Background
Insufficient attention is paid to the underlying tumor microenvironment (TME) evolution, that resulting in tumor heterogeneity and driving differences in cancer aggressiveness and ...treatment outcomes. The morphological evaluation of the proportion of the stroma at the most invasive part of primary tumor (tumor-stromal ratio, TSR) in cancer is gaining momentum as evidence strengthens for the clinical relevance.
Methods
Tissue samples from the most invasive part of the primary gastric cancer (GC) of 494 patients were analyzed for their TSR, and a new TSNM (tumor-stromal node metastasis) staging system based on patho-biological behaviors was established and assessed.
Results
TSR is a new and strong independent prognostic factor for GC patients. The likelihood of tumor invasion is increased significantly for patients in the stromal-high subgroup compared to those in the stromal-low subgroup (
P
= 0.011). The discrimination ability of TSR was not less than the TNM staging system and was better in patients with stages I and II GC. We integrated the TSR parameter into the TNM staging system and proposed a new TSNM staging system creatively. There were three new subgroups (IC, IIC, IIID). There were four major groups and 10 subgroups in the TSNM system. The difference in overall survival (OS) was statistically significant among all TSNM system (
P
< 0.005 for all). Deep analyses revealed well predictive performance of the TSNM (
P
< 0.001).
Conclusions
This study confirms the TSR as a TME prognostic factor for GC. TSR is a candidate TME parameter that could easily be implemented in routine pathology diagnostics, and the TSNM staging system has been established to optimize risk stratification for GC. The value of the TSNM staging system should be validated in further prospective study.
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•Amino-modified cellulose membrane (CA-PVAm) was prepared.•CA-PVAm was employed for adsorption of three typical organoarsenic contaminants.•Adsorption isotherms, thermodynamics, ...kinetics and reusability were studied.•Plausible adsorption mechanism were further discussed.
Herein, an amino-modified electrospun nanofibrous cellulose membrane (CA-PVAm) was prepared and employed to adsorb the typical organoarsenic contaminants (roxarsone (ROX), p-arsanilic acid (p-ASA), and phenylarsonic acid (PAA)). The SEM, FT-IR, and XPS results showed that the CA-PVAm composed of abundant nanofibres and owned ample functional groups such as NH2, OH, and CO groups. The batch experiments demonstrated that the CA-PVAm exhibited excellent adsorption performance on ROX (186.22 mg g−1), p-ASA (69.15 mg g−1), and PAA (62.77 mg g−1), which were 15.98, 6.83, and 6.25 folds larger than those of the pristine CA. In addition, the adsorption process of ROX, p-ASA, and PAA on CA-PVAm accorded with the Langmuir model and obeyed the pseudo-second-order model with intraparticle diffusion. Meanwhile, the adsorption of ROX and PAA was endothermic process, but the exothermic process was observed during the p-ASA adsorption. Furthermore, the main adsorption mechanisms involved electrostatic interactions and hydrogen-bonding interactions. The formed stable six-membered structure between NH2 and NO2 groups could significantly enhance the hydrogen-bonding interactions between CA-PVAm and ROX molecule, resulting in evident improvement in ROX adsorption. Importantly, the CA-PVAm displayed outstanding reusability (4 cycles) and rapid desorption rate. This study probably provides an important theoretical and experimental basis for the remediation of the emerging organic pollutants.
Abstract
There is currently insufficient evidence of correlation between on-admission serum uric acid and in-hospital mortality of patients with acute type A aortic dissection. Thus, this study ...analysed the relation between serum uric acid and in-hospital deaths in patients with acute type A aortic dissection. A total of 1048 patients with acute type A aortic dissection participated in this study between January 2010 and December 2018. The independent variable was on-admission serum uric acid, whilst the dependent variable was in-hospital deaths. The covariates of the study included patient age, gender, body mass index, smoking status, hypertension, diabetes, Marfan syndrome, bicuspid aortic valve, chronic renal insufficiency, stroke, atherosclerosis, time to presentation, systolic blood pressure, diastolic blood pressure, aortic diameter, aortic regurgitation, abdominal vessel involvement, arch vessel involvement, ejection fraction value, laboratory parameters, symptom, coronary malperfusion, mesenteric malperfusion, cerebral malperfusion, hypotension/shock, cardiac tamponade and operation status. The mean age of the sample was 50.17 ± 11.47 years, with approximately 24.24% of the participants being female. After analysis, it was found that the admission serum uric acid of patients with acute type A aortic dissection was positively correlated with in-hospital death (OR = 1.04, 95% CI 1.02–1.06). Subsequently, a non-linear relationship was determined between admission serum uric acid (point 260 µmol/L) and in-hospital mortality for patients with acute type A aortic dissection. The effect sizes and confidence intervals of the right (serum uric acid > 260 µmol/L) and left (serum uric acid ≤ 260 µmol/L) aspects of the inflection point were 1.04 (1.02–1.05) and 1.00 (0.99–1.02), respectively. Furthermore, subgroup analysis indicated a stable relationship between serum uric acid and in-hospital mortality, whilst an insignificant difference was found for the interactions between different subgroups. Overall, a non-linear correlation was determined between admission serum uric acid and in-hospital mortality of patients with acute type A aortic dissection. When serum uric acid > 260 µmol/L, it showed a positive correlation with in-hospital mortality.
To determine the association of unintentional changes in body mass index (BMI) and waist circumference (WC) with the risk of heart failure (HF) among adults with type 2 diabetes mellitus (T2DM).
This ...was a randomized controlled trial (the Action to Control Cardiovascular Risk in Diabetes ACCORD study), with a double 2×2 factorial design conducted at 77 clinical centers across the United States and Canada. In total, the study comprised 10,251 patients with T2DM and cardiovascular disease (CVD) or at a high risk of CVD. The outcome of interest in the present analysis was incident HF, defined as the first hospitalization event for HF or death due to HF. Hospitalization for HF was based on documented clinical and radiological evidence. Death due to HF was based on clinical, radiological, or postmortem evidence of HF, with an absence of an acute ischemic event according to clinical or postmortem evidence.
Participants with class III obesity had the smallest BMI and WC changes, followed by those with normal weight, overweight, class I obesity, and class II obesity. Increasing BMI (hazard ratio HR per standard deviation increase, 1.24; 95% confidence interval CI, 1.07-1.45) and WC (1.27; 1.10-1.47) were significantly associated with a higher risk of HF. The relationship between BMI and WC changes and HF formed a J-shaped curve, while stable BMI and WC were associated with lower risks of HF. Compared with participants in the first tertiles of BMI and WC change, those in the third tertiles had HRs of 1.41 (95% CI, 1.07-1.45) and 1.48 (1.12-1.95), respectively.
In conclusion, our findings suggest a noteworthy association between BMI and WC changes among adults with T2DM in HF. We observed a distinctive J-shaped curve in this relationship, indicating that participants with both low and high BMI and WC changes were more susceptible to developing HF.
http://www.clinicaltrials.gov. Unique identifier: NCT00000620.
COVID-19 (coronavirus disease 2019) has caused a major epidemic worldwide; however, much is yet to be known about the epidemiology and evolution of the virus partly due to the scarcity of full-length ...SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) genomes reported. One reason is that the challenges underneath sequencing SARS-CoV-2 directly from clinical samples have not been completely tackled, i.e., sequencing samples with low viral load often results in insufficient viral reads for analyses.
We applied a novel multiplex PCR amplicon (amplicon)-based and hybrid capture (capture)-based sequencing, as well as ultra-high-throughput metatranscriptomic (meta) sequencing in retrieving complete genomes, inter-individual and intra-individual variations of SARS-CoV-2 from serials dilutions of a cultured isolate, and eight clinical samples covering a range of sample types and viral loads. We also examined and compared the sensitivity, accuracy, and other characteristics of these approaches in a comprehensive manner.
We demonstrated that both amplicon and capture methods efficiently enriched SARS-CoV-2 content from clinical samples, while the enrichment efficiency of amplicon outran that of capture in more challenging samples. We found that capture was not as accurate as meta and amplicon in identifying between-sample variations, whereas amplicon method was not as accurate as the other two in investigating within-sample variations, suggesting amplicon sequencing was not suitable for studying virus-host interactions and viral transmission that heavily rely on intra-host dynamics. We illustrated that meta uncovered rich genetic information in the clinical samples besides SARS-CoV-2, providing references for clinical diagnostics and therapeutics. Taken all factors above and cost-effectiveness into consideration, we proposed guidance for how to choose sequencing strategy for SARS-CoV-2 under different situations.
This is, to the best of our knowledge, the first work systematically investigating inter- and intra-individual variations of SARS-CoV-2 using amplicon- and capture-based whole-genome sequencing, as well as the first comparative study among multiple approaches. Our work offers practical solutions for genome sequencing and analyses of SARS-CoV-2 and other emerging viruses.
This paper examines the characteristics of historical meteorological hazards and associated natural-anthropogenic variations in China, with specific attention given to the meteorological drought ...hazards occurring at very high frequency and affecting social–economic development in North China. Owing to an increasing awareness of meteorological droughts in this area, the aim of this contribution is to provide a comprehensive overview of meteorological droughts in North China by reviewing the meteorological references and their intrinsic linkages with climatic, geological, and anthropogenic controls. Our study highlights the region-wide meteorological droughts with a rather clear recurrence of 30 and 100 years, totally indicating Shanxi and Shandong being the predominated area suffering from extreme meteorological droughts. The spatial and temporal distribution of meteorological drought hazards in this region is considered to be a function of climatic, topographic, hydrological, and anthropogenic characteristics. In view of the wide distribution and linkage with geo-hazards and changes of dynasties, the meteorological drought hazard is one of the key issues for long-term social–economic harmonization. This study can be expected to prioritize drought mitigation measures and ensure regional sustainable development in North China.
Abstract
Differential diagnosis and management for perforated appendicitis and non-perforated appendicitis are current hot topics. The aim of this study is to demonstrate a new entity of ...non-perforated appendicitis, “acute hemorrhagic appendicitis” through studying cluster of acute appendicitis among Tibetan students at a high school in central China. Over the 11-year period, there were 120 patients with more female patients (102 of 499, 20.4%) than male patients (18 of 474, 3.8%) among 973 Tibetan students. 117 patients’ clinical data were available. Clinical manifestations were identical to classic appendicitis. However, axilla temperature, white blood cell counts and neutrophil level were elevated mildly in 12 (10.3%), 19 (16.2%) and 12 (10.3%) patients respectively. Pathologically, the resected appendices exhibited focal or diffuse hemorrhages in mucosa and/or submucosa, and infiltration by eosinophil and by lymphocytes. No patients had perforated appendicitis. The median time from the onset to surgery was 3 days (IQR, 2–4). All patients were discharged with full recovery. In conclusion, “acute hemorrhagic appendicitis” represented a new entity of non-perforated appendicitis with unique cause and pathogenesis, which might be treated with antibiotics alone or self-limited. Studying the cluster is a reliable method to find new entity of appendicitis.
As the cheap and efficient catalysts, the iron-based catalysts have been considered as one of the most promising catalysts for peroxydisulfate (PDS) activation and the development of high-performance ...iron-based catalysts are attracting growing attentions. In this work, a magnetic Fe-based catalysts (Fe/NC-1000) was obtained by using Fe modified ZIF-8 as the precursor and used to activate the PDS for the degradation of perfluorooctane sulphonate (PFOS). Morphology and structure analysis showed that the resulted Fe/NC-1000 catalyst was displayed porous spheres (40–60 nm) and mainly composed of Fe0, FeNx and carbon. When Fe/NC-1000 was employed to activate the PDS (0.1 g/L of catalyst dosage, 0.5 g/L of PDS dosage and at initial pH of 4.6), the Fe/NC-1000/PDS system exhibited excellent efficiency (97.9 ± 0.1) % for PFOS (10 mg/L) degradation within 30 min. The quenching tests and EPR results revealed that the Fe/NC-1000/PDS system degraded PFOS primarily through singlet oxygen (1O2) evolution and electron-transfer process. Besides, based on the degradation byproducts determined by LC-MS-MS, the PFOS first occurred de-sulfonation to form PFOA, and then the resulted PFOA underwent stepwise defluorination in the Fe/NC-1000/PDS system. Density Functional Theory (DFT) calculations and electrochemistry tests strongly confirmed that Fe/NC-1000 exhibited high electron transfer efficiency, resulting in promoted performance on activating PDS. Importantly, the results of Ecological Structure-Activity Relationship (ECOSAR) analysis showed that the intermediates were lowly toxic during the PFOS degradation, manifesting a green process for PFOS removal. This study would provide more understandings for the persulfate activation process mediated by Fe-based catalysts for Perfluorinated alkyl substances (PFAS) elimination.
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•A magnetic Fe-based catalyst was obtained based on Fe modified ZIF-8.•DFT calculation and electrochemistry tests strongly confirmed high electron transfer efficiency.•Single-linear oxygen oxidation and electron transfer processes were the dominant reaction pathway.•Pathway and mechanism for PFOS degradation were proposed.•Toxicity of the intermediates during PFOS degradation were evaluated.
This work explored the prognostic prediction capabilities of ischemia-modified albumin (IMA) in patients suffering from acute aortic dissection (AAD).
We conducted a retrospective analysis using ...electronic health records. This study included AAD patients admitted to the Second Xiangya Hospital of Central South University from January 2015 to December 2018 in ≤24 h from the onset of symptoms to hospital admission. The levels of IMA were recorded upon admittance and the final was the all-cause mortality during hospitalization.
This study enrolled 731 AAD patients. Among who, 160 passed away in the course of medication while 571 of them survived. Those who passed away exhibited higher levels of IMA (94.35 ± 26.84 vs. 69.14 ± 14.70,
< 0.001) than the survivors. Following the adjustment confounders, the fully adjusted model showed IMA to be an independent forecastor for in-hospital mortality for AAD patients (OR 1.10, 95% CI 1.08-1.13,
< 0.001). Analysis based on receiver operating characteristic (ROC) revealed that 79.35 μ/ml was the best threshold of IMA level. The area under the curve (AUC) based on this IMA level was 0.854 (95% CI 0.822-0.898) while the specificity and sensitivity to anticipate in-hospital death were 84.8 and 80.6%, respectively.
Admission IMA was an independent forecastor for in-hospital mortality among people suffering from AAD.
This study aimed to explore the association between uric acid (UA) and total femur bone mineral density (BMD) in hypertensive and non-hypertensive groups.
We conducted a cross-sectional study of ...13,108 participants in the NHANES database, including 4,679 hypertensive and 8,429 non-hypertensive subjects. A weighted multiple linear regression analysis was conducted to explore the association between UA and total femur BMD.
In the hypertensive group, the relationship between UA and total femur BMD was positive β, 3.02 (95% CI, -0.44 to 6.48), p = 0.0962). In the non-hypertensive group, the association was significantly positive β, 5.64 (95% CI, 2.06-9.22), p = 0.0038. In gender-stratified analysis, UA was analyzed as a continuous variable and a categorical variable (quartile). The significantly positive association was present in both the hypertensive male group β, 5.10 (95% CI, 0.98-9.21), p for trend = 0.0042 and non-hypertensive male group β, 10.63 (95% CI, 6.32-14.94), p for trend = 0.0001. A smooth curve fitting showed that in the hypertensive male group, the relationship between UA and total femur BMD was an inverted U-shaped curve. In the hypertensive female group, the relationship was basically negative. In the non-hypertensive population, the relationship between UA and total femur BMD was an inverted U curve in both men and women.
In the hypertensive male group, the association between UA and total femur BMD was an inverted U-shaped curve. As to women, the relationship was basically negative. In the non-hypertensive group, the association between UA and total femur BMD was an inverted U-shaped curve in different genders.
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