID group, the dose was 45 Gy at 1.5 Gy per twice-daily fraction.ResultsData from a total of 143 LD-SCLC patients treated at the Shandong Cancer Hospital & Institute were retrospectively analyzed. Statistically significant differences were found in the rates of both grade 2 or higher esophagitis (P = 0.036) and pneumonitis (P = 0.043) between QD and BID groups, respectively. Grade 3 esophagitis occurred in 6% of patients receiving QD and 19% of those receiving BID therapy. The median overall survival (OS) of all patients was 30.4 months: 29.5 months for QD therapy, and 31.4 months for BID therapy. The two-year OS rate was 43.3% for QD therapy, and 48.8% for BID therapy. The two-year locoregional recurrence-free survival (LRFS) rate was 45% versus 63.4% for the QD group versus the BID group, respectively.ConclusionsPneumonitis was more common in the QD group, and esophagitis was more common in the BID group. Although there were no significant differences in OS and LRFS between the QD and BID groups, there was a trend toward improved local control in the BID group.

Picophytoplankton were investigated during spring 2015 and 2016 extending from near‐shore coastal waters to oligotrophic open waters in the eastern Indian Ocean (EIO). They were typically composed of Prochlorococcus ( Pro ), Synechococcus ( Syn ), and picoeukaryotes ( PEuks ). Pro dominated most regions of the entire EIO and were approximately 1–2 orders of magnitude more abundant than Syn and PEuks . Under the influence of physicochemical conditions induced by annual variations of circulations and water masses, no coherent abundance and horizontal distributions of picophytoplankton were observed between spring 2015 and 2016. Although previous studies reported the limited effects of nutrients and heavy metals around coastal waters or upwelling zones could constrain Pro growth, Pro abundance showed strong positive correlation with nutrients, indicating the increase in nutrient availability particularly in the oligotrophic EIO could appreciably elevate their abundance. The exceptional appearance of picophytoplankton with high abundance along the equator appeared to be associated with the advection processes supported by the Wyrtki jets. For vertical patterns of picophytoplankton, a simple conceptual model was built based upon physicochemical parameters. However, Pro and PEuks simultaneously formed a subsurface maximum, while Syn generally restricted to the upper waters, significantly correlating with the combined effects of temperature, light, and nutrient availability. The average chlorophyll a concentrations (Chl a ) of picophytoplankton accounted for above 49.6% and 44.9% of the total Chl a during both years, respectively, suggesting that picophytoplankton contributed a significant proportion of the phytoplankton community in the whole EIO.

ObjectiveTo compare the adverse maternal and neonatal outcomes of multiple pregnancy and singleton pregnancy from multiple medical centers in Beijing.MethodsData concerning maternal and neonatal adverse outcomes in multiple and singleton pregnancies were collected from 15 hospitals in Beijing by a systemic cluster sampling survey conducted from 20 June to 30 November 2013. The SPSS software (version 20.0) was used for data analysis. The χ2 test was used for statistical analyses.ResultsThe rate of caesarean deliveries was much higher in women with multiple pregnancies (85.8%) than that in women with singleton pregnancies (42.6%, χ2 = 190.8, P < 0.001). The incidences of anemia (χ2 = 40.023, P < 0.001), preterm labor (χ2 = 1021.172, P < 0.001), gestational diabetes mellitus (χ2 = 9.311, P < 0.01), hypertensive disorders (χ2 = 122.708, P < 0.001) and post-partum hemorrhage (χ2 = 48.550, P < 0.001) was significantly increased with multiple pregnancy. In addition, multiple pregnancy was associated with a significantly higher rate of small-for-gestational-age infants (χ2 = 92.602, P < 0.001), low birth weight (χ2 = 1141.713, P < 0.001), and neonatal intensive care unit (NICU) admission (χ2 = 340.129, P < 0.001).ConclusionsMultiple pregnancy is a significant risk factor for adverse maternal and neonatal outcomes in Beijing. Improving obstetric care for multiple pregnancy, particularly in reducing preterm labor, is required to reduce the risk to mothers and infants.

Marine picophytoplankton are abundant in many oligotrophic oceans, but the known geographical patterns of picophytoplankton are primarily based on small-scale cruises or time-series observations. Here, we conducted a wider survey (5 cruises) in the Bay of Bengal (BOB), South China Sea (SCS) and Western Pacific Ocean (WPO) to better understand the biogeographic variations of picophytoplankton. Prochlorococcus (Pro) were the most abundant picophytoplankton (averaging [1.9-3.6] × 104 cells ml-1) across the 3 seas, while average abundances of Synechococcus (Syn) and picoeukaryotes (PEuks) were generally 1-2 orders of magnitude lower than Pro. Average abundances of total picophytoplankton were similar between the BOB and SCS (4.7 × 104 cells ml-1), but were close to 2-fold less abundant in the WPO (2.5 × 104 cells ml-1). Pro and Syn accounted for a substantial fraction of total picophytoplankton biomass (70-83%) in the 3 contrasting seas, indicating the ecological importance of Pro and Syn as primary producers. Pro were generally abundant in oligotrophic open waters; however, the exceptional presence of Pro near the SCS coast was potentially associated with the Kuroshio intrusion. Syn and PEuk abundances were higher near freshwater-dominated areas, which was likely due to dilution waters. Water temperature and cold eddies were also major drivers responsible for the biogeographic distributions of picophytoplankton. Although Pro, Syn and PEuks showed negative correlations with nutrient concentrations, their maximal abundances in vertical distribution showed positive correlations with the nutricline depth, indicating that nutrient availability plays a 2-faceted role in regulating the biogeographic variation in picophytoplankton.