BACKGROUND Hypertrophic cardiomyopathy(HCM)is characterized by left ventricular hypertrophy and interstitial fibrosis,which contribute to adverse outcomes such as heart failure and sudden cardiac death.While cardiac m...BACKGROUND Hypertrophic cardiomyopathy(HCM)is characterized by left ventricular hypertrophy and interstitial fibrosis,which contribute to adverse outcomes such as heart failure and sudden cardiac death.While cardiac magnetic resonance(CMR)imaging is commonly used to detect myocardial fibrosis,circulating microRNAs(miRNAs)have emerged as promising noninvasive biomarkers for this condition due to their stability in blood plasma and resistance to pH and temperature variance.AIM To explore the role of specific circulating miRNAs in identifying myocardial fibrosis in patients with HCM.METHODS Using PubMed/MEDLINE and Google Scholar,we reviewed studies from 2014 to 2024 examining the link between circulating miRNAs and myocardial fibrosis in HCM.We included studies measuring miRNA expression in blood samples from HCM patients and assessing fibrosis via imaging,mostly CMR.Data extraction concentrated on the population,methodology,and findings related to the correlation between miRNA levels and fibrosis.RESULTS Seven studies involving 365 HCM patients with a mean age of 49.37±10.5 years,116(31.78%)females,and one animal study identified miR-21,miR-29a,miR-133,miR-4454,and miR-221 as frequently dysregulated markers associated with fibrosis.Elevated levels of miR-21 and miR-29a correlated with more extensive fibrosis,as assessed by late gadolinium enhancement in CMR imaging,with miR-29a consistently linked to both fibrosis and hypertrophy across the studies.CONCLUSION Circulating miRNAs,particularly miR-21,miR-29a,and miR-221,show significant potential as biomarkers for myocardial fibrosis in HCM.Further research should validate these findings and investigate the clinical application of miRNA-based diagnostics in HCM.展开更多
Short-chain fatty acids,metabolites produced by the fermentation of dietary fiber by gut microbiota,have garnered significant attention due to their correlation with neurodegenerative diseases,particularly Parkinson’...Short-chain fatty acids,metabolites produced by the fermentation of dietary fiber by gut microbiota,have garnered significant attention due to their correlation with neurodegenerative diseases,particularly Parkinson’s disease.In this review,we summarize the changes in short-chain fatty acid levels and the abundance of short-chain fatty acid-producing bacteria in various samples from patients with Parkinson’s disease,highlighting the critical role of gut homeostasis imbalance in the pathogenesis and progression of the disease.Focusing on the nervous system,we discuss the molecular mechanisms by which short-chain fatty acids influence the homeostasis of both the enteric nervous system and the central nervous system.We identify key processes,including the activation of G protein-coupled receptors and the inhibition of histone deacetylases by short-chain fatty acids.Importantly,structural or functional disruptions in the enteric nervous system mediated by these fatty acids may lead to abnormalα-synuclein expression and gastrointestinal dysmotility,which could serve as an initiating event in Parkinson’s disease.Furthermore,we propose that short-chain fatty acids help establish communication between the enteric nervous system and the central nervous system via the vagal nerve,immune circulation,and endocrine signaling.This communication may shed light on their potential role in the transmission ofα-synuclein from the gut to the brain.Finally,we elucidate novel treatment strategies for Parkinson’s disease that target short-chain fatty acids and examine the challenges associated with translating short-chain fatty acid-based therapies into clinical practice.In conclusion,this review emphasizes the pivotal role of short-chain fatty acids in regulating gut-brain axis integrity and their significance in the pathogenesis of Parkinson’s disease from the perspective of the nervous system.Moreover,it highlights the potential value of short-chain fatty acids in early intervention for Parkinson’s disease.Future research into the molecular mechanisms of short-chain fatty acids and their synergistic interactions with other gut metabolites is likely to advance the clinical translation of innovative short-chain fatty acid-based therapies for Parkinson’s disease.展开更多
Objectives:Although immune checkpoint inhibitors(ICIs)and targeted therapies have reshaped treatment non-small cell lung cancer(NSCLC)paradigms,prognosis remains poor for many patients due to delayed diagnosis and res...Objectives:Although immune checkpoint inhibitors(ICIs)and targeted therapies have reshaped treatment non-small cell lung cancer(NSCLC)paradigms,prognosis remains poor for many patients due to delayed diagnosis and resistance mechanisms.Liquid biopsy offers a minimally invasive approach to monitoring tumor evolution.Among circulating biomarkers,circulating tumor cells(CTCs)and cancer-associated macrophage-like cells(CAM-Ls)may provide complementary prognostic insights.The study aimed to evaluate the prognostic role of CTC and CAM-Ls dynamic in metastatic NSCLC patients.Methods:We retrospectively analyzed 77 patients with metastatic NSCLC who underwent CTC and CAM-L evaluation via the CellSearch^(■)system at baseline(T0)and after three months of first-line treatment(T1)including chemotherapy,targeted therapy,or ICIs.Survival outcomes were analyzed using Kaplan-Meier and Cox regression analyses.Results:Conversion to CTC-negative status at T1 was associated with improved outcomes,with median overall survival(OS)and progression-free survival(PFS)of 33 and 18 months,respectively,vs.10 and 6 months in persistently positive patients(both p<0.001).CTC negativity at T1 remained an independent prognostic factor for OS(HR:6.68)and PFS(HR:5.91,both p<0.0001).CAM-L positivity at T1 also correlated with longer OS(30 vs.12 months)and PFS(13 vs.6 months,both p<0.0001),particularly among ICI-treated patients.Combined CTC and CAM-L assessment further refined risk stratification.Conclusions:Dynamic monitoring of CTCs and CAM-Ls provides actionable prognostic information in metastatic NSCLC.CTC-negative status predicted longer OS and PFS,while CAM-L positivity at T1 was associated with improved outcomes,particularly in ICI-treated patients.Combined assessment of both biomarkers may directly inform therapeutic decision-making,through early detection of outcomes.展开更多
Objective:We investigated the clinical value of a novel circulating tumor cell(CTC)detection method—subtraction enrichment combined with immunostaining and fluorescence in situ hybridization(SEi FISH)—in ovarian can...Objective:We investigated the clinical value of a novel circulating tumor cell(CTC)detection method—subtraction enrichment combined with immunostaining and fluorescence in situ hybridization(SEi FISH)—in ovarian cancer(OC).This study evaluated the diagnostic and prognostic significance of chromosome 8aneuploidy in CTCs and circulating tumor endothelial cells(CTECs)for preoperative diagnosis,treatment efficacy assessment,and recurrence monitoring.Methods:A total of 331 patients were enrolled,including 56 with newly diagnosed primary OC,265 with benign ovarian tumors,and 10 with borderline tumors.Peripheral blood CTCs and CTECs were detected using SEi FISH;their quantity and ploidy characteristics were analyzed in relation to clinical indicators.To assess dynamic CTC changes during disease progression and treatment response,72 patients were followed longitudinally,of whom 19 experienced recurrence.Results:The CTC detection rate in OC patients was 92.9%,with significantly higher counts than that in the benign tumor group(median 5 vs.2).Receiver operating characteristic analysis demonstrated good diagnostic performance for total CTCs[area under the curve(AUC)=0.699],with triploid CTCs achieving the highest efficacy(AUC=0.792),surpassing carbohydrate antigen 125(CA125)(AUC=0.702).Postoperative follow-up showed that70%of patients exhibited concurrent decreases in CTCs and CA125 levels,indicating disease improvement.In30%of patients,CTC levels did not correlate with changes in CA125 levels.Individual case evidence suggests that CTC alterations may serve as an early indicator of recurrence or metastasis.Among the 19 recurrent cases,73.7%showed elevated CTCs at recurrence that decreased following treatment.In four patients,CTCs reflected disease progression earlier than CA125,indicating higher sensitivity for recurrence monitoring.Conclusions:CTCs with chromosome 8 aneuploidy demonstrate significant clinical value in the preoperative diagnosis,treatment efficacy evaluation,and recurrence monitoring of OC.Dynamic CTC changes may serve as a more sensitive indicator than CA125 for disease surveillance,supporting the translational potential of CTC-based biomarkers in OC.展开更多
Cervical cancer related to human papillomavirus(HPV)is a leading cause of cancer-related mortality among women worldwide.Cancer cells release fragments of their DNA,known as circulating tumor DNA(ctDNA),which can be d...Cervical cancer related to human papillomavirus(HPV)is a leading cause of cancer-related mortality among women worldwide.Cancer cells release fragments of their DNA,known as circulating tumor DNA(ctDNA),which can be detected in bodily fluids.A PubMed search using the terms“ctHPV”or“circulating tumor DNA”and“cervical cancer”,limited to the past ten years,identified 104 articles,complemented by hand-searching for literature addressing medico-legal implications.Studies were evaluated for relevance and methodological quality.Detection and characterization of circulating tumor HPV DNA(ctHPV DNA)have emerged as promising tools for assessing prognosis and disease recurrence in cervical cancer.Detection techniques include polymerase chain reaction(PCR),digital droplet PCR(ddPCR),and next-generation sequencing(NGS).This review summarizes current knowledge on ctHPV DNA in cervical cancer and explores its clinical and medico-legal implications,including management of discordant results,diagnostic errors,liability,and data protection compliance.展开更多
To solve the problem of circulating power of dual active bridge(DAB)DC-DC converter over a wide voltage conversion ratio,this paper proposes a novel synchronous PWM(S-PWM)modulation.Existence of circulating power incr...To solve the problem of circulating power of dual active bridge(DAB)DC-DC converter over a wide voltage conversion ratio,this paper proposes a novel synchronous PWM(S-PWM)modulation.Existence of circulating power increases current stress of devices and decreases efficiency,especially under light load conditions.Several modulation methods have been proposed to overcome the problem.They can reduce or eliminate either input or output side circulating power.In contrast,S-PWM not only eliminates both sides circulating power and reduces current stress,but also achieves zero-current-switching(ZCS)turn-on for all switches and ZCS turn-off for most across the full power range.No auxiliary or snubber circuits are increased.In addition,the control can be simplified so the transmitted power is related to only one variable.The S-PWM has four cases under different gain and power conditions.The detailed operation principle and modes of DAB under S-PWM are analyzed in the paper.In addition,four modulations in literature are discussed,and corresponding comparative analyses with S-PWM are given.Finally,a laboratory prototype is built to verify advantages and effectiveness of the proposed modulation.展开更多
Recent research on deterministic methods for circulating cooling water systems optimization has been well developed. However, the actual operating conditions of the system are mostly variable, so the system obtained u...Recent research on deterministic methods for circulating cooling water systems optimization has been well developed. However, the actual operating conditions of the system are mostly variable, so the system obtained under deterministic conditions may not be stable and economical. This paper studies the optimization of circulating cooling water systems under uncertain circumstance. To improve the reliability of the system and reduce the water and energy consumption, the influence of different uncertain parameters is taken into consideration. The chance constrained programming method is used to build a model under uncertain conditions, where the confidence level indicates the degree of constraint violation. Probability distribution functions are used to describe the form of uncertain parameters. The objective is to minimize the total cost and obtain the optimal cooling network configuration simultaneously.An algorithm based on Monte Carlo method is proposed, and GAMS software is used to solve the mixed integer nonlinear programming model. A case is optimized to verify the validity of the model. Compared with the deterministic optimization method, the results show that when considering the different types of uncertain parameters, a system with better economy and reliability can be obtained(total cost can be reduced at least 2%).展开更多
Fouling caused by excess metal ions in hard water can negatively impact the performance of the circulating cooling water system(CCWS)by depositing ions on the heat exchanger's surface.Currently,the operation optim...Fouling caused by excess metal ions in hard water can negatively impact the performance of the circulating cooling water system(CCWS)by depositing ions on the heat exchanger's surface.Currently,the operation optimization of CCWS often prioritizes short-term flow velocity optimization for minimizing power consumption,without considering fouling.However,low flow velocity promotes fouling.Therefore,it's crucial to balance fouling and energy/water conservation for optimal CCWS long-term operation.This study proposes a mixed-integer nonlinear programming(MINLP)model to achieve this goal.The model considers fouling in the pipeline,dynamic concentration cycle,and variable frequency drive to optimize the synergy between heat transfer,pressure drop,and fouling.By optimizing the concentration cycle of the CCWS,water conservation and fouling control can be achieved.The model can obtain the optimal operating parameters for different operation intervals,including the number of pumps,frequency,and valve local resistance coefficient.Sensitivity experiments on cycle and environmental temperature reveal that as the cycle increases,the marginal benefits of energy/water conservation decrease.In periods with minimal impact on fouling rate,energy/water conservation can be achieved by increasing the cycle while maintaining a low fouling rate.Overall,the proposed model has significant energy/water saving effects and can comprehensively optimize the CCWS through its incorporation of fouling and cycle optimization.展开更多
A circulating fluidized bed evaporator(including down-flow, horizontal, and up-flow beds) was constructed to study the effect of flow directions on multiphase flow boiling heat transfer. A range of experimental invest...A circulating fluidized bed evaporator(including down-flow, horizontal, and up-flow beds) was constructed to study the effect of flow directions on multiphase flow boiling heat transfer. A range of experimental investigations were carried out by varying amount of added particles(0-2%), circulation flow rate(2.15-5.16 m^3/h) and heat flux(8-16 kW/m^2). The comparison of heat transfer performance in different vertical heights of the horizontal bed was also discussed. Results reveal that the glass bead particle can enhance heat transfer compared with vapor-liquid two-phase flow for all beds. At a low heat flux(q = 8 kW/m), the heat-transfer-enhancing factor of the horizontal bed is obviously greater than those of the up-flow and down-flow beds. With the increase in the amount of added particles, the heat-transfer-enhancing factors of the up-flow and down-flow beds increase, whereas that of the horizontal bed initially increases and then decreases. However, at a high heat flux(q=16 kW/m), the heat-transfer-enhancing factors of the three beds show an increasing tendency with the increase in the amount of added particles and become closer than those at a low heat flux. For all beds, the heat-transfer-enhancing factor generally increases with the circulation flow rate but decreases with the increase in heat flux.展开更多
The corrosion inhibition performance of co-immobilized lysozyme and lipase was investigated in a recirculating cooling water system. Four methods were carried out in co-immobilization, and the operating parameters wer...The corrosion inhibition performance of co-immobilized lysozyme and lipase was investigated in a recirculating cooling water system. Four methods were carried out in co-immobilization, and the operating parameters were optimized by using the respond surface methodology(RSM). The corrosion inhibition performance of co-immobilized lipase and lysozyme was evaluated by weight loss measurements and electrochemical measurements. The results revealed that the optimal co-immobilization method should be the sequential immobilization of lysozyme and then lipase. The inhibition efficiency was 86.10% under the optimal co-immobilized conditions. Electrochemical data showed that co-immobilized lysozyme and lipase was a mixed-type inhibitor and the corrosion inhibition efficiency was 81%.展开更多
This research investigated the outputting circulation current inhibition characteristic which are controlled by the instantaneous feedback voltage in inverter parallel driving of the mine hoist. We established a trans...This research investigated the outputting circulation current inhibition characteristic which are controlled by the instantaneous feedback voltage in inverter parallel driving of the mine hoist. We established a transfer function of the parallel inverters controlled by the close-loop adjustment of instantaneous voltage feedback. The influence of the parameters of the close-loop feedback circuit to the inhibition effects to the outputting circulation current is observed. After analyzing the circulating current inhibition characteristics, the proportion integration （PI） controller is introduced into the close-loop adjustment by instantaneous voltage feedback. The characteristics equation is gained to determine the PI parameters by drawing the Bode plots. The inhibition effects of the proposed controller are examined by the established simulation model of parallel inverter system. The harmonic distortion rate at the outputting voltage frequency value of 4, 10, 20, 41 and 50 Hz, are all lower than 2.32 % by the instantaneous outputting voltage feedback.展开更多
Objective MicroRNAs are fine regulators for gene expression during the post-transcriptional stage in many autoimmune diseases.HypoxamiRs(miR-210 and miR-21)play an important role in hypoxia and in inflammation-associa...Objective MicroRNAs are fine regulators for gene expression during the post-transcriptional stage in many autoimmune diseases.HypoxamiRs(miR-210 and miR-21)play an important role in hypoxia and in inflammation-associated hypoxia.Systemic lupus erythematosus(SLE)is a chronic systemic autoimmune disease that would potentiate many pathological complications,including hemolytic anemia.This study aimed to investigate the role of hypoxamiRs in SLE/hemolytic anemia patients.Methods This work was designed to analyze the circulating levels of↱the miR-210 and miR-21 expressions and hypoxia-inducible factor-1α(HIF-α)in SLE/hemolytic anemia patients.SLE activity was evaluated for all patients by SLE Disease Activity Index(SLEDAI).Clinical manifestations/complications and serological/hematological investigations were reported.HIF-αconcentration was assayed by ELISA and expression of miR-21 and miR-210 was analyzed by qRT-PCR.Results The results indicated that the fold change of the miR-210/miR-21 expressions in plasma was significantly elevated in SLE/hemolytic anemia patients.A strong positive correlation between the miR-210 and miR-21 expression levels was also recorded.Among the associated-disease complications,hypertension,arthritis,oral ulcers,and serositis were associated with a high circulating miR-210 expression,while the occurrence of renal disorders was associated with the increased miR-21 expression.Furthermore,the HIF-αlevel was remarkably elevated in SLE/hemolytic anemia patients.A high positive correlation was recorded between the HIF-αconcentration and miR-210/miR-21 expression levels.The occurrence of oral ulcers,arthritis,and hypertension was associated with the increased HIF-αconcentration.On the other hand,SLEDAI and white blood cell count were positively correlated with miR-21/miR-210.The erythrocyte sedimentation rate was positively correlated with miR-21.Conclusion The dysregulation of the circulating miR-210/miR-210/HIF-1αlevels in SLE/hemolytic anemia patients advocated that the hypoxia pathway might have an essential role in the pathogenesis and complications of these diseases.展开更多
An analysis approach considering gas-solids hydrodynamics,reaction kinetics and reacting species nonuniformity together in a dual-reactor system is presented for better understanding its mass and energy balance.It was...An analysis approach considering gas-solids hydrodynamics,reaction kinetics and reacting species nonuniformity together in a dual-reactor system is presented for better understanding its mass and energy balance.It was achieved by a 3-dimensional comprehensive hydrodynamics and reaction model for the dual-reactor system,which was developed from the successfully verified 3-dimensional comprehensive combustion model for one circulating fluidized bed(CFB)system(Xu and Cheng,2019).The developed model and analysis approach was successfully used on a 1 MW circulating fluidized bed–bubbling fluidized bed(CFB-BFB)dual-reactor system.Results showed the sensible and chemical energy between two reactors as well as the energy distributions in each reactor were balanced and they agreed well with the experimental measurements.The analysis approach indicated energy balance had a close relationship with the mass transfer in the CFB-BFB dual-reactor system.It may be applied in a design and operation optimization for a dual-reactor system.展开更多
MIC is one of the main problems of circulating cooling water system. The direct economic loss by MIC is about 300 to 500 billion dollars. It is good to understand MIC in order to control MIC. Source and species of mic...MIC is one of the main problems of circulating cooling water system. The direct economic loss by MIC is about 300 to 500 billion dollars. It is good to understand MIC in order to control MIC. Source and species of microorganisms was introduced firstly. There are three kinds of microorganisms in the system, including bacteria, fungi and algae. Species of these microorganisms are shown in the paper. Then, mechanisms of MIC are analysed. Although there is no universal mechanism of MIC, MIC is still mainly an electrochemical corrosion in nature. Meanwhile, the mechanisms on SRB and iron bacteria are introduced in details. At last, several methods of microorganisms control are put forward in the paper.展开更多
Mesoporous SiO_2 microspheres were synthesized using the sol-gel method and were characterized by TEM, FT-IR and BET techniques. The diameter of the microspheres is about 100—150 nm, and the average mesopore diameter...Mesoporous SiO_2 microspheres were synthesized using the sol-gel method and were characterized by TEM, FT-IR and BET techniques. The diameter of the microspheres is about 100—150 nm, and the average mesopore diameter is 2.55 nm, while the specific surface area is 1 088.9 m2/g. Mesoporous SiO_2 microspheres adsorb glutaraldehyde and immobilize laccase by means of the aldehyde group in glutaral which can react with the amidogen of laccase. The immobilization conditions were optimized at a glutaraldehyde concentration of 0.75%, a crosslinking time of 8 h, a laccase concentration of 0.04 L/L and an immobilization time of 10 h. When diesel leakage concentration was 80 mg/L, the highest corrosion inhibition efficiency of immobilized laccase reached 49.23%, which was slightly lower than the corrosion inhibition efficiency of free laccase(59%). The diesel degradation ratio could reach up to 45%. It has been proved that the immobilized laccase could degrade diesel to inhibit corrosion.展开更多
This paper presents a solution to the circulating current fault of aircraft power supply.The DC-link type Variable Frequency to Constant Frequency(VFCF)converter system is the preferred scheme to feed the constant 400...This paper presents a solution to the circulating current fault of aircraft power supply.The DC-link type Variable Frequency to Constant Frequency(VFCF)converter system is the preferred scheme to feed the constant 400 Hz load in an aircraft with a variable frequency power supply.Due to the requirement of aircraft standards,both grounds of the rectification and inversion stage are tied to the metal frame of the aircraft.With such a tied ground,the DC bus voltage rises greatly,and a large circulating current appears in the casing as the ground,which leads to equipment failure and potential safety hazards.According to the existing methods of circulating current fault suppression,this paper analyzes the causes of the above faults and the harmonic components of circulating current and points out the limitations of the existing methods.Therefore,a Common-Mode(CM)choke-based method is proposed to provide a high impedance in the path of the CM circulating current.By doing so,the circulating current can be suppressed without the additional burden of the hardware and control algorithm,which is quite friendly for quality control of mass-production aircraft.Moreover,a simplified mathematic model of the VFCF converter system is derived to calculate the minimum inductance value reference of the CM choke,which saves the weight of passive devices to the greatest extent.Finally,simulation and experimental results are studied to verify the effectiveness of the proposed method.展开更多
The presence of cancer cells in circulating blood and the possibility of colonization in the tissues of the body worsen in a determinant way the prognosis of the disease. Nevertheless, there are factors in the body th...The presence of cancer cells in circulating blood and the possibility of colonization in the tissues of the body worsen in a determinant way the prognosis of the disease. Nevertheless, there are factors in the body that can lead to a prognostic improvement, even in such conditions. In addition to the immune system, other favorable factors can act at the level of the microenvironment of the tumor so much that cases of spontaneous total regression, not only of primary tumors but also metastases, have been reported in the literature. Since it was recently reported that patients with renal tumors and in permanent hemodialysis present at post mortem examination, a metastatic spread much less extensive than observed in patients deceased for renal tumors but not on hemodialysis. The authors maintain it likely that the dialytic membrane concurs to block at least in part the cancer cells circulating in the blood. The possibility to block cancer cells can be extended in addition to the dialytic membrane also to other types of filters inserted in the extracorporeal circulation. The block of the cancer cells thus is obtained and that occurs in regional lymph nodes and in the microenvironment of the tumor causing a relative increase in the elements of the immune system compared to the number of cancer cells, which could determine clearly positive therapeutic results also in cases with advanced metastatic spread.展开更多
BACKGROUND Cholangiocarcinoma(CCA),also known as bile duct cancer,is a devastating malignancy primarily affecting the biliary tract.AIM To assess their performance in clinical diagnosis and monitoring of CCA,plasma me...BACKGROUND Cholangiocarcinoma(CCA),also known as bile duct cancer,is a devastating malignancy primarily affecting the biliary tract.AIM To assess their performance in clinical diagnosis and monitoring of CCA,plasma methylation and circulating tumor cells were detected.METHODS Plasma samples were collected from Hubei Cancer Hospital(n=156).Plasma DNA was tested to detect SHOX2,HOXA9,SEPTIN9,and RASSF1A methylation using TaqMan PCR.Circulating tumor cells(CTCs)were detected in the peripheral blood of patients using the United States Food and Drug Administration-approved cell search system before and after clinical therapy.The CCA diagnostic value was estimated using the area under the curve.The independent prognosis risk factors for patients with CCA were estimated using Cox and logistic regression analyses.RESULTS The sensitivity and specificity of the four DNA plasma methylations exhibited 64.74%sensitivity and 93.88%specificity for detecting CCA.The receiver operating characteristic curve of the combined value for CCA diagnosis in plasma was 0.828±0.032.RASSF1A plasma methylation was related to the prognosis of patients with CCA.We determined the prognostic hazard ratio for CCA using CTC count,tumor stage,methylation,and carbohydrate antigen 19-9 levels as key factors.Our overall survival nomogram achieved a C-index of 0.705(0.605-0.805).CONCLUSION SHOX2,HOXA9,SEPTIN9,and RASSF1A plasma methylation demonstrated increased sensitivity for diagnosing CCA.RASSF1A plasma methylation and CTCs were valuable predictors to assess CCA prognosis and recurrence.展开更多
Given the growing burden of colorectal cancer(CRC)as a global health challenge,it becomes imperative to focus on strategies that can mitigate its impact.Posttreatment surveillance has emerged as essential for early de...Given the growing burden of colorectal cancer(CRC)as a global health challenge,it becomes imperative to focus on strategies that can mitigate its impact.Posttreatment surveillance has emerged as essential for early detection of recurrence,significantly improving patient outcomes.However,intensive surveillance strategies have shown mixed results compared to less intensive methods,emphasizing the necessity for personalized,risk-adapted approaches.The observed suboptimal adherence to existing surveillance protocols underscores the urgent need for more tailored and efficient strategies.In this context,circulating tumor DNA(ctDNA)emerges as a promising biomarker with significant potential to revolutionize post-treatment surveillance,demonstrating high specificity[0.95,95%confidence interval(CI):0.91-0.97]and robust diagnostic odds(37.6,95%CI:20.8-68.0)for recurrence detection.Furthermore,artificial intelligence and machine learning models integrating patient-specific and tumor features can enhance risk stratification and optimize surveillance strategies.The reported area under the receiver operating characteristic curve,measuring artificial intelligence model performance in predicting CRC recurrence,ranged from 0.581 and 0.593 at the lowest to 0.979 and 0.978 at the highest in training and validation cohorts,respectively.Despite this promise,addressing cost,accessibility,and extensive validation remains crucial for equitable integration into clinical practice.展开更多
文摘BACKGROUND Hypertrophic cardiomyopathy(HCM)is characterized by left ventricular hypertrophy and interstitial fibrosis,which contribute to adverse outcomes such as heart failure and sudden cardiac death.While cardiac magnetic resonance(CMR)imaging is commonly used to detect myocardial fibrosis,circulating microRNAs(miRNAs)have emerged as promising noninvasive biomarkers for this condition due to their stability in blood plasma and resistance to pH and temperature variance.AIM To explore the role of specific circulating miRNAs in identifying myocardial fibrosis in patients with HCM.METHODS Using PubMed/MEDLINE and Google Scholar,we reviewed studies from 2014 to 2024 examining the link between circulating miRNAs and myocardial fibrosis in HCM.We included studies measuring miRNA expression in blood samples from HCM patients and assessing fibrosis via imaging,mostly CMR.Data extraction concentrated on the population,methodology,and findings related to the correlation between miRNA levels and fibrosis.RESULTS Seven studies involving 365 HCM patients with a mean age of 49.37±10.5 years,116(31.78%)females,and one animal study identified miR-21,miR-29a,miR-133,miR-4454,and miR-221 as frequently dysregulated markers associated with fibrosis.Elevated levels of miR-21 and miR-29a correlated with more extensive fibrosis,as assessed by late gadolinium enhancement in CMR imaging,with miR-29a consistently linked to both fibrosis and hypertrophy across the studies.CONCLUSION Circulating miRNAs,particularly miR-21,miR-29a,and miR-221,show significant potential as biomarkers for myocardial fibrosis in HCM.Further research should validate these findings and investigate the clinical application of miRNA-based diagnostics in HCM.
基金supported by the National Key R&D Program of China,No.2021YFC2501200(to PC).
文摘Short-chain fatty acids,metabolites produced by the fermentation of dietary fiber by gut microbiota,have garnered significant attention due to their correlation with neurodegenerative diseases,particularly Parkinson’s disease.In this review,we summarize the changes in short-chain fatty acid levels and the abundance of short-chain fatty acid-producing bacteria in various samples from patients with Parkinson’s disease,highlighting the critical role of gut homeostasis imbalance in the pathogenesis and progression of the disease.Focusing on the nervous system,we discuss the molecular mechanisms by which short-chain fatty acids influence the homeostasis of both the enteric nervous system and the central nervous system.We identify key processes,including the activation of G protein-coupled receptors and the inhibition of histone deacetylases by short-chain fatty acids.Importantly,structural or functional disruptions in the enteric nervous system mediated by these fatty acids may lead to abnormalα-synuclein expression and gastrointestinal dysmotility,which could serve as an initiating event in Parkinson’s disease.Furthermore,we propose that short-chain fatty acids help establish communication between the enteric nervous system and the central nervous system via the vagal nerve,immune circulation,and endocrine signaling.This communication may shed light on their potential role in the transmission ofα-synuclein from the gut to the brain.Finally,we elucidate novel treatment strategies for Parkinson’s disease that target short-chain fatty acids and examine the challenges associated with translating short-chain fatty acid-based therapies into clinical practice.In conclusion,this review emphasizes the pivotal role of short-chain fatty acids in regulating gut-brain axis integrity and their significance in the pathogenesis of Parkinson’s disease from the perspective of the nervous system.Moreover,it highlights the potential value of short-chain fatty acids in early intervention for Parkinson’s disease.Future research into the molecular mechanisms of short-chain fatty acids and their synergistic interactions with other gut metabolites is likely to advance the clinical translation of innovative short-chain fatty acid-based therapies for Parkinson’s disease.
基金funded by Sapienza University PNRR-RT_SPOKE_1—ROME TECHNOPOLE—Spoke 1—B83C22002820006—ECS00000024 and FO R.O.onlus.
文摘Objectives:Although immune checkpoint inhibitors(ICIs)and targeted therapies have reshaped treatment non-small cell lung cancer(NSCLC)paradigms,prognosis remains poor for many patients due to delayed diagnosis and resistance mechanisms.Liquid biopsy offers a minimally invasive approach to monitoring tumor evolution.Among circulating biomarkers,circulating tumor cells(CTCs)and cancer-associated macrophage-like cells(CAM-Ls)may provide complementary prognostic insights.The study aimed to evaluate the prognostic role of CTC and CAM-Ls dynamic in metastatic NSCLC patients.Methods:We retrospectively analyzed 77 patients with metastatic NSCLC who underwent CTC and CAM-L evaluation via the CellSearch^(■)system at baseline(T0)and after three months of first-line treatment(T1)including chemotherapy,targeted therapy,or ICIs.Survival outcomes were analyzed using Kaplan-Meier and Cox regression analyses.Results:Conversion to CTC-negative status at T1 was associated with improved outcomes,with median overall survival(OS)and progression-free survival(PFS)of 33 and 18 months,respectively,vs.10 and 6 months in persistently positive patients(both p<0.001).CTC negativity at T1 remained an independent prognostic factor for OS(HR:6.68)and PFS(HR:5.91,both p<0.0001).CAM-L positivity at T1 also correlated with longer OS(30 vs.12 months)and PFS(13 vs.6 months,both p<0.0001),particularly among ICI-treated patients.Combined CTC and CAM-L assessment further refined risk stratification.Conclusions:Dynamic monitoring of CTCs and CAM-Ls provides actionable prognostic information in metastatic NSCLC.CTC-negative status predicted longer OS and PFS,while CAM-L positivity at T1 was associated with improved outcomes,particularly in ICI-treated patients.Combined assessment of both biomarkers may directly inform therapeutic decision-making,through early detection of outcomes.
基金sponsored by the Peking University People’s Hospital Research and Development Fund(No.RDZH2024-06)the National Key Research and Development Program of China(No.2022YFC2704204)。
文摘Objective:We investigated the clinical value of a novel circulating tumor cell(CTC)detection method—subtraction enrichment combined with immunostaining and fluorescence in situ hybridization(SEi FISH)—in ovarian cancer(OC).This study evaluated the diagnostic and prognostic significance of chromosome 8aneuploidy in CTCs and circulating tumor endothelial cells(CTECs)for preoperative diagnosis,treatment efficacy assessment,and recurrence monitoring.Methods:A total of 331 patients were enrolled,including 56 with newly diagnosed primary OC,265 with benign ovarian tumors,and 10 with borderline tumors.Peripheral blood CTCs and CTECs were detected using SEi FISH;their quantity and ploidy characteristics were analyzed in relation to clinical indicators.To assess dynamic CTC changes during disease progression and treatment response,72 patients were followed longitudinally,of whom 19 experienced recurrence.Results:The CTC detection rate in OC patients was 92.9%,with significantly higher counts than that in the benign tumor group(median 5 vs.2).Receiver operating characteristic analysis demonstrated good diagnostic performance for total CTCs[area under the curve(AUC)=0.699],with triploid CTCs achieving the highest efficacy(AUC=0.792),surpassing carbohydrate antigen 125(CA125)(AUC=0.702).Postoperative follow-up showed that70%of patients exhibited concurrent decreases in CTCs and CA125 levels,indicating disease improvement.In30%of patients,CTC levels did not correlate with changes in CA125 levels.Individual case evidence suggests that CTC alterations may serve as an early indicator of recurrence or metastasis.Among the 19 recurrent cases,73.7%showed elevated CTCs at recurrence that decreased following treatment.In four patients,CTCs reflected disease progression earlier than CA125,indicating higher sensitivity for recurrence monitoring.Conclusions:CTCs with chromosome 8 aneuploidy demonstrate significant clinical value in the preoperative diagnosis,treatment efficacy evaluation,and recurrence monitoring of OC.Dynamic CTC changes may serve as a more sensitive indicator than CA125 for disease surveillance,supporting the translational potential of CTC-based biomarkers in OC.
文摘Cervical cancer related to human papillomavirus(HPV)is a leading cause of cancer-related mortality among women worldwide.Cancer cells release fragments of their DNA,known as circulating tumor DNA(ctDNA),which can be detected in bodily fluids.A PubMed search using the terms“ctHPV”or“circulating tumor DNA”and“cervical cancer”,limited to the past ten years,identified 104 articles,complemented by hand-searching for literature addressing medico-legal implications.Studies were evaluated for relevance and methodological quality.Detection and characterization of circulating tumor HPV DNA(ctHPV DNA)have emerged as promising tools for assessing prognosis and disease recurrence in cervical cancer.Detection techniques include polymerase chain reaction(PCR),digital droplet PCR(ddPCR),and next-generation sequencing(NGS).This review summarizes current knowledge on ctHPV DNA in cervical cancer and explores its clinical and medico-legal implications,including management of discordant results,diagnostic errors,liability,and data protection compliance.
文摘To solve the problem of circulating power of dual active bridge(DAB)DC-DC converter over a wide voltage conversion ratio,this paper proposes a novel synchronous PWM(S-PWM)modulation.Existence of circulating power increases current stress of devices and decreases efficiency,especially under light load conditions.Several modulation methods have been proposed to overcome the problem.They can reduce or eliminate either input or output side circulating power.In contrast,S-PWM not only eliminates both sides circulating power and reduces current stress,but also achieves zero-current-switching(ZCS)turn-on for all switches and ZCS turn-off for most across the full power range.No auxiliary or snubber circuits are increased.In addition,the control can be simplified so the transmitted power is related to only one variable.The S-PWM has four cases under different gain and power conditions.The detailed operation principle and modes of DAB under S-PWM are analyzed in the paper.In addition,four modulations in literature are discussed,and corresponding comparative analyses with S-PWM are given.Finally,a laboratory prototype is built to verify advantages and effectiveness of the proposed modulation.
基金Financial support from the National Natural Science Foundation of China (22022816, 22078358)。
文摘Recent research on deterministic methods for circulating cooling water systems optimization has been well developed. However, the actual operating conditions of the system are mostly variable, so the system obtained under deterministic conditions may not be stable and economical. This paper studies the optimization of circulating cooling water systems under uncertain circumstance. To improve the reliability of the system and reduce the water and energy consumption, the influence of different uncertain parameters is taken into consideration. The chance constrained programming method is used to build a model under uncertain conditions, where the confidence level indicates the degree of constraint violation. Probability distribution functions are used to describe the form of uncertain parameters. The objective is to minimize the total cost and obtain the optimal cooling network configuration simultaneously.An algorithm based on Monte Carlo method is proposed, and GAMS software is used to solve the mixed integer nonlinear programming model. A case is optimized to verify the validity of the model. Compared with the deterministic optimization method, the results show that when considering the different types of uncertain parameters, a system with better economy and reliability can be obtained(total cost can be reduced at least 2%).
基金Financial support from the National Natural Science Foundation of China (22022816 and 22078358)
文摘Fouling caused by excess metal ions in hard water can negatively impact the performance of the circulating cooling water system(CCWS)by depositing ions on the heat exchanger's surface.Currently,the operation optimization of CCWS often prioritizes short-term flow velocity optimization for minimizing power consumption,without considering fouling.However,low flow velocity promotes fouling.Therefore,it's crucial to balance fouling and energy/water conservation for optimal CCWS long-term operation.This study proposes a mixed-integer nonlinear programming(MINLP)model to achieve this goal.The model considers fouling in the pipeline,dynamic concentration cycle,and variable frequency drive to optimize the synergy between heat transfer,pressure drop,and fouling.By optimizing the concentration cycle of the CCWS,water conservation and fouling control can be achieved.The model can obtain the optimal operating parameters for different operation intervals,including the number of pumps,frequency,and valve local resistance coefficient.Sensitivity experiments on cycle and environmental temperature reveal that as the cycle increases,the marginal benefits of energy/water conservation decrease.In periods with minimal impact on fouling rate,energy/water conservation can be achieved by increasing the cycle while maintaining a low fouling rate.Overall,the proposed model has significant energy/water saving effects and can comprehensively optimize the CCWS through its incorporation of fouling and cycle optimization.
基金supported by Tianjin Municipal Science and Technology Commission, China (No. 2009ZCKFGX01900)
文摘A circulating fluidized bed evaporator(including down-flow, horizontal, and up-flow beds) was constructed to study the effect of flow directions on multiphase flow boiling heat transfer. A range of experimental investigations were carried out by varying amount of added particles(0-2%), circulation flow rate(2.15-5.16 m^3/h) and heat flux(8-16 kW/m^2). The comparison of heat transfer performance in different vertical heights of the horizontal bed was also discussed. Results reveal that the glass bead particle can enhance heat transfer compared with vapor-liquid two-phase flow for all beds. At a low heat flux(q = 8 kW/m), the heat-transfer-enhancing factor of the horizontal bed is obviously greater than those of the up-flow and down-flow beds. With the increase in the amount of added particles, the heat-transfer-enhancing factors of the up-flow and down-flow beds increase, whereas that of the horizontal bed initially increases and then decreases. However, at a high heat flux(q=16 kW/m), the heat-transfer-enhancing factors of the three beds show an increasing tendency with the increase in the amount of added particles and become closer than those at a low heat flux. For all beds, the heat-transfer-enhancing factor generally increases with the circulation flow rate but decreases with the increase in heat flux.
基金financially supported by the National Natural Science Foundation of China (project 21077133)the Natural Foundation of Shandong Province and the Top Talent Project of China University of Petroleum (16RC17040003)
文摘The corrosion inhibition performance of co-immobilized lysozyme and lipase was investigated in a recirculating cooling water system. Four methods were carried out in co-immobilization, and the operating parameters were optimized by using the respond surface methodology(RSM). The corrosion inhibition performance of co-immobilized lipase and lysozyme was evaluated by weight loss measurements and electrochemical measurements. The results revealed that the optimal co-immobilization method should be the sequential immobilization of lysozyme and then lipase. The inhibition efficiency was 86.10% under the optimal co-immobilized conditions. Electrochemical data showed that co-immobilized lysozyme and lipase was a mixed-type inhibitor and the corrosion inhibition efficiency was 81%.
文摘This research investigated the outputting circulation current inhibition characteristic which are controlled by the instantaneous feedback voltage in inverter parallel driving of the mine hoist. We established a transfer function of the parallel inverters controlled by the close-loop adjustment of instantaneous voltage feedback. The influence of the parameters of the close-loop feedback circuit to the inhibition effects to the outputting circulation current is observed. After analyzing the circulating current inhibition characteristics, the proportion integration （PI） controller is introduced into the close-loop adjustment by instantaneous voltage feedback. The characteristics equation is gained to determine the PI parameters by drawing the Bode plots. The inhibition effects of the proposed controller are examined by the established simulation model of parallel inverter system. The harmonic distortion rate at the outputting voltage frequency value of 4, 10, 20, 41 and 50 Hz, are all lower than 2.32 % by the instantaneous outputting voltage feedback.
基金supported by the Taif University Researchers Supporting Project(No.TURSP-2020/103).
文摘Objective MicroRNAs are fine regulators for gene expression during the post-transcriptional stage in many autoimmune diseases.HypoxamiRs(miR-210 and miR-21)play an important role in hypoxia and in inflammation-associated hypoxia.Systemic lupus erythematosus(SLE)is a chronic systemic autoimmune disease that would potentiate many pathological complications,including hemolytic anemia.This study aimed to investigate the role of hypoxamiRs in SLE/hemolytic anemia patients.Methods This work was designed to analyze the circulating levels of↱the miR-210 and miR-21 expressions and hypoxia-inducible factor-1α(HIF-α)in SLE/hemolytic anemia patients.SLE activity was evaluated for all patients by SLE Disease Activity Index(SLEDAI).Clinical manifestations/complications and serological/hematological investigations were reported.HIF-αconcentration was assayed by ELISA and expression of miR-21 and miR-210 was analyzed by qRT-PCR.Results The results indicated that the fold change of the miR-210/miR-21 expressions in plasma was significantly elevated in SLE/hemolytic anemia patients.A strong positive correlation between the miR-210 and miR-21 expression levels was also recorded.Among the associated-disease complications,hypertension,arthritis,oral ulcers,and serositis were associated with a high circulating miR-210 expression,while the occurrence of renal disorders was associated with the increased miR-21 expression.Furthermore,the HIF-αlevel was remarkably elevated in SLE/hemolytic anemia patients.A high positive correlation was recorded between the HIF-αconcentration and miR-210/miR-21 expression levels.The occurrence of oral ulcers,arthritis,and hypertension was associated with the increased HIF-αconcentration.On the other hand,SLEDAI and white blood cell count were positively correlated with miR-21/miR-210.The erythrocyte sedimentation rate was positively correlated with miR-21.Conclusion The dysregulation of the circulating miR-210/miR-210/HIF-1αlevels in SLE/hemolytic anemia patients advocated that the hypoxia pathway might have an essential role in the pathogenesis and complications of these diseases.
基金The authors are grateful for the financial support of the National Key Research and Development Program of China(2018YFB0605403).
文摘An analysis approach considering gas-solids hydrodynamics,reaction kinetics and reacting species nonuniformity together in a dual-reactor system is presented for better understanding its mass and energy balance.It was achieved by a 3-dimensional comprehensive hydrodynamics and reaction model for the dual-reactor system,which was developed from the successfully verified 3-dimensional comprehensive combustion model for one circulating fluidized bed(CFB)system(Xu and Cheng,2019).The developed model and analysis approach was successfully used on a 1 MW circulating fluidized bed–bubbling fluidized bed(CFB-BFB)dual-reactor system.Results showed the sensible and chemical energy between two reactors as well as the energy distributions in each reactor were balanced and they agreed well with the experimental measurements.The analysis approach indicated energy balance had a close relationship with the mass transfer in the CFB-BFB dual-reactor system.It may be applied in a design and operation optimization for a dual-reactor system.
文摘MIC is one of the main problems of circulating cooling water system. The direct economic loss by MIC is about 300 to 500 billion dollars. It is good to understand MIC in order to control MIC. Source and species of microorganisms was introduced firstly. There are three kinds of microorganisms in the system, including bacteria, fungi and algae. Species of these microorganisms are shown in the paper. Then, mechanisms of MIC are analysed. Although there is no universal mechanism of MIC, MIC is still mainly an electrochemical corrosion in nature. Meanwhile, the mechanisms on SRB and iron bacteria are introduced in details. At last, several methods of microorganisms control are put forward in the paper.
基金supported by the Foundation for Top Talents Program of China University of Petroleum
文摘Mesoporous SiO_2 microspheres were synthesized using the sol-gel method and were characterized by TEM, FT-IR and BET techniques. The diameter of the microspheres is about 100—150 nm, and the average mesopore diameter is 2.55 nm, while the specific surface area is 1 088.9 m2/g. Mesoporous SiO_2 microspheres adsorb glutaraldehyde and immobilize laccase by means of the aldehyde group in glutaral which can react with the amidogen of laccase. The immobilization conditions were optimized at a glutaraldehyde concentration of 0.75%, a crosslinking time of 8 h, a laccase concentration of 0.04 L/L and an immobilization time of 10 h. When diesel leakage concentration was 80 mg/L, the highest corrosion inhibition efficiency of immobilized laccase reached 49.23%, which was slightly lower than the corrosion inhibition efficiency of free laccase(59%). The diesel degradation ratio could reach up to 45%. It has been proved that the immobilized laccase could degrade diesel to inhibit corrosion.
基金supported by the Natural Science Foundation for Young Scientists of Shanxi Province,China(No.52007154).
文摘This paper presents a solution to the circulating current fault of aircraft power supply.The DC-link type Variable Frequency to Constant Frequency(VFCF)converter system is the preferred scheme to feed the constant 400 Hz load in an aircraft with a variable frequency power supply.Due to the requirement of aircraft standards,both grounds of the rectification and inversion stage are tied to the metal frame of the aircraft.With such a tied ground,the DC bus voltage rises greatly,and a large circulating current appears in the casing as the ground,which leads to equipment failure and potential safety hazards.According to the existing methods of circulating current fault suppression,this paper analyzes the causes of the above faults and the harmonic components of circulating current and points out the limitations of the existing methods.Therefore,a Common-Mode(CM)choke-based method is proposed to provide a high impedance in the path of the CM circulating current.By doing so,the circulating current can be suppressed without the additional burden of the hardware and control algorithm,which is quite friendly for quality control of mass-production aircraft.Moreover,a simplified mathematic model of the VFCF converter system is derived to calculate the minimum inductance value reference of the CM choke,which saves the weight of passive devices to the greatest extent.Finally,simulation and experimental results are studied to verify the effectiveness of the proposed method.
文摘The presence of cancer cells in circulating blood and the possibility of colonization in the tissues of the body worsen in a determinant way the prognosis of the disease. Nevertheless, there are factors in the body that can lead to a prognostic improvement, even in such conditions. In addition to the immune system, other favorable factors can act at the level of the microenvironment of the tumor so much that cases of spontaneous total regression, not only of primary tumors but also metastases, have been reported in the literature. Since it was recently reported that patients with renal tumors and in permanent hemodialysis present at post mortem examination, a metastatic spread much less extensive than observed in patients deceased for renal tumors but not on hemodialysis. The authors maintain it likely that the dialytic membrane concurs to block at least in part the cancer cells circulating in the blood. The possibility to block cancer cells can be extended in addition to the dialytic membrane also to other types of filters inserted in the extracorporeal circulation. The block of the cancer cells thus is obtained and that occurs in regional lymph nodes and in the microenvironment of the tumor causing a relative increase in the elements of the immune system compared to the number of cancer cells, which could determine clearly positive therapeutic results also in cases with advanced metastatic spread.
基金Supported by the Medical Talents of Wuhan Health and Family Planning Commission,No.2017[51](to Yu J)the Medical Talents of Wuhan Hospital of Traditional Chinese and Western Medicine(to Yu J)+1 种基金the Hubei Natural Science Foundation,No.2023AFB1091Wuhan Medical Research Project,No.WX23A36(to Yu J).
文摘BACKGROUND Cholangiocarcinoma(CCA),also known as bile duct cancer,is a devastating malignancy primarily affecting the biliary tract.AIM To assess their performance in clinical diagnosis and monitoring of CCA,plasma methylation and circulating tumor cells were detected.METHODS Plasma samples were collected from Hubei Cancer Hospital(n=156).Plasma DNA was tested to detect SHOX2,HOXA9,SEPTIN9,and RASSF1A methylation using TaqMan PCR.Circulating tumor cells(CTCs)were detected in the peripheral blood of patients using the United States Food and Drug Administration-approved cell search system before and after clinical therapy.The CCA diagnostic value was estimated using the area under the curve.The independent prognosis risk factors for patients with CCA were estimated using Cox and logistic regression analyses.RESULTS The sensitivity and specificity of the four DNA plasma methylations exhibited 64.74%sensitivity and 93.88%specificity for detecting CCA.The receiver operating characteristic curve of the combined value for CCA diagnosis in plasma was 0.828±0.032.RASSF1A plasma methylation was related to the prognosis of patients with CCA.We determined the prognostic hazard ratio for CCA using CTC count,tumor stage,methylation,and carbohydrate antigen 19-9 levels as key factors.Our overall survival nomogram achieved a C-index of 0.705(0.605-0.805).CONCLUSION SHOX2,HOXA9,SEPTIN9,and RASSF1A plasma methylation demonstrated increased sensitivity for diagnosing CCA.RASSF1A plasma methylation and CTCs were valuable predictors to assess CCA prognosis and recurrence.
文摘Given the growing burden of colorectal cancer(CRC)as a global health challenge,it becomes imperative to focus on strategies that can mitigate its impact.Posttreatment surveillance has emerged as essential for early detection of recurrence,significantly improving patient outcomes.However,intensive surveillance strategies have shown mixed results compared to less intensive methods,emphasizing the necessity for personalized,risk-adapted approaches.The observed suboptimal adherence to existing surveillance protocols underscores the urgent need for more tailored and efficient strategies.In this context,circulating tumor DNA(ctDNA)emerges as a promising biomarker with significant potential to revolutionize post-treatment surveillance,demonstrating high specificity[0.95,95%confidence interval(CI):0.91-0.97]and robust diagnostic odds(37.6,95%CI:20.8-68.0)for recurrence detection.Furthermore,artificial intelligence and machine learning models integrating patient-specific and tumor features can enhance risk stratification and optimize surveillance strategies.The reported area under the receiver operating characteristic curve,measuring artificial intelligence model performance in predicting CRC recurrence,ranged from 0.581 and 0.593 at the lowest to 0.979 and 0.978 at the highest in training and validation cohorts,respectively.Despite this promise,addressing cost,accessibility,and extensive validation remains crucial for equitable integration into clinical practice.
