Effect of preoperative jaundice on long-term prognosis of gallbladder carcinoma with radical resection.

PURPOSES: This study was designed to evaluate the effect of preoperative jaundice on long-term prognosis of gallbladder carcinoma (GBC) after radical resection (R0). METHODS: A total of 267 GBC patients who underwent R0 resection from January 2004 to December 2014 were enrolled, including 54 patients with preoperative jaundice and 213 patients without jaundice. The clinicopathological parameters between the two groups were compared, and the correlation between preoperative jaundice and the long-term prognosis was furtherly analyzed. RESULTS: Unilateral and multivariate analyses of 267 GBC patients showed that the depth of tumor invasion (pT stage), lymphatic metastasis, and hepatic invasion were independent prognostic factors. The univariate and multivariate analysis of 54 GBC patients with preoperative jaundice showed that only pT stage was an independent factor for prognosis. Furthermore, the intraoperative blood transfusion and pT stage were significant different between long-term survival (survive for more than 3 years) and those who died within 3 years (P < 0.05). CONCLUSION: Preoperative jaundice was not the independent factor resulting in the poor long-term prognosis of gallbladder carcinoma after R0 resection. The pT stage was the only long-term prognostic factor in all GBC patients regardless of preoperative jaundice.

Elevation of CA19-9 and CEA is associated with a poor prognosis in patients with resectable gallbladder carcinoma.

AIMS: The aim of this study was to determine whether a combination of the tumour markers carcinoembryonic (CEA) and carbohydrate antigen 19-9 (CA19-9) would be helpful in predicting the prognosis of patients with gallbladder carcinoma (GBC) who underwent resection. METHODS: A retrospective analysis of clinico-pathological features and survival of 390 patients with GBC who were treated between January 2003 and December 2013. Time-dependent receiver operating characteristic (ROC) was used to evaluate the prognostic ability of tumour markers. Combinations of preoperative CEA and CA19-9 were tested as potential prognostic factors. RESULTS: The evaluation of preoperative CEA and CA19-9 showed that patients with both tumour markers within the normal range had the best prognosis with a median survival of 27 months and R0 rate of 86%. Patients with both tumour markers elevated had the poorest prognosis and lower R0 rate (p < 0.001). The combination of CEA and CA19-9 was an independent risk factor for overall survival. The AUROC at 5 years of combination of CEA and CA19-9 was 0.798, which was similar to CEA (0.765) or CA19-9 (0.771) alone (p = 0.103, p = 0.147). CONCLUSIONS: A combination of an elevated preoperative CEA and CA19-9 was associated with a worse prognosis for patients with GBC who underwent resection.

A ruler detection method for auto-adjusting scales of shoeprint images.

Digital shoeprint comparison often requires the calibration of the image resolution so that features, such as patterns in shoeprints, can be compared on the same scale. To enable scaling, a shoeprint photograph can be taken with a forensic ruler in the same frame to obtain the pixel distance between two nearby graduations. However, manually measuring the number of pixels is a time-consuming process. Additionally, the measurement process might not be conducted accurately when the image is noisy or there is distortion in the ruler. In this study, we present an automated ruler detection method for adjusting the image scale. We show that this method can accurately estimate the image scale with a mean absolute percentage error of 3%. We also conducted automated shoeprint retrieval experiments on scale-unadjusted shoeprint images to show how the automated image scaling might be used in a common forensic process. Our results from these experiments show an increase in the retrieval performance from 0.735 to 0.929 at S1 by employing this approach to adjust the shoeprint image scales.

Nomograms to predict long-term survival for patients with gallbladder carcinoma after resection.

BACKGROUND: Surgical resection remains the primary treatment option for gallbladder carcinoma (GBC). However, there is a pressing demand for prognostic tools that can refine patients' treatment choices and tailor personalized therapies accordingly. AIMS: The nomograms were constructed using the data of a training cohort (n = 378) of GBC patients at Eastern Hepatobiliary Surgery Hospital (EHBH) between 2008 and 2018. The model's performance was validated in GBC patients (n = 108) at Guangzhou Centre from 2007 to 2018. METHODS AND RESULTS: The 5-year overall survival (OS) rate in the training cohort was 24.4%. Multivariate analyses were performed using preoperative and postoperative data to identify independent predictors of OS. These predictors were then incorporated into preoperative and postoperative nomograms, respectively. The C-index of the preoperative nomogram was 0.661 (95% CI, 0.627 to 0.694) for OS prediction and correctly delineated four subgroups (5-year OS rates: 48.1%, 19.0%, 15.6%, and 8.1%, p < 0.001). The C-index of the postoperative nomogram was 0.778 (95%CI, 0.756 -0.800). Furthermore, this nomogram was superior to the 8th TNM system in both C-index and the net benefit on decision curve analysis. The results were externally validated. CONCLUSION: The two nomograms showed an optimally prognostic prediction in GBC patients after curative-intent resection.

Shoeprint image retrieval and crime scene shoeprint image linking by using convolutional neural network and normalized cross correlation.

A shoeprint image retrieval process aims to identify and match images of shoeprints found at crime scenes with shoeprint images from a known reference database. It is a challenging problem in the forensic discipline of footwear analysis because a shoeprint found at the crime scene is often imperfect. Recovered shoeprints may be partial, distorted, left on surfaces that do not mark easily, or perhaps come from shoes that do not transfer marks easily. In this study, we present a shoeprint retrieval method by using a convolutional neural network (CNN) and normalized cross-correlation (NCC). A pre-trained CNN was used to extract features from the pre-processed shoeprint images. We then employed NCC to compute a similarity score based on the extracted image features. We achieved a retrieval accuracy of 82% in our experiments, where a "successful" retrieval means that the ground truth image was returned in the top 1% of returned images. We also extend our shoeprint retrieval method to the problem of linking shoeprints recovered from crime scenes. This new method can provide a linkage between two crime scenes if the two recovered shoeprints originated from the same shoe. This new method achieved a retrieval accuracy of 88.99% in the top 20% of returned images.

Classification of firing pin impressions using HOG-SVM.

Crimes, such as robbery and murder, often involve firearms. In order to assist with the investigation into the crime, firearm examiners are asked to determine whether cartridge cases found at a crime scene had been fired from a suspect's firearm. This examination is based on a comparison of the marks left on the surfaces of cartridge cases. Firing pin impressions can be one of the most commonly used of these marks. In this study, a total of nine Ruger model 10/22 semiautomatic rifles were used. Fifty cartridges were fired from each rifle. The cartridge cases were collected, and each firing pin impression was then cast and photographed using a comparison microscope. In this paper, we will describe how one may use a computer vision algorithm, the Histogram of Orientated Gradient (HOG), and a machine learning method, Support Vector Machines (SVMs), to classify images of firing pin impressions. Our method achieved a reasonably high accuracy at 93%. This can be used to associate a firearm with a cartridge case recovered from a scene. We also compared our method with other feature extraction algorithms. The comparison results showed that the HOG-SVM method had the highest performance in this classification task.

Sintilimab induced ICIAM in the treatment of advanced HCC: A case report and analysis of research progress.

Immune checkpoint inhibitor-associated adverse reactions (irAEs) are a clinical treatment issue that requires additional attention when ICIs have significant survival benefits in patients with advanced hepatocellular carcinoma (HCC). Among them, ICIs-associated myocarditis (ICIAM) is a kind of severe irAE with a high mortality rate (17%-50%). Despite its low incidence (PD1/PD-L1 related: 0.41%-0.8%), ICIAM can significantly disturb the decision making of therapeutic schemes and even the survival outcomes of patients. ICIAM induced by sintilimab has not been reported in any complete clinical studies yet and understanding the clinical characteristics involved may inform better practices for the management. Here, we reported a 78 y/o patient with advanced HCC, who experienced ICIAM induced by sintilimab within a short course from treatment onset and found that adequate baseline examination before the implementation of the therapeutic scheme, regular monitoring of myocardial enzymonram and cardiac imaging were measures for the early detection, while glucocorticoid pulse therapy is still the best choice with timely and sufficient application. Simultaneously, the combination of other immunosuppressants may lead to better results. New-predictive markers and examination methods are still required to facilitate the early detection.

Exosomal MicroRNA signature acts as an efficient biomarker for non-invasive diagnosis of gallbladder carcinoma.

Through a three-step study that relies on biomarker discovery, training, and validation, we identified a set of five exosomal microRNAs (miRNAs) that can be used to evaluate the risk of gallbladder carcinoma (GBC), including miR-552-3p, miR-581, miR-4433a-3p, miR-496, and miR-203b-3p. When validated in 102 GBC patients and 112 chronic cholecystitis patients from multiple medical centers, the AUC of this combinatorial biomarker was 0.905, with a sensitivity of 81.37% and a specificity of 86.61%. The performance of this biomarker is superior to that of the standard biomarkers CA199 and CEA and is suited for GBC early diagnosis. The multi-clinicopathological features and prognosis of GBC patients were significantly associated with this biomarker. After building a miRNA-target gene regulation network, cell functions and signaling pathways regulated by these five miRNAs were examined. This biomarker signature can be used in the development of a noninvasive tool for GBC diagnosis, screening and prognosis prediction.

Bayesian mixture modelling for glass refractive index measurement.

Glass is a common type of physical evidence in forensic science. Broken glass recovered from a suspect may have similar physical characteristics to glass collected at a crime scene and therefore can be used as evidence. Statistical treatment of this evidence involves computing a measure of the weight of evidence. This may be done in a Bayesian framework that incorporates information from the circumstances of the crime. One of the most crucial quantities in this calculation is the assessment of the relative rarity of the characteristics of the glass, essentially the probability distribution used to model the physical characteristics of recovered glass. Typical characteristics used in casework are the elemental composition of glass and the refractive index measurement. There is a considerable body of scientific literature devoted to the modelling of this information. For example a kernel density estimation has been used to model the background population of glass based on the refractive index measurement and a multivariate Gaussian finite mixture model has been used to model the elemental composition of glass. In this paper, we present an alternative approach, the Dirichlet Process Mixture Model, to model the glass refractive index measurement in a Bayesian methodology. A key advantage is that using this method allows us to model the probability density distribution of refractive index measurements in a more flexible way.

Downregulation of PRRX1 via the p53-dependent signaling pathway predicts poor prognosis in hepatocellular carcinoma.

Paired-related homeobox 1 (PRRX1) has been identified as a novel molecule associated with induction of epithelial-mesenchymal transition (EMT), acquisition of cancer stem cell like properties and poor prognosis in tumors. However, the function of PRRX1 in hepatocellular carcinoma has not been elucidated. In the present study, we observed that PRRX1 expression levels were downregulated and positively correlated with the downregulated expression of p53 in hepatocellular carcinoma specimens. Decreased expression of PRRX1 and/or p53 by siRNA induced both the migration and the invasion features of HCC cells in vitro. Furthermore, the loss of PRRX1 inhibits hepatocellular carcinoma (HCC) cell apoptosis, an anti-apoptotic expression profile was upregulated accompanied by downregulated expression of p53. HCC patients with low-expression of both PRRX1 and p53 had a significantly shorter overall and disease-free survival. These findings demonstrate that PRRX1 plays an important role in metastasis and apoptosis of HCC cells through the p53-dependent signaling pathway and is expected to become a novel biomarker associated with patient prognosis and survival.

Case-control study of the efficacy of retrogastric Roux-en-Y choledochojejunostomy.

The traditional, retrocolic/antegastric Roux-en-Y choledochojejunostomy is technically complicated, and the incidence of postoperative complications remains high. Here we report the outcome of 59 consecutively treated patients (study group, SG) that underwent a new choledochojejunostomy method in which the jejunal loop is passed behind the antrum pyloricum (retrogastric route). A retrospective comparison was made between this group of patients and 187 patients (control group, CG) that underwent conventional Roux-en-Y choledochojejunostomy (antegastric route). Baseline clinicopathological characteristics were similar in both groups, except for the BMI, which was significantly higher in the SG. The time spent on constructing the anastomosis, as well as overall postoperative complications, did not differ between groups. Compared with the CG, the incidence of postoperative delayed gastric emptying was decreased in the SG, and the time elapsed before the patients' first postoperative liquid food consumption was shorter. We ascribe these beneficial effects to the superiority of the modified, retropyloric choledochojejunostomy approach, and propose that this surgical technique is particularly suitable for obese patients, especially those with a short ascending bowel loop.

GIT1 is a novel prognostic biomarker and facilitates tumor progression via activating ERK/MMP9 signaling in hepatocellular carcinoma.

AIM: Multiple studies have revealed that G-protein-coupled receptor kinase-interacting protein 1 (GIT1) is overexpressed in many cancers and facilitates tumor progression. However, the role of GIT1 in hepatocellular carcinoma (HCC) remains unclear. METHODS: GIT1 expression was detected in cell lines and 130 pairs of HCC and matched adjacent noncancerous samples. Transwell assay, flow cytometry, caspase 3/7 activity assay, 5-bromodeoxyuridine cell proliferation assay, and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay were used to assess invasion, migration, apoptosis, and proliferation of HCC cells. Furthermore, GIT1 expression was detected by immunohistochemistry to evaluate its correlation with phospho-extracellular signal-regulated kinase (p-ERK)1/2. The regulatory effect of GIT1 on ERK1/2, p-ERK1/2, and matrix metalloproteinase-9 (MMP9) in HCC cells was confirmed by immunoblotting. RESULTS: In this study, we demonstrated that GIT1 was more highly expressed in HCC samples than that in non-HCC samples, and overexpression of GIT1 was correlated with clinicopathological features of poor prognosis. Clinical analysis demonstrated that GIT1 is an independent prognostic biomarker for predicting overall survival and disease-free survival of patients with HCC. In vitro studies showed that downregulation of GIT1 facilitated HCC cell apoptosis and repressed HCC cell invasion, migration, and proliferation. Overexpression of GIT1 is associated with p-ERK1/2 amplification in HCC tissues. Moreover, downregulation of GIT1 resulted in inactivation of ERK signaling and downregulation of MMP9. CONCLUSION: Our findings indicate that GIT1 is an independent prognostic biomarker and facilitates HCC progression via activating ERK/MMP9 signaling.