BACKGROUND: Currently, prophylactic antibiotics are recommended only for cirrhotic patients with acute upper gastrointestinal bleeding(AUGIB);however, the benefit for other AUGIB patients remains undetermined. We aime...BACKGROUND: Currently, prophylactic antibiotics are recommended only for cirrhotic patients with acute upper gastrointestinal bleeding(AUGIB);however, the benefit for other AUGIB patients remains undetermined. We aimed to compare the clinical outcomes between patients with AUGIB with and without prophylactic antibiotics to identify the population that requires this therapy.METHODS: Patients with AUGIB admitted between 1st January 2019 and 31st December 2021 in the Emergency Department of Peking Union Medical College Hospital were enrolled. Patients were divided into the antibiotic and non-antibiotic groups. The primary outcome was in-hospital mortality, and the secondary outcome was the onset of new infection. The risk factors for mortality and infection were analyzed, and stratification analysis of prophylactic antibiotics was performed. Continuous data were analyzed using the t-test or nonparametric rank sum test, and categorical data were analyzed using the Chi-square test or Fisher's exact test. Indicators with significant differences between the groups were included for logistic regression analysis. A P-value <0.05 was considered statistically significant. RESULTS: A total of 392 individuals were included, among them, 281 patients received prophylactic antibiotics, and 111 patients did not receive prophylactic antibiotics. The mortality rates were significantly lower in the antibiotic group than in the non-antibiotics group(6.41% vs. 17.12%, P=0.001). The risk factors for infection were varicose veins(P=0.045) and endotracheal intubation(P=0.005) in the prophylactic antibiotic group, and endoscopic treatment(P=0.010) in the non-prophylactic antibiotic group. Stratified analyses showed that patients with age ≥ 65 years, endotracheal intubation, endoscopic treatment, and AUGIB of variceal etiologies benefited from prophylactic antibiotics.CONCLUSION: AUGIB patients may benefit from prophylactic antibiotics to decrease mortality, especially those aged ≥ 65 years and those with endotracheal intubation, endoscopic treatment, and variceal etiologies.展开更多
Primary esophageal or gastric melanoma is a very rare disease with early metastasis. Due to its atypical symptom and less efficiency of chemotherapy and radiotherapy, the prognosis of esophageal or gastric melanoma is...Primary esophageal or gastric melanoma is a very rare disease with early metastasis. Due to its atypical symptom and less efficiency of chemotherapy and radiotherapy, the prognosis of esophageal or gastric melanoma is still very poor. Surgical resection remains the preferential treatment for esophageal or gastric melanoma. Here we present an extremely rare case of primary advanced esophago-gastric melanoma. Debulking surgery was performed without chemotherapy or radiotherapy. However, abdominal recurrence and hepatic metastases were found within one month by a postoperative follow-up computed tomography. Three and a half months after surgical resection, the patient died of extensive abdominal metastasis.展开更多
Extrathoracic solitary fibrous tumors(SFTs) have been described at almost every anatomic location of human body,but reports of SFT in the abdominal cavity are rare.We herein present a rare case of SFT originating from...Extrathoracic solitary fibrous tumors(SFTs) have been described at almost every anatomic location of human body,but reports of SFT in the abdominal cavity are rare.We herein present a rare case of SFT originating from greater omentum.Computed tomography revealed a 15.8 cm × 21.0 cm solid mass located at superior aspect of stomach.Open laparotomy confirmed its mesenchymal origin.Microscopically,its tissue was composed of non-organized and spindle-shaped cells exhibiting atypical nuclei,which were divided up by branching vessel and collagen bundles.Immunohistochemical staining showed that this tumor was negative for CD117,CD99,CD68,cytokeratin,calretinin,desmin,epithelial membrane antigen,F8 and S-100,but positive for CD34,bcl-2,α-smooth muscle actin and vimentin.The patient presented no evidence of recurrence during follow-up.SFT arising from abdominal cavity can be diagnosed by histological findings and immunohistochemical markers,especially for CD34 and bcl-2 positive cases.展开更多
AIM:To evaluate human epidermal growth factor receptor 2(HER2)and death decoy receptor(DcR3)as colorectal cancer prognostic indicators.METHODS:Colorectal carcinoma specimens from 300patients were analyzed by immunohis...AIM:To evaluate human epidermal growth factor receptor 2(HER2)and death decoy receptor(DcR3)as colorectal cancer prognostic indicators.METHODS:Colorectal carcinoma specimens from 300patients were analyzed by immunohistochemistry to detect the staining patterns of HER2 and DcR3.Classification of HER2 staining was carried out using the United States Food and Drug Administration semi-quantitative scoring system,with scores of 0 or 1+indicating a tumor-negative(normal expression)status and scores of 2+and 3+indicating a tumor-positive(overexpression)status.Classification of DcR3 was carried out by quantitating the percentage of positive cells within the stained section,with<10%indicating a tumor-negative status and≥10%indicating a tumor-positive status.Correlation of the HER2 and DcR3 staining status with clinicopathological parameters[age,sex,tumor size,differentiation,and the tumor,node,metastasis(pTNM)classification]and survival was statistically assessed.RESULTS:Tumor-positive status for HER2 and DcR3was found in 18.33%and 58.33%of the 300 colorectal carcinoma specimens,respectively.HER2 tumorpositive status showed a significant correlation with tumor size(P=0.003)but not with other clinicopathological parameters.DcR3 tumor-positive status showed a significant correlation with tumor differentiation(P<0.001),pTNM stage(P<0.001),and lymph node metastasis(P<0.001).However,correlation coefficient analysis did not indicate that a statistically significant correlation exists between tumor-positive status for the HER2 and DcR3 overexpression(P=0.236).Patients with specimens classified as DcR3-overexpressing had a significantly worse overall survival(OS)rate than those without DcR3 overexpression(median OS:42.11vs 61.21 mo;HR=50.27,95%CI:44.90-55.64,P<0.001).HER2 overexpression had no significant impact on median OS(35.10 mo vs 45.25 mo;HR=44.40,95%CI:39.32-49.48,P=0.344).However,patients with specimens classified as both HER2-and DcR3-overexpressing had a significantly poorer median OS than those with only HER2 overexpression(31.80 mo vs 52.20 mo;HR=35.10,95%CI:22.04-48.16,P=0.006).CONCLUSION:HER2 overexpression is not an independent prognostic marker of colorectal cancer,but DcR3 overexpression is highly correlated with lymph node metastasis and poor OS.展开更多
Ameloblastoma is a benign but locally aggressive odontogenie neoplasm that accounts for 10% of all tumors arising in the mandible and maxilla (1).Eighty percent of ameloblastomas arise in the mandible,and they are usu...Ameloblastoma is a benign but locally aggressive odontogenie neoplasm that accounts for 10% of all tumors arising in the mandible and maxilla (1).Eighty percent of ameloblastomas arise in the mandible,and they are usually found in young adults.It frequently recurs if not adequately resected.Therefore,the standard therapy for this tumor is complete bone resection with an adequate margin of safety: marginal or segmental osteotomy.However,aesthetic deformities,functional impairments and psychological impairments after radical surgery for large ameloblastoma, have been serious issues (1).展开更多
BACKGROUND Immunoinflammatory markers such as the peripheral blood neutrophil-tolymphocyte ratio(NLR)and the platelet-to-lymphocyte ratio(PLR)have gained considerable attention as prognostic markers in gastrointestina...BACKGROUND Immunoinflammatory markers such as the peripheral blood neutrophil-tolymphocyte ratio(NLR)and the platelet-to-lymphocyte ratio(PLR)have gained considerable attention as prognostic markers in gastrointestinal stromal tumors(GISTs).AIM To assess the prognostic value of Onodera’s Prognostic Nutritional Index(OPNI)for GISTs.METHODS All patients who had undergone surgical resection for a primary,localized GIST from 2009 to 2016 at our cancer center were initially and retrospectively identified.Recurrence-free survival(RFS)was calculated by the Kaplan-Meier method and compared by the log-rank test.We used multivariate Cox proportional hazard regression models to identify associations with outcome variables.RESULTS A total of 235 GISTs were identified and included for analysis under our inclusion criteria.Univariate and multivariate analyses both identified the OPNI as an independent prognostic marker,and the OPNI was associated with the primary site,tumor size,mitotic index,tumor rupture,necrosis,and modified NIH risk classification.Low OPNI(<51.30;hazard ratio=5.852;95% confidence interval:1.072–31.964;P=0.0414)was associated with worse RFS.The 2-and 5-year RFS rates of the patients with a low OPNI were 92.83% and 76.22%,respectively,whereas 100% and 98.41% were achieved by the patients with a high OPNI.CONCLUSION The preoperative OPNI is a novel and useful prognostic marker for GISTs.展开更多
Secretory carcinoma(SC), previously described as mammary analogue secretory carcinoma(MASC), is a recently described salivary gland tumor which morphologically resembles mammary secretory carcinoma. The first descript...Secretory carcinoma(SC), previously described as mammary analogue secretory carcinoma(MASC), is a recently described salivary gland tumor which morphologically resembles mammary secretory carcinoma. The first description of SC/MASC, reported by Skálová et al. in 2010, was as a rare salivary carcinoma imitating secretory carcinoma of the breast. SC/MASC is a unique salivary gland tumor with morphological overlap with acinic cell carcinoma(Aci CC), mucoepidermoid carcinoma(MEC), and adenocarcinoma not otherwise specified(ADCNOS). SC/MASC shares similar clinicopathological features with Aci CC. As a critical difference between SC/MASC and Aci CC, SC/MASC characteristically has the chromosomal translocation t(12;15)(p13;q25) which leads to a fusion gene between the ETV6 gene on chromosome 12 and the NTRK3 gene on chromosome 15. This genetic background is an important differential diagnostic finding for excluding other salivary gland tumors and may be a critical factor determining the prognosis for patients with SC/MASC. Research in recent years has provided a large body of new data on SC/MASC and suggests the possibility that the ETV6-NTRK3 translocation could be a therapeutic target. Here, we review the morphological and clinicopathological features of SC/MASC and discuss new directions for therapy.展开更多
Sekeres et al.(1)conducted a multicenter randomized,controlled trial to compare whether azacitidine-based combinations with lenalidomide or vorinostat produce superior overall response rates to azacitidine in the trea...Sekeres et al.(1)conducted a multicenter randomized,controlled trial to compare whether azacitidine-based combinations with lenalidomide or vorinostat produce superior overall response rates to azacitidine in the treatment of myelodysplastic syndromes(MDS).In that trial,224 patients with higher-risk MDS and 53 with chronic myelomonocytic leukemia(CMML)were展开更多
BACKGROUND Many clinical studies for the long-term survival or efficacy of capecitabine plus oxaliplatin(XELOX)in colon cancer have already been studied,but its clinical benefit is controversial.AIM To evaluate the lo...BACKGROUND Many clinical studies for the long-term survival or efficacy of capecitabine plus oxaliplatin(XELOX)in colon cancer have already been studied,but its clinical benefit is controversial.AIM To evaluate the long-term efficacy of XELOX regimen in comparison with other adjuvant chemotherapy protocols in colon cancer.METHODS By searching the PubMed,EMBASE and Cochrane databases,a total of 12 randomized controlled trials involving 6698 stageⅢcolon cancer cases(XELOX protocol:n=3298 cases;other adjuvant chemotherapy protocol:n=3268 cases)were included.The parameter outcomes included the overall survival and the disease-free survival.The quality control of selected literature was based on the Jadad scale and the GRADE system.RESULTS In comparison to other adjuvant chemotherapy regimen,XELOX regimen showed a better overall survival(odds ratio=1.29,95% confidence interval:1.15-1.44,P<0.0001)and a better disease-free survival(odds ratio=1.32,95%confidence interval:1.18-1.46,P<0.0001)for colon cancer patients,suggesting the XELOX regimen can be a good option for postoperative treatment of stage III colon cancer.CONCLUSION The XELOX regimen can be a preferred option for adjuvant treatment of stageⅢcolon cancer after surgery.展开更多
The Jiangmen Underground Neutrino Observatory(JUNO)is a large liquid scintillator detector designed to explore many topics in fundamental physics.In this study,the potential of searching for proton decay in the p→νK...The Jiangmen Underground Neutrino Observatory(JUNO)is a large liquid scintillator detector designed to explore many topics in fundamental physics.In this study,the potential of searching for proton decay in the p→νK^(+)mode with JUNO is investigated.The kaon and its decay particles feature a clear three-fold coincidence signature that results in a high efficiency for identification.Moreover,the excellent energy resolution of JUNO permits suppression of the sizable background caused by other delayed signals.Based on these advantages,the detection efficiency for the proton decay via p→νK^(+)is 36.9%±4.9%with a background level of 0.2±0.05(syst)±0.2(stat)events after 10 years of data collection.The estimated sensitivity based on 200 kton-years of exposure is 9.6×1033 years,which is competitive with the current best limits on the proton lifetime in this channel and complements the use of different detection technologies.展开更多
BACKGROUND The combination of programmed cell death protein-1(PD-1)inhibitor and che-motherapy is approved as a standard first-or second-line treatment in patients with advanced oesophageal or gastric cancer.However,i...BACKGROUND The combination of programmed cell death protein-1(PD-1)inhibitor and che-motherapy is approved as a standard first-or second-line treatment in patients with advanced oesophageal or gastric cancer.However,it is unclear whether this combination is superior to chemotherapy alone.AIM To assess the comparative effectiveness and tolerability of combining PD-1 inhibitors with chemotherapy vs chemotherapy alone in patients with advanced gastric cancer,gastroesophageal junction(GEJ)cancer,or oesophageal carcinoma.METHODS We searched the PubMed and Embase databases for studies that compared the efficacy and tolerance of PD-1 inhibitors in combination with chemotherapy vs chemotherapy alone in patients with advanced oesophageal or gastric cancer.We employed either random or fixed models to analyze the outcomes of each clinical trial,en-compassing data on overall survival(OS),progression-free survival(PFS),objective response rate,and adverse events(AEs).RESULTS Nine phase 3 clinical trials(7016 advanced oesophageal and gastric cancer patients)met the inclusion criteria.Our meta-analysis demonstrated that the pooled PD-1 inhibitor+chemotherapy group had a significantly longer OS than the chemotherapy-alone group[hazard ratio(HR)=0.76,95%confidence interval(CI):0.71-0.81];the pooled PFS result was consistent with that of OS(HR=0.67,95%CI:0.61-0.74).The count of patients achieving an objective response in the PD-1 inhibitor+chemotherapy group surpassed that of the chemotherapy-alone group[odds ratio(OR)=1.86,95%CI:1.59-2.18].AE incidence was also higher in the combination-therapy group than in the chemotherapy-alone group,regardless of whether≥grade 3 only(OR=1.30,95%CI:1.07-1.57)or all AE grades(OR=1.88,95%CI:1.39-2.54)were examined.We performed a subgroup analysis based on the programmed death-ligand 1(PD-L1)combined positive score(CPS)and noted extended OS and PFS durations within the CPS≥1,CPS≥5,and CPS≥10 subgroups of the PD-1 inhibitor+chemotherapy group.CONCLUSION In contrast to chemotherapy alone,the combination of PD-1 inhibitor and chemotherapy appears to present a more favorable option for initial or subsequent treatment in patients with gastric cancer,GEJ tumor,or oesophageal cancer.This holds true particularly for individuals with PD-L1 CPS scores of≥5 and≥10.展开更多
Auditory neuropathy spectrum disorder is a unique group of hearing dysfunctions characterized by preserved outer hair cell function and abnormal neural conduction of the auditory pathway. However, the pathogenic mecha...Auditory neuropathy spectrum disorder is a unique group of hearing dysfunctions characterized by preserved outer hair cell function and abnormal neural conduction of the auditory pathway. However, the pathogenic mechanism underlying this disorder is not clear. We therefore performed a systematic review of genetic mouse models with different gene mutations to provide a valuable tool for better understanding of the process and the possible molecular mechanisms. Of the 18 articles retrieved, nine met the required criteria. All biochemical, histological, and electrophysiological results were recorded for each of the mouse models, as was the transgenic technology. This review provides a summary of different mouse models that may play an important role in the diagnosis and management of auditory neuropathy spectrum disorder in the future.展开更多
Objective: Chinese rhubarb is a promising Chinese medicine for the promotion of gastrointestinal function. This study was conducted to investigate the safety and efficacy of Chinese rhubarb administered via ultrasound...Objective: Chinese rhubarb is a promising Chinese medicine for the promotion of gastrointestinal function. This study was conducted to investigate the safety and efficacy of Chinese rhubarb administered via ultrasound delivery in promoting the early recovery of gastrointestinal function after gastrectomy.Methods: In this prospective randomized controlled study, 100 patients who were scheduled to undergo total or subtotal gastrectomy in Changzhi People’s Hospital or Subei People’s Hospital from August 2017 to January 2018 were recruited. These patients were randomly assigned into two equal groups before surgery: 50 in the experimental (Chinese rhubarb) group, and 50 in the control (routine nursing) group. After surgery, time to flatus, bowel movement, clear liquid diet, and removal of nasogastric tube were recorded and analyzed. In addition, postoperative pain, postoperative bowel movement-related complications, and postoperative hospital stay duration were also recorded and analyzed. The study was approved by The protocol was approved by the Institutional Review Board of Changzhi People’s Hospital and Subei People’s Hospital on July 1, 2017 and registered with the Chinese Clinical Trial Registry on December 17, 2018 (registration number: ChiCTR1800020143).Results: Time to flatus (control group 85.68±22.00 hours vs experimental group 73.06±23.42 hours;P=0.007), bowel movement (5.52±1.56 vs 4.40±1.21 days;P<0.001), clear liquid diet (6.72±1.16 vs 6.22±1.28 days;P=0.044), and removal of nasogastric tube (6.30±1.52 vs 5.65±1.58 days;P=0.044) were significantly shorter in the experimental group compared with the control group, as was the postoperative hospital stay duration (14.30±3.46 vs 12.86±1.36 days;P=0.006). In addition, better pain relief (P=0.003) and a lower incidence of postoperative bowel movement-related complications (6 vs 21;P=0.001) were noted in the experimental group.Conclusion: Ultrasound delivery of Chinese rhubarb is useful to promote the early recovery of gastrointestinal function after gastrectomy.展开更多
Hereditary hearing loss is one of the most common neurosensory defects in humans.Approximately 70%of cases are nonsyndromic and could be inherited in autosomal dominant, autosomal recessive,mitochondrial,X-linked,and ...Hereditary hearing loss is one of the most common neurosensory defects in humans.Approximately 70%of cases are nonsyndromic and could be inherited in autosomal dominant, autosomal recessive,mitochondrial,X-linked,and Y-linked manners(Wang et al.,2004;Alford,2011).The autosomal dominant type,comprising 15%-20%of nonsyndromic hearing loss,is monogenic and genetically heterogeneous.Since the first dominant deafness展开更多
JUNO is a multi-purpose neutrino observatory under construction in the south of China.This publication presents new sensitivity estimates for the measurement of the △m_(31)^(2),△m_(21)^(2),sin^(2)θ_(12),and sin^(2)...JUNO is a multi-purpose neutrino observatory under construction in the south of China.This publication presents new sensitivity estimates for the measurement of the △m_(31)^(2),△m_(21)^(2),sin^(2)θ_(12),and sin^(2)θ_(13) oscillation parameters using reactor antineutrinos,which is one of the primary physics goals of the experiment.The sensitivities are obtained using the best knowledge available to date on the location and overburden of the experimental site,the nuclear reactors in the surrounding area and beyond,the detector response uncertainties,and the reactor antineutrino spectral shape constraints expected from the TAO satellite detector.It is found that the △m_(21)^(2) and sin^(2)θ_(12) oscillation parameters will be determined to 0.5%precision or better in six years of data collection.In the same period,the △m_(31)^(2) parameter will be determined to about 0.2%precision for each mass ordering hypothesis.The new precision represents approximately an order of magnitude improvement over existing constraints for these three parameters.展开更多
The Jiangmen Underground Neutrino Observatory(JUNO)features a 20 kt multi-purpose underground liquid scintillator sphere as its main detector.Some of JUNO's features make it an excellent location for^8B solar neut...The Jiangmen Underground Neutrino Observatory(JUNO)features a 20 kt multi-purpose underground liquid scintillator sphere as its main detector.Some of JUNO's features make it an excellent location for^8B solar neutrino measurements,such as its low-energy threshold,high energy resolution compared with water Cherenkov detectors,and much larger target mass compared with previous liquid scintillator detectors.In this paper,we present a comprehensive assessment of JUNO's potential for detecting^8B solar neutrinos via the neutrino-electron elastic scattering process.A reduced 2 MeV threshold for the recoil electron energy is found to be achievable,assuming that the intrinsic radioactive background^(238)U and^(232)Th in the liquid scintillator can be controlled to 10^(-17)g/g.With ten years of data acquisition,approximately 60,000 signal and 30,000 background events are expected.This large sample will enable an examination of the distortion of the recoil electron spectrum that is dominated by the neutrino flavor transformation in the dense solar matter,which will shed new light on the inconsistency between the measured electron spectra and the predictions of the standard three-flavor neutrino oscillation framework.IfDelta m^(2)_(21)=4.8times10^(-5);(7.5times10^(-5))eV^(2),JUNO can provide evidence of neutrino oscillation in the Earth at approximately the 3sigma(2sigma)level by measuring the non-zero signal rate variation with respect to the solar zenith angle.Moreover,JUNO can simultaneously measureDelta m^2_(21)using^8B solar neutrinos to a precision of 20% or better,depending on the central value,and to sub-percent precision using reactor antineutrinos.A comparison of these two measurements from the same detector will help understand the current mild inconsistency between the value of Delta m^2_(21)reported by solar neutrino experiments and the KamLAND experiment.展开更多
Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasm of the digestive system and are not sensitive to traditional chemotherapy. Therefore, historically, surgical resection was the only effe...Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasm of the digestive system and are not sensitive to traditional chemotherapy. Therefore, historically, surgical resection was the only effective therapy. However, the emergence of tyrosine kinase inhibitors (TKIs) has revolutionized the treatment of GISTs, because they target c-Kit and PDGF receptor-α (PDGFRA), which are important in GIST development and progression. As research into c-Kit and PDGFRA continues, an increasing number of different TKIs are being used in the clinical setting. This review aims to discuss the current state of chemotherapy for the treatment of GISTs with different genotypes.展开更多
Objective:To identify risk factors for anastomotic leakage after gastrectomy in patients with Siewert type II/III adenocarcinoma(AEG)of the esophagogastric junction.Methods:This was a retrospective case-control study ...Objective:To identify risk factors for anastomotic leakage after gastrectomy in patients with Siewert type II/III adenocarcinoma(AEG)of the esophagogastric junction.Methods:This was a retrospective case-control study of 903 patients with Siewert type II/III AEG treated from January 2012 to January 2015 at the Shanxi Cancer Hospital in China.All patients underwent gastrectomy,and their clinical characteristics were analyzed to identify associations with anastomotic leakage.Independent risk factors were identified by binary logistic regression.The 2-year disease-free survival was calculated and compared between patients with anastomotic leakage and control patients.The study was approved by the Institutional Review Board of Shanxi Medical University(approval No.2014-09-39)on September 19,2014.Results:Out of the 903 patients were included in the study,80(8.86%,80/903)experienced anastomotic leakage.The mortality rate attributed to anastomotic leakage was 8.75%(7/80).Logistic regression analysis revealed that preoperative hypoalbuminemia(odds ratio(OR)=3.249,95%confidence interval(CI):1.569-6.725,P=0.002),type of reconstruction(OR=1.795,95%CI:1.026-3.142,P=0.040),and combined organ resection(OR=1.807,95%CI:1.069-3.055,P=0.027)were independent risk factors for anastomotic leakage.Conclusion:Preoperative hypoalbuminemia,type of reconstruction,and combined organ resection were identified as risk factors for anastomotic leakage in patients undergoing gastrectomy for Siewert type Ⅱ/Ⅲ AEG.展开更多
文摘BACKGROUND: Currently, prophylactic antibiotics are recommended only for cirrhotic patients with acute upper gastrointestinal bleeding(AUGIB);however, the benefit for other AUGIB patients remains undetermined. We aimed to compare the clinical outcomes between patients with AUGIB with and without prophylactic antibiotics to identify the population that requires this therapy.METHODS: Patients with AUGIB admitted between 1st January 2019 and 31st December 2021 in the Emergency Department of Peking Union Medical College Hospital were enrolled. Patients were divided into the antibiotic and non-antibiotic groups. The primary outcome was in-hospital mortality, and the secondary outcome was the onset of new infection. The risk factors for mortality and infection were analyzed, and stratification analysis of prophylactic antibiotics was performed. Continuous data were analyzed using the t-test or nonparametric rank sum test, and categorical data were analyzed using the Chi-square test or Fisher's exact test. Indicators with significant differences between the groups were included for logistic regression analysis. A P-value <0.05 was considered statistically significant. RESULTS: A total of 392 individuals were included, among them, 281 patients received prophylactic antibiotics, and 111 patients did not receive prophylactic antibiotics. The mortality rates were significantly lower in the antibiotic group than in the non-antibiotics group(6.41% vs. 17.12%, P=0.001). The risk factors for infection were varicose veins(P=0.045) and endotracheal intubation(P=0.005) in the prophylactic antibiotic group, and endoscopic treatment(P=0.010) in the non-prophylactic antibiotic group. Stratified analyses showed that patients with age ≥ 65 years, endotracheal intubation, endoscopic treatment, and AUGIB of variceal etiologies benefited from prophylactic antibiotics.CONCLUSION: AUGIB patients may benefit from prophylactic antibiotics to decrease mortality, especially those aged ≥ 65 years and those with endotracheal intubation, endoscopic treatment, and variceal etiologies.
文摘Primary esophageal or gastric melanoma is a very rare disease with early metastasis. Due to its atypical symptom and less efficiency of chemotherapy and radiotherapy, the prognosis of esophageal or gastric melanoma is still very poor. Surgical resection remains the preferential treatment for esophageal or gastric melanoma. Here we present an extremely rare case of primary advanced esophago-gastric melanoma. Debulking surgery was performed without chemotherapy or radiotherapy. However, abdominal recurrence and hepatic metastases were found within one month by a postoperative follow-up computed tomography. Three and a half months after surgical resection, the patient died of extensive abdominal metastasis.
文摘Extrathoracic solitary fibrous tumors(SFTs) have been described at almost every anatomic location of human body,but reports of SFT in the abdominal cavity are rare.We herein present a rare case of SFT originating from greater omentum.Computed tomography revealed a 15.8 cm × 21.0 cm solid mass located at superior aspect of stomach.Open laparotomy confirmed its mesenchymal origin.Microscopically,its tissue was composed of non-organized and spindle-shaped cells exhibiting atypical nuclei,which were divided up by branching vessel and collagen bundles.Immunohistochemical staining showed that this tumor was negative for CD117,CD99,CD68,cytokeratin,calretinin,desmin,epithelial membrane antigen,F8 and S-100,but positive for CD34,bcl-2,α-smooth muscle actin and vimentin.The patient presented no evidence of recurrence during follow-up.SFT arising from abdominal cavity can be diagnosed by histological findings and immunohistochemical markers,especially for CD34 and bcl-2 positive cases.
文摘AIM:To evaluate human epidermal growth factor receptor 2(HER2)and death decoy receptor(DcR3)as colorectal cancer prognostic indicators.METHODS:Colorectal carcinoma specimens from 300patients were analyzed by immunohistochemistry to detect the staining patterns of HER2 and DcR3.Classification of HER2 staining was carried out using the United States Food and Drug Administration semi-quantitative scoring system,with scores of 0 or 1+indicating a tumor-negative(normal expression)status and scores of 2+and 3+indicating a tumor-positive(overexpression)status.Classification of DcR3 was carried out by quantitating the percentage of positive cells within the stained section,with<10%indicating a tumor-negative status and≥10%indicating a tumor-positive status.Correlation of the HER2 and DcR3 staining status with clinicopathological parameters[age,sex,tumor size,differentiation,and the tumor,node,metastasis(pTNM)classification]and survival was statistically assessed.RESULTS:Tumor-positive status for HER2 and DcR3was found in 18.33%and 58.33%of the 300 colorectal carcinoma specimens,respectively.HER2 tumorpositive status showed a significant correlation with tumor size(P=0.003)but not with other clinicopathological parameters.DcR3 tumor-positive status showed a significant correlation with tumor differentiation(P<0.001),pTNM stage(P<0.001),and lymph node metastasis(P<0.001).However,correlation coefficient analysis did not indicate that a statistically significant correlation exists between tumor-positive status for the HER2 and DcR3 overexpression(P=0.236).Patients with specimens classified as DcR3-overexpressing had a significantly worse overall survival(OS)rate than those without DcR3 overexpression(median OS:42.11vs 61.21 mo;HR=50.27,95%CI:44.90-55.64,P<0.001).HER2 overexpression had no significant impact on median OS(35.10 mo vs 45.25 mo;HR=44.40,95%CI:39.32-49.48,P=0.344).However,patients with specimens classified as both HER2-and DcR3-overexpressing had a significantly poorer median OS than those with only HER2 overexpression(31.80 mo vs 52.20 mo;HR=35.10,95%CI:22.04-48.16,P=0.006).CONCLUSION:HER2 overexpression is not an independent prognostic marker of colorectal cancer,but DcR3 overexpression is highly correlated with lymph node metastasis and poor OS.
文摘Ameloblastoma is a benign but locally aggressive odontogenie neoplasm that accounts for 10% of all tumors arising in the mandible and maxilla (1).Eighty percent of ameloblastomas arise in the mandible,and they are usually found in young adults.It frequently recurs if not adequately resected.Therefore,the standard therapy for this tumor is complete bone resection with an adequate margin of safety: marginal or segmental osteotomy.However,aesthetic deformities,functional impairments and psychological impairments after radical surgery for large ameloblastoma, have been serious issues (1).
基金Supported by Health Commission of Shanxi Province,No.2020130 and No.2020TD27the Science and Technology Planning Project of Yangzhou City,No.YZ2018092。
文摘BACKGROUND Immunoinflammatory markers such as the peripheral blood neutrophil-tolymphocyte ratio(NLR)and the platelet-to-lymphocyte ratio(PLR)have gained considerable attention as prognostic markers in gastrointestinal stromal tumors(GISTs).AIM To assess the prognostic value of Onodera’s Prognostic Nutritional Index(OPNI)for GISTs.METHODS All patients who had undergone surgical resection for a primary,localized GIST from 2009 to 2016 at our cancer center were initially and retrospectively identified.Recurrence-free survival(RFS)was calculated by the Kaplan-Meier method and compared by the log-rank test.We used multivariate Cox proportional hazard regression models to identify associations with outcome variables.RESULTS A total of 235 GISTs were identified and included for analysis under our inclusion criteria.Univariate and multivariate analyses both identified the OPNI as an independent prognostic marker,and the OPNI was associated with the primary site,tumor size,mitotic index,tumor rupture,necrosis,and modified NIH risk classification.Low OPNI(<51.30;hazard ratio=5.852;95% confidence interval:1.072–31.964;P=0.0414)was associated with worse RFS.The 2-and 5-year RFS rates of the patients with a low OPNI were 92.83% and 76.22%,respectively,whereas 100% and 98.41% were achieved by the patients with a high OPNI.CONCLUSION The preoperative OPNI is a novel and useful prognostic marker for GISTs.
文摘Secretory carcinoma(SC), previously described as mammary analogue secretory carcinoma(MASC), is a recently described salivary gland tumor which morphologically resembles mammary secretory carcinoma. The first description of SC/MASC, reported by Skálová et al. in 2010, was as a rare salivary carcinoma imitating secretory carcinoma of the breast. SC/MASC is a unique salivary gland tumor with morphological overlap with acinic cell carcinoma(Aci CC), mucoepidermoid carcinoma(MEC), and adenocarcinoma not otherwise specified(ADCNOS). SC/MASC shares similar clinicopathological features with Aci CC. As a critical difference between SC/MASC and Aci CC, SC/MASC characteristically has the chromosomal translocation t(12;15)(p13;q25) which leads to a fusion gene between the ETV6 gene on chromosome 12 and the NTRK3 gene on chromosome 15. This genetic background is an important differential diagnostic finding for excluding other salivary gland tumors and may be a critical factor determining the prognosis for patients with SC/MASC. Research in recent years has provided a large body of new data on SC/MASC and suggests the possibility that the ETV6-NTRK3 translocation could be a therapeutic target. Here, we review the morphological and clinicopathological features of SC/MASC and discuss new directions for therapy.
文摘Sekeres et al.(1)conducted a multicenter randomized,controlled trial to compare whether azacitidine-based combinations with lenalidomide or vorinostat produce superior overall response rates to azacitidine in the treatment of myelodysplastic syndromes(MDS).In that trial,224 patients with higher-risk MDS and 53 with chronic myelomonocytic leukemia(CMML)were
文摘BACKGROUND Many clinical studies for the long-term survival or efficacy of capecitabine plus oxaliplatin(XELOX)in colon cancer have already been studied,but its clinical benefit is controversial.AIM To evaluate the long-term efficacy of XELOX regimen in comparison with other adjuvant chemotherapy protocols in colon cancer.METHODS By searching the PubMed,EMBASE and Cochrane databases,a total of 12 randomized controlled trials involving 6698 stageⅢcolon cancer cases(XELOX protocol:n=3298 cases;other adjuvant chemotherapy protocol:n=3268 cases)were included.The parameter outcomes included the overall survival and the disease-free survival.The quality control of selected literature was based on the Jadad scale and the GRADE system.RESULTS In comparison to other adjuvant chemotherapy regimen,XELOX regimen showed a better overall survival(odds ratio=1.29,95% confidence interval:1.15-1.44,P<0.0001)and a better disease-free survival(odds ratio=1.32,95%confidence interval:1.18-1.46,P<0.0001)for colon cancer patients,suggesting the XELOX regimen can be a good option for postoperative treatment of stage III colon cancer.CONCLUSION The XELOX regimen can be a preferred option for adjuvant treatment of stageⅢcolon cancer after surgery.
基金supported by the Chinese Academy of Sciencesthe National Key R&D Program of China+22 种基金the CAS Center for Excellence in Particle PhysicsWuyi Universitythe Tsung-Dao Lee Institute of Shanghai Jiao Tong University in Chinathe Institut National de Physique Nucléaire et de Physique de Particules (IN2P3) in Francethe Istituto Nazionale di Fisica Nucleare (INFN) in Italythe Italian-Chinese collaborative research program MAECI-NSFCthe Fond de la Recherche Scientifique (F.R.S-FNRS)FWO under the "Excellence of Science-EOS" in Belgiumthe Conselho Nacional de Desenvolvimento Científico e Tecnològico in Brazilthe Agencia Nacional de Investigacion y Desarrollo in Chilethe Charles University Research Centrethe Ministry of Education,Youth,and Sports in Czech Republicthe Deutsche Forschungsgemeinschaft (DFG)the Helmholtz Associationthe Cluster of Excellence PRISMA+ in Germanythe Joint Institute of Nuclear Research (JINR)Lomonosov Moscow State University in Russiathe joint Russian Science Foundation (RSF)National Natural Science Foundation of China (NSFC) research programthe MOST and MOE in Taiwan,Chinathe Chulalongkorn UniversitySuranaree University of Technology in Thailandthe University of California at Irvine in USA
文摘The Jiangmen Underground Neutrino Observatory(JUNO)is a large liquid scintillator detector designed to explore many topics in fundamental physics.In this study,the potential of searching for proton decay in the p→νK^(+)mode with JUNO is investigated.The kaon and its decay particles feature a clear three-fold coincidence signature that results in a high efficiency for identification.Moreover,the excellent energy resolution of JUNO permits suppression of the sizable background caused by other delayed signals.Based on these advantages,the detection efficiency for the proton decay via p→νK^(+)is 36.9%±4.9%with a background level of 0.2±0.05(syst)±0.2(stat)events after 10 years of data collection.The estimated sensitivity based on 200 kton-years of exposure is 9.6×1033 years,which is competitive with the current best limits on the proton lifetime in this channel and complements the use of different detection technologies.
文摘BACKGROUND The combination of programmed cell death protein-1(PD-1)inhibitor and che-motherapy is approved as a standard first-or second-line treatment in patients with advanced oesophageal or gastric cancer.However,it is unclear whether this combination is superior to chemotherapy alone.AIM To assess the comparative effectiveness and tolerability of combining PD-1 inhibitors with chemotherapy vs chemotherapy alone in patients with advanced gastric cancer,gastroesophageal junction(GEJ)cancer,or oesophageal carcinoma.METHODS We searched the PubMed and Embase databases for studies that compared the efficacy and tolerance of PD-1 inhibitors in combination with chemotherapy vs chemotherapy alone in patients with advanced oesophageal or gastric cancer.We employed either random or fixed models to analyze the outcomes of each clinical trial,en-compassing data on overall survival(OS),progression-free survival(PFS),objective response rate,and adverse events(AEs).RESULTS Nine phase 3 clinical trials(7016 advanced oesophageal and gastric cancer patients)met the inclusion criteria.Our meta-analysis demonstrated that the pooled PD-1 inhibitor+chemotherapy group had a significantly longer OS than the chemotherapy-alone group[hazard ratio(HR)=0.76,95%confidence interval(CI):0.71-0.81];the pooled PFS result was consistent with that of OS(HR=0.67,95%CI:0.61-0.74).The count of patients achieving an objective response in the PD-1 inhibitor+chemotherapy group surpassed that of the chemotherapy-alone group[odds ratio(OR)=1.86,95%CI:1.59-2.18].AE incidence was also higher in the combination-therapy group than in the chemotherapy-alone group,regardless of whether≥grade 3 only(OR=1.30,95%CI:1.07-1.57)or all AE grades(OR=1.88,95%CI:1.39-2.54)were examined.We performed a subgroup analysis based on the programmed death-ligand 1(PD-L1)combined positive score(CPS)and noted extended OS and PFS durations within the CPS≥1,CPS≥5,and CPS≥10 subgroups of the PD-1 inhibitor+chemotherapy group.CONCLUSION In contrast to chemotherapy alone,the combination of PD-1 inhibitor and chemotherapy appears to present a more favorable option for initial or subsequent treatment in patients with gastric cancer,GEJ tumor,or oesophageal cancer.This holds true particularly for individuals with PD-L1 CPS scores of≥5 and≥10.
基金This work was supported by the grants from the National Key Basic Research Program of China （No.2014CB943001）, the National Natural Science Foundation of China （No. 81120108009 and No. 81530032）, and the China Postdoctoral Science Foundation （No.2015M572690）.
基金supported by the National Key Basic Research Program of China (2014CB943001)the National Natural Science Foundation of China (81120108009, 81530032)
文摘Auditory neuropathy spectrum disorder is a unique group of hearing dysfunctions characterized by preserved outer hair cell function and abnormal neural conduction of the auditory pathway. However, the pathogenic mechanism underlying this disorder is not clear. We therefore performed a systematic review of genetic mouse models with different gene mutations to provide a valuable tool for better understanding of the process and the possible molecular mechanisms. Of the 18 articles retrieved, nine met the required criteria. All biochemical, histological, and electrophysiological results were recorded for each of the mouse models, as was the transgenic technology. This review provides a summary of different mouse models that may play an important role in the diagnosis and management of auditory neuropathy spectrum disorder in the future.
基金This work was supported by the Jiangsu Natural Science Foundation(No.BK20180274,to LZ).
文摘Objective: Chinese rhubarb is a promising Chinese medicine for the promotion of gastrointestinal function. This study was conducted to investigate the safety and efficacy of Chinese rhubarb administered via ultrasound delivery in promoting the early recovery of gastrointestinal function after gastrectomy.Methods: In this prospective randomized controlled study, 100 patients who were scheduled to undergo total or subtotal gastrectomy in Changzhi People’s Hospital or Subei People’s Hospital from August 2017 to January 2018 were recruited. These patients were randomly assigned into two equal groups before surgery: 50 in the experimental (Chinese rhubarb) group, and 50 in the control (routine nursing) group. After surgery, time to flatus, bowel movement, clear liquid diet, and removal of nasogastric tube were recorded and analyzed. In addition, postoperative pain, postoperative bowel movement-related complications, and postoperative hospital stay duration were also recorded and analyzed. The study was approved by The protocol was approved by the Institutional Review Board of Changzhi People’s Hospital and Subei People’s Hospital on July 1, 2017 and registered with the Chinese Clinical Trial Registry on December 17, 2018 (registration number: ChiCTR1800020143).Results: Time to flatus (control group 85.68±22.00 hours vs experimental group 73.06±23.42 hours;P=0.007), bowel movement (5.52±1.56 vs 4.40±1.21 days;P<0.001), clear liquid diet (6.72±1.16 vs 6.22±1.28 days;P=0.044), and removal of nasogastric tube (6.30±1.52 vs 5.65±1.58 days;P=0.044) were significantly shorter in the experimental group compared with the control group, as was the postoperative hospital stay duration (14.30±3.46 vs 12.86±1.36 days;P=0.006). In addition, better pain relief (P=0.003) and a lower incidence of postoperative bowel movement-related complications (6 vs 21;P=0.001) were noted in the experimental group.Conclusion: Ultrasound delivery of Chinese rhubarb is useful to promote the early recovery of gastrointestinal function after gastrectomy.
基金supported by the grants from the National Natural Science Foundation of China,key project(No.30830104) and major project(No.81120108009)
文摘Hereditary hearing loss is one of the most common neurosensory defects in humans.Approximately 70%of cases are nonsyndromic and could be inherited in autosomal dominant, autosomal recessive,mitochondrial,X-linked,and Y-linked manners(Wang et al.,2004;Alford,2011).The autosomal dominant type,comprising 15%-20%of nonsyndromic hearing loss,is monogenic and genetically heterogeneous.Since the first dominant deafness
基金Supported by the Chinese Academy of Sciencesthe National Key R&D Program of China+18 种基金the CAS Center for Excellence in Particle Physics,Wuyi Universitythe Tsung-Dao Lee Institute of Shanghai Jiao Tong University in Chinathe Institut National de Physique Nucléaire et de Physique de Particules(IN2P3)in Francethe Istituto Nazionale di Fisica Nucleare(INFN)in Italythe Italian-Chinese collaborative research program MAECI-NSFCthe Fond de la Recherche Scientifique(F.R.S-FNRS)FWO under the“Excellence of Science-EOS in Belgium”the Conselho Nacional de Desenvolvimento Científico e Tecnològico in Brazilthe Agencia Nacional de Investigacion y Desarrollo and ANID-Millennium Science Initiative Program-ICN2019_044 in Chilethe Charles University Research Centre and the Ministry of Education,Youth,and Sports in Czech Republicthe Deutsche Forschungsgemeinschaft(DFG)the Helmholtz Associationthe Cluster of Excellence PRISMA+in Germanythe Joint Institute of Nuclear Research(JINR)and Lomonosov Moscow State University in Russiathe joint Russian Science Foundation(RSF)National Natural Science Foundation of China(NSFC)research programthe MOST and MOE in Taiwanthe Chulalongkorn University and Suranaree University of Technology in Thailand,University of California at Irvinethe National Science Foundation in USA。
文摘JUNO is a multi-purpose neutrino observatory under construction in the south of China.This publication presents new sensitivity estimates for the measurement of the △m_(31)^(2),△m_(21)^(2),sin^(2)θ_(12),and sin^(2)θ_(13) oscillation parameters using reactor antineutrinos,which is one of the primary physics goals of the experiment.The sensitivities are obtained using the best knowledge available to date on the location and overburden of the experimental site,the nuclear reactors in the surrounding area and beyond,the detector response uncertainties,and the reactor antineutrino spectral shape constraints expected from the TAO satellite detector.It is found that the △m_(21)^(2) and sin^(2)θ_(12) oscillation parameters will be determined to 0.5%precision or better in six years of data collection.In the same period,the △m_(31)^(2) parameter will be determined to about 0.2%precision for each mass ordering hypothesis.The new precision represents approximately an order of magnitude improvement over existing constraints for these three parameters.
基金This work was supported by the Chinese Academy of Sciences,the National Key R&D Program of China,the CAS Center for Excellence in Particle Physics,the Joint Large Scale Scientific Facility Funds of the NSFC and CAS,Wuyi University,and the Tsung-Dao Lee Instiute of Shanghai Jiao Tong University in China,the In stiut National de Physique Nucleaire et de Physique de Particules(IN2P3)in France,the Istituto Nazionale di Fisica Nucleare(INFN)in Italy,the Fond de la Recherche Scintifique(F.R.S-FNRS)and FWO under the"Excellence of Science-EOS"in Belgium,the Conselho Nacional de Desenvolvimento Cientificoce Tecnologico in Brazil,the Agencia Nacional de Investigacion y Desrrollo in Chile,the Charles University Research Centre and the Ministry of Education,Youth,and Sports in Czech Republic,the Deutsche Forschungsgemeinschaft(DFG),the Helmholtz Association,and the Cluster of Exellence PRISMA+in Germany,the Joint Institute of Nuclear Research(JINR),Lomonosov Moscow State University,and Russian Foundation for Basic Research(RFBR)in Russia,the MOST and MOE in Taiwan,the Chu-lalongkorm University and Suranaree University of Technology in Thailand,and the University of aliformia at Irvine in USA.
文摘The Jiangmen Underground Neutrino Observatory(JUNO)features a 20 kt multi-purpose underground liquid scintillator sphere as its main detector.Some of JUNO's features make it an excellent location for^8B solar neutrino measurements,such as its low-energy threshold,high energy resolution compared with water Cherenkov detectors,and much larger target mass compared with previous liquid scintillator detectors.In this paper,we present a comprehensive assessment of JUNO's potential for detecting^8B solar neutrinos via the neutrino-electron elastic scattering process.A reduced 2 MeV threshold for the recoil electron energy is found to be achievable,assuming that the intrinsic radioactive background^(238)U and^(232)Th in the liquid scintillator can be controlled to 10^(-17)g/g.With ten years of data acquisition,approximately 60,000 signal and 30,000 background events are expected.This large sample will enable an examination of the distortion of the recoil electron spectrum that is dominated by the neutrino flavor transformation in the dense solar matter,which will shed new light on the inconsistency between the measured electron spectra and the predictions of the standard three-flavor neutrino oscillation framework.IfDelta m^(2)_(21)=4.8times10^(-5);(7.5times10^(-5))eV^(2),JUNO can provide evidence of neutrino oscillation in the Earth at approximately the 3sigma(2sigma)level by measuring the non-zero signal rate variation with respect to the solar zenith angle.Moreover,JUNO can simultaneously measureDelta m^2_(21)using^8B solar neutrinos to a precision of 20% or better,depending on the central value,and to sub-percent precision using reactor antineutrinos.A comparison of these two measurements from the same detector will help understand the current mild inconsistency between the value of Delta m^2_(21)reported by solar neutrino experiments and the KamLAND experiment.
基金This work was supported by the Wu Jieping Medical Foundation(Nos.320.6750.2020-11-5 and 320.6750.2020-11-6)the Health commission of Shanxi Province(Nos.2020130 and 2020TD27).
文摘Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasm of the digestive system and are not sensitive to traditional chemotherapy. Therefore, historically, surgical resection was the only effective therapy. However, the emergence of tyrosine kinase inhibitors (TKIs) has revolutionized the treatment of GISTs, because they target c-Kit and PDGF receptor-α (PDGFRA), which are important in GIST development and progression. As research into c-Kit and PDGFRA continues, an increasing number of different TKIs are being used in the clinical setting. This review aims to discuss the current state of chemotherapy for the treatment of GISTs with different genotypes.
基金the Wu Jieping Medical Foundation(Nos.320.6750.2020-11-5 and 320.6750.2020-11-6)Key Research and Development(R&D)Projects of Shanxi Province(No.201703D321008).
文摘Objective:To identify risk factors for anastomotic leakage after gastrectomy in patients with Siewert type II/III adenocarcinoma(AEG)of the esophagogastric junction.Methods:This was a retrospective case-control study of 903 patients with Siewert type II/III AEG treated from January 2012 to January 2015 at the Shanxi Cancer Hospital in China.All patients underwent gastrectomy,and their clinical characteristics were analyzed to identify associations with anastomotic leakage.Independent risk factors were identified by binary logistic regression.The 2-year disease-free survival was calculated and compared between patients with anastomotic leakage and control patients.The study was approved by the Institutional Review Board of Shanxi Medical University(approval No.2014-09-39)on September 19,2014.Results:Out of the 903 patients were included in the study,80(8.86%,80/903)experienced anastomotic leakage.The mortality rate attributed to anastomotic leakage was 8.75%(7/80).Logistic regression analysis revealed that preoperative hypoalbuminemia(odds ratio(OR)=3.249,95%confidence interval(CI):1.569-6.725,P=0.002),type of reconstruction(OR=1.795,95%CI:1.026-3.142,P=0.040),and combined organ resection(OR=1.807,95%CI:1.069-3.055,P=0.027)were independent risk factors for anastomotic leakage.Conclusion:Preoperative hypoalbuminemia,type of reconstruction,and combined organ resection were identified as risk factors for anastomotic leakage in patients undergoing gastrectomy for Siewert type Ⅱ/Ⅲ AEG.
