Cascading failures pose a serious threat to the survivability of underwater unmanned swarm networks(UUSNs),significantly limiting their service ability in collaborative missions such as military reconnaissance and env...Cascading failures pose a serious threat to the survivability of underwater unmanned swarm networks(UUSNs),significantly limiting their service ability in collaborative missions such as military reconnaissance and environmental monitoring.Existing failure models primarily focus on power grids and traffic systems,and don't address the unique challenges of weak-communication UUSNs.In UUSNs,cascading failure present a complex and dynamic process driven by the coupling of unstable acoustic channels,passive node drift,adversarial attacks,and network heterogeneity.To address these challenges,a directed weighted graph model of UUSNs is first developed,in which node positions are updated according to ocean-current-driven drift and link weights reflect the probability of successful acoustic transmission.Building on this UUSNs graph model,a cascading failure model is proposed that integrates a normal-failure-recovery state-cycle mechanism,multiple attack strategies,and routingbased load redistribution.Finally,under a five-level connectivity UUSNs scheme,simulations are conducted to analyze how dynamic topology,network load,node recovery delay,and attack modes jointly affect network survivability.The main findings are:(1)moderate node drift can improve survivability by activating weak links;(2)based-energy routing(BER)outperform based-depth routing(BDR)in harsh conditions;(3)node self-recovery time is critical to network survivability;(4)traditional degree-based critical node metrics are inadequate for weak-communication UUSNs.These results provide a theoretical foundation for designing robust survivability mechanisms in weak-communication UUSNs.展开更多
Cutting off or controlling the enemy’s power supply at critical moments or strategic locations may result in a cascade failure,thus gaining an advantage in a war.However,the exist-ing cascading failure modeling analy...Cutting off or controlling the enemy’s power supply at critical moments or strategic locations may result in a cascade failure,thus gaining an advantage in a war.However,the exist-ing cascading failure modeling analysis of interdependent net-works is insufficient for describing the load characteristics and dependencies of subnetworks,and it is difficult to use for model-ing and failure analysis of power-combat(P-C)coupling net-works.This paper considers the physical characteristics of the two subnetworks and studies the mechanism of fault propaga-tion between subnetworks and across systems.Then the surviv-ability of the coupled network is evaluated.Firstly,an integrated modeling approach for the combat system and power system is predicted based on interdependent network theory.A heteroge-neous one-way interdependent network model based on proba-bility dependence is constructed.Secondly,using the operation loop theory,a load-capacity model based on combat-loop betweenness is proposed,and the cascade failure model of the P-C coupling system is investigated from three perspectives:ini-tial capacity,allocation strategy,and failure mechanism.Thirdly,survivability indexes based on load loss rate and network sur-vival rate are proposed.Finally,the P-C coupling system is con-structed based on the IEEE 118-bus system to demonstrate the proposed method.展开更多
Background:Tumor location affects rectal cancer management,but no consensus exists on criteria.The anterior peritoneal reflection(aPR),an anatomical landmark,shows potential for defining tumor location but requires cl...Background:Tumor location affects rectal cancer management,but no consensus exists on criteria.The anterior peritoneal reflection(aPR),an anatomical landmark,shows potential for defining tumor location but requires clinical validation.This study evaluated the utility of aPR in guiding neoadjuvant chemoradiotherapy(nCRT)decisions and predicting lateral lymph node(LLN)/distant metastasis patterns.Methods:This single-center retrospective cohort analyzed data from Peking Union Medical College Hospital(Beijing,China)between January 2016 and August 2022.Magnetic resonance imaging(MRI)-measured aPR parameters were pathologically validated.Patients were stratified by aPR-based definition and tumor height(10 cm).Kaplan-Meier survival curves,log-rank tests,and Cox regression were used for prognostic analysis.Results:Among 588 patients(439 tumors≥5 cm from the anal verge),MRI identified aPR with an accuracy of 95.4%.For tumors≥5 cm,aPR-defined middle-to-low rectal cancer showed lower 3-year disease-free survival(DFS)rate than the upper rectal cancer(P=0.010),while their 3-year overall survival(OS)rates were comparable.Conversely,10-cm-defined classification showed no DFS or OS differences(both P>0.2).Cox regression confirmed aPR-defined classification as an independent DFS predictor(HR=3.19,P=0.014),while 10-cm classification was non-predictive.nCRT with tumor regression grade(TRG)0-1 trended toward improved DFS compared with direct surgery(HR=0.56,P=0.072).The independent protective effect of nCRT with TRG 0-1 for DFS was exclusive to the aPR-defined middle-to-low rectal cancer subgroup(HR=0.45,P=0.026)and not observed in the 10-cm subgroup.aPR-defined classification was independently associated with LLNs on MRI and postoperative pulmonary metastasis.Conclusion:aPR may guide nCRT decision-making and predict LLN metastasis and postoperative distant organ metastasis.展开更多
BACKGROUND Primary gastrointestinal diffuse large B-cell lymphoma(PGI-DLBCL),the most prevalent extranodal non-Hodgkin lymphoma,poses significant diagnostic and therapeutic challenges due to its non-specific symptoms ...BACKGROUND Primary gastrointestinal diffuse large B-cell lymphoma(PGI-DLBCL),the most prevalent extranodal non-Hodgkin lymphoma,poses significant diagnostic and therapeutic challenges due to its non-specific symptoms and poor prognosis.AIM To develop and validate a risk model for the early identification of PGI-DLBCL using Least Absolute Shrinkage and Selection-Cox regression,with the aim of guiding clinical decision-making.METHODS The clinical data of patients diagnosed with PGI-DLBCL at the Tumor Hospital Affiliated to Xinjiang Medical University were analyzed retrospectively from January 2010 to April 2022.RESULTS A total of 319 patients with PGI-DLBCL were included and divided into training(n=223)and validation(n=96)cohorts.The median age was 55 years,with 48.9%male and 51.1%female patients.Key clinical features included Eastern Cooperative Oncology Group performance status≥2(40.8%),advanced-stage disease(stage IV:27.6%),extranodal involvement≥2 sites(47%),tumor>5 cm(46.1%),elevated beta-2 microglobulin(50.5%),elevated lactate dehydrogenase(27%),high International Prognostic Index(3-5:69.9%),non-germinal center B-cell-like subtype(59.9%),and B symptoms(55.8%).Immunohistochemical analysis showed frequent expression of CD10(51.1%),B-cell lymphoma 6(53.3%),multiple myeloma oncogene 1(40.1%),Bcell lymphoma 2(49.2%),myelocytomatosis viral oncogene homolog(48.3%),Ki-67(67.1%),and CD5(42.6%);Epstein-Barr virus-encoded RNA was positive in 3.1%.Based on Least Absolute Shrinkage and Selection regression and subsequent univariate and multivariate Cox regression analyses,extranodal sites≥2,B symptoms,mixed lesion type,and negative multiple myeloma oncogene 1 expression were identified as independent risk factors for PGI-DLBCL.The risk model stratified patients into high-and low-risk groups with significantly different overall survival(P<0.05).Area under the curve values for 1-,3-,and 5-year overall survival were 0.625,0.663,and 0.723 in the training cohort,with consistent performance in the validation cohort.Decision curve analysis indicated favorable clinical utility.CONCLUSION PGI-DLBCL in our cohort showed distinctive clinical features and a predominance of the non-germinal center Bcell-like subtype.Decision curve analysis confirmed the clinical applicability of our prognostic model.Although molecular biomarkers will be needed to improve predictive precision,our model offers a practical tool for early risk identification and individualized management in clinical practice.展开更多
Colorectal cancer is the third most diagnosed cancer worldwide,and immune checkpoint inhibitors have shown promising therapeutic outcomes in selected patient groups.This study performed a comprehensive analysis of mul...Colorectal cancer is the third most diagnosed cancer worldwide,and immune checkpoint inhibitors have shown promising therapeutic outcomes in selected patient groups.This study performed a comprehensive analysis of multi-omics data from The Cancer Genome Atlas colorectal adenocarcinoma cohort(TCGA-COADREAD),accessed through cBioPortal,to develop machine learning models for predicting progression-free survival(PFS)following immunotherapy.The dataset included clinical variables,genomic alterations in Kirsten Rat Sarcoma Viral Oncogene Homolog(KRAS),B-Raf Proto-Oncogene(BRAF),and Neuroblastoma RAS Viral Oncogene Homolog(NRAS),microsatellite instability(MSI)status,tumor mutation burden(TMB),and expression of immune checkpoint genes.Kaplan–Meier analysis showed that KRAS mutations were significantly associated with reduced PFS,while BRAF and NRAS mutations had no significant impact.MSI-high tumors exhibited elevated TMB and increased immune checkpoint expression,reflecting their immunologically active phenotype.We developed both survival and classification models,with the Extra Trees classifier achieving the best performance(accuracy=0.86,precision=0.67,recall=0.70,F1-score=0.68,AUC=0.84).These findings highlight the potential of combining genomic and immune biomarkers with machine learning to improve patient stratification and guide personalized immunotherapy decisions.An interactive web application was also developed to enable clinicians to input patient-specific molecular and clinical data and visualize individualized PFS predictions,supporting timely,data-driven treatment planning.展开更多
AIM:To identify metastasis-associated prognostic genes and construct a robust molecular signature for survival prediction in uveal melanoma(UVM)patients.METHODS:Transcriptomic data and clinical information from 80 UVM...AIM:To identify metastasis-associated prognostic genes and construct a robust molecular signature for survival prediction in uveal melanoma(UVM)patients.METHODS:Transcriptomic data and clinical information from 80 UVM patients in the Cancer Genome Atlas(TCGA)-UVM cohort and an external Gene Expression Omnibus(GEO)microarray dataset(GSE73652;8 non-metastatic vs 5 metastatic cases)were analyzed to identify differentially expressed genes(DEGs).Functional enrichment,proteinprotein interaction(PPI)network construction,and survival analyses identified seven metastasis-and prognosisrelated genes.Their expression was further examined using public single-cell RNA-seq data(GSE139829;11 tumors).Experimental validation was performed in UVM cell lines(92.1,OMM1,MEL270)and adult retinal pigment epithelial(ARPE-19)cells using quantitative real-time polymerase chain reaction(qRT-PCR)and Western blotting to confirm transcriptomic trends.A LASSO Cox model was applied to construct a metastasis-related risk Score signature.Tumor immune microenvironment characteristics were evaluated via single-sample gene set enrichment analysis(ssGSEA)and ESTIMATE.Somatic mutation and copy number variation(CNV)profiles were also examined.RESULTS:Seven key genes(UBE2T,KIF20A,DLGAP5,KLC3,TPX2,UBE2C,AURKA)were significantly associated with overall survival and used to construct a metastasisrelated riskScore signature,which effectively stratified patients into high-and low-risk groups and served as an independent prognostic factor.qRT-PCR and Western blot results confirmed that the expression levels of selected key genes in UVM cell lines showed significant differences compared to ARPE-19 cells,which were largely consistent with the transcriptomic findings.The high-risk group exhibited reduced immune infiltration and stromal activity.Single-cell analysis revealed these genes were predominantly expressed in a tumor cell cluster characterized by BAP1 loss and high metastatic potential.Mutation and CNV analyses further supported the relevance of these genes to UVM progression.CONCLUSION:This study establishes and validates a seven-gene signature associated with metastasis and prognosis in UVM.The findings provide a framework for understanding molecular determinants of tumor progression and immune microenvironment alterations,and may offer guidance for future mechanistic studies and therapeutic exploration.展开更多
Populus euphratica Oliv. is widely distributed along the Tarim River. Maintaining stability of P. euphratica population is important to local development. This study explored the static life table, survivorship curves...Populus euphratica Oliv. is widely distributed along the Tarim River. Maintaining stability of P. euphratica population is important to local development. This study explored the static life table, survivorship curves and four function curves (survival rate, cumulative mortality rate, mortality density, and hazard rate), and development index of P. euphratica population in the middle reaches of Tarim River. The results indicated that the age structure of P. euphratica population belonged to positive pyramidal type, which meant young age-class individuals occupied most populations. The number ofⅠ-Ⅱage classes accounted for 66.2% of whole population, and this indicated that there were abundant subsequent seedlings resources to support the growth of P. euphratica population in the middle reaches of Tarim River. The survivorship curve of P. euphratica belonged to the Deevey Ⅲ (concave-type) and the development index was 47.72%. Four function curves revealed that the individuals of P. euphratica sharply decreased at the initial stage and then leveled off at the late stage of survival curve. Time sequence prediction models predicted that the number of midlife individuals would increase in future 10, 20, 30 years, and P. euphratica population grew steadily as a result of rich saplings.展开更多
Objective： To investigate the clinicopathological features, survival and prognostic factors for gastroenteropancreatic neuroendocrine neoplasms（GEP-NENs） in a Chinese population.Methods： We investigated 154 consec...Objective： To investigate the clinicopathological features, survival and prognostic factors for gastroenteropancreatic neuroendocrine neoplasms（GEP-NENs） in a Chinese population.Methods： We investigated 154 consecutive patients（88 males, 66 females; median age 56 years, age range 9-86 years） diagnosed with GEP-NENs between 2001 and 2013 at The Affiliated Hospital of Qingdao University. Demographic, clinical and pathological variables and survival data were retrieved.Results： The pancreas was the most common site of involvement（63/154, 40.9%）. Tumor size varied from 0.3 to 16.0 cm（median, 1.2 cm）. The patients were followed up for a median period of 22 months（range, 1-157 months）. The estimated 3- and 5-year overall survival（OS） rates for all patients were 84.0% and 81.9%, respectively. Multivariate analysis showed that larger tumor size, lymphatic metastases and distant metastases were significant predictors for poor survival outcome.Conclusions： Our data provide further information on the clinicopathological features of GEP-NENs in China. Additionally, we identified tumor size, lymphatic metastases and distant metastases as independent prognostic factors for long-term survival.展开更多
AIM： To investigate the 152 cases of paragangliomas resected over the past 32 years in West China Hospital dinicopathologically.METHODS： All cases of paragangliomas diagnosed at the Department of Gastrointestinal Su...AIM： To investigate the 152 cases of paragangliomas resected over the past 32 years in West China Hospital dinicopathologically.METHODS： All cases of paragangliomas diagnosed at the Department of Gastrointestinal Surgery and Department of Pathology, West China Hospital, China were reviewed. The pathological documents were supplied by the Department of Pathology, West China Hospital, and other necessary data were extracted from the hospital records. The statistical analyses were performed by survival analysis （Kaplan-Meier method）, descriptive statistical analyses and Х^2 analysis.RESULTS： The neuroendocrine marker vimentin was found to be selectively expressed in the benign tumors, and there were significant differences in the expression of those markers in both benign and malignant tumors. The survival analysis revealed that survival correlated significantly with the malignancy, metastasis and nodal status.CONCLUSION： Vimentin may be useful in the differential diagnosis between malignant and benign tumors. The difference in the expression of this marker in the tumors could be a clue to the future clinical diagnosis. The malignancy, metastasis and the nodal status may predict the prognosis of this disease.展开更多
AIM： To identify the clinical and prognostic features of patients with hepatocellular carcinoma （HCC） aged 80 years or more. METHODS： A total of 1310 patients with HCC were included in this study. Ninety-one patie...AIM： To identify the clinical and prognostic features of patients with hepatocellular carcinoma （HCC） aged 80 years or more. METHODS： A total of 1310 patients with HCC were included in this study. Ninety-one patients aged 80 years or more at the time of diagnosis of HCC were defined as the extremely elderly group. Two hundred and thirty-four patients aged 〉/ 50 years but less than 60 years were regarded as the non-elderly group. RESULTS： The sex ratio （male to female） was significantly lower in the extremely elderly group （0.90：1） than in the non-elderly group （3.9：1, P〈 0.001）. The positive rate for HBsAg was significantly lower in the extremely elderly group and the proportion of patients negative for HBsAg and HCVAb obviously increased in the extremely elderly group （P〈 0.001）. There were no significant differences in the following parameters： diameter and number of tumors, Child-Pugh grading, tumor staging, presence of portal thrombosis or ascites, and positive rate for HCVAb. Extremely elderly patients did not often receive surgical treatment （P 〈 0.001） and they were more likely to receive conservative treatment （P〈 0.01）. There were no significant differences in survival curves based on the Kaplan-Meier methods in comparison with the overall patients between the two groups. However, the survival curves were significantly worse in the extremely elderly patients with stage Ⅰ/Ⅱ, stage Ⅰ/Ⅱ and Child-Pugh grade A cirrhosis in comparison with the non-elderly group. The causes of death did not differ among the patients, and most cases died of liverrelated diseases even in the extremely elderly patients. CONCLUSION： In the patients with good liver functions and good performance status, aggressive treatment for HCC might improve the survival rate, even in extremely elderly patients.展开更多
AIM:To assess the consecutive recurrence following early success of intermittent exotropia surgery and to determine the clinical factors that affect the survival.METHODS:One hundred and thirty-five patients who underw...AIM:To assess the consecutive recurrence following early success of intermittent exotropia surgery and to determine the clinical factors that affect the survival.METHODS:One hundred and thirty-five patients who underwent intermittent exotropia surgery and experienced early surgical success[≤5 prism diopters(PD)esophoria(E)to≤10 PD exophoria(X)on the postoperative sixth month]were enrolled in this study.Their consecutive survival on the postoperative first year,second year and third year and at the last visit of fourth year or more,and the factors that might affect their survival,were analyzed.The final surgical outcomes after the postoperative fourth year were also investigated by dividing the patients into the success group(≤5 PD E to≤10 PD X)and the failure group(】5 PD esodeviation or】10 PD exodeviation)RESULTS:The survival rates from the Kaplan-Meier analysis were 97.78%,92.89%,83.70%and 50.49%on the postoperative first,second and third years and fourth year or more,respectively.None of the clinical factors was determined to have affected the survival.The amount of the exodrift was largest(2.29 PD)between the first year and the second year,and smallest(1.47 PD)between the fourth year and the last visit.Sixty-three patients had their final visit after the postoperative fourth year,and 29 of them were in the failure group.Twentyfive patients in the failure group had an intermittent exotropia(IXT)of【20 PD with good to fair distant fusion;two had an IXT of【20 PD with poor distant fusion;one had an IXT of≥20 PD with fair distant fusion;and another had delayed-onset consecutive esotropia.The exodeviation on the postoperative sixth month was smaller in the success group than in the failure group(2.81 PD vs 5.86 PD,P=0.012).The reoperation rate for recurrent IXT was 3.7%.CONCLUSION:The survival rate steadily decreases with the exodrift,but the amount of the exodrift decreases with long-term follow-up.The final outcomes demonstrate favorable results via surgical success or small-angle IXT with good fusion in most of the patients.A smaller deviation on the postoperative sixth month is associated with long-term survival.展开更多
Background: Liver recurrence after resection of colorectal liver metastases(CRLM) is frequent. Repeat hepatectomy has been shown to have satisfactory perioperative results. However, the long-term outcomes and the bene...Background: Liver recurrence after resection of colorectal liver metastases(CRLM) is frequent. Repeat hepatectomy has been shown to have satisfactory perioperative results. However, the long-term outcomes and the benefts for patients with early recurrence have not been clarifed. The aim of this study was to compare the short-and long-term outcomes of patients undergoing single hepatectomy and repeat hepatectomy for CRLM. Additionally, the oncological outcomes of patients with early( ≤ 6 months) and late recurrence who underwent repeat hepatectomy were compared. Methods: Consecutive adult patients undergoing hepatectomy for CRLM between June 20 0 0 and February 2020 were included and divided into two groups: single hepatectomy and repeat hepatectomy. Results: A total of 709 patients were included: 649 in the single hepatectomy group and 60 in the repeat hepatectomy group. Patients in the repeat hepatectomy group underwent more cycles of preoperative chemotherapy [4(3-6) vs. 3(2-4), P = 0.003]. Patients in the single hepatectomy group more frequently underwent major hepatectomies(34.5% vs. 16.7%, P = 0.004) and had a greater number of lesions resected(2.9 ± 3.6 vs. 1.9 ± 1.8, P = 0.011). There was no increase in operative time, estimated blood loss, length of hospital stay, complications, or mortality in the repeat hepatectomy group. There were no differences in overall survival( P = 0.626) and disease-free survival( P = 0.579) between the two groups. Similarly, for patients underwent repeat hepatectomy, no difference was observed between the early and late recurrence groups in terms of overall survival( P = 0.771) or disease-free survival( P = 0.350). Conclusions: Repeat hepatectomy is feasible and safe, with similar short-and long-term outcomes when compared to single hepatectomy. Surgical treatment of early liver recurrence offers similar oncological outcomes to those obtained for late recurrence.展开更多
Objective: To compare the efficacy and adverse effects of paclitaxel-etoposide-carboplatin/cisplatin(TEP/TCE) regimen with those of etoposide-carboplatin/cisplatin(EP/CE) regimen as first-line treatment for combined s...Objective: To compare the efficacy and adverse effects of paclitaxel-etoposide-carboplatin/cisplatin(TEP/TCE) regimen with those of etoposide-carboplatin/cisplatin(EP/CE) regimen as first-line treatment for combined small-cell lung cancer(CSCLC).Methods: A retrospective study was conducted on 62 CSCLC patients who were treated at Tianjin Medical University Cancer Institute and Hospital from July 2000 to April 2013 and administered with TEP/TCE regimen(n=19) or EP/CE regimen(n=43) as first-line CSCLC treatment. All patients received more than two cycles of chemotherapy, and the response was evaluated every two cycles. The primary endpoint was overall survival(OS), and the secondary endpoints were progression-free survival(PFS), objective response rate(ORR), disease control rate(DCR), and adverse effects. Results: ORR between the TEP/TCE and EP/CE groups showed a statistical difference(90% vs. 53%, P=0.033). Both groups failed to reach a statistical difference in DCR(100% vs. 86%, P=0.212). The median PFS and OS of the TEP/TCE group were slightly longer than those of the EP/CE group, although both groups failed to reach a statistical difference(10.5 vs. 8.9 months, P=0.484; 24.0 vs. 17.5 months, P=0.457). However, stratified analysis indicated that the PFS of patients with stages III and IV CSCLC showed marginally significant difference between the TEP/TCE and EP/CE groups(19.5 vs. 7.6 months; P=0.071). Both rates of grade IV bone marrow depression and termination of chemotherapy in the TEP/TCE group were significantly higher than those in the EP/CE group(26.3% vs. 7.0%, P=0.036; 31.6% vs. 14.7%, P=0.004). Conclusion: The TEP/TCE regimen may not be preferred for CSCLC, and this three-drug regimen requires further exploration and research. To date, the EP/CE regimen remains the standard treatment for CSCLC patients.展开更多
Most studies of coronavirus disease 2019(COVID-19)progression have focused on the transfer of patients within secondary or tertiary care hospitals from regular wards to intensive care units.Little is known about the r...Most studies of coronavirus disease 2019(COVID-19)progression have focused on the transfer of patients within secondary or tertiary care hospitals from regular wards to intensive care units.Little is known about the risk factors predicting the progression to severe COVID-19 among patients in community iso-lation,who are either asymptomatic or suffer from only mild to moderate symptoms.Using a multivari-able competing risk survival analysis,we identify several important predictors of progression to severe COVID-19—rather than to recovery—among patients in the largest community isolation center in Wuhan,China from 6 February 2020(when the center opened)to 9 March 2020(when it closed).All patients in community isolation in Wuhan were either asymptomatic or suffered from mild to moderate COVID-19 symptoms.We performed competing risk survival analysis on time-to-event data from a cohort study of all COVID-19 patients(n=1753)in the isolation center.The potential predictors we inves-tigated were the routine patient data collected upon admission to the isolation center:age,sex,respira-tory symptoms,gastrointestinal symptoms,general symptoms,and computed tomography(CT)scan signs.The main outcomes were time to severe COVID-19 or recovery.The factors predicting progression to severe COVID-19 were:male sex(hazard ratio(HR)=1.29,95%confidence interval(CI)1.04–1.58,p=0.018),young and old age,dyspnea(HR=1.58,95%CI 1.24–2.01,p<0.001),and CT signs of ground-glass opacity(HR=1.39,95%CI 1.04–1.86,p=0.024)and infiltrating shadows(HR=1.84,95%CI 1.22–2.78,p=0.004).The risk of progression was found to be lower among patients with nausea or vomiting(HR=0.53,95%CI 0.30–0.96,p=0.036)and headaches(HR=0.54,95%CI 0.29–0.99,p=0.046).Our results suggest that several factors that can be easily measured even in resource-poor set-tings(dyspnea,sex,and age)can be used to identify mild COVID-19 patients who are at increased risk of disease progression.Looking for CT signs of ground-glass opacity and infiltrating shadows may be an affordable option to support triage decisions in resource-rich settings.Common and unspecific symptoms(headaches,nausea,and vomiting)are likely to have led to the identification and subsequent community isolation of COVID-19 patients who were relatively unlikely to deteriorate.Future public health and clinical guidelines should build on this evidence to improve the screening,triage,and monitoring of COVID-19 patients who are asymtomatic or suffer from mild to moderate symptoms.展开更多
Objective:To compare the prognostic factors of mortality among melioidosis patients between lognormal accelerated failure time(AFT),Cox proportional hazards(PH),and Cox PH with time-varying coefficient(TVC)models.Meth...Objective:To compare the prognostic factors of mortality among melioidosis patients between lognormal accelerated failure time(AFT),Cox proportional hazards(PH),and Cox PH with time-varying coefficient(TVC)models.Methods:A retrospective study was conducted from 2014 to 2019 among 453 patients who were admitted to Hospital Sultanah Bahiyah,Kedah and Hospital Tuanku Fauziah,Perlis in Northern Malaysia due to confirmed-cultured melioidosis.The prognostic factors of mortality from melioidosis were obtained from AFT survival analysis,and Cox’s models and the findings were compared by using the goodness of fit methods.The analyses were done by using Stata SE version 14.0.Results:A total of 242 patients(53.4%)survived.In this study,the median survival time of melioidosis patients was 30.0 days(95%CI 0.0-60.9).Six significant prognostic factors were identified in the Cox PH model and Cox PH-TVC model.In AFT survival analysis,a total of seven significant prognostic factors were identified.The results were found to be only a slight difference between the identified prognostic factors among the models.AFT survival showed better results compared to Cox's models,with the lowest Akaike information criteria and best fitted Cox-snell residuals.Conclusions:AFT survival analysis provides more reliable results and can be used as an alternative statistical analysis for determining the prognostic factors of mortality in melioidosis patients in certain situations.展开更多
AIM:To identify metastatic genes and mi RNAs and to investigate the metastatic mechanism of uveal melanoma(UVM).METHODS:GSE27831,GSE39717,and GSE73652 gene expression profiles were downloaded from the Gene Expression ...AIM:To identify metastatic genes and mi RNAs and to investigate the metastatic mechanism of uveal melanoma(UVM).METHODS:GSE27831,GSE39717,and GSE73652 gene expression profiles were downloaded from the Gene Expression Omnibus(GEO)database,and the limma R package was used to identify differentially expressed genes(DEGs).Gene Ontology(GO)term enrichment analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway analysis were performed using the DAVID online tool.A comprehensive list of interacting DEGs was constructed using the Search Tool for the Retrieval of Interacting Genes(STRING)database and Cytoscape software.The Cytoscape MCODE plug-in was used to identify clustered sub-networks and modules of hub genes from the proteinprotein interaction network.GEPIA online software was used for survival analysis of UVM patients(n=80)from the The Cancer Genome Atlas(TCGA)cohort.Oncomi R online software was used to find that the mi RNAs were associated with UVM prognosis from the TCGA cohort.Target Scan Human 7.2 software was then used to identify the mi RNAs targeting the genes.RESULTS:There were 1600 up-regulated genes and 1399 down-regulated genes.The up-regulated genes were mainly involved in protein translation in the cytosol,whereas the down-regulated genes were correlated with extracellular matrix organization and cell adhesion in the extracellular space.Among the 2999 DEGs,five genes,Znf391,Mrps11,Htra3,Sulf2,and Smarcd3 were potential predictors of UVM prognosis.Otherwise,three mi RNAs,hsa-mi R-509-3-5 p,hsa-mi R-513 a-5 p,and hsa-mi R-1269 a were associated with UVM prognosis.CONCLUSION:After analyzing the metastasis-related enriched terms and signaling pathways,the up-regulated DEGs are mainly involved in protein synthesis and cell proliferation by ribosome and mitogen-activated protein kinase(MAPK)pathways.However,the down-regulated DEGs are mainly involved in processes that reduced cell-cell adhesion and promoted cell migration in the extracellular matrix through PI3 K-Akt signaling pathway,focal adhesion,and extracellular matrix-receptor interactions.Bioinformatics and interaction analysis may provide new insights on the events leading up to the development and progression of UVM.展开更多
BACKGROUND Follicular lymphoma(FL)is a type of B-cell lymphoma that originates at the germinal center and has a low malignancy rate.FL has become the most common inert lymphoma in Europe and America but has a relative...BACKGROUND Follicular lymphoma(FL)is a type of B-cell lymphoma that originates at the germinal center and has a low malignancy rate.FL has become the most common inert lymphoma in Europe and America but has a relatively low incidence in Asia.AIM To explore the clinical features,curative effects,and prognostic factors of FL.METHODS Completed medical records of 49 patients with FL who were admitted to the Ningbo First Hospital from June 2010 to June 2021 were examined.These patients were definitively diagnosed by pathological biopsy or immunohistochemical staining.The diagnostic criteria were based on the 2008 World Health Organization classification of lymphomas.Ann Arbor staging was performed according to the imaging and bone marrow examination results.Risk stratification of all patients was performed based on the International Prognostic Index(IPI),age-adjusted IPI,Follicular Lymphoma International Prognosis Index(FLIPI),and FLIPI2 to compare the efficacy of different treatment regimens and analyze the related prognostic factors.RESULTS The age of onset in patients ranged from 24 to 76 years,with a median age of 51 years.Most patients developed the disease at 40–59 years of age,and the male:female ratio was 1.6:1.No significant difference was noted in the curative effect between the non-chemotherapy,combined chemotherapy,and other chemotherapy regimens(P>0.05).Hemoglobin(Hb)level<120 g/L,Ki-67 value>50%,bone marrow involvement,and clinical stagesⅢ–IV were associated with a poor prognosis of FL(P<0.05).However,the influence of other indicators was not statistically significant.Risk grouping was performed using the FLIPI,and the results showed that 24.5%,40.8%,and 34.7%of patients were in the low-,moderate-,and high-risk groups,respectively.According to the survival analysis results,the survival rate of patients was lower in the high-risk group than in the other low-risk and moderate-risk groups(P<0.05).CONCLUSION FL mainly occurs in middle-aged and elderly men,primarily affecting lymph nodes and bone marrow.Hb level,Ki-67 value,bone marrow involvement,and clinical staging were used to evaluate prognosis.展开更多
Objective:Osteosarcoma is one of the most common types of bone sarcoma with a poor prognosis.However,identifying the predictive factors that contribute to the response to neoadjuvant chemotherapy remains a significant...Objective:Osteosarcoma is one of the most common types of bone sarcoma with a poor prognosis.However,identifying the predictive factors that contribute to the response to neoadjuvant chemotherapy remains a significant challenge.Methods:A public data series(GSE87437)was downloaded to identify differentially expressed genes(DEGs)and differentially expressed lncRNAs(DElncRNAs)between osteosarcoma patients that do and do not respond to preoperative chemotherapy.Subsequently,functional analysis of the transcriptome expression profile,regulatory networks of DEGs and DElncRNAs,competing endogenous RNAs(ceRNA)and protein-protein interaction networks were performed.Furthermore,the function,pathway,and survival analysis of hub genes was performed and drug and disease relationship prediction of DElncRNA was carried out.Results:A total of 626 DEGs,26 DElncRNAs,and 18 hub genes were identified.However,only one gene and two lncRNAs were found to be suitable as candidate gene and lncRNAs respectively.Conclusion:The DEGs,hub genes,candidate gene,and candidate lncRNAs screened out in this context were considered as potential biomarkers for the response to neoadjuvant chemotherapy of osteosarcoma.展开更多
In this study,we assessed the relationship between lifestyle and prostate cancer.We selected the Gene Expression Omnibus(GEO)dataset GSE10306 to analyze the expression levels of ataxin10(ATXN10),interferon related dev...In this study,we assessed the relationship between lifestyle and prostate cancer.We selected the Gene Expression Omnibus(GEO)dataset GSE10306 to analyze the expression levels of ataxin10(ATXN10),interferon related developmental regulator 1(IFRD1),formin-binding protein 1 like(FNBP1 L)and THO complex 2(THOC2)in prostate biopsies pre and post intensive nutrition and lifestyle intervention.Following a three-month intervention of nutrition and lifestyle,these genes showed a significant down-regulation.ONCOMINE database analysis showed that the four genes exhibited high expression in prostate cancer tissues compared with normal prostate tissues,which indicated that comprehensive lifestyle changes may modify the progression of prostate cancer mediated by altering the expression of ATXN10,FNBP1 L,THOC2 and IFRD1.Among the four genes,the high expression of IFRD1 was found to indicate a worse overall survival(OS)and disease-free survival(DFS).FNBP1 L and THOC2 were associated with CD8+T cell infiltration of prostate cancer.We also speculated a possible regulatory network for lifestyle to influence miRNA,subsequently influencing the expression of relevant genes.Our findings suggested that these genes may be used as potential target sites for the treatment of prostate cancer.展开更多
Based on the nonlinear continuum damage model （CDM） developed by Chaboehe, a modified model for high cycle fatigue of TC4 alloy was proposed. Unsymmetrical cycle fatigue tests were conducted on rod specimens at room...Based on the nonlinear continuum damage model （CDM） developed by Chaboehe, a modified model for high cycle fatigue of TC4 alloy was proposed. Unsymmetrical cycle fatigue tests were conducted on rod specimens at room temperature. Then the material parameters needed in the CDM were obtained by the fatigue tests, and the stress distribution of the specimen was calculated by FE method. Compared with the linear damage model （LDM）, the dam- age results and the life prediction of the CDM show a better agreement with the test and they are more precise than the LDM. By applying the CDM developed in this study to the life prediction of aeroengine blades, it is concluded that the root is the most dangerous region of the whole blade and the shortest life is 58 211 cycles. Finally, the Cox propor- tional hazard model of survival analysis was applied to the analysis of the fatigue reliability. The Cox model takes the covariates into consideration, which include diameter, weight, mean stress and tensile strength. The result shows that the mean stress is the only factor that accelerates the fracture process.展开更多
基金supported in part by the National Natural Science Foundation of China(Key Program)under Grant No.62031021。
文摘Cascading failures pose a serious threat to the survivability of underwater unmanned swarm networks(UUSNs),significantly limiting their service ability in collaborative missions such as military reconnaissance and environmental monitoring.Existing failure models primarily focus on power grids and traffic systems,and don't address the unique challenges of weak-communication UUSNs.In UUSNs,cascading failure present a complex and dynamic process driven by the coupling of unstable acoustic channels,passive node drift,adversarial attacks,and network heterogeneity.To address these challenges,a directed weighted graph model of UUSNs is first developed,in which node positions are updated according to ocean-current-driven drift and link weights reflect the probability of successful acoustic transmission.Building on this UUSNs graph model,a cascading failure model is proposed that integrates a normal-failure-recovery state-cycle mechanism,multiple attack strategies,and routingbased load redistribution.Finally,under a five-level connectivity UUSNs scheme,simulations are conducted to analyze how dynamic topology,network load,node recovery delay,and attack modes jointly affect network survivability.The main findings are:(1)moderate node drift can improve survivability by activating weak links;(2)based-energy routing(BER)outperform based-depth routing(BDR)in harsh conditions;(3)node self-recovery time is critical to network survivability;(4)traditional degree-based critical node metrics are inadequate for weak-communication UUSNs.These results provide a theoretical foundation for designing robust survivability mechanisms in weak-communication UUSNs.
基金supported by the National Natural Science Foundation of China(72271242)Hunan Provincial Natural Science Foundation of China for Excellent Young Scholars(2022JJ20046).
文摘Cutting off or controlling the enemy’s power supply at critical moments or strategic locations may result in a cascade failure,thus gaining an advantage in a war.However,the exist-ing cascading failure modeling analysis of interdependent net-works is insufficient for describing the load characteristics and dependencies of subnetworks,and it is difficult to use for model-ing and failure analysis of power-combat(P-C)coupling net-works.This paper considers the physical characteristics of the two subnetworks and studies the mechanism of fault propaga-tion between subnetworks and across systems.Then the surviv-ability of the coupled network is evaluated.Firstly,an integrated modeling approach for the combat system and power system is predicted based on interdependent network theory.A heteroge-neous one-way interdependent network model based on proba-bility dependence is constructed.Secondly,using the operation loop theory,a load-capacity model based on combat-loop betweenness is proposed,and the cascade failure model of the P-C coupling system is investigated from three perspectives:ini-tial capacity,allocation strategy,and failure mechanism.Thirdly,survivability indexes based on load loss rate and network sur-vival rate are proposed.Finally,the P-C coupling system is con-structed based on the IEEE 118-bus system to demonstrate the proposed method.
基金supported by National High Level Hospital Clinical Research Funding(2022-PUMCH-C-027).
文摘Background:Tumor location affects rectal cancer management,but no consensus exists on criteria.The anterior peritoneal reflection(aPR),an anatomical landmark,shows potential for defining tumor location but requires clinical validation.This study evaluated the utility of aPR in guiding neoadjuvant chemoradiotherapy(nCRT)decisions and predicting lateral lymph node(LLN)/distant metastasis patterns.Methods:This single-center retrospective cohort analyzed data from Peking Union Medical College Hospital(Beijing,China)between January 2016 and August 2022.Magnetic resonance imaging(MRI)-measured aPR parameters were pathologically validated.Patients were stratified by aPR-based definition and tumor height(10 cm).Kaplan-Meier survival curves,log-rank tests,and Cox regression were used for prognostic analysis.Results:Among 588 patients(439 tumors≥5 cm from the anal verge),MRI identified aPR with an accuracy of 95.4%.For tumors≥5 cm,aPR-defined middle-to-low rectal cancer showed lower 3-year disease-free survival(DFS)rate than the upper rectal cancer(P=0.010),while their 3-year overall survival(OS)rates were comparable.Conversely,10-cm-defined classification showed no DFS or OS differences(both P>0.2).Cox regression confirmed aPR-defined classification as an independent DFS predictor(HR=3.19,P=0.014),while 10-cm classification was non-predictive.nCRT with tumor regression grade(TRG)0-1 trended toward improved DFS compared with direct surgery(HR=0.56,P=0.072).The independent protective effect of nCRT with TRG 0-1 for DFS was exclusive to the aPR-defined middle-to-low rectal cancer subgroup(HR=0.45,P=0.026)and not observed in the 10-cm subgroup.aPR-defined classification was independently associated with LLNs on MRI and postoperative pulmonary metastasis.Conclusion:aPR may guide nCRT decision-making and predict LLN metastasis and postoperative distant organ metastasis.
基金Supported by the Natural Science Foundation of Xinjiang Uygur Autonomous Region,No.2022D01D21“Tianshan Talents”Cultivation Program of Xinjiang Uygur Autonomous Region,No.2024TSYCLJ0025National Natural Science Foundation of China,No.82360037.
文摘BACKGROUND Primary gastrointestinal diffuse large B-cell lymphoma(PGI-DLBCL),the most prevalent extranodal non-Hodgkin lymphoma,poses significant diagnostic and therapeutic challenges due to its non-specific symptoms and poor prognosis.AIM To develop and validate a risk model for the early identification of PGI-DLBCL using Least Absolute Shrinkage and Selection-Cox regression,with the aim of guiding clinical decision-making.METHODS The clinical data of patients diagnosed with PGI-DLBCL at the Tumor Hospital Affiliated to Xinjiang Medical University were analyzed retrospectively from January 2010 to April 2022.RESULTS A total of 319 patients with PGI-DLBCL were included and divided into training(n=223)and validation(n=96)cohorts.The median age was 55 years,with 48.9%male and 51.1%female patients.Key clinical features included Eastern Cooperative Oncology Group performance status≥2(40.8%),advanced-stage disease(stage IV:27.6%),extranodal involvement≥2 sites(47%),tumor>5 cm(46.1%),elevated beta-2 microglobulin(50.5%),elevated lactate dehydrogenase(27%),high International Prognostic Index(3-5:69.9%),non-germinal center B-cell-like subtype(59.9%),and B symptoms(55.8%).Immunohistochemical analysis showed frequent expression of CD10(51.1%),B-cell lymphoma 6(53.3%),multiple myeloma oncogene 1(40.1%),Bcell lymphoma 2(49.2%),myelocytomatosis viral oncogene homolog(48.3%),Ki-67(67.1%),and CD5(42.6%);Epstein-Barr virus-encoded RNA was positive in 3.1%.Based on Least Absolute Shrinkage and Selection regression and subsequent univariate and multivariate Cox regression analyses,extranodal sites≥2,B symptoms,mixed lesion type,and negative multiple myeloma oncogene 1 expression were identified as independent risk factors for PGI-DLBCL.The risk model stratified patients into high-and low-risk groups with significantly different overall survival(P<0.05).Area under the curve values for 1-,3-,and 5-year overall survival were 0.625,0.663,and 0.723 in the training cohort,with consistent performance in the validation cohort.Decision curve analysis indicated favorable clinical utility.CONCLUSION PGI-DLBCL in our cohort showed distinctive clinical features and a predominance of the non-germinal center Bcell-like subtype.Decision curve analysis confirmed the clinical applicability of our prognostic model.Although molecular biomarkers will be needed to improve predictive precision,our model offers a practical tool for early risk identification and individualized management in clinical practice.
基金funded by the Research,Development,and Innovation Authority(RDIA)—Kingdom of Saudi Arabia(Grant No.13292-psu-2023-PSNU-R-3-1-EF-).
文摘Colorectal cancer is the third most diagnosed cancer worldwide,and immune checkpoint inhibitors have shown promising therapeutic outcomes in selected patient groups.This study performed a comprehensive analysis of multi-omics data from The Cancer Genome Atlas colorectal adenocarcinoma cohort(TCGA-COADREAD),accessed through cBioPortal,to develop machine learning models for predicting progression-free survival(PFS)following immunotherapy.The dataset included clinical variables,genomic alterations in Kirsten Rat Sarcoma Viral Oncogene Homolog(KRAS),B-Raf Proto-Oncogene(BRAF),and Neuroblastoma RAS Viral Oncogene Homolog(NRAS),microsatellite instability(MSI)status,tumor mutation burden(TMB),and expression of immune checkpoint genes.Kaplan–Meier analysis showed that KRAS mutations were significantly associated with reduced PFS,while BRAF and NRAS mutations had no significant impact.MSI-high tumors exhibited elevated TMB and increased immune checkpoint expression,reflecting their immunologically active phenotype.We developed both survival and classification models,with the Extra Trees classifier achieving the best performance(accuracy=0.86,precision=0.67,recall=0.70,F1-score=0.68,AUC=0.84).These findings highlight the potential of combining genomic and immune biomarkers with machine learning to improve patient stratification and guide personalized immunotherapy decisions.An interactive web application was also developed to enable clinicians to input patient-specific molecular and clinical data and visualize individualized PFS predictions,supporting timely,data-driven treatment planning.
基金Supported by the National Natural Science Foundation of China(No.82460215)National Natural Science Foundation of China Pre-experimental Project(No.2025GZRYSY006)+4 种基金2025 Youth Training Project of the Xi’an Municipal Health Commission(No.2025qn05)Xi’an Medical Research-Discipline Capacity Building Project(No.23YXYJ0002)Key R&D Plan of Shaanxi Province:Key Industrial Innovation Chain(Cluster)-Social Development Field(No.2022ZDLSF03-10)Research Incubation Fund of Xi’an People’s Hospital(Xi’an Fourth HospitalNo.LH-13).
文摘AIM:To identify metastasis-associated prognostic genes and construct a robust molecular signature for survival prediction in uveal melanoma(UVM)patients.METHODS:Transcriptomic data and clinical information from 80 UVM patients in the Cancer Genome Atlas(TCGA)-UVM cohort and an external Gene Expression Omnibus(GEO)microarray dataset(GSE73652;8 non-metastatic vs 5 metastatic cases)were analyzed to identify differentially expressed genes(DEGs).Functional enrichment,proteinprotein interaction(PPI)network construction,and survival analyses identified seven metastasis-and prognosisrelated genes.Their expression was further examined using public single-cell RNA-seq data(GSE139829;11 tumors).Experimental validation was performed in UVM cell lines(92.1,OMM1,MEL270)and adult retinal pigment epithelial(ARPE-19)cells using quantitative real-time polymerase chain reaction(qRT-PCR)and Western blotting to confirm transcriptomic trends.A LASSO Cox model was applied to construct a metastasis-related risk Score signature.Tumor immune microenvironment characteristics were evaluated via single-sample gene set enrichment analysis(ssGSEA)and ESTIMATE.Somatic mutation and copy number variation(CNV)profiles were also examined.RESULTS:Seven key genes(UBE2T,KIF20A,DLGAP5,KLC3,TPX2,UBE2C,AURKA)were significantly associated with overall survival and used to construct a metastasisrelated riskScore signature,which effectively stratified patients into high-and low-risk groups and served as an independent prognostic factor.qRT-PCR and Western blot results confirmed that the expression levels of selected key genes in UVM cell lines showed significant differences compared to ARPE-19 cells,which were largely consistent with the transcriptomic findings.The high-risk group exhibited reduced immune infiltration and stromal activity.Single-cell analysis revealed these genes were predominantly expressed in a tumor cell cluster characterized by BAP1 loss and high metastatic potential.Mutation and CNV analyses further supported the relevance of these genes to UVM progression.CONCLUSION:This study establishes and validates a seven-gene signature associated with metastasis and prognosis in UVM.The findings provide a framework for understanding molecular determinants of tumor progression and immune microenvironment alterations,and may offer guidance for future mechanistic studies and therapeutic exploration.
基金the National Science and Technology Support Program Projects (2009BAC54B04) for financing this research
文摘Populus euphratica Oliv. is widely distributed along the Tarim River. Maintaining stability of P. euphratica population is important to local development. This study explored the static life table, survivorship curves and four function curves (survival rate, cumulative mortality rate, mortality density, and hazard rate), and development index of P. euphratica population in the middle reaches of Tarim River. The results indicated that the age structure of P. euphratica population belonged to positive pyramidal type, which meant young age-class individuals occupied most populations. The number ofⅠ-Ⅱage classes accounted for 66.2% of whole population, and this indicated that there were abundant subsequent seedlings resources to support the growth of P. euphratica population in the middle reaches of Tarim River. The survivorship curve of P. euphratica belonged to the Deevey Ⅲ (concave-type) and the development index was 47.72%. Four function curves revealed that the individuals of P. euphratica sharply decreased at the initial stage and then leveled off at the late stage of survival curve. Time sequence prediction models predicted that the number of midlife individuals would increase in future 10, 20, 30 years, and P. euphratica population grew steadily as a result of rich saplings.
文摘Objective： To investigate the clinicopathological features, survival and prognostic factors for gastroenteropancreatic neuroendocrine neoplasms（GEP-NENs） in a Chinese population.Methods： We investigated 154 consecutive patients（88 males, 66 females; median age 56 years, age range 9-86 years） diagnosed with GEP-NENs between 2001 and 2013 at The Affiliated Hospital of Qingdao University. Demographic, clinical and pathological variables and survival data were retrieved.Results： The pancreas was the most common site of involvement（63/154, 40.9%）. Tumor size varied from 0.3 to 16.0 cm（median, 1.2 cm）. The patients were followed up for a median period of 22 months（range, 1-157 months）. The estimated 3- and 5-year overall survival（OS） rates for all patients were 84.0% and 81.9%, respectively. Multivariate analysis showed that larger tumor size, lymphatic metastases and distant metastases were significant predictors for poor survival outcome.Conclusions： Our data provide further information on the clinicopathological features of GEP-NENs in China. Additionally, we identified tumor size, lymphatic metastases and distant metastases as independent prognostic factors for long-term survival.
文摘AIM： To investigate the 152 cases of paragangliomas resected over the past 32 years in West China Hospital dinicopathologically.METHODS： All cases of paragangliomas diagnosed at the Department of Gastrointestinal Surgery and Department of Pathology, West China Hospital, China were reviewed. The pathological documents were supplied by the Department of Pathology, West China Hospital, and other necessary data were extracted from the hospital records. The statistical analyses were performed by survival analysis （Kaplan-Meier method）, descriptive statistical analyses and Х^2 analysis.RESULTS： The neuroendocrine marker vimentin was found to be selectively expressed in the benign tumors, and there were significant differences in the expression of those markers in both benign and malignant tumors. The survival analysis revealed that survival correlated significantly with the malignancy, metastasis and nodal status.CONCLUSION： Vimentin may be useful in the differential diagnosis between malignant and benign tumors. The difference in the expression of this marker in the tumors could be a clue to the future clinical diagnosis. The malignancy, metastasis and the nodal status may predict the prognosis of this disease.
基金Supported by the grant of the Center of Excellence,Biomedical Research using accelerator technology
文摘AIM： To identify the clinical and prognostic features of patients with hepatocellular carcinoma （HCC） aged 80 years or more. METHODS： A total of 1310 patients with HCC were included in this study. Ninety-one patients aged 80 years or more at the time of diagnosis of HCC were defined as the extremely elderly group. Two hundred and thirty-four patients aged 〉/ 50 years but less than 60 years were regarded as the non-elderly group. RESULTS： The sex ratio （male to female） was significantly lower in the extremely elderly group （0.90：1） than in the non-elderly group （3.9：1, P〈 0.001）. The positive rate for HBsAg was significantly lower in the extremely elderly group and the proportion of patients negative for HBsAg and HCVAb obviously increased in the extremely elderly group （P〈 0.001）. There were no significant differences in the following parameters： diameter and number of tumors, Child-Pugh grading, tumor staging, presence of portal thrombosis or ascites, and positive rate for HCVAb. Extremely elderly patients did not often receive surgical treatment （P 〈 0.001） and they were more likely to receive conservative treatment （P〈 0.01）. There were no significant differences in survival curves based on the Kaplan-Meier methods in comparison with the overall patients between the two groups. However, the survival curves were significantly worse in the extremely elderly patients with stage Ⅰ/Ⅱ, stage Ⅰ/Ⅱ and Child-Pugh grade A cirrhosis in comparison with the non-elderly group. The causes of death did not differ among the patients, and most cases died of liverrelated diseases even in the extremely elderly patients. CONCLUSION： In the patients with good liver functions and good performance status, aggressive treatment for HCC might improve the survival rate, even in extremely elderly patients.
文摘AIM:To assess the consecutive recurrence following early success of intermittent exotropia surgery and to determine the clinical factors that affect the survival.METHODS:One hundred and thirty-five patients who underwent intermittent exotropia surgery and experienced early surgical success[≤5 prism diopters(PD)esophoria(E)to≤10 PD exophoria(X)on the postoperative sixth month]were enrolled in this study.Their consecutive survival on the postoperative first year,second year and third year and at the last visit of fourth year or more,and the factors that might affect their survival,were analyzed.The final surgical outcomes after the postoperative fourth year were also investigated by dividing the patients into the success group(≤5 PD E to≤10 PD X)and the failure group(】5 PD esodeviation or】10 PD exodeviation)RESULTS:The survival rates from the Kaplan-Meier analysis were 97.78%,92.89%,83.70%and 50.49%on the postoperative first,second and third years and fourth year or more,respectively.None of the clinical factors was determined to have affected the survival.The amount of the exodrift was largest(2.29 PD)between the first year and the second year,and smallest(1.47 PD)between the fourth year and the last visit.Sixty-three patients had their final visit after the postoperative fourth year,and 29 of them were in the failure group.Twentyfive patients in the failure group had an intermittent exotropia(IXT)of【20 PD with good to fair distant fusion;two had an IXT of【20 PD with poor distant fusion;one had an IXT of≥20 PD with fair distant fusion;and another had delayed-onset consecutive esotropia.The exodeviation on the postoperative sixth month was smaller in the success group than in the failure group(2.81 PD vs 5.86 PD,P=0.012).The reoperation rate for recurrent IXT was 3.7%.CONCLUSION:The survival rate steadily decreases with the exodrift,but the amount of the exodrift decreases with long-term follow-up.The final outcomes demonstrate favorable results via surgical success or small-angle IXT with good fusion in most of the patients.A smaller deviation on the postoperative sixth month is associated with long-term survival.
文摘Background: Liver recurrence after resection of colorectal liver metastases(CRLM) is frequent. Repeat hepatectomy has been shown to have satisfactory perioperative results. However, the long-term outcomes and the benefts for patients with early recurrence have not been clarifed. The aim of this study was to compare the short-and long-term outcomes of patients undergoing single hepatectomy and repeat hepatectomy for CRLM. Additionally, the oncological outcomes of patients with early( ≤ 6 months) and late recurrence who underwent repeat hepatectomy were compared. Methods: Consecutive adult patients undergoing hepatectomy for CRLM between June 20 0 0 and February 2020 were included and divided into two groups: single hepatectomy and repeat hepatectomy. Results: A total of 709 patients were included: 649 in the single hepatectomy group and 60 in the repeat hepatectomy group. Patients in the repeat hepatectomy group underwent more cycles of preoperative chemotherapy [4(3-6) vs. 3(2-4), P = 0.003]. Patients in the single hepatectomy group more frequently underwent major hepatectomies(34.5% vs. 16.7%, P = 0.004) and had a greater number of lesions resected(2.9 ± 3.6 vs. 1.9 ± 1.8, P = 0.011). There was no increase in operative time, estimated blood loss, length of hospital stay, complications, or mortality in the repeat hepatectomy group. There were no differences in overall survival( P = 0.626) and disease-free survival( P = 0.579) between the two groups. Similarly, for patients underwent repeat hepatectomy, no difference was observed between the early and late recurrence groups in terms of overall survival( P = 0.771) or disease-free survival( P = 0.350). Conclusions: Repeat hepatectomy is feasible and safe, with similar short-and long-term outcomes when compared to single hepatectomy. Surgical treatment of early liver recurrence offers similar oncological outcomes to those obtained for late recurrence.
基金supported by grants from the Tianjin Municipal Science and Technology Project (Grant No. 11JCYBJC11300)National Natural Science Foundation of China (Grant No. 81372517)National Science and Technology Major Project (Grant No. 09303001)
文摘Objective: To compare the efficacy and adverse effects of paclitaxel-etoposide-carboplatin/cisplatin(TEP/TCE) regimen with those of etoposide-carboplatin/cisplatin(EP/CE) regimen as first-line treatment for combined small-cell lung cancer(CSCLC).Methods: A retrospective study was conducted on 62 CSCLC patients who were treated at Tianjin Medical University Cancer Institute and Hospital from July 2000 to April 2013 and administered with TEP/TCE regimen(n=19) or EP/CE regimen(n=43) as first-line CSCLC treatment. All patients received more than two cycles of chemotherapy, and the response was evaluated every two cycles. The primary endpoint was overall survival(OS), and the secondary endpoints were progression-free survival(PFS), objective response rate(ORR), disease control rate(DCR), and adverse effects. Results: ORR between the TEP/TCE and EP/CE groups showed a statistical difference(90% vs. 53%, P=0.033). Both groups failed to reach a statistical difference in DCR(100% vs. 86%, P=0.212). The median PFS and OS of the TEP/TCE group were slightly longer than those of the EP/CE group, although both groups failed to reach a statistical difference(10.5 vs. 8.9 months, P=0.484; 24.0 vs. 17.5 months, P=0.457). However, stratified analysis indicated that the PFS of patients with stages III and IV CSCLC showed marginally significant difference between the TEP/TCE and EP/CE groups(19.5 vs. 7.6 months; P=0.071). Both rates of grade IV bone marrow depression and termination of chemotherapy in the TEP/TCE group were significantly higher than those in the EP/CE group(26.3% vs. 7.0%, P=0.036; 31.6% vs. 14.7%, P=0.004). Conclusion: The TEP/TCE regimen may not be preferred for CSCLC, and this three-drug regimen requires further exploration and research. To date, the EP/CE regimen remains the standard treatment for CSCLC patients.
基金supported by the Alexander von Humboldt Foundation in Germany and the Bill & Melinda Gates Foundation (Project INV-006261)supported by the National Center for Advancing Translational Sciences of the National Institutes of Health (KL2TR003143)+4 种基金supported by the Alexander von Humboldt Foundation through the Alexander von Humboldt Professor awardfunded by the German Federal Ministry of Education and Research, the European Union’s Research and Innovation Programme Horizon 2020the European & Developing Countries Clinical Trials Partnership (EDCTP)supported by the Sino-German Center for Research Promotion (Project C-0048), which is funded by the German Research Foundation (DFG)the National Natural Science Foundation of China (NSFC)
文摘Most studies of coronavirus disease 2019(COVID-19)progression have focused on the transfer of patients within secondary or tertiary care hospitals from regular wards to intensive care units.Little is known about the risk factors predicting the progression to severe COVID-19 among patients in community iso-lation,who are either asymptomatic or suffer from only mild to moderate symptoms.Using a multivari-able competing risk survival analysis,we identify several important predictors of progression to severe COVID-19—rather than to recovery—among patients in the largest community isolation center in Wuhan,China from 6 February 2020(when the center opened)to 9 March 2020(when it closed).All patients in community isolation in Wuhan were either asymptomatic or suffered from mild to moderate COVID-19 symptoms.We performed competing risk survival analysis on time-to-event data from a cohort study of all COVID-19 patients(n=1753)in the isolation center.The potential predictors we inves-tigated were the routine patient data collected upon admission to the isolation center:age,sex,respira-tory symptoms,gastrointestinal symptoms,general symptoms,and computed tomography(CT)scan signs.The main outcomes were time to severe COVID-19 or recovery.The factors predicting progression to severe COVID-19 were:male sex(hazard ratio(HR)=1.29,95%confidence interval(CI)1.04–1.58,p=0.018),young and old age,dyspnea(HR=1.58,95%CI 1.24–2.01,p<0.001),and CT signs of ground-glass opacity(HR=1.39,95%CI 1.04–1.86,p=0.024)and infiltrating shadows(HR=1.84,95%CI 1.22–2.78,p=0.004).The risk of progression was found to be lower among patients with nausea or vomiting(HR=0.53,95%CI 0.30–0.96,p=0.036)and headaches(HR=0.54,95%CI 0.29–0.99,p=0.046).Our results suggest that several factors that can be easily measured even in resource-poor set-tings(dyspnea,sex,and age)can be used to identify mild COVID-19 patients who are at increased risk of disease progression.Looking for CT signs of ground-glass opacity and infiltrating shadows may be an affordable option to support triage decisions in resource-rich settings.Common and unspecific symptoms(headaches,nausea,and vomiting)are likely to have led to the identification and subsequent community isolation of COVID-19 patients who were relatively unlikely to deteriorate.Future public health and clinical guidelines should build on this evidence to improve the screening,triage,and monitoring of COVID-19 patients who are asymtomatic or suffer from mild to moderate symptoms.
文摘Objective:To compare the prognostic factors of mortality among melioidosis patients between lognormal accelerated failure time(AFT),Cox proportional hazards(PH),and Cox PH with time-varying coefficient(TVC)models.Methods:A retrospective study was conducted from 2014 to 2019 among 453 patients who were admitted to Hospital Sultanah Bahiyah,Kedah and Hospital Tuanku Fauziah,Perlis in Northern Malaysia due to confirmed-cultured melioidosis.The prognostic factors of mortality from melioidosis were obtained from AFT survival analysis,and Cox’s models and the findings were compared by using the goodness of fit methods.The analyses were done by using Stata SE version 14.0.Results:A total of 242 patients(53.4%)survived.In this study,the median survival time of melioidosis patients was 30.0 days(95%CI 0.0-60.9).Six significant prognostic factors were identified in the Cox PH model and Cox PH-TVC model.In AFT survival analysis,a total of seven significant prognostic factors were identified.The results were found to be only a slight difference between the identified prognostic factors among the models.AFT survival showed better results compared to Cox's models,with the lowest Akaike information criteria and best fitted Cox-snell residuals.Conclusions:AFT survival analysis provides more reliable results and can be used as an alternative statistical analysis for determining the prognostic factors of mortality in melioidosis patients in certain situations.
基金Supported by the Natural Science Foundation for Young Scholars of Shanxi(No.201801D221256)the Science Foundation for Young Scholars of Shanxi Eye Hospital(No.Q201803)。
文摘AIM:To identify metastatic genes and mi RNAs and to investigate the metastatic mechanism of uveal melanoma(UVM).METHODS:GSE27831,GSE39717,and GSE73652 gene expression profiles were downloaded from the Gene Expression Omnibus(GEO)database,and the limma R package was used to identify differentially expressed genes(DEGs).Gene Ontology(GO)term enrichment analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway analysis were performed using the DAVID online tool.A comprehensive list of interacting DEGs was constructed using the Search Tool for the Retrieval of Interacting Genes(STRING)database and Cytoscape software.The Cytoscape MCODE plug-in was used to identify clustered sub-networks and modules of hub genes from the proteinprotein interaction network.GEPIA online software was used for survival analysis of UVM patients(n=80)from the The Cancer Genome Atlas(TCGA)cohort.Oncomi R online software was used to find that the mi RNAs were associated with UVM prognosis from the TCGA cohort.Target Scan Human 7.2 software was then used to identify the mi RNAs targeting the genes.RESULTS:There were 1600 up-regulated genes and 1399 down-regulated genes.The up-regulated genes were mainly involved in protein translation in the cytosol,whereas the down-regulated genes were correlated with extracellular matrix organization and cell adhesion in the extracellular space.Among the 2999 DEGs,five genes,Znf391,Mrps11,Htra3,Sulf2,and Smarcd3 were potential predictors of UVM prognosis.Otherwise,three mi RNAs,hsa-mi R-509-3-5 p,hsa-mi R-513 a-5 p,and hsa-mi R-1269 a were associated with UVM prognosis.CONCLUSION:After analyzing the metastasis-related enriched terms and signaling pathways,the up-regulated DEGs are mainly involved in protein synthesis and cell proliferation by ribosome and mitogen-activated protein kinase(MAPK)pathways.However,the down-regulated DEGs are mainly involved in processes that reduced cell-cell adhesion and promoted cell migration in the extracellular matrix through PI3 K-Akt signaling pathway,focal adhesion,and extracellular matrix-receptor interactions.Bioinformatics and interaction analysis may provide new insights on the events leading up to the development and progression of UVM.
基金Supported by Zhejiang TCM Science and Technology Project,No.2023ZL653。
文摘BACKGROUND Follicular lymphoma(FL)is a type of B-cell lymphoma that originates at the germinal center and has a low malignancy rate.FL has become the most common inert lymphoma in Europe and America but has a relatively low incidence in Asia.AIM To explore the clinical features,curative effects,and prognostic factors of FL.METHODS Completed medical records of 49 patients with FL who were admitted to the Ningbo First Hospital from June 2010 to June 2021 were examined.These patients were definitively diagnosed by pathological biopsy or immunohistochemical staining.The diagnostic criteria were based on the 2008 World Health Organization classification of lymphomas.Ann Arbor staging was performed according to the imaging and bone marrow examination results.Risk stratification of all patients was performed based on the International Prognostic Index(IPI),age-adjusted IPI,Follicular Lymphoma International Prognosis Index(FLIPI),and FLIPI2 to compare the efficacy of different treatment regimens and analyze the related prognostic factors.RESULTS The age of onset in patients ranged from 24 to 76 years,with a median age of 51 years.Most patients developed the disease at 40–59 years of age,and the male:female ratio was 1.6:1.No significant difference was noted in the curative effect between the non-chemotherapy,combined chemotherapy,and other chemotherapy regimens(P>0.05).Hemoglobin(Hb)level<120 g/L,Ki-67 value>50%,bone marrow involvement,and clinical stagesⅢ–IV were associated with a poor prognosis of FL(P<0.05).However,the influence of other indicators was not statistically significant.Risk grouping was performed using the FLIPI,and the results showed that 24.5%,40.8%,and 34.7%of patients were in the low-,moderate-,and high-risk groups,respectively.According to the survival analysis results,the survival rate of patients was lower in the high-risk group than in the other low-risk and moderate-risk groups(P<0.05).CONCLUSION FL mainly occurs in middle-aged and elderly men,primarily affecting lymph nodes and bone marrow.Hb level,Ki-67 value,bone marrow involvement,and clinical staging were used to evaluate prognosis.
基金supported by the grant from the Research Foundation of Tongji Hospital(No.2019B17).
文摘Objective:Osteosarcoma is one of the most common types of bone sarcoma with a poor prognosis.However,identifying the predictive factors that contribute to the response to neoadjuvant chemotherapy remains a significant challenge.Methods:A public data series(GSE87437)was downloaded to identify differentially expressed genes(DEGs)and differentially expressed lncRNAs(DElncRNAs)between osteosarcoma patients that do and do not respond to preoperative chemotherapy.Subsequently,functional analysis of the transcriptome expression profile,regulatory networks of DEGs and DElncRNAs,competing endogenous RNAs(ceRNA)and protein-protein interaction networks were performed.Furthermore,the function,pathway,and survival analysis of hub genes was performed and drug and disease relationship prediction of DElncRNA was carried out.Results:A total of 626 DEGs,26 DElncRNAs,and 18 hub genes were identified.However,only one gene and two lncRNAs were found to be suitable as candidate gene and lncRNAs respectively.Conclusion:The DEGs,hub genes,candidate gene,and candidate lncRNAs screened out in this context were considered as potential biomarkers for the response to neoadjuvant chemotherapy of osteosarcoma.
基金Supported by the Natural Science Foundation of Hubei Province(2012FFC010)the National Natural Science Foundation of China(31371750)。
文摘In this study,we assessed the relationship between lifestyle and prostate cancer.We selected the Gene Expression Omnibus(GEO)dataset GSE10306 to analyze the expression levels of ataxin10(ATXN10),interferon related developmental regulator 1(IFRD1),formin-binding protein 1 like(FNBP1 L)and THO complex 2(THOC2)in prostate biopsies pre and post intensive nutrition and lifestyle intervention.Following a three-month intervention of nutrition and lifestyle,these genes showed a significant down-regulation.ONCOMINE database analysis showed that the four genes exhibited high expression in prostate cancer tissues compared with normal prostate tissues,which indicated that comprehensive lifestyle changes may modify the progression of prostate cancer mediated by altering the expression of ATXN10,FNBP1 L,THOC2 and IFRD1.Among the four genes,the high expression of IFRD1 was found to indicate a worse overall survival(OS)and disease-free survival(DFS).FNBP1 L and THOC2 were associated with CD8+T cell infiltration of prostate cancer.We also speculated a possible regulatory network for lifestyle to influence miRNA,subsequently influencing the expression of relevant genes.Our findings suggested that these genes may be used as potential target sites for the treatment of prostate cancer.
基金Supported by National Natural Science Foundation of China(No.60879002)Key Technologies R and D Program of Tianjin (No.10ZCKFGX03800)
文摘Based on the nonlinear continuum damage model （CDM） developed by Chaboehe, a modified model for high cycle fatigue of TC4 alloy was proposed. Unsymmetrical cycle fatigue tests were conducted on rod specimens at room temperature. Then the material parameters needed in the CDM were obtained by the fatigue tests, and the stress distribution of the specimen was calculated by FE method. Compared with the linear damage model （LDM）, the dam- age results and the life prediction of the CDM show a better agreement with the test and they are more precise than the LDM. By applying the CDM developed in this study to the life prediction of aeroengine blades, it is concluded that the root is the most dangerous region of the whole blade and the shortest life is 58 211 cycles. Finally, the Cox propor- tional hazard model of survival analysis was applied to the analysis of the fatigue reliability. The Cox model takes the covariates into consideration, which include diameter, weight, mean stress and tensile strength. The result shows that the mean stress is the only factor that accelerates the fracture process.
