Treatment Options for Signet Ring Cell Carcinoma of the Urinary Bladder: A Population-Based Study.

OBJECTIVES: Signet ring cell carcinoma (SRCC) of the urinary bladder is a rare and highly aggressive form of bladder cancer, with no widely agreed-upon treatment strategy. The aim of this study was to identify important factors influencing patient prognosis and to assess how various treatment approaches affect survival outcomes. METHODS: A retrospective study was conducted using data from the Surveillance, Epidemiology, and End Results (SEER) Program, including patients with bladder primary SRCC who were presented between 2000 and 2017. Univariate and multivariate Cox regression models were used to examine the impact of various factors on cancer-specific survival (CSS) and overall survival (OS). Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were applied to homogenize both groups. The impact of different treatment regimens on patient CSS and OS was analyzed using the Kaplan-Meier method. RESULTS: A total of 33 cases of non-muscular invasive SRCC and 210 cases of muscular invasive SRCC were included in this study. Multivariate analysis identified race, TNM stage, and surgical method as independent variables influencing both OS and CSS. In non-muscle invasive bladder SRCC patients, radical cystectomy showed no CSS benefit compared to transurethral resection of bladder tumors (P = 0.304). For muscle invasive SRCC, patients who underwent partial cystectomy had better OS and CSS compared to those who underwent radical cystectomy (P = 0.019, P = 0.024). However, after conducting a PSM analysis, the differences between the two surgical outcomes were not statistically significant (P = 0.504, P = 0.335). Lymphadenectomy, chemotherapy, and radiation did not show any benefit to the prognosis of patients. CONCLUSION: This study identified race, TNM stage, and surgical approach as significant independent predictors for SRCC outcomes. Simple radical cystectomy and partial cystectomy proved to be effective treatments for SRCC. The optimal treatment option still needs to be supported by a number of prospective research trials.

Computing degree based topological indices of algebraic hypergraphs.

Topological indices are numerical parameters that indicate the topology of graphs or hypergraphs. A hypergraph H = ( V ( H ) , E ( H ) ) consists of a vertex set V ( H ) and an edge set E ( H ) , where each edge e ∈ E ( H ) is a subset of V ( H ) with at least two elements. In this paper, our main aim is to introduce a general hypergraph structure for the prime ideal sum (PIS)- graph of a commutative ring. The prime ideal sum hypergraph of a ring R is a hypergraph whose vertices are all non-trivial ideals of R and a subset of vertices E i with at least two elements is a hyperedge whenever I + J is a prime ideal of R for each non-trivial ideal I, J in E i and E i is maximal with respect to this property. Moreover, we also compute some degree-based topological indices (first and second Zagreb indices, forgotten topological index, harmonic index, Randic index, Sombor index) for these hypergraphs. In particular, we describe some degree-based topological indices for the newly defined algebraic hypergraph based on prime ideal sum for Z n where n = p α , p q , p 2 q , p 2 q 2 , p q r , p 3 q , p 2 q r , p q r s for the distinct primes p , q , r and s.

Temperature effects on the branching dynamics in the model ambimodal (6 + 4)/(4 + 2) intramolecular cycloaddition reaction.

C14H20 (tetradecapentaene) is a simple model system exhibiting post transition-state behavior, wherein both the (6 + 4) and (4 + 2) cycloaddition products are formed from one ambimocal transition state structure. We studied the bifurcation dynamics starting from the two ambimodal transition state structures, the chair-form and boat-form, using the quasi-classical trajectory, classical molecular dynamics, and ring-polymer molecular dynamics methods on the parameter-optimized semiempirical GFN2-xTB potential energy surface. It was found that the calculated branching fractions differ between the chair-form and boat-form due to the different nature in the IRC pathways. We also investigated the effects of temperature on bifurcation dynamics and found that, at higher temperatures, trajectories stay longer in the intermediate region of the potential energy surface.

Rational Design of Oil-Resistant and Electrically Conductive Fluorosilicone Rubber Foam Nanocomposites for Sensitive Detectability in Complex Solvent Environments.

Recent years have witnessed the explosive development of highly sensitive smart sensors based on conductive polymer foam materials. However, the design and development of multifunctional polymeric foam composites as smart sensors applied in complex solvent and oil environments remain a critical challenge. Herein, we design and synthesize vinyl-terminated polytrifluoropropylmethylsiloxane through anionic ring-opening polymerization to fabricate fluorosilicone rubber foam (FSiRF) materials with nanoscale wrinkled surfaces and reactive Si-H groups via a green and rapid chemical foaming strategy. Based on the strong adhesion between FSiRF materials and consecutive oxidized ketjen black (OKB) nano-network, multifunctional FSiRF nanocomposites were prepared by a dip-coating strategy followed by fluoroalkylsilane modification. The optimized F-OKB@FSiRF nanocomposites exhibit outstanding mechanical flexibility in wide-temperature range (100 cycle compressions from -20 to 200 °C), structure stability (no detached particles after being immersed into various aqueous solutions for up to 15 days), surface superhydrophobicity (water contact angle of 154° and sliding angle of ∼7°), and tunable electrical conductivity (from 10-5 to 10-2 S m-1). Additionally, benefiting from the combined actions of multiple lines of defense (low surface energy groups, physical barriers, and "shielding effect"), the F-OKB@FSiRF sensor presents excellent anti-swelling property and high sensitivity in monitoring both large-deformation and tiny vibrations generated by knocking the beaker, ultrasonic action, agitating, and sinking objects in weak-polar or nonpolar solvents. This work conceivably provides a chemical strategy for the fabrication of multifunctional polymeric foam nanocomposite materials as smart sensors for broad applications.

Successful transcatheter edge-to-edge repair for atrial functional mitral regurgitation after surgical annuloplasty ring dehiscence: a case report.

Background: Annuloplasty ring dehiscence (ARD) after surgical mitral valve repair is a rare complication, which causes recurrent mitral regurgitation (MR) and is associated with adverse outcomes in patients with a prohibitive risk of repeat surgery. However, a patient developed severe MR, when challenging transcatheter edge-to-edge repair (TEER) after surgical ring dehiscence, it should be considering the relative efficacy and safety. Case summary: An 89-year-old man underwent mitral valve repair with an annuloplasty ring for moderate atrial functional MR (AFMR). Post-operative transthoracic echocardiography on Day 7 suggested a dislodged mitral annuloplasty ring and recurrent moderate AFMR. However, the MR developed severely, which led to two hospitalizations for congestive heart failure in the past year. Transoesophageal echocardiography (TOE) was performed carefully to ensure that the TEER clip did not interfere with the dislodged annuloplasty ring. Consequently, only the therapeutic target on the medial side of the A2-P2 region was approached posteriorly behind the peri-ring space, without gripper interference. Discussion: Transcatheter edge-to-edge repair using the G4-MitraClip® system is feasible and safe in patients with recurrent severe AFMR after surgical mitral valve repair concomitant with ARD. Meticulous simulation with pre-operative TOE is one of the crucial steps for successful outcomes.

Paediatric oral hyaline ring granuloma associated with an impacted tooth and its management preserving the tooth germ: A case report.

Oral hyaline ring granuloma is an unusual granulomatous lesion affecting the jaws characterized by the presence of numerous eosinophilic rings with multinucleated giant cells. The lesion can be of central or peripheral variety, caused by the impaction of foreign particles in the oral cavity. While literature describes this lesion in association with dentures, carious teeth and extraction socket, this paper reports the first case of an oral hyaline ring granuloma associated with an impacted premolar tooth and its surgical management.

Efficacy of the Dapivirine Vaginal Ring Accounting for Imperfect Adherence.

Product adherence is critical to obtaining objective estimates of efficacy of pre-exposure prophylactic interventions against HIV-1 infection. With imperfect adherence, intention-to-treat analyses assess the collective effects of complete, sub-optimal and non-adherence, providing a biased and attenuated estimate of the average causal effect of an intervention. Using data from the MTN-020/ASPIRE phase III trial evaluating HIV-1 efficacy of the dapivirine vaginal ring, we conducted per-protocol, and adherence-adjusted causal inference analyses using principal stratification and marginal structural models. We constructed two adherence cut offs of ≥ 0.9 mg (low cutoff) and > 4.0 mg (high cutoff) that represent drug released from the ring over a 28-day period. The HIV-1 efficacy estimate (95% CI) was 30.8% (3.6%, 50.3%) (P = 0.03) from the per-protocol analysis, and 53.6% (16.5%, 74.3%) (P = 0.01) among the highest predicted adherers from principal stratification analyses using the low cutoff. Marginal structural models produced efficacy estimates (95% CIs) ranging from 48.8 (21.8, 66.4) (P = 0.0019) to 56.5% (32.8%, 71.9%) (P = 0.0002). Application of adherence-adjusted causal inference methods are useful in interpreting HIV-1 efficacy in secondary analyses of PrEP clinical trials.

Bifunctional Nitrogen-Rich Heterocyclic Compounds: Synthesis, Photoluminescence and Energetic Properties.

Nitrogen-rich heterocyclic frameworks have attracted enormous interest in organic chemistry and materials science. However, their potential for developing photoluminescent materials remains underexplored due to their relatively low molecular stabilities. In this work, two tricyclic fused nitrogen-rich fluorescent heterocycles were synthesized and characterized. The photophysical properties of the synthesized 4 and 5 were investigated through theoretical and experimental studies. In addition, their physicochemical and energetic properties and the performance as an additive to the perovskite absorption layer of the perovskite solar cell were also studied.

Degradation pathways and product formation mechanisms of asphaltene in supercritical water.

Asphaltene is the compound with the most complex structure and the most difficult degradation in oily sludge, which is the key to limit the efficiency of supercritical water oxidation treatment of oily sludge. In this paper, the supercritical water oxidation process of asphaltene was investigated in terms of free radical reaction, degradation pathway, and product generation mechanism using ReaxFF molecular dynamics simulation method. The results showed that increasing temperature, increasing O2, and increasing H2O have different effects on HO2·generation. Benzene rings undergo fusion and condensation through hydrogenation abstraction and oxygen addition reactions, subsequently breaking down into long-chain alkanes. Increasing O2 can effectively promote the ring-opening of nitrogen-containing heterocycles. -COOH is the most important intermediate fragment for CO and CO2 generation, and there is a reaction competition with -CHO3 and -CO3. When the number of oxygen molecules increases from 300 to 700, the reaction frequency of -CHO3 and -CO3 to generate CO and CO2 increases by 17.14 % and 12.77 %·H2O determines the production of H2 by controlling the number of H·radicals present. As the amount of H2O increases from 500 to 1500, the product ratio of H2 increases from 12.73 % to 21.31 %. ENVIRONMENTAL IMPLICATION: Asphaltene is the most structurally complex organic matter in oily sludge, and its presence makes it difficult for oily sludge to be completely degraded by conventional treatment methods such as pyrolysis and incineration. Polycyclic aromatic hydrocarbons (PAHs) represented by asphaltene increase the carcinogenicity and mutagenicity of oily sludge, and even irreversibly pollute soil and groundwater. Supercritical water oxidation, as an efficient organic waste treatment technology, can realize harmlessness in a green and efficient way. So the study on the mechanism of supercritical water oxidation of asphaltene is of great significance for environmental protection.

Short-term mobility in low-energy pelvic ring fractures after conservative treatment.

BACKGROUND: The growing population of elderly people is leading to a rising number of pelvic ring fractures. These often involve combinations of pubic branch and sacrum fractures, as seen in lateral compression type 1 (LC1) and 2 (LC2) fractures or more precisely classified as fragility fractures of the pelvis (FFP). The combined impact on the anterior and posterior ring brings the risk of prolonged pain, resulting in decreased mobility and increased complications. Given the higher multimorbidity of this population, surgical treatment poses a greater risk of intra- and post-operative complications. Hence, the management and treatment of this particular type of fracture remain challenging. METHODS: A retrospective data analysis of 41 patients (F/M; 27/14) treated conservatively for low-energy LC1 or LC2 fractures was performed between 2017 and 2020. The fractures were classified using Rommens' FFP classification. The primary outcome was mobility at 2 and 6 weeks, assessed through chart analysis and phone interviews. To determine factors influencing patient outcomes fracture consolidation was assessed via X-ray analysis. As a secondary outcome logistic regression and decision tree analyzes were conducted. RESULTS: The mean age at the time of fracture was 79.8 ± 12.5 (SD) years. Thirty-two patients regained mobility (F/M; 25/7) after 2 weeks. Another 7 patients were mobile after 6 weeks (F/M; 2/5). Two male patients did not regain mobility. Male sex emerged as the sole independent predictor of non-mobility at 2 weeks (p = 0.0037). Age, BMI, pubic branch fracture dislocation >5 mm, analgesic use of opiates, corticosteroid therapy, alcohol and smoking showed no association with mobility recovery. Fracture consolidation was observed in 73.2 % of patients (F/M; 21/9), while one female had no consolidation. Ten patients (F/M; 5/5) were lost to follow-up. CONCLUSIONS: Our study shows that LC1 (FFP IIb, IIc) and LC2 (FFP IIIc, IVb) fractures can be effectively treated conservatively, with successful remobilization within 6 weeks. The only independent negative predictor of early mobilization was male sex. Pubic branch displacement >5 mm did not affect the outcome. Therefore, conservative management proves to be a viable option for low-energy LC1 or LC2 fractures. LEVEL OF EVIDENCE: IV (retrospective study).

Highly enhanced Hg2+ detection using optimized DNA and a double coffee ring effect-based SERS map.

Hg2+ is a highly toxic heavy metal ion that poses serious risks to human health and the environment. Due to its tendency to accumulate, it can easily enter the human body through the food chain, making it crucial to develop detection sensors that mimic real environmental conditions. To achieve this, our study employed a surface-enhanced Raman scattering (SERS) sensor using two strategies. First, we designed a highly selective probe by optimizing the probe and reporter DNA strands to bind Hg2+ within a thymine-thymine mismatch. Second, we used the double coffee ring effect to concentrate the optimized probe DNA. These two strategies greatly enhanced the SERS signal, resulting in a sensor with exceptional sensitivity, a low detection limit of 208.71 fM, and superior selectivity for Hg2+. The practical application of the sensor was demonstrated by successfully detecting Hg2+ in drinking water, tap water, canned tuna, and tuna sashimi. Additionally, the experimental results were presented in a pizza-shaped SERS mapping image, allowing users to estimate Hg2+ concentrations through color, providing a user-friendly and intuitive method for data comprehension and analysis. Our study presents a promising approach for sensitive and reliable Hg2+ detection, with potential implications for environmental monitoring and food safety.

Vascularized posterior interosseous nerve graft for digital neurovascular bundle reconstruction.

INTRODUCTION: Despite the progress in microsurgery in recent decades, neurovascular bundle defects during ring finger injuries still pose challenges for the surgeon. Usually, a reversed venous graft and a non-vascularized nerve graft are utilized to reconstruct this defect. One of the most common challenges encountered when using a venous graft is the caliber mismatch between the graft and the digital arterial ends. The use of an arterialized nerve graft (neurovascular graft) is poorly described and could represent an attractive reconstructive option. CASE PRESENTATION: We present the case of a 36-year-old manual worker, a non-smoker, with no significant medical or surgical comorbidities, who presented a ring avulsion type trauma, leading to the amputation of the third left finger at the distal interphalangeal joint and avulsion of the circumferential skin at the level of the middle and proximal phalanges (Urbaniak III). The patient presented a neurovascular bundle defect of 3 cm, reconstructed by the vascularized posterior interosseous nerve graft along the distal perforator of the dorsal branch of the anterior interosseous artery serving both as an interpositional arterial conduit and as a nerve graft. The results of postoperative nerve regeneration at three years are satisfactory, with the patient demonstrating a two-point discrimination measured at 6 mm. CONCLUSION: Simultaneous digital artery and nerve reconstruction using a neurovascular flap is very appealing to the hand surgeon as it offers several advantages over traditional methods, particularly the ideal diameter match between the digital arteries and the distal perforator of the dorsal branch of the anterior interosseous artery.

Novel multitarget directed ligands inspired by riluzole: A serendipitous synthesis of substituted benzo[b][1,4]thiazepines potentially useful as neuroprotective agents.

Riluzole, the first clinically approved treatment for amyotrophic lateral sclerosis (ALS), represents a successful example of a drug endowed with a multimodal mechanism of action. In recent years, different series of riluzole-based compounds have been reported, including several agents acting as Multi-Target-Directed Ligands (MTLDs) endowed with neuroprotective effects. Aiming at identical twin structures inspired by riluzole (2a-c), a synthetic procedure was planned, but the reactivity of the system took a different path, leading to the serendipitous isolation of benzo[b][1,4]thiazepines 3a-c and expanded intermediates N-cyano-benzo[b][1,4]thiazepines 4a-c, which were fully characterized. The newly obtained structures 3a-c, bearing riluzole key elements, were initially tested in an in vitro ischemia/reperfusion injury protocol, simulating the cerebral stroke. Results identified compound 3b as the most effective in reverting the injury caused by an ischemia-like condition, and its activity was comparable, or even higher than that of riluzole, exhibiting a concentration-dependent neuroprotective effect. Moreover, derivative 3b completely reverted the release of Lactate Dehydrogenase (LDH), lowering the values to those of the control slices. Based on its very promising pharmacological properties, compound 3b was then selected to assess its effects on voltage-dependent Na+ and K+ currents. The results indicated that derivative 3b induced a multifaceted inhibitory effect on voltage-gated currents in SH-SY5Y differentiated neurons, suggesting its possible applications in epilepsy and stroke management, other than ALS. Accordingly, brain penetration was also measured for 3b, as it represents an elegant example of a MTDL and opens the way to further ex-vivo and/or in-vivo characterization.

Endotracheal tube cuff position in relationship to the walls of the trachea: A retrospective computed tomography-based analysis.

Background: The use of cuffed endotracheal tubes (ETTs) has become the standard of care in pediatric practice. The rationale for the use of a cuffed ETT is to minimize pressure around the cricoid while providing an effective airway seal. However, safe care requires that the cuff lie distal to the cricoid ring following endotracheal intubation. The current study demonstrates the capability of computed tomography (CT) imaging in identifying the position of the cuff of the ETT in intubated patients. Methods: The study included patients ranging in age from 1 month to 10 years who underwent neck and chest CT imaging that required general anesthesia and endotracheal intubation. The location of the ETT and of the cuff within the airway was determined from axial CT images at three levels (proximal, middle, and distal). Anatomical orientations were tabulated, and percent chances of each orientation were determined for the ETT and the cuff. Results: The study cohort included 42 patients ranging in age from 1 to 114 months. An ETT with a polyvinylchloride cuff was used in 24 patients, and an ETT with a polyurethane cuff was used in 18 patients. The ETT was located near the posterior wall of the trachea in approximately 24-38% of patients, being most likely to be centrally located at the proximal end and at its mid-portion. The middle part of the cuff was most likely to be positioned in the mid-portion of the trachea but tended to skew anteriorly at both the proximal and distal ends. Conclusion: This is the first study using CT imaging to identify the uniformity of cuff inflation within the trachea in children. With commonly used cuffed ETTs, cuff inflation and the final position of ETT cuff within the tracheal lumen were not uniform. Future investigations are needed to determine the reasons for this asymmetry and its clinical implications.

Recent warming and increasing CO2 stimulate growth of dominant trees under no water limitation in South Korea.

Increases of temperatures and atmospheric CO2 concentration influence the growth performance of trees worldwide. The direction and intensity of tree growth and physiological responses to changing climate do, however, vary according to environmental conditions. Here we present complex, long-term, tree-physiological responses to unprecedented temperature increase in East Asia. For this purpose, we studied radial growth and isotopic (δ13C and δ18O) variations using tree-ring data for the past 100 years of dominant Quercus mongolica trees from the cool-temperate forests from Hallasan, South Korea. Overall, we found that tree stem basal area increment, intercellular CO2 concentration, and intrinsic water-use efficiency significantly increased over the last century. We observed, however, short-term variability in the trends of these variables among four periods identified by change point analysis. In comparison, δ18O did not show significant changes over time, suggesting no major hydrological changes in this precipitation-rich area. The strength and direction of growth-climate relationships also varied during the past 100 years. Basal Area Increment (BAI) did not show significant relationships with the climate over 1924-1949 and 1975-1999 periods. However, over 1950-1974 BAI was negatively affected by both temperature and precipitation, while after 2000 a temperature stimulus was observed. Finally, over the last two decades, the increase in Q. mongolica tree growth accelerated and was associated with high spring-summer temperatures and atmospheric CO2 concentrations and decreasing intrinsic water-use efficiency, δ18O, and VPD, suggesting that the photosynthetic rate continued increasing under no water limitations. Our results indicate that the performance of dominant trees of one of the most widely distributed species in East Asia has benefited from recent global changes, mainly over the last two decades. Such findings are essential for projections of forest dynamics and carbon sequestration under climate change.

On-Demand Picoliter-Level-Droplet Inkjet Printing for Micro Fabrication and Functional Applications.

With the advent of Internet of Things (IoTs) and wearable devices, manufacturing requirements have shifted toward miniaturization, flexibility, environmentalization, and customization. Inkjet printing, as a non-contact picoliter-level droplet printing technology, can achieve material deposition at the microscopic level, helping to achieve high resolution and high precision patterned design. Meanwhile, inkjet printing has the advantages of simple process, high printing efficiency, mask-free digital printing, and direct pattern deposition, and is gradually emerging as a promising technology to meet such new requirements. However, there is a long way to go in constructing functional materials and emerging devices due to the uncommercialized ink materials, complicated film-forming process, and geometrically/functionally mismatched interface, limiting film quality and device applications. Herein, recent developments in working mechanisms, functional ink systems, droplet ejection and flight process, droplet drying process, as well as emerging multifunctional and intelligence applications including optics, electronics, sensors, and energy storage and conversion devices is reviewed. Finally, it is also highlight some of the critical challenges and research opportunities. The review is anticipated to provide a systematic comprehension and valuable insights for inkjet printing, thereby facilitating the advancement of their emerging applications.

Adhesive solid-state fermentation producing Aspergillus niger conidia on stainless-steel dixon ring supports.

An adhesive solid-state fermentation (adSSF) mode was developed to produce Aspergillus niger conidia, which used a stainless-steel Dixon ring as the support and water-retaining adhesive to load nutritional media on its surface. To obtain high conidia yields, the components of the water-retaining adhesive were screened, optimized by single-factor optimization and response surface methodology, and the optimal dosages of the main components were: wheat bran powder 0.023 g·cm-3bed, cassava starch 0.0022 g·cm-3bed, and xanthan gum 0.0083 g·cm-3bed. The experimentally tested conidia yield was 4.2-fold that without water-retaining adhesive but was 3.7% lower than the maximum yield predicted by the model. The observed double-side growth of A. niger on the Dixon ring supports improved space utilization of the fermentation bed, and the void fraction can increase with the shrinkage of the gel layer. In 1.6 L tray reactors with three-point online temperature monitoring, the inner-bed temperature of adSSF was at most 4 °C lower than the adsorbed carrier solid-state fermentation (ACSSF) mode, and the conidia yield was 1.68 × 108 conidia.cm-3bed, 61.5% higher than that of the ACSSF bed at the same time, but when the fermentation time was extended to 168 h, the conidia yield of the adSSF bed and ACSSF bed were close to each other. The results revealed that the high voidage of the adSSF bed was the main reason for low bed temperature, which can benefit the inner-bed natural convection and water evaporation.

Comparison of clinical and radiographic outcomes of bilateral versus unilateral ramus fixation in straddle fractures with posterior pelvic ring injury.

INTRODUCTION: Superior and inferior ramus fractures, termed straddle fractures, are high-energy fractures often accompanied by unstable pelvic ring injuries. However, consensus is lacking regarding indications for surgical treatment or fixation methods. We aimed to compare clinical and radiological outcomes of unilateral ramus fixation (URF) and bilateral ramus fixation (BRF) for straddle fractures with unilateral posterior pelvic ring injuries. MATERIALS AND METHODS: We enrolled 118 patients (73 males, 45 females; mean age, 47 years) diagnosed with straddle fractures between March 2015 and December 2021 with > 1 year of follow-up. Patients were divided into URF (n = 60) and BRF (n = 58) groups based on the anterior pelvic ring fixation method. Preoperative factors including body mass index, diabetes, smoking, injury mechanism, injury severity score, American Society of Anesthesiologists classification system, Tile classification, and Young and Burgess classification were compared. Intraoperative blood loss, operation time, postoperative bone union rate, complications, and the need for additional surgeries were analyzed. RESULTS: There were no statistically significant preoperative differences between the two groups. However, the URF group showed a significantly lower mean operative time and blood transfusion requirement (63 min and 2 units, respectively) than the BRF group (104 min and 3 units, respectively) (both p < 0.001). Postoperatively, bone union was achieved in 57 (95.0%) and 56 (96.6%) patients in the URF and BRF groups, respectively. Complications occurred in 17 (28.3%) and 14 (24.1%) patients in the URF and BRF groups, respectively, with additional surgeries needed in 3 (5.0%) patients in the URF group and 2 (3.4%) patients in the BRF group. CONCLUSIONS: Unilateral anterior fixation can provide sufficient stability and clinical effectiveness in the surgical treatment of straddle fractures in areas with posterior pelvic ring injuries. Compared with bilateral anterior fixation, unilateral fixation significantly reduces operation time and blood loss, making it a viable fixation method for straddle fractures.

Colon signet-ring cell carcinoma with chylous ascites caused by immunosuppressants following liver transplantation: A case report.

BACKGROUND: Chylous ascites is caused by disruption of the lymphatic system, which is characterized by the accumulation of a turbid fluid containing high levels of triglycerides within the abdominal cavity. The two most common causes are cirrhosis and tuberculosis, and colon signer ring cell carcinoma (SRCC) due to the use of immunosuppressants is extremely rare in cirrhotic patients after liver transplantation, making it prone to misdiagnosis and missed diagnosis. CASE SUMMARY: A 52-year-old man who underwent liver transplantation and was administered with immunosuppressants for 8 months was admitted with a 3-month history of progressive abdominal distention. Initially, based on lymphoscintigraphy and lymphangiography, lymphatic obstruction was considered, and cystellar chyli decompression with band lysis and external membrane stripping of the lymphatic duct was performed. However, his abdominal distention was persistent without resolution. Abdominal paracentesis revealed allogenic cells in the ascites, and immunohistochemistry analysis revealed adenocarcinoma cells with phenotypic features suggestive of a gastrointestinal origin. Gastrointestinal endoscopy was performed, and biopsy showed atypical signet ring cells in the ileocecal valve. The patient eventually died after a three-month follow-up due to progression of the tumor. CONCLUSION: Colon SRCC, caused by immunosuppressants, is an unusual but un-neglected cause of chylous ascites.

Molecular characteristics of patients with colorectal signet-ring cell carcinoma with different ABO blood groups.

Background: Colorectal signet-ring cell carcinoma (SRCC) is a rare subtype of malignant adenocarcinoma, accounting for approximately 1 % of colorectal cancer (CRC) cases. Its biomarkers and molecular characteristics remain controversial, and there are no specific therapeutic targets or strategies for its clinical treatment. Methods: A retrospective study was conducted between January 2010 and December 2021. 1058 colorectal cancer cases from the Sun Yat-sen University Cancer Center and 489 cases from the Tumor Genome Atlas Project were included in the analysis, of which 64 were SRCC. Data extraction included patient demographics, blood types and risk factors, including clinical variables and genomics (either a 19-gene panel NGS or 1021-gene panel NGS). Univariate analyses were performed to identify factors significantly associated with overall survival. Results: The blood groups of 27 (42.2 %), 18 (28.1 %), 12 (18.8 %), and seven (10.9 %) patients were classified as O, A, B, and AB, respectively. We found that O was a unique blood group characterized by a low frequency of KRAS mutations, a high frequency of heterozygosity at each HLA class I locus, and a high tumor mutational burden (TMB). Patients in blood group A with high-frequency KRAS mutations and those in blood group B with anemia and metabolic abnormalities required targeted treatment. Furthermore, genetic alterations in SRCC differed from those in adenocarcinoma and mucinous adenocarcinoma. Conclusions: Our study revealed genomic changes in SRCC patients across different blood groups, which could advance the understanding and precise treatment of colorectal SRCC.