The prognostic value of quantitative assessments of the number of retrieved lymph nodes (RLNs) in gastric cancer (GC) patients needs further study.
To discuss how to obtain a more accurate count of ...metastatic lymph nodes (MLNs) based on RLNs in different pT stages and then to evaluate patient prognosis.
This study retrospectively analyzed patients who underwent GC radical surgery and D2/D2+ LN dissection at the Cancer Hospital of Harbin Medical University from January 2011 to May 2017. Locally weighted smoothing was used to analyze the relationship between RLNs and the number of MLNs. Restricted cubic splines were used to analyze the relationship between RLNs and hazard ratios (HRs), and X-tile was used to determine the optimal cutoff value for RLNs. Patient survival was analyzed with the Kaplan-Meier method and log-rank test. Finally, HRs and 95% confidence intervals were calculated using Cox proportional hazards models to analyze independent risk factors associated with patient outcomes.
A total of 4968 patients were included in the training cohort, and 11154 patients were included in the validation cohort. The smooth curve showed that the number of MLNs increased with an increasing number of RLNs, and a nonlinear relationship between RLNs and HRs was observed. X-tile analysis showed that the optimal number of RLNs for pT1-pT4 stage GC patients was 26, 31, 39, and 45, respectively. A greater number of RLNs can reduce the risk of death in patients with pT1, pT2, and pT4 stage cancers but may not reduce the risk of death in patients with pT3 stage cancer. Multivariate analysis showed that RLNs were an independent risk factor associated with the prognosis of patients with pT1-pT4 stage cancer (
= 0.044,
= 0.037,
= 0.003,
< 0.001).
A greater number of RLNs may not benefit the survival of patients with pT3 stage disease but can benefit the survival of patients with pT1, pT2, and pT4 stage disease. For the pT1, pT2, and pT4 stages, it is recommended to retrieve 26, 31 and 45 LNs, respectively.
Abstract
Intra-tumor heterogeneity (ITH) is a key challenge in cancer treatment, but previous studies have focused mainly on the genomic alterations without exploring phenotypic (transcriptomic and ...immune) heterogeneity. Using one of the largest prospective surgical cohorts for hepatocellular carcinoma (HCC) with multi-region sampling, we sequenced whole genomes and paired transcriptomes from 67 HCC patients (331 samples). We found that while genomic ITH was rather constant across stages, phenotypic ITH had a very different trajectory and quickly diversified in stage II patients. Most strikingly, 30% of patients were found to contain more than one transcriptomic subtype within a single tumor. Such phenotypic ITH was found to be much more informative in predicting patient survival than genomic ITH and explains the poor efficacy of single-target systemic therapies in HCC. Taken together, we not only revealed an unprecedentedly dynamic landscape of phenotypic heterogeneity in HCC, but also highlighted the importance of studying phenotypic evolution across cancer types.
Using a prospective cohort for Hepatocellular Carcinoma (the PLANET study), this work revealed a dynamic landscape of phenotypic intra-tumor heterogeneity, providing several novel approaches for patient treatment and prognosis prediction.
Advanced exfoliation techniques are crucial for exploring the intrinsic properties and applications of 2D materials. Though the recently discovered Au-enhanced exfoliation technique provides an ...effective strategy for preparation of large-scale 2D crystals, the high cost of gold hinders this method from being widely adopted in industrial applications. In addition, direct Au contact could significantly quench photoluminescence (PL) emission in 2D semiconductors. It is therefore crucial to find alternative metals that can replace gold to achieve efficient exfoliation of 2D materials. Here, we present a one-step Ag-assisted method that can efficiently exfoliate many large-area 2D monolayers, where the yield ratio is comparable to Au-enhanced exfoliation method. Differing from Au film, however, the surface roughness of as-prepared Ag films on SiO2/Si substrate is much higher, which facilitates the generation of surface plasmons resulting from the nanostructures formed on the rough Ag surface. More interestingly, the strong coupling between 2D semiconductor crystals (e.g. MoS2, MoSe2) and Ag film leads to a unique PL enhancement that has not been observed in other mechanical exfoliation techniques, which can be mainly attributed to enhanced light-matter interaction as a result of extended propagation of surface plasmonic polariton (SPP). Our work provides a lower-cost and universal Ag-assisted exfoliation method, while at the same offering enhanced SPP-matter interactions.
To investigate changes in endogenous bactericidal/permeability-increasing protein (BPI) levels and their significance in patients with surgical sepsis.
In the prospective study, 19 surgical patients ...with infection were involved. The plasma BPI, lipopolysaccharide-binding protein (LBP) and interleukin-6 levels were measured on post-infected days 1, 3, 5, 7 and 14 by an enzyme-linked immunosorbent assay (ELISA). Plasma endotoxin concentrations were determined by the modified chromogenic Limulus Amebocyte Lysate (LAL).
Compared with normal controls, significant lower plasma BPI/LBP ratios were observed in septic patients on days 1 to 5 after infection (P < 0.01), and in severe septic patients on days 1 to 7 (P < 0.01). Moreover, plasma BPI/LBP ratios were much lower in severe sepsis than those in sepsis on days 1 to 3 after infection (P < 0.05).
Plasma BPI and LBP levels increased rapidly after infection, but BPI/LBP ratios were significantly decreased during sepsis. Plasma BPI/LBP ratios appear to be closely re
To analyze the basic characteristics and related factors of ED.
Using the self-designed National Key Collaboration Platform for Impotence Disease Research, we enrolled 297 ED males at the urological ...clinic of the Second Hospital of Zhejiang University of Chinese Medicine from January 2015 to August 2018, and analyzed their basic characteristics, IIEF-5 scores, and erection hardness grades based on the Erectile Hardness Grading Scale.
The patients were aged 21－81 years, 41.4% at the age of 31－40 years, 81.5% with a disease course of less than 5 years, 56.9% with mild ED, and 44.8% with grade-3 erectile hardness. The IIEF-5 scores were significantly lower in the patients over 60 years old than in those aged 31－40 years (13.82±5.36 vs 8.50±4.99, P < 0.05), in those with a disease course of <5 years than in those with a disease course of >10 years (P < 0.05), and in those with a poor than in those with a loving relationship (P < 0.05), but showed no statistically significant difference among those with different
Statins and therapeutic ultrasound (TUS) have been shown to ameliorate angiogenesis on ischemic hindlimb animals and promote human umbilical vein endothelial cells (HUVECs) tube formation and ...proliferation. Here, we evaluate the therapeutic effect of TUS in combination with atorvastatin (Ator) therapy on angiogenesis in hindlimb ischemia and HUVECs. After subjecting excision of the left femoral artery, all mice were randomly distributed to one of four groups: Control; Ator treated mice (Ator); TUS treated mice (TUS); and Ator plus TUS treated mice (Ator+TUS). At day 14 post-surgery, the Ator plus TUS treatment cohort had the greatest blood perfusion, accompanied by elevated capillary density. In vitro, Ator plus TUS augmented tube formation, migration and proliferative capacities of HUVECs. Additionally, the united administration upregulated expression of angiogenic factors phosphorylated Akt (p-Akt), phosphorylated endothelial nitric oxide synthase (p-eNOS), as well as vascular endothelial growth factor (VEGF), both in vivo and in vitro. These benefits could be blocked by either phosphoinositide 3-kinase (PI3K) or eNOS inhibitor. Our data indicated that the united administration could significantly enhance ischemia-mediated angiogenesis and exert a protective effect against ischemic/hypoxia induced damage among HUVECs through up-regulating VEGF expression and activating the PI3K-Akt-eNOS pathway.
These studies established a macaque model of early-phase endotoxic shock, and investigated the resuscitation effects of three different solutions. Twenty-four macaques were assigned to four groups. ...Nineteen animals were given an intravenous dose of 2.8 mg/kg lipopolysaccharide (LPS). At 60 min after LPS challenge, the animals were given (i) 5 mL/kg normal saline (Ns group, n = 6), (ii) 5% of 5 mL/kg sodium bicarbonate (Sb group, n = 6), (iii) hypertonic 3.5% sodium chloride of 5 mL/kg (Hs group, n = 7). The control group (Co group, n = 5) was first injected with 1 mL/kg Ns and with 5 mL/kg Ns 60 min later. Haemodynamic parameters and blood gases were measured during the experiment, and myocardial morphology was examined on termination of the experiment. Administration of LPS caused hypotension and decreases of the left ventricular work index (LVWI). In the Sb group, mean arterial pressure, cardiac index, systemic vascular resistance index, LVWI and right ventricular work index were significantly higher than those of the Ns group. Pathological changes of myocardium were identified in all of the LPS groups. The studies suggest that macaques are suitable models for studying endotoxic shock and potential fluid therapies.
In order to explore the impacts of nitrogen fertilizer and straw returning methods on N
O emissions, a two-factor split-zone design was adopted for experimentation under the winter wheat-summer maize ...rotation model in the Guanzhong area of Shanxi, China. The main areas of interest were conventional nitrogen (G) and reduced nitrogen (70% G); the sub-areas were straw no return (N), straw return (S), and straw return + biochar (SB); we analyzed their impacts on N
O emissions and crop yield, and the relationships with related impact factors. The results showed that the N
O emissions peaks appeared in the wheat season and maize season treatments within 5-16 days after fertilization, and also appeared after rainfall. The N
O flux was significantly and positively correlated with soil temperature and NH
-N content. Regardless of the wheat season, maize season, or annual total N
O emissions, the 70% GSB treatment was the lowest and the GS treatment was the highest. At the same level of nitrogen application, S treatmen
Objective
To analyze the relevant literature regarding the effect of tuina on postpartum milk secretion and thus summarize the clinical rules on tuina for lactation disorder.
Method
Investigate the ...relationship between tuina and postpartum milk secretion for four aspects, including the initial time of lactation, level of serum prolactin, volume of lactation, and Chinese medicine’s understanding of tuina on milk secretion.
Result and Conclusion
Tuina on breasts after childbirth can speed and promote lactation. This has been proved by clinical practice over the past hundreds of years, along with modern laboratory and scientific research. This method, therefore, is of great significance in obstetrical nursing.
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