Background
The systemic inflammation score (SIS), based on preoperative serum albumin (Alb) level and lymphocyte-to-monocyte ratio (LMR), has been shown to be a novel prognostic score for some ...tumors. We investigate the prognostic value of the SIS in patients with resectable gastric cancer (GC).
Methods
Patients with GC who underwent curative resection between December 2008 and December 2013 were included. Time-dependent receiver operating characteristics analysis (t-ROC), concordance index (C-index) and AUC were used to compare the prognostic impact.
Results
Totally, 1786 patients with resectable GC were included in the study. By multivariate analysis, the SIS was not an independent prognostic factor. However, the normal Alb level (≥ 40 g/l) and LMR ≥ 3.4 both remained independent protective factors for GC (both
P
< 0.05). Due to the similar survival of patients with LMR ≥ 3.4 and LMR < 3.4 in the normal Alb group, we combined the two subgroups to establish the modified SIS (mSIS). Multivariate analysis revealed that the mSIS was the only significant independent biomarker (
P
< 0.05). The t-ROC curve and C-index for the mSIS were superior to those of the SIS throughout the observation period. Furthermore, the AUC of the mSIS was significantly greater than that of the SIS at 3 and 5 years after operation (both
P
< 0.05).
Conclusion
The preoperative mSIS is a novel, simple and useful prognostic factor for postoperative survival in patients with GC and can be used as a part of the preoperative risk stratification process to improve the prediction of clinical outcomes.
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•The mechanism of CO oxidation on two-dimensional porphyrin sheet with single iron atom was investigated by density functional theory.•The current results indicated that ...two-dimensional porphyrin sheet with single iron atom was a candidate catalyst for CO oxidation under mild conditions, providing an excellent substrate for single-atom catalysts.
CO produced by incomplete combustion of fuel poses a great threat to the environment and human health. Single atom catalysis can increase the active site of the catalyst, but it is unstable and easy to agglomerate at the higher temperatures. A stable single iron atom two-dimensional porphyrin sheet (Fe–TDPS) was designed, which was as CO oxidation catalyst to reduce costs and increase catalytic activity, and the reaction mechanism was investigated by density functional theory. Fe–TDPS has good stability at 1000 K with the ab initio molecular dynamics simulation. Absorption energies suggested that both CO and O2 preferred to anchor at the Fe–N4 site. The mechanisms of CO oxidation, which have reacted on the Fe–TDPS, were explored by Langmuir–Hinshelwood, Eley–Rideal, and ter-molecular Eley–Rideal mechanisms. Ter-molecular Eley–Rideal mechanism was feasible because of the small energy barrier. Results indicated that Fe–TDPS can be used as a catalyst for CO oxidation in the mild condition.
Organic/inorganic hybrid lead halide perovskites are promising optoelectronic materials due to their unique structure, excellent properties, and fascinating potential applications in lighting, ...photovoltaic, etc. However, perovskite materials are very sensitive to moisture and polar solvent, which greatly hinders their practical applications. Here, highly luminescent perovskite–polystyrene composite beads with uniform morphology are prepared via a simple swelling–shrinking strategy. This process is carried out only in nonpolar toluene and hexane without the addition of any polar reagents. As a result, the as‐prepared composite beads not only retain high luminescence but also exhibit superior water‐resistant property. The composites emit strong luminescence after being immersed into water over nine months. Moreover, even in some harsh environments such as acid/alkali aqueous solution, phosphate buffer solution, and Dulbecco's modified eagle medium biological buffers, they still preserve high luminescence. The applications in light‐emitting diodes and cellular labeling agents are also carried out to demonstrate their ultrastability.
Highly luminescent perovskite–polystyrene composite beads with uniform morphology are prepared by packing perovskite quantum dots in crosslinked polystyrene beads via swelling in toluene and then shrinking the beads in hexane. The composite not only retains high luminescence but also exhibits superior water resistance.
The incorporation of amide groups into biologically active molecules has been proven to be an efficient strategy for drug design and discovery. In this study, we present a simple and practical method ...for the synthesis of amide-containing quinazolin-4(3
)-ones under transition-metal-free conditions. This is achieved through a carbamoyl-radical-triggered cascade cyclization of N3-alkenyl-tethered quinazolinones. Notably, the carbamoyl radical is generated in situ from the oxidative decarboxylative process of oxamic acids in the presence of (NH
)
S
O
.
Background
An accurate recurrence risk assessment system and surveillance strategy for hepatoid adenocarcinoma of the stomach (HAS) remain poorly defined. This study aimed to develop a nomogram to ...predict postoperative recurrence of HAS and guide individually tailored surveillance strategies.
Methods
The study enrolled all patients with primary HAS who had undergone curative-intent resection at 14 institutions from 2004 to 2019. Clinicopathologic variables with statistical significance in the multivariate Cox regression were incorporated into a nomogram to build a recurrence predictive model.
Results
The nomogram of recurrence-free survival (RFS) based on independent prognostic factors, including age, preoperative carcinoembryonic antigen, number of examined lymph nodes, perineural invasion, and lymph node ratio, achieved a C-index of 0.723 (95% confidence interval CI, 0.674–0.772) in the whole cohort, which was significantly higher than those of the eighth American Joint Committed on Cancer (AJCC) staging system (C-index, 0.629; 95% CI, 0.573–0.685;
P
< 0.001). The nomogram accurately stratified patients into low-, middle-, and high-risk groups of postoperative recurrence. The postoperative recurrence risk rates for patients in the middle- and high-risk groups were respectively 3 and 10 times higher than for the low-risk group. The patients in the middle- and high-risk groups showed more recurrence and metastasis, particularly multiple site metastasis, within 36 months after the operation than those in the low-risk group (low, 2.2%; middle, 8.6%; high, 24.0%;
P
= 0.003).
Conclusions
The nomogram achieved good prediction of postoperative recurrence for the patients with HAS after radical resection. For the middle- and high-risk patients, more active surveillance and targeted examination methods should be adopted within 36 months after the operation, particularly for liver and multiple metastases.
Cardiac MRI feature-tracking (FT) with breath-holding (BH) cine balanced steady state free precession (bSSFP) imaging is well established. It is unclear whether FT-strain measurements can be reliably ...derived from free-breathing (FB) compressed sensing (CS) bSSFP imaging.
To compare left ventricular (LV) strain analysis and image quality of an FB CS bSSFP cine sequence with that of a conventional BH bSSFP sequence in children.
Prospective.
40 children able to perform BHs (cohort 1 12.1 ± 2.2 years) and 17 children unable to perform BHs (cohort 2 5.2 ± 1.8 years).
3T, bSSFP sequence with and without CS.
Acquisition times and image quality were assessed. LV myocardial deformation parameters were compared between BH cine and FB CS cine studies in cohort 1. Strain indices and image quality of FB CS cine studies were also assessed in cohort 2. Intraobserver and interobserver variability of strain parameters was determined.
Paired t-test, Wilcoxon signed-rank test, intraclass correlation coefficient (ICC), and Bland-Altman analysis. A P-value <0.05 was considered statistically significant.
In cohort 1, the mean acquisition time of the FB CS cine study was significantly lower than for conventional BH cine study (15.6 s vs. 209.4 s). No significant difference were found in global circumferential strain rate (P = 0.089), global longitudinal strain rate (P = 0.366) and EuroCMR image quality scores (P = 0.128) between BH and FB sequences in cohort 1. The overall image quality score of FB CS cine in cohort 2 was 3.5 ± 0.5 with acquisition time of 14.7 ± 2.1 s. Interobserver and intraobserver variabilities were good to excellent (ICC = 0.810 to 0.943).
FB CS cine imaging may be a promising alternative technique for strain assessment in pediatric patients with poor BH ability.
1 TECHNICAL EFFICACY: Stage 1.
Objective
The aim of this study was to investigate the prognostic value of preoperative sarcopenia and systemic inflammation for patients with resectable gastric cancer (GC) and develop a novel and ...powerful prognostic score based on these factors.
Materials and Methods
Patients with GC who underwent radical gastrectomy between December 2009 and December 2013 were included. A multivariate Cox regression analysis was performed to identify the prognostic factors. A novel prognostic score (SLMR) was developed based on preoperative sarcopenia and the lymphocyte‐monocyte ratio (LMR), and its prognostic value was evaluated.
Results
In total, 1,167 patients with resectable GC were included in the study. On multivariate analysis, preoperative sarcopenia and the LMR were shown to be independent prognostic factors (both p < .001). A low LMR was an independent predictor from sarcopenia (p < .001). Based on preoperative sarcopenia and the LMR, we established the SLMR. An elevated SLMR was associated with older age, higher ASA scores, larger tumor size, advanced stages, and vascular invasion (all p < .05). Multivariate analysis revealed that the SLMR was a significant independent predictor (p < .001). We incorporated the SLMR into a prognostic model that included tumor size and TNM stage and generated a nomogram, which accurately predicted 3‐ and 5‐year survival for GC patients.
Conclusion
Preoperative systemic inflammation is significantly associated with sarcopenia. The LMR combined with sarcopenia could enhance prognostication for patients with GC who underwent radical gastrectomy.
Implications for Practice
Increasing evidence shows that sarcopenia and systemic inflammation are closely associated with the prognosis of malignant tumors, and it is essential for clinicians to understand the relationship and combined prognostic effects of these factors for gastric cancer (GC). Based on a large data set, this study found that preoperative systemic inflammation was significantly associated with sarcopenia in GC, and combining these two predictors could effectively predict the prognosis and complement the prognostic value of the TNM staging system. These findings may lead to the development of new therapeutic avenues to improve cancer outcomes.
摘要
目标。本研究的目的在于调查可切除性胃癌 (GC) 患者出现术前肌肉减少症和全身炎症的预后价值，并根据这些因素建立新的有效预后评分。
材料和方法。我们招募了 2009 年 12 月至 2013 年 12 月接受胃癌根治术的GC患者。采用多变量 Cox 回归分析确定了预后因素。我们根据术前肌肉减少症和淋巴细胞与单核细胞比率 (LMR) 建立了新的预后评分 (SLMR)，并评估了其预后价值。
结果。本研究共招募了 1 167 名可切除性GC患者。多变量分析显示，术前肌肉减少症和LMR属于独立预后因素(两者的 p < 0.001)。LMR低是肌肉减少症的独立预测因子 (p < 0.001)。根据术前肌肉减少症和LMR，我们确立了SLMR。SLMR升高与年龄较大、ASA 评分较高、肿瘤尺寸较大、晚期胃癌和血管浸润(所有的 p < 0.05)有关。多变量分析表明，SLMR是重要的独立预测因子 (p < 0.001)。我们将SLMR纳入包括肿瘤尺寸和 TNM 分期的预后模型中，并生成了列线图，准确预测胃癌患者的 3 年和 5 年生存率。
结论。术前全身炎症与肌肉减少症显著相关。LMR结合肌肉减少症可加强对接受过胃癌根治术的GC患者的预后。
实践意义:越来越多的证据表明，肌肉减少症和全身炎症与恶性肿瘤的预后密切相关，临床医生必须了解这些因素与胃癌 (GC) 的关系及综合预后效果。基于大量的数据集，本研究发现，术前全身炎症与GC肌肉减少症显著相关，将这两种预测因子相结合，可有效预测预后并补强 TNM 分期系统的预后价值。上述结果让我们可以开发新的治疗途径，进而改善癌症预后。
Evidence shows that sarcopenia and systemic inflammation are closely associated with poor prognosis from malignant tumors. This article assesses the prognostic efficacy of preoperative sarcopenia and systemic inflammation and reports a novel prognostic score based on these factors to predict long‐term outcomes for patients with resectable gastric cancer.
Background
Type 2 diabetes mellitus (T2DM) and obesity often coexist and together contribute to left atrial (LA) functional abnormalities. However, little is known about the impact of body mass index ...(BMI) on LA strains measured using cardiac magnetic resonance feature tracking (MR‐FT).
Purpose
To investigate the additive effect of BMI on LA functional remodeling using MR‐FT as well as to explore abnormal atrioventricular interaction in T2DM patients.
Study Type
Retrospective.
Population
One hundred and fifty‐nine T2DM patients (53, 34, and 72 normal‐weight, overweight, and obese individuals) and 105 non‐diabetic controls (46, 32, and 27 normal‐weight, overweight, and obese individuals).
Field Strength/Sequence
3.0 T/balanced steady‐state free precession.
Assessment
LA reservoir strain (εs), conduit strain (εe), and active strain (εa) and their corresponding strain rates (SRs, SRe, SRa) were measured together with left ventricular (LV) radial, circumferential, and longitudinal peak strain, peak systolic strain rate, and peak diastolic strain rate.
Statistical Tests
Student's t‐test or Mann–Whitney U test, one‐way ANOVA, univariate and multivariate linear regression. A P value <0.05 was considered statistically significant.
Results
Compared to controls in the same BMI category, T2DM patients had significantly decreased reservoir and conduit function, while pump function was not significantly different (εa and SRa: P = 0.757 and 0.583 for normal‐weight, P = 0.171 and 0.426 for overweight, P = 0.067 and 0.330 for obese). LA strains were significantly correlated with BMI (r = −0.346 for εs, −0.345 for εe) in T2DM patients. Multivariable linear regression analysis indicated that BMI was independently associated with LA εs and εe, LV global longitudinal strain was independently associated with LA εs and εa, and LV circumferential peak diastolic strain rate was independently associated with LA εe.
Data Conclusion
These findings suggest that the coexistence of increased body weight and T2DM patients can exacerbate the impairment of LA strains and indicate abnormal atrioventricular interactions.
Level of Evidence
3
Technical Efficacy
Stage 3
Background and Aim
It has been reported that serum quantification of anti‐HBc (qAnti‐HBc) could predict antiviral response in chronic hepatitis B (CHB) patients, while its role in hepatitis B ...virus‐related acute‐on‐chronic liver failure (HBV‐ACLF) remains unclear. Its implication in HBV‐ACLF was evaluated in this study.
Methods
Baseline serum qAnti‐HBc levels were retrospectively detected in HBV‐ACLF and CHB patients using recently developed double‐sandwich immunoassay. The association of qAnti‐HBc level with clinical outcomes was evaluated by multiple logistic regression. Nomogram was adopted to formulate an algorithm incorporating qAnti‐HBc for the prediction of survival in HBV‐ACLF. The post‐hospitalization of HBV‐ACLF patients were followed‐up for 1 year.
Results
Eighty‐eight HBV‐ACLF as training set, 80 HBV‐ACLF as validation set and 216 CHB cases were included. Serum qAnti‐HBc level was significantly higher in HBV‐ACLF (4.95 ± 0.54 log10 IU/mL) than CHB patients (4.47 ± 0.84 log10 IU/mL) (P < 0.01). Among HBV‐ACLF cases, both in training and validation set, patients with poor outcomes had lower qAnti‐HBc level. Area under receiver operating characteristic curve of the novel qAnti‐HBc inclusive model was 0.82, superior to 0.73 from model for end‐stage liver disease scores (P = 0.018), which was confirmed in validation set. During follow‐up, the qAnti‐HBc level declined at month 3 and month 6, then plateaued at 3.84 log10 IU/mL.
Conclusions
Serum qAnti‐HBc level was associated with disease severity and might be served as a novel biomarker in the prediction of HBV‐ACLF clinical outcomes. The underlying immunological mechanism warrants further investigation.
The ubiquity of microplastics in the environment has attracted much attention on their risks. Though newly produced plastics were considered inert to aqueous metals, a few studies suggest aged ...microplastics can accumulate metals. Still, knowledge gap exists on the comparability of metal accumulation in field condition and that acquired in controlled laboratory settings. Accordingly, we comparatively assessed the field accumulation and laboratory adsorption of metals on aged microplastics in coastal waters. Microplastics of different polymeric types were aged for 8 weeks at three coastal sites with different contamination levels. Microplastics accumulated metals to substantial concentrations during ageing (median concentrations, μg g−1: Fe = 950, Mn = 94, Zn = 19, Cu = 2.8, Ni = 1.7, Pb = 1.6, and Cd = 0.005). Adsorption capacity of (aged) microplastics was evaluated in laboratory using a stable isotope tracer method. At environmentally realistic concentrations (μg L−1, 114Cd = 1.7, 65Cu = 4.4, 62Ni = 5.4, 206Pb = 0.5, and 68Zn = 13), the median concentrations of newly adsorbed isotopes on the aged microplastics were 0.01, 1.4, 0.07, 0.56, and 1.1 μg g−1, respectively, one to two orders of magnitude higher than those adsorbed on pristine microplastics. However, the composition pattern of metals accumulated on aged microplastics differed from the composition of metals newly adsorbed in laboratory: the prior one reflected the contamination status of ageing sites and varied by polymeric types; whereas the laboratory newly adsorbed metals on aged microplastics were uniformly correlated to particulate Fe and Mn concentrations, suggesting Fe and Mn mineral coatings mediated the ensuing metal adsorption. Such discrepancy unveiled the complexity of metal accumulation behavior in the real environment and highlighted that cares should be taken when translating laboratory findings to risk assessment of metal contaminated microplastics in the real environment.
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•Ageing in coastal waters elevates metal adsorption capacity of microplastics.•Metals accumulated in the field reflect metal contamination of the ageing sites.•Metals accumulated in the field are affected by polymeric types.•Lab adsorption of metals on aged microplastics is mediated by Fe/Mn oxide coatings.
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