The unfolded protein response pathway is an evolutionarily conserved cytoprotective signaling cascade,essential for cell function and survival.Unfolded protein response signaling is tightly integrated with bone cell d...The unfolded protein response pathway is an evolutionarily conserved cytoprotective signaling cascade,essential for cell function and survival.Unfolded protein response signaling is tightly integrated with bone cell differentiation and function,and chronic unfolded protein response activation has been identified in bone disease.The unfolded protein response has been found to promote oncogenesis and drug resistance,raising the possibility that unfolded protein response modulators may have activity as anti-cancer agents.Cancer-associated bone disease remains a major cause of morbidity for patients with multiple myeloma or bone-metastatic disease.Understanding the critical role of unfolded protein response signaling in cancer development and metastasis,as well as its role in bone homeostasis,may lead to novel mechanisms by which to target cancer-associated bone disease.In this review,we summarize the current research delineating the roles of the unfolded protein response in bone biology and pathophysiology,and furthermore,review unfolded protein response modulating agents in the contexts of cancer and cancer-associated bone disease.展开更多
This study presents an efficient feature selection method based on the Gower distance to enhance the accuracy and efficiency of standard classifiers on high-dimensional medical datasets.High-dimensional data poses sig...This study presents an efficient feature selection method based on the Gower distance to enhance the accuracy and efficiency of standard classifiers on high-dimensional medical datasets.High-dimensional data poses significant challenges for traditional classifiers due to feature redundancy or being irrelevant.The proposed method addresses these challenges by partitioning the dataset into blocks,calculating the Gower distance within each block,and selecting features based on their average similarity.Technically,the Gower distance normalizes the absolute difference between numerical features,ensuring that each feature contributes equally to the distance calculation.This normalization prevents features with larger scales from overshadowing those with smaller scales.This process facilitates the identification of features that exhibit high harmony and are the most relevant for classification.The proposed feature selection strategy significantly reduces dimensionality,retains the most relevant features,and improves model performance.Experimental results show that the accuracy for the classifiers including k-nearest neighbors(KNN),naive Bayes(NB),decision tree(DT),random forest(RF),support vector machine(SVM),and logistic regression(LR)was increased by 4.38%-7.02%.Besides,the reduction in the feature set size contributes to a considerable decrease in computational complexity and thus faster diagnosis speed.The execution time was averagely reduced by 77.82%for all samples and 76.45%for one sample.These results demonstrate that the proposed feature selection method shows enhanced performance on both prediction accuracy and diagnostic speed,making it a promising tool for real-time clinical decision-making and improving patient care outcomes.展开更多
The association between inflammatory bowel disease(IBD) and colorectal cancer(CRC) has been recognised since 1925 and still accounts for 10%-15% of deaths in IBD.IBD-associated CRC(IBD-CRC) affects patients at a young...The association between inflammatory bowel disease(IBD) and colorectal cancer(CRC) has been recognised since 1925 and still accounts for 10%-15% of deaths in IBD.IBD-associated CRC(IBD-CRC) affects patients at a younger age than sporadic CRC.The prognosis for sporadic CRC and IBD-CRC is similar,with a 5-year survival of approximately 50%.Identifying at risk patients and implementing appropriate surveillance for these patients is central to managing the CRC risk in IBD.The increased risk of colorectal cancer in association with IBD is thought to be due to genetic and acquired factors.The link between inflammation and cancer is well recognised but the molecular biology,immune pathobiology and genetics of IBD-CRC are areas of much ongoing research.This review examines the literature relating to IBD-CRC,focusing on the incidence of IBD-CRC and examining potential risk factors including age at diagnosis,gender,duration and extent of colitis,severity of inflammation,family history of sporadic CRC and co-existent primary sclerosing cholangitis(PSC).Confirmed risk factors for IBD-CRC are duration,severity and extent of colitis,the presence of co-existent PSC and a family history of CRC.There is insufficient evidence currently to support an increased frequency of surveillance for patients diagnosed with IBD at a younger age.Evidence-based guidelines advise surveillance colonoscopy for patients with colitis 8 to 10 years after diagnosis,with the interval for further surveillance guided by risk factors(extent of disease,family history of CRC,post-inflammatory polyps,concomitant PSC,personal history of colonic dysplasia,colonic strictures).There is a move away from using random colonic biopsies towards targeted biopsies aimed at abnormal areas identified by newer colonoscopic techniques(narrow band imaging,chromoendoscopy,confocal microendoscopy).展开更多
Altered micro RNA（mi RNA） associated with gastric cancer（GC） development and mi R-17 and mi R-106 b were differentially expressed in GC tissues. This study detected serum levels of mi R-17 and mi R-106 b expressio...Altered micro RNA（mi RNA） associated with gastric cancer（GC） development and mi R-17 and mi R-106 b were differentially expressed in GC tissues. This study detected serum levels of mi R-17 and mi R-106 b expression in GC, benign gastric disease（BGD） and healthy controls to assess them as tumor markers for GC. Serum samples from 40 GC, 32 BGD（10 gastric ulcer, 14 gastric polyps, and 8 gastric ulcer with polyps） and 36 healthy individuals were subjected to quantitative reverse transcription polymerase chain reaction（q RT-PCR） analysis of mi R-17 and mi R-106 b expression. The data showed that the serum levels of mi R-17 and mi R-106 b were significantly reduced in healthy individuals and BGD patients compared to GC patients. There was a significant association of mi R-17 and mi R-106 b expression with age, but not with other clinicopathological features, such as gender, tumor differentiation, stage and lymphatic metastasis. Further analysis showed that, in discriminating GC patients from healthy controls, mi R-17 could yield a receiver-operating characteristic（ROC） area under the curve（AUC） of 0.879 with 80.6% sensitivity and 87.5% specificity and mi R-106 b could yield an AUC of 0.856 with 75.0% sensitivity and 92.5% specificity. The combined AUC of mi R-17 and mi R-106 b was 0.913 with 83.3% sensitivity and 87.5% specificity. Collectively, these data suggest that detection of serum mi R-17 and mi R-106 b levels should be further evaluated as novel non-invasive biomarkers in early GC detection and surveillance of disease progression.展开更多
Cancer is a common term for many diseases that can affect any part of the body.In 2020,ten million people will die due to cancer.A worldwide leading cause of death is cancer by the World Health Organization(WHO)report...Cancer is a common term for many diseases that can affect any part of the body.In 2020,ten million people will die due to cancer.A worldwide leading cause of death is cancer by the World Health Organization(WHO)report.Interaction of cancer cells,viral therapy,and immune response are identified in this model.Mathematical and computational modeling is an effective tool to predict the dynamics of cancer virotherapy.The cell population is categorized into three parts like uninfected cells(x),infected cells(y),virus-free cells(v),and immune cells(z).The modeling of cancerlike diseases is based on the law of mass action(the rate of change of reacting substances is directly proportional to the product of interacting substances).Positivity,boundedness,equilibria,threshold analysis,are part of deterministic modeling.Later on,a numerical analysis is designed by using the standard and non-standard finite difference methods.The non-standard finite difference method is developed to study the long-term behavior of the cancer model.For its efficiency,a comparison of the methods is investigated.展开更多
In this paper,two crossover hybrid variable-order derivatives of the cancer model are developed.Grünwald-Letnikov approximation is used to approximate the hybrid fractional and variable-order fractional operators...In this paper,two crossover hybrid variable-order derivatives of the cancer model are developed.Grünwald-Letnikov approximation is used to approximate the hybrid fractional and variable-order fractional operators.The existence,uniqueness,and stability of the proposed model are discussed.Adams Bashfourth’s fifth-step method with a hybrid variable-order fractional operator is developed to study the proposed models.Comparative studies with generalized fifth-order Runge-Kutta method are given.Numerical examples and comparative studies to verify the applicability of the used methods and to demonstrate the simplicity of these approximations are presented.We have showcased the efficiency of the proposed method and garnered robust empirical support for our theoretical findings.展开更多
Objective To estimate the lung cancer burden that may be attributable to ambient fine particulate matter （PM2.5） pollution in Guangzhou city in China from 2005 to 2013. Methods The data regarding PM2.5 exposure were...Objective To estimate the lung cancer burden that may be attributable to ambient fine particulate matter （PM2.5） pollution in Guangzhou city in China from 2005 to 2013. Methods The data regarding PM2.5 exposure were obtained from the ＆#39;Ambient air pollution exposure estimation for the Global Burden of Disease 2013＇ dataset at 0.1° ×0.1° spatial resolution. Disability-adjusted life years （DALYs） were estimated based on the information of mortality and incidence of lung cancer. Comparative risk analysis and integrated exposure-response function were used to estimate attributed disease burden. Results The population-weighted average concentration of PM2.5 was increased by 34.6% between 1990 and 2013, from 38.37 μg/m3 to 51.31 μg/m^3. The lung cancer DALYs in both men and women were increased by 36.2% from 2005 to 2013. The PM2.5 attributed lung cancer DALYs increased from 12105.0 （8181.0 for males and 3924.0 for females） in 2005 to 16489.3 （11291.7 for males and 5197.6 for females） in 2013. An average of 23.1% lung cancer burden was attributable to PM2.5 pollution in 2013. Conclusion PM2.5 has caused serious but under-appreciated public health burden in Guangzhou and the trend deteriorates. Effective strategies are needed to tackle this major public health problem.展开更多
Radiotherapy as monotherapy or in combination with chemotherapy, has contributed to the drop in mortality rates related to neoplasms in the last 60 years. However, irradiation may promote heart damage and involvement ...Radiotherapy as monotherapy or in combination with chemotherapy, has contributed to the drop in mortality rates related to neoplasms in the last 60 years. However, irradiation may promote heart damage and involvement is very common. As a result, VHD （valvular heart disease） is one of the earliest cardiovascular events post-radiotherapy. What it concerns to valve disease induced by chemotherapeutics, there are still only few studies. However, patients treated with chemotherapy in combination with radiotherapy had twice the risk of developing the disease when compared to those treated by radiotherapy alone. The heart injury caused by radiotherapy begins with damage to the endothelium and results in fibrosis and diffuses calcification primarily of the mitral and aortic valves. The echocardiography is the tool of choice to the patient’s assessment and follow-up after exposure. Prevention is the best option to face the valve damage induced by radiation.展开更多
Pancreatic cancer is one of the most deadly cancers and is characterized by a poor prognosis. Single agent gemcitabine, despite its limited activity and modest impact on disease outcome, is considered as the standard ...Pancreatic cancer is one of the most deadly cancers and is characterized by a poor prognosis. Single agent gemcitabine, despite its limited activity and modest impact on disease outcome, is considered as the standard therapy in pancreatic cancer. Most of the combination regimens used in the treatment of this disease, also including the targeted agents, did not improve the outcome of patients. Also, taxanes have been tested as single agent and in combination chemotherapy, both in first line and as salvage chemotherapy, as another possible option for treating pancreatic cancer. The inclusion of taxanes in combination with gemcitabine as upfront therapy obtained promising results. Accordingly, taxanes, and above all, new generation taxanes, appear to be suitable candidates for further testing to assess their role against pancreatic cancer in various clinical settings.展开更多
Despite its various vital roles in the different body’s metabolisms,iron may have a hazardous impact on health when it exceeds its normal values.Iron overload is triggered by many genetic and behavioral factors.Furth...Despite its various vital roles in the different body’s metabolisms,iron may have a hazardous impact on health when it exceeds its normal values.Iron overload is triggered by many genetic and behavioral factors.Furthermore,excessive iron levels have also been observed in many pathologies such as Alzheimer’s,Parkinson’s,cardiovascular and some cancerous diseases.This paper describes a set of natural iron chelators as an effective and a safe orthomolecular approach in chelating iron.Orthomolecular medicine is based on providing patients with nutritional supplementation at high doses to treat and prevent diseases.This paper describes the properties of a set of flavonoids and phenolic acids such as curcumin and ferulic acid that can be administered as supplements to patients suffering from iron overload since they are classified as strong chelators.Those natural iron chelators’supplements are mainly extracted from fruits,vegetables,and plants.As chelators,they are able to bind effectively to iron,inhibit the production of reactive oxygen species,and reduce the levels of oxidative stress.They can also play an effective therapeutic role in the treatment of neurodegenerative,cardiovascular,diabetic,and cancerous diseases thanks to their iron chelation,antioxidant,and anti-inflammatory properties.展开更多
Hepatitis C virus(HCV)affects 130-210 million people worldwide and is one of the major risk factors for hepatocellular carcinoma.Globally,at least one third of hepatocellular carcinoma cases are attributed to HCV infe...Hepatitis C virus(HCV)affects 130-210 million people worldwide and is one of the major risk factors for hepatocellular carcinoma.Globally,at least one third of hepatocellular carcinoma cases are attributed to HCV infection,and 350000 people died from HCV related diseases per year.There is a great geographical variation of HCV infection globally,with risk factors for the HCV infection differing in various countries.The progression of chronic hepatitis C to end-stage liver disease also varies in different study populations.A long-term follow-up cohort enrolling participants with asymptomatic HCV infection is essential for elucidating the natural history of HCV-caused hepatocellular carcinoma,and for exploring potential seromarkers that have high predictability for risk of hepatocellular carcinoma.However,prospective cohorts comprising individuals with HCV infection are still uncommon.The risk evaluation of viral load elevation and associated liver disease/cancer in HCV(REVEAL-HCV)study has followed a cohort of 1095 residents seropositive for antibodies against hepatitis C virus living in seven townships in Taiwan for more than fifteen years.Most of them have acquired HCV infection through iatrogenic transmission routes.As the participants in the REVEALHCV study rarely receive antiviral therapies,it provides a unique opportunity to study the natural history of chronic HCV infection.In this review,the prevalence,risk factors and natural history of HCV infection are comprehensively reviewed.The study cohort,data collection,and findings on liver disease progression of the REVEAL-HCV study are described.展开更多
AIM:To study the short-term outcome of patients treated with laparoscopic right colectomy and how intracorporeal anastomosis has improved the outcome.METHODS:We retrospectively examined all patients affected by colore...AIM:To study the short-term outcome of patients treated with laparoscopic right colectomy and how intracorporeal anastomosis has improved the outcome.METHODS:We retrospectively examined all patients affected by colorectal cancer who underwent a laparoscopic right colectomy between January 2006 and December 2010 in our department.Our evaluation criteria were:diagnosis of colorectal carcinoma at presurgical biopsy,elective surgery,and the same surgeon.We excluded:emergency surgery,conversions from laparotomic colectomy,and other surgeons.The endpoints we examined were:surgical time,number of lymph nodes removed,length of stay(removal of nasogastric tube,bowel movements,gas evacuation,solid and liquid feeding,hospitalization),and major complications.Seventy-two patients were divided into two groups:intracorporeal anastomosis(39 patients)and extracorporeal anastomosis(33 patients).RESULTS:Significant differences were observed between intracorporeal vs extracorporeal anastomosis,respectively,for surgical times(186.8 min vs 184.1 min,P < 0.001),time to resumption of gas evacuation(3 d vs 3.5 d,P < 0.001),days until resumption of bowel movements(3.8 d vs 4.9 d,P < 0.001),days until resumption of liquid diet(3.5 d vs 4.5 d,P < 0.001),days until resuming a solid diet(4.6 d vs 5.7 d,P < 0.001),and total hospitalization duration(7.4 d vs 8.5 d,P < 0.001).In the intracorporeal group,on average,19 positive lymph nodes were removed;in the extracorporeal group,on average,14 were removed P < 0.001).Thus,intracorporeal anastomosis for right laparoscopic colectomy improved patient outcome by providing faster recovery of nutrition,faster recovery of intestinal function,and shorter hospitalization than extracorporeal anastomosis.CONCLUSION:Short-term outcomes favor intracorporeal anastomosis,confirming that a less traumatic surgical approach improves patient outcome.展开更多
To examine whether vitamin / mineral supplementation may lower mortality and incidence for human cancer and mortality from other diseases as well as to provide the scientific basis and feasible approach for human canc...To examine whether vitamin / mineral supplementation may lower mortality and incidence for human cancer and mortality from other diseases as well as to provide the scientific basis and feasible approach for human cancer prevention and control,from 1982 to 1991 scientists from China and USA conducted two randomized, double-blind,placebo-controlled nutrition intervention trials in Linxian,China,where the mortality rates of esophageal and gastric cardia cancer are among the highest in the world and there is suspicion that the population’s chronic deficiencies of multiple展开更多
In this post-genomic era, more and more susceptibility loci of many possible genetic diseases are published. As our knowledge about these susceptibility loci is limited and partial, we should be very careful and respo...In this post-genomic era, more and more susceptibility loci of many possible genetic diseases are published. As our knowledge about these susceptibility loci is limited and partial, we should be very careful and responsible when patients seek genetic counseling about these possible genetic diseases. We should apply Confucius' s principle about knowledge and information to genetic conseling, and tell the truth to our patients about what we know and what we do not know. Like many other cancers, breast cancer is a very complicated, multifactorial disease; genetic factors, lifestyles and eating habits, environmental factors, and viral infections might be involved in breast cancer; hence, it is difficult to figure out the real etiology of breast cancer. It is not crystal clear that a person who carries mutations of the breast cancer 1, early onset and/or breast cancer 2, early onset genes would eventually get breast cancer in her/his lifetime. No person should undergo a preventive double mastectomy, unless we know the etiology of breast cancer someday.展开更多
Introduction: Invasive lobular carcinoma (ILC) is the second most common histologic type of breast cancer, representing 5% to 15% of invasive tumors. ILC tends to spread to bones, lungs, central nervous system, reprod...Introduction: Invasive lobular carcinoma (ILC) is the second most common histologic type of breast cancer, representing 5% to 15% of invasive tumors. ILC tends to spread to bones, lungs, central nervous system, reproductive organs, and the gastrointestinal tract (GI tract). The most commonly affected organs in the GI tract are the stomach, small intestine, followed by colon and rectum. Case presentation: A 78-year-old woman who was referred to our institution after having a bowel obstruction that required a diagnostic laparoscopy where they identified an obstructing ulcerative lesion in the distal ileum that was managed with a segmental bowel resection. Pathology report showed an invasive lobular breast carcinoma that occluded 90% of the bowel lumen. A PET/CT scan revealed a left breast tumor with increased metabolism. The patient was staged as a clinical cT4b, cN0, cM1 left breast invasive lobular carcinoma (ER/PgR positive, HER-2 negative). She was managed with endocrine therapy with Letrozole (an eight-week course). A follow-up PET/CT showed a peritoneal hypermetabolic nodule adjacent to the previous ileal anastomosis. The lesion decreased in size and metabolic activity. In a multidisciplinary fashion, the endocrine therapy was extended for another three months. Another follow-up PET/CT scan was performed three months after the identification of the peritoneal implant that showed that the nodule increased in size and in metabolism. The lesion continued to decrease significantly in size and became metabolically inactivity. Due to the good breast response and the possibility that the ileal nodule could be a granuloma, she underwent an exploratory laparoscopy with excision of the peritoneal nodule, and a modified left radical mastectomy with immediate breast reconstruction (complex wound closure). The final pathology report of the nodule was negative for malignancy. She continued on endocrine therapy and underwent whole breast irradiation four weeks after the operation. Currently, she is free of disease with no evidence of local, regional, or distant recurrence, and she is still on endocrine therapy. Discussion: The time interval between primary breast cancer and gastrointestinal involvement may range from synchronous presentation to as long as 30 years. The clinical manifestations in GI lobular breast cancer metastasis may range from non-specific complaints to acute GI symptoms, such as a bowel obstruction. There are multiple controversies in the management of ILC. Systemic treatment should be initiated as soon as possible. Indications for postmastectomy radiotherapy are also controversial, given the propensity for multifocal/multicentric tumors and late recurrences, sometimes in atypical locations. Five years of postoperative adjuvant hormonal therapy is an option for women with poor prognosis. Remissions are observed in 32% to 53% of patients. Conclusion: Metastatic lobular carcinoma of the breast has a wide range of clinical presentations. Patients with a history of breast cancer who present with new GI tumors should have these lesions evaluated for evidence of metastasis through histopathologic and immunohistochemical analysis, this will allow for appropriate management. Currently, breast cancer management involves a multidisciplinary approach including surgery, radiotherapy, and systemic medical therapy, and the treatment must be tailored to the patient’s needs.展开更多
Gastric cancer is the fourth commonest cancer and the second leading cause of cancer-related death worldwide[1].Its incidence ranks no.2 and its mortality rate ranks no.3 among all malignant tumors in China according ...Gastric cancer is the fourth commonest cancer and the second leading cause of cancer-related death worldwide[1].Its incidence ranks no.2 and its mortality rate ranks no.3 among all malignant tumors in China according to the latest cancer disease spectrum[2].The gastric cancer prognosis is very poor with 5-year survivals below 24%[3].Early gastric cancer can be cured with surgery;advanced gastric cancer often needs multidisciplinary combined therapy.Gastric cancer seems insensitive to current chemotherapy agents,which may be closely related to stomach cancer stem cells[4].Early gastric cancer refers to the in situ gastric cancer which locates only in stomach mucous membraneand does not infiltrate into thin submucosa.In China,early gastric cancer diagnosis rate is less than 20%,while the diagnosis rate of early gastric cancer in Japan and South Korea has reached 30%-50%[5,6].It is definite to classify H.pylori as the class I carcinogen by the World Health Organization.Approximately 75%of the global gastric cancer are attributable to H.pylori-induced inflammation and injury[7].To date,the precise mechanism of H.pylori-associated gastric carcinogenesis has not been well clarified.To develop prewarning and early theranostic system of gastric cancer can save a lot of patients with gastric cancer and can also reduce the cost of treatment and even cure or significantly prolong the lifespan of patients.展开更多
Purpose-This study aims to differential diagnosis of some diseases using classification methods to support effective medical treatment.For this purpose,different classification methods based on data,experts’knowledge...Purpose-This study aims to differential diagnosis of some diseases using classification methods to support effective medical treatment.For this purpose,different classification methods based on data,experts’knowledge and both are considered in some cases.Besides,feature reduction and some clustering methods are used to improve their performance.Design/methodology/approach-First,the performances of classification methods are evaluated for differential diagnosis of different diseases.Then,experts’knowledge is utilized to modify the Bayesian networks’structures.Analyses of the results show that using experts’knowledge is more effective than other algorithms for increasing the accuracy of Bayesian network classification.A total of ten different diseases are used for testing,taken from the Machine Learning Repository datasets of the University of California at Irvine(UCI).Findings-The proposed method improves both the computation time and accuracy of the classification methods used in this paper.Bayesian networks based on experts’knowledge achieve a maximum average accuracy of 87 percent,with a minimum standard deviation average of 0.04 over the sample datasets among all classification methods.Practical implications-The proposed methodology can be applied to perform disease differential diagnosis analysis.Originality/value-This study presents the usefulness of experts’knowledge in the diagnosis while proposing an adopted improvement method for classifications.Besides,the Bayesian network based on experts’knowledge is useful for different diseases neglected by previous papers.展开更多
基金supported by the National Institutes of Health(Grants P30 CA036727 and R01 CA258621)and funding from the University of Nebraska Medical Center Graduate Studies Assistantship.
文摘The unfolded protein response pathway is an evolutionarily conserved cytoprotective signaling cascade,essential for cell function and survival.Unfolded protein response signaling is tightly integrated with bone cell differentiation and function,and chronic unfolded protein response activation has been identified in bone disease.The unfolded protein response has been found to promote oncogenesis and drug resistance,raising the possibility that unfolded protein response modulators may have activity as anti-cancer agents.Cancer-associated bone disease remains a major cause of morbidity for patients with multiple myeloma or bone-metastatic disease.Understanding the critical role of unfolded protein response signaling in cancer development and metastasis,as well as its role in bone homeostasis,may lead to novel mechanisms by which to target cancer-associated bone disease.In this review,we summarize the current research delineating the roles of the unfolded protein response in bone biology and pathophysiology,and furthermore,review unfolded protein response modulating agents in the contexts of cancer and cancer-associated bone disease.
文摘This study presents an efficient feature selection method based on the Gower distance to enhance the accuracy and efficiency of standard classifiers on high-dimensional medical datasets.High-dimensional data poses significant challenges for traditional classifiers due to feature redundancy or being irrelevant.The proposed method addresses these challenges by partitioning the dataset into blocks,calculating the Gower distance within each block,and selecting features based on their average similarity.Technically,the Gower distance normalizes the absolute difference between numerical features,ensuring that each feature contributes equally to the distance calculation.This normalization prevents features with larger scales from overshadowing those with smaller scales.This process facilitates the identification of features that exhibit high harmony and are the most relevant for classification.The proposed feature selection strategy significantly reduces dimensionality,retains the most relevant features,and improves model performance.Experimental results show that the accuracy for the classifiers including k-nearest neighbors(KNN),naive Bayes(NB),decision tree(DT),random forest(RF),support vector machine(SVM),and logistic regression(LR)was increased by 4.38%-7.02%.Besides,the reduction in the feature set size contributes to a considerable decrease in computational complexity and thus faster diagnosis speed.The execution time was averagely reduced by 77.82%for all samples and 76.45%for one sample.These results demonstrate that the proposed feature selection method shows enhanced performance on both prediction accuracy and diagnostic speed,making it a promising tool for real-time clinical decision-making and improving patient care outcomes.
文摘The association between inflammatory bowel disease(IBD) and colorectal cancer(CRC) has been recognised since 1925 and still accounts for 10%-15% of deaths in IBD.IBD-associated CRC(IBD-CRC) affects patients at a younger age than sporadic CRC.The prognosis for sporadic CRC and IBD-CRC is similar,with a 5-year survival of approximately 50%.Identifying at risk patients and implementing appropriate surveillance for these patients is central to managing the CRC risk in IBD.The increased risk of colorectal cancer in association with IBD is thought to be due to genetic and acquired factors.The link between inflammation and cancer is well recognised but the molecular biology,immune pathobiology and genetics of IBD-CRC are areas of much ongoing research.This review examines the literature relating to IBD-CRC,focusing on the incidence of IBD-CRC and examining potential risk factors including age at diagnosis,gender,duration and extent of colitis,severity of inflammation,family history of sporadic CRC and co-existent primary sclerosing cholangitis(PSC).Confirmed risk factors for IBD-CRC are duration,severity and extent of colitis,the presence of co-existent PSC and a family history of CRC.There is insufficient evidence currently to support an increased frequency of surveillance for patients diagnosed with IBD at a younger age.Evidence-based guidelines advise surveillance colonoscopy for patients with colitis 8 to 10 years after diagnosis,with the interval for further surveillance guided by risk factors(extent of disease,family history of CRC,post-inflammatory polyps,concomitant PSC,personal history of colonic dysplasia,colonic strictures).There is a move away from using random colonic biopsies towards targeted biopsies aimed at abnormal areas identified by newer colonoscopic techniques(narrow band imaging,chromoendoscopy,confocal microendoscopy).
基金supported by National Natural Science Foundation of China (Grant No. 81372140, 81301688, 81272192, 81171882, 81172298)Ph.D. Programs Foundation of Ministry of Education of China (No. 20130162110050 and 20130162120093)+6 种基金Post-doctoral Foundation of Central South University (No. 131425) China Postdoctoral Science Foundation (2014M552167)Key Program for International Cooperation Projects of Hunan Province (no. 2011WK2011)Natural Science Foundation of Hunan Province (Grant No. 12JJ4088)Technology Project of Hunan Province (2012SK3229)Research foundation of Health Department of Hunan Province (B2012-100)125 Talent Project of the Third Xiangya Hospital of Central South University
文摘Altered micro RNA（mi RNA） associated with gastric cancer（GC） development and mi R-17 and mi R-106 b were differentially expressed in GC tissues. This study detected serum levels of mi R-17 and mi R-106 b expression in GC, benign gastric disease（BGD） and healthy controls to assess them as tumor markers for GC. Serum samples from 40 GC, 32 BGD（10 gastric ulcer, 14 gastric polyps, and 8 gastric ulcer with polyps） and 36 healthy individuals were subjected to quantitative reverse transcription polymerase chain reaction（q RT-PCR） analysis of mi R-17 and mi R-106 b expression. The data showed that the serum levels of mi R-17 and mi R-106 b were significantly reduced in healthy individuals and BGD patients compared to GC patients. There was a significant association of mi R-17 and mi R-106 b expression with age, but not with other clinicopathological features, such as gender, tumor differentiation, stage and lymphatic metastasis. Further analysis showed that, in discriminating GC patients from healthy controls, mi R-17 could yield a receiver-operating characteristic（ROC） area under the curve（AUC） of 0.879 with 80.6% sensitivity and 87.5% specificity and mi R-106 b could yield an AUC of 0.856 with 75.0% sensitivity and 92.5% specificity. The combined AUC of mi R-17 and mi R-106 b was 0.913 with 83.3% sensitivity and 87.5% specificity. Collectively, these data suggest that detection of serum mi R-17 and mi R-106 b levels should be further evaluated as novel non-invasive biomarkers in early GC detection and surveillance of disease progression.
文摘Cancer is a common term for many diseases that can affect any part of the body.In 2020,ten million people will die due to cancer.A worldwide leading cause of death is cancer by the World Health Organization(WHO)report.Interaction of cancer cells,viral therapy,and immune response are identified in this model.Mathematical and computational modeling is an effective tool to predict the dynamics of cancer virotherapy.The cell population is categorized into three parts like uninfected cells(x),infected cells(y),virus-free cells(v),and immune cells(z).The modeling of cancerlike diseases is based on the law of mass action(the rate of change of reacting substances is directly proportional to the product of interacting substances).Positivity,boundedness,equilibria,threshold analysis,are part of deterministic modeling.Later on,a numerical analysis is designed by using the standard and non-standard finite difference methods.The non-standard finite difference method is developed to study the long-term behavior of the cancer model.For its efficiency,a comparison of the methods is investigated.
文摘In this paper,two crossover hybrid variable-order derivatives of the cancer model are developed.Grünwald-Letnikov approximation is used to approximate the hybrid fractional and variable-order fractional operators.The existence,uniqueness,and stability of the proposed model are discussed.Adams Bashfourth’s fifth-step method with a hybrid variable-order fractional operator is developed to study the proposed models.Comparative studies with generalized fifth-order Runge-Kutta method are given.Numerical examples and comparative studies to verify the applicability of the used methods and to demonstrate the simplicity of these approximations are presented.We have showcased the efficiency of the proposed method and garnered robust empirical support for our theoretical findings.
基金supported by the Centre for Health Statistics Information,National Health and Family Planning Commission of the People’s Republic of China
文摘Objective To estimate the lung cancer burden that may be attributable to ambient fine particulate matter （PM2.5） pollution in Guangzhou city in China from 2005 to 2013. Methods The data regarding PM2.5 exposure were obtained from the ＆#39;Ambient air pollution exposure estimation for the Global Burden of Disease 2013＇ dataset at 0.1° ×0.1° spatial resolution. Disability-adjusted life years （DALYs） were estimated based on the information of mortality and incidence of lung cancer. Comparative risk analysis and integrated exposure-response function were used to estimate attributed disease burden. Results The population-weighted average concentration of PM2.5 was increased by 34.6% between 1990 and 2013, from 38.37 μg/m3 to 51.31 μg/m^3. The lung cancer DALYs in both men and women were increased by 36.2% from 2005 to 2013. The PM2.5 attributed lung cancer DALYs increased from 12105.0 （8181.0 for males and 3924.0 for females） in 2005 to 16489.3 （11291.7 for males and 5197.6 for females） in 2013. An average of 23.1% lung cancer burden was attributable to PM2.5 pollution in 2013. Conclusion PM2.5 has caused serious but under-appreciated public health burden in Guangzhou and the trend deteriorates. Effective strategies are needed to tackle this major public health problem.
文摘Radiotherapy as monotherapy or in combination with chemotherapy, has contributed to the drop in mortality rates related to neoplasms in the last 60 years. However, irradiation may promote heart damage and involvement is very common. As a result, VHD （valvular heart disease） is one of the earliest cardiovascular events post-radiotherapy. What it concerns to valve disease induced by chemotherapeutics, there are still only few studies. However, patients treated with chemotherapy in combination with radiotherapy had twice the risk of developing the disease when compared to those treated by radiotherapy alone. The heart injury caused by radiotherapy begins with damage to the endothelium and results in fibrosis and diffuses calcification primarily of the mitral and aortic valves. The echocardiography is the tool of choice to the patient’s assessment and follow-up after exposure. Prevention is the best option to face the valve damage induced by radiation.
文摘Pancreatic cancer is one of the most deadly cancers and is characterized by a poor prognosis. Single agent gemcitabine, despite its limited activity and modest impact on disease outcome, is considered as the standard therapy in pancreatic cancer. Most of the combination regimens used in the treatment of this disease, also including the targeted agents, did not improve the outcome of patients. Also, taxanes have been tested as single agent and in combination chemotherapy, both in first line and as salvage chemotherapy, as another possible option for treating pancreatic cancer. The inclusion of taxanes in combination with gemcitabine as upfront therapy obtained promising results. Accordingly, taxanes, and above all, new generation taxanes, appear to be suitable candidates for further testing to assess their role against pancreatic cancer in various clinical settings.
文摘Despite its various vital roles in the different body’s metabolisms,iron may have a hazardous impact on health when it exceeds its normal values.Iron overload is triggered by many genetic and behavioral factors.Furthermore,excessive iron levels have also been observed in many pathologies such as Alzheimer’s,Parkinson’s,cardiovascular and some cancerous diseases.This paper describes a set of natural iron chelators as an effective and a safe orthomolecular approach in chelating iron.Orthomolecular medicine is based on providing patients with nutritional supplementation at high doses to treat and prevent diseases.This paper describes the properties of a set of flavonoids and phenolic acids such as curcumin and ferulic acid that can be administered as supplements to patients suffering from iron overload since they are classified as strong chelators.Those natural iron chelators’supplements are mainly extracted from fruits,vegetables,and plants.As chelators,they are able to bind effectively to iron,inhibit the production of reactive oxygen species,and reduce the levels of oxidative stress.They can also play an effective therapeutic role in the treatment of neurodegenerative,cardiovascular,diabetic,and cancerous diseases thanks to their iron chelation,antioxidant,and anti-inflammatory properties.
文摘Hepatitis C virus(HCV)affects 130-210 million people worldwide and is one of the major risk factors for hepatocellular carcinoma.Globally,at least one third of hepatocellular carcinoma cases are attributed to HCV infection,and 350000 people died from HCV related diseases per year.There is a great geographical variation of HCV infection globally,with risk factors for the HCV infection differing in various countries.The progression of chronic hepatitis C to end-stage liver disease also varies in different study populations.A long-term follow-up cohort enrolling participants with asymptomatic HCV infection is essential for elucidating the natural history of HCV-caused hepatocellular carcinoma,and for exploring potential seromarkers that have high predictability for risk of hepatocellular carcinoma.However,prospective cohorts comprising individuals with HCV infection are still uncommon.The risk evaluation of viral load elevation and associated liver disease/cancer in HCV(REVEAL-HCV)study has followed a cohort of 1095 residents seropositive for antibodies against hepatitis C virus living in seven townships in Taiwan for more than fifteen years.Most of them have acquired HCV infection through iatrogenic transmission routes.As the participants in the REVEALHCV study rarely receive antiviral therapies,it provides a unique opportunity to study the natural history of chronic HCV infection.In this review,the prevalence,risk factors and natural history of HCV infection are comprehensively reviewed.The study cohort,data collection,and findings on liver disease progression of the REVEAL-HCV study are described.
文摘AIM:To study the short-term outcome of patients treated with laparoscopic right colectomy and how intracorporeal anastomosis has improved the outcome.METHODS:We retrospectively examined all patients affected by colorectal cancer who underwent a laparoscopic right colectomy between January 2006 and December 2010 in our department.Our evaluation criteria were:diagnosis of colorectal carcinoma at presurgical biopsy,elective surgery,and the same surgeon.We excluded:emergency surgery,conversions from laparotomic colectomy,and other surgeons.The endpoints we examined were:surgical time,number of lymph nodes removed,length of stay(removal of nasogastric tube,bowel movements,gas evacuation,solid and liquid feeding,hospitalization),and major complications.Seventy-two patients were divided into two groups:intracorporeal anastomosis(39 patients)and extracorporeal anastomosis(33 patients).RESULTS:Significant differences were observed between intracorporeal vs extracorporeal anastomosis,respectively,for surgical times(186.8 min vs 184.1 min,P < 0.001),time to resumption of gas evacuation(3 d vs 3.5 d,P < 0.001),days until resumption of bowel movements(3.8 d vs 4.9 d,P < 0.001),days until resumption of liquid diet(3.5 d vs 4.5 d,P < 0.001),days until resuming a solid diet(4.6 d vs 5.7 d,P < 0.001),and total hospitalization duration(7.4 d vs 8.5 d,P < 0.001).In the intracorporeal group,on average,19 positive lymph nodes were removed;in the extracorporeal group,on average,14 were removed P < 0.001).Thus,intracorporeal anastomosis for right laparoscopic colectomy improved patient outcome by providing faster recovery of nutrition,faster recovery of intestinal function,and shorter hospitalization than extracorporeal anastomosis.CONCLUSION:Short-term outcomes favor intracorporeal anastomosis,confirming that a less traumatic surgical approach improves patient outcome.
文摘To examine whether vitamin / mineral supplementation may lower mortality and incidence for human cancer and mortality from other diseases as well as to provide the scientific basis and feasible approach for human cancer prevention and control,from 1982 to 1991 scientists from China and USA conducted two randomized, double-blind,placebo-controlled nutrition intervention trials in Linxian,China,where the mortality rates of esophageal and gastric cardia cancer are among the highest in the world and there is suspicion that the population’s chronic deficiencies of multiple
文摘In this post-genomic era, more and more susceptibility loci of many possible genetic diseases are published. As our knowledge about these susceptibility loci is limited and partial, we should be very careful and responsible when patients seek genetic counseling about these possible genetic diseases. We should apply Confucius' s principle about knowledge and information to genetic conseling, and tell the truth to our patients about what we know and what we do not know. Like many other cancers, breast cancer is a very complicated, multifactorial disease; genetic factors, lifestyles and eating habits, environmental factors, and viral infections might be involved in breast cancer; hence, it is difficult to figure out the real etiology of breast cancer. It is not crystal clear that a person who carries mutations of the breast cancer 1, early onset and/or breast cancer 2, early onset genes would eventually get breast cancer in her/his lifetime. No person should undergo a preventive double mastectomy, unless we know the etiology of breast cancer someday.
文摘Introduction: Invasive lobular carcinoma (ILC) is the second most common histologic type of breast cancer, representing 5% to 15% of invasive tumors. ILC tends to spread to bones, lungs, central nervous system, reproductive organs, and the gastrointestinal tract (GI tract). The most commonly affected organs in the GI tract are the stomach, small intestine, followed by colon and rectum. Case presentation: A 78-year-old woman who was referred to our institution after having a bowel obstruction that required a diagnostic laparoscopy where they identified an obstructing ulcerative lesion in the distal ileum that was managed with a segmental bowel resection. Pathology report showed an invasive lobular breast carcinoma that occluded 90% of the bowel lumen. A PET/CT scan revealed a left breast tumor with increased metabolism. The patient was staged as a clinical cT4b, cN0, cM1 left breast invasive lobular carcinoma (ER/PgR positive, HER-2 negative). She was managed with endocrine therapy with Letrozole (an eight-week course). A follow-up PET/CT showed a peritoneal hypermetabolic nodule adjacent to the previous ileal anastomosis. The lesion decreased in size and metabolic activity. In a multidisciplinary fashion, the endocrine therapy was extended for another three months. Another follow-up PET/CT scan was performed three months after the identification of the peritoneal implant that showed that the nodule increased in size and in metabolism. The lesion continued to decrease significantly in size and became metabolically inactivity. Due to the good breast response and the possibility that the ileal nodule could be a granuloma, she underwent an exploratory laparoscopy with excision of the peritoneal nodule, and a modified left radical mastectomy with immediate breast reconstruction (complex wound closure). The final pathology report of the nodule was negative for malignancy. She continued on endocrine therapy and underwent whole breast irradiation four weeks after the operation. Currently, she is free of disease with no evidence of local, regional, or distant recurrence, and she is still on endocrine therapy. Discussion: The time interval between primary breast cancer and gastrointestinal involvement may range from synchronous presentation to as long as 30 years. The clinical manifestations in GI lobular breast cancer metastasis may range from non-specific complaints to acute GI symptoms, such as a bowel obstruction. There are multiple controversies in the management of ILC. Systemic treatment should be initiated as soon as possible. Indications for postmastectomy radiotherapy are also controversial, given the propensity for multifocal/multicentric tumors and late recurrences, sometimes in atypical locations. Five years of postoperative adjuvant hormonal therapy is an option for women with poor prognosis. Remissions are observed in 32% to 53% of patients. Conclusion: Metastatic lobular carcinoma of the breast has a wide range of clinical presentations. Patients with a history of breast cancer who present with new GI tumors should have these lesions evaluated for evidence of metastasis through histopathologic and immunohistochemical analysis, this will allow for appropriate management. Currently, breast cancer management involves a multidisciplinary approach including surgery, radiotherapy, and systemic medical therapy, and the treatment must be tailored to the patient’s needs.
文摘Gastric cancer is the fourth commonest cancer and the second leading cause of cancer-related death worldwide[1].Its incidence ranks no.2 and its mortality rate ranks no.3 among all malignant tumors in China according to the latest cancer disease spectrum[2].The gastric cancer prognosis is very poor with 5-year survivals below 24%[3].Early gastric cancer can be cured with surgery;advanced gastric cancer often needs multidisciplinary combined therapy.Gastric cancer seems insensitive to current chemotherapy agents,which may be closely related to stomach cancer stem cells[4].Early gastric cancer refers to the in situ gastric cancer which locates only in stomach mucous membraneand does not infiltrate into thin submucosa.In China,early gastric cancer diagnosis rate is less than 20%,while the diagnosis rate of early gastric cancer in Japan and South Korea has reached 30%-50%[5,6].It is definite to classify H.pylori as the class I carcinogen by the World Health Organization.Approximately 75%of the global gastric cancer are attributable to H.pylori-induced inflammation and injury[7].To date,the precise mechanism of H.pylori-associated gastric carcinogenesis has not been well clarified.To develop prewarning and early theranostic system of gastric cancer can save a lot of patients with gastric cancer and can also reduce the cost of treatment and even cure or significantly prolong the lifespan of patients.
文摘Purpose-This study aims to differential diagnosis of some diseases using classification methods to support effective medical treatment.For this purpose,different classification methods based on data,experts’knowledge and both are considered in some cases.Besides,feature reduction and some clustering methods are used to improve their performance.Design/methodology/approach-First,the performances of classification methods are evaluated for differential diagnosis of different diseases.Then,experts’knowledge is utilized to modify the Bayesian networks’structures.Analyses of the results show that using experts’knowledge is more effective than other algorithms for increasing the accuracy of Bayesian network classification.A total of ten different diseases are used for testing,taken from the Machine Learning Repository datasets of the University of California at Irvine(UCI).Findings-The proposed method improves both the computation time and accuracy of the classification methods used in this paper.Bayesian networks based on experts’knowledge achieve a maximum average accuracy of 87 percent,with a minimum standard deviation average of 0.04 over the sample datasets among all classification methods.Practical implications-The proposed methodology can be applied to perform disease differential diagnosis analysis.Originality/value-This study presents the usefulness of experts’knowledge in the diagnosis while proposing an adopted improvement method for classifications.Besides,the Bayesian network based on experts’knowledge is useful for different diseases neglected by previous papers.
