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AIM: To explore the clinical factors associated with pathologic complete response (pCR) for locally advanced rectal cancer (LARC) patients treated with neoadjuvant chemoradiotherapy (nCRT) and develop a web-based dynamic nomogram. METHODS: Retrospective analysis of patients with examination confirmed LARC from 2011 to 2022. Patients from the Union Hospital of Fujian Medical University were included as the training cohort (n = 1579) and Zhangzhou Hospital of Fujian Medical University as the external validation cohort (n = 246). RESULTS: In the training cohort, after nCRT, 350 (22.2%) patients achieved pCR. More stomas were avoided in pCR patients (73.9% vs. 69.7%, p = 0.043). After a median follow-up time of 47.7 months (IQR 2-145) shown OS (5-year: 93.7% vs. 81.0%, HR = 0.310, 95%CI: 0.189-0.510, p < 0.001) and DFS (5-year: 91.2% vs. 75.0%, HR = 0.204, 95%CI: 0.216-0.484, p < 0.001) were significantly better among patients with pCR than non-pCR. Multivariable Logistic analysis shown pCR was significantly associated with Pre-CRT CEA (HR = 0.944, 95%CI: 0.921-0.968; p < 0.001), histopathology (HR = 4.608, 95%CI: 2.625-8.089; p < 0.001), Pre-CRT T stage (HR = 0.793, 95%CI: 0.634-0.993; p = 0.043), Pre-CRT N stage (HR = 0.727, 95%CI: 0.606-0.873; p = 0.001), Pre-CRT MRI EMVI (HR = 0.352, 95%CI: 0.262-0.473; p < 0.001), total neoadjuvant therapy (HR = 2.264, 95%CI: 1.280-4.004; p = 0.005). Meanwhile, the online version of the nomogram established in this study was publicized on an open-access website (URL: https://pcrpredict.shinyapps.io/LARC2/). The model predicted accuracy with a C-index of 0.73 (95% CI: 0.70-0.75), with an average C-index of 0.73 for the internal cross validation and 0.78 (95% CI: 0.72-0.83) for the external validation cohort, showing excellent model accuracy. Delong test results showed the model has an important gain value for clinical characteristics to predict pCR in rectal cancer. CONCLUSIONS: Patients with pCR had a better prognosis, including OS and DFS, and were independently associated with Pre-CRT CEA, histopathology, Pre-CRT T/N stage, Pre-CRT MRI EMVI, and TNT. A web-based dynamic nomogram was successfully established for clinical use at any time.
Assuntos
Terapia Neoadjuvante , Nomogramas , Neoplasias Retais , Humanos , Neoplasias Retais/terapia , Neoplasias Retais/patologia , Neoplasias Retais/mortalidade , Neoplasias Retais/diagnóstico por imagem , Neoplasias Retais/tratamento farmacológico , Masculino , Feminino , Terapia Neoadjuvante/métodos , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento , Idoso , Adulto , Estadiamento de Neoplasias , Resposta Patológica CompletaRESUMO
Glyphosate as an effective broad-spectrum herbicide is frequently detected in various water and soil resources. Given the ubiquity of ß-MnO2 and δ-MnO2 colloids in groundwater and soil, the abiotic removal of glyphosate by MnO2 colloids was investigated. ß-MnO2 colloids exhibited superior glyphosate removal efficiency, up to 37%, compared to 21% for δ-MnO2 colloids at a pH of 4.0. Glyphosate removal involved simultaneous adsorption and oxidation process, identified by HRTEM, NH3-TPD, XPS, LC-MS, FTIR analyses and the occurrence of aminomethylphosphonic acid (AMPA) and Mn2+. Moreover, adsorption dominated the removal of glyphosate by two MnO2 colloids. The solution pH had a substantial effect on glyphosate removal. Co-existing ions in the solution, such as carbonate (CO32-), phosphate (Na2HPO4, NaH2PO4) and humic acid (HA), were also found to impede glyphosate removal. Phosphate, in particular, exhibited a strong competitive effect for adsorption sites on both MnO2 colloids. Of them, the removal of glyphosate by ß-MnO2 colloids was more prone to occur due to its higher specific surface area, abundant oxygen vacancies, and moderate acid sites. However, δ-MnO2 colloids presented a stronger oxidation capacity than that of ß-MnO2 colloids due to the quicker generation rate of Mn2+. Finally, AMPA was the same products by two MnO2 colloids in the oxidation process, revealing the degradation pathway based on the cleavage of C-N bond. Therefore, by comparing kinetics and mechanisms of glyphosate removal by ß- and δ-MnO2 colloids, this study improves us better understanding for the behavior of glyphosate in the environment.
Assuntos
Coloides , Glicina , Glifosato , Herbicidas , Compostos de Manganês , Óxidos , Glicina/análogos & derivados , Glicina/química , Compostos de Manganês/química , Óxidos/química , Coloides/química , Herbicidas/química , Adsorção , Cinética , Poluentes Químicos da Água/química , Oxirredução , Poluentes do Solo/química , Água Subterrânea/química , Substâncias HúmicasRESUMO
Marine microplastics (MPs) pollution, with rivers as a major source, leads to MPs accumulation in estuarine sediments, which are also nitrogen cycling hotspots. However, the impact of MPs on nitrogen cycling in estuarine sediments has rarely been documented. In this study, we conducted microcosm experiment to investigate the effects of commonly encountered polyethylene (PE) and polystyrene (PS) MPs, with two MPs concentrations (0.3% and 3% wet sediment weight) based on environmental concentration considerations and dose-response effects, on sediment dissolved oxygen (DO) diffusion capacity and microbial communities using microelectrode system and metagenomic analysis respectively. The results indicated that high concentrations of PE-MPs inhibited DO diffusion during the mid-phase of the experiment, an effect that dissipated in the later stages. Metagenomic analysis revealed that MP treatments reduced the relative abundance of dominant microbial colonies in the sediments. The PCoA results demonstrated that MPs altered the microbial community structure, particularly evident under high concentration PE-MPs treatments. Functional analysis related to the nitrogen cycle suggested that PS-MPs promoted the nitrification, denitrification, and DNRA processes, but inhibited the ANRA process, while PE-MPs had an inhibitory effect on the nitrate reduction process and the ANRA process. Additionally, the high concentration of PE-MPs treatment significantly stimulated the abundance of genus (Bacillus) by 34.1% and genes (lip, pnbA) by 100-187.5% associated with plastic degradation, respectively. Overall, in terms of microbial community structure and the abundance of nitrogen cycling functional genes, PE- and PS- MPs exhibit both similarities and differences in their impact on nitrogen cycling. Our findings highlight the complexity of MP effects on nitrogen cycling in estuarine sediments and high concentrations of PE-MP stimulated plastic-degrading genus and genes.
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Microplastics (MPs) are widely distributed in the sea, but the vertical transfer of MPs by marine organisms in coastal area is still poorly understood. In this study, we used laser direct infrared (LDIR) spectroscopy to determine the number and characteristics of MPs deposited by cultured oyster Crassostrea gigas and further compared the differences between MPs of natural deposit and biodeposit in field environments. The amounts of MPs found in the biodeposit of cultured oysters were 3.54 times greater than that in the natural deposition. The polymer types of biodeposit MPs also differed from those of natural deposition. It was estimated that a single oyster can deposit 15.88 MPs per day, which is a figure much higher than the initial results, and hotspots of MPs deposition may be formed within the oyster aquaculture area. We used generalized linear mixed model (GLMM) to further infer the sources of MPs in sediments and found that distance to shore, cultured zone and urban center were important predictors of MPs abundance in sediments of aquaculture area. The above results suggest that cultured bivalves have an important capacity for MPs biodeposition and will further change the vertical distribution pattern of MPs in coastal environments.