BACKGROUND Gastric cancer(GC)has a poor prognosis,and the accurate prediction of patient survival remains a significant challenge in oncology.Machine learning(ML)has emerged as a promising tool for survival prediction...BACKGROUND Gastric cancer(GC)has a poor prognosis,and the accurate prediction of patient survival remains a significant challenge in oncology.Machine learning(ML)has emerged as a promising tool for survival prediction,though concerns regarding model interpretability,reliance on retrospective data,and variability in performance persist.AIM To evaluate ML applications in predicting GC survival and to highlight key limitations in current methods.METHODS A comprehensive search of PubMed and Web of Science in November 2024 identified 16 relevant studies published after 2019.The most frequently used ML models were deep learning(37.5%),random forests(37.5%),support vector machines(31.25%),and ensemble methods(18.75%).The dataset sizes varied from 134 to 14177 patients,with nine studies incorporating external validation.RESULTS The reported area under the curve values were 0.669–0.980 for overall survival,0.920–0.960 for cancer-specific survival,and 0.710–0.856 for disease-free survival.These results highlight the potential of ML-based models to improve clinical practice by enabling personalized treatment planning and risk stratification.CONCLUSION Despite challenges concerning retrospective studies and a lack of interpretability,ML models show promise;prospective trials and multidimensional data integration are recommended for improving their clinical applicability.展开更多
Primary esophageal or gastric melanoma is a very rare disease with early metastasis. Due to its atypical symptom and less efficiency of chemotherapy and radiotherapy, the prognosis of esophageal or gastric melanoma is...Primary esophageal or gastric melanoma is a very rare disease with early metastasis. Due to its atypical symptom and less efficiency of chemotherapy and radiotherapy, the prognosis of esophageal or gastric melanoma is still very poor. Surgical resection remains the preferential treatment for esophageal or gastric melanoma. Here we present an extremely rare case of primary advanced esophago-gastric melanoma. Debulking surgery was performed without chemotherapy or radiotherapy. However, abdominal recurrence and hepatic metastases were found within one month by a postoperative follow-up computed tomography. Three and a half months after surgical resection, the patient died of extensive abdominal metastasis.展开更多
Extrathoracic solitary fibrous tumors(SFTs) have been described at almost every anatomic location of human body,but reports of SFT in the abdominal cavity are rare.We herein present a rare case of SFT originating from...Extrathoracic solitary fibrous tumors(SFTs) have been described at almost every anatomic location of human body,but reports of SFT in the abdominal cavity are rare.We herein present a rare case of SFT originating from greater omentum.Computed tomography revealed a 15.8 cm × 21.0 cm solid mass located at superior aspect of stomach.Open laparotomy confirmed its mesenchymal origin.Microscopically,its tissue was composed of non-organized and spindle-shaped cells exhibiting atypical nuclei,which were divided up by branching vessel and collagen bundles.Immunohistochemical staining showed that this tumor was negative for CD117,CD99,CD68,cytokeratin,calretinin,desmin,epithelial membrane antigen,F8 and S-100,but positive for CD34,bcl-2,α-smooth muscle actin and vimentin.The patient presented no evidence of recurrence during follow-up.SFT arising from abdominal cavity can be diagnosed by histological findings and immunohistochemical markers,especially for CD34 and bcl-2 positive cases.展开更多
In a recent paper,Hong et al developed an artificial intelligence(AI)-driven predictive scoring system for potential complications following laparoscopic radical gastrectomy for gastric cancer patients.They demonstrat...In a recent paper,Hong et al developed an artificial intelligence(AI)-driven predictive scoring system for potential complications following laparoscopic radical gastrectomy for gastric cancer patients.They demonstrated that integrating AI with random forest models significantly improved the preoperative prediction and patient outcome management accuracy.By incorporating data from multiple centers,their model ensures standardization,reliability,and broad applicability,distinguishing it from the prior models.The present study highlights AI's potential in clinical decision support,aiding in the preoperative and postoperative management of gastric cancer patients.Our findings may pave the way for future prospective studies to further enhance AI-supported diagnoses in clinical practice.展开更多
BACKGROUND Immunoinflammatory markers such as the peripheral blood neutrophil-tolymphocyte ratio(NLR)and the platelet-to-lymphocyte ratio(PLR)have gained considerable attention as prognostic markers in gastrointestina...BACKGROUND Immunoinflammatory markers such as the peripheral blood neutrophil-tolymphocyte ratio(NLR)and the platelet-to-lymphocyte ratio(PLR)have gained considerable attention as prognostic markers in gastrointestinal stromal tumors(GISTs).AIM To assess the prognostic value of Onodera’s Prognostic Nutritional Index(OPNI)for GISTs.METHODS All patients who had undergone surgical resection for a primary,localized GIST from 2009 to 2016 at our cancer center were initially and retrospectively identified.Recurrence-free survival(RFS)was calculated by the Kaplan-Meier method and compared by the log-rank test.We used multivariate Cox proportional hazard regression models to identify associations with outcome variables.RESULTS A total of 235 GISTs were identified and included for analysis under our inclusion criteria.Univariate and multivariate analyses both identified the OPNI as an independent prognostic marker,and the OPNI was associated with the primary site,tumor size,mitotic index,tumor rupture,necrosis,and modified NIH risk classification.Low OPNI(<51.30;hazard ratio=5.852;95% confidence interval:1.072–31.964;P=0.0414)was associated with worse RFS.The 2-and 5-year RFS rates of the patients with a low OPNI were 92.83% and 76.22%,respectively,whereas 100% and 98.41% were achieved by the patients with a high OPNI.CONCLUSION The preoperative OPNI is a novel and useful prognostic marker for GISTs.展开更多
BACKGROUND: Currently, prophylactic antibiotics are recommended only for cirrhotic patients with acute upper gastrointestinal bleeding(AUGIB);however, the benefit for other AUGIB patients remains undetermined. We aime...BACKGROUND: Currently, prophylactic antibiotics are recommended only for cirrhotic patients with acute upper gastrointestinal bleeding(AUGIB);however, the benefit for other AUGIB patients remains undetermined. We aimed to compare the clinical outcomes between patients with AUGIB with and without prophylactic antibiotics to identify the population that requires this therapy.METHODS: Patients with AUGIB admitted between 1st January 2019 and 31st December 2021 in the Emergency Department of Peking Union Medical College Hospital were enrolled. Patients were divided into the antibiotic and non-antibiotic groups. The primary outcome was in-hospital mortality, and the secondary outcome was the onset of new infection. The risk factors for mortality and infection were analyzed, and stratification analysis of prophylactic antibiotics was performed. Continuous data were analyzed using the t-test or nonparametric rank sum test, and categorical data were analyzed using the Chi-square test or Fisher's exact test. Indicators with significant differences between the groups were included for logistic regression analysis. A P-value <0.05 was considered statistically significant. RESULTS: A total of 392 individuals were included, among them, 281 patients received prophylactic antibiotics, and 111 patients did not receive prophylactic antibiotics. The mortality rates were significantly lower in the antibiotic group than in the non-antibiotics group(6.41% vs. 17.12%, P=0.001). The risk factors for infection were varicose veins(P=0.045) and endotracheal intubation(P=0.005) in the prophylactic antibiotic group, and endoscopic treatment(P=0.010) in the non-prophylactic antibiotic group. Stratified analyses showed that patients with age ≥ 65 years, endotracheal intubation, endoscopic treatment, and AUGIB of variceal etiologies benefited from prophylactic antibiotics.CONCLUSION: AUGIB patients may benefit from prophylactic antibiotics to decrease mortality, especially those aged ≥ 65 years and those with endotracheal intubation, endoscopic treatment, and variceal etiologies.展开更多
Ameloblastoma is a benign but locally aggressive odontogenic neoplasm that accounts for 10% of all tumors arising in the mandible and maxilla (1). Eighty percent of ameloblastomas arise in the mandible, and they are u...Ameloblastoma is a benign but locally aggressive odontogenic neoplasm that accounts for 10% of all tumors arising in the mandible and maxilla (1). Eighty percent of ameloblastomas arise in the mandible, and they are usually found in young adults. It frequently recurs if not adequately展开更多
Secretory carcinoma（SC）, previously described as mammary analogue secretory carcinoma（MASC）, is a recently described salivary gland tumor which morphologically resembles mammary secretory carcinoma. The first desc...Secretory carcinoma（SC）, previously described as mammary analogue secretory carcinoma（MASC）, is a recently described salivary gland tumor which morphologically resembles mammary secretory carcinoma. The first description of SC/MASC, reported by Skálová et al. in 2010, was as a rare salivary carcinoma imitating secretory carcinoma of the breast. SC/MASC is a unique salivary gland tumor with morphological overlap with acinic cell carcinoma（Aci CC）, mucoepidermoid carcinoma（MEC）, and adenocarcinoma not otherwise specified（ADCNOS）. SC/MASC shares similar clinicopathological features with Aci CC. As a critical difference between SC/MASC and Aci CC, SC/MASC characteristically has the chromosomal translocation t（12;15）（p13;q25） which leads to a fusion gene between the ETV6 gene on chromosome 12 and the NTRK3 gene on chromosome 15. This genetic background is an important differential diagnostic finding for excluding other salivary gland tumors and may be a critical factor determining the prognosis for patients with SC/MASC. Research in recent years has provided a large body of new data on SC/MASC and suggests the possibility that the ETV6-NTRK3 translocation could be a therapeutic target. Here, we review the morphological and clinicopathological features of SC/MASC and discuss new directions for therapy.展开更多
BACKGROUND The combination of programmed cell death protein-1(PD-1)inhibitor and che-motherapy is approved as a standard first-or second-line treatment in patients with advanced oesophageal or gastric cancer.However,i...BACKGROUND The combination of programmed cell death protein-1(PD-1)inhibitor and che-motherapy is approved as a standard first-or second-line treatment in patients with advanced oesophageal or gastric cancer.However,it is unclear whether this combination is superior to chemotherapy alone.AIM To assess the comparative effectiveness and tolerability of combining PD-1 inhibitors with chemotherapy vs chemotherapy alone in patients with advanced gastric cancer,gastroesophageal junction(GEJ)cancer,or oesophageal carcinoma.METHODS We searched the PubMed and Embase databases for studies that compared the efficacy and tolerance of PD-1 inhibitors in combination with chemotherapy vs chemotherapy alone in patients with advanced oesophageal or gastric cancer.We employed either random or fixed models to analyze the outcomes of each clinical trial,en-compassing data on overall survival(OS),progression-free survival(PFS),objective response rate,and adverse events(AEs).RESULTS Nine phase 3 clinical trials(7016 advanced oesophageal and gastric cancer patients)met the inclusion criteria.Our meta-analysis demonstrated that the pooled PD-1 inhibitor+chemotherapy group had a significantly longer OS than the chemotherapy-alone group[hazard ratio(HR)=0.76,95%confidence interval(CI):0.71-0.81];the pooled PFS result was consistent with that of OS(HR=0.67,95%CI:0.61-0.74).The count of patients achieving an objective response in the PD-1 inhibitor+chemotherapy group surpassed that of the chemotherapy-alone group[odds ratio(OR)=1.86,95%CI:1.59-2.18].AE incidence was also higher in the combination-therapy group than in the chemotherapy-alone group,regardless of whether≥grade 3 only(OR=1.30,95%CI:1.07-1.57)or all AE grades(OR=1.88,95%CI:1.39-2.54)were examined.We performed a subgroup analysis based on the programmed death-ligand 1(PD-L1)combined positive score(CPS)and noted extended OS and PFS durations within the CPS≥1,CPS≥5,and CPS≥10 subgroups of the PD-1 inhibitor+chemotherapy group.CONCLUSION In contrast to chemotherapy alone,the combination of PD-1 inhibitor and chemotherapy appears to present a more favorable option for initial or subsequent treatment in patients with gastric cancer,GEJ tumor,or oesophageal cancer.This holds true particularly for individuals with PD-L1 CPS scores of≥5 and≥10.展开更多
Sekeres et al. （1） conducted a multicenter randomized, controlled trial to compare whether azacitidine-based combinations with lenalidomide or vorinostat produce superior overall response rates to azacitidine in the...Sekeres et al. （1） conducted a multicenter randomized, controlled trial to compare whether azacitidine-based combinations with lenalidomide or vorinostat produce superior overall response rates to azacitidine in the treatment of myelodysplastic syndromes （MDS）. In that trial, 224 patients with higher-risk MDS and 53 with chronic myelomonocytic leukemia （CMML） were enrolled and randomly assigned to the ＂azacitidine＂ group, ＂azacitidine plus lenalidomide＂ group or ＂azacitidine plus vorinostat＂ group. The researchers found that patients with MDS treated with azacitidine-based combinations had similar response rate to azacitidine monotherapy. Using genomic mutation analysis, they found that the overall response rate to azacitidine-based treatment was higher for patients with mutations in DNMT3A and lower for those with mutations in SRSF2. Whereas in another study, Welch et al. enrolled 26 patients with MDS and 90 with acute myeloid leukemia （AML） who were treated with decitabine, and they found that patients with TP53 mutations had a higher response rate, but not those with DNMT3A mutations （2）. We propose that this big discrepancy in the conclusions between the two studies might have been caused by the presence of many co-interacting factors, e.g. study aims, DNA demethylating agents, treatment protocols, and patient sources.展开更多
Trans-anal barotrauma resulting from the use of air guns is rare in the emergency department.Early diagnosis and timely treatment can yield a good prognosis.The first published case of trans-anal barotrauma caused by ...Trans-anal barotrauma resulting from the use of air guns is rare in the emergency department.Early diagnosis and timely treatment can yield a good prognosis.The first published case of trans-anal barotrauma caused by a manually operated force pump was reported in 1904.[1]Colorectal injuries have the potential to progress to high-mortality complications,such as abdominal infection,peritonitis,and septic shock.[2,3]Herein,we report a case of trans-anal barotrauma in a man who presented with pneumoperitoneum,pneumomediastinum,and pneumoscrotum.We performed laparoscopic exploration and loop ileostomy on this patient.展开更多
Survival rates following radical surgery for gastric neuroendocrine neoplasms(g-NENs)are low,with high recurrence rates.This fact impacts patient prognosis and complicates postoperative management.Traditional prognost...Survival rates following radical surgery for gastric neuroendocrine neoplasms(g-NENs)are low,with high recurrence rates.This fact impacts patient prognosis and complicates postoperative management.Traditional prognostic models,including the Cox proportional hazards(CoxPH)model,have shown limited predictive power for postoperative survival in gastrointestinal neuroectodermal tumor patients.Machine learning methods offer a unique opportunity to analyze complex relationships within datasets,providing tools and methodologies to assess large volumes of high-dimensional,multimodal data generated by biological sciences.These methods show promise in predicting outcomes across various medical disciplines.In the context of g-NENs,utilizing machine learning to predict survival outcomes holds potential for personalized postoperative management strategies.This editorial reviews a study exploring the advantages and effectiveness of the random survival forest(RSF)model,using the lymph node ratio(LNR),in predicting disease-specific survival(DSS)in postoperative g-NEN patients stratified into low-risk and high-risk groups.The findings demonstrate that the RSF model,incorporating LNR,outperformed the CoxPH model in predicting DSS and constitutes an important step towards precision medicine.展开更多
BACKGROUND Many clinical studies for the long-term survival or efficacy of capecitabine plus oxaliplatin(XELOX)in colon cancer have already been studied,but its clinical benefit is controversial.AIM To evaluate the lo...BACKGROUND Many clinical studies for the long-term survival or efficacy of capecitabine plus oxaliplatin(XELOX)in colon cancer have already been studied,but its clinical benefit is controversial.AIM To evaluate the long-term efficacy of XELOX regimen in comparison with other adjuvant chemotherapy protocols in colon cancer.METHODS By searching the PubMed,EMBASE and Cochrane databases,a total of 12 randomized controlled trials involving 6698 stageⅢcolon cancer cases(XELOX protocol:n=3298 cases;other adjuvant chemotherapy protocol:n=3268 cases)were included.The parameter outcomes included the overall survival and the disease-free survival.The quality control of selected literature was based on the Jadad scale and the GRADE system.RESULTS In comparison to other adjuvant chemotherapy regimen,XELOX regimen showed a better overall survival(odds ratio=1.29,95% confidence interval:1.15-1.44,P<0.0001)and a better disease-free survival(odds ratio=1.32,95%confidence interval:1.18-1.46,P<0.0001)for colon cancer patients,suggesting the XELOX regimen can be a good option for postoperative treatment of stage III colon cancer.CONCLUSION The XELOX regimen can be a preferred option for adjuvant treatment of stageⅢcolon cancer after surgery.展开更多
Hereditary hearing loss is one of the most common neurosensory defects in humans. Approximately 70% of cases are nonsyndromic and could be inherited in autosomal domi- nant, autosomal recessive, mitochondrial, X-linke...Hereditary hearing loss is one of the most common neurosensory defects in humans. Approximately 70% of cases are nonsyndromic and could be inherited in autosomal domi- nant, autosomal recessive, mitochondrial, X-linked, and Y-linked manners （Wang et al., 2004; Alford, 2011）. The autosomal dominant type, comprising 15%-20% of non- syndromic hearing loss, is monogenic and genetically heterogeneous. Since the first dominant deafness locus （DFNA 1） was identified in 1992, a total of 64 DFNA loci have been mapped （DFNA1-DFNA64）,展开更多
This paper presents an energy resolution study of the JUNO experiment,incorporating the latest knowledge acquired during the detector construction phase.The determination of neutrino mass ordering in JUNO requires an ...This paper presents an energy resolution study of the JUNO experiment,incorporating the latest knowledge acquired during the detector construction phase.The determination of neutrino mass ordering in JUNO requires an exceptional energy resolution better than 3% at 1 MeV.To achieve this ambitious goal,significant efforts have been undertaken in the design and production of the key components of the JUNO detector.Various factors affecting the detection of inverse beta decay signals have an impact on the energy resolution,extending beyond the statistical fluctuations of the detected number of photons,such as the properties of the liquid scintillator,performance of photomultiplier tubes,and the energy reconstruction algorithm.To account for these effects,a full JUNO simulation and reconstruction approach is employed.This enables the modeling of all relevant effects and the evaluation of associated inputs to accurately estimate the energy resolution.The results of this study reveal an energy resolution of 2.95% at 1 Mev.Furthermore,this study assesses the contribution of major effects to the overall energy resolution budget.This analysis serves as a reference for interpreting future measurements of energy resolution during JUNO data collection.Moreover,it provides a guideline for comprehending the energy resolution characteristics of liquid scintillator-based detectors.展开更多
The Jiangmen Underground Neutrino Observatory(JUNO)is a multi-purpose neutrino experiment under construction in South China.This paper presents an updated estimate of JUNO’s sensitivity to neutrino mass ordering usin...The Jiangmen Underground Neutrino Observatory(JUNO)is a multi-purpose neutrino experiment under construction in South China.This paper presents an updated estimate of JUNO’s sensitivity to neutrino mass ordering using the reactor antineutrinos emitted from eight nuclear reactor cores in the Taishan and Yangjiang nuclear power plants.This measurement is planned by studying the fine interference pattern caused by quasi-vacuum oscillations in the oscillated antineutrino spectrum at a baseline of 52.5 km and is completely independent of the CP violating phase and neutrino mixing angleθ_(23).The sensitivity is obtained through a joint analysis of JUNO and Taishan Antineutrino Observatory(TAO)detectors utilizing the best available knowledge to date about the location and overburden of the JUNO experimental site,local and global nuclear reactors,JUNO and TAO detector responses,expected event rates and spectra of signals and backgrounds,and systematic uncertainties of analysis inputs.We find that a 3σmedian sensitivity to reject the wrong mass ordering hypothesis can be reached with an exposure of about 6.5 years×26.6 GW thermal power.展开更多
Background： The molecular genetic research showed the association between X-linked bearing loss and mutations in POU3F4. This research aimed to identify a POU3F4 mutation in a nonsyndromic X-linked recessive hearing ...Background： The molecular genetic research showed the association between X-linked bearing loss and mutations in POU3F4. This research aimed to identify a POU3F4 mutation in a nonsyndromic X-linked recessive hearing loss family. Methods： A series of clinical evaluations including medical history, otologic examinations, l：amily history, audiologic testing, and a high-resolution computed tomography scan were performed t＇or each patient. Bidirectional sequencing was carried out for all polymerase chain reaction products or＇the samples. Moreover, 834 controls with normal hearing were also tested. Results： The pedigree showed X-linkage recessive inheritance pattern, and pathogenic mutation （c.499C〉T） was identified in the proband and his family member, which led to a premature termination prior to the entire POU domains. This mutation co-segregated with bearing loss in this family. No mutation ofPOU3F4 gene was found in 834 controls. Conclusions： A nonsense mutation is identified in a family displaying the pedigree consistent with X-linked recessive pattern in POU3F4 gene. In addition, we may provide molecular diagnosis and genetic counseling for this family.展开更多
Auditory neuropathy spectrum disorder is a unique group of hearing dysfunctions characterized by preserved outer hair cell function and abnormal neural conduction of the auditory pathway. However, the pathogenic mecha...Auditory neuropathy spectrum disorder is a unique group of hearing dysfunctions characterized by preserved outer hair cell function and abnormal neural conduction of the auditory pathway. However, the pathogenic mechanism underlying this disorder is not clear. We therefore performed a systematic review of genetic mouse models with different gene mutations to provide a valuable tool for better understanding of the process and the possible molecular mechanisms. Of the 18 articles retrieved, nine met the required criteria. All biochemical, histological, and electrophysiological results were recorded for each of the mouse models, as was the transgenic technology. This review provides a summary of different mouse models that may play an important role in the diagnosis and management of auditory neuropathy spectrum disorder in the future.展开更多
The Jiangmen Underground Neutrino Observatory(JUNO)is a large liquid scintillator detector designed to explore many topics in fundamental physics.In this study,the potential of searching for proton decay in the p→νK...The Jiangmen Underground Neutrino Observatory(JUNO)is a large liquid scintillator detector designed to explore many topics in fundamental physics.In this study,the potential of searching for proton decay in the p→νK^(+)mode with JUNO is investigated.The kaon and its decay particles feature a clear three-fold coincidence signature that results in a high efficiency for identification.Moreover,the excellent energy resolution of JUNO permits suppression of the sizable background caused by other delayed signals.Based on these advantages,the detection efficiency for the proton decay via p→νK^(+)is 36.9%±4.9%with a background level of 0.2±0.05(syst)±0.2(stat)events after 10 years of data collection.The estimated sensitivity based on 200 kton-years of exposure is 9.6×1033 years,which is competitive with the current best limits on the proton lifetime in this channel and complements the use of different detection technologies.展开更多
文摘BACKGROUND Gastric cancer(GC)has a poor prognosis,and the accurate prediction of patient survival remains a significant challenge in oncology.Machine learning(ML)has emerged as a promising tool for survival prediction,though concerns regarding model interpretability,reliance on retrospective data,and variability in performance persist.AIM To evaluate ML applications in predicting GC survival and to highlight key limitations in current methods.METHODS A comprehensive search of PubMed and Web of Science in November 2024 identified 16 relevant studies published after 2019.The most frequently used ML models were deep learning(37.5%),random forests(37.5%),support vector machines(31.25%),and ensemble methods(18.75%).The dataset sizes varied from 134 to 14177 patients,with nine studies incorporating external validation.RESULTS The reported area under the curve values were 0.669–0.980 for overall survival,0.920–0.960 for cancer-specific survival,and 0.710–0.856 for disease-free survival.These results highlight the potential of ML-based models to improve clinical practice by enabling personalized treatment planning and risk stratification.CONCLUSION Despite challenges concerning retrospective studies and a lack of interpretability,ML models show promise;prospective trials and multidimensional data integration are recommended for improving their clinical applicability.
文摘Primary esophageal or gastric melanoma is a very rare disease with early metastasis. Due to its atypical symptom and less efficiency of chemotherapy and radiotherapy, the prognosis of esophageal or gastric melanoma is still very poor. Surgical resection remains the preferential treatment for esophageal or gastric melanoma. Here we present an extremely rare case of primary advanced esophago-gastric melanoma. Debulking surgery was performed without chemotherapy or radiotherapy. However, abdominal recurrence and hepatic metastases were found within one month by a postoperative follow-up computed tomography. Three and a half months after surgical resection, the patient died of extensive abdominal metastasis.
文摘Extrathoracic solitary fibrous tumors(SFTs) have been described at almost every anatomic location of human body,but reports of SFT in the abdominal cavity are rare.We herein present a rare case of SFT originating from greater omentum.Computed tomography revealed a 15.8 cm × 21.0 cm solid mass located at superior aspect of stomach.Open laparotomy confirmed its mesenchymal origin.Microscopically,its tissue was composed of non-organized and spindle-shaped cells exhibiting atypical nuclei,which were divided up by branching vessel and collagen bundles.Immunohistochemical staining showed that this tumor was negative for CD117,CD99,CD68,cytokeratin,calretinin,desmin,epithelial membrane antigen,F8 and S-100,but positive for CD34,bcl-2,α-smooth muscle actin and vimentin.The patient presented no evidence of recurrence during follow-up.SFT arising from abdominal cavity can be diagnosed by histological findings and immunohistochemical markers,especially for CD34 and bcl-2 positive cases.
文摘In a recent paper,Hong et al developed an artificial intelligence(AI)-driven predictive scoring system for potential complications following laparoscopic radical gastrectomy for gastric cancer patients.They demonstrated that integrating AI with random forest models significantly improved the preoperative prediction and patient outcome management accuracy.By incorporating data from multiple centers,their model ensures standardization,reliability,and broad applicability,distinguishing it from the prior models.The present study highlights AI's potential in clinical decision support,aiding in the preoperative and postoperative management of gastric cancer patients.Our findings may pave the way for future prospective studies to further enhance AI-supported diagnoses in clinical practice.
基金Supported by Health Commission of Shanxi Province,No.2020130 and No.2020TD27the Science and Technology Planning Project of Yangzhou City,No.YZ2018092。
文摘BACKGROUND Immunoinflammatory markers such as the peripheral blood neutrophil-tolymphocyte ratio(NLR)and the platelet-to-lymphocyte ratio(PLR)have gained considerable attention as prognostic markers in gastrointestinal stromal tumors(GISTs).AIM To assess the prognostic value of Onodera’s Prognostic Nutritional Index(OPNI)for GISTs.METHODS All patients who had undergone surgical resection for a primary,localized GIST from 2009 to 2016 at our cancer center were initially and retrospectively identified.Recurrence-free survival(RFS)was calculated by the Kaplan-Meier method and compared by the log-rank test.We used multivariate Cox proportional hazard regression models to identify associations with outcome variables.RESULTS A total of 235 GISTs were identified and included for analysis under our inclusion criteria.Univariate and multivariate analyses both identified the OPNI as an independent prognostic marker,and the OPNI was associated with the primary site,tumor size,mitotic index,tumor rupture,necrosis,and modified NIH risk classification.Low OPNI(<51.30;hazard ratio=5.852;95% confidence interval:1.072–31.964;P=0.0414)was associated with worse RFS.The 2-and 5-year RFS rates of the patients with a low OPNI were 92.83% and 76.22%,respectively,whereas 100% and 98.41% were achieved by the patients with a high OPNI.CONCLUSION The preoperative OPNI is a novel and useful prognostic marker for GISTs.
文摘BACKGROUND: Currently, prophylactic antibiotics are recommended only for cirrhotic patients with acute upper gastrointestinal bleeding(AUGIB);however, the benefit for other AUGIB patients remains undetermined. We aimed to compare the clinical outcomes between patients with AUGIB with and without prophylactic antibiotics to identify the population that requires this therapy.METHODS: Patients with AUGIB admitted between 1st January 2019 and 31st December 2021 in the Emergency Department of Peking Union Medical College Hospital were enrolled. Patients were divided into the antibiotic and non-antibiotic groups. The primary outcome was in-hospital mortality, and the secondary outcome was the onset of new infection. The risk factors for mortality and infection were analyzed, and stratification analysis of prophylactic antibiotics was performed. Continuous data were analyzed using the t-test or nonparametric rank sum test, and categorical data were analyzed using the Chi-square test or Fisher's exact test. Indicators with significant differences between the groups were included for logistic regression analysis. A P-value <0.05 was considered statistically significant. RESULTS: A total of 392 individuals were included, among them, 281 patients received prophylactic antibiotics, and 111 patients did not receive prophylactic antibiotics. The mortality rates were significantly lower in the antibiotic group than in the non-antibiotics group(6.41% vs. 17.12%, P=0.001). The risk factors for infection were varicose veins(P=0.045) and endotracheal intubation(P=0.005) in the prophylactic antibiotic group, and endoscopic treatment(P=0.010) in the non-prophylactic antibiotic group. Stratified analyses showed that patients with age ≥ 65 years, endotracheal intubation, endoscopic treatment, and AUGIB of variceal etiologies benefited from prophylactic antibiotics.CONCLUSION: AUGIB patients may benefit from prophylactic antibiotics to decrease mortality, especially those aged ≥ 65 years and those with endotracheal intubation, endoscopic treatment, and variceal etiologies.
文摘Ameloblastoma is a benign but locally aggressive odontogenic neoplasm that accounts for 10% of all tumors arising in the mandible and maxilla (1). Eighty percent of ameloblastomas arise in the mandible, and they are usually found in young adults. It frequently recurs if not adequately
文摘Secretory carcinoma（SC）, previously described as mammary analogue secretory carcinoma（MASC）, is a recently described salivary gland tumor which morphologically resembles mammary secretory carcinoma. The first description of SC/MASC, reported by Skálová et al. in 2010, was as a rare salivary carcinoma imitating secretory carcinoma of the breast. SC/MASC is a unique salivary gland tumor with morphological overlap with acinic cell carcinoma（Aci CC）, mucoepidermoid carcinoma（MEC）, and adenocarcinoma not otherwise specified（ADCNOS）. SC/MASC shares similar clinicopathological features with Aci CC. As a critical difference between SC/MASC and Aci CC, SC/MASC characteristically has the chromosomal translocation t（12;15）（p13;q25） which leads to a fusion gene between the ETV6 gene on chromosome 12 and the NTRK3 gene on chromosome 15. This genetic background is an important differential diagnostic finding for excluding other salivary gland tumors and may be a critical factor determining the prognosis for patients with SC/MASC. Research in recent years has provided a large body of new data on SC/MASC and suggests the possibility that the ETV6-NTRK3 translocation could be a therapeutic target. Here, we review the morphological and clinicopathological features of SC/MASC and discuss new directions for therapy.
文摘BACKGROUND The combination of programmed cell death protein-1(PD-1)inhibitor and che-motherapy is approved as a standard first-or second-line treatment in patients with advanced oesophageal or gastric cancer.However,it is unclear whether this combination is superior to chemotherapy alone.AIM To assess the comparative effectiveness and tolerability of combining PD-1 inhibitors with chemotherapy vs chemotherapy alone in patients with advanced gastric cancer,gastroesophageal junction(GEJ)cancer,or oesophageal carcinoma.METHODS We searched the PubMed and Embase databases for studies that compared the efficacy and tolerance of PD-1 inhibitors in combination with chemotherapy vs chemotherapy alone in patients with advanced oesophageal or gastric cancer.We employed either random or fixed models to analyze the outcomes of each clinical trial,en-compassing data on overall survival(OS),progression-free survival(PFS),objective response rate,and adverse events(AEs).RESULTS Nine phase 3 clinical trials(7016 advanced oesophageal and gastric cancer patients)met the inclusion criteria.Our meta-analysis demonstrated that the pooled PD-1 inhibitor+chemotherapy group had a significantly longer OS than the chemotherapy-alone group[hazard ratio(HR)=0.76,95%confidence interval(CI):0.71-0.81];the pooled PFS result was consistent with that of OS(HR=0.67,95%CI:0.61-0.74).The count of patients achieving an objective response in the PD-1 inhibitor+chemotherapy group surpassed that of the chemotherapy-alone group[odds ratio(OR)=1.86,95%CI:1.59-2.18].AE incidence was also higher in the combination-therapy group than in the chemotherapy-alone group,regardless of whether≥grade 3 only(OR=1.30,95%CI:1.07-1.57)or all AE grades(OR=1.88,95%CI:1.39-2.54)were examined.We performed a subgroup analysis based on the programmed death-ligand 1(PD-L1)combined positive score(CPS)and noted extended OS and PFS durations within the CPS≥1,CPS≥5,and CPS≥10 subgroups of the PD-1 inhibitor+chemotherapy group.CONCLUSION In contrast to chemotherapy alone,the combination of PD-1 inhibitor and chemotherapy appears to present a more favorable option for initial or subsequent treatment in patients with gastric cancer,GEJ tumor,or oesophageal cancer.This holds true particularly for individuals with PD-L1 CPS scores of≥5 and≥10.
文摘Sekeres et al. （1） conducted a multicenter randomized, controlled trial to compare whether azacitidine-based combinations with lenalidomide or vorinostat produce superior overall response rates to azacitidine in the treatment of myelodysplastic syndromes （MDS）. In that trial, 224 patients with higher-risk MDS and 53 with chronic myelomonocytic leukemia （CMML） were enrolled and randomly assigned to the ＂azacitidine＂ group, ＂azacitidine plus lenalidomide＂ group or ＂azacitidine plus vorinostat＂ group. The researchers found that patients with MDS treated with azacitidine-based combinations had similar response rate to azacitidine monotherapy. Using genomic mutation analysis, they found that the overall response rate to azacitidine-based treatment was higher for patients with mutations in DNMT3A and lower for those with mutations in SRSF2. Whereas in another study, Welch et al. enrolled 26 patients with MDS and 90 with acute myeloid leukemia （AML） who were treated with decitabine, and they found that patients with TP53 mutations had a higher response rate, but not those with DNMT3A mutations （2）. We propose that this big discrepancy in the conclusions between the two studies might have been caused by the presence of many co-interacting factors, e.g. study aims, DNA demethylating agents, treatment protocols, and patient sources.
基金supported by National High Level Hospital Clinical Research Funding(2022-PUMCH-B-110).
文摘Trans-anal barotrauma resulting from the use of air guns is rare in the emergency department.Early diagnosis and timely treatment can yield a good prognosis.The first published case of trans-anal barotrauma caused by a manually operated force pump was reported in 1904.[1]Colorectal injuries have the potential to progress to high-mortality complications,such as abdominal infection,peritonitis,and septic shock.[2,3]Herein,we report a case of trans-anal barotrauma in a man who presented with pneumoperitoneum,pneumomediastinum,and pneumoscrotum.We performed laparoscopic exploration and loop ileostomy on this patient.
文摘Survival rates following radical surgery for gastric neuroendocrine neoplasms(g-NENs)are low,with high recurrence rates.This fact impacts patient prognosis and complicates postoperative management.Traditional prognostic models,including the Cox proportional hazards(CoxPH)model,have shown limited predictive power for postoperative survival in gastrointestinal neuroectodermal tumor patients.Machine learning methods offer a unique opportunity to analyze complex relationships within datasets,providing tools and methodologies to assess large volumes of high-dimensional,multimodal data generated by biological sciences.These methods show promise in predicting outcomes across various medical disciplines.In the context of g-NENs,utilizing machine learning to predict survival outcomes holds potential for personalized postoperative management strategies.This editorial reviews a study exploring the advantages and effectiveness of the random survival forest(RSF)model,using the lymph node ratio(LNR),in predicting disease-specific survival(DSS)in postoperative g-NEN patients stratified into low-risk and high-risk groups.The findings demonstrate that the RSF model,incorporating LNR,outperformed the CoxPH model in predicting DSS and constitutes an important step towards precision medicine.
文摘BACKGROUND Many clinical studies for the long-term survival or efficacy of capecitabine plus oxaliplatin(XELOX)in colon cancer have already been studied,but its clinical benefit is controversial.AIM To evaluate the long-term efficacy of XELOX regimen in comparison with other adjuvant chemotherapy protocols in colon cancer.METHODS By searching the PubMed,EMBASE and Cochrane databases,a total of 12 randomized controlled trials involving 6698 stageⅢcolon cancer cases(XELOX protocol:n=3298 cases;other adjuvant chemotherapy protocol:n=3268 cases)were included.The parameter outcomes included the overall survival and the disease-free survival.The quality control of selected literature was based on the Jadad scale and the GRADE system.RESULTS In comparison to other adjuvant chemotherapy regimen,XELOX regimen showed a better overall survival(odds ratio=1.29,95% confidence interval:1.15-1.44,P<0.0001)and a better disease-free survival(odds ratio=1.32,95%confidence interval:1.18-1.46,P<0.0001)for colon cancer patients,suggesting the XELOX regimen can be a good option for postoperative treatment of stage III colon cancer.CONCLUSION The XELOX regimen can be a preferred option for adjuvant treatment of stageⅢcolon cancer after surgery.
基金supported by the grants from the National Natural Science Foundation of China,key project(No.30830104) and major project(No.81120108009)
文摘Hereditary hearing loss is one of the most common neurosensory defects in humans. Approximately 70% of cases are nonsyndromic and could be inherited in autosomal domi- nant, autosomal recessive, mitochondrial, X-linked, and Y-linked manners （Wang et al., 2004; Alford, 2011）. The autosomal dominant type, comprising 15%-20% of non- syndromic hearing loss, is monogenic and genetically heterogeneous. Since the first dominant deafness locus （DFNA 1） was identified in 1992, a total of 64 DFNA loci have been mapped （DFNA1-DFNA64）,
基金Supported by the Chinese Academy of Sciencesthe National Key R&D Program of China+20 种基金the CAS Center for Excellence in Particle Physics,Wuyi Universitythe Tsung-Dao Lee Institute of Shanghai Jiao Tong University in Chinathe Institut National de Physique Nucléaire et de Physique de Particules(IN2P3)in Francethe Istituto Nazionale di Fisica Nucleare(INFN)in Italythe Italian-Chinese collaborative research program MAECI-NSFCthe Fond de la Recherche Scientifique(F.R.S-FNRS)FWO under the"Excellence of Science-EOS"in Belgiumthe Conselho Nacional de Desenvolvimento Científico e Tecnològico in Brazilthe Agencia Nacional de Investigacion y Desarrollo and ANID Millennium Science Initiative Program—ICN2019_044 in Chilethe Charles University Research Centre and the Ministry of Education,Youth,and Sports in Czech Republicthe Deutsche Forschungsgemeinschaft(DFG)the Helmholtz Associationthe Cluster of Excellence PRISMA+in Germanythe Joint Institute of Nuclear Research(JINR)Lomonosov Moscow State University in Russiathe joint Russian Science Foundation(RSF)National Natural Science Foundation of China(NSFC)research programthe MOST and MOE in Taiwan,Chinathe Chulalongkorn University and Suranaree University of Technology in Thailandthe University of California at Irvinethe National Science Foundation in USA。
文摘This paper presents an energy resolution study of the JUNO experiment,incorporating the latest knowledge acquired during the detector construction phase.The determination of neutrino mass ordering in JUNO requires an exceptional energy resolution better than 3% at 1 MeV.To achieve this ambitious goal,significant efforts have been undertaken in the design and production of the key components of the JUNO detector.Various factors affecting the detection of inverse beta decay signals have an impact on the energy resolution,extending beyond the statistical fluctuations of the detected number of photons,such as the properties of the liquid scintillator,performance of photomultiplier tubes,and the energy reconstruction algorithm.To account for these effects,a full JUNO simulation and reconstruction approach is employed.This enables the modeling of all relevant effects and the evaluation of associated inputs to accurately estimate the energy resolution.The results of this study reveal an energy resolution of 2.95% at 1 Mev.Furthermore,this study assesses the contribution of major effects to the overall energy resolution budget.This analysis serves as a reference for interpreting future measurements of energy resolution during JUNO data collection.Moreover,it provides a guideline for comprehending the energy resolution characteristics of liquid scintillator-based detectors.
基金Supported by the Chinese Academy of Sciences,the National Key R&D Program of Chinathe CAS Center for Excellence in Particle Physics,Wuyi University,and the TsungDao Lee Institute of Shanghai Jiao Tong University in China+3 种基金the Institut National de Physique Nucléaire et de Physique de Particules(IN2P3)in Francethe Istituto Nazionale di Fisica Nucleare(INFN)in Italy,the Italian-Chinese collaborative research program MAECI-NSFC,the Fond de la Recherche Scientifique(F.R.S-FNRS)and FWO under the“Excellence of Science–EOS”in Belgium,the Conselho Nacional de Desenvolvimento Cient´ıfico e Tecnol`ogico in Brazil,the Agencia Nacional de Investigacion y Desarrollo and ANID-Millennium Science Initiative Program-ICN2019_044 in Chilethe Charles University Research Centre and the Ministry of Education,Youth,and Sports in Czech Republic,the Deutsche Forschungsgemeinschaft(DFG)the Helmholtz Association,and the Cluster of Excellence PRISMA+in Germany,the Joint Institute of Nuclear Research(JINR)and Lomonosov Moscow State University in Russia,the joint Russian Science Foundation(RSF)and National Natural Science Foundation of China(NSFC)research program,the MOST and MOE in Taiwan,China,the Chulalongkorn University and Suranaree University of Technology in Thailand,University of California at Irvine and the National Science Foundation in the US。
文摘The Jiangmen Underground Neutrino Observatory(JUNO)is a multi-purpose neutrino experiment under construction in South China.This paper presents an updated estimate of JUNO’s sensitivity to neutrino mass ordering using the reactor antineutrinos emitted from eight nuclear reactor cores in the Taishan and Yangjiang nuclear power plants.This measurement is planned by studying the fine interference pattern caused by quasi-vacuum oscillations in the oscillated antineutrino spectrum at a baseline of 52.5 km and is completely independent of the CP violating phase and neutrino mixing angleθ_(23).The sensitivity is obtained through a joint analysis of JUNO and Taishan Antineutrino Observatory(TAO)detectors utilizing the best available knowledge to date about the location and overburden of the JUNO experimental site,local and global nuclear reactors,JUNO and TAO detector responses,expected event rates and spectra of signals and backgrounds,and systematic uncertainties of analysis inputs.We find that a 3σmedian sensitivity to reject the wrong mass ordering hypothesis can be reached with an exposure of about 6.5 years×26.6 GW thermal power.
基金This work was supported by the grants from the National Key Basic Research Program of China （No.2014CB943001）, the National Natural Science Foundation of China （No. 81120108009 and No. 81530032）, and the China Postdoctoral Science Foundation （No.2015M572690）.
文摘Background： The molecular genetic research showed the association between X-linked bearing loss and mutations in POU3F4. This research aimed to identify a POU3F4 mutation in a nonsyndromic X-linked recessive hearing loss family. Methods： A series of clinical evaluations including medical history, otologic examinations, l：amily history, audiologic testing, and a high-resolution computed tomography scan were performed t＇or each patient. Bidirectional sequencing was carried out for all polymerase chain reaction products or＇the samples. Moreover, 834 controls with normal hearing were also tested. Results： The pedigree showed X-linkage recessive inheritance pattern, and pathogenic mutation （c.499C〉T） was identified in the proband and his family member, which led to a premature termination prior to the entire POU domains. This mutation co-segregated with bearing loss in this family. No mutation ofPOU3F4 gene was found in 834 controls. Conclusions： A nonsense mutation is identified in a family displaying the pedigree consistent with X-linked recessive pattern in POU3F4 gene. In addition, we may provide molecular diagnosis and genetic counseling for this family.
基金supported by the National Key Basic Research Program of China (2014CB943001)the National Natural Science Foundation of China (81120108009, 81530032)
文摘Auditory neuropathy spectrum disorder is a unique group of hearing dysfunctions characterized by preserved outer hair cell function and abnormal neural conduction of the auditory pathway. However, the pathogenic mechanism underlying this disorder is not clear. We therefore performed a systematic review of genetic mouse models with different gene mutations to provide a valuable tool for better understanding of the process and the possible molecular mechanisms. Of the 18 articles retrieved, nine met the required criteria. All biochemical, histological, and electrophysiological results were recorded for each of the mouse models, as was the transgenic technology. This review provides a summary of different mouse models that may play an important role in the diagnosis and management of auditory neuropathy spectrum disorder in the future.
基金supported by the Chinese Academy of Sciencesthe National Key R&D Program of China+22 种基金the CAS Center for Excellence in Particle PhysicsWuyi Universitythe Tsung-Dao Lee Institute of Shanghai Jiao Tong University in Chinathe Institut National de Physique Nucléaire et de Physique de Particules (IN2P3) in Francethe Istituto Nazionale di Fisica Nucleare (INFN) in Italythe Italian-Chinese collaborative research program MAECI-NSFCthe Fond de la Recherche Scientifique (F.R.S-FNRS)FWO under the "Excellence of Science-EOS" in Belgiumthe Conselho Nacional de Desenvolvimento Científico e Tecnològico in Brazilthe Agencia Nacional de Investigacion y Desarrollo in Chilethe Charles University Research Centrethe Ministry of Education,Youth,and Sports in Czech Republicthe Deutsche Forschungsgemeinschaft (DFG)the Helmholtz Associationthe Cluster of Excellence PRISMA+ in Germanythe Joint Institute of Nuclear Research (JINR)Lomonosov Moscow State University in Russiathe joint Russian Science Foundation (RSF)National Natural Science Foundation of China (NSFC) research programthe MOST and MOE in Taiwan,Chinathe Chulalongkorn UniversitySuranaree University of Technology in Thailandthe University of California at Irvine in USA
文摘The Jiangmen Underground Neutrino Observatory(JUNO)is a large liquid scintillator detector designed to explore many topics in fundamental physics.In this study,the potential of searching for proton decay in the p→νK^(+)mode with JUNO is investigated.The kaon and its decay particles feature a clear three-fold coincidence signature that results in a high efficiency for identification.Moreover,the excellent energy resolution of JUNO permits suppression of the sizable background caused by other delayed signals.Based on these advantages,the detection efficiency for the proton decay via p→νK^(+)is 36.9%±4.9%with a background level of 0.2±0.05(syst)±0.2(stat)events after 10 years of data collection.The estimated sensitivity based on 200 kton-years of exposure is 9.6×1033 years,which is competitive with the current best limits on the proton lifetime in this channel and complements the use of different detection technologies.
