Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 318
Filtrar
1.
Radiat Oncol ; 19(1): 78, 2024 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-38915112

RESUMO

PURPOSE: This study aims to develop an ensemble machine learning-based (EML-based) risk prediction model for radiation dermatitis (RD) in patients with head and neck cancer undergoing proton radiotherapy, with the goal of achieving superior predictive performance compared to traditional models. MATERIALS AND METHODS: Data from 57 head and neck cancer patients treated with intensity-modulated proton therapy at Kaohsiung Chang Gung Memorial Hospital were analyzed. The study incorporated 11 clinical and 9 dosimetric parameters. Pearson's correlation was used to eliminate highly correlated variables, followed by feature selection via LASSO to focus on potential RD predictors. Model training involved traditional logistic regression (LR) and advanced ensemble methods such as Random Forest and XGBoost, which were optimized through hyperparameter tuning. RESULTS: Feature selection identified six key predictors, including smoking history and specific dosimetric parameters. Ensemble machine learning models, particularly XGBoost, demonstrated superior performance, achieving the highest AUC of 0.890. Feature importance was assessed using SHAP (SHapley Additive exPlanations) values, which underscored the relevance of various clinical and dosimetric factors in predicting RD. CONCLUSION: The study confirms that EML methods, especially XGBoost with its boosting algorithm, provide superior predictive accuracy, enhanced feature selection, and improved data handling compared to traditional LR. While LR offers greater interpretability, the precision and broader applicability of EML make it more suitable for complex medical prediction tasks, such as predicting radiation dermatitis. Given these advantages, EML is highly recommended for further research and application in clinical settings.


Assuntos
Neoplasias de Cabeça e Pescoço , Aprendizado de Máquina , Terapia com Prótons , Radiodermite , Humanos , Neoplasias de Cabeça e Pescoço/radioterapia , Terapia com Prótons/efeitos adversos , Radiodermite/etiologia , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Radioterapia de Intensidade Modulada/efeitos adversos , Radioterapia de Intensidade Modulada/métodos , Medição de Risco , Dosagem Radioterapêutica , Adulto
2.
Front Public Health ; 12: 1381754, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38873317

RESUMO

Background: The population with chronic kidney disease (CKD) has significantly heightened risk of fall accidents. The aim of this study was to develop a validated risk prediction model for fall accidents among CKD in the community. Methods: Participants with CKD from the China Health and Retirement Longitudinal Study (CHARLS) were included. The study cohort underwent a random split into a training set and a validation set at a ratio of 70 to 30%. Logistic regression and LASSO regression analyses were applied to screen variables for optimal predictors in the model. A predictive model was then constructed and visually represented in a nomogram. Subsequently, the predictive performance was assessed through ROC curves, calibration curves, and decision curve analysis. Result: A total of 911 participants were included, and the prevalence of fall accidents was 30.0% (242/911). Fall down experience, BMI, mobility, dominant handgrip, and depression were chosen as predictor factors to formulate the predictive model, visually represented in a nomogram. The AUC value of the predictive model was 0.724 (95% CI 0.679-0.769). Calibration curves and DCA indicated that the model exhibited good predictive performance. Conclusion: In this study, we constructed a predictive model to assess the risk of falls among individuals with CKD in the community, demonstrating good predictive capability.


Assuntos
Acidentes por Quedas , Insuficiência Renal Crônica , Humanos , Insuficiência Renal Crônica/epidemiologia , Masculino , Feminino , Acidentes por Quedas/estatística & dados numéricos , Idoso , China/epidemiologia , Estudos Longitudinais , Pessoa de Meia-Idade , Fatores de Risco , Medição de Risco/métodos , Modelos Logísticos , Nomogramas , Curva ROC
3.
Nat Commun ; 15(1): 3807, 2024 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-38714670

RESUMO

Optical spectrometers are essential tools for analysing light‒matter interactions, but conventional spectrometers can be complicated and bulky. Recently, efforts have been made to develop miniaturized spectrometers. However, it is challenging to overcome the trade-off between miniaturizing size and retaining performance. Here, we present a complementary metal oxide semiconductor image sensor-based miniature computational spectrometer using a plasmonic nanoparticles-in-cavity microfilter array. Size-controlled silver nanoparticles are directly printed into cavity-length-varying Fabry‒Pérot microcavities, which leverage strong coupling between the localized surface plasmon resonance of the silver nanoparticles and the Fabry‒Pérot microcavity to regulate the transmission spectra and realize large-scale arrayed spectrum-disparate microfilters. Supported by a machine learning-based training process, the miniature computational spectrometer uses artificial intelligence and was demonstrated to measure visible-light spectra at subnanometre resolution. The high scalability of the technological approaches shown here may facilitate the development of high-performance miniature optical spectrometers for extensive applications.

4.
Trends Mol Med ; 2024 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-38755043

RESUMO

In this opinion article, we discuss potential connections between sleep disturbances observed in Alzheimer's disease (AD) and Parkinson's disease (PD) and the dysregulation of lipids in the brain. Research using Drosophila has highlighted the role of glial-mediated lipid metabolism in sleep and diurnal rhythms. Relevant to AD, the formation of lipid droplets in glia, which occurs in response to elevated neuronal reactive oxygen species (ROS), is required for sleep. In disease models, this process is disrupted, arguing a connection to sleep dysregulation. Relevant to PD, the degradation of neuronally synthesized glucosylceramides by glia requires glucocerebrosidase (GBA, a PD-associated risk factor) and this regulates sleep. Loss of GBA in glia causes an accumulation of glucosylceramides and neurodegeneration. Overall, research primarily using Drosophila has highlighted how dysregulation of glial lipid metabolism may underlie sleep disturbances in neurodegenerative diseases.

5.
Int J Spine Surg ; 2024 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-38744484

RESUMO

BACKGROUND: There is a lack of consensus on the use of postoperative bracing for lumbar degenerative conditions. Spine surgeons typically determine whether to apply postoperative braces based primarily on clinical experience rather than robust, evidence-based medical data. Thus, the present study sought to assess the impact of postoperative bracing on clinical outcomes, complications, and fusion rates following lumbar fusion surgery in patients with degenerative spinal conditions. METHODS: Only randomized controlled studies published between January 1990 and 20 October 2023 were included in this meta-analysis. The primary outcome measures consisted of pre- and postoperative assessments of the Oswestry Disability Index (ODI) and visual analog scale (VAS) scores. Improvements in VAS and ODI scores were analyzed in the early postoperative period (1 month after operation) and at final follow-up, respectively. The analysis also encompassed fusion rates and complications. RESULTS: Five studies with 362 patients were included in the present meta-analysis. In the early postoperative period, the brace group showed a relatively better improvement in ODI scores compared with the no-brace group (19.47 vs 18.18), although this difference was not statistically significant (P = 0.34). Similarly, during the late postoperative period, the brace group demonstrated a slightly greater improvement in VAS scores in comparison to the no-brace group (4.05 vs 3.84), but this difference did not reach statistical significance (P = 0.30). The complication rate was relatively lower in the brace group compared with the no-brace group (14.9% vs 17.4%), although there was no statistical difference between the 2 groups (P = 0.83). Importantly, there were no substantial differences in fusion rates between patients with or without braces. CONCLUSION: The present meta-analysis revealed that the implementation of a brace following lumbar fusion surgery did not yield substantial differences in terms of postoperative pain relief, functional recovery, complication rates, or fusion rates when compared with cases where no brace was employed. CLINICAL RELEVANCE: This meta-analysis provides valuable insights into the clinical impact of postoperative bracing following lumbar fusion surgery for degenerative spinal conditions.

6.
Microb Pathog ; 192: 106715, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38810767

RESUMO

Porcine circovirus type 3 (PCV3) has become an important pathogen in the global swine industry and poses a threat to pig health, but its pathogenic mechanism remains unknown. In this study, we constructed an innovative, linear infectious clone of PCV3 for rescuing the virus, and explored the transcriptome of infected cells to gain insights into its pathogenic mechanisms. Subsequently, an in vivo experiment was conducted to evaluate the pathogenicity of the rescued virus in pig. PCV3 nucleic acid was distributed across various organs, indicating systemic circulation via the bloodstream and viremia. Immunohistochemical staining also revealed a significant presence of PCV3 antigens in the spleen, lungs, and lymph nodes, indicating that PCV3 had tropism for these organs. Transcriptome analysis of infected ST cells revealed differential expression of genes associated with apoptosis, immune responses, and cellular metabolism. Notably, upregulation of genes related to the hypoxia-inducible factor-1 pathway, glycolysis, and the AGE/RAGE pathway suggests activation of inflammatory responses, ultimately leading to onset of disease. These findings have expanded our understanding of PCV3 pathogenesis, and the interplay between PCV3 and host factors.


Assuntos
Infecções por Circoviridae , Circovirus , Perfilação da Expressão Gênica , Doenças dos Suínos , Animais , Suínos , Circovirus/genética , Circovirus/patogenicidade , Circovirus/fisiologia , Infecções por Circoviridae/virologia , Infecções por Circoviridae/veterinária , Doenças dos Suínos/virologia , Transcriptoma , Linhagem Celular , Apoptose/genética , Pulmão/virologia , Pulmão/patologia
7.
Int J Surg ; 110(6): 3382-3391, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38597388

RESUMO

BACKGROUND: The efficacy of laparoscopic completion total gastrectomy (LCTG) for remnant gastric cancer (RGC) remains controversial. METHODS: The primary outcome was postoperative morbidity within 30 days after surgery. Secondary outcomes included 3-year disease-free survival (DFS), 3-year overall survival (OS), and recurrence. Inverse probability treatment weighted (IPTW) was used to balance the baseline between LCTG and OCTG. RESULTS: Final analysis included 46 patients with RGC who underwent LCTG at the FJMUUH between June 2016 and June 2020. The historical control group comprised of 160 patients who underwent open completion total gastrectomy (OCTG) in the six tertiary teaching hospitals from CRGC-01 study. After IPTW, no significant difference was observed between the LCTG and OCTG groups in terms of incidence (LCTG vs. OCTG: 28.0 vs. 35.0%, P =0.379) or severity of complications within 30 days after surgery. Compared with OCTG, LCTG resulted in better short-term outcomes and faster postoperative recovery. However, the textbook outcome rate was comparable between the two groups (45.9 vs. 32.8%, P =0.107). Additionally, the 3-year DFS and 3-year OS of LCTG were comparable to those of OCTG (DFS: log-rank P =0.173; OS: log-rank P =0.319). No significant differences in recurrence type, mean recurrence time, or 3-year cumulative hazard of recurrence were observed between the two groups (all P >0.05). Subgroup analyses and concurrent comparisons demonstrated similar trends. CONCLUSIONS: This prospective study suggested that LCTG was noninferior to OCTG in both short-term and long-term outcomes. In experienced centers, LCTG may be considered as a viable treatment option for RGC.


Assuntos
Estudos de Viabilidade , Gastrectomia , Laparoscopia , Neoplasias Gástricas , Humanos , Neoplasias Gástricas/cirurgia , Neoplasias Gástricas/patologia , Gastrectomia/métodos , Gastrectomia/efeitos adversos , Masculino , Laparoscopia/efeitos adversos , Laparoscopia/métodos , Feminino , Estudos Prospectivos , Pessoa de Meia-Idade , Idoso , Seguimentos , Resultado do Tratamento , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Coto Gástrico/cirurgia , Coto Gástrico/patologia , Intervalo Livre de Doença
8.
Int J Surg ; 2024 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-38652275

RESUMO

BACKGROUND: The safety and efficacy of neoadjuvant immunochemotherapy (nICT) for locally advanced gastric cancer (LAGC) remain controversial. METHODS: Patients with LAGC who received either nICT or neoadjuvant chemotherapy (nCT) at 3 tertiary referral teaching hospitals in China between January 2016 and October 2022 were analysed. After propensity-score matching (PSM), comparing the radiological response, pathological response rate, perioperative outcomes, and early recurrence between the two groups. RESULTS: After PSM, 585 patients were included, with 195 and 390 patients comprising the nICT and nCT groups, respectively. The nICT group exhibited a higher objective response rate (79.5% versus [vs.] 59.0%; P<0.001), pathological complete response rate (14.36% vs. 6.41%; P=0.002) and major pathological response rate (39.49% vs. 26.15%; P=0.001) compared with the nCT group. The incidence of surgical complications (17.44% vs. 16.15%, P=0.694) and proportion of perioperative textbook outcomes (80.0% vs. 81.0%; P=0.767) were similar in both groups. The nICT group had a significantly lower proportion of early recurrence than the nCT group (29.7% vs. 40.8%; P=0.047). Furthermore, the multivariable logistic analysis revealed that immunotherapy was an independent protective factor against early recurrence (odds ratio 0.62 [95% CI 0.41-0.92]; P=0.018). No significant difference was found in neoadjuvant therapy drug toxicity between the two groups (51.79% vs. 45.38%; P=0.143). CONCLUSIONS: Compared with nCT, nICT is safe and effective, which significantly enhanced objective and pathological response rates, and reduced the risk for early recurrence among patients with LAGC. TRIAL REGISTRATION: Clinical Trials.gov.

9.
BMC Musculoskelet Disord ; 25(1): 322, 2024 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-38654321

RESUMO

OBJECTIVE: This study aimed to assess the impact of full endoscopic transforaminal discectomy (FETD) on clinical outcomes and complications in both obese and non-obese patients presenting with lumbar disc herniation (LDH). METHODS: A systematic search of relevant literature was conducted across various primary databases until November 18, 2023. Operative time and hospitalization were evaluated. Clinical outcomes included preoperative and postoperative assessments of the Oswestry Disability Index (ODI) and visual analogue scale (VAS) scores, conducted to delineate improvements at 3 months postoperatively and during the final follow-up, respectively. Complications were also documented. RESULTS: Four retrospective studies meeting inclusion criteria provided a collective cohort of 258 patients. Obese patients undergoing FETD experienced significantly longer operative times compared to non-obese counterparts (P = 0.0003). Conversely, no statistically significant differences (P > 0.05) were observed in hospitalization duration, improvement of VAS for back and leg pain scores at 3 months postoperatively and final follow-up, improvement of ODI at 3 months postoperatively and final follow-up. Furthermore, the overall rate of postoperative complications was higher in the obese group (P = 0.02). The obese group demonstrated a total incidence of complications of 17.17%, notably higher than the lower rate of 9.43% observed in the non-obese group. CONCLUSION: The utilization of FETD for managing LDH in individuals with obesity is associated with prolonged operative times and a higher total complication rate compared to their non-obese counterparts. Nevertheless, it remains a safe and effective surgical intervention for treating herniated lumbar discs in the context of obesity.


Assuntos
Discotomia , Endoscopia , Deslocamento do Disco Intervertebral , Vértebras Lombares , Obesidade , Complicações Pós-Operatórias , Humanos , Deslocamento do Disco Intervertebral/cirurgia , Obesidade/cirurgia , Obesidade/complicações , Vértebras Lombares/cirurgia , Resultado do Tratamento , Endoscopia/métodos , Endoscopia/efeitos adversos , Discotomia/efeitos adversos , Discotomia/métodos , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/epidemiologia , Duração da Cirurgia , Medição da Dor , Avaliação da Deficiência , Estudos Retrospectivos
10.
Int J Mol Sci ; 25(7)2024 Mar 29.
Artigo em Inglês | MEDLINE | ID: mdl-38612672

RESUMO

Acinetobacter baumannii is a major cause of nosocomial infections, and its highly adaptive nature and broad range of antibiotic resistance enable it to persist in hospital environments. A. baumannii often employs two-component systems (TCSs) to regulate adaptive responses and virulence-related traits. This study describes a previously uncharacterized TCS in the A. baumannii ATCC19606 strain, consisting of a transcriptional sensor, DJ41_1407, and its regulator, DJ41_1408, located adjacent to GacA of the GacSA TCS. Markerless mutagenesis was performed to construct DJ41_1407 and DJ41_1408 single and double mutants. DJ41_1408 was found to upregulate 49 genes and downregulate 43 genes, most of which were associated with carbon metabolism and other metabolic pathways, such as benzoate degradation. MEME analysis revealed a putative binding box for DJ41_1408, 5'TGTAAATRATTAYCAWTWAT3'. Colony size, motility, biofilm-forming ability, virulence, and antibiotic resistance of DJ41_1407 and DJ41_1408 single and double mutant strains were assessed against wild type. DJ41_1407 was found to enhance motility, while DJ41_1408 was found to upregulate biofilm-forming ability, and may also modulate antibiotic response. Both DJ41_1407 and DJ41_1408 suppressed virulence, based on results from a G. mellonella infection assay. These results showcase a novel A. baumannii TCS involved in metabolism, with effects on motility, biofilm-forming ability, virulence, and antibiotic response.


Assuntos
Acinetobacter baumannii , Acinetobacter baumannii/genética , Virulência/genética , Antibacterianos/farmacologia , Biofilmes , Bioensaio
11.
J Phys Chem Lett ; 15(14): 3938-3945, 2024 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-38568182

RESUMO

Biased enhanced sampling methods that utilize collective variables (CVs) are powerful tools for sampling conformational ensembles. Due to their large intrinsic dimensions, efficiently generating conformational ensembles for complex systems requires enhanced sampling on high-dimensional free energy surfaces. While temperature-accelerated molecular dynamics (TAMD) can trivially adopt many CVs in a simulation, unbiasing the simulation to generate unbiased conformational ensembles requires accurate modeling of a high-dimensional CV probability distribution, which is challenging for traditional density estimation techniques. Here we propose an unbiasing method based on the score-based diffusion model, a deep generative learning method that excels in density estimation across complex data landscapes. We demonstrate that this unbiasing approach, tested on multiple TAMD simulations, significantly outperforms traditional unbiasing methods and can generate accurate unbiased conformational ensembles. With the proposed approach, TAMD can adopt CVs that focus on improving sampling efficiency and the proposed unbiasing method enables accurate evaluation of ensemble averages of important chemical features.

12.
Obes Surg ; 34(5): 1479-1490, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38489003

RESUMO

BACKGROUND: Sarcopenic obesity may affect the health outcome of people with obesity after laparoscopic sleeve gastrectomy (LSG). To assess the impact of sarcopenic obesity (SO) on weight loss outcomes and improvement of quality of life after LSG. MATERIALS AND METHODS: This observational study included patients who underwent LSG with SO (99 patients) or without SO (146 patients) from a single center. The primary endpoint was weight loss and disease-specific quality of life in patients with or without SO after the operation. Fat-free mass (FFM) and fat mass (FM) were calculated based on the L3-level images of preoperative CT scans. SO was diagnosed if FM/FFM ≥ 0.80. RESULTS: Operative time and postoperative hospital stay days were longer in the SO group (p < 0.001). After LSG, weight, BMI, and EBMI were significantly lower in the NSO group than in the SO group (all P < 0.05), while %EWL and the number of patients with %EWL ≥ 100% were significantly lower in the SO group (both p < 0.05). The total BAROS scores of patients in the NSO group were higher than those in the SO group (p < 0.05). Additionally, the MA II questionnaire assessment showed a lower percentage of "very good" and "good" outcomes in the SO group (p < 0.05). CONCLUSIONS: Patients with SO take a slower rate, longer time to reach the ideal weight, and lower quality of life self-ratings than NSO patients after LSG. Thus, preoperative evaluation and tailoring rehabilitation guidance for people with SO should be accounted.


Assuntos
Laparoscopia , Obesidade Mórbida , Sarcopenia , Humanos , Obesidade Mórbida/cirurgia , Estudos Retrospectivos , Qualidade de Vida , Laparoscopia/métodos , Obesidade/cirurgia , Gastrectomia/métodos , Redução de Peso , Índice de Massa Corporal , Resultado do Tratamento
13.
Surg Endosc ; 38(5): 2666-2676, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38512349

RESUMO

BACKGROUND: Textbook outcome (TO) has been widely employed as a comprehensive indicator to assess the short-term prognosis of patients with cancer. Preoperative malnutrition is a potential risk factor for adverse surgical outcomes in patients with gastric cancer (GC). This study aimed to compare the TO between robotic-assisted gastrectomy (RAG) and laparoscopic-assisted gastrectomy (LAG) in malnourished patients with GC. METHODS: According to the diagnostic consensus of malnutrition proposed by Global Leadership Initiative on Malnutrition (GLIM) and Nutrition Risk Index (NRI), 895 malnourished patients with GC who underwent RAG (n = 115) or LAG (n = 780) at a tertiary referral hospital between January 2016 and May 2021 were included in the propensity score matching (PSM, 1:2) analysis. RESULTS: After PSM, no significant differences in clinicopathological characteristics were observed between the RAG (n = 97) and LAG (n = 194) groups. The RAG group had significantly higher operative time and lymph nodes harvested, as well as significantly lower blood loss and hospital stay time compared to the LAG group. More patients in the RAG achieved TO. Logistic regression analysis revealed that RAG was an independent protective factor for achieving TO. There were more adjuvant chemotherapy (AC) cycles in the RAG group than in the LAG group. After one year of surgery, a higher percentage of patients (36.7% vs. 22.8%; P < 0.05) in the RAG group recovered from malnutrition compared to the LAG group. CONCLUSIONS: For malnourished patients with GC, RAG performed by experienced surgeons can achieved a higher rate of TO than those of LAG, which directly contributed to better AC compliance and a faster restoration of nutritional status.


Assuntos
Gastrectomia , Laparoscopia , Desnutrição , Procedimentos Cirúrgicos Robóticos , Neoplasias Gástricas , Humanos , Neoplasias Gástricas/cirurgia , Neoplasias Gástricas/complicações , Gastrectomia/métodos , Masculino , Feminino , Laparoscopia/métodos , Desnutrição/etiologia , Procedimentos Cirúrgicos Robóticos/métodos , Pessoa de Meia-Idade , Idoso , Estudos Retrospectivos , Resultado do Tratamento , Tempo de Internação/estatística & dados numéricos , Duração da Cirurgia , Pontuação de Propensão
14.
Artif Intell Med ; 149: 102801, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38462290

RESUMO

Since different disease grades require different treatments from physicians, i.e., the low-grade patients may recover with follow-up observations whereas the high-grade may need immediate surgery, the accuracy of disease grading is pivotal in clinical practice. In this paper, we propose a Triplet-Branch Network with ContRastive priOr-knoWledge embeddiNg (TBN-CROWN) for the accurate disease grading, which enables physicians to accordingly take appropriate treatments. Specifically, our TBN-CROWN has three branches, which are implemented for representation learning, classifier learning and grade-related prior-knowledge learning, respectively. The former two branches deal with the issue of class-imbalanced training samples, while the latter one embeds the grade-related prior-knowledge via a novel auxiliary module, termed contrastive embedding module. The proposed auxiliary module takes the features embedded by different branches as input, and accordingly constructs positive and negative embeddings for the model to deploy grade-related prior-knowledge via contrastive learning. Extensive experiments on our private and two publicly available disease grading datasets show that our TBN-CROWN can effectively tackle the class-imbalance problem and yield a satisfactory grading accuracy for various diseases, such as fatigue fracture, ulcerative colitis, and diabetic retinopathy.


Assuntos
Retinopatia Diabética , Médicos , Humanos , Aprendizagem
16.
Front Immunol ; 15: 1322152, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38333217

RESUMO

Objective: To explore the oncological outcomes of sequential laparoscopic gastrectomy after treatment with camrelizumab in combination with nab-paclitaxel plus S-1 for the treatment of gastric cancer with serosal invasion. Methods: This study is a retrospective cohort study and retrospectively analyzed the clinicopathological data of 128 patients with serosal invasion gastric cancer (cT4NxM0) who received nab-paclitaxel + S-1(SAP) or camrelizumab + nab-paclitaxel + S-1 (C-SAP) regimen and underwent laparoscopy assisted gastrectomy in Fujian Union Hospital from March 2019 to December 2020. The patients were divided into SAP group and C-SAP group. The 2-years overall survival rate, 2-year recurrence free survival rate recurrence rate and initial recurrence time were compared between the two groups. Results: A total of 128 patients were included, including 90 cases in SAP group and 38 cases in C-SAP group. There were no significant differences in age, gender, gastrectomy method, surgical approach, R0 resection, nerve invasion, vascular invasion, total number of harvested lymph nodes, number of positive lymph nodes and major pathologic response (MPR) rate between the two groups (P>0.05). However, the proportion of ypT0, ypN0 and pCR rate in C-SAP group were significantly higher than those in SAP group (P<0.05). The 2-year OS of C-SAP group (80.7%) was higher than that of SAP group (67.8%), and the difference was not statistically significant (P = 0.112); At 2 years after operation, the recurrence rate of C-SAP group (44.3%) was lower than that of SAP group (55.8%) (P = 0.097); Further analysis showed that the average time to recurrence in the C-SAP group was 18.9 months, which was longer than that in SAP group 13.1 months (P = 0.004); The 2-year recurrence free survival rate in C-SAP group was higher than that in SAP group (P=0.076); There was no significant difference in the overall survival time after recurrence between the two groups (P= 0.097). Conclusion: Camrelizumab combined with neoadjuvant chemotherapy can improve the proportion of ypT0, ypN0 and pCR in patients, while prolonging the initial recurrence time of patients in the C-SAP group, but did not increase the immunotherapy/chemotherapy related side effects and postoperative complications.


Assuntos
Albuminas , Anticorpos Monoclonais Humanizados , Laparoscopia , Paclitaxel , Neoplasias Gástricas , Humanos , Resultado do Tratamento , Estudos Retrospectivos , Neoplasias Gástricas/tratamento farmacológico , Neoplasias Gástricas/cirurgia , Laparoscopia/efeitos adversos , Gastrectomia/efeitos adversos , Gastrectomia/métodos
17.
Gastric Cancer ; 27(3): 598-610, 2024 05.
Artigo em Inglês | MEDLINE | ID: mdl-38379100

RESUMO

BACKGROUND: Laparoscopy-assisted gastrectomy (LG) is rapidly gaining popularity owing to its minimal invasiveness. Previous studies have found that compared with two-dimensional (2D)-LG, three-dimensional (3D)-LG showed better short-term outcomes. However, the long-term oncological outcomes in patients with locally resectable gastric cancer (GC) remain controversial. METHODS: In this noninferiority, open-label, randomized clinical trial, a total of 438 eligible GC participants were randomly assigned in a 1:1 ratio to either 3D-LG or 2D-LG from January 2015 to April 2016. The primary endpoint was operating time, while the secondary endpoints included 5-year overall survival (OS), disease-free survival (DFS), and recurrence pattern. RESULTS: Data from 401 participants were included in the per-protocol analysis, with 204 patients in the 3D group and 197 patients in the 2D group. The 5-year OS and DFS rates were comparable between the 3D and 2D groups (5-year OS: 70.6% vs. 71.1%, Log-rank P = 0.743; 5-year DFS: 68.1% vs. 69.0%, log-rank P = 0.712). No significant differences were observed between the 3D and 2D groups in the 5-year recurrence rate (28.9% vs. 28.9%, P = 0.958) or recurrence time (mean time, 22.6 vs. 20.5 months, P = 0.412). Further stratified analysis based on the type of gastrectomy, postoperative pathological staging, and preoperative BMI showed that the 5-year OS, DFS, and recurrence rates of the 3D group in each subgroup were similar to those of the 2D group (all P > 0.05). CONCLUSIONS: For patients with locally resectable GC, 3D-LG performed by experienced surgeons in high-volume professional institutions can achieve long-term oncological outcomes comparable to those of 2D-LG. REGISTRATION NUMBER: NCT02327481 ( http://clinicaltrials.gov ).


Assuntos
Laparoscopia , Neoplasias Gástricas , Humanos , Neoplasias Gástricas/patologia , Intervalo Livre de Doença , Intervalo Livre de Progressão , Gastrectomia/métodos , Laparoscopia/métodos , Resultado do Tratamento , Estudos Retrospectivos
18.
Microorganisms ; 12(2)2024 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-38399734

RESUMO

BACKGROUND: Previous studies have confirmed the involvement of EmaSR (ethanol metabolism a sensor/regulator) in the regulation of Acinetobacter baumannii ATCC 19606 ethanol and acetate metabolism. RNA-seq analysis further revealed that DJ41_568-571, DJ41_2796, DJ41_3218, and DJ41_3568 regulatory gene clusters potentially participate in ethanol and acetate metabolism under the control of EmaSR. METHODS: This study fused the EmaSR regulon promoter segments with reporter genes and used fluorescence expression levels to determine whether EmaSR influences regulon expression in ethanol or acetate salt environments. The enzymatic function and kinetics of significantly regulated regulons were also studied. RESULTS: The EmaSR regulons P2796 and P3218 exhibited > 2-fold increase in fluorescence expression in wild type compared to mutant strains in both ethanol and acetate environments, and PemaR demonstrated a comparable trend. Moreover, increases in DJ41_2796 concentration enhanced the conversion of acetate and succinyl-CoA into acetyl-CoA and succinate, suggesting that DJ41_2796 possesses acetate: succinyl-CoA transferase (ASCT) activity. The kcat/KM values for DJ41_2796 with potassium acetate, sodium acetate, and succinyl-CoA were 0.2131, 0.4547, and 20.4623 mM-1s-1, respectively. CONCLUSIONS: In A. baumannii, EmaSR controls genes involved in ethanol and acetate metabolism, and the EmaSR regulon DJ41_2796 was found to possess ASCT activity.

19.
Neurospine ; 21(1): 261-272, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38317558

RESUMO

OBJECTIVE: This meta-analysis aims to refine the understanding of the optimal choice between different cage shapes in transforaminal lumbar interbody fusion (TLIF) by systematically comparing perioperative data, radiological outcomes, clinical results, and complications associated with banana-shaped and straight bullet cages. METHODS: A meticulous literature search encompassing PubMed, Embase, Scopus, Web of Science, China Knowledge Network, and Wanfang Data was executed up to October 5, 2023. Inclusion criteria focused on studies comparing banana-shaped and straight bullet cages in TLIF. The quality of included studies was assessed using appropriate tools such as the Newcastle-Ottawa Scale (NOS) for nonrandomized studies. Rigorous evaluations were performed for radiographic outcomes, including disc height (DH), segmental lordosis (SL), lumbar lordosis (LL), subsidence, and fusion rates. Clinical outcomes were meticulously evaluated using visual analogue scale (VAS), Oswestry Disability Index (ODI), and complications. RESULTS: The analysis incorporated 7 studies, involving 573 patients (297 with banana-shaped cages, 276 with straight cages), all with NOS ratings exceeding 5 stars. No statistically significant differences were observed in operative time, blood loss, or hospitalization between the 2 cage shapes. Banana-shaped cages exhibited greater changes in DH (p = 0.001), SL (p = 0.02), and LL (p = 0.01). Despite statistically higher changes in ODI for straight cages (26.33, p < 0.0001), the actual value remained similar to banana-shaped cages (26.15). Both cage types demonstrated similar efficacy in VAS, complication rates, subsidence, and fusion rates. CONCLUSION: Although banana-shaped cages can excel in restoring DH, SL, and LL, straight bullet cages can provide comparable functional improvements, pain relief, and complication rates.

20.
J Comput Phys ; 5002024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38283188

RESUMO

Due to the complex behavior arising from non-uniqueness, symmetry, and bifurcations in the solution space, solving inverse problems of nonlinear differential equations (DEs) with multiple solutions is a challenging task. To address this, we propose homotopy physics-informed neural networks (HomPINNs), a novel framework that leverages homotopy continuation and neural networks (NNs) to solve inverse problems. The proposed framework begins with the use of NNs to simultaneously approximate unlabeled observations across diverse solutions while adhering to DE constraints. Through homotopy continuation, the proposed method solves the inverse problem by tracing the observations and identifying multiple solutions. The experiments involve testing the performance of the proposed method on one-dimensional DEs and applying it to solve a two-dimensional Gray-Scott simulation. Our findings demonstrate that the proposed method is scalable and adaptable, providing an effective solution for solving DEs with multiple solutions and unknown parameters. Moreover, it has significant potential for various applications in scientific computing, such as modeling complex systems and solving inverse problems in physics, chemistry, biology, etc.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA