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Gestational diabetes mellitus (GDM) is a frequent complication of pregnancy. The specific mechanisms underlying GDM have not yet been fully elucidated. Contemporary research indicates a potential association between liver enzyme irregularities and an increased risk of metabolic disorders, including diabetes. The alanine aminotransferase (ALT) level is recognized as a sensitive marker of liver injury. An increase in ALT levels is hypothesized to be linked to the pathogenesis of insulin resistance and diabetes. Nonetheless, the definitive causal link between ALT levels and GDM still needs to be determined. This investigation utilized two-sample Mendelian randomization (MR) to examine the genetic causation between alanine aminotransferase (ALT) and GDM. We acquired alanine aminotransferase (ALT)-related GWAS summary data from the UK Biobank, Million Veteran Program, Rotterdam Study, and Lifeline Study. Gestational diabetes data were obtained from the FinnGen Consortium. We employed various MR analysis techniques, including inverse-variance weighted (IVW), MR Egger, weighted median, simple, and weighted weighting. In addition to MR-Egger intercepts, Cochrane's Q test was also used to assess heterogeneity in the MR data, and the MR-PRESSO test was used to assess horizontal pleiotropy. To assess the association's sensitivity, a leave-one-out approach was employed. The IVW results confirmed the independent risk factor for GDM development, as indicated by the ALT level (p = .011). As shown by leave-one-out analysis, horizontal pleiotrophy did not significantly skew the causative link (p > .05). Our dual-sample MR analysis provides substantiated evidence of a genetic causal relationship between alanine aminotransferase (ALT) levels and gestational diabetes.
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Alanina Transaminasa , Diabetes Gestacional , Análisis de la Aleatorización Mendeliana , Humanos , Femenino , Diabetes Gestacional/genética , Diabetes Gestacional/sangre , Diabetes Gestacional/epidemiología , Alanina Transaminasa/sangre , Alanina Transaminasa/genética , Embarazo , Estudio de Asociación del Genoma Completo , Factores de Riesgo , Adulto , Polimorfismo de Nucleótido Simple , Predisposición Genética a la EnfermedadRESUMEN
BACKGROUND: Gestational Diabetes Mellitus (GDM) poses significant risks to maternal and fetal health. Current diagnostic methods based on glucose tolerance tests have limitations for early detection. tRNA-derived small RNAs (tsRNAs) have emerged as potential molecular regulators in various diseases, including metabolic disorders. However, the diagnostic value of tsRNAs in plasma for early GDM or postpartum remains unclear. METHODS: This longitudinal study profiled the expression of tsRNAs across different gestational stages and postpartum in women with GDM (n = 40) and healthy control gestational women (HCs, n = 40). High-throughput small RNA sequencing identified candidate tsRNAs, which were then validated and correlated with clinical biochemical markers such as fasting blood glucose (FBG), HOMA-IR, and GHbA1c. RESULTS: tRF-1:32-Val-AAC-1-M6, tRF-1:31-Glu-CTC-1-M2, and tRF-1:30-Gly-CCC-1-M4 were consistently upregulated in the GDM group compared to HCs during the second trimester (p < 0.05). Only tRF-1:31-Glu-CTC-1-M2 was highly expressed during the first trimester, and tRF-1:30-Gly-CCC-1-M4 increased during postpartum. tRF-1:31-Glu-CTC-1-M2 showed a significant correlation with FBG levels in the first trimester (R = 0.317, p = 0.047). The expression of tRF-1:30-Gly-CCC-1-M4 was significantly correlated with HOMA-IR (r = 0.65, p < 0.001) and GHBA1c (r = 0.33, p = 0.037) during postpartum. A joint diagnostic model incorporating tsRNAs expression and clinical markers demonstrated enhanced predictive power for GDM (ROC AUC = 0.768). CONCLUSION: Our results revealed distinct expression patterns of specific tsRNAs in GDM, showcasing their correlation with key metabolic parameters. This underscores their promising role as biomarkers for early prediction and diagnosis of GDM. The integration of tRFs into a composite biomarker panel holds the potential to improve clinical outcomes by enabling personalized risk assessment and targeted interventions.
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Diabetes Gestacional , ARN de Transferencia , Humanos , Femenino , Diabetes Gestacional/diagnóstico , Diabetes Gestacional/metabolismo , Diabetes Gestacional/sangre , Embarazo , Adulto , Estudios Longitudinales , ARN de Transferencia/sangre , ARN de Transferencia/genética , Biomarcadores/sangre , Biomarcadores/metabolismoRESUMEN
BACKGROUND: Achyranthes bidentata (AR) is a traditional Chinese herb used for the treatment of hypertension and cerebral ischemia, but its pharmacological effects are not known. AIM OF STUDY: We aimed to detect and accurately identify the components and metabolites of AR in the plasma and brain tissue of Sprague Dawley rats. METHODS: We employed ultrahigh performance liquid chromatography-high-resolution mass spectrometry (UHPLC-HR-MS) to detect AR components in the plasma and brain tissue of rats. The absorption and metabolites in the plasma and brain tissue of normal control rats and rats that underwent middle cerebral artery occlusion (MCAO) were characterized and compared. RESULTS: A total of 281 compounds, including alkaloids, flavonoids, terpenoids, phenylpropanes, sugars and glycosides, steroids, triterpenes, amino acids, and peptides, was identified in samples of Achyranthes bidentata (TCM-AR). Four types of absorbable prototype components and 48 kinds of metabolites were identified in rats in the normal control plasma group which were given AR (AR plasma group), and five kinds of metabolites were identified in rats of the normal control brain tissue group which were given AR (AR brain group). Three absorbed prototype components and 13 metabolites were identified in the plasma of rats which underwent MCAO and were given AR (MCAO + AR plasma group). Six absorbed prototype components and two metabolites were identified in the brain tissue of rats who underwent MCAO and were administered AR (MCAO + AR brain group). These results showed that, after the oral administration of AR, the number of identified components in plasma was more than that in brain tissue. The number of prototype components in the AR plasma group was higher than that in the MCAO + AR plasma group, which may indicate that metabolite absorption in rats undergoing MCAO was worse. The number of prototype components in the MCAO + AR brain group was higher than that in the AR brain group, indicating that the blood-brain barrier was destroyed after MCAO, resulting in more compounds entering brain tissue. CONCLUSIONS: UHPLC-HR-MS was used to rapidly analyze the components and metabolites of AR in the blood and brain of rats under normal and pathologic conditions, and to comprehensively characterize the components of TCM-AR. We also analyzed and compared the absorbable components and metabolites of normal rats under cerebral ischemia-reperfusion injury to explore the potential mechanism of action. This method could be applied to various Chinese herbs and disease models, which could promote TCM modernization.
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Achyranthes , Encéfalo , Ratas Sprague-Dawley , Animales , Achyranthes/química , Cromatografía Líquida de Alta Presión/métodos , Ratas , Encéfalo/metabolismo , Masculino , Espectrometría de Masas/métodos , Medicamentos Herbarios Chinos/farmacocinética , Medicamentos Herbarios Chinos/química , Infarto de la Arteria Cerebral Media/metabolismo , Infarto de la Arteria Cerebral Media/sangre , Flavonoides/sangre , Flavonoides/farmacocinética , Flavonoides/metabolismo , Alcaloides/sangre , Alcaloides/farmacocinética , Alcaloides/química , Alcaloides/metabolismoRESUMEN
BACKGROUND: This study retrospectively analyzed the feasibility and surgical outcome of an algorithmic approach using negative pressure wound therapy for patients with synchronous hypopharyngeal and esophageal cancer undergoing pharyngolaryngoesophagectomy with gastric tube reconstruction. METHODS: Patients undergoing pharyngolaryngoesophagectomy and gastric tube reconstruction for hypopharyngeal cancer between 2011 and 2019 were candidates for this study. Data were collected on patient demographics, comorbidities, performance status, cancer stage, treatment, complication, and survival. Survival analysis was performed using the Kaplan-Meier method. The Cox proportional hazards model was used for prognostic factors. RESULTS: The study enrolled 43 patients. Anastomotic leakage was found in 21 of the patients with a conventional surgical drain (61.9%) and in 10 of the 22 patients with negative pressure wound therapy (45.5%) (p = 0.280). Nine patients in the conventional drain group (42.9%) and two patients in the negative pressure wound therapy group (9.1%) had leakage-associated complications (p = 0.011). The incidence of pulmonary complications was higher in the conventional surgical drain group (9 vs 2; p = 0.011). The number of complications requiring surgery was higher in the conventional drain group (7 vs 0; p = 0.004). The overall survival in the negative pressure wound therapy group was better (hazard ratio [HR], 0.33; 95% confidence interval [CI], 0.15-0.76; p = 0.009). Negative pressure wound therapy was independently associated with overall survival (HR, 0.31; 95% CI, 0.13-0.77; p = 0.011). CONCLUSIONS: Negative pressure wound therapy with an algorithmic approach improved the overall survival for the patients undergoing gastric tube reconstruction after pharyngolaryngoesophagectomy for hypopharyngeal and esophageal cancer by preventing deadly complications secondary to anastomotic leakage.
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Neoplasias Esofágicas , Terapia de Presión Negativa para Heridas , Neoplasias Esofágicas/cirugía , Esofagectomía/efectos adversos , Humanos , Faringectomía/efectos adversos , Estudios RetrospectivosRESUMEN
Acer mono Maxim, mainly distributed in China, Japan, Korea and eastern Russia (Shang et al. 2012), is a widely planted ornamental and pharmaceutical tree (Zhang et al. 2015). In September 2020, leaf samples of A. mono infected by uredinia were collected in Shaanxi Province (34°15'40.06'' N, 108°3'54.54'' E, alt. 432.35m), China. Telia development was observed in late autumn. Voucher specimens were deposited in the Herbarium Mycologicum Academiae Sinicae (no. HMAS249354), China. This led to premature defoliation and in the 90% planting wide incidence. Geospatial investigations revealed that this rust was widely distributed in local urban parks, but was nonpathogenic to A. buergerianum, A. negundo, A. oblongum, A. palmatum and A. rubrum. This fungus was morphologically characterized and most closely matched descriptions of Pucciniastrum. Uredinia were hypophyllous, subepidermal, scattered to gregarious, oval or round, 0.10-0.30 × 0.08-0.15 mm, golden yellow to orange, somewhat pulverulent. Peridia were hemispherical, erumpent with apical pores; peridial cells minute, irregularly polygonal, hyaline to pale yellow; ostiolar cells ellipsoid or roundish. Urediniospores were subglobose, ovate or ellipsoid, 20-33 × 15-21 µm, yellow to pale orange; wall 1-2 µm thick, hyaline to pale yellow, echinulate, somewhere smooth. Pedicels were deciduous, hyaline, minute, fragile. Telia were hypophyllous, subepidermal, intermixed with uredinia, irregularly polygonal, restricted by veins, 0.34-0.91 × 0.21-0.54 mm, and orange to amber brown. Teliospores were produced parallelly single-layered, and were subglobose, oblong, sometimes angular, 23-47 × 16-34 µm, colorless to pale yellow, 1-5 mediastinal, 2-6-celled; lateral wall 1-1.6 µm thick, apical wall 1-3 µm thick, smooth, hyaline. The internal transcribed spacer (ITS) and rDNA-28S regions were amplified using ITS1F/ITS4 and NL1/NL4 (Ji et al. 2019) to confirm the identification. The aligned sequences were deposited in GenBank (accession no. MW391829, MW543709, MW541916, MW541917). Phylogenetic trees were constructed based on neighbor-joining (NJ), maximum-likelihood (ML) and Bayesian methods. ML and NJ bootstrap values were calculated by bootstrap analyses of 1,000 replicates with GTR+G+I model using MEGA-X (Kumar et al. 2018), while Bayesian Markov chain Monte Carlo analyses were performed using MrBayes ver. 3.1.2 (Huelsenbeck & Ronquist 2001; Ji et al. 2019). Phylogenetic analysis revealed that HMAS249354 and Pucciniastrum hikosanense were grouped into one clade highly supported by bootstrap values of NJ, ML, and Bayesian posterior probability (Bpp) of 97%/93%/1, respectively. Koch's postulates were fulfilled with 1-year-old healthy plants of A. mono. Fresh urediniospores were collected and suspended in a 0.05% water solution of Tween 20, and 100 µl of urediniospores suspension (106 urediniospores/ml) per leaf (n=10) were sprayed, with another ten healthy leaves sprayed with sterile water as the control. The plants were placed in dark for 48 h and then moved into greenhouse at 22°C with 12 h light per day. Disease symptoms after 10-12 days' inoculation on the inoculated leaves which were identical to the original observations, while the control leaves remained healthy. Previously, P. hikosanense was reported to infect Acer rufinerve Sieb. et Zucc. in Japan (Hiratsuka 1940) and A. rubescens Hayata in Taiwan, China (Dai 1979). This is the first report of leaf rust of Acer mono caused by Pucciniastrum hikosanense Hirats. f. in China.
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BACKGROUND: It is challenging to proceed thoracoscopic anatomic resection when encountering severe pleural adhesion or calcified peribronchial lymphadenopathy. Compared with multiple-port video-assisted thoracoscopic surgery (MP-VATS), how to overcome these challenges in single-port (SP-) VATS is still an intractable problem. In the present study, we reported the surgical results of chronic inflammatory lung disease and shared some useful SP-VATS techniques. METHODS: We retrospectively assessed the surgical results of chronic inflammatory lung disease, primarily bronchiectasis, and mycobacterial infection, at our institution between 2010 and 2018. The patients who underwent SP-VATS anatomic resection were compared with those who underwent MP-VATS procedures. We analyzed the baseline characteristics, perioperative data, and postoperative outcomes, and illustrated four special techniques depending on the situation: flexible hook electrocautery, hilum-first technique, application of Satinsky vascular clamp, and staged closure of bronchial stump method. RESULTS: We classified 170 consecutive patients undergoing thoracoscopic anatomic resection into SP and MP groups, which had significant between-group differences in operation time and overall complication rate (P = 0.037 and 0.018, respectively). Compared to the MP-VATS group, the operation time of SP-VATS was shorter, and the conversion rate of SP-VATS was relatively lower (3.1% vs. 10.5%, P = 0.135). The most common complication was prolonged air leakage (SP-VATS, 10.8%; MP-VATS, 2.9%, P = 0.045). CONCLUSIONS: For chronic inflammatory lung disease, certain surgical techniques render SP-VATS anatomic resection feasible and safe with a lower conversion rate.
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Enfermedades Pulmonares , Neoplasias Pulmonares , Humanos , Enfermedades Pulmonares/cirugía , Neoplasias Pulmonares/cirugía , Neumonectomía , Estudios Retrospectivos , Cirugía Torácica Asistida por VideoRESUMEN
A solvent-vapor transport route produces centimeter-sized single-crystal red phosphors. The epitaxial growth route to yield its core-shell structure at ambient temperature was adopted. These red phosphors could be applied in all-inorganic WLED devices. Cs2 TiF6 :Mn4+ (CTFM) single crystal provides enhancement of quantum efficiency, moisture resistance, and thermal stability compared to polycrystalline powders. The internal quantum efficiency can reach as high as 98.7 %. To further improve waterproof stability, the Cs2 TiF6 (CTF) shell with tunable thickness has been epitaxially grown on the CTFM single crystal surface and a unique three-step photoluminescence intensity evolution mechanism has been proposed. By combining as-prepared CTFM@CTF core-shell structured single crystal, YAG:Ce single crystal and blue-chip, warm WLEDs with excellent color rendition (Ra =90, R9 =94), low correlated color temperature (CCT=3155â K), and high luminous efficacy were fabricated without any organic resins.
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BACKGROUND: Mammography is not effective in detecting breast cancer in dense breasts. METHODS: A search in Medline, Cochrane, EMBASE and Google Scholar databases was conducted from January 1, 1980 to April 10, 2019 to identify women with dense breasts screened by mammography (M) and/or ultrasound (US). Meta-analysis was performed using the random-effect model. RESULTS: A total of 21 studies were included. The pooled sensitivity values of M alone and M + US in patients were 74% and 96%, while specificity of the two methods were 93% and 87%, respectively. Screening sensitivity was significantly higher in M + US than M alone (risk ratio: M alone vs. M + US = 0.699, P < 0.001), but the slight difference in specificity was statistically significant (risk ratio = 1.060, P = 0.001). Pooled diagnostic performance of follow-up US after initial negative mammography demonstrated a high pooled sensitivity (96%) and specificity (88%). The findings were supported by subgroup analysis stratified by study country, US method and timing of US. CONCLUSIONS: Breast cancer screening by supplemental US among women with dense breasts shows added detection sensitivity compared with M alone. However, US slightly decreased the diagnostic specificity for breast cancer. The cost-effectiveness of supplemental US in detecting malignancy in dense breasts should be considered additionally.
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Neoplasias de la Mama/diagnóstico por imagen , Mamografía/métodos , Ultrasonografía Mamaria/métodos , Densidad de la Mama , Terapia Combinada , Detección Precoz del Cáncer , Femenino , Humanos , Sensibilidad y EspecificidadRESUMEN
BACKGROUND: The diffusion-weighted imaging (DWI) signals of the female pelvic bone marrow show great variability and are usually high in female patients with fibroid-associated symptoms and anemia. PURPOSE: To ascertain clinical factors contributing to high signal intensity in the bone marrow of the female pelvis on DWI. STUDY TYPE: Retrospective case-control study. SUBJECTS: A single-institution review of 221 female patients underwent a pelvic magnetic resonance study from December 2012 to July 2014. FIELD STRENGTH/SEQUENCE: 1.5T/DWI (b = 0 and 1000) and apparent diffusion coefficient (ADC). ASSESSMENT: The ADC of pelvic bone marrow and the muscle-normalized signal intensity (SI) on DWI (mnDWI) were measured. A brightness grading scale ranging from 0 to 4 was used for pelvic bone assessment. Clinical factors, namely, age, the lowest hemoglobin level in the last 6 months, the presence of large uterine fibroids, and/or adenomyosis and fibroid-associated symptoms were recorded. STATISTICAL TESTS: The relationships between the brightness grade and clinical factors were evaluated through multinomial logistic regression, and correlations of mnDWI and the ADC with the clinical factors were analyzed through the Kruskal-Wallis test, Jonckheere's trend test, and the Mann-Whitney U-test with Bonferroni correction. RESULTS: Age and the hemoglobin level were inversely associated with the bone marrow brightness grade on DWI (both P < 0.05), whereas the presence of fibroid-associated symptoms showed a positive association (P = 0.028). The ADC and mnDWI in women younger than 50 years were significantly higher than those in older women (both P < 0.0001). The ADC had no significant correlation with anemia (P = 0.511), whereas mnDWI increased as the severity of anemia increased (P = 0.00154). DATA CONCLUSION: Our study showed an association of high DWI SI of pelvic bone marrow with anemia in premenopausal women. LEVEL OF EVIDENCE: 4 Technical Efficacy Stage 3 J. Magn. Reson. Imaging 2018;48:1024-1033.
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Anemia/complicaciones , Médula Ósea/diagnóstico por imagen , Imagen de Difusión por Resonancia Magnética , Leiomioma/diagnóstico por imagen , Pelvis/diagnóstico por imagen , Adenomiosis/diagnóstico por imagen , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Estudios de Casos y Controles , Niño , Femenino , Hemoglobinas/análisis , Humanos , Procesamiento de Imagen Asistido por Computador/métodos , Modelos Lineales , Persona de Mediana Edad , Variaciones Dependientes del Observador , Huesos Pélvicos/diagnóstico por imagen , Premenopausia , Análisis de Regresión , Estudios Retrospectivos , Adulto JovenRESUMEN
We report an angiographic image of a 58-year-old woman with profuse bleeding from a tracheo-innominate artery fistula. It may not have been possible to obtain this valuable image if adequate initial resuscitation and an over-inflated tracheostomy tube cuff had not been administered to stop bleeding during an emergency.
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Large primary tumor volume has been identified as a poor prognostic factor of esophageal squamous cell carcinoma (ESCC) treated with definitive concurrent chemoradiotherapy (CCRT). However, when neoadjuvant CCRT and surgery are adopted, the prognostic impact of primary tumor and lymph node (LN) volume on clinical outcomes in ESCC remains to be elucidated. This study included 107 patients who received neoadjuvant CCRT and surgery for ESCC. The volume of the primary tumor and LN was measured using radiotherapy planning computed tomography scans, and was correlated with overall survival (OS), disease-free survival (DFS), and cancer failure pattern. The median OS was 24.2 months (IQR, 11.1-93.9) after a median follow-up of 18.4 months (IQR, 8.1-40.7). The patients with a baseline LN volume > 7.7 ml had a significantly worse median OS compared to those with smaller LN volume (18.8 vs. 46.9 months, p = 0.049), as did those with tumor regression grade (TRG) 3-5 after CCRT (13.9 vs. 86.7 months, p < 0.001). However, there was no association between OS and esophageal tumor volume (p = 0.363). Multivariate analysis indicated that large LN volume (HR 1.753, 95% CI 1.015-3.029, p = 0.044) and high TRG (HR 3.276, 95% CI 1.556-6.898, p = 0.002) were negative prognostic factors for OS. Furthermore, large LN volume was linked to increased locoregional failure (p = 0.033) and decreased DFS (p = 0.041). In conclusion, this study demonstrated that large LN volume is correlated with poor OS, DFS, and locoregional control in ESCC treated with neoadjuvant CCRT and esophagectomy.
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Carcinoma de Células Escamosas , Neoplasias Esofágicas , Carcinoma de Células Escamosas de Esófago , Humanos , Carcinoma de Células Escamosas de Esófago/patología , Terapia Neoadyuvante/métodos , Neoplasias Esofágicas/terapia , Neoplasias Esofágicas/tratamiento farmacológico , Carcinoma de Células Escamosas/terapia , Carcinoma de Células Escamosas/tratamiento farmacológico , Estadificación de Neoplasias , Pronóstico , Ganglios Linfáticos/patología , Quimioradioterapia/métodos , Estudios Retrospectivos , Esofagectomía/métodosRESUMEN
IL-33 is a danger signal that binds to its receptor ST2L to promote tumor progression. This study identifies the IL-33/ST2L positive-feedback loop and the trafficking of ST2L membrane presentation in macrophages that contribute to lung tumor progression. Mechanistically, IL-33 induces ST2L upregulation by activating NF-κB, which binds to the promoter region of the ST2L gene. Moreover, Rab37, a small GTPase involved in membrane trafficking, mediates ST2L trafficking to the plasma membrane of M2 macrophages. This IL-33/NF-κB/ST2L/Rab37 axis promotes positive-feedback loops that enhance ST2L expression and membrane trafficking in M2 macrophages. Notably, neutralizing antibodies against IL-33 or ST2L block NF-κB activity, suppress M2 macrophage polarization, and synergistically inhibit tumor growth when combined with cisplatin treatment in vitro/vivo. Clinically, Rab37+/ST2L+/CD206+ tumor-infiltrating M2 macrophages correlate with advanced-stage lung cancer patients with poor response to chemotherapy. These findings unveil a positive-feedback mechanism and provide a basis for IL-33/ST2L-targeting therapy for cancer.
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Interleucina-33 , Neoplasias Pulmonares , Macrófagos , FN-kappa B , Proteínas de Unión al GTP rab , Interleucina-33/metabolismo , Interleucina-33/genética , Humanos , Neoplasias Pulmonares/patología , Neoplasias Pulmonares/tratamiento farmacológico , Neoplasias Pulmonares/metabolismo , Neoplasias Pulmonares/genética , FN-kappa B/metabolismo , Macrófagos/metabolismo , Macrófagos/efectos de los fármacos , Animales , Proteínas de Unión al GTP rab/metabolismo , Proteínas de Unión al GTP rab/genética , Ratones , Retroalimentación Fisiológica , Línea Celular Tumoral , Transducción de Señal/efectos de los fármacos , Ratones Endogámicos C57BL , FemeninoRESUMEN
The study aimed to develop machine learning (ML) classification models for differentiating patients who needed direct surgery from patients who needed core needle biopsy among patients with prevascular mediastinal tumor (PMT). Patients with PMT who received a contrast-enhanced computed tomography (CECT) scan and initial management for PMT between January 2010 and December 2020 were included in this retrospective study. Fourteen ML algorithms were used to construct candidate classification models via the voting ensemble approach, based on preoperative clinical data and radiomic features extracted from the CECT. The classification accuracy of clinical diagnosis was 86.1%. The first ensemble learning model was built by randomly choosing seven ML models from a set of fourteen ML models and had a classification accuracy of 88.0% (95% CI = 85.8 to 90.3%). The second ensemble learning model was the combination of five ML models, including NeuralNetFastAI, NeuralNetTorch, RandomForest with Entropy, RandomForest with Gini, and XGBoost, and had a classification accuracy of 90.4% (95% CI = 87.9 to 93.0%), which significantly outperformed clinical diagnosis (p < 0.05). Due to the superior performance, the voting ensemble learning clinical-radiomic classification model may be used as a clinical decision support system to facilitate the selection of the initial management of PMT.
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OBJECTIVE: The superiority of segmentectomy over lobectomy with regard to preservation of pulmonary function is controversial. This study aimed to examine changes in pulmonary function after uniportal video-assisted thoracoscopic surgery (VATS) according to the number of resected segments. METHODS: We retrospectively reviewed 135 consecutive patients who underwent anatomical lung resection via uniportal VATS from April 2015 to December 2020. Pulmonary function loss was evaluated using forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1). Patients were grouped according to number of resected segments: one-segment (n = 33), two segments (n = 22), three segments (n = 40), four segments (n = 15), and five segments (n = 25). RESULTS: Clinical characteristics did not significantly differ between groups, except for tumor size. Mean follow-up was 8.96 ± 3.16 months. FVC loss was significantly greater in five-segment resection (10.8%) than one-segment (0.97%, p = 0.008) and two-segment resections (2.44%, p = 0.040). FEV1 loss was significantly greater in five-segment resection (15.02%) than one-segment (3.83%, p < 0.001), two-segment (4.63%, p = 0.001), and three-segment resections (7.63%, p = 0.007). Mean FVC loss and FEV1 loss increased linearly from one-segment resection to five-segment resection. Mean loss in FVC and FEV1 per segment resected was 2.16% and 3.00%, respectively. CONCLUSIONS: Anatomical lung resection of fewer segments was associated with better preservation of pulmonary function in patients undergoing uniportal VATS, and function loss was approximately 2%-3% per segment resected with linear relationship.
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Neoplasias Pulmonares , Humanos , Neoplasias Pulmonares/cirugía , Cirugía Torácica Asistida por Video , Estudios Retrospectivos , Neumonectomía , Pulmón/cirugíaRESUMEN
Within urban green spaces, spontaneous groundcovers, as potential alternatives for traditional lawns, have garnered attention due to their ecological adaptability. However, little attention has been paid to whether spontaneous groundcovers can serve as suitable replacements for lawns in terms of the aesthetic values and human preferences for each. Based on questionnaires accompanied by photo elicitation, this study explored the perceptions of and preferences for seven kinds of lawns and six kinds of spontaneous groundcovers in China. The effects of social backgrounds on people's perceptions of and preferences for ground covers were also analyzed. The results indicated a general equivalence in preferences for the lawn and spontaneous groundcover. The Taraxacum mongolicum - Cynodon dactylon - Conyza canadensis community was significantly preferred most among all of the selected ground covers. Spontaneous groundcovers were regarded as more natural, wild, variable, and species-richer compared to lawns, while lawns were perceived as better kept than spontaneous groundcovers. Ground covers were preferred which were perceived to have high ecological aesthetic value and low wildness. Industry and attention to herbaceous plants mostly affected human perceptions and preferences among the social background factors, and gender, age, education level, and occupation also had significant effects. The results thus provide the support for the application of spontaneous groundcovers in moderately developed cities, but such application should consider the comprehensive development of ecological aesthetic value and the applicability of different groups of residents.
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We report an organic solvent-assisted (OSA) co-precipitation strategy for the production of Mn4+-activated K2TiF6 phosphor. The phosphor particle size was controlled through the selection of organic solvents with an alcohol functional group and different carbon chain lengths used in the synthesis. The synergistic effect of the organic solvent and hydrofluoric acid results in large smoothed hexagonal-shaped crystal sheets of particles that become larger as the carbon chain length of the organic solvent increases. The photoluminescence (PL) properties of K2TiF6:Mn powders strongly depend on the size and thickness of the particles. The addition of n-butanol during the synthesis increases the emission intensity of K2TiF6:Mn by 208%. The PL quantum efficiency of phosphors prepared using the n-butanol-assisted strategy is much higher (98.2%) than that of conventionally prepared phosphors (89.9%). Our findings demonstrate a way to prepare the K2TiF6:Mn phosphor with targeted morphology and very high quantum efficiency and also provide the route for the optimization of all Mn4+-activated fluoride phosphors used in white light-emitting diodes.
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Tumor resection could increase treatment efficacy of epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKI) in patients with advanced EGFR-mutant non-small cell lung cancer (NSCLC). This study aimed to retrospectively analyze patients with advanced EGFR-mutant NSCLC from a Taiwanese tertiary center and receiving EGFR-TKI treatment with or without tumor resection. A total of 349 patients were enrolled. After propensity score matching, 53 EGFR-TKI treated patients and 53 EGFR-TKI treated patients with tumor resection were analyzed. The tumor resection group showed improved progression-free survival (PFS) (52.0 vs. 9.8 months; hazard ratio [HR] = 0.19; p < 0.001) and overall survival (OS) (not reached vs. 30.6 months; HR = 0.14; p < 0.001) compared to the monotherapy group. In the subgroup analysis of patients with newly-diagnosed NSCLC, the tumor resection group showed longer PFS (52.0 vs. 9.9 months; HR = 0.14; p < 0.001) and OS (not reached vs. 32.6 months; HR = 0.12; p < 0.001) than the monotherapy group. In conclusion. the combination of EGFR-TKI and tumor resection provided better PFS and OS than EGFR-TKI alone, and patients who underwent tumor resection within six months had fewer co-existing genomic alterations and better PFS.
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Carcinoma de Pulmón de Células no Pequeñas , Neoplasias Pulmonares , Humanos , Carcinoma de Pulmón de Células no Pequeñas/tratamiento farmacológico , Carcinoma de Pulmón de Células no Pequeñas/genética , Carcinoma de Pulmón de Células no Pequeñas/cirugía , Neoplasias Pulmonares/tratamiento farmacológico , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/cirugía , Estudios de Cohortes , Estudios Retrospectivos , Mutación , Inhibidores de Proteínas Quinasas , Receptores ErbB/metabolismoRESUMEN
PURPOSES: This study aimed to evaluate the diagnostic capacity of apparent diffusion coefficient (ADC) in predicting pathological Masaoka and T stages in patients with thymic epithelial tumors (TETs). METHODS: Medical records of 62 patients who were diagnosed with TET and underwent diffusion-weighted imaging (DWI) prior to surgery between August 2017 and July 2021 were retrospectively analyzed. ADC values were calculated from DWI images using b values of 0, 400, and 800 s/mm2. Pathological stages were determined by histological examination of surgical specimens. Cut-off points of ADC values were calculated via receiver operating characteristic (ROC) analysis. RESULTS: Patients had a mean age of 56.3 years. Mean ADC values were negatively correlated with pathological Masaoka and T stages. Higher values of the area under the ROC curve suggested that mean ADC values more accurately predicated pathological T stages than pathological Masaoka stages. The optimal cut-off points of mean ADC were 1.62, 1.31, and 1.48 × 10-3 mm2/sec for distinguishing pathological T2-T4 from pathological T1, pathological T4 from pathological T1-T3, and pathological T3-T4 from pathological T2, respectively. CONCLUSION: ADC seems to more precisely predict pathological T stages, compared to pathological Masaoka stage. The cut-off values of ADC identified may be used to preoperatively predict pathological T stages of TETs.
Asunto(s)
Neoplasias Glandulares y Epiteliales , Neoplasias del Timo , Imagen de Difusión por Resonancia Magnética/métodos , Humanos , Persona de Mediana Edad , Neoplasias Glandulares y Epiteliales/diagnóstico por imagen , Curva ROC , Estudios Retrospectivos , Neoplasias del Timo/diagnóstico por imagen , Neoplasias del Timo/patologíaRESUMEN
This study aimed to build machine learning prediction models for predicting pathological subtypes of prevascular mediastinal tumors (PMTs). The candidate predictors were clinical variables and dynamic contrast-enhanced MRI (DCE-MRI)-derived perfusion parameters. The clinical data and preoperative DCE-MRI images of 62 PMT patients, including 17 patients with lymphoma, 31 with thymoma, and 14 with thymic carcinoma, were retrospectively analyzed. Six perfusion parameters were calculated as candidate predictors. Univariate receiver-operating-characteristic curve analysis was performed to evaluate the performance of the prediction models. A predictive model was built based on multi-class classification, which detected lymphoma, thymoma, and thymic carcinoma with sensitivity of 52.9%, 74.2%, and 92.8%, respectively. In addition, two predictive models were built based on binary classification for distinguishing Hodgkin from non-Hodgkin lymphoma and for distinguishing invasive from noninvasive thymoma, with sensitivity of 75% and 71.4%, respectively. In addition to two perfusion parameters (efflux rate constant from tissue extravascular extracellular space into the blood plasma, and extravascular extracellular space volume per unit volume of tissue), age and tumor volume were also essential parameters for predicting PMT subtypes. In conclusion, our machine learning-based predictive model, constructed with clinical data and perfusion parameters, may represent a useful tool for differential diagnosis of PMT subtypes.
RESUMEN
The papillary thyroid carcinoma (PTC) metastasizes through lymphatic spread, but the follicular thyroid cancer (FTC) metastasis occurs by following hematogenous spread. To date, the molecular mechanism underlying different metastatic routes between PTC and FTC is still unclear. Here, we showed that specifically androgen-regulated gene (SARG) was significantly up-regulated in PTC, while obviously down-regulated in FTC through analyzing the Gene Expression Omnibus (GEO) database. Immunohistochemistry assay verified that the PTC lymph node metastasis was associated with higher levels of SARG protein in clinical PTC patient samples. SARG-knockdown decreased TPC-1 and CGTH-W3 cells viability and migration significantly. On the contrary, SARG-overexpressed PTC cells possessed more aggressive migratory ability and viability. In vivo, SARG overexpression dramatically promoted popliteal lymph node metastasis of xenografts from TPC-1 cells mouse footpad transplanting. Mechanistically, SARG overexpression and knockdown significantly increased and decreased the expression of vascular endothelial growth factor C (VEGF-C) and VEGF receptor 3 (VEGFR-3), respectively, thereby facilitating or inhibiting the tube formation in HUVECs. The tube formation experiment showed that SARG overexpression and knockdown promoted or inhibited the number of tube formations in HUVEC cells, respectively. Taken together, we showed for the first time the differential expression profile of SARG between PTC and FTC, and SARG promotes PTC lymphatic metastasis via VEGF-C/VEGFR-3 signal. It indicates that SARG may represent a target for clinical intervention in lymphatic metastasis of PTC.