To the Editor:Hepatocellular carcinoma (HCC) is one of the most common lethal cancers and is the leading cause of cancer mortality worldwide [1].In recent years,developments in locoregional therapies have provided new...To the Editor:Hepatocellular carcinoma (HCC) is one of the most common lethal cancers and is the leading cause of cancer mortality worldwide [1].In recent years,developments in locoregional therapies have provided new options for the treatment of HCC,which are recommended by the international guidelines including the Barcelona Clinic Liver Cancer (BCLC) and the American Joint Committee on Cancer (AJCC)[2].展开更多
Objective:Colorectal cancer(CRC)surgeries can be performed using either laparoscopic or open laparotomy approaches.However,the long-term outcomes based on tumor location and age remain unclear.This study compared the ...Objective:Colorectal cancer(CRC)surgeries can be performed using either laparoscopic or open laparotomy approaches.However,the long-term outcomes based on tumor location and age remain unclear.This study compared the long-term outcomes of laparoscopic and laparotomy surgeries in patients with CRC,focusing on tumor location and age to identify suitable subgroups and determine an optimal cut-off age.Methods:This retrospective study analyzed 2,014 patients with CRC who underwent radical surgery.Patients were categorized into laparoscopy and laparotomy groups,and propensity score matching(PSM)was performed.Kaplan-Meier analysis,log-rank tests,and Cox regression models were used to identify the independent factors affecting overall survival(OS).Results:Analysis results before PSM indicated higher OS in the laparoscopy group(P=0.035);however,it was no significant difference in mean OS between the two groups after PSM analysis.Cox regression analysis identified several factors influencing the OS of patients with CRC,with age,T stage,nodal involvement,poorly differentiated adenocarcinoma,ascites,preoperative intestinal obstruction,and local tumor spread as independent risk factors.Family history was a protective factor[hazard ratio(HR)=0.33;95%CI,0.16-0.68;P=0.002],and the surgical modality did not independently affect OS.The subgroup analysis highlighted the advantages of laparoscopic surgery in specific subgroups.Conclusions:Overall,laparoscopic and laparotomy surgeries resulted in similar mid-and long-term prognoses for patients with CRC.Laparoscopic surgery showed better outcomes in specific subgroups,particularly in patients aged>60 years and in those with right-sided colon carcinoma.This study suggests that age>64 years might be the optimal cut-off age for laparoscopic surgery.展开更多
Objective： For patients with locally advanced rectal cancer treated with neoadjuvant chemoradiotherapy（NCRT）, significant pathological response of the primary tumor has been proposed to identify candidates for orga...Objective： For patients with locally advanced rectal cancer treated with neoadjuvant chemoradiotherapy（NCRT）, significant pathological response of the primary tumor has been proposed to identify candidates for organ preservation. However, this does not address metastatic lymph nodes in the mesorectum. The aim of this study was to assess the incidence of lymph node metastases in ypT0 patients treated with NCRT and curative resection and to explore risk factors associated with survival.Methods： This was a retrospective study of patients with ypT0 rectal cancer after NCRT and curative resection at a tertiary care center in China from 2005 to 2014.Results： A total of 60（18.6%） patients who underwent surgery after NCRT and achieved ypT0 were enrolled in this study; one patient was excluded owing to lack of follow-up. Of these 59 patients, lymph node metastases were found in the mesorectum（ypT0N＋） in eight（13.6%） patients. After a median follow-up of 52 months, 5-year recurrence-free survival（82.7% vs. 62.5%, P=0.014） and overall survival（OS）（90.9% vs. 70.0%, P=0.032） were much higher in ypN0 than yp N＋ patients. Multivariate analyses showed that ypN＋ status（P=0.009） and perioperative blood transfusion（BT）（P=0.001） were significantly independent risk factors associated with recurrence; however, no factor was correlated with 5-year OS.Conclusions： Patients with ypT0N0 rectal cancer can achieve excellent long-term outcomes; however, positive lymph nodes or tumor deposits can still be found in 13.6% of ypT0 patients. Nodal positivity in the mesorectum and perioperative BT are independent risk factors for recurrence.展开更多
AIM To systematically evaluate the prognostic-predictive capability of Bcl-2 in colorectal cancer(CRC).METHODS A systematic literature search was conducted using Pub Med,Web of Science and EMBASE databases. Any eligib...AIM To systematically evaluate the prognostic-predictive capability of Bcl-2 in colorectal cancer(CRC).METHODS A systematic literature search was conducted using Pub Med,Web of Science and EMBASE databases. Any eligible study must meet the following criteria:(1) bcl-2 expression was evaluated in human CRC tissues by immunohistochemistry;(2) assessment of the relationships between bcl-2 expression and overall survival(OS),disease free survival(DFS),recurrent free survival(RFS) or clinic-pathological characteristics of CRC was included;(3) sufficient information was provided to estimate the hazard ratio(HR) or odds ratio and their 95% confidence intervals(CIs); and(4) the study was published in English. The impact of Bcl-2 expression on survival of CRC patients were evaluated through this meta-analysis.RESULTS A total of 40 eligible articles involving 7658 patients were enrolled in our final analysis. We drew the conclusion that Bcl-2 high expression was significantly correlated with favorable OS(pooled HR = 0.69,95%CI: 0.55-0.87,P = 0.002) and better DFS/RFS(pooled HR = 0.65,95%CI: 0.50-0.85,P = 0.001). Additionally,the subgroup analysis suggested that Bcl-2 overexpression was significantly associated withprognosis(OS) especially in patients came from Europe and America but not Asian and patients who did not receive any adjuvant therapy before surgery. Finally,our present results indicated that expression of bcl-2 protein was associated with high differentiation grade and A/B Ducks' stage. CONCLUSION Bcl-2 high expression was significantly correlated with favorable OS and better DFS/RFS. Hence,we propose that Bcl-2 may be a valuable prognostic-predictive marker in CRC.展开更多
Task scheduling plays a crucial role in cloud computing and is a key factor determining cloud computing performance.To solve the task scheduling problem for remote sensing data processing in cloud computing,this paper...Task scheduling plays a crucial role in cloud computing and is a key factor determining cloud computing performance.To solve the task scheduling problem for remote sensing data processing in cloud computing,this paper proposes a workflow task scheduling algorithm—Workflow Task Scheduling Algorithm based on Deep Reinforcement Learning(WDRL).The remote sensing data process modeling is transformed into a directed acyclic graph scheduling problem.Then,the algorithm is designed by establishing a Markov decision model and adopting a fitness calculation method.Finally,combine the advantages of reinforcement learning and deep neural networks to minimize make-time for remote sensing data processes from experience.The experiment is based on the development of CloudSim and Python and compares the change of completion time in the process of remote sensing data.The results showthat compared with several traditionalmeta-heuristic scheduling algorithms,WDRL can effectively achieve the goal of optimizing task scheduling efficiency.展开更多
基金supported by grants from National S&T Major Project (2018ZX10301201)National Science Foundation of China (8202780008, 82070516 and 82027803)+1 种基金Zhejiang Provincial Natural Science Foundation (LZ21H160002 and LY19H040014)Medical Health Science and Technology Project of Zhejiang Provincial Health Commission (2021KY719)。
文摘To the Editor:Hepatocellular carcinoma (HCC) is one of the most common lethal cancers and is the leading cause of cancer mortality worldwide [1].In recent years,developments in locoregional therapies have provided new options for the treatment of HCC,which are recommended by the international guidelines including the Barcelona Clinic Liver Cancer (BCLC) and the American Joint Committee on Cancer (AJCC)[2].
基金supported by the Beijing Medical Award Foundation(No.YXJL-2023-0670-0150)。
文摘Objective:Colorectal cancer(CRC)surgeries can be performed using either laparoscopic or open laparotomy approaches.However,the long-term outcomes based on tumor location and age remain unclear.This study compared the long-term outcomes of laparoscopic and laparotomy surgeries in patients with CRC,focusing on tumor location and age to identify suitable subgroups and determine an optimal cut-off age.Methods:This retrospective study analyzed 2,014 patients with CRC who underwent radical surgery.Patients were categorized into laparoscopy and laparotomy groups,and propensity score matching(PSM)was performed.Kaplan-Meier analysis,log-rank tests,and Cox regression models were used to identify the independent factors affecting overall survival(OS).Results:Analysis results before PSM indicated higher OS in the laparoscopy group(P=0.035);however,it was no significant difference in mean OS between the two groups after PSM analysis.Cox regression analysis identified several factors influencing the OS of patients with CRC,with age,T stage,nodal involvement,poorly differentiated adenocarcinoma,ascites,preoperative intestinal obstruction,and local tumor spread as independent risk factors.Family history was a protective factor[hazard ratio(HR)=0.33;95%CI,0.16-0.68;P=0.002],and the surgical modality did not independently affect OS.The subgroup analysis highlighted the advantages of laparoscopic surgery in specific subgroups.Conclusions:Overall,laparoscopic and laparotomy surgeries resulted in similar mid-and long-term prognoses for patients with CRC.Laparoscopic surgery showed better outcomes in specific subgroups,particularly in patients aged>60 years and in those with right-sided colon carcinoma.This study suggests that age>64 years might be the optimal cut-off age for laparoscopic surgery.
基金supported by National Key R&D Program of China (No. 2017YFC0908203)CAMS Initiative for Innovative Medicine (No. CAMS-I2M-003)
文摘Objective： For patients with locally advanced rectal cancer treated with neoadjuvant chemoradiotherapy（NCRT）, significant pathological response of the primary tumor has been proposed to identify candidates for organ preservation. However, this does not address metastatic lymph nodes in the mesorectum. The aim of this study was to assess the incidence of lymph node metastases in ypT0 patients treated with NCRT and curative resection and to explore risk factors associated with survival.Methods： This was a retrospective study of patients with ypT0 rectal cancer after NCRT and curative resection at a tertiary care center in China from 2005 to 2014.Results： A total of 60（18.6%） patients who underwent surgery after NCRT and achieved ypT0 were enrolled in this study; one patient was excluded owing to lack of follow-up. Of these 59 patients, lymph node metastases were found in the mesorectum（ypT0N＋） in eight（13.6%） patients. After a median follow-up of 52 months, 5-year recurrence-free survival（82.7% vs. 62.5%, P=0.014） and overall survival（OS）（90.9% vs. 70.0%, P=0.032） were much higher in ypN0 than yp N＋ patients. Multivariate analyses showed that ypN＋ status（P=0.009） and perioperative blood transfusion（BT）（P=0.001） were significantly independent risk factors associated with recurrence; however, no factor was correlated with 5-year OS.Conclusions： Patients with ypT0N0 rectal cancer can achieve excellent long-term outcomes; however, positive lymph nodes or tumor deposits can still be found in 13.6% of ypT0 patients. Nodal positivity in the mesorectum and perioperative BT are independent risk factors for recurrence.
文摘AIM To systematically evaluate the prognostic-predictive capability of Bcl-2 in colorectal cancer(CRC).METHODS A systematic literature search was conducted using Pub Med,Web of Science and EMBASE databases. Any eligible study must meet the following criteria:(1) bcl-2 expression was evaluated in human CRC tissues by immunohistochemistry;(2) assessment of the relationships between bcl-2 expression and overall survival(OS),disease free survival(DFS),recurrent free survival(RFS) or clinic-pathological characteristics of CRC was included;(3) sufficient information was provided to estimate the hazard ratio(HR) or odds ratio and their 95% confidence intervals(CIs); and(4) the study was published in English. The impact of Bcl-2 expression on survival of CRC patients were evaluated through this meta-analysis.RESULTS A total of 40 eligible articles involving 7658 patients were enrolled in our final analysis. We drew the conclusion that Bcl-2 high expression was significantly correlated with favorable OS(pooled HR = 0.69,95%CI: 0.55-0.87,P = 0.002) and better DFS/RFS(pooled HR = 0.65,95%CI: 0.50-0.85,P = 0.001). Additionally,the subgroup analysis suggested that Bcl-2 overexpression was significantly associated withprognosis(OS) especially in patients came from Europe and America but not Asian and patients who did not receive any adjuvant therapy before surgery. Finally,our present results indicated that expression of bcl-2 protein was associated with high differentiation grade and A/B Ducks' stage. CONCLUSION Bcl-2 high expression was significantly correlated with favorable OS and better DFS/RFS. Hence,we propose that Bcl-2 may be a valuable prognostic-predictive marker in CRC.
基金funded in part by the Key Research and Promotion Projects of Henan Province under Grant Nos.212102210079,222102210052,222102210007,and 222102210062.
文摘Task scheduling plays a crucial role in cloud computing and is a key factor determining cloud computing performance.To solve the task scheduling problem for remote sensing data processing in cloud computing,this paper proposes a workflow task scheduling algorithm—Workflow Task Scheduling Algorithm based on Deep Reinforcement Learning(WDRL).The remote sensing data process modeling is transformed into a directed acyclic graph scheduling problem.Then,the algorithm is designed by establishing a Markov decision model and adopting a fitness calculation method.Finally,combine the advantages of reinforcement learning and deep neural networks to minimize make-time for remote sensing data processes from experience.The experiment is based on the development of CloudSim and Python and compares the change of completion time in the process of remote sensing data.The results showthat compared with several traditionalmeta-heuristic scheduling algorithms,WDRL can effectively achieve the goal of optimizing task scheduling efficiency.
