The leaf is the main organ for rapeseed photosynthesis,and its morphology influences photosynthetic efficiency and supports increased planting density and yield.However,the molecular regulatory mechanism of leaf morph...The leaf is the main organ for rapeseed photosynthesis,and its morphology influences photosynthetic efficiency and supports increased planting density and yield.However,the molecular regulatory mechanism of leaf morphology in Brassica napus is poorly understood,restricting progress in breeding for the trait.We describe a novel dominant mutation,curly leaf 1(cl1),which confers uneven dorsal–ventral axis development,irregular cellular structure and influenced gravitropic response in the seedling stage.The CL1 locus was mapped to a 1.573-Mb interval on chromosome A05 using simple sequence repeat(SSR)markers,and co-segregated with the phenotype of plants in the curly F2 population.A substitution(P62S)was identified in the highly conserved degron motif(GWSPV)of the IAA2 protein in the cl1mutant,and the P62S substitution impaired the interaction between IAA2 and TIR1 in the presence of auxin,influencing auxin signaling.The P62S substitution-induced curly leaf phenotype was verified by ectopic expression of Bna A05.iaa2 in Arabidopsis and B.napus.Our findings explain the function of IAA2 in rapeseed,providing a foundation for future investigation of auxin signaling and the mechanisms underlying leaf development in B.napus.展开更多
Benefiting from the distinctive ordering degree and local microstructure characteristics,hard carbon(HC)is considered as the most promising anode for sodium-ion batteries(SIBs).Unfortunately,the low initial Coulombic ...Benefiting from the distinctive ordering degree and local microstructure characteristics,hard carbon(HC)is considered as the most promising anode for sodium-ion batteries(SIBs).Unfortunately,the low initial Coulombic efficiency(ICE)and limited reversible capacity severely impede its extensive application.Here,a homogeneous curly graphene(CG)layer with a micropore structure on HC is designed and executed by a simple chemical vapor deposition method(without catalysts).CG not only improves the electronic/ionic conductivity of the hard carbon but also effectively shields its surface defects,enhancing its ICE.In particular,due to the spontaneous curling structural characteristics of CG sheets(CGs),the micropores(≤2 nm)formed provide additional active sites,increasing its capacity.When used as a sodium-ion battery anode,the HC-CG composite anode displayed an outstanding reversible capacity of 358 mAh·g^(-1),superior ICE of 88.6%,remarkable rate performance of 145.8 mAh·g^(-1)at 5 A·g^(-1),and long cycling life after 1000 cycles with 88.6%at 1 A·g^(-1).This work provides a simple defect/microstructure turning strategy for hard carbon anodes and deepens the understanding of Na+storage behavior in the plateau region,especially on the pore-filling mechanism by forming quasi-metallic clusters.展开更多
Virus isolate Y1 was obtained from tobacco showing curly shoot symptoms in Baoshan, Yunnan Province. Whitefly transmission test and virion morphology observa-tion showed that it is a begomovirus. In reactions with 14 ...Virus isolate Y1 was obtained from tobacco showing curly shoot symptoms in Baoshan, Yunnan Province. Whitefly transmission test and virion morphology observa-tion showed that it is a begomovirus. In reactions with 14 monoclonal antibodies raised against begomoviruses, Y1 was readily differentiated from begomoviruses reported in China, Pakistan and India. The complete nucleotide sequence of DNA-A was determined, it contains 2746 nucleotides, with two ORFs in virion-sense DNA and four ORFs in comple-mentary-sense DNA. Comparisons with total DNA-A, inter-genie region and deduced amino acid sequences of individual ORFs showed that Y1 is a distinct Begomovirus species, for which the name Tobacco curly shoot virus (TCSV) is pro-posed. The total DNA-A of TCSV is most closely related to that of Tomato leaf curl virus from India (85% sequence identity). In contrast, the deduced coat protein of TCSV is most like that of Cotton leaf curl virus 72b isolate from Paki-stan (98% amino acid sequence identity).展开更多
CURLY LEAF ( CLF) encodes the methyltransferase subunit of the Polycomb Repressor Complex 2 (PRC2), which regulates the expression of target genes through H3K27 trimethylation. We isolated a new CLF mutant allele ( cl...CURLY LEAF ( CLF) encodes the methyltransferase subunit of the Polycomb Repressor Complex 2 (PRC2), which regulates the expression of target genes through H3K27 trimethylation. We isolated a new CLF mutant allele ( clf-78) using a genetic screen designed to identify microRNA (miRNA) deficient mutants. CLF mutant plants showed impaired miRNA activity caused by increased ubiquitination and enhanced degradation of ARGONAUTE 1 (AGO1) in specific tissues. Such CLF-mediated AGO1 regulation was evident when plants were exposed to UV radiation, which caused increased susceptibility of clf mutants to some UV-induced responses. Furthermore, we showed that CLF directly regulates FBW2, which in turn triggers AGO1 degradation in the clf mutants. Interestingly, AGO1 bound to a target appeared particularly prone to degradation in the mutant plants, a process that was exacerbated when the complex bound a non-cleavable target. Thus, prolonged AGO1–target interaction seems to favor AGO1 degradation, suggesting that non-cleavable miRNA targets may overcome translation inhibition by modulating AGO1 stability in plants.展开更多
Acupuncture is an effective treatment for ischemic stroke(IS)and plays a key role in neurological rehabilitation after IS.Acupuncture can improve the clinical symptoms of various complications after IS,including motor...Acupuncture is an effective treatment for ischemic stroke(IS)and plays a key role in neurological rehabilitation after IS.Acupuncture can improve the clinical symptoms of various complications after IS,including motor dysfunction,swallowing disorders,speech disorders,cognitive impairment,depression,insomnia,and fatigue.However,the mechanisms underlying the effects of acupuncture in IS remain unclear.Available evidence suggests that acupuncture may exert neuroprotective effects through neuroplasticity(neurogenesis and synaptogenesis),angiogenesis,cell proliferation and apoptosis,and regulation of oxidative stress,inflammation,and immunity.Further studies should be conducted to improve the high-quality evidence-based system of acupuncture intervention for IS,by focusing on the clinical and basic research design,increasing the sample size,standardizing and quantifying the standards of acupuncture operations,using multidisciplinary techniques and methods to systematically explore the key targets of acupuncture intervention for IS,and reveal the efficacy and mechanism of acupuncture in the treatment of IS.展开更多
BACKGROUND Obstructive sleep apnea-hypopnea syndrome(OSAHS)is primarily caused by airway obstruction due to narrowing and blockage in the nasal and nasopha-ryngeal,oropharyngeal,soft palate,and tongue base areas.The m...BACKGROUND Obstructive sleep apnea-hypopnea syndrome(OSAHS)is primarily caused by airway obstruction due to narrowing and blockage in the nasal and nasopha-ryngeal,oropharyngeal,soft palate,and tongue base areas.The mid-frequency anti-snoring device is a new technology based on sublingual nerve stimulation.Its principle is to improve the degree of oropharyngeal airway stenosis in OSAHS patients under mid-frequency wave stimulation.Nevertheless,there is a lack of clinical application and imaging evidence.METHODS We selected 50 patients diagnosed with moderate OSAHS in our hospital between July 2022 and August 2023.They underwent a 4-wk treatment regimen involving the mid-frequency anti-snoring device during nighttime sleep.Following the treatment,we monitored and assessed the sleep apnea quality of life index and Epworth Sleepiness Scale scores.Additionally,we performed computed tomo-graphy scans of the oropharynx in the awake state,during snoring,and while using the mid-frequency anti-snoring device.Cross-sectional area measurements in different states were taken at the narrowest airway point in the soft palate posterior and retrolingual areas.RESULTS Compared to pretreatment measurements,patients exhibited a significant reduction in the apnea-hypopnea index,the percentage of time with oxygen saturation below 90%,snoring frequency,and the duration of the most prolonged apnea event.The lowest oxygen saturation showed a notable increase,and both sleep apnea quality of life index and Epworth Sleepiness Scale scores improved.Oropharyngeal computed tomography scans revealed that in OSAHS patients cross-sectional areas of the oropharyngeal airway in the soft palate posterior area and retrolingual area decreased during snoring compared to the awake state.Conversely,during mid-frequency anti-snoring device treatment,these areas increased compared to snoring.CONCLUSION The mid-frequency anti-snoring device demonstrates the potential to enhance various sleep parameters in patients with moderate OSAHS,thereby improving their quality of life and reducing daytime sleepiness.These therapeutic effects are attributed to the device’s ability to ameliorate the narrowing of the oropharynx in OSAHS patients.展开更多
BACKGROUND Diabetes and thyroiditis are closely related.They occur in combination and cause significant damage to the body.There is no clear treatment for type-2 diabetes mellitus(T2DM)with Hashimoto's thyroiditis...BACKGROUND Diabetes and thyroiditis are closely related.They occur in combination and cause significant damage to the body.There is no clear treatment for type-2 diabetes mellitus(T2DM)with Hashimoto's thyroiditis(HT).While single symptomatic drug treatment of the two diseases is less effective,combined drug treatment may improve efficacy.AIM To investigate the effect of a combination of vitamin D,selenium,and hypoglycemic agents in T2DM with HT.METHODS This retrospective study included 150 patients with T2DM and HT treated at The Central Hospital of Shaoyang from March 2020 to February 2023.Fifty patients were assigned to the control group,test group A,and test group B according to different treatment methods.The control group received low-iodine diet guidance and hypoglycemic drug treatment.Test group A received the control treatment plus vitamin D treatment.Test group B received the group A treatment plus selenium.Blood levels of markers of thyroid function[free T3(FT3),thyroid stimulating hormone(TSH),free T4(FT4)],autoantibodies[thyroid peroxidase antibody(TPOAB)and thyroid globulin antibody(TGAB)],blood lipid index[low-density lipoprotein cholesterol(LDL-C),total cholesterol(TC),triacylglycerol(TG)],blood glucose index[fasting blood glucose(FBG),and hemoglobin A1c(HbA1c)]were measured pre-treatment and 3 and 6 months after treatment.The relationships between serum 25-hydroxyvitamin D3[25(OH)D3]level and each of these indices were analyzed.RESULTS The levels of 25(OH)D3,FT3,FT4,and LDL-C increased in the order of the control group,test group A,and test group B(all P<0.05).The TPOAB,TGAB,TC,TG,FBG,HbA1c,and TSH levels increased in the order of test groups B,A,and the control group(all P<0.05).All the above indices were compared after 3 and 6 months of treatment.Pre-treatment,there was no divergence in serum 25(OH)D3 level,thyroid function-related indexes,autoantibodies level,blood glucose,and blood lipid index between the control group,test groups A and B(all P>0.05).The 25(OH)D3 levels in test groups A and B were negatively correlated with FT4 and TGAB(all P<0.05).CONCLUSION The combination drug treatment for T2DM with HT significantly improved thyroid function,autoantibody,and blood glucose and lipid levels.展开更多
Globally,many lakes are drying up,leaving exposed lakebeds where wind erosion releases dust and sand rich in salt and harmful heavy metals into the atmosphere.Therefore,understanding the characteristics and spatial di...Globally,many lakes are drying up,leaving exposed lakebeds where wind erosion releases dust and sand rich in salt and harmful heavy metals into the atmosphere.Therefore,understanding the characteristics and spatial distribution of playa surface crusts is important to recognize the manifestation of salt dust storms.The objective of this study was to explore the playa surface crust types as well as their spatial distribution and evolution of Qehan Lake in Inner Mongolia Autonomous Region,China to understand the salt dust release potential of different types of playa surface crusts.Various crust characteristics were investigated by field sampling in Qehan Lake,and playa surface crusts were further divided into five types:vegetated areas,salt crusts,clay flats,curly crusts,and margins.It should be noted that curly crusts were distributed in clay flats and covered only a small area in Qehan Lake.The spatial distribution characteristics of playa surface crust types were obtained by supervised classification of remote sensing images,and the salt dust release potential of crusts was explored by the wind tunnel experiments.The field investigation of Qehan Lake revealed that playa surface crust types had a circum-lake band distribution from the inside to the outside of this lake,which were successively vegetated areas,clay flats,salt crusts,and margins.The spatial distribution patterns of playa surface crust types were mainly controlled by the hydrodynamics of the playa,soil texture,and groundwater.There was a significant negative correlation between crust thickness and electrical conductivity.The results of the wind tunnel experiments showed that the initial threshold of friction wind velocity for the salt dust release was higher in clay flats(0.7–0.8 m/s)than in salt crusts(0.5–0.6 m/s).Moreover,the particle leap impact processes occurring under natural conditions may reduce this threshold value.Salinity was the main factor controlling the difference in the initial threshold of friction wind velocity for the salt dust release of clay flats and salt crusts.This study provides a scientific reference for understanding how salt dust is released from a lakebed,which may be used for ecological restoration of dry salt lakes.展开更多
Gallbladder carcinoma(GBC)is the most common biliary tract malignancy associated with a concealed onset,high invasiveness and poor prognosis.Radical surgery remains the only curative treatment for GBC,and the optimal ...Gallbladder carcinoma(GBC)is the most common biliary tract malignancy associated with a concealed onset,high invasiveness and poor prognosis.Radical surgery remains the only curative treatment for GBC,and the optimal extent of surgery depends on the tumor stage.Radical resection can be achieved by simple cholecystectomy for Tis and T1a GBC.However,whether simple cholecystectomy or extended cholecystectomy,including regional lymph node dissection and hepatectomy,is the standard surgical extent for T1b GBC remains controversial.Extended cholecystectomy should be performed for T2 and some T3 GBC without distant metastasis.Secondary radical surgery is essential for incidental gallbladder cancer diagnosed after cholecystectomy.For locally advanced GBC,hepatopancreatoduodenectomy may achieve R0 resection and improve long-term survival outcomes,but the extremely high risk of the surgery limits its implementation.Laparoscopic surgery has been widely used in the treatment of gastrointestinal malignancies.GBC was once regarded as a contraindication of laparoscopic surgery.However,with improvements in surgical instruments and skills,studies have shown that laparoscopic surgery will not result in a poorer prognosis for selected patients with GBC compared with open surgery.Moreover,laparoscopic surgery is associated with enhanced recovery after surgery since it is minimally invasive.展开更多
BACKGROUND Many studies have focused on the femoral tunnel technique and fixation method,but few studies have involved the tibial tunnel technique and fixation method.The all-inside technique is one of the new techniq...BACKGROUND Many studies have focused on the femoral tunnel technique and fixation method,but few studies have involved the tibial tunnel technique and fixation method.The all-inside technique is one of the new techniques that has been described in recent years.All-inside anterior cruciate ligament(ACL)reconstruction is based on a tibial socket instead of a full tunnel.This method has many potential advantages.AIM To compare clinical outcomes of knee ACL autograft reconstruction using allinside quadrupled semitendinosus(AIST)and traditional hamstring tendon(TBT)techniques.METHODS From January 2017 to October 2019,the clinical data of 80 patients with ACL reconstruction were retrospectively analyzed,including 67 males and 13 females.The patients had an average age of 24.3±3.1 years(age range:18-33 years).The AIST technique was used in 42 patients and the TBT technique was used in 38 patients.The time between operation and injury,operative duration,postoperative visual analogue scale(VAS)score and knee functional recovery were recorded and compared between the two groups.The International Knee Documentation Committee(IKDC)and Lysholm scoring system were used to comprehensively evaluate clinical efficacy.RESULTS Eighty patients were followed for 24-36 mo,with an average follow-up duration of 27.5±1.8 mo.There were no significant differences in the time between surgery and injury,operative duration,IKDC and Lysholm scores of the affected knee at the last follow-up evaluation between the two groups.There were significant differences in VAS scores 1 d,3 d,7 d,2 wk and 1 mo after surgery(P<0.05).There was no significant difference in VAS score at 3 mo,6 mo and 1 year after operation.CONCLUSION The efficacy of the AIST ACL reconstruction technique was comparable to the TBT technique,but the postoperative pain was less with the AIST technique.Thus,the AIST technique is an ideal treatment choice for ACL reconstruction.展开更多
Hepatocellular carcinoma(HCC)is the third most common cause for cancer-related death worldwide,especially in China[1].Hepatectomy is considered one of the most potentially curative therapies for HCC[2].As HCC is capab...Hepatocellular carcinoma(HCC)is the third most common cause for cancer-related death worldwide,especially in China[1].Hepatectomy is considered one of the most potentially curative therapies for HCC[2].As HCC is capable of vascular invasion and metastasis via the portal venous system,anatomical resection is often performed to reduce tumor recurrence.This process involves resecting the tumor-bearing portal branches and the corresponding hepatic parenchyma[3].Certain comparative studies have demonstrated better overall survival and disease-free survival with the use of anatomical resection when compared with nonanatomical resection[4–6].展开更多
Since the first liver transplantation(LT)was executed by Thomas E.Starzl in 1963,the past six decades have witnessed rapid progresses in LT,especially in the immunosuppressive agents,surgical techniques,and perioperat...Since the first liver transplantation(LT)was executed by Thomas E.Starzl in 1963,the past six decades have witnessed rapid progresses in LT,especially in the immunosuppressive agents,surgical techniques,and perioperative managements.LT has been well-recognized as the only curative intervention for end-stage liver diseases.In this special issue on frontiers in LT,authors from several international LT centers summarized the current state and progresses in LT,including selection criteria for LT candidates,and precise management in LT recipients with HCC.展开更多
BACKGROUND Gastric cancer(GC)is a malignant tumor with a high incidence and mortality rate worldwide for which acute bleeding is a common clinical complication.Gastro-scopic hemostasis is an important method for treat...BACKGROUND Gastric cancer(GC)is a malignant tumor with a high incidence and mortality rate worldwide for which acute bleeding is a common clinical complication.Gastro-scopic hemostasis is an important method for treating acute bleeding in GC;however,its efficacy and safety remain controversial.AIM To systematically analyze the efficacy and safety of gastroscopic hemostasis for the treatment of acute gastric hemorrhage.METHODS The PUBMED,Web of Science,Wiley Library,EMBASE,Wanfang,CNKI,and VIP databases were searched for studies related to gastroscopic hemostatic treatment for acute GC published through February 20,2023.The literature was screened according to the inclusion and exclusion criteria,data were extracted,and lite-rature quality was evaluated.The meta-analysis was performed using RevMan software(version 5.3),while Begg’s test for publication bias was performed using Stata 13.0 software.RESULTS Six randomized controlled trials and two retrospective analyses were retrieved.Five studies had a low,two had an uncertain,and one had a high risk of bias.Compared with the control group,the hemostatic rate of gastroscopic hemostasis was increased[relative risk(RR)=1.24;95%confidence interval(CI):1.08 to 1.43;P=0.003];the rate of rebleeding(RR=0.27;95%CI:0.09 to 0.80;P=0.02),rate of surgery transfer(RR=0.16;95%CI:0.06 to 0.43;P=0.0003),serum C-reactive protein level[mean difference(MD)=-5.16;95%CI:-6.11 to 4.21;P<0.00001],interleukin-6 level(MD=-6.37;95%CI:-10.33 to-2.42;P=0.002),and tumor necrosis factor-αlevel(MD=-2.29;95%CI:-4.06 to-0.52;P=0.01)were decreased;and the quality of life improvement rate was increased(RR=1.95;95%C I=1.41-2.71;P<0.0001).Begg’s test revealed no significant publication bias.CONCLUSION The efficacy and safety of endoscopic hemostasis were higher than those of the control group,suggesting that it is an effective treatment for acute GC hemorrhage.展开更多
Background:This study was designed to investigate the feasibility of tumor-infiltrating immune cells with different phenotypic characteristics for predicting short-term clinical responses in patients with locally adva...Background:This study was designed to investigate the feasibility of tumor-infiltrating immune cells with different phenotypic characteristics for predicting short-term clinical responses in patients with locally advanced cervical cancer(LACC).Methods:Thirty-four patients who received concurrent chemoradiotherapy and twenty-one patients who merely underwent radiotherapy were enrolled in this study.We retrospectively analyzed the T cell markers(i.e.,CD3,CD4,CD8),memory markers(i.e.,CD45,CCR7),and differentiation markers(i.e.,CD27)in the peripheral blood and tumor tissues of patients with LACC before treatment based on flow cytometry.We also analyzed the relationship of T cell subsets between peripheral blood and tumor tissues,and their correlation with complete response or partial response.Results:The percentage of central memory CD8^(+)TCM(CD8^(+)CD45RA^(−)CD27^(+)CCR7^(+))cells in LACC patients was significantly lower than that of the control group.The percentage of CD8^(+)TN in the peripheral blood of LACC patients was significantly higher than that of tumor tissues.CD8^(+)TEM in the peripheral blood was significantly lower than that of tumor tissues.The percentage of CD8^(+)TN and CD8^(+)TCM in human papillomavirus(HPV)positive samples was significantly higher than that of HPV-negative samples.Similarly,the percentage of CD8^(+)TCM in tumor tissues was significantly higher in cancer tissue samples with lymph nodes compared with those without.Conclusion:A higher proportion of CD4^(+)TCM and a lower proportion of CD8^(+)TN in the tumor microenvironment of LACC may contribute to the therapy response prediction.展开更多
BACKGROUND The frequency and content of follow-up strategies remain controversial for colorectal cancer(CRC),and scheduled follow-ups have limited value.AIM To compare intensive and conventional follow-up strategies f...BACKGROUND The frequency and content of follow-up strategies remain controversial for colorectal cancer(CRC),and scheduled follow-ups have limited value.AIM To compare intensive and conventional follow-up strategies for the prognosis of non-metastatic CRC treated with curative intent using a meta-analysis.METHODS PubMed,Embase,and the Cochrane Library databases were systematically searched for potentially eligible randomized controlled trials(RCTs)from inception until April 2023.The Cochrane risk of bias was used to assess the methodological quality of the included studies.The hazard ratio,relative risk,and 95%confidence interval were used to calculate survival and categorical data,and pooled analyses were performed using the random-effects model.Additional exploratory analyses were performed for sensitivity,subgroups,and publication bias.RESULTS Eighteen RCTs involving 8533 patients with CRC were selected for the final analysis.Intensive follow-up may be superior to conventional follow-up in improving overall survival,but this difference was not statistically significant.Moreover,intensive follow-up was associated with an increased incidence of salvage surgery compared to conventional follow-up.In addition,there was no significant difference in the risk of recurrence between intensive and conventional follow-up strategies,whereas intensive follow-up was associated with a reduced risk of interval recurrence compared to conventional follow-up.Finally,the effects of intensive and conventional follow-up strategies differed when stratified by tumor location and follow-up duration.CONCLUSION Intensive follow-up may have a beneficial effect on the overall survival of patients with non-metastatic CRC treated with curative intent.展开更多
BACKGROUND Follicular lymphoma(FL)is a type of B-cell lymphoma that originates at the germinal center and has a low malignancy rate.FL has become the most common inert lymphoma in Europe and America but has a relative...BACKGROUND Follicular lymphoma(FL)is a type of B-cell lymphoma that originates at the germinal center and has a low malignancy rate.FL has become the most common inert lymphoma in Europe and America but has a relatively low incidence in Asia.AIM To explore the clinical features,curative effects,and prognostic factors of FL.METHODS Completed medical records of 49 patients with FL who were admitted to the Ningbo First Hospital from June 2010 to June 2021 were examined.These patients were definitively diagnosed by pathological biopsy or immunohistochemical staining.The diagnostic criteria were based on the 2008 World Health Organization classification of lymphomas.Ann Arbor staging was performed according to the imaging and bone marrow examination results.Risk stratification of all patients was performed based on the International Prognostic Index(IPI),age-adjusted IPI,Follicular Lymphoma International Prognosis Index(FLIPI),and FLIPI2 to compare the efficacy of different treatment regimens and analyze the related prognostic factors.RESULTS The age of onset in patients ranged from 24 to 76 years,with a median age of 51 years.Most patients developed the disease at 40–59 years of age,and the male:female ratio was 1.6:1.No significant difference was noted in the curative effect between the non-chemotherapy,combined chemotherapy,and other chemotherapy regimens(P>0.05).Hemoglobin(Hb)level<120 g/L,Ki-67 value>50%,bone marrow involvement,and clinical stagesⅢ–IV were associated with a poor prognosis of FL(P<0.05).However,the influence of other indicators was not statistically significant.Risk grouping was performed using the FLIPI,and the results showed that 24.5%,40.8%,and 34.7%of patients were in the low-,moderate-,and high-risk groups,respectively.According to the survival analysis results,the survival rate of patients was lower in the high-risk group than in the other low-risk and moderate-risk groups(P<0.05).CONCLUSION FL mainly occurs in middle-aged and elderly men,primarily affecting lymph nodes and bone marrow.Hb level,Ki-67 value,bone marrow involvement,and clinical staging were used to evaluate prognosis.展开更多
BACKGROUND Recurrent hepatocellular carcinoma(rHCC)is a common outcome after curative treatment.Retreatment for rHCC is recommended,but no guidelines exist.AIM To compare curative treatments such as repeated hepatecto...BACKGROUND Recurrent hepatocellular carcinoma(rHCC)is a common outcome after curative treatment.Retreatment for rHCC is recommended,but no guidelines exist.AIM To compare curative treatments such as repeated hepatectomy(RH),radiofrequency ablation(RFA),transarterial chemoembolization(TACE)and liver transplantation(LT)for patients with rHCC after primary hepatectomy by conducting a network meta-analysis(NMA).METHODS From 2011 to 2021,30 articles involving patients with rHCC after primary liver resection were retrieved for this NMA.The Q test was used to assess heterogeneity among studies,and Egger’s test was used to assess publication bias.The efficacy of rHCC treatment was assessed using disease-free survival(DFS)and overall survival(OS).RESULTS From 30 articles,a total of 17,11,8,and 12 arms of RH,RFA,TACE,and LT subgroups were collected for analysis.Forest plot analysis revealed that the LT subgroup had a better cumulative DFS and 1-year OS than the RH subgroup,with an odds ratio(OR)of 0.96(95%CI:0.31-2.96).However,the RH subgroup had a better 3-year and 5-year OS compared to the LT,RFA,and TACE subgroups.Hierarchic step diagram of different subgroups measured by the Wald test yielded the same results as the forest plot analysis.LT had a better 1-year OS(OR:1.04,95%CI:0.34-03.20),and LT was inferior to RH in 3-year OS(OR:10.61,95%CI:0.21-1.73)and 5-year OS(OR:0.95,95%CI:0.39-2.34).According to the predictive P score evaluation,the LT subgroup had a better DFS,and RH had the best OS.However,meta-regression analysis revealed that LT had a better DFS(P<0.001)as well as 3-year OS(P=0.881)and 5-year OS(P=0.188).The differences in superiority between DFS and OS were due to the different testing methods used.CONCLUSION According to this NMA,RH and LT had better DFS and OS for rHCC than RFA and TACE.However,treatment strategies should be determined by the recurrent tumor characteristics,the patient’s general health status,and the care program at each institution.展开更多
Objective:Inhibition of tumor angiogenesis has become a new targeted tumor therapy.In this study,we established a micellar carrier with a tumor neovascularization-targeting effect modified by the neovascularization-ta...Objective:Inhibition of tumor angiogenesis has become a new targeted tumor therapy.In this study,we established a micellar carrier with a tumor neovascularization-targeting effect modified by the neovascularization-targeting peptide NGR.Methods:The targeted polymer poly(ethylene glycol)-b-poly(lactide-co-glycolide)(PEG-PLGA)modified with Asn–Gly–Arg(NGR)peptide was prepared and characterized by 1H nuclear magnetic resonance and Fourier-transform infrared spectrometry.NGR-PEG-PLGA was used to construct curcumin(Cur)-loaded micelles by the solvent evaporation method.The physicochemical properties of the micelles were also investigated.Additionally,we evaluated the antitumor efficacy of the polymer micelles(PM)using in vitro cytology experiments and in vivo animal studies.Results:The particle size of Cur-NGR-PM was 139.70±2.51 nm,and the drug-loading capacity was 14.37±0.06%.In vitro cytological evaluation showed that NGR-modified micelles showed higher cellular uptake through receptor-mediated endocytosis pathways than did unmodified micelles,leading to the apoptosis of tumor cells.Then,in vivo antitumor experiments showed that the modified micelles significantly inhibited tumor growth and were safe.Conclusions:NGR-modified micelles significantly optimized the therapeutic efficacy of Cur.This strategy offers a viable avenue for cancer treatment.展开更多
BACKGROUND Chemotherapy followed by gastrojejunostomy remains the main treatment for unresectable gastric cancer(GC)in the middle-or lower-third regions with gastric outlet obstruction(GOO).Radical surgery is performe...BACKGROUND Chemotherapy followed by gastrojejunostomy remains the main treatment for unresectable gastric cancer(GC)in the middle-or lower-third regions with gastric outlet obstruction(GOO).Radical surgery is performed as part of a multimodal treatment strategy for selected patients who respond well to chemotherapy.This study describes a case of successful radical resection with completely laparoscopic subtotal gastrectomy after a modified stomach-partitioning gastrojejunostomy(SPGJ)for obstruction relief,in a patient with GOO.CASE SUMMARY During the initial esophagogastroduodenoscopy,an advanced growth was detected in the lower part of the stomach,which caused an obstruction in the pyloric ring.Following this,a computed tomography(CT)scan revealed the presence of lymph node metastases and tumor invasion in the duodenum,but no evidence of distant metastasis was found.Consequently,we performed a modified SPGJ,a complete laparoscopic SPGJ combined with No.4sb lymph node dissection,for obstruction relief.Seven courses of adjuvant capecitabine plus oxaliplatin combined with Toripalimab(programmed death ligand-1 inhibitor)were administered thereafter.A preoperative CT showed partial response;therefore,completely laparoscopic radical subtotal gastrectomy with D2 lymphadenectomy was performed after conversion therapy,and pathological complete remission was achieved.CONCLUSION Laparoscopic SPGJ combined with No.4sb lymph node dissection was an effective surgical technique for initially unresectable GC with GOO.展开更多
基金supported by the National Natural Science Foundation of China(31971902,32001509)China Agriculture Research System of MOF and MARA。
文摘The leaf is the main organ for rapeseed photosynthesis,and its morphology influences photosynthetic efficiency and supports increased planting density and yield.However,the molecular regulatory mechanism of leaf morphology in Brassica napus is poorly understood,restricting progress in breeding for the trait.We describe a novel dominant mutation,curly leaf 1(cl1),which confers uneven dorsal–ventral axis development,irregular cellular structure and influenced gravitropic response in the seedling stage.The CL1 locus was mapped to a 1.573-Mb interval on chromosome A05 using simple sequence repeat(SSR)markers,and co-segregated with the phenotype of plants in the curly F2 population.A substitution(P62S)was identified in the highly conserved degron motif(GWSPV)of the IAA2 protein in the cl1mutant,and the P62S substitution impaired the interaction between IAA2 and TIR1 in the presence of auxin,influencing auxin signaling.The P62S substitution-induced curly leaf phenotype was verified by ectopic expression of Bna A05.iaa2 in Arabidopsis and B.napus.Our findings explain the function of IAA2 in rapeseed,providing a foundation for future investigation of auxin signaling and the mechanisms underlying leaf development in B.napus.
基金The authors acknowledge the financial support of this work by the National Natural Science Foundation of China(No.52202302)National Natural Science Foundation of Shaanxi(Nos.2019JLZ-01 and 2022KXJ-146)+1 种基金the Fundamental Research Funds for the Central Universities(No.3102019JC005)the Youth Innovation Team of Shaanxi Universities and ND Basic Research Funds(No.G2022WD).
文摘Benefiting from the distinctive ordering degree and local microstructure characteristics,hard carbon(HC)is considered as the most promising anode for sodium-ion batteries(SIBs).Unfortunately,the low initial Coulombic efficiency(ICE)and limited reversible capacity severely impede its extensive application.Here,a homogeneous curly graphene(CG)layer with a micropore structure on HC is designed and executed by a simple chemical vapor deposition method(without catalysts).CG not only improves the electronic/ionic conductivity of the hard carbon but also effectively shields its surface defects,enhancing its ICE.In particular,due to the spontaneous curling structural characteristics of CG sheets(CGs),the micropores(≤2 nm)formed provide additional active sites,increasing its capacity.When used as a sodium-ion battery anode,the HC-CG composite anode displayed an outstanding reversible capacity of 358 mAh·g^(-1),superior ICE of 88.6%,remarkable rate performance of 145.8 mAh·g^(-1)at 5 A·g^(-1),and long cycling life after 1000 cycles with 88.6%at 1 A·g^(-1).This work provides a simple defect/microstructure turning strategy for hard carbon anodes and deepens the understanding of Na+storage behavior in the plateau region,especially on the pore-filling mechanism by forming quasi-metallic clusters.
基金This work was partially supported by the National Science Fund for Distinguished Young Scholars (Grant No. 30125032) the Teaching and Research Award Program for Outstanding Young Teachers in Higher Education Institutions of MOE The work was also sup
文摘Virus isolate Y1 was obtained from tobacco showing curly shoot symptoms in Baoshan, Yunnan Province. Whitefly transmission test and virion morphology observa-tion showed that it is a begomovirus. In reactions with 14 monoclonal antibodies raised against begomoviruses, Y1 was readily differentiated from begomoviruses reported in China, Pakistan and India. The complete nucleotide sequence of DNA-A was determined, it contains 2746 nucleotides, with two ORFs in virion-sense DNA and four ORFs in comple-mentary-sense DNA. Comparisons with total DNA-A, inter-genie region and deduced amino acid sequences of individual ORFs showed that Y1 is a distinct Begomovirus species, for which the name Tobacco curly shoot virus (TCSV) is pro-posed. The total DNA-A of TCSV is most closely related to that of Tomato leaf curl virus from India (85% sequence identity). In contrast, the deduced coat protein of TCSV is most like that of Cotton leaf curl virus 72b isolate from Paki-stan (98% amino acid sequence identity).
基金This work was supported by grants from ANPCyT(Agenda Nacional de Prom ocion Cientificay Tecnologica,Argentina),HFSP(Human Frontier Science Program),the Max Planck Society,and ICGEB(International Center for Genetic Engineering and Biotechnology)to P.A.M.,and from UNL(Universidad Nacional del Litoral)to D.A.R.D.A.R.,A.L.A.,F.D.A.,and P.A.M.are members of CONICETD.A.C.and A.H.T.are fellows of the same institution.
文摘CURLY LEAF ( CLF) encodes the methyltransferase subunit of the Polycomb Repressor Complex 2 (PRC2), which regulates the expression of target genes through H3K27 trimethylation. We isolated a new CLF mutant allele ( clf-78) using a genetic screen designed to identify microRNA (miRNA) deficient mutants. CLF mutant plants showed impaired miRNA activity caused by increased ubiquitination and enhanced degradation of ARGONAUTE 1 (AGO1) in specific tissues. Such CLF-mediated AGO1 regulation was evident when plants were exposed to UV radiation, which caused increased susceptibility of clf mutants to some UV-induced responses. Furthermore, we showed that CLF directly regulates FBW2, which in turn triggers AGO1 degradation in the clf mutants. Interestingly, AGO1 bound to a target appeared particularly prone to degradation in the mutant plants, a process that was exacerbated when the complex bound a non-cleavable target. Thus, prolonged AGO1–target interaction seems to favor AGO1 degradation, suggesting that non-cleavable miRNA targets may overcome translation inhibition by modulating AGO1 stability in plants.
基金funded by the Ministry of Science and Technology of the People’s Republic of China,National Key Research and Development Program(2018YFC1706001)Tianjin Municipal Science and Technology Bureau,Tianjin Science and Technology Plan Project(21JCQNJC01560)+5 种基金Tianjin Education Commission scientific research project(2022KJ170)Tianjin Municipal Education commissionTianjin Graduate Research Innovation Project(Service Industry Project)(2022BKYZ046)Tianjin University of Traditional Chinese MedicineTianjin University of Traditional Chinese Medicine Graduate Research Innovation Project(Clinical Research Project YJSKC-20222002)and the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine,Exploration and Innovation Project(YB202112).
文摘Acupuncture is an effective treatment for ischemic stroke(IS)and plays a key role in neurological rehabilitation after IS.Acupuncture can improve the clinical symptoms of various complications after IS,including motor dysfunction,swallowing disorders,speech disorders,cognitive impairment,depression,insomnia,and fatigue.However,the mechanisms underlying the effects of acupuncture in IS remain unclear.Available evidence suggests that acupuncture may exert neuroprotective effects through neuroplasticity(neurogenesis and synaptogenesis),angiogenesis,cell proliferation and apoptosis,and regulation of oxidative stress,inflammation,and immunity.Further studies should be conducted to improve the high-quality evidence-based system of acupuncture intervention for IS,by focusing on the clinical and basic research design,increasing the sample size,standardizing and quantifying the standards of acupuncture operations,using multidisciplinary techniques and methods to systematically explore the key targets of acupuncture intervention for IS,and reveal the efficacy and mechanism of acupuncture in the treatment of IS.
文摘BACKGROUND Obstructive sleep apnea-hypopnea syndrome(OSAHS)is primarily caused by airway obstruction due to narrowing and blockage in the nasal and nasopha-ryngeal,oropharyngeal,soft palate,and tongue base areas.The mid-frequency anti-snoring device is a new technology based on sublingual nerve stimulation.Its principle is to improve the degree of oropharyngeal airway stenosis in OSAHS patients under mid-frequency wave stimulation.Nevertheless,there is a lack of clinical application and imaging evidence.METHODS We selected 50 patients diagnosed with moderate OSAHS in our hospital between July 2022 and August 2023.They underwent a 4-wk treatment regimen involving the mid-frequency anti-snoring device during nighttime sleep.Following the treatment,we monitored and assessed the sleep apnea quality of life index and Epworth Sleepiness Scale scores.Additionally,we performed computed tomo-graphy scans of the oropharynx in the awake state,during snoring,and while using the mid-frequency anti-snoring device.Cross-sectional area measurements in different states were taken at the narrowest airway point in the soft palate posterior and retrolingual areas.RESULTS Compared to pretreatment measurements,patients exhibited a significant reduction in the apnea-hypopnea index,the percentage of time with oxygen saturation below 90%,snoring frequency,and the duration of the most prolonged apnea event.The lowest oxygen saturation showed a notable increase,and both sleep apnea quality of life index and Epworth Sleepiness Scale scores improved.Oropharyngeal computed tomography scans revealed that in OSAHS patients cross-sectional areas of the oropharyngeal airway in the soft palate posterior area and retrolingual area decreased during snoring compared to the awake state.Conversely,during mid-frequency anti-snoring device treatment,these areas increased compared to snoring.CONCLUSION The mid-frequency anti-snoring device demonstrates the potential to enhance various sleep parameters in patients with moderate OSAHS,thereby improving their quality of life and reducing daytime sleepiness.These therapeutic effects are attributed to the device’s ability to ameliorate the narrowing of the oropharynx in OSAHS patients.
基金Supported by Science and Technology Plan Project of Shaoyang City,No.2022GX4139.
文摘BACKGROUND Diabetes and thyroiditis are closely related.They occur in combination and cause significant damage to the body.There is no clear treatment for type-2 diabetes mellitus(T2DM)with Hashimoto's thyroiditis(HT).While single symptomatic drug treatment of the two diseases is less effective,combined drug treatment may improve efficacy.AIM To investigate the effect of a combination of vitamin D,selenium,and hypoglycemic agents in T2DM with HT.METHODS This retrospective study included 150 patients with T2DM and HT treated at The Central Hospital of Shaoyang from March 2020 to February 2023.Fifty patients were assigned to the control group,test group A,and test group B according to different treatment methods.The control group received low-iodine diet guidance and hypoglycemic drug treatment.Test group A received the control treatment plus vitamin D treatment.Test group B received the group A treatment plus selenium.Blood levels of markers of thyroid function[free T3(FT3),thyroid stimulating hormone(TSH),free T4(FT4)],autoantibodies[thyroid peroxidase antibody(TPOAB)and thyroid globulin antibody(TGAB)],blood lipid index[low-density lipoprotein cholesterol(LDL-C),total cholesterol(TC),triacylglycerol(TG)],blood glucose index[fasting blood glucose(FBG),and hemoglobin A1c(HbA1c)]were measured pre-treatment and 3 and 6 months after treatment.The relationships between serum 25-hydroxyvitamin D3[25(OH)D3]level and each of these indices were analyzed.RESULTS The levels of 25(OH)D3,FT3,FT4,and LDL-C increased in the order of the control group,test group A,and test group B(all P<0.05).The TPOAB,TGAB,TC,TG,FBG,HbA1c,and TSH levels increased in the order of test groups B,A,and the control group(all P<0.05).All the above indices were compared after 3 and 6 months of treatment.Pre-treatment,there was no divergence in serum 25(OH)D3 level,thyroid function-related indexes,autoantibodies level,blood glucose,and blood lipid index between the control group,test groups A and B(all P>0.05).The 25(OH)D3 levels in test groups A and B were negatively correlated with FT4 and TGAB(all P<0.05).CONCLUSION The combination drug treatment for T2DM with HT significantly improved thyroid function,autoantibody,and blood glucose and lipid levels.
基金funded by the National Natural Science Foundation of China (42067013, 41571090)
文摘Globally,many lakes are drying up,leaving exposed lakebeds where wind erosion releases dust and sand rich in salt and harmful heavy metals into the atmosphere.Therefore,understanding the characteristics and spatial distribution of playa surface crusts is important to recognize the manifestation of salt dust storms.The objective of this study was to explore the playa surface crust types as well as their spatial distribution and evolution of Qehan Lake in Inner Mongolia Autonomous Region,China to understand the salt dust release potential of different types of playa surface crusts.Various crust characteristics were investigated by field sampling in Qehan Lake,and playa surface crusts were further divided into five types:vegetated areas,salt crusts,clay flats,curly crusts,and margins.It should be noted that curly crusts were distributed in clay flats and covered only a small area in Qehan Lake.The spatial distribution characteristics of playa surface crust types were obtained by supervised classification of remote sensing images,and the salt dust release potential of crusts was explored by the wind tunnel experiments.The field investigation of Qehan Lake revealed that playa surface crust types had a circum-lake band distribution from the inside to the outside of this lake,which were successively vegetated areas,clay flats,salt crusts,and margins.The spatial distribution patterns of playa surface crust types were mainly controlled by the hydrodynamics of the playa,soil texture,and groundwater.There was a significant negative correlation between crust thickness and electrical conductivity.The results of the wind tunnel experiments showed that the initial threshold of friction wind velocity for the salt dust release was higher in clay flats(0.7–0.8 m/s)than in salt crusts(0.5–0.6 m/s).Moreover,the particle leap impact processes occurring under natural conditions may reduce this threshold value.Salinity was the main factor controlling the difference in the initial threshold of friction wind velocity for the salt dust release of clay flats and salt crusts.This study provides a scientific reference for understanding how salt dust is released from a lakebed,which may be used for ecological restoration of dry salt lakes.
基金Supported by Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences,No.2022-I2M-C&T-A-004National High Level Hospital Clinical Research Funding,No.2022-PUMCH-B-005.
文摘Gallbladder carcinoma(GBC)is the most common biliary tract malignancy associated with a concealed onset,high invasiveness and poor prognosis.Radical surgery remains the only curative treatment for GBC,and the optimal extent of surgery depends on the tumor stage.Radical resection can be achieved by simple cholecystectomy for Tis and T1a GBC.However,whether simple cholecystectomy or extended cholecystectomy,including regional lymph node dissection and hepatectomy,is the standard surgical extent for T1b GBC remains controversial.Extended cholecystectomy should be performed for T2 and some T3 GBC without distant metastasis.Secondary radical surgery is essential for incidental gallbladder cancer diagnosed after cholecystectomy.For locally advanced GBC,hepatopancreatoduodenectomy may achieve R0 resection and improve long-term survival outcomes,but the extremely high risk of the surgery limits its implementation.Laparoscopic surgery has been widely used in the treatment of gastrointestinal malignancies.GBC was once regarded as a contraindication of laparoscopic surgery.However,with improvements in surgical instruments and skills,studies have shown that laparoscopic surgery will not result in a poorer prognosis for selected patients with GBC compared with open surgery.Moreover,laparoscopic surgery is associated with enhanced recovery after surgery since it is minimally invasive.
文摘BACKGROUND Many studies have focused on the femoral tunnel technique and fixation method,but few studies have involved the tibial tunnel technique and fixation method.The all-inside technique is one of the new techniques that has been described in recent years.All-inside anterior cruciate ligament(ACL)reconstruction is based on a tibial socket instead of a full tunnel.This method has many potential advantages.AIM To compare clinical outcomes of knee ACL autograft reconstruction using allinside quadrupled semitendinosus(AIST)and traditional hamstring tendon(TBT)techniques.METHODS From January 2017 to October 2019,the clinical data of 80 patients with ACL reconstruction were retrospectively analyzed,including 67 males and 13 females.The patients had an average age of 24.3±3.1 years(age range:18-33 years).The AIST technique was used in 42 patients and the TBT technique was used in 38 patients.The time between operation and injury,operative duration,postoperative visual analogue scale(VAS)score and knee functional recovery were recorded and compared between the two groups.The International Knee Documentation Committee(IKDC)and Lysholm scoring system were used to comprehensively evaluate clinical efficacy.RESULTS Eighty patients were followed for 24-36 mo,with an average follow-up duration of 27.5±1.8 mo.There were no significant differences in the time between surgery and injury,operative duration,IKDC and Lysholm scores of the affected knee at the last follow-up evaluation between the two groups.There were significant differences in VAS scores 1 d,3 d,7 d,2 wk and 1 mo after surgery(P<0.05).There was no significant difference in VAS score at 3 mo,6 mo and 1 year after operation.CONCLUSION The efficacy of the AIST ACL reconstruction technique was comparable to the TBT technique,but the postoperative pain was less with the AIST technique.Thus,the AIST technique is an ideal treatment choice for ACL reconstruction.
基金This study was supported by a grant from the National Natural Science Foundation of China(82102861).
文摘Hepatocellular carcinoma(HCC)is the third most common cause for cancer-related death worldwide,especially in China[1].Hepatectomy is considered one of the most potentially curative therapies for HCC[2].As HCC is capable of vascular invasion and metastasis via the portal venous system,anatomical resection is often performed to reduce tumor recurrence.This process involves resecting the tumor-bearing portal branches and the corresponding hepatic parenchyma[3].Certain comparative studies have demonstrated better overall survival and disease-free survival with the use of anatomical resection when compared with nonanatomical resection[4–6].
基金supported by a grant from the Key Program of the National Natural Science Foundation of China(No.81930016)。
文摘Since the first liver transplantation(LT)was executed by Thomas E.Starzl in 1963,the past six decades have witnessed rapid progresses in LT,especially in the immunosuppressive agents,surgical techniques,and perioperative managements.LT has been well-recognized as the only curative intervention for end-stage liver diseases.In this special issue on frontiers in LT,authors from several international LT centers summarized the current state and progresses in LT,including selection criteria for LT candidates,and precise management in LT recipients with HCC.
文摘BACKGROUND Gastric cancer(GC)is a malignant tumor with a high incidence and mortality rate worldwide for which acute bleeding is a common clinical complication.Gastro-scopic hemostasis is an important method for treating acute bleeding in GC;however,its efficacy and safety remain controversial.AIM To systematically analyze the efficacy and safety of gastroscopic hemostasis for the treatment of acute gastric hemorrhage.METHODS The PUBMED,Web of Science,Wiley Library,EMBASE,Wanfang,CNKI,and VIP databases were searched for studies related to gastroscopic hemostatic treatment for acute GC published through February 20,2023.The literature was screened according to the inclusion and exclusion criteria,data were extracted,and lite-rature quality was evaluated.The meta-analysis was performed using RevMan software(version 5.3),while Begg’s test for publication bias was performed using Stata 13.0 software.RESULTS Six randomized controlled trials and two retrospective analyses were retrieved.Five studies had a low,two had an uncertain,and one had a high risk of bias.Compared with the control group,the hemostatic rate of gastroscopic hemostasis was increased[relative risk(RR)=1.24;95%confidence interval(CI):1.08 to 1.43;P=0.003];the rate of rebleeding(RR=0.27;95%CI:0.09 to 0.80;P=0.02),rate of surgery transfer(RR=0.16;95%CI:0.06 to 0.43;P=0.0003),serum C-reactive protein level[mean difference(MD)=-5.16;95%CI:-6.11 to 4.21;P<0.00001],interleukin-6 level(MD=-6.37;95%CI:-10.33 to-2.42;P=0.002),and tumor necrosis factor-αlevel(MD=-2.29;95%CI:-4.06 to-0.52;P=0.01)were decreased;and the quality of life improvement rate was increased(RR=1.95;95%C I=1.41-2.71;P<0.0001).Begg’s test revealed no significant publication bias.CONCLUSION The efficacy and safety of endoscopic hemostasis were higher than those of the control group,suggesting that it is an effective treatment for acute GC hemorrhage.
基金the Project of the Central Government Guiding Local Science and Technology under Grant Number ZYYD2022B18the Institutional Ethics Committee of Affiliated Cancer Hospital of Xinjiang Medical University(No.K-2019001).
文摘Background:This study was designed to investigate the feasibility of tumor-infiltrating immune cells with different phenotypic characteristics for predicting short-term clinical responses in patients with locally advanced cervical cancer(LACC).Methods:Thirty-four patients who received concurrent chemoradiotherapy and twenty-one patients who merely underwent radiotherapy were enrolled in this study.We retrospectively analyzed the T cell markers(i.e.,CD3,CD4,CD8),memory markers(i.e.,CD45,CCR7),and differentiation markers(i.e.,CD27)in the peripheral blood and tumor tissues of patients with LACC before treatment based on flow cytometry.We also analyzed the relationship of T cell subsets between peripheral blood and tumor tissues,and their correlation with complete response or partial response.Results:The percentage of central memory CD8^(+)TCM(CD8^(+)CD45RA^(−)CD27^(+)CCR7^(+))cells in LACC patients was significantly lower than that of the control group.The percentage of CD8^(+)TN in the peripheral blood of LACC patients was significantly higher than that of tumor tissues.CD8^(+)TEM in the peripheral blood was significantly lower than that of tumor tissues.The percentage of CD8^(+)TN and CD8^(+)TCM in human papillomavirus(HPV)positive samples was significantly higher than that of HPV-negative samples.Similarly,the percentage of CD8^(+)TCM in tumor tissues was significantly higher in cancer tissue samples with lymph nodes compared with those without.Conclusion:A higher proportion of CD4^(+)TCM and a lower proportion of CD8^(+)TN in the tumor microenvironment of LACC may contribute to the therapy response prediction.
文摘BACKGROUND The frequency and content of follow-up strategies remain controversial for colorectal cancer(CRC),and scheduled follow-ups have limited value.AIM To compare intensive and conventional follow-up strategies for the prognosis of non-metastatic CRC treated with curative intent using a meta-analysis.METHODS PubMed,Embase,and the Cochrane Library databases were systematically searched for potentially eligible randomized controlled trials(RCTs)from inception until April 2023.The Cochrane risk of bias was used to assess the methodological quality of the included studies.The hazard ratio,relative risk,and 95%confidence interval were used to calculate survival and categorical data,and pooled analyses were performed using the random-effects model.Additional exploratory analyses were performed for sensitivity,subgroups,and publication bias.RESULTS Eighteen RCTs involving 8533 patients with CRC were selected for the final analysis.Intensive follow-up may be superior to conventional follow-up in improving overall survival,but this difference was not statistically significant.Moreover,intensive follow-up was associated with an increased incidence of salvage surgery compared to conventional follow-up.In addition,there was no significant difference in the risk of recurrence between intensive and conventional follow-up strategies,whereas intensive follow-up was associated with a reduced risk of interval recurrence compared to conventional follow-up.Finally,the effects of intensive and conventional follow-up strategies differed when stratified by tumor location and follow-up duration.CONCLUSION Intensive follow-up may have a beneficial effect on the overall survival of patients with non-metastatic CRC treated with curative intent.
基金Supported by Zhejiang TCM Science and Technology Project,No.2023ZL653。
文摘BACKGROUND Follicular lymphoma(FL)is a type of B-cell lymphoma that originates at the germinal center and has a low malignancy rate.FL has become the most common inert lymphoma in Europe and America but has a relatively low incidence in Asia.AIM To explore the clinical features,curative effects,and prognostic factors of FL.METHODS Completed medical records of 49 patients with FL who were admitted to the Ningbo First Hospital from June 2010 to June 2021 were examined.These patients were definitively diagnosed by pathological biopsy or immunohistochemical staining.The diagnostic criteria were based on the 2008 World Health Organization classification of lymphomas.Ann Arbor staging was performed according to the imaging and bone marrow examination results.Risk stratification of all patients was performed based on the International Prognostic Index(IPI),age-adjusted IPI,Follicular Lymphoma International Prognosis Index(FLIPI),and FLIPI2 to compare the efficacy of different treatment regimens and analyze the related prognostic factors.RESULTS The age of onset in patients ranged from 24 to 76 years,with a median age of 51 years.Most patients developed the disease at 40–59 years of age,and the male:female ratio was 1.6:1.No significant difference was noted in the curative effect between the non-chemotherapy,combined chemotherapy,and other chemotherapy regimens(P>0.05).Hemoglobin(Hb)level<120 g/L,Ki-67 value>50%,bone marrow involvement,and clinical stagesⅢ–IV were associated with a poor prognosis of FL(P<0.05).However,the influence of other indicators was not statistically significant.Risk grouping was performed using the FLIPI,and the results showed that 24.5%,40.8%,and 34.7%of patients were in the low-,moderate-,and high-risk groups,respectively.According to the survival analysis results,the survival rate of patients was lower in the high-risk group than in the other low-risk and moderate-risk groups(P<0.05).CONCLUSION FL mainly occurs in middle-aged and elderly men,primarily affecting lymph nodes and bone marrow.Hb level,Ki-67 value,bone marrow involvement,and clinical staging were used to evaluate prognosis.
基金Supported by the Research Fund from E-Da Hospital,No.EDAHS110012.
文摘BACKGROUND Recurrent hepatocellular carcinoma(rHCC)is a common outcome after curative treatment.Retreatment for rHCC is recommended,but no guidelines exist.AIM To compare curative treatments such as repeated hepatectomy(RH),radiofrequency ablation(RFA),transarterial chemoembolization(TACE)and liver transplantation(LT)for patients with rHCC after primary hepatectomy by conducting a network meta-analysis(NMA).METHODS From 2011 to 2021,30 articles involving patients with rHCC after primary liver resection were retrieved for this NMA.The Q test was used to assess heterogeneity among studies,and Egger’s test was used to assess publication bias.The efficacy of rHCC treatment was assessed using disease-free survival(DFS)and overall survival(OS).RESULTS From 30 articles,a total of 17,11,8,and 12 arms of RH,RFA,TACE,and LT subgroups were collected for analysis.Forest plot analysis revealed that the LT subgroup had a better cumulative DFS and 1-year OS than the RH subgroup,with an odds ratio(OR)of 0.96(95%CI:0.31-2.96).However,the RH subgroup had a better 3-year and 5-year OS compared to the LT,RFA,and TACE subgroups.Hierarchic step diagram of different subgroups measured by the Wald test yielded the same results as the forest plot analysis.LT had a better 1-year OS(OR:1.04,95%CI:0.34-03.20),and LT was inferior to RH in 3-year OS(OR:10.61,95%CI:0.21-1.73)and 5-year OS(OR:0.95,95%CI:0.39-2.34).According to the predictive P score evaluation,the LT subgroup had a better DFS,and RH had the best OS.However,meta-regression analysis revealed that LT had a better DFS(P<0.001)as well as 3-year OS(P=0.881)and 5-year OS(P=0.188).The differences in superiority between DFS and OS were due to the different testing methods used.CONCLUSION According to this NMA,RH and LT had better DFS and OS for rHCC than RFA and TACE.However,treatment strategies should be determined by the recurrent tumor characteristics,the patient’s general health status,and the care program at each institution.
基金supported by Scientific Research Project of Tianjin Municipal Education Commission (No.2019KJ080).
文摘Objective:Inhibition of tumor angiogenesis has become a new targeted tumor therapy.In this study,we established a micellar carrier with a tumor neovascularization-targeting effect modified by the neovascularization-targeting peptide NGR.Methods:The targeted polymer poly(ethylene glycol)-b-poly(lactide-co-glycolide)(PEG-PLGA)modified with Asn–Gly–Arg(NGR)peptide was prepared and characterized by 1H nuclear magnetic resonance and Fourier-transform infrared spectrometry.NGR-PEG-PLGA was used to construct curcumin(Cur)-loaded micelles by the solvent evaporation method.The physicochemical properties of the micelles were also investigated.Additionally,we evaluated the antitumor efficacy of the polymer micelles(PM)using in vitro cytology experiments and in vivo animal studies.Results:The particle size of Cur-NGR-PM was 139.70±2.51 nm,and the drug-loading capacity was 14.37±0.06%.In vitro cytological evaluation showed that NGR-modified micelles showed higher cellular uptake through receptor-mediated endocytosis pathways than did unmodified micelles,leading to the apoptosis of tumor cells.Then,in vivo antitumor experiments showed that the modified micelles significantly inhibited tumor growth and were safe.Conclusions:NGR-modified micelles significantly optimized the therapeutic efficacy of Cur.This strategy offers a viable avenue for cancer treatment.
基金Supported by the National Natural Science Foundation of China,No.82072734.
文摘BACKGROUND Chemotherapy followed by gastrojejunostomy remains the main treatment for unresectable gastric cancer(GC)in the middle-or lower-third regions with gastric outlet obstruction(GOO).Radical surgery is performed as part of a multimodal treatment strategy for selected patients who respond well to chemotherapy.This study describes a case of successful radical resection with completely laparoscopic subtotal gastrectomy after a modified stomach-partitioning gastrojejunostomy(SPGJ)for obstruction relief,in a patient with GOO.CASE SUMMARY During the initial esophagogastroduodenoscopy,an advanced growth was detected in the lower part of the stomach,which caused an obstruction in the pyloric ring.Following this,a computed tomography(CT)scan revealed the presence of lymph node metastases and tumor invasion in the duodenum,but no evidence of distant metastasis was found.Consequently,we performed a modified SPGJ,a complete laparoscopic SPGJ combined with No.4sb lymph node dissection,for obstruction relief.Seven courses of adjuvant capecitabine plus oxaliplatin combined with Toripalimab(programmed death ligand-1 inhibitor)were administered thereafter.A preoperative CT showed partial response;therefore,completely laparoscopic radical subtotal gastrectomy with D2 lymphadenectomy was performed after conversion therapy,and pathological complete remission was achieved.CONCLUSION Laparoscopic SPGJ combined with No.4sb lymph node dissection was an effective surgical technique for initially unresectable GC with GOO.
