Neuroendocrine neoplasms(NENs)are relatively rare tumors that arise from peptidergic neurons and neuroendocrine cells.NENs are highly heterogeneous and can occur in any part of the body,with a particular prevalence in...Neuroendocrine neoplasms(NENs)are relatively rare tumors that arise from peptidergic neurons and neuroendocrine cells.NENs are highly heterogeneous and can occur in any part of the body,with a particular prevalence in the digestive system.NENs consist of a range of tumor types and the biological behaviors exhibit significant differences.NENs are classified into well-differentiated neuroendocrine tumors(NETs)and poorly differentiated neuroendocrine carcinomas(NECs).NETs can be further classified and graded into the following three categories:low-grade NETs,grade 1(NET G1);intermediate-grade NET G2;and high-grade NET G3.NECs include large cell-type NEC(LCNEC)and small cell-type NEC(SCNEC),both of which are considered high grade.Currently,the main treatments for advanced NENs are biological treatments,targeted therapy,chemotherapy,and newer treatments that are still under development,such as immunotherapy and peptide receptor radionuclide therapy(PRRT).However,owing to the rarity of NENs,pharmaceutical company investment is limited and few phase Ⅲ studies have targeted advanced NENs.Most current research consists of investigator-initiated phase Ⅰ and Ⅱ clinical trials or largescale retrospective studies.NEN treatment should be chosen carefully because it is cumbersome and complicated,as indicated above.Herein,we comprehensively summarize the clinical application status and research progress for advanced NEN treatment regimens,especially for advanced NETs,which may help to create awareness on NENs among medical professionals across specialties.展开更多
BACKGROUND Recently,several endoscopic techniques have been used to improve the R0 resection rate of rectal neuroendocrine neoplasms(R-NENs).However,none of these methods can achieve 100%complete resection(CR),particu...BACKGROUND Recently,several endoscopic techniques have been used to improve the R0 resection rate of rectal neuroendocrine neoplasms(R-NENs).However,none of these methods can achieve 100%complete resection(CR),particularly in the vertical direction.Endoscopic full-thickness resection(EFTR)has proven to be an effective method for the treatment of submucosal tumors but is seldom utilized in the eradication of R-NENs.AIM To review cases of R-NENs removed using EFTR and to evaluate the safety and efficacy of this technique.METHODS This retrospective cohort study enrolled 160 patients with pathologically confirmed R-NENs,including 132 who underwent endoscopic submucosal dissection(ESD)and 28 who underwent EFTR.Lesions were categorized as<1 cm,1-2 cm,and>2 cm in size.CR rate,en bloc resection rate,operation time,and complications were evaluated.Subgroup analyses and follow-up were also performed.RESULTS EFTR achieved 100%CR rates for lesions<1 cm and 1-2 cm,compared with 67.0%and 50.0%,respectively,in the ESD group.En bloc resection and successful removal of the R-NENs were achieved in all patients.Meanwhile,EFTR showed performance comparable to ESD in terms of operation time,hospitalization cost,and postoperative adverse events,except for a one-day longer hospital stay.We also analyzed the invasion depth of R-NENs based on full-thickness specimens.The data showed that 80%of lesions(<1 cm)and 85.7%of lesions(1-2 cm)had invaded the SM3 level or deeper at the time of resection.For ESD specimens,46.6%(<1 cm)and 89.3%(1-2 cm)of lesions had infiltrated more than 2000μm beneath the muscularis mucosae.CONCLUSION EFTR has shown superior performance in the resection of small R-NENs compared with that of ESD.展开更多
This study summarizes the examination data of registration labels for ordinary cosmetics in Beijing from May 2021 to April 2024.It analyzes and categorizes the issues identified during label evaluations,explores the u...This study summarizes the examination data of registration labels for ordinary cosmetics in Beijing from May 2021 to April 2024.It analyzes and categorizes the issues identified during label evaluations,explores the underlying causes,and proposes regulatory countermeasures and recommendations for registrants,regulatory authorities,and social organizations.The objective is to offer practical insights and regulatory guidance to support the enhancement of cosmetic registration and regulatory standards.展开更多
Objective To put forward some suggestions for improving the registration and regulation,the efficiency of evaluation,and approval of biosimilar in China so as to promote the development of biopharmaceutical industry a...Objective To put forward some suggestions for improving the registration and regulation,the efficiency of evaluation,and approval of biosimilar in China so as to promote the development of biopharmaceutical industry and increase the accessibility of therapeutic drugs in China.Methods Literature related to the registration and regulation,evaluation and approval of biosimilars were sorted out to analyze the differences in China and the USA.Results and Conclusion Based on the analysis of the current situation of registration and regulation of biosimilars between China and the USA,it is suggested to improve the registration and regulation of biosimilars in China from the following four aspects:Establishing a biosimilar regulatory department,expanding the professional evaluation personnel,scientifically simplifying the registration and approval procedures,and constantly refining the types of communication meetings.展开更多
Objective To provide a theoretical basis for the adjustment of the registration classification of China’s biological products,and to establish a continuously improved registration classification system.Methods Based ...Objective To provide a theoretical basis for the adjustment of the registration classification of China’s biological products,and to establish a continuously improved registration classification system.Methods Based on literature research,the specific classification methods,classification principles and considerations of biological registration in China,the United States and the European Union were studied to form a complete comparative analysis.Results and Conclusion It is recommended that the division between therapeutic and preventive use should be removed from the registration classification of biologics.The therapeutic,preventive and diagnostic use of the product should be limited as part of the product specification,and the registration should be classified according to the development of biotechnology,innovation,modification and bio-similar drugs.In addition,the supervision of registration of advanced therapeutic products should be different from that of traditional biologics.展开更多
Neuroendocrine neoplasms(NENs)are highly heterogeneous and potentially malignant tumors arising from secretory cells of the neuroendocrine system.Gastroenteropancreatic NENs(GEP-NENs)are the most common subtype of NEN...Neuroendocrine neoplasms(NENs)are highly heterogeneous and potentially malignant tumors arising from secretory cells of the neuroendocrine system.Gastroenteropancreatic NENs(GEP-NENs)are the most common subtype of NENs.Historically,GEP-NENs have been regarded as infrequent and slow-growing malignancies;however,recent data have demonstrated that the worldwide prevalence and incidence of GEP-NENs have increased exponentially over the last three decades.In addition,an increasing number of studies have proven that GEP-NENs result in a limited life expectancy.These findings suggested that the natural biology of GEP-NENs is more aggressive than commonly assumed.Therefore,there is an urgent need for advanced researches focusing on the diagnosis and management of patients with GEP-NENs.In this review,we have summarized the limitations and recent advancements in our comprehension of the epidemiology,clinical presentations,pathology,molecular biology,diagnosis,and treatment of GEP-NETs to identify factors contributing to delays in diagnosis and timely treatment of these patients.展开更多
Background:Modern acupuncture anesthesia is a combination of Chinese and Western medicine that integrates the theories of acupuncture with anesthesia.However,some clinical studies of acupuncture anesthesia lack specif...Background:Modern acupuncture anesthesia is a combination of Chinese and Western medicine that integrates the theories of acupuncture with anesthesia.However,some clinical studies of acupuncture anesthesia lack specific descriptions of randomization,allocation concealment,and blinding processes,with subsequent systematic reviews indicating a risk of bias.Objective:Clinical trial registration is essential for the enhancement of the quality of clinical trials.This study aims to summarize the status of clinical trial registrations for acupuncture anesthesia listed on the World Health Organization International Clinical Trials Registry Platform(ICTRP).Search strategy:We searched the ICTRP for clinical trials related to acupuncture anesthesia registered between January 1,2001 and May 31,2023.Additionally,related publications were retrieved from PubMed,Cochrane Library,Embase,China National Knowledge Infrastructure,China Science and Technology Journal Database,and Wanfang Data.Registrations and publications were analyzed for consistency in trial design characteristics.Inclusion criteria:Clinical trials that utilized one of several acupuncture-related therapies in combination with pharmacological anesthesia during the perioperative period were eligible for this review.Data extraction and analysis:Data extracted from articles included type of surgical procedure,perioperative symptoms,study methodology,type of intervention,trial recruitment information,and publication information related to clinical enrollment.Results:A total of 166 trials related to acupuncture anesthesia from 21 countries were included in the analysis.The commonly reported symptoms in the included studies were postoperative nausea and vomiting(19.9%)and postoperative pain(13.3%).The concordance between the publications and the trial protocols in the clinical registry records was poor,with only 31.7%of the studies being fully compatible.Inconsistency rates were high for sample size(39.0%,16/41),blinding(36.6%,15/41),and secondary outcome indicators(24.4%,10/41).Conclusion:The volume of acupuncture anesthesia clinical trials registered in international trial registries over the last 20 years is low,with insufficient disclosure of results.Postoperative nausea and vomiting as well as postoperative pain,are the most investigated for acupuncture intervention.展开更多
To the Editor,We have read the article by Gener-Ricos et al.titled"NPM1-mutated myeloid neoplasms are a unique entity not defined by bone marrow blast percentage",published in Cancer[1].This retrospective,cr...To the Editor,We have read the article by Gener-Ricos et al.titled"NPM1-mutated myeloid neoplasms are a unique entity not defined by bone marrow blast percentage",published in Cancer[1].This retrospective,cross-sectional pilot study provides valuable insights into the clinicopathological features and treatment outcomes of patients with NPM1-mutated myeloid neoplasms(MNs)with less than 20%bone marrow blasts[1].展开更多
Appendiceal mucinous neoplasms(AMNs)are rare tumors originating from mucin-producing epithelial cells of the appendix.They can exhibit both benign and malignant behavior.They are often incidentally discovered during a...Appendiceal mucinous neoplasms(AMNs)are rare tumors originating from mucin-producing epithelial cells of the appendix.They can exhibit both benign and malignant behavior.They are often incidentally discovered during appendectomy.Clinical presentation ranges from asymptomatic to mimicking acute appendicitis.Histologically,noninvasive AMNs are classified as low-grade AMNs(LAMNs)or high-grade AMNs(HAMNs),whereas invasive tumors are categorized as mucinous adenocarcinomas.Although LAMNs and HAMNs are generally nonmalignant,rupture can lead to pseudomyxoma peritonei(PMP).Surgical resection is the primary diagnostic and therapeutic approach,with intraoperative assessment to prevent rupture.Treatment strategies vary based on findings and include appendectomy,right hemicolectomy,and cytoreductive surgery with hyperthermic intraperitoneal chemotherapy.Histological diagnosis relies on mucin detection,and immunohistochemical markers such as cytokeratin 20(diffusely positive),cytokeratin 7(often negative),mucin 5AC,and special ATrich sequence-binding protein 2 assist in characterization.Molecular profiling frequently identifies KRAS,GNAS,and TP53 mutations.KRAS mutations are generally associated with a favorable prognosis,whereas GNAS and TP53 mutations correlate with poorer survival outcomes.These findings highlight the potential role of molecular profiling in guiding treatment strategies for AMN and PMP.展开更多
Robot-assisted surgery has become an indispensable component in modern neurosurgical procedures.However,existing registration methods for neurosurgical robots often rely on high-end hardware and involve prolonged or u...Robot-assisted surgery has become an indispensable component in modern neurosurgical procedures.However,existing registration methods for neurosurgical robots often rely on high-end hardware and involve prolonged or unstable registration times,limiting their applicability in dynamic and time-sensitive intraoperative settings.This paper proposes a novel fully automatic monocular-based registration and real-time tracking method.First,dedicated fiducials are designed,and an automatic preoperative and intraoperative detection method for these fiducials is introduced.Second,a geometric representation of the fiducials is constructed based on a 2D KD-Tree.Through a two-stage optimization process,the depth of 2D fiducials is estimated,and 2D-3D correspondences are established to achieve monocular registration.This approach enables fully automatic intraoperative registration using only a single optical camera.Finally,a six-degree-of-freedom visual servo control strategy inspired by the mass-spring-damper system is proposed.By integrating artificial potential field and admittance control,the strategy ensures real-time responsiveness and stable tracking.Experimental results demonstrate that the proposed method achieves a registration time of 0.23 s per instance with an average error of 0.58 mm.Additionally,the motion performance of the control strategy has been validated.Preliminary experiments verify the effectiveness of MonoTracker in dynamic tracking scenarios.This method holds promise for enhancing the adaptability of neurosurgical robots and offers significant clinical application potential.展开更多
BACKGROUND Pancreatic cystic neoplasms(PCNs)are increasingly detected due to advancements in radiographic techniques,with a prevalence of approximately 15%in the general population.These lesions range from benign to p...BACKGROUND Pancreatic cystic neoplasms(PCNs)are increasingly detected due to advancements in radiographic techniques,with a prevalence of approximately 15%in the general population.These lesions range from benign to premalignant and malignant,posing a diagnostic challenge.Accurate differentiation is critical,as premalignant and malignant PCNs often require surgical intervention,while benign cysts may only need monitoring unless symptomatic.Current diagnostic methods,including cross-sectional imaging,endoscopic ultrasonography,and endoscopic ultrasonography-guided fine-needle aspiration/biopsy,are specialized,not universally available,and have variable accuracy.Clinical and laboratory parameters such as carbohydrate antigen 19-9(CA 19-9),neutrophillymphocyte ratio,platelet-lymphocyte ratio,and red cell distribution width(RDW)have been associated with malignancy risk,though only CA 19-9 is guideline-supported.AIM To assess the malignancy risk of PCNs using preoperative clinical and routine laboratory parameters.METHODS A retrospective cohort study analyzed 70 patients who underwent surgery for PCNs at Ankara Bilkent City Hospital between February 2019 and March 2023.Patients were categorized into group A(benign or low-grade dysplasia,n=40)and group B(malignancy or high-grade dysplasia,n=30)based on postoperative pathology.Preoperative demographic and laboratory parameters,including age,RDW,albumin,and CA 19-9,were compared.Univariate and multivariate logistic regression analyses identified independent predictors of malignancy.Receiver operating characteristic curve analysis evaluated predictive performance,with internal validation using bootstrapping.RESULTS Group B patients were older(69.86±9.58 years vs 52.74±16.85 years,P<0.001)and had a higher incidence of diabetes mellitus(57.1%vs 21.4%,P=0.002).RDW(16.2%vs 13.7%,P<0.001),platelet-lymphocyte ratio(178 vs 126,P=0.008),and CA 19-9(21.7 U/mL vs 9.3 U/mL,P=0.009)were significantly higher in group B,while albumin was lower(41 g/L vs 45 g/L,P=0.008).Multivariate analysis identified age[odds ratio=1.067,95%confidence interval(CI):1.014-1.122,P=0.012]and RDW(odds ratio=1.784,95%CI:1.172-2.715,P=0.007)as independent predictors.The area under the curve for age,RDW,and their combination was 0.798(95%CI:0.695-0.900),0.801(95%CI:0.692-0.911),and 0.858(95%CI:0.771-0.944),respectively,with bootstrapped validation confirming stability.Cut-off values of age≥60 years and RDW≥15.5%balanced sensitivity and specificity,increasing malignancy risk 15.3-fold and 22.6-fold,respectively.CONCLUSION Age and RDW are independent predictors of malignancy in PCNs,aiding in patient selection for advanced diagnostics and surgery.Larger,multicenter studies are needed to validate these findings.展开更多
The geolocation of ground targets by airborne image sensors is an important task for unmanned aerial vehicles or surveillance aircraft.This paper proposes an Iterative Geolocation based on Cross-view Image Registratio...The geolocation of ground targets by airborne image sensors is an important task for unmanned aerial vehicles or surveillance aircraft.This paper proposes an Iterative Geolocation based on Cross-view Image Registration(IGCIR)that can provide real-time target location results with high precision.The proposed method has two key features.First,a cross-view image registration process is introduced,including a projective transformation and a two-stage multi-sensor registration.This process utilizes both gradient information and phase information of cross-view images.This allows the registration process to reach a good balance between matching precision and computational efficiency.By matching the airborne camera view to the preloaded digital map,the geolocation accuracy can reach the accuracy level of the digital map for any ground target appearing in the airborne camera view.Second,the proposed method uses the registration results to perform an iteration process,which compensates for the bias of the strap-down initial navigation module online.Although it is challenging to provide cross-view registration results with high frequency,such an iteration process allows the method to generate real-time,highly accurate location results.The effectiveness of the proposed IGCIR method is verified by a series of flying-test experiments.The results show that the location accuracy of the method can reach 4.18 m(at 10 km standoff distance).展开更多
This paper aims to develop a nonrigid registration method of preoperative and intraoperative thoracoabdominal CT images in computer-assisted interventional surgeries for accurate tumor localization and tissue visualiz...This paper aims to develop a nonrigid registration method of preoperative and intraoperative thoracoabdominal CT images in computer-assisted interventional surgeries for accurate tumor localization and tissue visualization enhancement.However,fine structure registration of complex thoracoabdominal organs and large deformation registration caused by respiratory motion is challenging.To deal with this problem,we propose a 3D multi-scale attention VoxelMorph(MAVoxelMorph)registration network.To alleviate the large deformation problem,a multi-scale axial attention mechanism is utilized by using a residual dilated pyramid pooling for multi-scale feature extraction,and position-aware axial attention for long-distance dependencies between pixels capture.To further improve the large deformation and fine structure registration results,a multi-scale context channel attention mechanism is employed utilizing content information via adjacent encoding layers.Our method was evaluated on four public lung datasets(DIR-Lab dataset,Creatis dataset,Learn2Reg dataset,OASIS dataset)and a local dataset.Results proved that the proposed method achieved better registration performance than current state-of-the-art methods,especially in handling the registration of large deformations and fine structures.It also proved to be fast in 3D image registration,using about 1.5 s,and faster than most methods.Qualitative and quantitative assessments proved that the proposed MA-VoxelMorph has the potential to realize precise and fast tumor localization in clinical interventional surgeries.展开更多
To provide reference for the prevention and control of diseases,pests,and weeds on Zanthoxylum bungeanum Maxim.and the research and development of new pesticide registrations,this paper analyzes the quantity,variety s...To provide reference for the prevention and control of diseases,pests,and weeds on Zanthoxylum bungeanum Maxim.and the research and development of new pesticide registrations,this paper analyzes the quantity,variety structure,dosage forms,and toxicity of pesticides registered on Z.bungeanum in China.The analysis reveals a relatively low quantity of pesticide registrations on Z.bungeanum,with no herbicide registrations;suspension concentrates dominate the dosage forms,and pesticide toxicity is classified as low-toxicity or micro-toxicity;registered pesticides target only rust,anthracnose,scale insects,aphids,and spider mites,while plant growth regulators solely involve growth regulation and shoot control.Given the current status of limited and incomplete pesticide registrations targeting major diseases,pests,and weeds on Z.bungeanum,severe product homogenization,and unknown maximum residue limits,it is recommended to intensify efforts in pesticide registration on Z.bungeanum,actively research and apply green control technologies,strengthen technical training guidance and pesticide supervision enforcement,to promote the healthy development of the industry.展开更多
BACKGROUND Pancreatic neuroendocrine neoplasms(pNENs)are rare,heterogeneous tumors accounting for 1%-2%of pancreatic tumors,with significant malignant potential.Intraductal papillary mucinous neoplasm of the bile duct...BACKGROUND Pancreatic neuroendocrine neoplasms(pNENs)are rare,heterogeneous tumors accounting for 1%-2%of pancreatic tumors,with significant malignant potential.Intraductal papillary mucinous neoplasm of the bile duct(IPMN-B)is a rare precancerous lesion in the bile duct system,with potential for malignancy.The combination of pNENs and IPMN-B is exceptionally rare and often leads to misdiagnosis.This study aims to report a rare case of pNENs combined with IPMN-B treated at Yanbian University Hospital to improve understanding and management of this unusual tumor combination.CASE SUMMARY We retrospectively analyzed a case from Yanbian University Hospital.We re-viewed clinical records,imaging findings,endoscopic retrograde cholangiopan-creatography,surgical exploration,and histopathological examination.The pa-tient was diagnosed with pNENs and IPMN-B.Surgical treatment was performed,with follow-up showing effective management and no significant recurrence.CONCLUSION This case represents the first report of pNENs combined with IPMN-B.It high-lights the need for thorough diagnostic evaluation to prevent misdiagnosis and improve treatment strategies.展开更多
Mucinous cystic neoplasms of the liver(MCN-L)are rare cystic lesions characterized by mucin-producing epithelium and ovarian-like stroma.Although they constitute fewer than 5%of hepatic cystic lesions,MCN-L poses sign...Mucinous cystic neoplasms of the liver(MCN-L)are rare cystic lesions characterized by mucin-producing epithelium and ovarian-like stroma.Although they constitute fewer than 5%of hepatic cystic lesions,MCN-L poses significant diagnostic challenges due to overlapping features with other cystic lesions and their potential for malignant transformation.Early recognition and definitive surgical intervention are therefore critical to ensure optimal patient outcomes.A literature review was conducted to summarize epidemiology,clinical presentation,diagnostic modalities,and management strategies for MCN-L.Additionally,from 2019 to 2025,9 patients with MCN-L were identified at our center.Clinical data and outcomes were retrospectively analyzed.MCN-L predominantly affects middle-aged women and presents as large,multiloculated cystic lesions without biliary communication.The revised 2010 World Health Organization classification emphasizes the presence of ovarian-like stroma for definitive diagnosis.Contrast-enhanced computed tomography or magnetic resonance imaging are often suggestive but not pathognomonic,reinforcing the need for histopathological confirmation.MCN-L remains a diagnostic and therapeutic challenge due to its resemblance to other cystic liver lesions.Complete surgical resection is the treatment of choice to prevent recurrence and malignant transformation,reinforcing the importance of early intervention.Further research is needed to improve diagnostic accuracy and refine management strategies.展开更多
Airborne LiDAR(Light Detection and Ranging)is an evolving high-tech active remote sensing technology that has the capability to acquire large-area topographic data and can quickly generate DEM(Digital Elevation Model)...Airborne LiDAR(Light Detection and Ranging)is an evolving high-tech active remote sensing technology that has the capability to acquire large-area topographic data and can quickly generate DEM(Digital Elevation Model)products.Combined with image data,this technology can further enrich and extract spatial geographic information.However,practically,due to the limited operating range of airborne LiDAR and the large area of task,it would be necessary to perform registration and stitching process on point clouds of adjacent flight strips.By eliminating grow errors,the systematic errors in the data need to be effectively reduced.Thus,this paper conducts research on point cloud registration methods in urban building areas,aiming to improve the accuracy and processing efficiency of airborne LiDAR data.Meanwhile,an improved post-ICP(Iterative Closest Point)point cloud registration method was proposed in this study to determine the accurate registration and efficient stitching of point clouds,which capable to provide a potential technical support for applicants in related field.展开更多
Compared with colorectal adenocarcinoma,neuroendocrine neoplasms(NENs),which affect the colon and rectum,are uncommon tumor conditions that have received relatively limited attention in basic research.Furthermore,the ...Compared with colorectal adenocarcinoma,neuroendocrine neoplasms(NENs),which affect the colon and rectum,are uncommon tumor conditions that have received relatively limited attention in basic research.Furthermore,the scarcity of these NENs has hindered extensive clinical investigations,thereby leading to a dearth of robust evidence for guiding clinical practice and impeding the establishment of standardized approaches for diagnosis and treatment.However,with the increasing awareness of population screening,as well as the increasing popularity of colonoscopy screening programs,the incidence of colorectal NENs has gradually increased.Moreover,some high-grade NENs are highly malignant and invasive,thereby leading to poor treatment outcomes and prognoses.These challenges have elicited increased attention from clinical physicians,thus prompting researchers to explore relevant studies using limited specimens and clinical data.This scenario has resulted in preliminary findings that provide evidence for addressing diagnostic and therapeutic challenges associated with NENs of the colon and rectum.In this article,we review recent literature reports and summarize the advances regarding the diagnosis and treatment of colorectal NENs.展开更多
BACKGROUND Gamma-glutamyl transferase(GGT)is a known surrogate marker of hepatic dysfunction and oxidative stress.It has recently been reported to be associated with metabolic diseases,cardiovascular diseases,and mali...BACKGROUND Gamma-glutamyl transferase(GGT)is a known surrogate marker of hepatic dysfunction and oxidative stress.It has recently been reported to be associated with metabolic diseases,cardiovascular diseases,and malignancies including pancreatic cancer.However,data on its association with pancreatic cystic neo-plasm(PCN),is unknown.AIM To investigate the association of GGT with the incidence of PCN.METHODS In this nationwide retrospective cohort study,participants who received general health checkup by National Health Insurance Service in 2009 were included.Newly diagnosed PCNs from one year after the checkup to 2020 were identified.Participants were divided into quartiles based on GGT levels.Multivariable cox proportional hazard models estimated the risk of PCNs according to GGT quartiles(Q1-Q4).Subgroup analyses by age,sex,and comorbidities,and sensitivity analyses varying lag periods and GGT categorizations were performed.RESULTS There were 28940 cases of PCNs among 2655665 eligible participants.The incidence rate was 1.09 cases per 1000 person-years,with a median follow-up of 10.32(interquartile range:10.09-10.58)years.In multivariate regression analysis,adjusted hazard ratios for GGT quartiles using Q1 group as a reference were:1.04[95%confidence interval(CI):1.005-1.075]for Q2,1.065(95%CI:1.03-1.102)for Q3,and 1.109(95%CI:1.07-1.15)for Q4.Subgroup analysis showed consistent results across age,sex,and comorbidities.In sensitivity analyses,the association remained robust even at 3-year and 5-year lag periods.A clear dose-response relationship was also observed when using GGT deciles(All P for trend<0.001).CONCLUSION Higher GGT level is associated with increased risk of PCNs.Therefore,serum GGT levels might have a role as a biomarker for the development of PCNs.展开更多
In this article,we discussed the article by Zeng et al,published in a recent issue of the World Journal of Gastroenterology.The publication represents a significant advancement in the prognostic evaluation of rectal n...In this article,we discussed the article by Zeng et al,published in a recent issue of the World Journal of Gastroenterology.The publication represents a significant advancement in the prognostic evaluation of rectal neuroendocrine neoplasms.The GATIS score is a single nomogram model that incorporates five key progno-stic factors:Tumor grade;T stage;tumor size;age;and the prognostic nutritional index.This innovation optimizes the prognostic process,delivering more accurate predictions of overall survival and progression-free survival compared to tradi-tional TNM staging and World Health Organization classification systems.The findings of the study were based on a retrospective analysis spanning 12 years and involving 1408 patients from 17 reference centers in China.In this editorial,we specifically examined the strengths and limitations of the study,the clinical implications of the GATIS score,and the questions arising from its conclusions.展开更多
文摘Neuroendocrine neoplasms(NENs)are relatively rare tumors that arise from peptidergic neurons and neuroendocrine cells.NENs are highly heterogeneous and can occur in any part of the body,with a particular prevalence in the digestive system.NENs consist of a range of tumor types and the biological behaviors exhibit significant differences.NENs are classified into well-differentiated neuroendocrine tumors(NETs)and poorly differentiated neuroendocrine carcinomas(NECs).NETs can be further classified and graded into the following three categories:low-grade NETs,grade 1(NET G1);intermediate-grade NET G2;and high-grade NET G3.NECs include large cell-type NEC(LCNEC)and small cell-type NEC(SCNEC),both of which are considered high grade.Currently,the main treatments for advanced NENs are biological treatments,targeted therapy,chemotherapy,and newer treatments that are still under development,such as immunotherapy and peptide receptor radionuclide therapy(PRRT).However,owing to the rarity of NENs,pharmaceutical company investment is limited and few phase Ⅲ studies have targeted advanced NENs.Most current research consists of investigator-initiated phase Ⅰ and Ⅱ clinical trials or largescale retrospective studies.NEN treatment should be chosen carefully because it is cumbersome and complicated,as indicated above.Herein,we comprehensively summarize the clinical application status and research progress for advanced NEN treatment regimens,especially for advanced NETs,which may help to create awareness on NENs among medical professionals across specialties.
基金Supported by National Natural Science Foundation of China,No.82004298Jiangsu Graduate Research and Practice Innovation Program,China,No.KYCX23_2090.
文摘BACKGROUND Recently,several endoscopic techniques have been used to improve the R0 resection rate of rectal neuroendocrine neoplasms(R-NENs).However,none of these methods can achieve 100%complete resection(CR),particularly in the vertical direction.Endoscopic full-thickness resection(EFTR)has proven to be an effective method for the treatment of submucosal tumors but is seldom utilized in the eradication of R-NENs.AIM To review cases of R-NENs removed using EFTR and to evaluate the safety and efficacy of this technique.METHODS This retrospective cohort study enrolled 160 patients with pathologically confirmed R-NENs,including 132 who underwent endoscopic submucosal dissection(ESD)and 28 who underwent EFTR.Lesions were categorized as<1 cm,1-2 cm,and>2 cm in size.CR rate,en bloc resection rate,operation time,and complications were evaluated.Subgroup analyses and follow-up were also performed.RESULTS EFTR achieved 100%CR rates for lesions<1 cm and 1-2 cm,compared with 67.0%and 50.0%,respectively,in the ESD group.En bloc resection and successful removal of the R-NENs were achieved in all patients.Meanwhile,EFTR showed performance comparable to ESD in terms of operation time,hospitalization cost,and postoperative adverse events,except for a one-day longer hospital stay.We also analyzed the invasion depth of R-NENs based on full-thickness specimens.The data showed that 80%of lesions(<1 cm)and 85.7%of lesions(1-2 cm)had invaded the SM3 level or deeper at the time of resection.For ESD specimens,46.6%(<1 cm)and 89.3%(1-2 cm)of lesions had infiltrated more than 2000μm beneath the muscularis mucosae.CONCLUSION EFTR has shown superior performance in the resection of small R-NENs compared with that of ESD.
文摘This study summarizes the examination data of registration labels for ordinary cosmetics in Beijing from May 2021 to April 2024.It analyzes and categorizes the issues identified during label evaluations,explores the underlying causes,and proposes regulatory countermeasures and recommendations for registrants,regulatory authorities,and social organizations.The objective is to offer practical insights and regulatory guidance to support the enhancement of cosmetic registration and regulatory standards.
文摘Objective To put forward some suggestions for improving the registration and regulation,the efficiency of evaluation,and approval of biosimilar in China so as to promote the development of biopharmaceutical industry and increase the accessibility of therapeutic drugs in China.Methods Literature related to the registration and regulation,evaluation and approval of biosimilars were sorted out to analyze the differences in China and the USA.Results and Conclusion Based on the analysis of the current situation of registration and regulation of biosimilars between China and the USA,it is suggested to improve the registration and regulation of biosimilars in China from the following four aspects:Establishing a biosimilar regulatory department,expanding the professional evaluation personnel,scientifically simplifying the registration and approval procedures,and constantly refining the types of communication meetings.
文摘Objective To provide a theoretical basis for the adjustment of the registration classification of China’s biological products,and to establish a continuously improved registration classification system.Methods Based on literature research,the specific classification methods,classification principles and considerations of biological registration in China,the United States and the European Union were studied to form a complete comparative analysis.Results and Conclusion It is recommended that the division between therapeutic and preventive use should be removed from the registration classification of biologics.The therapeutic,preventive and diagnostic use of the product should be limited as part of the product specification,and the registration should be classified according to the development of biotechnology,innovation,modification and bio-similar drugs.In addition,the supervision of registration of advanced therapeutic products should be different from that of traditional biologics.
基金supported by the National Natural Science Foundation of China(82104596)the Shenzhen Key Medical Discipline Construction Fund&Sanming Project of Medicine in Shenzhen(SZSM202111002)+1 种基金the Medicine-Engineering Interdisciplinary Research Foundation of Shenzhen University(2023YG019)the Shenzhen Science and Technology Program(GJHZ20220913143005010)。
文摘Neuroendocrine neoplasms(NENs)are highly heterogeneous and potentially malignant tumors arising from secretory cells of the neuroendocrine system.Gastroenteropancreatic NENs(GEP-NENs)are the most common subtype of NENs.Historically,GEP-NENs have been regarded as infrequent and slow-growing malignancies;however,recent data have demonstrated that the worldwide prevalence and incidence of GEP-NENs have increased exponentially over the last three decades.In addition,an increasing number of studies have proven that GEP-NENs result in a limited life expectancy.These findings suggested that the natural biology of GEP-NENs is more aggressive than commonly assumed.Therefore,there is an urgent need for advanced researches focusing on the diagnosis and management of patients with GEP-NENs.In this review,we have summarized the limitations and recent advancements in our comprehension of the epidemiology,clinical presentations,pathology,molecular biology,diagnosis,and treatment of GEP-NETs to identify factors contributing to delays in diagnosis and timely treatment of these patients.
基金supported by grants from Shanghai Municipal Health Commission and Shanghai Municipal Administration of TCM—Standardization of TCM in 2023“Clinical Practice Guide for Combined Acupuncture-Drug Anesthesia”(No.2023JS05)Shanghai Clinical Medical Research Center of Acupuncture and Moxibustion(No.20MC1920500)+1 种基金Shanghai master Chinese medicine practitioners academic experience research studio construction project(No.SHGZS-202212)Shanghai Key Clinical Specialties 2019 Accreditation Program(No.shslczdzk04701)。
文摘Background:Modern acupuncture anesthesia is a combination of Chinese and Western medicine that integrates the theories of acupuncture with anesthesia.However,some clinical studies of acupuncture anesthesia lack specific descriptions of randomization,allocation concealment,and blinding processes,with subsequent systematic reviews indicating a risk of bias.Objective:Clinical trial registration is essential for the enhancement of the quality of clinical trials.This study aims to summarize the status of clinical trial registrations for acupuncture anesthesia listed on the World Health Organization International Clinical Trials Registry Platform(ICTRP).Search strategy:We searched the ICTRP for clinical trials related to acupuncture anesthesia registered between January 1,2001 and May 31,2023.Additionally,related publications were retrieved from PubMed,Cochrane Library,Embase,China National Knowledge Infrastructure,China Science and Technology Journal Database,and Wanfang Data.Registrations and publications were analyzed for consistency in trial design characteristics.Inclusion criteria:Clinical trials that utilized one of several acupuncture-related therapies in combination with pharmacological anesthesia during the perioperative period were eligible for this review.Data extraction and analysis:Data extracted from articles included type of surgical procedure,perioperative symptoms,study methodology,type of intervention,trial recruitment information,and publication information related to clinical enrollment.Results:A total of 166 trials related to acupuncture anesthesia from 21 countries were included in the analysis.The commonly reported symptoms in the included studies were postoperative nausea and vomiting(19.9%)and postoperative pain(13.3%).The concordance between the publications and the trial protocols in the clinical registry records was poor,with only 31.7%of the studies being fully compatible.Inconsistency rates were high for sample size(39.0%,16/41),blinding(36.6%,15/41),and secondary outcome indicators(24.4%,10/41).Conclusion:The volume of acupuncture anesthesia clinical trials registered in international trial registries over the last 20 years is low,with insufficient disclosure of results.Postoperative nausea and vomiting as well as postoperative pain,are the most investigated for acupuncture intervention.
文摘To the Editor,We have read the article by Gener-Ricos et al.titled"NPM1-mutated myeloid neoplasms are a unique entity not defined by bone marrow blast percentage",published in Cancer[1].This retrospective,cross-sectional pilot study provides valuable insights into the clinicopathological features and treatment outcomes of patients with NPM1-mutated myeloid neoplasms(MNs)with less than 20%bone marrow blasts[1].
文摘Appendiceal mucinous neoplasms(AMNs)are rare tumors originating from mucin-producing epithelial cells of the appendix.They can exhibit both benign and malignant behavior.They are often incidentally discovered during appendectomy.Clinical presentation ranges from asymptomatic to mimicking acute appendicitis.Histologically,noninvasive AMNs are classified as low-grade AMNs(LAMNs)or high-grade AMNs(HAMNs),whereas invasive tumors are categorized as mucinous adenocarcinomas.Although LAMNs and HAMNs are generally nonmalignant,rupture can lead to pseudomyxoma peritonei(PMP).Surgical resection is the primary diagnostic and therapeutic approach,with intraoperative assessment to prevent rupture.Treatment strategies vary based on findings and include appendectomy,right hemicolectomy,and cytoreductive surgery with hyperthermic intraperitoneal chemotherapy.Histological diagnosis relies on mucin detection,and immunohistochemical markers such as cytokeratin 20(diffusely positive),cytokeratin 7(often negative),mucin 5AC,and special ATrich sequence-binding protein 2 assist in characterization.Molecular profiling frequently identifies KRAS,GNAS,and TP53 mutations.KRAS mutations are generally associated with a favorable prognosis,whereas GNAS and TP53 mutations correlate with poorer survival outcomes.These findings highlight the potential role of molecular profiling in guiding treatment strategies for AMN and PMP.
基金Supported by National Natural Science Foundation of China(Grant No.92148206).
文摘Robot-assisted surgery has become an indispensable component in modern neurosurgical procedures.However,existing registration methods for neurosurgical robots often rely on high-end hardware and involve prolonged or unstable registration times,limiting their applicability in dynamic and time-sensitive intraoperative settings.This paper proposes a novel fully automatic monocular-based registration and real-time tracking method.First,dedicated fiducials are designed,and an automatic preoperative and intraoperative detection method for these fiducials is introduced.Second,a geometric representation of the fiducials is constructed based on a 2D KD-Tree.Through a two-stage optimization process,the depth of 2D fiducials is estimated,and 2D-3D correspondences are established to achieve monocular registration.This approach enables fully automatic intraoperative registration using only a single optical camera.Finally,a six-degree-of-freedom visual servo control strategy inspired by the mass-spring-damper system is proposed.By integrating artificial potential field and admittance control,the strategy ensures real-time responsiveness and stable tracking.Experimental results demonstrate that the proposed method achieves a registration time of 0.23 s per instance with an average error of 0.58 mm.Additionally,the motion performance of the control strategy has been validated.Preliminary experiments verify the effectiveness of MonoTracker in dynamic tracking scenarios.This method holds promise for enhancing the adaptability of neurosurgical robots and offers significant clinical application potential.
文摘BACKGROUND Pancreatic cystic neoplasms(PCNs)are increasingly detected due to advancements in radiographic techniques,with a prevalence of approximately 15%in the general population.These lesions range from benign to premalignant and malignant,posing a diagnostic challenge.Accurate differentiation is critical,as premalignant and malignant PCNs often require surgical intervention,while benign cysts may only need monitoring unless symptomatic.Current diagnostic methods,including cross-sectional imaging,endoscopic ultrasonography,and endoscopic ultrasonography-guided fine-needle aspiration/biopsy,are specialized,not universally available,and have variable accuracy.Clinical and laboratory parameters such as carbohydrate antigen 19-9(CA 19-9),neutrophillymphocyte ratio,platelet-lymphocyte ratio,and red cell distribution width(RDW)have been associated with malignancy risk,though only CA 19-9 is guideline-supported.AIM To assess the malignancy risk of PCNs using preoperative clinical and routine laboratory parameters.METHODS A retrospective cohort study analyzed 70 patients who underwent surgery for PCNs at Ankara Bilkent City Hospital between February 2019 and March 2023.Patients were categorized into group A(benign or low-grade dysplasia,n=40)and group B(malignancy or high-grade dysplasia,n=30)based on postoperative pathology.Preoperative demographic and laboratory parameters,including age,RDW,albumin,and CA 19-9,were compared.Univariate and multivariate logistic regression analyses identified independent predictors of malignancy.Receiver operating characteristic curve analysis evaluated predictive performance,with internal validation using bootstrapping.RESULTS Group B patients were older(69.86±9.58 years vs 52.74±16.85 years,P<0.001)and had a higher incidence of diabetes mellitus(57.1%vs 21.4%,P=0.002).RDW(16.2%vs 13.7%,P<0.001),platelet-lymphocyte ratio(178 vs 126,P=0.008),and CA 19-9(21.7 U/mL vs 9.3 U/mL,P=0.009)were significantly higher in group B,while albumin was lower(41 g/L vs 45 g/L,P=0.008).Multivariate analysis identified age[odds ratio=1.067,95%confidence interval(CI):1.014-1.122,P=0.012]and RDW(odds ratio=1.784,95%CI:1.172-2.715,P=0.007)as independent predictors.The area under the curve for age,RDW,and their combination was 0.798(95%CI:0.695-0.900),0.801(95%CI:0.692-0.911),and 0.858(95%CI:0.771-0.944),respectively,with bootstrapped validation confirming stability.Cut-off values of age≥60 years and RDW≥15.5%balanced sensitivity and specificity,increasing malignancy risk 15.3-fold and 22.6-fold,respectively.CONCLUSION Age and RDW are independent predictors of malignancy in PCNs,aiding in patient selection for advanced diagnostics and surgery.Larger,multicenter studies are needed to validate these findings.
基金supported by the National Level Project of China(No.52-L0D01-0613-20/22)。
文摘The geolocation of ground targets by airborne image sensors is an important task for unmanned aerial vehicles or surveillance aircraft.This paper proposes an Iterative Geolocation based on Cross-view Image Registration(IGCIR)that can provide real-time target location results with high precision.The proposed method has two key features.First,a cross-view image registration process is introduced,including a projective transformation and a two-stage multi-sensor registration.This process utilizes both gradient information and phase information of cross-view images.This allows the registration process to reach a good balance between matching precision and computational efficiency.By matching the airborne camera view to the preloaded digital map,the geolocation accuracy can reach the accuracy level of the digital map for any ground target appearing in the airborne camera view.Second,the proposed method uses the registration results to perform an iteration process,which compensates for the bias of the strap-down initial navigation module online.Although it is challenging to provide cross-view registration results with high frequency,such an iteration process allows the method to generate real-time,highly accurate location results.The effectiveness of the proposed IGCIR method is verified by a series of flying-test experiments.The results show that the location accuracy of the method can reach 4.18 m(at 10 km standoff distance).
基金supported in part by the National Natural Science Foundation of China[62301374]Hubei Provincial Natural Science Foundation of China[2022CFB804]+2 种基金Hubei Provincial Education Research Project[B2022057]the Youths Science Foundation of Wuhan Institute of Technology[K202240]the 15th Graduate Education Innovation Fund of Wuhan Institute of Technology[CX2023295].
文摘This paper aims to develop a nonrigid registration method of preoperative and intraoperative thoracoabdominal CT images in computer-assisted interventional surgeries for accurate tumor localization and tissue visualization enhancement.However,fine structure registration of complex thoracoabdominal organs and large deformation registration caused by respiratory motion is challenging.To deal with this problem,we propose a 3D multi-scale attention VoxelMorph(MAVoxelMorph)registration network.To alleviate the large deformation problem,a multi-scale axial attention mechanism is utilized by using a residual dilated pyramid pooling for multi-scale feature extraction,and position-aware axial attention for long-distance dependencies between pixels capture.To further improve the large deformation and fine structure registration results,a multi-scale context channel attention mechanism is employed utilizing content information via adjacent encoding layers.Our method was evaluated on four public lung datasets(DIR-Lab dataset,Creatis dataset,Learn2Reg dataset,OASIS dataset)and a local dataset.Results proved that the proposed method achieved better registration performance than current state-of-the-art methods,especially in handling the registration of large deformations and fine structures.It also proved to be fast in 3D image registration,using about 1.5 s,and faster than most methods.Qualitative and quantitative assessments proved that the proposed MA-VoxelMorph has the potential to realize precise and fast tumor localization in clinical interventional surgeries.
基金Supported by Sichuan Province Zanthoxylum bungeanum Maxim.Innovation Team Project"Green Control of Diseases and Weeds on Zanthoxylum bungeanum Maxim."Institute-Local Cooperation Project"Demonstration of Chemical Fertilizer and Pesticide Reduction Techniques in Hongya County(2024-2026)".
文摘To provide reference for the prevention and control of diseases,pests,and weeds on Zanthoxylum bungeanum Maxim.and the research and development of new pesticide registrations,this paper analyzes the quantity,variety structure,dosage forms,and toxicity of pesticides registered on Z.bungeanum in China.The analysis reveals a relatively low quantity of pesticide registrations on Z.bungeanum,with no herbicide registrations;suspension concentrates dominate the dosage forms,and pesticide toxicity is classified as low-toxicity or micro-toxicity;registered pesticides target only rust,anthracnose,scale insects,aphids,and spider mites,while plant growth regulators solely involve growth regulation and shoot control.Given the current status of limited and incomplete pesticide registrations targeting major diseases,pests,and weeds on Z.bungeanum,severe product homogenization,and unknown maximum residue limits,it is recommended to intensify efforts in pesticide registration on Z.bungeanum,actively research and apply green control technologies,strengthen technical training guidance and pesticide supervision enforcement,to promote the healthy development of the industry.
文摘BACKGROUND Pancreatic neuroendocrine neoplasms(pNENs)are rare,heterogeneous tumors accounting for 1%-2%of pancreatic tumors,with significant malignant potential.Intraductal papillary mucinous neoplasm of the bile duct(IPMN-B)is a rare precancerous lesion in the bile duct system,with potential for malignancy.The combination of pNENs and IPMN-B is exceptionally rare and often leads to misdiagnosis.This study aims to report a rare case of pNENs combined with IPMN-B treated at Yanbian University Hospital to improve understanding and management of this unusual tumor combination.CASE SUMMARY We retrospectively analyzed a case from Yanbian University Hospital.We re-viewed clinical records,imaging findings,endoscopic retrograde cholangiopan-creatography,surgical exploration,and histopathological examination.The pa-tient was diagnosed with pNENs and IPMN-B.Surgical treatment was performed,with follow-up showing effective management and no significant recurrence.CONCLUSION This case represents the first report of pNENs combined with IPMN-B.It high-lights the need for thorough diagnostic evaluation to prevent misdiagnosis and improve treatment strategies.
文摘Mucinous cystic neoplasms of the liver(MCN-L)are rare cystic lesions characterized by mucin-producing epithelium and ovarian-like stroma.Although they constitute fewer than 5%of hepatic cystic lesions,MCN-L poses significant diagnostic challenges due to overlapping features with other cystic lesions and their potential for malignant transformation.Early recognition and definitive surgical intervention are therefore critical to ensure optimal patient outcomes.A literature review was conducted to summarize epidemiology,clinical presentation,diagnostic modalities,and management strategies for MCN-L.Additionally,from 2019 to 2025,9 patients with MCN-L were identified at our center.Clinical data and outcomes were retrospectively analyzed.MCN-L predominantly affects middle-aged women and presents as large,multiloculated cystic lesions without biliary communication.The revised 2010 World Health Organization classification emphasizes the presence of ovarian-like stroma for definitive diagnosis.Contrast-enhanced computed tomography or magnetic resonance imaging are often suggestive but not pathognomonic,reinforcing the need for histopathological confirmation.MCN-L remains a diagnostic and therapeutic challenge due to its resemblance to other cystic liver lesions.Complete surgical resection is the treatment of choice to prevent recurrence and malignant transformation,reinforcing the importance of early intervention.Further research is needed to improve diagnostic accuracy and refine management strategies.
基金Guangxi Key Laboratory of Spatial Information and Geomatics(21-238-21-12)Guangxi Young and Middle-aged Teachers’Research Fundamental Ability Enhancement Project(2023KY1196).
文摘Airborne LiDAR(Light Detection and Ranging)is an evolving high-tech active remote sensing technology that has the capability to acquire large-area topographic data and can quickly generate DEM(Digital Elevation Model)products.Combined with image data,this technology can further enrich and extract spatial geographic information.However,practically,due to the limited operating range of airborne LiDAR and the large area of task,it would be necessary to perform registration and stitching process on point clouds of adjacent flight strips.By eliminating grow errors,the systematic errors in the data need to be effectively reduced.Thus,this paper conducts research on point cloud registration methods in urban building areas,aiming to improve the accuracy and processing efficiency of airborne LiDAR data.Meanwhile,an improved post-ICP(Iterative Closest Point)point cloud registration method was proposed in this study to determine the accurate registration and efficient stitching of point clouds,which capable to provide a potential technical support for applicants in related field.
文摘Compared with colorectal adenocarcinoma,neuroendocrine neoplasms(NENs),which affect the colon and rectum,are uncommon tumor conditions that have received relatively limited attention in basic research.Furthermore,the scarcity of these NENs has hindered extensive clinical investigations,thereby leading to a dearth of robust evidence for guiding clinical practice and impeding the establishment of standardized approaches for diagnosis and treatment.However,with the increasing awareness of population screening,as well as the increasing popularity of colonoscopy screening programs,the incidence of colorectal NENs has gradually increased.Moreover,some high-grade NENs are highly malignant and invasive,thereby leading to poor treatment outcomes and prognoses.These challenges have elicited increased attention from clinical physicians,thus prompting researchers to explore relevant studies using limited specimens and clinical data.This scenario has resulted in preliminary findings that provide evidence for addressing diagnostic and therapeutic challenges associated with NENs of the colon and rectum.In this article,we review recent literature reports and summarize the advances regarding the diagnosis and treatment of colorectal NENs.
文摘BACKGROUND Gamma-glutamyl transferase(GGT)is a known surrogate marker of hepatic dysfunction and oxidative stress.It has recently been reported to be associated with metabolic diseases,cardiovascular diseases,and malignancies including pancreatic cancer.However,data on its association with pancreatic cystic neo-plasm(PCN),is unknown.AIM To investigate the association of GGT with the incidence of PCN.METHODS In this nationwide retrospective cohort study,participants who received general health checkup by National Health Insurance Service in 2009 were included.Newly diagnosed PCNs from one year after the checkup to 2020 were identified.Participants were divided into quartiles based on GGT levels.Multivariable cox proportional hazard models estimated the risk of PCNs according to GGT quartiles(Q1-Q4).Subgroup analyses by age,sex,and comorbidities,and sensitivity analyses varying lag periods and GGT categorizations were performed.RESULTS There were 28940 cases of PCNs among 2655665 eligible participants.The incidence rate was 1.09 cases per 1000 person-years,with a median follow-up of 10.32(interquartile range:10.09-10.58)years.In multivariate regression analysis,adjusted hazard ratios for GGT quartiles using Q1 group as a reference were:1.04[95%confidence interval(CI):1.005-1.075]for Q2,1.065(95%CI:1.03-1.102)for Q3,and 1.109(95%CI:1.07-1.15)for Q4.Subgroup analysis showed consistent results across age,sex,and comorbidities.In sensitivity analyses,the association remained robust even at 3-year and 5-year lag periods.A clear dose-response relationship was also observed when using GGT deciles(All P for trend<0.001).CONCLUSION Higher GGT level is associated with increased risk of PCNs.Therefore,serum GGT levels might have a role as a biomarker for the development of PCNs.
文摘In this article,we discussed the article by Zeng et al,published in a recent issue of the World Journal of Gastroenterology.The publication represents a significant advancement in the prognostic evaluation of rectal neuroendocrine neoplasms.The GATIS score is a single nomogram model that incorporates five key progno-stic factors:Tumor grade;T stage;tumor size;age;and the prognostic nutritional index.This innovation optimizes the prognostic process,delivering more accurate predictions of overall survival and progression-free survival compared to tradi-tional TNM staging and World Health Organization classification systems.The findings of the study were based on a retrospective analysis spanning 12 years and involving 1408 patients from 17 reference centers in China.In this editorial,we specifically examined the strengths and limitations of the study,the clinical implications of the GATIS score,and the questions arising from its conclusions.
