BACKGROUND The prognosis of patients with poorly differentiated gastric neuroendocrine neoplasms(PDGNENs)is dismal and related research is limited.AIM To investigate the prognostic factors,and validate a novel prognos...BACKGROUND The prognosis of patients with poorly differentiated gastric neuroendocrine neoplasms(PDGNENs)is dismal and related research is limited.AIM To investigate the prognostic factors,and validate a novel prognostic nomogram for PDGNEN patients.METHODS We conducted a retrospective study using clinical and pathological data from PDGNEN patients treated at the First Medical Center of the Chinese PLA General Hospital from January 2000 to June 2023.Overall survival(OS)differences were assessed with the Log-rank test and Kaplan-Meier survival curves.Cox regression analysis identified independent risk factors for prognosis.Model performance was evaluated using Harrell’s concordance index,receiver operating characteristic analysis,area under the curve,calibration curves,and decision curve analysis(UDC),including the area under the UDC.RESULTS The study included 336 patients(227 with neuroendocrine carcinoma and 109 with mixed adenoneuroendocrine carcinoma).The average age was 62.7 years.The cohort comprised 80(24.7%)patients in stage I,146(42.9%)in stage II,62(18.1%)in stage III,and 48(14.3%)in stage IV.Significant differences in OS were observed across tumor-node-metastasis stages(P<0.001).Multivariate analysis showed age,Ki-67 index,invasion depth,lymph node metastasis,distant metastasis,and platelet-to-lymphocyte ratio as independent risk factors.We developed a nomogram with a concordance index of 0.779(95%confidence interval:0.743-0.858).Receiver operating characteristic analysis showed area under the curves for 1-year,3-year,and 5-year OS predictions of 0.865,0.850,and 0.890,respectively.The calibration curve demonstrated good agreement with actual outcomes.The area under the UDC for the nomogram vs the 8th American Joint Committee on Cancer tumor-node-metastasis staging system were 0.047 vs 0.027,0.291 vs 0.179,and 0.376 vs 0.216 for 1-year,3-year,and 5-year OS,respectively.CONCLUSION PDGNENs are predominantly found in older men,often in advanced stages at diagnosis,resulting in poor prognosis.The established nomogram demonstrates strong predictive capability and clinical utility.展开更多
BACKGROUND Thyroid malignancies,while accounting for a small proportion of cancer diagnoses globally,have demonstrated a consistent upward trend in occurrence across diverse populations,with gender-specific analyses r...BACKGROUND Thyroid malignancies,while accounting for a small proportion of cancer diagnoses globally,have demonstrated a consistent upward trend in occurrence across diverse populations,with gender-specific analyses revealing a disproportionate burden among women.Despite the characteristically indolent nature of most thyroid carcinomas and their associated high survival rates,emerging evidence points to significant unmet needs regarding psychosocial adaptation and neuropsychiatric sequelae in this growing survivor population.The spectrum of mental health conditions,ranging from affective and anxiety disorders to cognitive impairments,presents substantial barriers to functional recovery and may potentially influence disease trajectories through complex psychoneuroimmunological pathways.Clinical observations consistently report elevated rates of mood disturbances and executive function deficits persisting throughout the cancer continuum,from active treatment into extended follow-up periods.These findings highlight a critical knowledge gap in understanding the dynamic interplay between thyroid cancer biology,its therapeutic interventions,and the development of treatment-resistant psychiatric manifestations that complicate long-term patient care.AIM To analyse the factors influencing the poor prognosis of patients surviving longterm differentiated thyroid cancer with psychiatric disorders and to construct a prediction model.METHODS Forty-eight patients with mental disorders combined with differentiated thyroid cancer who were treated in our hospital during the period of March 2018 to March 2023 were retrospectively selected as the study subjects(thyroid cancer group),and 30 cases each of patients with mental disorders combined with benign thyroid nodules(benign nodules group)and patients with mental disorders alone(mental disorders group),who were treated during the same time period,were selected as controls.The patients with differentiated thyroid cancer were further divided into a poor prognosis group(10 cases)and a good prognosis group(38 cases).The study outcome was poor prognosis as shown by whole body bone imaging within 2 years after thyroid cancer surgery.Factors influencing poor prognosis in survivors of differentiated thyroid cancer were analyzed by univariate and multivariate logistic regression analyses,receiver operating characteristic(ROC)curve analysis was used to assess the predictive efficacy of these factors for poor prognosis,and the DeLong test was used to determine whether there was a statistically significant difference in the area under the curve(AUC)of the model.RESULTS One-way logistic regression analysis showed that tumour diameter[odds ratio(OR)=19.190,P=0.002],T-stage(OR=7.692,P=0.018),extra-glandular infiltration(OR=37.000,P=0.003),degree of differentiation(OR=24.667,P=0.008),serum free T3(OR=22.348,P=0.025),serum free T4(FT4)(OR=1.158,P=0.002),total bilirubin(TBil)(OR=1.792,P=0.004),albumin(OR=0.675,P=0.003),cortisol(OR=1.180,P=0.003),norepinephrine(OR=1.047,P=0.002),angiotensin II(OR=1.975,P=0.002),and superoxide dismutase(OR=0.515,P=0.005)all increased the risk of poor prognosis in patients with psychiatric disorders and long-term differentiated thyroid cancer.Multifactorial logistic regression analysis showed that tumour diameter(OR=16.570,P=0.021),extraglandular infiltration(OR=53.145,P=0.010),FT4(OR=1.186,P=0.007),and TBil(OR=2.823,P=0.048)were independent risk factors for poor prognosis of patients with psychiatric disorders with long-term differentiated thyroid cancer,and the regression equation was:Y=2.808×tumour diameter+3.973×extra-glandular infiltration+0.171×FT4+1.038×TBil-88.138.ROC analysis showed that the predictive power of the overall model(AUC=0.992,P=0.000)was significantly higher than that of independent risk factors(DeLong test P<0.05).CONCLUSION Tumour diameter,extra-glandular infiltration,FT4,and TBil are independent risk factors for poor prognosis in patients with psychiatric disorders with long-term differentiated thyroid cancer,and the combination of these factors is of higher value in predicting the prognosis of patients.These risk factors can be used as a basis to develop a reasonable prognostic management plan in clinical practice for patients with long-term differentiated thyroid cancer with mental disorders,so as to improve the prognosis and quality of life of patients.展开更多
BACKGROUND Poorly differentiated thyroid carcinoma(PDTC)is a rare and aggressive form of thyroid cancer.Distant metastasis occurs frequently in PDTC.AIM To determine factors associated with distant metastasis and the ...BACKGROUND Poorly differentiated thyroid carcinoma(PDTC)is a rare and aggressive form of thyroid cancer.Distant metastasis occurs frequently in PDTC.AIM To determine factors associated with distant metastasis and the effects of metastasis,either diagnosed on initial presentation or developing during follow-up,on mortality in PDTC patients.METHODS Patients with PDTC diagnosed between January 1,1985 and July 31,2022 were identified using a thyroid cancer database at a medical center in Taiwan.Factors associated with distant metastasis and cancer-specific survival(CSS)were analyzed using binary logistic analysis and Cox regression,respectively.Survival analysis was conducted using the Kaplan–Meier method.RESULTS The study cohort included 39 patients with PDTC,including 16 with distant metastasis on initial presentation,5 with metastasis during the follow-up period,and 18 with no evidence of metastasis.Older age(≥45 years)was significantly associated with a higher risk of distant metastasis(odds ratio:5.31;95%confi-dence interval:1.27–22.2;P=0.018),while sex,tumor size,T stage,and N stage were not associated with distant metastasis.Patients with metastatic PDTC,either diagnosed at presentation or developing during follow-up,had poorer 5-year CSS rates(55.0%and 40.0%,respectively)than those without metastasis(5-year CSS,93.8%)(P=0.001 for both comparisons).CONCLUSION Older patients with PDTC have an increased risk of distant metastasis.Patients with metastatic PDTC,both diagnosed at presentation and developing during follow-up,have a dismal prognosis.展开更多
This study explores differentiated instructional strategies in higher education,focusing on municipal universities in Beijing to address the needs of students requiring special academic and psychological support.Despi...This study explores differentiated instructional strategies in higher education,focusing on municipal universities in Beijing to address the needs of students requiring special academic and psychological support.Despite standardized cultivation frameworks in universities,significant variations persist among undergraduates in academic planning,cognitive traits,and psychological profiles.A minority of students face challenges due to cognitive misjudgments(e.g.,unrealistic self-assessment),goal fixation(e.g.,excessive focus on postgraduate exams or studying abroad),psychological barriers(e.g.,social withdrawal),or mental health crises,which hinder their academic integration and personal development.Universities must adopt flexible,compliance-oriented differentiated instruction within standardized frameworks to support at-risk students.Strategies should balance personalized interventions with institutional fairness,ensuring equitable opportunities for all students while safeguarding academic integrity.展开更多
BACKGROUND The log odds of positive lymph nodes(LODDS)are correlated with survival outcomes in gastric cancer(GC)patients.However,the prognostic value across different tumor differentiation levels remains unclear.AIM ...BACKGROUND The log odds of positive lymph nodes(LODDS)are correlated with survival outcomes in gastric cancer(GC)patients.However,the prognostic value across different tumor differentiation levels remains unclear.AIM To evaluate the independent prognostic value of LODDS and the stratified predictive efficacy in GC patients with different histologic differentiations.METHODS We conducted a retrospective analysis of 2103 GC patients who underwent radical gastrectomy at Zhejiang Cancer Hospital.The prognostic value of LODDS was compared with that of other lymph node-based metrics,including the pathologic N stage,number of positive lymph nodes,number of total lymph nodes,and lymph node ratio,stratified by tumor differentiation.RESULTS LODDS was identified as an independent prognostic factor for overall survival in moderately to poorly differentiated GC patients.LODDS demonstrated superior predictive accuracy over other lymph node metrics.A nomogram incorporating LODDS,age,carbohydrate antigen(CA)125,carcinoembryonic antigen,and tumor differentiation showed good predictive accuracy(C-index=0.703).A higher LODDS was significantly associated with an increased risk of recurrence or metastasis,poorly differentiated tumors,advanced cancer,mucinous gastric adenocarcinoma,nerve invasion,and vascular tumor thrombus.Additionally,LODDS was positively correlated with the tumor markers CA19-9,CA72-4,CA125,and CA242(all P<0.05).CONCLUSION LODDS is an independent prognostic indicator for patients with moderately and poorly differentiated GC,and its predictive performance is superior to that of other models.展开更多
Objective: Patients with radioactive iodine-refractory differentiated thyroid cancer(RAIR-DTC) are often diagnosed with delay and constrained to limited treatment options. The correlation between RAI refractoriness an...Objective: Patients with radioactive iodine-refractory differentiated thyroid cancer(RAIR-DTC) are often diagnosed with delay and constrained to limited treatment options. The correlation between RAI refractoriness and the underlying genetic characteristics has not been extensively studied.Methods: Adult patients with distant metastatic DTC were enrolled and assigned to undergo next-generation sequencing of a customized 26-gene panel(Thyro Lead). Patients were classified into RAIR-DTC or non-RAIR groups to determine the differences in clinicopathological and molecular characteristics. Molecular risk stratification(MRS) was constructed based on the association between molecular alterations identified and RAI refractoriness, and the results were classified as high, intermediate or low MRS.Results: A total of 220 patients with distant metastases were included, 63.2% of whom were identified as RAIRDTC. Genetic alterations were identified in 90% of all the patients, with BRAF(59.7% vs. 17.3%), TERT promoter(43.9% vs. 7.4%), and TP53 mutations(11.5% vs. 3.7%) being more prevalent in the RAIR-DTC group than in the non-RAIR group, except for RET fusions(15.8% vs. 39.5%), which had the opposite pattern. BRAF and TERT promoter are independent predictors of RAIR-DTC, accounting for 67.6% of patients with RAIR-DTC. MRS was strongly associated with RAI refractoriness(P<0.001), with an odds ratio(OR) of high to low MRS of 7.52 [95%confidence interval(95% CI), 3.96-14.28;P<0.001] and an OR of intermediate to low MRS of 3.20(95% CI,1.01-10.14;P=0.041).Conclusions: Molecular alterations were associated with RAI refractoriness, with BRAF and TERT promoter mutations being the predominant contributors, followed by TP53 and DICER1 mutations. MRS might serve as a valuable tool for both prognosticating clinical outcomes and directing precision-based therapeutic interventions.展开更多
BACKGROUND In recent years,confocal laser endomicroscopy(CLE)has become a new endoscopic imaging technology at the microscopic level,which is extensively performed for real-time in vivo histological examination.CLE ca...BACKGROUND In recent years,confocal laser endomicroscopy(CLE)has become a new endoscopic imaging technology at the microscopic level,which is extensively performed for real-time in vivo histological examination.CLE can be performed to distinguish benign from malignant lesions.In this study,we diagnosed using CLE an asymptomatic patient with poorly differentiated gastric adenocarcinoma.CASE SUMMARY A 63-year-old woman was diagnosed with gastric mucosal lesions,which may be gastric cancer,in the small curvature of the stomach by gastroscopy.She consented to undergo CLE for morphological observation of the gastric mucosa.Through the combination of CLE diagnosis and postoperative pathology,the intraoperative CLE diagnosis was considered to be reliable.According to our experience,CLE can be performed as the first choice for the diagnosis of gastric cancer.CONCLUSION CLE has several advantages over pathological diagnosis.We believe that CLE has great potential in the diagnosis of benign and malignant gastric lesions.展开更多
Molecular weaving is a powerful approach to make molecularly woven materials that have showed unprecedented characteristics and properties intrinsically distinct to those of non-woven materials.We here report a facile...Molecular weaving is a powerful approach to make molecularly woven materials that have showed unprecedented characteristics and properties intrinsically distinct to those of non-woven materials.We here report a facile and efficient approach for the synthesis of 2D woven supramolecular polymers by differentiated self-assembly through orthogonal noncovalent interactions.Importantly,the difference in binding strength of two orthogonal noncovalent interactions can be used to control the process of molecular weaving.Consequently,single-layered 2D woven supramolecular polymers were synthesized and fully characterized by various techniques.This study demonstrates a controllable method for molecular weaving,and will significantly hasten the development of molecularly woven materials.展开更多
This paper expounds upon a novel target detection methodology distinguished by its elevated discriminatory efficacy,specifically tailored for environments characterized by markedly low luminance levels.Conventional me...This paper expounds upon a novel target detection methodology distinguished by its elevated discriminatory efficacy,specifically tailored for environments characterized by markedly low luminance levels.Conventional methodologies struggle with the challenges posed by luminosity fluctuations,especially in settings characterized by diminished radiance,further exacerbated by the utilization of suboptimal imaging instrumentation.The envisioned approach mandates a departure from the conventional YOLOX model,which exhibits inadequacies in mitigating these challenges.To enhance the efficacy of this approach in low-light conditions,the dehazing algorithm undergoes refinement,effecting a discerning regulation of the transmission rate at the pixel level,reducing it to values below 0.5,thereby resulting in an augmentation of image contrast.Subsequently,the coiflet wavelet transform is employed to discern and isolate high-discriminatory attributes by dismantling low-frequency image attributes and extracting high-frequency attributes across divergent axes.The utilization of CycleGAN serves to elevate the features of low-light imagery across an array of stylistic variances.Advanced computational methodologies are then employed to amalgamate and conflate intricate attributes originating from images characterized by distinct stylistic orientations,thereby augmenting the model’s erudition potential.Empirical validation conducted on the PASCAL VOC and MS COCO 2017 datasets substantiates pronounced advancements.The refined low-light enhancement algorithm yields a discernible 5.9%augmentation in the target detection evaluation index when compared to the original imagery.Mean Average Precision(mAP)undergoes enhancements of 9.45%and 0.052%in low-light visual renditions relative to conventional YOLOX outcomes.The envisaged approach presents a myriad of advantages over prevailing benchmark methodologies in the realm of target detection within environments marked by an acute scarcity of luminosity.展开更多
Objective:To investigate the effect of TSH inhibition therapy in the postoperative management of patients with differentiated thyroid cancer.Methods:Seventy patients diagnosed with differentiated thyroid cancer were s...Objective:To investigate the effect of TSH inhibition therapy in the postoperative management of patients with differentiated thyroid cancer.Methods:Seventy patients diagnosed with differentiated thyroid cancer were selected for the study.TSH inhibition therapy was administered to the research group,while thyroxine replacement therapy was provided to the control group during the postoperative management phase.This allowed for a comparative analysis between the two groups.Results:In comparison with the control group,the research group exhibited significant decreases in serum TSH,T3,and T4 levels after treatment,while FT4 and FT3 levels significantly increased(P<0.05).Additionally,significant decreases in Tg,VEGF,TSGF,CD44V6,and sIL-2R levels were observed in the research group after treatment(P<0.05).No significant differences were found in pre-treatment thyroid function between the two groups(P>0.05).Conclusion:The application of TSH inhibition therapy in the postoperative management of patients with differentiated thyroid cancer demonstrates promising outcomes.展开更多
A fundamental shift in the regional development pattern is crucial to achieving a comprehensive green transformation in China.Currently,innovation-driven green development is a significant strategic option for regiona...A fundamental shift in the regional development pattern is crucial to achieving a comprehensive green transformation in China.Currently,innovation-driven green development is a significant strategic option for regional development.As the main body of innovation and the basic unit of regional composition,enterprises have a profound impact on the development of regional economy,society,ecology,and other aspects.However,considering China’s vast territory and significant regional differences in natural environment and industrial structure,it’s necessary to further explore the specific impact paths of regional green development driven by enterprise innovation.Therefore,taking industrial enterprises as an example,based on the panel data of 30 provinces in China from 2016 to 2020,this study verifies the impact of industrial enterprise innovation on the regional green development level by constructing a parallel multiple mediating effect model and dividing the economy into eastern,central,and western regions to discuss the specific impact paths.The results show that industrial enterprise innovation has a significant positive effect on regional green development level,via different influencing paths in each region:(1)The eastern region improves the regional green development level by narrowing the urban-rural income gap;(2)The central region improves the regional green development level by reducing resource dependence;and(3)The western region raises the regional green development level by improving the rationalization of industrial structure.展开更多
Formative assessment is crucial to differentiated language teaching.To ensure the quality of differentiated teaching,some assessment instruments should be adopted during formative assessment,such as differentiated lea...Formative assessment is crucial to differentiated language teaching.To ensure the quality of differentiated teaching,some assessment instruments should be adopted during formative assessment,such as differentiated learning portfolios and group activity journal.The effective application of these instruments can also improve the students' autonomous language learning ability.展开更多
Sector capacity estimation plays an important role in applied research of airspace management.Previous researches manifest that sector capacity should be influenced by its standard flow,or routes in that sector.Howeve...Sector capacity estimation plays an important role in applied research of airspace management.Previous researches manifest that sector capacity should be influenced by its standard flow,or routes in that sector.However,if air traffic controller(ATCO)workload busy levels(level of proactivity of an ATCO)are ignored,the estimated sector capacity may not be accurate.There is a need to compare the estimated sector capacity with and without busy levels consideration,both with differentiated routes consideration.This paper proposes a method for sector capacity estimation based on ATCO workload considering differentiated routes and busy levels.Firstly,the main routes in the sector are identified,and for each route,the ATCO workload per flight is determined.Secondly,the workload for each route at three busy levels is determined.Regression analysis is then applied to determine the relationship between workload and the number of flights(with and without considering busy levels)in 15 min and 1h time slices.Sector capacity is then determined on the basis of a specified workload threshold,for the two cases with and without considering busy levels.Comparing the two scenarios and following validation by ATCO survey,it is found that capacity estimation considering busy levels is a more realistic and accurate approach.The validated capacity values for the Zhengzhou approach(ZHCC AP)airspace sector accounting for the busy levels were determined accurately as 10 and 33 flights for the 15 min and 1h slices,respectively.The corresponding results without considering busy levels were 12 and 41 flights for the 15 min and 1h time slices,respectively.展开更多
Contents1. Diagnosis and dynamic assessment of persistent/recurrent and metastatic differentiated thyroid cancer (prmDTC)1.1 Basic principles of diagnosis1.2 Diagnostic methods1.3 Ongoing assessment of response to the...Contents1. Diagnosis and dynamic assessment of persistent/recurrent and metastatic differentiated thyroid cancer (prmDTC)1.1 Basic principles of diagnosis1.2 Diagnostic methods1.3 Ongoing assessment of response to therapy2. Multidisciplinary treatment of prmDTC2.1 Basic principles of treatment2.2 Surgical management2.2.1 Preoperative clinical assessment2.2.2 Principles of surgical treatment for prmDTC.展开更多
Objective: To investigate the role of collagen IV and PAS positive substancesecreted by tumor cells in vasculogenic mimicry (VM) and the effects of VM on tumor cells expressingVEGF. Methods: 158 cases of bi-direction ...Objective: To investigate the role of collagen IV and PAS positive substancesecreted by tumor cells in vasculogenic mimicry (VM) and the effects of VM on tumor cells expressingVEGF. Methods: 158 cases of bi-direction differential malignant tumor specimens withparaffin-embedded were enrolled into our study and made tissue microarray which were dual-stainedwith CD31-PAS and stained with collagen IV. The difference of the areas and distribution withpattern surrounded by between CD31 and PAS positive respectively were identified via grid-counting,as well as the difference of VEGF expression with VE absent and present. Results: The basementmembrane of VM was both PAS and collagen IV positive. VEGF expression in the bi-directiondifferential malignant tumor was higher VM-absent than VM-present and the difference wasstatistically significance in malignant melanoma and alveolar rhabdomyosarcoma (P 【 0.05).Conclusion: PAS positive substance and collagen IV compose the wall of VE and VE could provide theoxygen and nutrition for tumor growth and progression.展开更多
AIM:To identify the predictive clinicopathological factors for lymph node metastasis (LNM) in poorly differentiated early gastric cancer (EGC) and to further expand the possibility of using endoscopic mucosal resectio...AIM:To identify the predictive clinicopathological factors for lymph node metastasis (LNM) in poorly differentiated early gastric cancer (EGC) and to further expand the possibility of using endoscopic mucosal resection (EMR) for the treatment of poorly differentiated EGC. METHODS: Data were collected from 85 poorly- differentiated EGC patients who were surgically treated. Association between the clinicopathological factors and the presence of LNM was retrospectively analyzed by univariate and multivariate logistic regression analyses. RESULTS: Univariate analysis showed that tumor size (OR = 5.814, 95% CI = 1.050 - 32.172, P = 0.044), depth of invasion (OR = 10.763, 95% CI = 1.259 - 92.026, P = 0.030) and lymphatic vessel involvement (OR = 61.697, 95% CI = 2.144 - 175.485, P = 0.007) were the significant and independent risk factors for LNM. The LNM rate was 5.4%, 42.9% and 50%, respectively, in poorly differentiated EGC patients with one, two and three of the risk factors, respectively. No LNM was found in 25 patients without the three risk factors. Forty-four lymph nodes were found tohave metastasis, 29 (65.9%) and 15 (34.1%) of the lymph nodes involved were within N1 and beyond N1, respectively, in 12 patients with LNM. CONCLUSION: Endoscopic mucosal resection alone may be sufficient to treat poorly differentiated intramucosal EGC (≤ 2.0 cm in diameter) with no histologically-confirmed lymphatic vessel involvement. When lymphatic vessels are involved, lymph node dissection beyond limited (D1) dissection or D1+ lymph node dissection should be performed depending on the tumor location.展开更多
AIM: To evaluate the undifferentiated embryonal sarcoma of liver (UESL) in adults in order to improve its diagnosis and treatment. METHODS: Four primary and one recurrent cases of UESL were clinicopathologically evalu...AIM: To evaluate the undifferentiated embryonal sarcoma of liver (UESL) in adults in order to improve its diagnosis and treatment. METHODS: Four primary and one recurrent cases of UESL were clinicopathologically evaluated and immunohistochemically investigated with a panel of antibodies using the EnVision+ system. Relevant literature about UESL in adults was reviewed. RESULTS: Three males and one female were enrolled in this study. Their chief complaints were abdominal pain, weight loss, or fever. Laboratory tests, imaging and pathological features of UESL in adults were similar to those in children. Immunohistochemistry showed evidence of widely divergent differentiation into mesenchymal and epithelial phenotypes. The survival time of patients who underwent complete tumor resection followed by adjuvant transcatheter arterial chemoembolization (TACE) was significantly longer than that of those who underwent surgical treatment alone.CONCLUSION: UESL in adults may undergo pluripotential differentiation and its diagnosis should be made based on its morphological and immunohistochemical features. Complete tumor resection after adjuvant TACE may improve the survival time of such patients.展开更多
Objective： To observe the effect of thermosensitive moxibustion on anxiety and depression in the patients of insomnia differentiated as liver qi stagnation.Methods： From January 2015 to January 2017, 60 patients of ...Objective： To observe the effect of thermosensitive moxibustion on anxiety and depression in the patients of insomnia differentiated as liver qi stagnation.Methods： From January 2015 to January 2017, 60 patients of insomnia differentiated as liver qi stagnation were collected in Shijiazhuang Municipal Chinese Medicine Hospital. According to the random number table, the patients were randomized into a moxibustion group（30 cases） and an estazolam group（30 cases）. In the moxibustion group, the thermosensitive moxibustion was adopted alternatively to the bilateral yuan-source points of the liver and gallbladder meridians. In the estazolam group, estazolam, 1 mg was prescribed for oral administration before sleep every day. After 15-day treatments, the sleep quality, the severity of anxiety and depression and the therapeutic effects were observed before and after treatment in the two groups.Results： Before treatment, the differences were not significant in the scores of Pittsburgh sleep quality index（PSQI）, the self-rating anxiety scale（SAS） and the self-rating depression scale（SDS） between the two groups（all P〉0.05）. After treatment, the scores of PSQJ, SAS and SDS were all reduced remarkably as compared with those before treatment in the two groups（all P〈0.05）. PSQI score was（6.72 ±2.311）points in the moxibustion group and was（5.37 ±2.621） points in the estazolam group. SAS score was（31.76 ± 6.511） points in the moxibustion group and was（39.62 ± 4.371） points in the estazolam group.SDS score was（35.98 ±5.161） points in the moxibustion group and was（46.38 ±4.971） points in the estazolam group. After treatment, the scores of PSQI, SAS and SDS in the moxibustion group were reduced more remarkably as compared with the estazolam group, indicating the significant differences（all P 〈0.05）. After treatment, the scores of sleep efficacy and TCM symptoms were（72.65 ± 14.36） points and（69.36 ±4.28） points respectively in the moxibustion group, better than the estazolam group, indicating the significant differences（all P〈0.05）.Conclusion： The thermosensitive moxibustion at the yuan-source points of the liver and gallbladder meridians significantly improves the sleep quality, relieves the symptoms of anxiety and depression and enhances the therapeutic effects in the patients of insomnia differentiated as liver qi stagnation. Hence,this therapy deserves to be recommended in clinical practice.展开更多
The identification of an ideal cell source for tissue regeneration remains a challenge in the stem cell field. The ability of progeny cells to differentiate into other cell types is important for the processes of tiss...The identification of an ideal cell source for tissue regeneration remains a challenge in the stem cell field. The ability of progeny cells to differentiate into other cell types is important for the processes of tissue reconstruction and tissue engineering and has clinical, biochemical or molecular implications. The adaptation of stem cells from adipose tissue for use in regenerative medicine has created a new role for adipocytes. Mature adipocytes can easily be isolated from adipose cell suspensions and allowed to dedifferentiate into lipidfree multipotent cells, referred to as dedifferentiated fat(DFAT) cells. Compared to other adult stem cells, the DFAT cells have unique advantages in their abundance, ease of isolation and homogeneity. Under proper condition in vitro and in vivo, the DFAT cells have exhibited adipogenic, osteogenic, chondrogenic, cardiomyogenc, angiogenic, myogenic, and neurogenic potentials. In this review, we first discuss the phenomena of dedifferentiation and transdifferentiation of cells, and then dedifferentiation of adipocytes in particular. Understanding the dedifferentiation process itself may contribute to our knowledge of normal growth processes, as well as mechanisms of disease. Second, we highlight new developments in DFAT cell culture and summarize the current understanding of DFAT cell properties. The unique features of DFAT cells are promising for clinical applications such as tissue regeneration.展开更多
“Common but differentiated responsibilities and respective capabilities”(CBDRRC) is the most significant guiding principle in the international climate change regime, created by the United Nations Framework Conventi...“Common but differentiated responsibilities and respective capabilities”(CBDRRC) is the most significant guiding principle in the international climate change regime, created by the United Nations Framework Convention on Climate Change in 1992 and inherited by the Paris Agreement 24 years later. This paper examines the operationalization of the CBDRRC principle in one of the cornerstone rules of the regimedits transparency provisions, both in existing practice under the convention and possible evolvement in negotiations under the Paris Agreement, from the perspectives of both international rule-making and domestic implementation. The authors have found a continuous enhancement of the transparency framework since the 1990s, and gradual consolidation of a bifurcated system between developed and developing countries into a common one. The authors argue that the transparency framework, as part of the procedural rules, should be designed to facilitate transparent information sharing in accordance with substantive commitments under international climate change laws. Thus, it indirectly reflects historical responsibilities for climate change, while the framework should also be designed as feasible and reflective of the respective capabilities of nations. Finally, the evolution of the transparency framework will aim to enact common and enhanced provisions while differentiating between developed and developing countries in the near term, and greater transparency-related capacity-building for developing countries.展开更多
文摘BACKGROUND The prognosis of patients with poorly differentiated gastric neuroendocrine neoplasms(PDGNENs)is dismal and related research is limited.AIM To investigate the prognostic factors,and validate a novel prognostic nomogram for PDGNEN patients.METHODS We conducted a retrospective study using clinical and pathological data from PDGNEN patients treated at the First Medical Center of the Chinese PLA General Hospital from January 2000 to June 2023.Overall survival(OS)differences were assessed with the Log-rank test and Kaplan-Meier survival curves.Cox regression analysis identified independent risk factors for prognosis.Model performance was evaluated using Harrell’s concordance index,receiver operating characteristic analysis,area under the curve,calibration curves,and decision curve analysis(UDC),including the area under the UDC.RESULTS The study included 336 patients(227 with neuroendocrine carcinoma and 109 with mixed adenoneuroendocrine carcinoma).The average age was 62.7 years.The cohort comprised 80(24.7%)patients in stage I,146(42.9%)in stage II,62(18.1%)in stage III,and 48(14.3%)in stage IV.Significant differences in OS were observed across tumor-node-metastasis stages(P<0.001).Multivariate analysis showed age,Ki-67 index,invasion depth,lymph node metastasis,distant metastasis,and platelet-to-lymphocyte ratio as independent risk factors.We developed a nomogram with a concordance index of 0.779(95%confidence interval:0.743-0.858).Receiver operating characteristic analysis showed area under the curves for 1-year,3-year,and 5-year OS predictions of 0.865,0.850,and 0.890,respectively.The calibration curve demonstrated good agreement with actual outcomes.The area under the UDC for the nomogram vs the 8th American Joint Committee on Cancer tumor-node-metastasis staging system were 0.047 vs 0.027,0.291 vs 0.179,and 0.376 vs 0.216 for 1-year,3-year,and 5-year OS,respectively.CONCLUSION PDGNENs are predominantly found in older men,often in advanced stages at diagnosis,resulting in poor prognosis.The established nomogram demonstrates strong predictive capability and clinical utility.
文摘BACKGROUND Thyroid malignancies,while accounting for a small proportion of cancer diagnoses globally,have demonstrated a consistent upward trend in occurrence across diverse populations,with gender-specific analyses revealing a disproportionate burden among women.Despite the characteristically indolent nature of most thyroid carcinomas and their associated high survival rates,emerging evidence points to significant unmet needs regarding psychosocial adaptation and neuropsychiatric sequelae in this growing survivor population.The spectrum of mental health conditions,ranging from affective and anxiety disorders to cognitive impairments,presents substantial barriers to functional recovery and may potentially influence disease trajectories through complex psychoneuroimmunological pathways.Clinical observations consistently report elevated rates of mood disturbances and executive function deficits persisting throughout the cancer continuum,from active treatment into extended follow-up periods.These findings highlight a critical knowledge gap in understanding the dynamic interplay between thyroid cancer biology,its therapeutic interventions,and the development of treatment-resistant psychiatric manifestations that complicate long-term patient care.AIM To analyse the factors influencing the poor prognosis of patients surviving longterm differentiated thyroid cancer with psychiatric disorders and to construct a prediction model.METHODS Forty-eight patients with mental disorders combined with differentiated thyroid cancer who were treated in our hospital during the period of March 2018 to March 2023 were retrospectively selected as the study subjects(thyroid cancer group),and 30 cases each of patients with mental disorders combined with benign thyroid nodules(benign nodules group)and patients with mental disorders alone(mental disorders group),who were treated during the same time period,were selected as controls.The patients with differentiated thyroid cancer were further divided into a poor prognosis group(10 cases)and a good prognosis group(38 cases).The study outcome was poor prognosis as shown by whole body bone imaging within 2 years after thyroid cancer surgery.Factors influencing poor prognosis in survivors of differentiated thyroid cancer were analyzed by univariate and multivariate logistic regression analyses,receiver operating characteristic(ROC)curve analysis was used to assess the predictive efficacy of these factors for poor prognosis,and the DeLong test was used to determine whether there was a statistically significant difference in the area under the curve(AUC)of the model.RESULTS One-way logistic regression analysis showed that tumour diameter[odds ratio(OR)=19.190,P=0.002],T-stage(OR=7.692,P=0.018),extra-glandular infiltration(OR=37.000,P=0.003),degree of differentiation(OR=24.667,P=0.008),serum free T3(OR=22.348,P=0.025),serum free T4(FT4)(OR=1.158,P=0.002),total bilirubin(TBil)(OR=1.792,P=0.004),albumin(OR=0.675,P=0.003),cortisol(OR=1.180,P=0.003),norepinephrine(OR=1.047,P=0.002),angiotensin II(OR=1.975,P=0.002),and superoxide dismutase(OR=0.515,P=0.005)all increased the risk of poor prognosis in patients with psychiatric disorders and long-term differentiated thyroid cancer.Multifactorial logistic regression analysis showed that tumour diameter(OR=16.570,P=0.021),extraglandular infiltration(OR=53.145,P=0.010),FT4(OR=1.186,P=0.007),and TBil(OR=2.823,P=0.048)were independent risk factors for poor prognosis of patients with psychiatric disorders with long-term differentiated thyroid cancer,and the regression equation was:Y=2.808×tumour diameter+3.973×extra-glandular infiltration+0.171×FT4+1.038×TBil-88.138.ROC analysis showed that the predictive power of the overall model(AUC=0.992,P=0.000)was significantly higher than that of independent risk factors(DeLong test P<0.05).CONCLUSION Tumour diameter,extra-glandular infiltration,FT4,and TBil are independent risk factors for poor prognosis in patients with psychiatric disorders with long-term differentiated thyroid cancer,and the combination of these factors is of higher value in predicting the prognosis of patients.These risk factors can be used as a basis to develop a reasonable prognostic management plan in clinical practice for patients with long-term differentiated thyroid cancer with mental disorders,so as to improve the prognosis and quality of life of patients.
基金Supported by New Taipei Municipal TuCheng Hospital(Built and Operated by Chang Gung Medical Foundation),New Taipei City,Taiwan,No.CORPVVP0031the National Science and Technology Council of Taiwan,No.NSTC 112-2314-B-182A-111-MY3.
文摘BACKGROUND Poorly differentiated thyroid carcinoma(PDTC)is a rare and aggressive form of thyroid cancer.Distant metastasis occurs frequently in PDTC.AIM To determine factors associated with distant metastasis and the effects of metastasis,either diagnosed on initial presentation or developing during follow-up,on mortality in PDTC patients.METHODS Patients with PDTC diagnosed between January 1,1985 and July 31,2022 were identified using a thyroid cancer database at a medical center in Taiwan.Factors associated with distant metastasis and cancer-specific survival(CSS)were analyzed using binary logistic analysis and Cox regression,respectively.Survival analysis was conducted using the Kaplan–Meier method.RESULTS The study cohort included 39 patients with PDTC,including 16 with distant metastasis on initial presentation,5 with metastasis during the follow-up period,and 18 with no evidence of metastasis.Older age(≥45 years)was significantly associated with a higher risk of distant metastasis(odds ratio:5.31;95%confi-dence interval:1.27–22.2;P=0.018),while sex,tumor size,T stage,and N stage were not associated with distant metastasis.Patients with metastatic PDTC,either diagnosed at presentation or developing during follow-up,had poorer 5-year CSS rates(55.0%and 40.0%,respectively)than those without metastasis(5-year CSS,93.8%)(P=0.001 for both comparisons).CONCLUSION Older patients with PDTC have an increased risk of distant metastasis.Patients with metastatic PDTC,both diagnosed at presentation and developing during follow-up,have a dismal prognosis.
文摘This study explores differentiated instructional strategies in higher education,focusing on municipal universities in Beijing to address the needs of students requiring special academic and psychological support.Despite standardized cultivation frameworks in universities,significant variations persist among undergraduates in academic planning,cognitive traits,and psychological profiles.A minority of students face challenges due to cognitive misjudgments(e.g.,unrealistic self-assessment),goal fixation(e.g.,excessive focus on postgraduate exams or studying abroad),psychological barriers(e.g.,social withdrawal),or mental health crises,which hinder their academic integration and personal development.Universities must adopt flexible,compliance-oriented differentiated instruction within standardized frameworks to support at-risk students.Strategies should balance personalized interventions with institutional fairness,ensuring equitable opportunities for all students while safeguarding academic integrity.
基金Supported by the National Natural Science Foundation of China,No.82473195 and No.32370797the Natural Science Foundation of Zhejiang Province,No.LTGY23H160018+3 种基金the Zhejiang Medical and Health Science and Technology Program,No.2024KY789 and No.2023KY615the National Research Center for Translational Medicine at Shanghai Program,No.NRCTM(SH)-2025-07the Beijing Science and Technology Innovation Medical Development Foundation,No.KC2023-JX-0270-07the Key Laboratory of Prevention,Diagnosis and Therapy of Upper Gastrointestinal Cancer of Zhejiang Province,No.2022E10021.
文摘BACKGROUND The log odds of positive lymph nodes(LODDS)are correlated with survival outcomes in gastric cancer(GC)patients.However,the prognostic value across different tumor differentiation levels remains unclear.AIM To evaluate the independent prognostic value of LODDS and the stratified predictive efficacy in GC patients with different histologic differentiations.METHODS We conducted a retrospective analysis of 2103 GC patients who underwent radical gastrectomy at Zhejiang Cancer Hospital.The prognostic value of LODDS was compared with that of other lymph node-based metrics,including the pathologic N stage,number of positive lymph nodes,number of total lymph nodes,and lymph node ratio,stratified by tumor differentiation.RESULTS LODDS was identified as an independent prognostic factor for overall survival in moderately to poorly differentiated GC patients.LODDS demonstrated superior predictive accuracy over other lymph node metrics.A nomogram incorporating LODDS,age,carbohydrate antigen(CA)125,carcinoembryonic antigen,and tumor differentiation showed good predictive accuracy(C-index=0.703).A higher LODDS was significantly associated with an increased risk of recurrence or metastasis,poorly differentiated tumors,advanced cancer,mucinous gastric adenocarcinoma,nerve invasion,and vascular tumor thrombus.Additionally,LODDS was positively correlated with the tumor markers CA19-9,CA72-4,CA125,and CA242(all P<0.05).CONCLUSION LODDS is an independent prognostic indicator for patients with moderately and poorly differentiated GC,and its predictive performance is superior to that of other models.
基金supported by the Project on InterGovernmental International Scientific and Technological Innovation Cooperation in National Key Projects of Research and Development Plan (No. 2019YFE0106400)the National Natural Science Foundation of China (No. 81771875)。
文摘Objective: Patients with radioactive iodine-refractory differentiated thyroid cancer(RAIR-DTC) are often diagnosed with delay and constrained to limited treatment options. The correlation between RAI refractoriness and the underlying genetic characteristics has not been extensively studied.Methods: Adult patients with distant metastatic DTC were enrolled and assigned to undergo next-generation sequencing of a customized 26-gene panel(Thyro Lead). Patients were classified into RAIR-DTC or non-RAIR groups to determine the differences in clinicopathological and molecular characteristics. Molecular risk stratification(MRS) was constructed based on the association between molecular alterations identified and RAI refractoriness, and the results were classified as high, intermediate or low MRS.Results: A total of 220 patients with distant metastases were included, 63.2% of whom were identified as RAIRDTC. Genetic alterations were identified in 90% of all the patients, with BRAF(59.7% vs. 17.3%), TERT promoter(43.9% vs. 7.4%), and TP53 mutations(11.5% vs. 3.7%) being more prevalent in the RAIR-DTC group than in the non-RAIR group, except for RET fusions(15.8% vs. 39.5%), which had the opposite pattern. BRAF and TERT promoter are independent predictors of RAIR-DTC, accounting for 67.6% of patients with RAIR-DTC. MRS was strongly associated with RAI refractoriness(P<0.001), with an odds ratio(OR) of high to low MRS of 7.52 [95%confidence interval(95% CI), 3.96-14.28;P<0.001] and an OR of intermediate to low MRS of 3.20(95% CI,1.01-10.14;P=0.041).Conclusions: Molecular alterations were associated with RAI refractoriness, with BRAF and TERT promoter mutations being the predominant contributors, followed by TP53 and DICER1 mutations. MRS might serve as a valuable tool for both prognosticating clinical outcomes and directing precision-based therapeutic interventions.
基金The Health Science and Technology Foundation of Inner Mongolia,No.202201436Science and Technology Innovation Foundation of Inner Mongolia,No.CXYD2022BT01.
文摘BACKGROUND In recent years,confocal laser endomicroscopy(CLE)has become a new endoscopic imaging technology at the microscopic level,which is extensively performed for real-time in vivo histological examination.CLE can be performed to distinguish benign from malignant lesions.In this study,we diagnosed using CLE an asymptomatic patient with poorly differentiated gastric adenocarcinoma.CASE SUMMARY A 63-year-old woman was diagnosed with gastric mucosal lesions,which may be gastric cancer,in the small curvature of the stomach by gastroscopy.She consented to undergo CLE for morphological observation of the gastric mucosa.Through the combination of CLE diagnosis and postoperative pathology,the intraoperative CLE diagnosis was considered to be reliable.According to our experience,CLE can be performed as the first choice for the diagnosis of gastric cancer.CONCLUSION CLE has several advantages over pathological diagnosis.We believe that CLE has great potential in the diagnosis of benign and malignant gastric lesions.
基金supported by the National Natural Science Foundation of China(Nos.92156012 and 22071078).
文摘Molecular weaving is a powerful approach to make molecularly woven materials that have showed unprecedented characteristics and properties intrinsically distinct to those of non-woven materials.We here report a facile and efficient approach for the synthesis of 2D woven supramolecular polymers by differentiated self-assembly through orthogonal noncovalent interactions.Importantly,the difference in binding strength of two orthogonal noncovalent interactions can be used to control the process of molecular weaving.Consequently,single-layered 2D woven supramolecular polymers were synthesized and fully characterized by various techniques.This study demonstrates a controllable method for molecular weaving,and will significantly hasten the development of molecularly woven materials.
基金supported by National Sciences Foundation of China Grants(No.61902158).
文摘This paper expounds upon a novel target detection methodology distinguished by its elevated discriminatory efficacy,specifically tailored for environments characterized by markedly low luminance levels.Conventional methodologies struggle with the challenges posed by luminosity fluctuations,especially in settings characterized by diminished radiance,further exacerbated by the utilization of suboptimal imaging instrumentation.The envisioned approach mandates a departure from the conventional YOLOX model,which exhibits inadequacies in mitigating these challenges.To enhance the efficacy of this approach in low-light conditions,the dehazing algorithm undergoes refinement,effecting a discerning regulation of the transmission rate at the pixel level,reducing it to values below 0.5,thereby resulting in an augmentation of image contrast.Subsequently,the coiflet wavelet transform is employed to discern and isolate high-discriminatory attributes by dismantling low-frequency image attributes and extracting high-frequency attributes across divergent axes.The utilization of CycleGAN serves to elevate the features of low-light imagery across an array of stylistic variances.Advanced computational methodologies are then employed to amalgamate and conflate intricate attributes originating from images characterized by distinct stylistic orientations,thereby augmenting the model’s erudition potential.Empirical validation conducted on the PASCAL VOC and MS COCO 2017 datasets substantiates pronounced advancements.The refined low-light enhancement algorithm yields a discernible 5.9%augmentation in the target detection evaluation index when compared to the original imagery.Mean Average Precision(mAP)undergoes enhancements of 9.45%and 0.052%in low-light visual renditions relative to conventional YOLOX outcomes.The envisaged approach presents a myriad of advantages over prevailing benchmark methodologies in the realm of target detection within environments marked by an acute scarcity of luminosity.
文摘Objective:To investigate the effect of TSH inhibition therapy in the postoperative management of patients with differentiated thyroid cancer.Methods:Seventy patients diagnosed with differentiated thyroid cancer were selected for the study.TSH inhibition therapy was administered to the research group,while thyroxine replacement therapy was provided to the control group during the postoperative management phase.This allowed for a comparative analysis between the two groups.Results:In comparison with the control group,the research group exhibited significant decreases in serum TSH,T3,and T4 levels after treatment,while FT4 and FT3 levels significantly increased(P<0.05).Additionally,significant decreases in Tg,VEGF,TSGF,CD44V6,and sIL-2R levels were observed in the research group after treatment(P<0.05).No significant differences were found in pre-treatment thyroid function between the two groups(P>0.05).Conclusion:The application of TSH inhibition therapy in the postoperative management of patients with differentiated thyroid cancer demonstrates promising outcomes.
基金supported by the“Second Tibetan Plateau Scientific Expedition and Research Program(STEP),Grant No.2019QZKK1007”from the Ministry of Science and Technology of China。
文摘A fundamental shift in the regional development pattern is crucial to achieving a comprehensive green transformation in China.Currently,innovation-driven green development is a significant strategic option for regional development.As the main body of innovation and the basic unit of regional composition,enterprises have a profound impact on the development of regional economy,society,ecology,and other aspects.However,considering China’s vast territory and significant regional differences in natural environment and industrial structure,it’s necessary to further explore the specific impact paths of regional green development driven by enterprise innovation.Therefore,taking industrial enterprises as an example,based on the panel data of 30 provinces in China from 2016 to 2020,this study verifies the impact of industrial enterprise innovation on the regional green development level by constructing a parallel multiple mediating effect model and dividing the economy into eastern,central,and western regions to discuss the specific impact paths.The results show that industrial enterprise innovation has a significant positive effect on regional green development level,via different influencing paths in each region:(1)The eastern region improves the regional green development level by narrowing the urban-rural income gap;(2)The central region improves the regional green development level by reducing resource dependence;and(3)The western region raises the regional green development level by improving the rationalization of industrial structure.
文摘Formative assessment is crucial to differentiated language teaching.To ensure the quality of differentiated teaching,some assessment instruments should be adopted during formative assessment,such as differentiated learning portfolios and group activity journal.The effective application of these instruments can also improve the students' autonomous language learning ability.
基金partially supported by the National Natural Science Foundation of China(No.61304190)the Fundamental Research Funds for the Central Universities(No.NJ20140018)
文摘Sector capacity estimation plays an important role in applied research of airspace management.Previous researches manifest that sector capacity should be influenced by its standard flow,or routes in that sector.However,if air traffic controller(ATCO)workload busy levels(level of proactivity of an ATCO)are ignored,the estimated sector capacity may not be accurate.There is a need to compare the estimated sector capacity with and without busy levels consideration,both with differentiated routes consideration.This paper proposes a method for sector capacity estimation based on ATCO workload considering differentiated routes and busy levels.Firstly,the main routes in the sector are identified,and for each route,the ATCO workload per flight is determined.Secondly,the workload for each route at three busy levels is determined.Regression analysis is then applied to determine the relationship between workload and the number of flights(with and without considering busy levels)in 15 min and 1h time slices.Sector capacity is then determined on the basis of a specified workload threshold,for the two cases with and without considering busy levels.Comparing the two scenarios and following validation by ATCO survey,it is found that capacity estimation considering busy levels is a more realistic and accurate approach.The validated capacity values for the Zhengzhou approach(ZHCC AP)airspace sector accounting for the busy levels were determined accurately as 10 and 33 flights for the 15 min and 1h slices,respectively.The corresponding results without considering busy levels were 12 and 41 flights for the 15 min and 1h time slices,respectively.
文摘Contents1. Diagnosis and dynamic assessment of persistent/recurrent and metastatic differentiated thyroid cancer (prmDTC)1.1 Basic principles of diagnosis1.2 Diagnostic methods1.3 Ongoing assessment of response to therapy2. Multidisciplinary treatment of prmDTC2.1 Basic principles of treatment2.2 Surgical management2.2.1 Preoperative clinical assessment2.2.2 Principles of surgical treatment for prmDTC.
基金This work was partially supported by a grant from the National Natural Science Foundation of China (No. 30370378)
文摘Objective: To investigate the role of collagen IV and PAS positive substancesecreted by tumor cells in vasculogenic mimicry (VM) and the effects of VM on tumor cells expressingVEGF. Methods: 158 cases of bi-direction differential malignant tumor specimens withparaffin-embedded were enrolled into our study and made tissue microarray which were dual-stainedwith CD31-PAS and stained with collagen IV. The difference of the areas and distribution withpattern surrounded by between CD31 and PAS positive respectively were identified via grid-counting,as well as the difference of VEGF expression with VE absent and present. Results: The basementmembrane of VM was both PAS and collagen IV positive. VEGF expression in the bi-directiondifferential malignant tumor was higher VM-absent than VM-present and the difference wasstatistically significance in malignant melanoma and alveolar rhabdomyosarcoma (P 【 0.05).Conclusion: PAS positive substance and collagen IV compose the wall of VE and VE could provide theoxygen and nutrition for tumor growth and progression.
基金Gastric Cancer Laboratory of China Medical University,Shenyang,Liaoning Province,China
文摘AIM:To identify the predictive clinicopathological factors for lymph node metastasis (LNM) in poorly differentiated early gastric cancer (EGC) and to further expand the possibility of using endoscopic mucosal resection (EMR) for the treatment of poorly differentiated EGC. METHODS: Data were collected from 85 poorly- differentiated EGC patients who were surgically treated. Association between the clinicopathological factors and the presence of LNM was retrospectively analyzed by univariate and multivariate logistic regression analyses. RESULTS: Univariate analysis showed that tumor size (OR = 5.814, 95% CI = 1.050 - 32.172, P = 0.044), depth of invasion (OR = 10.763, 95% CI = 1.259 - 92.026, P = 0.030) and lymphatic vessel involvement (OR = 61.697, 95% CI = 2.144 - 175.485, P = 0.007) were the significant and independent risk factors for LNM. The LNM rate was 5.4%, 42.9% and 50%, respectively, in poorly differentiated EGC patients with one, two and three of the risk factors, respectively. No LNM was found in 25 patients without the three risk factors. Forty-four lymph nodes were found tohave metastasis, 29 (65.9%) and 15 (34.1%) of the lymph nodes involved were within N1 and beyond N1, respectively, in 12 patients with LNM. CONCLUSION: Endoscopic mucosal resection alone may be sufficient to treat poorly differentiated intramucosal EGC (≤ 2.0 cm in diameter) with no histologically-confirmed lymphatic vessel involvement. When lymphatic vessels are involved, lymph node dissection beyond limited (D1) dissection or D1+ lymph node dissection should be performed depending on the tumor location.
文摘AIM: To evaluate the undifferentiated embryonal sarcoma of liver (UESL) in adults in order to improve its diagnosis and treatment. METHODS: Four primary and one recurrent cases of UESL were clinicopathologically evaluated and immunohistochemically investigated with a panel of antibodies using the EnVision+ system. Relevant literature about UESL in adults was reviewed. RESULTS: Three males and one female were enrolled in this study. Their chief complaints were abdominal pain, weight loss, or fever. Laboratory tests, imaging and pathological features of UESL in adults were similar to those in children. Immunohistochemistry showed evidence of widely divergent differentiation into mesenchymal and epithelial phenotypes. The survival time of patients who underwent complete tumor resection followed by adjuvant transcatheter arterial chemoembolization (TACE) was significantly longer than that of those who underwent surgical treatment alone.CONCLUSION: UESL in adults may undergo pluripotential differentiation and its diagnosis should be made based on its morphological and immunohistochemical features. Complete tumor resection after adjuvant TACE may improve the survival time of such patients.
基金Supported by Funding project of Hebei Administration of Traditional Chinese Medicine(2015190)Funding project of Natural Science Foundation of China(81072883,81173342,81473773)~~
文摘Objective： To observe the effect of thermosensitive moxibustion on anxiety and depression in the patients of insomnia differentiated as liver qi stagnation.Methods： From January 2015 to January 2017, 60 patients of insomnia differentiated as liver qi stagnation were collected in Shijiazhuang Municipal Chinese Medicine Hospital. According to the random number table, the patients were randomized into a moxibustion group（30 cases） and an estazolam group（30 cases）. In the moxibustion group, the thermosensitive moxibustion was adopted alternatively to the bilateral yuan-source points of the liver and gallbladder meridians. In the estazolam group, estazolam, 1 mg was prescribed for oral administration before sleep every day. After 15-day treatments, the sleep quality, the severity of anxiety and depression and the therapeutic effects were observed before and after treatment in the two groups.Results： Before treatment, the differences were not significant in the scores of Pittsburgh sleep quality index（PSQI）, the self-rating anxiety scale（SAS） and the self-rating depression scale（SDS） between the two groups（all P〉0.05）. After treatment, the scores of PSQJ, SAS and SDS were all reduced remarkably as compared with those before treatment in the two groups（all P〈0.05）. PSQI score was（6.72 ±2.311）points in the moxibustion group and was（5.37 ±2.621） points in the estazolam group. SAS score was（31.76 ± 6.511） points in the moxibustion group and was（39.62 ± 4.371） points in the estazolam group.SDS score was（35.98 ±5.161） points in the moxibustion group and was（46.38 ±4.971） points in the estazolam group. After treatment, the scores of PSQI, SAS and SDS in the moxibustion group were reduced more remarkably as compared with the estazolam group, indicating the significant differences（all P 〈0.05）. After treatment, the scores of sleep efficacy and TCM symptoms were（72.65 ± 14.36） points and（69.36 ±4.28） points respectively in the moxibustion group, better than the estazolam group, indicating the significant differences（all P〈0.05）.Conclusion： The thermosensitive moxibustion at the yuan-source points of the liver and gallbladder meridians significantly improves the sleep quality, relieves the symptoms of anxiety and depression and enhances the therapeutic effects in the patients of insomnia differentiated as liver qi stagnation. Hence,this therapy deserves to be recommended in clinical practice.
基金Supported by In part by the American Heart Association(Medet Jumabay)NIH grants P01 HL30568,R01 HL81397,and R01 HL112839(Kristina I Bostrom)
文摘The identification of an ideal cell source for tissue regeneration remains a challenge in the stem cell field. The ability of progeny cells to differentiate into other cell types is important for the processes of tissue reconstruction and tissue engineering and has clinical, biochemical or molecular implications. The adaptation of stem cells from adipose tissue for use in regenerative medicine has created a new role for adipocytes. Mature adipocytes can easily be isolated from adipose cell suspensions and allowed to dedifferentiate into lipidfree multipotent cells, referred to as dedifferentiated fat(DFAT) cells. Compared to other adult stem cells, the DFAT cells have unique advantages in their abundance, ease of isolation and homogeneity. Under proper condition in vitro and in vivo, the DFAT cells have exhibited adipogenic, osteogenic, chondrogenic, cardiomyogenc, angiogenic, myogenic, and neurogenic potentials. In this review, we first discuss the phenomena of dedifferentiation and transdifferentiation of cells, and then dedifferentiation of adipocytes in particular. Understanding the dedifferentiation process itself may contribute to our knowledge of normal growth processes, as well as mechanisms of disease. Second, we highlight new developments in DFAT cell culture and summarize the current understanding of DFAT cell properties. The unique features of DFAT cells are promising for clinical applications such as tissue regeneration.
文摘“Common but differentiated responsibilities and respective capabilities”(CBDRRC) is the most significant guiding principle in the international climate change regime, created by the United Nations Framework Convention on Climate Change in 1992 and inherited by the Paris Agreement 24 years later. This paper examines the operationalization of the CBDRRC principle in one of the cornerstone rules of the regimedits transparency provisions, both in existing practice under the convention and possible evolvement in negotiations under the Paris Agreement, from the perspectives of both international rule-making and domestic implementation. The authors have found a continuous enhancement of the transparency framework since the 1990s, and gradual consolidation of a bifurcated system between developed and developing countries into a common one. The authors argue that the transparency framework, as part of the procedural rules, should be designed to facilitate transparent information sharing in accordance with substantive commitments under international climate change laws. Thus, it indirectly reflects historical responsibilities for climate change, while the framework should also be designed as feasible and reflective of the respective capabilities of nations. Finally, the evolution of the transparency framework will aim to enact common and enhanced provisions while differentiating between developed and developing countries in the near term, and greater transparency-related capacity-building for developing countries.
