ObjectiveTo explore the prognostic value of pretreated maximum standardized uptake value (SUVmax) using 18-fluorodeoxyglucose positron emission tomography with computed tomography (18FDG PET/CT) in locally-advanced nasopharyngeal carcinoma (NPC) treated by intensity-modulated radiotherapy (IMRT).MethodsOne hundred and forty previously untreated stage Ⅲ - Ⅳb ( UICC/AJCC 6th) patients with biopsy-proven nasopharyngeal carcinoma were examined.All of the enrolled patients accepted whole body/head-neck 18FDG PET/CT before radical IMRT. 18FDG uptakes were recorded as SUVmax of primary tumor (SUVmax-P) and SUVmax of cervical lymph nodes (SUVmax-N).The relationships between SUVmax and long-term clinical outcomes were analyzed.ResultsThe median SUVmax-P was 10.4,and the median SUVmax-N was 6.2.The SUVmax-P was weakly correlated with T-stage ( R =0.279,P =0.001 ).The SUVmax-N was weakly correlated with N stage ( R =0.334,P =0.000 ).There were no difference of the median SUVmax-P (9.2 vs.10.4,U =560.50,P =0.805 ) and the median SUVmax-N (4.0vs.5.0,U =576.00,P =0.908) between patients with and without local recurrence.The median SUVmax-P of patients with distant metastasis was significantly higher than those without metastasis (11.9 vs.9.8,U =987.50,P =0.014).The SUV of 10.2 was taken as a cut-off for high and low uptake tumors.For patients with SUVmax-P ＞ 10.2,the 5-year distant metastasis-free survival (DMFS) and 5-year overall survival (OS)were significantly higher than those with SUVmax-P ≤ 10.2 (69.1％ vs.95.5％,x2 =15.88,P =0.000;68.4％ vs.94.0％,x2 =15.56,P =0.000,respectively).Multivariate analysis showed that SUVmax-P was the only independent risk factor of 5-year DMFS and OS ( HR =7.87,P =0.001 and HR =5.14,P =0.003). Conclusion SUVmax-P is a useful biomarker predicting long-term clinical outcomes in newly diagnosed locally-advanced NPC patients.

Background: PTSD (Post-traumatic stress disorder, PTSD) had a great impact on health care workers during the COVID-19 (Corona Virus Disease 2019, COVID-19). Better knowledge of the prevalence of PTSD and its risk factors is a major public health problem. This study was conducted to assess the prevalence and important risk factors of PTSD among medical staff during the COVID-19. Methods: The databases were searched for studies published during the COVID-19, and a PRISMA (preferred reporting items for systematic review and meta-analysis) compliant systematic review (PROSPERO-CRD 42021278970) was carried out to identify articles from multiple databases reporting the prevalence of PTSD outcomes among medical staff. Proportion random effect analysis, I2 statistic, quality assessment, subgroup analysis, and sensitivity analysis were carried out. Results: A total of 28 cross-sectional studies and the PTSD results of doctors and nurses were summarized from 14 and 27 studies: the prevalences were 31% (95% CI [confidence interval, CI]: 21%–40%) and 38% (95% CI: 30%–45%) in doctors and nurses, respectively. The results also showed seven risks (p < 0.05): long working hours, isolation wards, COVID-19 symptoms, nurses, women, fear of infection, and pre-existing mental illness. Two factors were of borderline significance: higher professional titles and married. Conclusion Health care workers have a higher prevalence of PTSD during COVID-19. Health departments should provide targeted preventive measures for medical staff away from PTSD.Previous arti

The extremely low bioavailability of oral paclitaxel (PTX) mainly due to the complicated gastrointestinal environment, the obstruction of intestinal mucus layer and epithelium barrier. Thus, it is of great significance to construct a coordinative delivery system which can overcome multiple intestinal physicochemical obstacles simultaneously. In this work, a high-density PEGylation-based glycocholic acid-decorated micelles (PTX@GNPs) was constructed by a novel polymer, 9-Fluorenylmethoxycarbonyl-polyethylene glycocholic acid (Fmoc-PEG-GCA). The Fmoc motif in this polymer could encapsulate PTX via π‒π stacking to form the core of micelles, and the low molecular weight and non-long hydrophobic chain of Fmoc ensures the high-density of PEG. Based on this versatile and flexible carriers, PTX@GNPs possess mucus trapping escape ability due to the flexible PEG, and excellent intestine epithelium targeting attributed to the high affinity of GCA with apical sodium-dependent bile acid transporter. The in vitro and in vivo results showed that this oral micelle could enhance oral bioavailability of PTX, and exhibited similar antitumor efficacy to Taxol injection via intravenous route. In addition, oral PTX@GNPs administered with lower dosage within shorter interval could increase in vivo retention time of PTX, which supposed to remodel immune microenvironment and enhance oral chemotherapy efficacy by synergistic effect.