Abstract Our aim was to differentiate IgG4-related sialadenitis, primary Sjögren syndrome, and chronic obstructive submandibular sialadenitis by analysing clinical, radiographic, and pathological ...features. Fifty-five patients, 50, and 50 were enrolled, respectively and their baseline characteristics and serological, sialographic, and pathological findings compared. The male:female ratio for IgG4-related sialadenitis was 1:1.2 for primary Sjögren syndrome 1:15.7, and for chronic obstructive submandibular sialadenitis1:0.92. Numbers with enlarged salivary glands were 55, 16, and 50; with xerostomia 26, 48, and 0; with a history of allergy 26, 4, and 6, and with coexisting systemic disease 12, 19, and 0 (p = 0.14). Mean (SD) serum IgG4 concentrations were 109.1 (97.9), 4.9. (1.9) g/L, and 5.3 (1.6) g/L, p < 0.001 in all cases. Sialography showed enlargement of the gland, dilatation of the duct, and slightly decreased secretory function in IgG4-related disease; obvious sialectasia and decreased secretory function in Sjögren syndrome; and dilatation of Wharton’s duct and filling defects in obstructive sialadenitis. Histopathological examination showed lymphoplasmacytic infiltration with storiform fibrosis, lymphoplasmacytic inflammation and lymphoepithelial lesions, and dilatation of the duct with epithelial metaplasia in the three groups, respectively. The number of IgG4-positive plasma cells was 123 (45)/HPF, 8 (3)/HPF, and 5 (4)/HPF, while the IgG4-/IgG-positive cell ratio was 71.7 (13.9)%, 4.6 (2.5)%, 18.9 (19.7)%, respectively (p < 0.001). The three conditions have different clinical, radiographic, and pathological features that provide important clues to the differential diagnosis. Serological and histological tests are important, and comprehensive consideration is necessary.
Background
The aim of this study was to evaluate whether adjuvant chemotherapy is associated with improved survival in patients with resectable gastric neuroendocrine carcinomas (G‐NECs) or mixed ...adenoneuroendocrine carcinomas (G‐MANECs).
Methods
The study included patients with G‐NECs or G‐MANECs who underwent surgery in one of 21 centres in China between 2004 and 2016. Propensity score matching analysis was used to reduce selection bias, and overall survival (OS) in different treatment groups was estimated by the Kaplan–Meier method.
Results
In total, 804 patients with resectable G‐NECs or G‐MANECs were included, of whom 490 (60·9 per cent) received adjuvant chemotherapy. After propensity score matching, OS in the chemotherapy group was similar to that in the no‐chemotherapy group. Among patients with G‐NECs, survival in the fluorouracil (5‐FU)‐based chemotherapy group and the non‐5‐FU‐based chemotherapy group was similar to that in the no‐chemotherapy group. Similarly, etoposide plus cisplatin or irinotecan plus cisplatin was not associated with better OS in patients with G‐NECs. Among patients with G‐MANECs, OS in the non‐5‐FU‐based chemotherapy group was worse than that in the no‐chemotherapy group. Patients with G‐MANECs did not have better OS when platinum‐based chemotherapy was
used.
Conclusion
There was no survival benefit in patients who received adjuvant chemotherapy for G‐NECs or G‐MANECs.
Antecedentes
El objetivo de este estudio fue evaluar si la quimioterapia adyuvante mejoraba la supervivencia en pacientes con carcinomas gástricos resecables neuroendocrinos (gastric neuroendocrine carcinomas, G‐NECs) y carcinomas adenoneuroendocrinos mixtos (mixed adenoneuroendocrine carcinomas, G‐MANECs).
Métodos
Se incluyeron pacientes con G‐NECs y G‐MANECs tratados quirúrgicamente en 21 centros en China entre 2004 y 2016. Se utilizó un análisis de emparejamiento por puntaje de propensión para reducir el sesgo de selección y el método de Kaplan‐Meier para estimar la supervivencia global (overall survival, OS) de los pacientes en los diferentes grupos de tratamiento.
Resultados
En total, se incluyeron en el estudio 804 pacientes con G‐NECs y G‐MANECs resecables y 490 pacientes (60,9%) recibieron quimioterapia adyuvante. Después del emparejamiento por puntaje de propensión, la OS del grupo con quimioterapia fue similar a la del grupo sin quimioterapia. En los pacientes con G‐NECs, la supervivencia en los grupos con quimioterapia basada en 5‐FU (fluorouracilo) y de quimioterapia sin 5‐FU fue similar a la del grupo sin quimioterapia. Asimismo, la combinación de etopósido y cisplatino o de irinotecán y cisplatino no se asoció con una mejor OS en pacientes con G‐NECs. En pacientes con G‐MANECs, la OS del grupo con quimioterapia sin 5‐FU fue peor que la del grupo sin quimioterapia. Los pacientes con G‐MANECs no presentaron una mejor OS cuando se administró quimioterapia basada en platinos.
Conclusión
La administración de quimioterapia adyuvante en pacientes con G‐NECs y G‐MANECs no mejoró la supervivencia.
This multicentre study enrolled 804 patients with resectable gastric neuroendocrine carcinomas and gastric mixed adenoneuroendocrine carcinomas. In propensity score matching analysis, there were no associations between the use of adjuvant chemotherapy and improved overall survival. Similar results were obtained in stratified analysis according to different chemotherapy regimens.
No benefit
The natural resonance appears at 16
GHz for (Fe, Ni)/C nanocapsules with (Fe, Ni) alloys as cores and graphite as shells. Reflection loss (RL) exceeding −10
dB was obtained in the whole Ku-band ...(12.4–18
GHz) for an absorber thickness of 2.0
mm, while it exceeds −20
dB over the 13.6–16.6
GHz range. In addition, the bandwidth does not change dramatically for the thicknesses of 1.87–2.1
mm for the RL values exceeding −10
dB. The (Fe, Ni)/C nanocapsules with wide bandwidth absorption can be used as excellent electromagnetic-wave-absorption materials in the whole Ku-band.
•Proposed a new nonlinear interval programming method.•Introduced a multidimensional parallelepiped interval model.•The model hand led the dependencies among the interval variables.•Formulated an ...efficient interval iterative method.
This paper proposes a new nonlinear interval programming method that can be used to handle uncertain optimization problems when there are dependencies among the interval variables. The uncertain domain is modeled using a multidimensional parallelepiped interval model. The model depicts single-variable uncertainty using a marginal interval and depicts the degree of dependencies among the interval variables using correlation angles and correlation coefficients. Based on the order relation of interval and the possibility degree of interval, the uncertain optimization problem is converted to a deterministic two-layer nesting optimization problem. The affine coordinate is then introduced to convert the uncertain domain of a multidimensional parallelepiped interval model to a standard interval uncertain domain. A highly efficient iterative algorithm is formulated to generate an efficient solution for the multi-layer nesting optimization problem after the conversion. Three computational examples are given to verify the effectiveness of the proposed method.
Background
The overproduction of IgE plays a critical role in the pathogenesis of allergy; the mechanism is unclear. Histone‐acetyltransferase (HAT) activities are required in gene transcription of a ...large number of molecules in the immune system of the body.
Objectives
This study tests a hypothesis that HAT Tat‐interactive protein 60 (Tip60) plays an important role in the initiation of IgE‐mediated allergy.
Methods
The effects of Tip60 on regulating IgE expression were assessed with B cells. An intestinal allergy mouse model was developed to assess the role of Tip60 in the induction of IgE‐mediated allergic inflammation.
Results
High levels of Tip60 were observed in the peripheral B cells of patients with FA. Tat‐interactive protein 60 (Tip60) was required in the expression of IgE and IgG1 in B cells by inducing the chromatin remolding at the gene locus, in which histone acetylation, signal transducer and activator of transcription 6 (STAT6), and nuclear factor‐κB at the locus of Iε promoter were markedly increased. Blocking Tip60 significantly attenuated the allergic inflammation in the mouse intestinal mucosa.
Conclusions
Tat‐interactive protein 60 (Tip60) plays an important role in the induction of IgE in B cells. Blocking Tip60 inhibits the allergic inflammation in the intestine, suggesting Tip60 inhibitor may be a potential anti‐allergy drug.
In December 2019, a new type of coronavirus-infected pneumonia broke out in Wuhan and spread rapidly to other parts of the country. The purpose of this study was to investigate the clinical features ...of coronavirus disease 2019 (COVID-19).
A retrospective analysis was performed on the confirmed cases of COVID-19, who were admitted to the North Hospital of Changsha first Hospital (Changsha Public Health treatment Center) from January 17 to February 7, 2020.
The median age of COVID-19 patients was 45 years (range 33.5-57). The male patients accounted for 49.7%, 64.6% of the patients had a history of exposure in Wuhan, and 31.7% had family aggregation. The median days of onset were six, and the incidence of severe illness was 18.6%. Compared with the non-severe group, the severe group showed statistical significance in older age, hypertension, bilateral lung plaque shadow, decrease in lymphocyte count, increase in C-reactive protein (CRP), aspartate aminotransferase (AST), lactate dehydrogenase, and creatine kinase.
Age, combined hypertension, oxygenation index, double lung patch, decreased lymphocyte count, and elevated levels of C-reactive protein, aspartate aminotransferase, lactate dehydrogenase, and creatine kinase can be used as predictors of the disease severity.
Neoadjuvant therapy is recommended for locally advanced esophageal cancer, but the optimal strategy remains unclear. We aimed to evaluate the safety and efficacy of neoadjuvant chemoradiotherapy ...(nCRT) versus neoadjuvant chemotherapy (nCT) followed by minimally invasive esophagectomy (MIE) for locally advanced esophageal squamous cell carcinoma (ESCC).
Eligible patients staged as cT3-4aN0-1M0 ESCC were randomly assigned (1 : 1) to the nCRT or nCT group stratified by age, cN stage, and centers. The chemotherapy, based on paclitaxel and cisplatin, was administered to both groups, while concurrent radiotherapy was added for the nCRT group; then MIE was carried out. The primary endpoint was 3-year overall survival. This study is registered with ClinicalTrials.gov (NCT03001596).
A total of 264 patients were eligible for the intention-to-treat analysis. By 30 November 2021, 121 deaths had occurred. The median follow-up was 43.9 months (interquartile range 36.6-49.3 months). The overall survival in the intention-to-treat population was comparable between the nCRT and nCT strategies hazard ratio (HR) 0.82, 95% confidence interval (CI) 0.58-1.18; P = 0.28, with a 3-year survival rate of 64.1% (95% CI 56.4% to 72.9%) versus 54.9% (95% CI 47.0% to 64.2%), respectively. There were also no differences in progression-free survival (HR 0.83, 95% CI 0.59-1.16; P = 0.27) and recurrence-free survival (HR 1.07, 95% CI 0.71-1.60; P = 0.75), although the pathological complete response in the nCRT group (31/112, 27.7%) was significantly higher than that in the nCT group (3/104, 2.9%; P < 0.001). Besides, a trend of lower risk of recurrence was observed in the nCRT group (P = 0.063), while the recurrence pattern was similar (P = 0.802).
NCRT followed by MIE was not associated with significantly better overall survival than nCT among patients with cT3-4aN0-1M0 ESCC. The results underscore the pending issue of the best strategy of neoadjuvant therapy for locally advanced bulky ESCC.
•The CMISG1701 trial assessed the safety and efficacy of nCRT versus nCT followed by MIE for locally advanced bulky ESCC.•The nCRT followed by MIE strategy could not improve survival significantly compared with the nCT strategy.•The best strategy of neoadjuvant therapy for locally advanced bulky ESCC remains a pending issue.
Summary
We performed a GWAS of trochanter and intertrochanter bone mineral density (BMD) in the Framingham Heart Study and replicated in three independent studies. Our results identified one novel ...locus around the associated variations at chromosomal region 3q13.32 and replicated two loci at chromosomal regions 3p21 and 8q24. Our findings provide useful insights that enhance our understanding of bone development, osteoporosis, and fracture pathogenesis.
Introduction
Hip trochanter (TRO) and intertrochanter (INT) subregions have important clinical relevance to subtrochanteric and intertrochanteric fractures but have rarely been studied by genome-wide association studies (GWASs).
Methods
Aiming to identify genomic loci associated with BMD variation at TRO and INT regions, we performed a GWAS utilizing the Framingham Heart Study (FHS,
N
= 6,912) as discovery sample and utilized the Women’s Health Initiative (WHI) African-American subsample (
N
= 845), WHI Hispanic subsample (
N
= 446), and Omaha osteoporosis study (
N
= 971), for replication.
Results
Combining the evidence from both the discovery and the replication samples, we identified one novel locus around the associated variations at chromosomal region 3q13.32 (
rs1949542
, discovery
p
= 6.16 × 10
−8
, replication
p
= 2.86 × 10
−4
for INT-BMD; discovery
p
= 1.35 × 10
−7
, replication
p
= 4.16 × 10
−4
for TRO-BMD, closest gene
RP11-384F7.1
). We also replicated two loci at chromosomal regions 3p21 (
rs148725943
, discovery
p
= 6.61 × 10
−7
, replication
p
= 5.22 × 10
−4
for TRO-BMD, closest gene
CTNNB1
) and 8q24 (
rs7839059
, discovery
p
= 2.28 × 10
−7
, replication
p
= 1.55 × 10
−3
for TRO-BMD, closest gene
TNFRSF11B
) that were reported previously. We demonstrated that the effects at both 3q13.32 and 3p21 were specific to the TRO, but not to the femoral neck and spine. In contrast, the effect at 8q24 was common to all the sites.
Conclusion
Our findings provide useful insights that enhance our understanding of bone development, osteoporosis, and fracture pathogenesis.
Neutron diffraction data obtained on single crystals of PbZr(1-x)Ti(x)O3 with x=0.325 and x=0.460, which lie on the pseudorhombohedral side of the morphotropic phase boundary, suggest a coexistence ...of rhombohedral (R3m/R3c) and monoclinic (Cm) domains and that monoclinic order is enhanced by Ti substitution. A monoclinic phase with a doubled unit cell (Cc) is ruled out as the ground state.
A 6 mm thickness medium-Mn ultrahigh strength steel was friction stir welded (FSW) with various rotation speed at constant of welding speed in this study. The microstructural evolution and impact ...toughness of the stir zone were investigated in a systematic manner. The microstructural observation results suggested that the metastable austenite in base metal disappeared after FSW, and the stir zone of FSW samples contained various morphology of martensite (i.e., well tempered martensite, less tempered martensite and common martensite). The content of well tempered martensite and less tempered martensite in the stir zone was decreased with the increase of rotation speed, and the martensite blocks and prior austenite grain size were gradually coarsened. It is suggested that the plastic deformation and the small prior austenite grain size promoted the formation of well tempered martensite in the stir zone at low rotation speed. The well tempered martensite could effectively release the stress concentration by interfaces separation with other martensite of different morphology during impact test, which greatly benefited the impact toughness. Furthermore, the small martensite blocks could also improve the impact toughness. The impact toughness of the stir zone was decided by the martensite blocks size and the content of different morphology of martensite phase.
•The stir zone of FSW samples contained various morphology of martensite.•The martensite morphology varies greatly at different welding parameters.•Massive well tempered martensite formed in the stir zone at low rotation speed.•The well tempered martensite can effectively release the stress concentration.
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