Optimal number of harvested lymph nodes for curatively resected gallbladder adenocarcinoma based on a Bayesian network model.

BACKGROUND AND OBJECTIVES: To identify the optimal range and the minimum number of lymph nodes (LNs) to be examined to maximize survival time of patients with curatively resected gallbladder adenocarcinoma (GBAC). METHODS: Data were collected from the surveillance, epidemiology, and end results database on patients with GBAC who underwent curative resection between 2004 and 2015. A Bayesian network (BN) model was constructed to identify the optimal range of harvested LNs. Model accuracy was evaluated using the confusion matrix and receiver operating characteristic (ROC) curve. RESULTS: A total of 1268 patients were enrolled in this study. Accuracy of the BN model was 72.82%, and the area under the curve of the ROC for the testing dataset was 78.49%. We found that at least seven LNs should be harvested to maximize survival time, and that the optimal count of harvested LNs was in the range of 7 to 10 overall, with an optimal range of 10 to 11 for N+ patients, 7 to 10 for stage T1-T2 patients, and 7 to 11 for stage T3-T4 patients. CONCLUSIONS: According to a BN model, at least seven LNs should be retrieved for GBAC with curative resection, with an overall optimal range of 7 to 10 harvested LNs.

[Study on nanoparticles in Yangtze Estuary].

Filtration and cross-flow ultrafiltration (CFUF) was applied for the effective separation of NPs in the Yangtze Estuary. The physiochemical properties of NP were characterized, and their relationships with environmental factors were further studied in the present study. The results show that NP size in Yangtze Estuary ranged from 69.5 to 263.5 nm with the average value of 157.3 nm and Zeta-potential values ranged from -40.1 mV to 196.0 mV. NOC concentrations ranged from 0.3 mg/L to 1.5 mg/L and the average value was 0.7 mg/L. NOC account for 5.1% to 30.5% of DOC, with an average of 16.7%. The binding capacity of metals with NP in the Yangtze River Estuary was in the order of Zn > Cu > total Cr > Co > Ni > Mn > Fe > Li > Al > B > K > Ba > Sr > Mg > Ca > Na, which reveals that terrigenous input may be the main source of NOC in the Yangtze River. The binding capacity of NP with trace metal is generally higher than the conventional metallic element. There was no significant correlation between NP size and salinity, DOC, NOC, SPM and Zeta-potential, respectively. Compared to NOC and UOC, better correlation was investigated between DOC, salinity and NP bound trace metals.