Comparison of the Seventh and Eighth Edition of American Joint Committee on Cancer (AJCC) Staging for Selected and Nonselected Oropharyngeal Squamous Cell Carcinomas

ObjectivesThe eighth edition American Joint Committee on Cancer (AJCC) Staging incorporates significant changes to the seventh edition in the staging of oropharyngeal squamous cell carcinomas (OPSCC). An important change was the inclusion of OPSCC associated with the human papilloma virus (HPV). Our goal is to compare the performance of both staging systems for patients with HPV-selected and unselected clinical characteristics for OPSCC.MethodsUsing the Surveillance, Epidemiology, and End Results (SEER) database, 2004-2016, we identified patients with likely HPV-associated OPSCC based on surrogate markers (white males aged <65 years old with squamous cell carcinomas of the tonsil and base of tongue), excluding those who underwent surgery. We re-classified these patients using seventh and eighth edition staging for HPV-selected OPSCC and compared the prediction performance of both staging editions for overall survival (OS) and disease-specific survival (DSS). We performed the same analysis for clinically unselected patients with OPSCC.ResultsOur analysis included 9554 patients with a median follow-up of 67 months. Comparing the eighth versus seventh edition for our HPV-selected cohort, clinical staging changed for 92.3% of patients and 10-year OS was 62.2%, 61.2%, 35.3%, and 15.5% for Stage I, II, III, and IV, versus 52.9%, 59.2%, 61.6%, 55.1%, 38.3%, and 15.5% for stage I, II, III, IVA, IVB, and IVC, respectively. A similar pattern was observed for 10-year DSS. The concordance statistics for our HPV-selected cohort were improved for both AJCC 7 (0.6260) and AJCC 8 (0.6846) compared with the unselected cohort, 0.5860 and 0.6457 for AJCC 7 and 8, respectively.ConclusionThe overall performance of discrimination improved from AJCC 7 to AJCC 8 for both clinically selected and unselected patients, but more notably for our HPV-selected cohort. Despite the lack of statistically significant differentiation between Stages I and II in AJCC 8 in either groups, markedly improved discrimination was observed between Stages I/II, III, and IV in the HPV-selected cohort.     

Dopaminergic regulation in anorexia nervosa

An endocrine study that showed a lack of response of growth hormone to L-DOPA in weight-restored anorectics indicated that dopaminergk regulation may be impaired in anorexia nervosa. We studied another indirect as- sessment of dopaminergk activity by measuring the prolactin response to the dopamine antagonist, chlorpromazine, in six female anorectic normal- weight, recently recovered patients. Two of these patients had no response to chlorpromazine, another three patients had a minimal response, and only one patient had a normal prolactin response to chlorpromazine. Our findings suggest that anorexia nervosa patients have a defect in the negative feedback system in dopamine synthesis, such as an impairment at the dopamine post-synaptic receptor site.     

Increasing a child's prosocial behaviors: positive and negative consequences in correspondence training

Correspondence training procedures were used with a young developmentally delayed child to facilitate peer directed talk in a preschool. The typical procedures that provide positive consequences for correspondence were not successful. Therefore, the contingency of a brief timeout for noncorrespondence was added in addition to the positive consequences. Increased verbalizations to peers occurred under these conditions. Generalized changes of increased proximity to peers and increased handraising and participation in groups were also documented. Behavior changes were maintained following the withdrawal of treatment procedures.     

Mycobacterium avium-complex infections in normal and immunodeficient mice

Specific pathogen-free C57Bl/6 X DBA/2 (B6D2) F1 hybrid mice were challenged aerogenically with M. avium, M. intracellulare and M. scrofulaceum and the resulting lung and spleen infections were followed over a period of several months. Growth of the mouse virulent M. avium 724 and M. intracellulare D673 was more extensive in the susceptible (Balb/c or C57Bl/6) mice than it was in the resistant A/J and B6D2 strains. Oral challenge of normal C57Bl/6 mice with virulent M. avium-complex serotypes resulted in substantial infection of the gut-associated lymphoid tissues, the lungs and spleen. No infection developed when the mice were infected orally with the avirulent MAC serotypes. T-cell depleted Balb/c (nude or Thxb) mice infected with virulent M. avium developed markedly enhanced lung and spleen infections compared to those seen in the immunocompetent controls. T-cell depletion did not potentiate the systemic growth of the avirulent MAC strains. The significance of these growth patterns (especially in the T-cell depleted mouse) is discussed in relation to the development of life-threatening M. avium-complex infections in patients with Acquired Immune Deficiency Syndrome.     

燕滨扶正胶囊治疗代偿期及失代偿期肝硬化临床疗效观察研究

目的 研究中药燕滨扶正胶囊治疗肝硬化（代偿期或失代偿期）临床疗效。方法 选择代偿期及失代偿期肝硬化患者41例,随机分为治疗组（21例）及对照组（20例）。治疗组给予燕滨扶正胶囊1500 mg/次,口服,2次/日。对照组给予扶正化瘀胶囊2500 mg/次,3次/日。两组疗程均为48周。两组依据病情给予抗病毒,护肝降酶、对症支持等一般治疗（替比夫定、甘利欣、消炎利胆片、茵栀黄胶囊等）,观察两组患者症状、血常规、肝功能、门静脉宽度、腹水、肝脏及脾脏形态。结果 中药燕滨扶正胶囊联合抗病毒药物可使代偿期及失代偿期肝硬化患者门静脉宽度、脾肿大回缩或复常,可使纤维化指标复常或大幅下降且肝脏功能好转或复常。结论 燕滨扶正胶囊可改善肝硬化。     

Alterations in the growth plate associated with growth modulation by sustained compression or distraction

Sustained mechanical load is known to modulate endochondral growth in the immature skeleton, but it is not known what causes this mechanical sensitivity. This study aimed to quantify alterations in parameters of growth plate performance associated with mechanically altered growth rate. Vertebral and proximal tibial growth plates of immature rats and cattle, and rabbit (proximal tibia only) were subjected to different magnitudes of sustained loading, which altered growth rates by up to 53%. The numbers of proliferative chondrocytes, their rate of proliferation, and the amount of chondrocytic enlargement occurring in the hypertrophic zone were quantified. It was found that reduced growth rate with compression and increased growth rate with distraction were associated with corresponding changes in the number of proliferative chondrocytes per unit width of growth plate, and in the final (maximum) chondrocytic height in the hypertrophic zone (overall correlation coefficients 0.38 and 0.56 respectively). According to multiple linear regression coefficients for these two variables (0.72 and 1.39 respectively), chondrocytic enlargement made a greater contribution to altered growth rates.