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Byline: Yan. Xu, Li. Ding, Yong-Qiang. Zhang Background: It is challenging to identify robust elderly patients suitable for systemic chemotherapy. The goal of this study was to ascertain clinical characteristics [...]

Propionyl-CoA is an intermediate metabolite produced through a variety of pathways including thioesterification of propionate and catabolism of odd chain Fatty acids and select amino acids. Previously, we found that disruption of the methylcitrate synthase gene, mcsA, which blocks propionyl-CoA utilization, as well as growth on propionate impaired production of several polyketides--molecules typically derived from acetyl-CoA and malonyl-CoA--including sterigmatocystin (ST), a potent carcinogen, and the conidiospore pigment. Here we describe three lines of evidence that demonstrate that excessive propionyl-CoA levels in the cell can inhibit polyketide synthesis. First, inactivation of a putative propionyl-CoA synthase, PcsA, which converts propionate to propionyl-CoA, restored polyketide production and reduced cellular propionyl-CoA content in a [DELTA]mcsA background. Second, inactivation of the acetyl-CoA synthase. FacA, which is also involved in propionate utilization, restored polyketide production in the [DELTA]mcsA background. Third, fungal growth on several compounds (e.g., heptadecanoic acid, isoleucine, and methionine) whose catabolism includes the formation of propionyl-CoA, were found to inhibit ST and conidiospore pigment production. These results demonstrate that excessive propionyl-CoA levels in the cell can inhibit polyketide synthesis.

Background: It is challenging to identify robust elderly patients suitable for systemic chemotherapy. The goal of this study was to ascertain clinical characteristics that may best predict the most benefit of systemic chemotherapy for geriatric patients (aged ≥80 years) with advanced solid tumors.Methods: A retrospective cohort study was conducted of advanced solid tumors patients treated with systemic chemotherapy. We divided the patients into chemotherapy tolerant and intolerant groups. We assessed the efficacy, adverse reactions, progression-free survival, and overall survival of patients treated with chemotherapy. We accounted for comorbidities, Eastern Cooperative Oncology Group performance status (PS), activities of daily living (ADL), and routine serologic lab metrics. We compiled survival curves for the two groups, and Cox regression univariate and multivariate analyses were used to identify factors that influenced survival.Results: We included 84 patients in the analyses. Comorbidities ≤3, medications ≤4, ADL score ≥90, and PS score ≤1 were associated with chemotherapy tolerance (P < 0.05). Normal D-Dimer and serum albumin concentrations were associated with chemotherapy tolerance (P < 0.05). The median overall survival was 15.0 months (95% confidence interval [CI]: 12.8 - 17.2) in the tolerant group and 7.0 months (95% CI: 4.3 - 9.7) in the intolerant group (P < 0.05). Thus, most tolerant patients (79.6%) benefited from chemotherapy. PS, ADL, normal albumin, and chemotherapy tolerance were statistically correlated with overall survival (P < 0.05).Conclusion: Some clinical characteristics were associated with chemotherapy tolerance. The overall survival time of elderly patients with good tolerance to chemotherapy was longer. [ABSTRACT FROM AUTHOR]

Abstract Background Health related quality of life (HRQOL) has increasingly emphasized on cancer patients. The psychometric properties of the standard Chinese version of the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire 30 (EORTC QLQ-C30, version 3.0) in brain tumor patients wasn't proven, and there was no baseline HRQOL in brain tumor patients prior to surgery. Methods The questionnaire EORTC QLQ-C30 (version 3.0) was administered at three time points: T1, the first or the second day that patients were hospitalized after the brain tumor suspected or diagnosed by MRI or CT; T2, 1 to 2 days after T1, (T1 and T2 were both before surgery); T3, the day before discharge. Clinical variables included disease histologic types, cognitive function, and Karnofsky Performance Status. Results Cronbach's alpha coefficients for multi-item scales were greater than .70 and multitrait scaling analysis showed that most of the item-scale correlation coefficients met the standards of convergent and discriminant validity, except for the cognitive functioning scale. All scales and items exhibited construct validity. Score changes over peri-operation were observed in physical and role functioning scales. Compared with mixed cancer patients assessed after surgery but before adjuvant treatment, brain tumor patients assessed pre-surgery presented better function and fewer symptoms. Conclusions The standard Chinese version of the EORTC QLQ-C30 was overall a valid instrument to assess HRQOL in brain tumor patients in China. The baseline HRQOL in brain tumor patients pre-surgery was better than that in mixed cancer patients post-surgery. Future study should modify cognitive functioning scale and examine test-retest reliability and response validity.

Abstract Background Health-related quality of life (HRQOL) has been increasingly emphasized in cancer patients. There are no reports comparing baseline HRQOL of different subgroups of glioma patients prior to surgery. Methods HRQOL assessments by the standard Chinese version of the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire 30 (EORTC QLQ-C30, version 3.0), the Mini-Mental State Examination and Karnofsky Performance Status were obtained from glioma patients prior to surgery. Results Ninety-two pathologically confirmed glioma patients were recruited. There were 84.8% patients with emotional impairment, 75% with social and cognitive impairment, 70.7% with physical impairment, and 50% with role impairment. Eighty-two percent of patients reported fatigue symptoms, 72.8% reported pain, 50% reported appetite loss, 39.1% reported insomnia, and 36.9% reported nausea/vomiting, whereas other symptoms (dyspnea, diarrhea, constipation) in the QLQ-C30 were reported by fewer than 30% of patients. Fatigue and pain symptoms and all "functioning" scales were strongly correlated with global health status/quality of life (QoL). Fatigue was strongly related to all functioning scales, pain, appetite loss, and global health status/QoL. No difference in baseline HRQOL prior to surgery was reported between females and males, among different lesion locations, or between normal- and abnormal-cognition subgroups of glioma patients. Age, KPS, WHO grade, and tumor recurrence significantly affected HRQOL in glioma patients. Conclusions These data provided the baseline HRQOL in glioma patients prior to surgery in China. Most pre-surgery glioma patients indicated emotional, social, cognitive, physical, and role impairment. Fatigue, pain, appetite loss, insomnia, and nausea/vomiting were common in these patients. The fatigue and pain symptoms and all types of functioning strongly affected global health status/QoL. Old age, worse performance status, WHO grade IV and tumor recurrence had deleterious effects on HRQOL.

Objective To investigate the clinical significance of intraoperative B-ultrasound real- time monitoring in craniotomy for patients with severe traumatic brain injury (sTBI). Methods From March 2017 to June 2019, 64 patients with sTBI who met the admission criteria were included in the study. Craniotomy and/or decompressive craniectomy were performed. According to the application of real-time B- ultrasound-guided surgery, the patients were randomly divided into 2 groups: ultrasound group (n = 32) and control group (n = 32). The operation time, the number of new hematoma during and after operation, the probability of bone flap removal, the probability of second operation and Glasgow Coma Scale (GCS) score were recorded. Glasgow Outcome Scale (GOS) was used to evaluate the prognosis and calculate the good prognosis rate. Results In the ultrasound group, 32 cases were successfully operated under the guidance of B-ultrasound, and the detection rate of new hematoma was 76% (19/25). The rate of hematoma clearance rate > 90% [84.38% (27/32) vs. 59.38% (19/32); χ² = 4.947, P = 0.026], GCS score at 3 d after operation (11.38 ± 3.54 vs. 9.19 ± 3.81; t = 2.382, P = 0.020) and good prognosis rate at discharge [56.25% (18/32) vs. 31.25% (10/32); χ² = 0.077, P = 0.038] in the ultrasound group were higher than those in the control group, but there were no significant differences in the operation time, the probability of bone flap removal and the probability of second operation between 2 groups (P > 0.05, for all). Conclusions Intraoperative real-time B-ultrasound-guided surgery can improve the prognosis of patients with sTBI. [ABSTRACT FROM AUTHOR]