In recent years,the occurrence of rice Chilo suppressalis( Walker) in Longyou County of Zhejiang Province has increased year by year and has become aggravated. This poses a great threat to the safety of rice productio...In recent years,the occurrence of rice Chilo suppressalis( Walker) in Longyou County of Zhejiang Province has increased year by year and has become aggravated. This poses a great threat to the safety of rice production. In order to curb the recurrence momentum of rice C. suppressalis,according to the dynamic monitoring and field system survey of rice C. suppressalis in Longyou County since 2015,the causes of the annual increase of rice C. suppressalis in recent years were analyzed,and the recurrence area of C. suppressalis was introduced,and finally some prevention and control measures were put forward.展开更多
BACKGROUND In children, it is common to see failure and recurrence in the correction ofepiblepharon and to have reoperation due to obvious irritation symptoms andcorneal injury.AIM To explore the causes of failure and...BACKGROUND In children, it is common to see failure and recurrence in the correction ofepiblepharon and to have reoperation due to obvious irritation symptoms andcorneal injury.AIM To explore the causes of failure and recurrence after epiblepharon correction inchildren, to remove accurately redundant epiblepharon and orbicularis oculimuscle in patients via the cilia-everting suture technique combined with lidmargin splitting in some patients due to inverted lashes in the medial part of theeyelid, and to observe the therapeutic effect.METHODS From 2015 to 2019, in the Outpatient Department of Ophthalmology of BeijingTongren Hospital, 22 children (40 eyes) with epiblepharon, aged 5-12 years, weretreated due to correction failure and recurrence. Fourteen patients (28 eyes)underwent the full-thickness everting suture technique, and eight patients (16eyes) underwent incisional surgery. They were treated by reviewing the previoussurgical methods and observing epiblepharon, eyelash direction, and cornealinjury. During reoperation, a subciliary incision was made 1 mm below theinferior lash line. Incisional surgery for the lower eyelid was used to removeaccurately redundant epiblepharon and part of the pretarsal orbicularis muscle.Subcutaneous tissue and the orbicularis muscle of the upper skin-muscle flapwere anchored to the anterior fascia of the tarsal plate by rotational sutures. Lidmargin splitting was used only for patients who had seriously inverted lasheslocated in the medial part of the eyelid. All patients were followed for 6-12 moafter reoperation to observe the lower eyelid position, skin incision, eyelash direction, corneal damage, and recurrence.RESULTS After reoperation, all the patients were corrected. Photophobia, rubbing the eye,winking, and tearing disappeared. There was no lower eyelid entropion,ectropion, or retraction. There was no obvious sunken scar or lower eyelid crease.The eyelashes were far away from the cornea, and when the patients lookeddown, the eyelashes on the lower eyelid did not contact the cornea or conjunctiva.The corneal injuries were repaired. Follow-up observation for 6 mo showed norecurrence of epiblepharon.CONCLUSION The type of suture method, the failure to remove accurately redundant skin andorbicularis muscle, the lack of cilia rotational suture use, and excessive reversegrowth of eyelashes are the main causes of failure and recurrence afterepiblepharon correction in children.展开更多
Natural disasters usually involve a phenomenon with consequences that exceed the response capabilities of local communities and have a significant impact on the region’s socioeconomic development. Droughts, floods, a...Natural disasters usually involve a phenomenon with consequences that exceed the response capabilities of local communities and have a significant impact on the region’s socioeconomic development. Droughts, floods, and hurricanes are all natural disasters that jeopardize the environment and the lives of Somalis. Severe floods have devastated the south and central parts of the country multiple times, destroying infrastructure and homes and killing many vulnerable people. Droughts in the south and central parts of the country, particularly in the Middle Shebelle region, have killed a number of children and mothers. It also had a negative influence on crops and cattle. Objective of this study is to know the recurrence of Natural Disasters in Jowhar, Middle Shabelle region, Somalia: The Causes and Impacts. The Somali people are completely aware of natural disasters such as droughts and floods, and they are self-sufficient in dealing with the consequences of these disasters. Furthermore, the Somali government has not fully created environmental laws to protect and conserve the environment, and the majority of laws, rules, acts, and regulations are not used or administered effectively. We also found that the Somali government is not yet financially prepared to deal with these crises, and that there are no strategic plans in the central government or even state administrations to prevent or at least control these disasters from causing extreme harm to the community and the environment.展开更多
AIM To study the local recurrent rate and the causes of rectal cancer after surgery. METHODS The clinicopathological data of 213 rectal cancer patients and the follow up information were analyzed. The overall recu...AIM To study the local recurrent rate and the causes of rectal cancer after surgery. METHODS The clinicopathological data of 213 rectal cancer patients and the follow up information were analyzed. The overall recurrent rate and the recurrent rates from different surgical appreaches were calculated. The main causes of recurrence were investigated. RESULTS Among the 213 cases, 73 (34 27%) had local recurrence. The recurrent time ranged from 3 months to 62 months after the first operation. Most of the recurrence ( 65/73 , 89 04%) occurred within 3 years after operation. CONCLUSION Local recurrence had no significant correlation with surgical methods or pathological types, but closely related to Dukes′ stages, location of primary tumors and the length of the distal rectum resected. Early resection and a wide tumor free resection margin are key factors to prevent local recurrence.展开更多
BACKGROUND Unicompartmental knee arthroplasty(UKA)has great advantages in the treatment of unicompartmental knee osteoarthritis,but its revision rate is higher than that of total knee arthroplasty.AIM To summarize and...BACKGROUND Unicompartmental knee arthroplasty(UKA)has great advantages in the treatment of unicompartmental knee osteoarthritis,but its revision rate is higher than that of total knee arthroplasty.AIM To summarize and analyse the causes of revision after UKA.METHODS This is a retrospective case series study in which the reasons for the first revision after UKA are summarized.We analysed the clinical symptoms,medical histories,laboratory test results,imaging examination results and treatment processes of the patients who underwent revision and summarized the reasons for primary revision after UKA.RESULTS A total of 13 patients,including 3 males and 10 females,underwent revision surgery after UKA.The average age of the included patients was 67.62 years.The prosthesis was used for 3 d to 72 months.The main reasons for revision after UKA were improper suturing of the surgical opening(1 patient),osteophytes(2 patients),intra-articular loose bodies(2 patients),tibial prosthesis loosening(2 patients),rheumatoid arthritis(1 patient),gasket dislocation(3 patients),anterior cruciate ligament injury(1 patient),and medial collateral ligament injury with residual bone cement(1 patient).CONCLUSION The causes of primary revision after UKA were gasket dislocation,osteophytes,intra-articular loose bodies and tibial prosthesis loosening.Avoidance of these factors may greatly reduce the rate of revision after UKA,improve patient satisfaction and reduce medical burden.展开更多
The high rate of early recurrence in hepatocellular carcinoma(HCC)post curative surgical intervention poses a substantial clinical hurdle,impacting patient outcomes and complicating postoperative management.The advent...The high rate of early recurrence in hepatocellular carcinoma(HCC)post curative surgical intervention poses a substantial clinical hurdle,impacting patient outcomes and complicating postoperative management.The advent of machine learning provides a unique opportunity to harness vast datasets,identifying subtle patterns and factors that elude conventional prognostic methods.Machine learning models,equipped with the ability to analyse intricate relationships within datasets,have shown promise in predicting outcomes in various medical disciplines.In the context of HCC,the application of machine learning to predict early recurrence holds potential for personalized postoperative care strategies.This editorial comments on the study carried out exploring the merits and efficacy of random survival forests(RSF)in identifying significant risk factors for recurrence,stratifying patients at low and high risk of HCC recurrence and comparing this to traditional COX proportional hazard models(CPH).In doing so,the study demonstrated that the RSF models are superior to traditional CPH models in predicting recurrence of HCC and represent a giant leap towards precision medicine.展开更多
In this study,the characteristics and preliminary causes of tropical cyclone remote precipitation(TRP)over China during the period from 1979 to 2020 are investigated.Results indicated that approximately 72.42%of tropi...In this study,the characteristics and preliminary causes of tropical cyclone remote precipitation(TRP)over China during the period from 1979 to 2020 are investigated.Results indicated that approximately 72.42%of tropical cyclones(TCs)in the Western Pacific produce TRP over China.The peak months for TRP are July and August.The four key regions of TRP are the adjacent areas between the Sichuan and Shaanxi Provinces,the northern coast of the Bohai Sea,the coast of the Yellow Sea,and the southern coast area.The typical distance between the station with TRP and the TC center ranges from 1500 to 2500 km.Most of these stations are situated north to 60°west of north of the TC.The south–west water vapor transportation on the west side of the TC is crucial to TRP.TRP has a decreasing trend because of the decrease in the number of TCs that generate TRP.From the perspective of large-scale environmental conditions,a decrease in the integrated horizontal water vapor transport in China' Mainland,the weakening of upward motion at approximately 25°–35°N,which is inconducive to convection,and an increase in low-level vertical wind shear,which is unfavorable for the development of TC in areas with high frequencies of TRP-related TCs,are the factors that result in the decreasing trend of TRP.展开更多
BACKGROUND Pancreatectomy with concomitant portomesenteric vein resection(PVR)enables patients with portomesenteric vein(PV)involvement to achieve radical resection of pancreatic ductal adenocarcinoma,however,early re...BACKGROUND Pancreatectomy with concomitant portomesenteric vein resection(PVR)enables patients with portomesenteric vein(PV)involvement to achieve radical resection of pancreatic ductal adenocarcinoma,however,early recurrence(ER)is frequently observed.AIM To predict ER and identify patients at high risk of ER for individualized therapy.METHODS Totally 238 patients undergoing pancreatectomy and PVR were retrospectively enrolled and were allocated to the training or validating cohort.Univariate Cox and LASSO regression analyses were performed to construct serum recurrence score(SRS)based on 26 serum-derived parameters.Uni-and multivariate Cox regression analyses of SRS and 18 clinicopathological variables were performed to establish a Nomogram.Receiver operating characteristic curve analysis was used to evaluate the predictive accuracy.Survival analysis was performed using Kaplan-Meier method and log-rank test.RESULTS Independent serum-derived recurrence-relevant factors of LASSO regression model,including postoperative carbohydrate antigen 19-9,postoperative carcinoembryonic antigen,postoperative carbohydrate antigen 125,preoperative albumin(ALB),preoperative platelet to ALB ratio,and postoperative platelets to lymphocytes ratio,were used to construct SRS[area under the curve(AUC):0.855,95%CI:0.786–0.924].Independent risk factors of recurrence,including SRS[hazard ratio(HR):1.688,95%CI:1.075-2.652],pain(HR:1.653,95%CI:1.052-2.598),perineural invasion(HR:2.070,95%CI:0.827-5.182),and PV invasion(HR:1.603,95%CI:1.063-2.417),were used to establish the recurrence nomogram(AUC:0.869,95%CI:0.803-0.934).Patients with either SRS>0.53 or recurrence nomogram score>4.23 were considered at high risk for ER,and had poor long-term outcomes.CONCLUSION The recurrence scoring system unique for pancreatectomy and PVR,will help clinicians in predicting recurrence efficiently and identifying patients at high risk of ER for individualized therapy.展开更多
We show that the nonlinear stage of the dual-wavelength pumped modulation instability(MI)in nonlinear Schrödinger equation(NLSE)can be effectively analyzed by mode truncation methods.The resulting complicated het...We show that the nonlinear stage of the dual-wavelength pumped modulation instability(MI)in nonlinear Schrödinger equation(NLSE)can be effectively analyzed by mode truncation methods.The resulting complicated heteroclinic structure of instability unveils all possible dynamic trajectories of nonlinear waves.Significantly,the latticed-Fermi-Pasta-Ulam recurrences on the modulated-wave background in NLSE are also investigated and their dynamic trajectories run along the Hamiltonian contours of the heteroclinic structure.It is demonstrated that there has much richer dynamic behavior,in contrast to the nonlinear waves reported before.This novel nonlinear wave promises to inject new vitality into the study of MI.展开更多
Introduction: Neonatal mortality represents a global health problem that has been at the core of programs developed by the World Health Organization (WHO) for more than 30 years. In our country, it represents a real s...Introduction: Neonatal mortality represents a global health problem that has been at the core of programs developed by the World Health Organization (WHO) for more than 30 years. In our country, it represents a real scourge and remains high despite the efforts made by the Ministry of Health. The goal of this study was to investigate the prevalence and causes of neonatal mortality at CHU-MEL of Cotonou in 2023. Material and Methods: This was a cross-sectional and descriptive study with retrospective data collection, carried out in the neonatology unit of the Mother and Child Teaching Hospital of Lagune (CHU-MEL) in Cotonou over a period of six months from January 1, 2023 to June 30, 2023. All neonates, premature or full-term, born alive and who died during hospitalization in the unit were included. Results: 211 cases of neonatal deaths were recorded among the 2884 neonates hospitalized in the unit during the study period, representing a hospital prevalence of 7.31%. Early neonatal mortality represented 81.5% of cases. The average age at admission was 4.6 days ± 5.3. The average weight of deceased neonates was 1609.08 ± 798.35 g. The most frequent reasons for hospitalization were represented by prematurity (60.66%) and respiratory distress (23.22%), respectively. Prematurity was the leading cause of neonatal mortality (41.7%), followed by neonatal infections (29.4%) and perinatal asphyxia (10.9%). Conclusion: The prevalence of neonatal mortality in the neonatology unit of CHU-MEL is high. Efforts to improve the quality of perinatal care departments must be intensified to reduce this prevalence.展开更多
Fear of disease progression is one of the most common psychological problems in the treatment of cancer patients. Early recognition and intervention can effectively control the level of fear of disease progression and...Fear of disease progression is one of the most common psychological problems in the treatment of cancer patients. Early recognition and intervention can effectively control the level of fear of disease progression and improve the quality of life of patients. The present situation and influencing factors of FoP in breast cancer patients were reviewed in this paper, in order to provide reference for clinical research of breast cancer patients.展开更多
Fine particulate matter(PM_(2.5))and ozone(O_(3))double high pollution(DHP)events have occurred frequently over China in recent years,but their causes are not completely clear.In this study,the spatiotemporal distribu...Fine particulate matter(PM_(2.5))and ozone(O_(3))double high pollution(DHP)events have occurred frequently over China in recent years,but their causes are not completely clear.In this study,the spatiotemporal distribution of DHP events in China during 2013–20 is analyzed.The synoptic types affecting DHP events are identified with the Lamb–Jenkinson circulation classification method.The meteorological and chemical causes of DHP events controlled by the main synoptic types are further investigated.Results show that DHP events(1655 in total for China during 2013–20)mainly occur over the North China Plain,Yangtze River Delta,Pearl River Delta,Sichuan Basin,and Central China.The occurrence frequency increases by 5.1%during 2013–15,and then decreases by 56.1%during 2015–20.The main circulation types of DHP events are“cyclone”and“anticyclone”,accounting for over 40%of all DHP events over five main polluted regions in China,followed by southerly or easterly flat airflow types,like“southeast”,“southwest”,and“east”.Compared with non-DHP events,DHP events are characterized by static or weak wind,high temperature(20.9℃ versus 23.1℃)and low humidity(70.0%versus 64.9%).The diurnal cycles of meteorological conditions cause PM_(2.5)(0300–1200 LST,Local Standard Time=UTC+8 hours)and O_(3)(1500–2100 LST)to exceed the national standards at different periods of the DHP day.Three pollutant conversion indices further indicate the rapid secondary conversions during DHP events,and thus the concentrations of NO_(2),SO_(2) and volatile organic compounds decrease by 13.1%,4.7%and 4.4%,respectively.The results of this study can be informative for future decisions on the management of DHP events.展开更多
This report provides an overall assessment of land fragmentation problems in East Africa. Many parts of East Africa have become highly fragmented, putting development systems and activities in these areas at risk of c...This report provides an overall assessment of land fragmentation problems in East Africa. Many parts of East Africa have become highly fragmented, putting development systems and activities in these areas at risk of complete collapse. Land fragmentation occurs when land gets converted for agriculture, industrialization, or urbanization, invaded by non-local plants, or enclosed for individual use and by subdividing farmlands into subsequent smaller units called parcels with varying average farm sizes. Fragmentation results from inappropriate agricultural development processes and ineffective land use planning that fails to recognize how farmland is used, and the importance of its interconnected areas. Insecurity of tenure and resource rights are key factors in making this possible. Land fragmentation is one of the key reasons why the ability of most resources in East Africa becomes scarcer, and those remaining become “privatized” by more powerful community members—keen to maintain their access to them. Such individualistic attitudes are new and disadvantage the poorest even further by affecting the traditional customary safety nets and agricultural outputs. Neither the government nor customary governance systems effectively protect resource access for the poorest. This review summary report identifies the key causes, measures, and implications, government interventions, and the common remedies to land fragmentation problems in the East African Countries of Kenya, Uganda, Rwanda, and Tanzania including neighboring Ethiopia, and the Sudan. The findings indicated from 2005 to 2015, the population kept increasing for all the named countries in East Africa with Rwanda and Uganda having a substantial increase in population density. The study review further explores the trend in the performance of agriculture by average farm sizes within the intervals of five years by highlighting their strong linkages and found that the average farm size has declined drastically, especially for Kenya. This can only mean that small farms kept becoming smaller and smaller and that there were more small-scale farmers. The results further depicted that the major and commonly cultivated food crops among the East African countries include maize, sorghum, rice, cassava, sweet potatoes, bananas, Irish potatoes, beans, peas, etc., with maize yields (Mt/ha) in 2003 for Uganda being the highest (1.79 Mt/ha) and the lowest in Rwanda (0.77 Mt/ha) respectively. Therefore, from the review results, recommendations are being made as to how the negative impacts of land fragmentation on agricultural productivity can be reduced or mitigated. One way is by community sensitization and awareness about the importance of land consolidation and its proposition on farm productivity.展开更多
BACKGROUND Colorectal cancer is a common malignancy and various methods have been introduced to decrease the possibility of recurrence.Early recurrence(ER)is related to worse prognosis.To date,few observational studie...BACKGROUND Colorectal cancer is a common malignancy and various methods have been introduced to decrease the possibility of recurrence.Early recurrence(ER)is related to worse prognosis.To date,few observational studies have reported on the analysis of rectal cancer.Hence,we reported on the timing and risk factors for the ER of resectable rectal cancer at our institute.AIM To analyze a cohort of patients with local and/or distant recurrence following the radical resection of the primary tumor.METHODS Data were retrospectively collected from the institutional database from March 2011 to January 2021.Clinicopathological data at diagnosis,perioperative and postoperative data,and first recurrence were collected and analyzed.ER was defined via receiver operating characteristic curve.Prognostic factors were evaluated using the Kaplan–Meier method and Cox proportional hazards modeling.RESULTS We included 131 patients.The optimal cut off value of recurrence-free survival(RFS)to differentiate between ER(n=55,41.9%)and late recurrence(LR)(n=76,58.1%)was 8 mo.The median post-recurrence survival(PRS)of ER and LR was 1.4 mo and 2.9 mo,respectively(P=0.008)but PRS was not strongly associated with RFS(R^(2)=0.04).Risk factors included age≥70 years[hazard ratio(HR)=1.752,P=0.047],preoperative concurrent chemoradiotherapy(HR=3.683,P<0.001),colostomy creation(HR=2.221,P=0.036),and length of stay>9 d(HR=0.441,P=0.006).CONCLUSION RFS of 8 mo was the optimal cut-off value.Although ER was not associated with PRS,it was still related to prognosis;thus,intense surveillance is recommended.展开更多
BACKGROUND Endometrial cancer(EC)is a common gynecological malignancy that typically requires prompt surgical intervention;however,the advantage of surgical management is limited by the high postoperative recurrence r...BACKGROUND Endometrial cancer(EC)is a common gynecological malignancy that typically requires prompt surgical intervention;however,the advantage of surgical management is limited by the high postoperative recurrence rates and adverse outcomes.Previous studies have highlighted the prognostic potential of circulating tumor DNA(ctDNA)monitoring for minimal residual disease in patients with EC.AIM To develop and validate an optimized ctDNA-based model for predicting shortterm postoperative EC recurrence.METHODS We retrospectively analyzed 294 EC patients treated surgically from 2015-2019 to devise a short-term recurrence prediction model,which was validated on 143 EC patients operated between 2020 and 2021.Prognostic factors were identified using univariate Cox,Lasso,and multivariate Cox regressions.A nomogram was created to predict the 1,1.5,and 2-year recurrence-free survival(RFS).Model performance was assessed via receiver operating characteristic(ROC),calibration,and decision curve analyses(DCA),leading to a recurrence risk stratification system.RESULTS Based on the regression analysis and the nomogram created,patients with postoperative ctDNA-negativity,postoperative carcinoembryonic antigen 125(CA125)levels of<19 U/mL,and grade G1 tumors had improved RFS after surgery.The nomogram’s efficacy for recurrence prediction was confirmed through ROC analysis,calibration curves,and DCA methods,highlighting its high accuracy and clinical utility.Furthermore,using the nomogram,the patients were successfully classified into three risk subgroups.CONCLUSION The nomogram accurately predicted RFS after EC surgery at 1,1.5,and 2 years.This model will help clinicians personalize treatments,stratify risks,and enhance clinical outcomes for patients with EC.展开更多
In this editorial,we comment on the article by Zhang et al entitled Development of a machine learning-based model for predicting the risk of early postoperative recurrence of hepatocellular carcinoma.Hepatocellular ca...In this editorial,we comment on the article by Zhang et al entitled Development of a machine learning-based model for predicting the risk of early postoperative recurrence of hepatocellular carcinoma.Hepatocellular carcinoma(HCC),which is characterized by high incidence and mortality rates,remains a major global health challenge primarily due to the critical issue of postoperative recurrence.Early recurrence,defined as recurrence that occurs within 2 years posttreatment,is linked to the hidden spread of the primary tumor and significantly impacts patient survival.Traditional predictive factors,including both patient-and treatment-related factors,have limited predictive ability with respect to HCC recurrence.The integration of machine learning algorithms is fueled by the exponential growth of computational power and has revolutionized HCC research.The study by Zhang et al demonstrated the use of a groundbreaking preoperative prediction model for early postoperative HCC recurrence.Challenges persist,including sample size constraints,issues with handling data,and the need for further validation and interpretability.This study emphasizes the need for collaborative efforts,multicenter studies and comparative analyses to validate and refine the model.Overcoming these challenges and exploring innovative approaches,such as multi-omics integration,will enhance personalized oncology care.This study marks a significant stride toward precise,efficient,and personalized oncology practices,thus offering hope for improved patient outcomes in the field of HCC treatment.展开更多
BACKGROUND The prognosis for hepatocellular carcinoma(HCC)in the presence of cirrhosis is unfavourable,primarily attributable to the high incidence of recurrence.AIM To develop a machine learning model for predicting ...BACKGROUND The prognosis for hepatocellular carcinoma(HCC)in the presence of cirrhosis is unfavourable,primarily attributable to the high incidence of recurrence.AIM To develop a machine learning model for predicting early recurrence(ER)of posthepatectomy HCC in patients with cirrhosis and to stratify patients’overall survival(OS)based on the predicted risk of recurrence.METHODS In this retrospective study,214 HCC patients with cirrhosis who underwent curative hepatectomy were examined.Radiomics feature selection was conducted using the least absolute shrinkage and selection operator and recursive feature elimination methods.Clinical-radiologic features were selected through univariate and multivariate logistic regression analyses.Five machine learning methods were used for model comparison,aiming to identify the optimal model.The model’s performance was evaluated using the receiver operating characteristic curve[area under the curve(AUC)],calibration,and decision curve analysis.Additionally,the Kaplan-Meier(K-M)curve was used to evaluate the stratification effect of the model on patient OS.RESULTS Within this study,the most effective predictive performance for ER of post-hepatectomy HCC in the background of cirrhosis was demonstrated by a model that integrated radiomics features and clinical-radiologic features.In the training cohort,this model attained an AUC of 0.844,while in the validation cohort,it achieved a value of 0.790.The K-M curves illustrated that the combined model not only facilitated risk stratification but also exhibited significant discriminatory ability concerning patients’OS.CONCLUSION The combined model,integrating both radiomics and clinical-radiologic characteristics,exhibited excellent performance in HCC with cirrhosis.The K-M curves assessing OS revealed statistically significant differences.展开更多
BACKGROUND Advanced gastric cancer is a common malignancy that is often diagnosed at an advanced stage and is still at risk of recurrence after radical surgical treatment.Chemoradiotherapy,as one of the important trea...BACKGROUND Advanced gastric cancer is a common malignancy that is often diagnosed at an advanced stage and is still at risk of recurrence after radical surgical treatment.Chemoradiotherapy,as one of the important treatment methods for gastric cancer,is of great significance for improving the survival rate of patients.However,the tumor recurrence and survival prognosis of gastric cancer patients after radio-therapy and chemotherapy are still uncertain.AIM To analyze the tumor recurrence after radical radiotherapy and chemotherapy for advanced gastric cancer and provide more in-depth guidance for clinicians.METHODS A retrospective analysis was performed on 171 patients with gastric cancer who received postoperative adjuvant radiotherapy and chemotherapy in our hospital from 2021 to 2023.The Kaplan-Meier method was used to calculate the recurrence rate and survival rate;the log-rank method was used to analyze the single-factor prognosis;and the Cox model was used to analyze the prognosis associated with multiple factors.RESULTS The median follow-up time of the whole group was 63 months,and the follow-up rate was 93.6%.Stage Ⅱ and Ⅲ patients accounted for 31.0%and 66.7%,respec-tively.The incidences of Grade 3 and above acute gastrointestinal reactions and hematological adverse reactions were 8.8%and 9.9%,respectively.A total of 166 patients completed the entire chemoradiotherapy regimen,during which no adverse reaction-related deaths occurred.In terms of the recurrence pattern,17 patients had local recurrence,29 patients had distant metastasis,and 12 patients had peritoneal implantation metastasis.The 1-year,3-year,and 5-year overall survival(OS)rates were 83.7%,66.3%,and 60.0%,respectively.The 1-year,3-year,and 5-year disease-free survival rates were 75.5%,62.7%,and 56.5%,respectively.Multivariate analysis revealed that T stage,peripheral nerve invasion,and the lymph node metastasis rate(LNR)were independent prognostic factors for OS.CONCLUSION Postoperative intensity-modulated radiotherapy combined with chemotherapy for gastric cancer treatment is well tolerated and has acceptable adverse effects,which is beneficial for local tumor control and can improve the long-term survival of patients.The LNR was an independent prognostic factor for OS.For patients with a high risk of local recurrence,postoperative adjuvant chemoradiation should be considered.展开更多
BACKGROUND Current surgical procedures for anorectal abscesses,including incision and drainage alone or combined concurrent fistulotomy,remain controversial primarily due to the unpredictability of postoperative recur...BACKGROUND Current surgical procedures for anorectal abscesses,including incision and drainage alone or combined concurrent fistulotomy,remain controversial primarily due to the unpredictability of postoperative recurrence or the progression to anal fistula.AIM To evaluate factors that predict postoperative recurrence of anorectal abscesses and propose a new classification to guide surgical procedures.METHODS In this retrospective study,525 patients with anorectal abscesses treated by incision and drainage alone,at a tertiary general hospital from August 2012 to July 2022,were included.A new classification for anorectal abscesses based on their propensity to develop into fistulas,considering 18 other potential risk factors,was established.These factors,from electronic medical records,were screened for significance using theχ^(2)test and subsequently analyzed with multivariate logistic regression to evaluate their relationship with postoperative recurrence of anorectal abscesses.RESULTSOne year post-follow-up,the overall recurrence rate was 39%:81.0%and 23.5%for fistula-prone and non-fistulaproneabscesses,respectively.Univariateχ^(2)analysis showed significant differences in recurrence rates based onanatomical classifications and pus culture results(P<0.05).Fistula-prone abscess,≥7 days between symptomonset and surgery,chronic diarrhea,preoperative antibiotic use,and local anesthesia were risk factors for recurrence,while diabetes mellitus was protective(P<0.05).Moreover,fistula-prone abscess[odds ratio(OR)=7.651,95%CI:4.049–14.458,P<0.001],≥7 days from symptom onset to surgery(OR=2.137,95%CI:1.090–4.190,P=0.027),chronic diarrhea(OR=2.508,95%CI:1.216–5.173,P=0.013),and local anesthesia(OR=2.308,95%CI:1.313–4.059,P=0.004)were independent risk factors for postoperative anorectal abscess recurrence using multivariatelogistic regression.Body mass index≥28(OR=2.935,95%CI:1.203–7.165,P=0.018)was an independentrisk factor for postoperative recurrence of non-fistula-prone abscess.CONCLUSIONThe choice of surgical procedure for treating anorectal abscesses should follow this new classification.Prompt andthorough incision and drainage can significantly reduce postoperative recurrence.展开更多
Postoperative tumor recurrence remains a predominant cause of treatment failure. In this study, we developed an in situ injectable hydrogel, termed MPB-NO@DOX + ATRA gel, which was locally formed within the tumor rese...Postoperative tumor recurrence remains a predominant cause of treatment failure. In this study, we developed an in situ injectable hydrogel, termed MPB-NO@DOX + ATRA gel, which was locally formed within the tumor resection cavity. The MPB-NO@DOX + ATRA gel was fabricated by mixing a thrombin solution, a fibrinogen solution containing all-trans retinoic acid (ATRA), and a Mn/NO-based immune nano-activator termed MPB-NO@DOX. ATRA promoted the differentiation of cancer stem cells, inhibited cancer cell migration, and affected the polarization of tumor-associated macrophages. The outer MnO2 shell disintegrated due to its reaction with glutathione and hydrogen peroxide in the cytoplasm to release Mn2+ and produce O2, resulting in the release of doxorubicin (DOX). The released DOX entered the nucleus and destroyed DNA, and the fragmented DNA cooperated with Mn2+ to activate the cGAS-STING pathway and stimulate an anti-tumor immune response. In addition, when MPB-NO@DOX was exposed to 808 nm laser irradiation, the Fe-NO bond was broken to release NO, which downregulated the expression of PD-L1 on the surface of tumor cells and reversed the immunosuppressive tumor microenvironment. In conclusion, the MPB-NO@DOX + ATRA gel exhibited excellent anti-tumor efficacy. The results of this study demonstrated the great potential of in situ injectable hydrogels in preventing postoperative tumor recurrence.展开更多
文摘In recent years,the occurrence of rice Chilo suppressalis( Walker) in Longyou County of Zhejiang Province has increased year by year and has become aggravated. This poses a great threat to the safety of rice production. In order to curb the recurrence momentum of rice C. suppressalis,according to the dynamic monitoring and field system survey of rice C. suppressalis in Longyou County since 2015,the causes of the annual increase of rice C. suppressalis in recent years were analyzed,and the recurrence area of C. suppressalis was introduced,and finally some prevention and control measures were put forward.
文摘BACKGROUND In children, it is common to see failure and recurrence in the correction ofepiblepharon and to have reoperation due to obvious irritation symptoms andcorneal injury.AIM To explore the causes of failure and recurrence after epiblepharon correction inchildren, to remove accurately redundant epiblepharon and orbicularis oculimuscle in patients via the cilia-everting suture technique combined with lidmargin splitting in some patients due to inverted lashes in the medial part of theeyelid, and to observe the therapeutic effect.METHODS From 2015 to 2019, in the Outpatient Department of Ophthalmology of BeijingTongren Hospital, 22 children (40 eyes) with epiblepharon, aged 5-12 years, weretreated due to correction failure and recurrence. Fourteen patients (28 eyes)underwent the full-thickness everting suture technique, and eight patients (16eyes) underwent incisional surgery. They were treated by reviewing the previoussurgical methods and observing epiblepharon, eyelash direction, and cornealinjury. During reoperation, a subciliary incision was made 1 mm below theinferior lash line. Incisional surgery for the lower eyelid was used to removeaccurately redundant epiblepharon and part of the pretarsal orbicularis muscle.Subcutaneous tissue and the orbicularis muscle of the upper skin-muscle flapwere anchored to the anterior fascia of the tarsal plate by rotational sutures. Lidmargin splitting was used only for patients who had seriously inverted lasheslocated in the medial part of the eyelid. All patients were followed for 6-12 moafter reoperation to observe the lower eyelid position, skin incision, eyelash direction, corneal damage, and recurrence.RESULTS After reoperation, all the patients were corrected. Photophobia, rubbing the eye,winking, and tearing disappeared. There was no lower eyelid entropion,ectropion, or retraction. There was no obvious sunken scar or lower eyelid crease.The eyelashes were far away from the cornea, and when the patients lookeddown, the eyelashes on the lower eyelid did not contact the cornea or conjunctiva.The corneal injuries were repaired. Follow-up observation for 6 mo showed norecurrence of epiblepharon.CONCLUSION The type of suture method, the failure to remove accurately redundant skin andorbicularis muscle, the lack of cilia rotational suture use, and excessive reversegrowth of eyelashes are the main causes of failure and recurrence afterepiblepharon correction in children.
文摘Natural disasters usually involve a phenomenon with consequences that exceed the response capabilities of local communities and have a significant impact on the region’s socioeconomic development. Droughts, floods, and hurricanes are all natural disasters that jeopardize the environment and the lives of Somalis. Severe floods have devastated the south and central parts of the country multiple times, destroying infrastructure and homes and killing many vulnerable people. Droughts in the south and central parts of the country, particularly in the Middle Shebelle region, have killed a number of children and mothers. It also had a negative influence on crops and cattle. Objective of this study is to know the recurrence of Natural Disasters in Jowhar, Middle Shabelle region, Somalia: The Causes and Impacts. The Somali people are completely aware of natural disasters such as droughts and floods, and they are self-sufficient in dealing with the consequences of these disasters. Furthermore, the Somali government has not fully created environmental laws to protect and conserve the environment, and the majority of laws, rules, acts, and regulations are not used or administered effectively. We also found that the Somali government is not yet financially prepared to deal with these crises, and that there are no strategic plans in the central government or even state administrations to prevent or at least control these disasters from causing extreme harm to the community and the environment.
文摘AIM To study the local recurrent rate and the causes of rectal cancer after surgery. METHODS The clinicopathological data of 213 rectal cancer patients and the follow up information were analyzed. The overall recurrent rate and the recurrent rates from different surgical appreaches were calculated. The main causes of recurrence were investigated. RESULTS Among the 213 cases, 73 (34 27%) had local recurrence. The recurrent time ranged from 3 months to 62 months after the first operation. Most of the recurrence ( 65/73 , 89 04%) occurred within 3 years after operation. CONCLUSION Local recurrence had no significant correlation with surgical methods or pathological types, but closely related to Dukes′ stages, location of primary tumors and the length of the distal rectum resected. Early resection and a wide tumor free resection margin are key factors to prevent local recurrence.
基金Supported by National Natural Science Foundation of China,No.82004386and Guangdong Basic and Applied Basic Research Foundation,No.2022A1515011700.
文摘BACKGROUND Unicompartmental knee arthroplasty(UKA)has great advantages in the treatment of unicompartmental knee osteoarthritis,but its revision rate is higher than that of total knee arthroplasty.AIM To summarize and analyse the causes of revision after UKA.METHODS This is a retrospective case series study in which the reasons for the first revision after UKA are summarized.We analysed the clinical symptoms,medical histories,laboratory test results,imaging examination results and treatment processes of the patients who underwent revision and summarized the reasons for primary revision after UKA.RESULTS A total of 13 patients,including 3 males and 10 females,underwent revision surgery after UKA.The average age of the included patients was 67.62 years.The prosthesis was used for 3 d to 72 months.The main reasons for revision after UKA were improper suturing of the surgical opening(1 patient),osteophytes(2 patients),intra-articular loose bodies(2 patients),tibial prosthesis loosening(2 patients),rheumatoid arthritis(1 patient),gasket dislocation(3 patients),anterior cruciate ligament injury(1 patient),and medial collateral ligament injury with residual bone cement(1 patient).CONCLUSION The causes of primary revision after UKA were gasket dislocation,osteophytes,intra-articular loose bodies and tibial prosthesis loosening.Avoidance of these factors may greatly reduce the rate of revision after UKA,improve patient satisfaction and reduce medical burden.
文摘The high rate of early recurrence in hepatocellular carcinoma(HCC)post curative surgical intervention poses a substantial clinical hurdle,impacting patient outcomes and complicating postoperative management.The advent of machine learning provides a unique opportunity to harness vast datasets,identifying subtle patterns and factors that elude conventional prognostic methods.Machine learning models,equipped with the ability to analyse intricate relationships within datasets,have shown promise in predicting outcomes in various medical disciplines.In the context of HCC,the application of machine learning to predict early recurrence holds potential for personalized postoperative care strategies.This editorial comments on the study carried out exploring the merits and efficacy of random survival forests(RSF)in identifying significant risk factors for recurrence,stratifying patients at low and high risk of HCC recurrence and comparing this to traditional COX proportional hazard models(CPH).In doing so,the study demonstrated that the RSF models are superior to traditional CPH models in predicting recurrence of HCC and represent a giant leap towards precision medicine.
基金supported by the Postgraduate Research&Practice Innovation Program of Jiangsu Province (No.KYCX22_1136)the National Natural Scientific Foundation of China (No.42275037)+2 种基金the Basic Research Fund of CAMS (No.2023Z016)the Key Laboratory of South China Sea Meteorological Disaster Prevention and Mitigation of Hainan Province (No.SCSF202202)supported by the Jiangsu Collaborative Innovation Center for Climate Change。
文摘In this study,the characteristics and preliminary causes of tropical cyclone remote precipitation(TRP)over China during the period from 1979 to 2020 are investigated.Results indicated that approximately 72.42%of tropical cyclones(TCs)in the Western Pacific produce TRP over China.The peak months for TRP are July and August.The four key regions of TRP are the adjacent areas between the Sichuan and Shaanxi Provinces,the northern coast of the Bohai Sea,the coast of the Yellow Sea,and the southern coast area.The typical distance between the station with TRP and the TC center ranges from 1500 to 2500 km.Most of these stations are situated north to 60°west of north of the TC.The south–west water vapor transportation on the west side of the TC is crucial to TRP.TRP has a decreasing trend because of the decrease in the number of TCs that generate TRP.From the perspective of large-scale environmental conditions,a decrease in the integrated horizontal water vapor transport in China' Mainland,the weakening of upward motion at approximately 25°–35°N,which is inconducive to convection,and an increase in low-level vertical wind shear,which is unfavorable for the development of TC in areas with high frequencies of TRP-related TCs,are the factors that result in the decreasing trend of TRP.
基金Supported by National Natural Science Foundation of China,No.82373012.
文摘BACKGROUND Pancreatectomy with concomitant portomesenteric vein resection(PVR)enables patients with portomesenteric vein(PV)involvement to achieve radical resection of pancreatic ductal adenocarcinoma,however,early recurrence(ER)is frequently observed.AIM To predict ER and identify patients at high risk of ER for individualized therapy.METHODS Totally 238 patients undergoing pancreatectomy and PVR were retrospectively enrolled and were allocated to the training or validating cohort.Univariate Cox and LASSO regression analyses were performed to construct serum recurrence score(SRS)based on 26 serum-derived parameters.Uni-and multivariate Cox regression analyses of SRS and 18 clinicopathological variables were performed to establish a Nomogram.Receiver operating characteristic curve analysis was used to evaluate the predictive accuracy.Survival analysis was performed using Kaplan-Meier method and log-rank test.RESULTS Independent serum-derived recurrence-relevant factors of LASSO regression model,including postoperative carbohydrate antigen 19-9,postoperative carcinoembryonic antigen,postoperative carbohydrate antigen 125,preoperative albumin(ALB),preoperative platelet to ALB ratio,and postoperative platelets to lymphocytes ratio,were used to construct SRS[area under the curve(AUC):0.855,95%CI:0.786–0.924].Independent risk factors of recurrence,including SRS[hazard ratio(HR):1.688,95%CI:1.075-2.652],pain(HR:1.653,95%CI:1.052-2.598),perineural invasion(HR:2.070,95%CI:0.827-5.182),and PV invasion(HR:1.603,95%CI:1.063-2.417),were used to establish the recurrence nomogram(AUC:0.869,95%CI:0.803-0.934).Patients with either SRS>0.53 or recurrence nomogram score>4.23 were considered at high risk for ER,and had poor long-term outcomes.CONCLUSION The recurrence scoring system unique for pancreatectomy and PVR,will help clinicians in predicting recurrence efficiently and identifying patients at high risk of ER for individualized therapy.
基金Project supported by the National Natural Science Foundation of China(NSFC)(Grant No.12004309)the Shaanxi Fundamental Science Research Project for Mathematics and Physics(Grant No.22JSQ036)the Scientific Research Program funded by Shaanxi Provincial Education Department(Grant No.20JK0947).
文摘We show that the nonlinear stage of the dual-wavelength pumped modulation instability(MI)in nonlinear Schrödinger equation(NLSE)can be effectively analyzed by mode truncation methods.The resulting complicated heteroclinic structure of instability unveils all possible dynamic trajectories of nonlinear waves.Significantly,the latticed-Fermi-Pasta-Ulam recurrences on the modulated-wave background in NLSE are also investigated and their dynamic trajectories run along the Hamiltonian contours of the heteroclinic structure.It is demonstrated that there has much richer dynamic behavior,in contrast to the nonlinear waves reported before.This novel nonlinear wave promises to inject new vitality into the study of MI.
文摘Introduction: Neonatal mortality represents a global health problem that has been at the core of programs developed by the World Health Organization (WHO) for more than 30 years. In our country, it represents a real scourge and remains high despite the efforts made by the Ministry of Health. The goal of this study was to investigate the prevalence and causes of neonatal mortality at CHU-MEL of Cotonou in 2023. Material and Methods: This was a cross-sectional and descriptive study with retrospective data collection, carried out in the neonatology unit of the Mother and Child Teaching Hospital of Lagune (CHU-MEL) in Cotonou over a period of six months from January 1, 2023 to June 30, 2023. All neonates, premature or full-term, born alive and who died during hospitalization in the unit were included. Results: 211 cases of neonatal deaths were recorded among the 2884 neonates hospitalized in the unit during the study period, representing a hospital prevalence of 7.31%. Early neonatal mortality represented 81.5% of cases. The average age at admission was 4.6 days ± 5.3. The average weight of deceased neonates was 1609.08 ± 798.35 g. The most frequent reasons for hospitalization were represented by prematurity (60.66%) and respiratory distress (23.22%), respectively. Prematurity was the leading cause of neonatal mortality (41.7%), followed by neonatal infections (29.4%) and perinatal asphyxia (10.9%). Conclusion: The prevalence of neonatal mortality in the neonatology unit of CHU-MEL is high. Efforts to improve the quality of perinatal care departments must be intensified to reduce this prevalence.
文摘Fear of disease progression is one of the most common psychological problems in the treatment of cancer patients. Early recognition and intervention can effectively control the level of fear of disease progression and improve the quality of life of patients. The present situation and influencing factors of FoP in breast cancer patients were reviewed in this paper, in order to provide reference for clinical research of breast cancer patients.
基金supported by the National Natural Science Foundation of China(Grant Nos.41830965 and 41905112)the Key Program of the Ministry of Science and Technology of the People’s Republic of China(Grant No.2019YFC0214703)+2 种基金the Hubei Natural Science Foundation(Grant No.2022CFB027)supported by the State Key Laboratory of Atmospheric Boundary Layer Physics and Atmospheric Chemistry(Grant No.LAPC-KF-2023-07)the Key Laboratory of Atmospheric Chemistry,China Meteorological Administration(Grant No.2023B08).
文摘Fine particulate matter(PM_(2.5))and ozone(O_(3))double high pollution(DHP)events have occurred frequently over China in recent years,but their causes are not completely clear.In this study,the spatiotemporal distribution of DHP events in China during 2013–20 is analyzed.The synoptic types affecting DHP events are identified with the Lamb–Jenkinson circulation classification method.The meteorological and chemical causes of DHP events controlled by the main synoptic types are further investigated.Results show that DHP events(1655 in total for China during 2013–20)mainly occur over the North China Plain,Yangtze River Delta,Pearl River Delta,Sichuan Basin,and Central China.The occurrence frequency increases by 5.1%during 2013–15,and then decreases by 56.1%during 2015–20.The main circulation types of DHP events are“cyclone”and“anticyclone”,accounting for over 40%of all DHP events over five main polluted regions in China,followed by southerly or easterly flat airflow types,like“southeast”,“southwest”,and“east”.Compared with non-DHP events,DHP events are characterized by static or weak wind,high temperature(20.9℃ versus 23.1℃)and low humidity(70.0%versus 64.9%).The diurnal cycles of meteorological conditions cause PM_(2.5)(0300–1200 LST,Local Standard Time=UTC+8 hours)and O_(3)(1500–2100 LST)to exceed the national standards at different periods of the DHP day.Three pollutant conversion indices further indicate the rapid secondary conversions during DHP events,and thus the concentrations of NO_(2),SO_(2) and volatile organic compounds decrease by 13.1%,4.7%and 4.4%,respectively.The results of this study can be informative for future decisions on the management of DHP events.
文摘This report provides an overall assessment of land fragmentation problems in East Africa. Many parts of East Africa have become highly fragmented, putting development systems and activities in these areas at risk of complete collapse. Land fragmentation occurs when land gets converted for agriculture, industrialization, or urbanization, invaded by non-local plants, or enclosed for individual use and by subdividing farmlands into subsequent smaller units called parcels with varying average farm sizes. Fragmentation results from inappropriate agricultural development processes and ineffective land use planning that fails to recognize how farmland is used, and the importance of its interconnected areas. Insecurity of tenure and resource rights are key factors in making this possible. Land fragmentation is one of the key reasons why the ability of most resources in East Africa becomes scarcer, and those remaining become “privatized” by more powerful community members—keen to maintain their access to them. Such individualistic attitudes are new and disadvantage the poorest even further by affecting the traditional customary safety nets and agricultural outputs. Neither the government nor customary governance systems effectively protect resource access for the poorest. This review summary report identifies the key causes, measures, and implications, government interventions, and the common remedies to land fragmentation problems in the East African Countries of Kenya, Uganda, Rwanda, and Tanzania including neighboring Ethiopia, and the Sudan. The findings indicated from 2005 to 2015, the population kept increasing for all the named countries in East Africa with Rwanda and Uganda having a substantial increase in population density. The study review further explores the trend in the performance of agriculture by average farm sizes within the intervals of five years by highlighting their strong linkages and found that the average farm size has declined drastically, especially for Kenya. This can only mean that small farms kept becoming smaller and smaller and that there were more small-scale farmers. The results further depicted that the major and commonly cultivated food crops among the East African countries include maize, sorghum, rice, cassava, sweet potatoes, bananas, Irish potatoes, beans, peas, etc., with maize yields (Mt/ha) in 2003 for Uganda being the highest (1.79 Mt/ha) and the lowest in Rwanda (0.77 Mt/ha) respectively. Therefore, from the review results, recommendations are being made as to how the negative impacts of land fragmentation on agricultural productivity can be reduced or mitigated. One way is by community sensitization and awareness about the importance of land consolidation and its proposition on farm productivity.
文摘BACKGROUND Colorectal cancer is a common malignancy and various methods have been introduced to decrease the possibility of recurrence.Early recurrence(ER)is related to worse prognosis.To date,few observational studies have reported on the analysis of rectal cancer.Hence,we reported on the timing and risk factors for the ER of resectable rectal cancer at our institute.AIM To analyze a cohort of patients with local and/or distant recurrence following the radical resection of the primary tumor.METHODS Data were retrospectively collected from the institutional database from March 2011 to January 2021.Clinicopathological data at diagnosis,perioperative and postoperative data,and first recurrence were collected and analyzed.ER was defined via receiver operating characteristic curve.Prognostic factors were evaluated using the Kaplan–Meier method and Cox proportional hazards modeling.RESULTS We included 131 patients.The optimal cut off value of recurrence-free survival(RFS)to differentiate between ER(n=55,41.9%)and late recurrence(LR)(n=76,58.1%)was 8 mo.The median post-recurrence survival(PRS)of ER and LR was 1.4 mo and 2.9 mo,respectively(P=0.008)but PRS was not strongly associated with RFS(R^(2)=0.04).Risk factors included age≥70 years[hazard ratio(HR)=1.752,P=0.047],preoperative concurrent chemoradiotherapy(HR=3.683,P<0.001),colostomy creation(HR=2.221,P=0.036),and length of stay>9 d(HR=0.441,P=0.006).CONCLUSION RFS of 8 mo was the optimal cut-off value.Although ER was not associated with PRS,it was still related to prognosis;thus,intense surveillance is recommended.
文摘BACKGROUND Endometrial cancer(EC)is a common gynecological malignancy that typically requires prompt surgical intervention;however,the advantage of surgical management is limited by the high postoperative recurrence rates and adverse outcomes.Previous studies have highlighted the prognostic potential of circulating tumor DNA(ctDNA)monitoring for minimal residual disease in patients with EC.AIM To develop and validate an optimized ctDNA-based model for predicting shortterm postoperative EC recurrence.METHODS We retrospectively analyzed 294 EC patients treated surgically from 2015-2019 to devise a short-term recurrence prediction model,which was validated on 143 EC patients operated between 2020 and 2021.Prognostic factors were identified using univariate Cox,Lasso,and multivariate Cox regressions.A nomogram was created to predict the 1,1.5,and 2-year recurrence-free survival(RFS).Model performance was assessed via receiver operating characteristic(ROC),calibration,and decision curve analyses(DCA),leading to a recurrence risk stratification system.RESULTS Based on the regression analysis and the nomogram created,patients with postoperative ctDNA-negativity,postoperative carcinoembryonic antigen 125(CA125)levels of<19 U/mL,and grade G1 tumors had improved RFS after surgery.The nomogram’s efficacy for recurrence prediction was confirmed through ROC analysis,calibration curves,and DCA methods,highlighting its high accuracy and clinical utility.Furthermore,using the nomogram,the patients were successfully classified into three risk subgroups.CONCLUSION The nomogram accurately predicted RFS after EC surgery at 1,1.5,and 2 years.This model will help clinicians personalize treatments,stratify risks,and enhance clinical outcomes for patients with EC.
文摘In this editorial,we comment on the article by Zhang et al entitled Development of a machine learning-based model for predicting the risk of early postoperative recurrence of hepatocellular carcinoma.Hepatocellular carcinoma(HCC),which is characterized by high incidence and mortality rates,remains a major global health challenge primarily due to the critical issue of postoperative recurrence.Early recurrence,defined as recurrence that occurs within 2 years posttreatment,is linked to the hidden spread of the primary tumor and significantly impacts patient survival.Traditional predictive factors,including both patient-and treatment-related factors,have limited predictive ability with respect to HCC recurrence.The integration of machine learning algorithms is fueled by the exponential growth of computational power and has revolutionized HCC research.The study by Zhang et al demonstrated the use of a groundbreaking preoperative prediction model for early postoperative HCC recurrence.Challenges persist,including sample size constraints,issues with handling data,and the need for further validation and interpretability.This study emphasizes the need for collaborative efforts,multicenter studies and comparative analyses to validate and refine the model.Overcoming these challenges and exploring innovative approaches,such as multi-omics integration,will enhance personalized oncology care.This study marks a significant stride toward precise,efficient,and personalized oncology practices,thus offering hope for improved patient outcomes in the field of HCC treatment.
基金Supported by Anhui Provincial Key Research and Development Plan,No.202104j07020048.
文摘BACKGROUND The prognosis for hepatocellular carcinoma(HCC)in the presence of cirrhosis is unfavourable,primarily attributable to the high incidence of recurrence.AIM To develop a machine learning model for predicting early recurrence(ER)of posthepatectomy HCC in patients with cirrhosis and to stratify patients’overall survival(OS)based on the predicted risk of recurrence.METHODS In this retrospective study,214 HCC patients with cirrhosis who underwent curative hepatectomy were examined.Radiomics feature selection was conducted using the least absolute shrinkage and selection operator and recursive feature elimination methods.Clinical-radiologic features were selected through univariate and multivariate logistic regression analyses.Five machine learning methods were used for model comparison,aiming to identify the optimal model.The model’s performance was evaluated using the receiver operating characteristic curve[area under the curve(AUC)],calibration,and decision curve analysis.Additionally,the Kaplan-Meier(K-M)curve was used to evaluate the stratification effect of the model on patient OS.RESULTS Within this study,the most effective predictive performance for ER of post-hepatectomy HCC in the background of cirrhosis was demonstrated by a model that integrated radiomics features and clinical-radiologic features.In the training cohort,this model attained an AUC of 0.844,while in the validation cohort,it achieved a value of 0.790.The K-M curves illustrated that the combined model not only facilitated risk stratification but also exhibited significant discriminatory ability concerning patients’OS.CONCLUSION The combined model,integrating both radiomics and clinical-radiologic characteristics,exhibited excellent performance in HCC with cirrhosis.The K-M curves assessing OS revealed statistically significant differences.
基金Supported by the Hebei Provincial Department of Finance and the Hebei Provincial Health Commission,No.ZF2023242。
文摘BACKGROUND Advanced gastric cancer is a common malignancy that is often diagnosed at an advanced stage and is still at risk of recurrence after radical surgical treatment.Chemoradiotherapy,as one of the important treatment methods for gastric cancer,is of great significance for improving the survival rate of patients.However,the tumor recurrence and survival prognosis of gastric cancer patients after radio-therapy and chemotherapy are still uncertain.AIM To analyze the tumor recurrence after radical radiotherapy and chemotherapy for advanced gastric cancer and provide more in-depth guidance for clinicians.METHODS A retrospective analysis was performed on 171 patients with gastric cancer who received postoperative adjuvant radiotherapy and chemotherapy in our hospital from 2021 to 2023.The Kaplan-Meier method was used to calculate the recurrence rate and survival rate;the log-rank method was used to analyze the single-factor prognosis;and the Cox model was used to analyze the prognosis associated with multiple factors.RESULTS The median follow-up time of the whole group was 63 months,and the follow-up rate was 93.6%.Stage Ⅱ and Ⅲ patients accounted for 31.0%and 66.7%,respec-tively.The incidences of Grade 3 and above acute gastrointestinal reactions and hematological adverse reactions were 8.8%and 9.9%,respectively.A total of 166 patients completed the entire chemoradiotherapy regimen,during which no adverse reaction-related deaths occurred.In terms of the recurrence pattern,17 patients had local recurrence,29 patients had distant metastasis,and 12 patients had peritoneal implantation metastasis.The 1-year,3-year,and 5-year overall survival(OS)rates were 83.7%,66.3%,and 60.0%,respectively.The 1-year,3-year,and 5-year disease-free survival rates were 75.5%,62.7%,and 56.5%,respectively.Multivariate analysis revealed that T stage,peripheral nerve invasion,and the lymph node metastasis rate(LNR)were independent prognostic factors for OS.CONCLUSION Postoperative intensity-modulated radiotherapy combined with chemotherapy for gastric cancer treatment is well tolerated and has acceptable adverse effects,which is beneficial for local tumor control and can improve the long-term survival of patients.The LNR was an independent prognostic factor for OS.For patients with a high risk of local recurrence,postoperative adjuvant chemoradiation should be considered.
基金Supported by The Zhenjiang City Key Research and Development Plan Social Development,China,No.SH2023047.
文摘BACKGROUND Current surgical procedures for anorectal abscesses,including incision and drainage alone or combined concurrent fistulotomy,remain controversial primarily due to the unpredictability of postoperative recurrence or the progression to anal fistula.AIM To evaluate factors that predict postoperative recurrence of anorectal abscesses and propose a new classification to guide surgical procedures.METHODS In this retrospective study,525 patients with anorectal abscesses treated by incision and drainage alone,at a tertiary general hospital from August 2012 to July 2022,were included.A new classification for anorectal abscesses based on their propensity to develop into fistulas,considering 18 other potential risk factors,was established.These factors,from electronic medical records,were screened for significance using theχ^(2)test and subsequently analyzed with multivariate logistic regression to evaluate their relationship with postoperative recurrence of anorectal abscesses.RESULTSOne year post-follow-up,the overall recurrence rate was 39%:81.0%and 23.5%for fistula-prone and non-fistulaproneabscesses,respectively.Univariateχ^(2)analysis showed significant differences in recurrence rates based onanatomical classifications and pus culture results(P<0.05).Fistula-prone abscess,≥7 days between symptomonset and surgery,chronic diarrhea,preoperative antibiotic use,and local anesthesia were risk factors for recurrence,while diabetes mellitus was protective(P<0.05).Moreover,fistula-prone abscess[odds ratio(OR)=7.651,95%CI:4.049–14.458,P<0.001],≥7 days from symptom onset to surgery(OR=2.137,95%CI:1.090–4.190,P=0.027),chronic diarrhea(OR=2.508,95%CI:1.216–5.173,P=0.013),and local anesthesia(OR=2.308,95%CI:1.313–4.059,P=0.004)were independent risk factors for postoperative anorectal abscess recurrence using multivariatelogistic regression.Body mass index≥28(OR=2.935,95%CI:1.203–7.165,P=0.018)was an independentrisk factor for postoperative recurrence of non-fistula-prone abscess.CONCLUSIONThe choice of surgical procedure for treating anorectal abscesses should follow this new classification.Prompt andthorough incision and drainage can significantly reduce postoperative recurrence.
基金supported by the National Natural Science Foundation of China(No.82003298)the Scientiffc and Technological Project of Henan Province(No.232102310392)+5 种基金the Key Research and Development Projects of Henan Province(No.222102310453,212102311025)Postdoctoral Research Grant in Henan Province(No.201901025)the Key Research Project of Henan Higher Education Institutions(No.18A350003)Open Fund of Key Laboratory of Targeting Therapy and Diagnosis for Critical Diseases,Henan Province(No.NMZL2020102)the Natural Science Foundation of Chongqing(No.cstc2019jcyj-msxmX0035)the Scientiffc Research Seedling Project of Chongqing Medicinal Biotechnology Association(No.cmba2022kyym-zkxmQ0009).
文摘Postoperative tumor recurrence remains a predominant cause of treatment failure. In this study, we developed an in situ injectable hydrogel, termed MPB-NO@DOX + ATRA gel, which was locally formed within the tumor resection cavity. The MPB-NO@DOX + ATRA gel was fabricated by mixing a thrombin solution, a fibrinogen solution containing all-trans retinoic acid (ATRA), and a Mn/NO-based immune nano-activator termed MPB-NO@DOX. ATRA promoted the differentiation of cancer stem cells, inhibited cancer cell migration, and affected the polarization of tumor-associated macrophages. The outer MnO2 shell disintegrated due to its reaction with glutathione and hydrogen peroxide in the cytoplasm to release Mn2+ and produce O2, resulting in the release of doxorubicin (DOX). The released DOX entered the nucleus and destroyed DNA, and the fragmented DNA cooperated with Mn2+ to activate the cGAS-STING pathway and stimulate an anti-tumor immune response. In addition, when MPB-NO@DOX was exposed to 808 nm laser irradiation, the Fe-NO bond was broken to release NO, which downregulated the expression of PD-L1 on the surface of tumor cells and reversed the immunosuppressive tumor microenvironment. In conclusion, the MPB-NO@DOX + ATRA gel exhibited excellent anti-tumor efficacy. The results of this study demonstrated the great potential of in situ injectable hydrogels in preventing postoperative tumor recurrence.
