Survival prognostic in different age groups of patients undergoing local versus radical excision for rectal cancer: a study based on the SEER database.

Age significantly affects the prognosis of patients with rectal cancer after radical excision (RE), and local excision (LE) is an alternative surgical procedure to RE. To compare the survival prognosis in different age groups of LE versus RE for rectal cancer. Patients diagnosed with rectal adenocarcinoma treated by LE or RE from 2010 to 2017 were obtained from the SEER database. The primary outcomes are 5-year OS and CSS. A total of 11,170 patients were eventually included, and there were 490 patients in LE and RE groups, respectively, after 1:1 propensity score matching. The 5-year OS and CSS after LE were significantly better in < 50 years and 50-66 years groups than in > 66 years group (5-year OS: 95.70% vs 88.40% vs 67.00%, P < 0.001; 5-year CSS: 95.70% vs 96.30% vs 82.60%, P < 0.001). No statistical significance was found for the differences in 5-year OS and CSS between LE and RE in < 50, 50-66, and > 66 years group (P > 0.05). Multivariate analysis showed age > 66 years, poorly differentiated or undifferentiated (Grade III/IV), and tumor size 3 to 5 cm was independent risk factors for 5-year OS after LE; age > 66 years, perineural invasion, and tumor size 3 to 5 cm were the 5-year CSS independent risk factors for after LE. We found that the survival prognosis of younger rectal cancer patients treated with LE was significantly better than older (> 66 years) patients, and the survival prognosis of rectal cancer patients in the three age groups was similar between LE and RE.

Prognostic impact of tumor budding in rectal cancer after neoadjuvant therapy: a systematic review and meta-analysis.

BACKGROUND: Tumor budding (TB) is a negative prognostic factor in colorectal cancer; however, its prognostic impact following neoadjuvant therapy for patients with rectal cancer remains unclear. This study aims to assess the prognostic impact of TB and the correlation between TB and other pathological features in patients with rectal cancer after neoadjuvant therapy. METHODS: A comprehensive search of PubMed, Embase, Cochrane, Scopus, CNKI, Wanfang, and ClinicalKey databases was conducted for studies on the prognosis of TB in rectal cancer after neoadjuvant therapy from the inception of the databases to January 2023, and the final literature included was determined using predefined criteria. Quality assessment of the studies included, extraction of general and prognostic information from them, and meta-analyses were carried out progressively. RESULTS: A total of 11 studies were included, and the results of the meta-analysis showed that high-grade tumor budding (TB-1) increased the risk of poor 5-year disease-free survival (HR = 1.75, 95% CI 1.38-2.22, P < 0.00001), 5-year overall survival (HR = 1.77, 95% CI 1.21-2.59, P = 0.003), local recurrence (OR = 4.15, 95% CI 1.47-11.75, P = 0.007), and distant metastasis (OR = 5.36, 95% CI 2.51-11.44, P < 0.0001) in patients with rectal cancer after neoadjuvant therapy. TB-1 was significantly associated with poor differentiation and lymphatic, perineural, and venous invasion. CONCLUSION: Tumor budding is significantly correlated with unfavorable prognosis and poor pathological characteristics following neoadjuvant therapy for rectal cancer. We anticipate more high-quality, prospective studies in the future to confirm our findings. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42022377564.

Efficacy and safety of apatinib combined with radiotherapy in the treatment of advanced pancreatic cancer: a meta-analysis.

OBJECTIVE: At present, pancreatic cancer (PC) has a high morbidity and mortality rate and a poor prognosis. The aim of this article was to study the efficacy and safety of apatinib combined with radiotherapy in the treatment of advanced PC. METHODS: The PubMed, Cochrane Library, Embase, Wanfang, CNKI, VIP, and CBM databases were searched by computer to identify studies on the application of apatinib in patients with advanced PC. The patients in the included study were divided into an observation group (apatinib combined with radiotherapy) and a control group (radiotherapy only), and meta-analysis was performed for each outcome with Revman 5.4 software. This study was successfully registered on the PROSPERO website, and the registration number is CRD: 42,022,384,056 (available at https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=384056 ). RESULTS: A total of 7 randomized controlled trials (RCTs) with 428 patients were included, including 215 in the observation group and 213 in the control group. Compared with the control group, the observation group showed a greater objective response rate [OR = 3.26, 95% CI (2.18, 4.87), P < 0.0001], disease control rate [OR = 5.04, 95% CI (3.12, 8.12), P < 0.0001], complete response rate [OR = 3.87, 95% CI (1.51, 9.88), P = 0.005], and partial response rate [OR = 2.43, 95% CI (1.63, 3.61), P < 0.001], The 1-year survival rate [OR = 2.39, 95% CI (1.15, 4.96), P < 0.05], 2-year survival rate [OR = 2.41, 95% CI (1.03, 5.61), P < 0.05], progression-free survival time [MD = 1.17, 95% CI (0.37, 1.96), P < 0.05], overall survival time [MD = 1.47, 95% CI (0.13, 2.80), P < 0.05], while the stability rate [OR = 1.14, 95% CI (0.72, 1.81), P = 0.58] and various complications were not significantly different between the two groups. CONCLUSION: Apatinib combined with radiotherapy was more effective than radiotherapy alone in the treatment of advanced pancreatic cancer (PC), and apatinib had acceptable safety. However, since our study was limited by the quantity and quality of the included studies, we look forward to more large-sample, multicentre, and high-quality RCTs in the future to verify the conclusions.

Outcomes after the watch-and-wait strategy and local excision treatment for rectal cancer: a meta-analysis.

BACKGROUND: The watch-and-wait (W&W) strategy and local excision (LE) have been used in patients with clinical complete response (cCR) for rectal cancer, but the comparative outcomes of the two strategies are controversial. We compared the efficacy of the W&W strategy with LE for rectal cancer patients after neoadjuvant chemoradiotherapy (nCRT) or total neoadjuvant therapy (TNT). RESEARCH DESIGN AND METHODS: Several domestic and foreign databases were searched for the relevant literature on comparative trials of the W&W strategy and LE surgery for rectal cancer after neoadjuvant therapy with the following outcomes; differences in local recurrence (LR), distant metastasis (DM/DM+LR), 3-year disease-free survival (DFS), 3-year local recurrence-free survival (LRFS) and 3-year overall survival (OS). RESULTS: Nine articles, were analyzed. Overall, 442 patients were included, with 267 and 175 patients in the W&W and LE groups, respectively. Meta-analysis results showed no significant differences the between W&W and LE groups with respect to LR, DM/DM+LR, 3-year DFS, 3-year LRFS, and 3-year OS. This study has been registered in PROSPERO (registration number: CRD42022331208). CONCLUSION: The W&W strategy may be preferred for some rectal cancer patients who select LE and reach cCR or near cCR after nCRT or TNT.

[Granulomatosis with polyangiitis with head and neck symptoms as the first clinical manifestation: clinical analysis of 28 cases].

Objective:To investigate the early clinical features and diagnosis of granulomatous polyangiitis（GPA） with head and neck symptoms as the first presentation. Methods:The data of 28 patients with GPA diagnosed in the Second Hospital of Shanxi Medical University from 2014 to 2021, whose first symptoms appeared on the head and neck, were collected. All patients underwent relevant imaging examinations, laboratory tests, endoscopy, and pathological tissue biopsies. Systemic glucocorticoid or combined immunosuppressive therapy was administered and followed up for 1-5 years. Results:Two patients refused treatment and were lost to follow-up; 26 patients were discharged with improved symptoms, complaining of nasal ventilation, resolution of supraorbital swelling, reduced dyspnoea, and renal symptoms. Five patients were repeatedly admitted to the hospital due to recurrent renal involvement. Conclusion:Although GPA often begins with head and neck symptoms, it is non-specific and can easily be confused with chronic inflammatory disease, leading to misdiagnosis. If suspicious cases are identified, they should be combined with endoscopy, pathological tissue biopsy, and special laboratory tests as early as possible to shorten the time to diagnosis, and obtain early diagnosis and treatment.

Quantitative susceptibility mapping to evaluate brain iron deposition and its correlation with physiological parameters in hypertensive patients.

BACKGROUND: Regional excessive iron overload is pernicious to motor functions and cognitive functioning of the brain. The aim of this research was to utilize quantitative susceptibility mapping (QSM) to inspect brain iron accumulation in patients with hypertension (HP), and to evaluate whether it is correlated with physiological parameters. METHODS: Thirty-one HP and 31 age- and sex-matched healthy controls (HC) were included. All participants underwent brain magnetic resonance imaging (MRI), and QSM data were obtained. Differences in brain iron deposition in deep gray matter nuclei of participants were compared between HP and HC. The correlations between iron deposition, body mass index (BMI), maximum systolic blood pressure (SBP), and diastolic blood pressure (DBP) were analyzed. RESULTS: The HP group showed increased susceptibility values in the caudate nucleus (CA), putamen (PU), globus pallidus (GP), and dorsal thalamus (TH), compared with the HC group. There was a significant positive correlation between BMI and the susceptibility values in the dentate nucleus (DN); the maximum SBP and DBP were positively correlated with magnetic susceptibility of the CA, PU, GP, and TH, respectively. CONCLUSIONS: These results are indicative of the role of overload brain iron in deep brain gray matter nuclei in HP and suggest that HP is associated with excess brain iron in certain deep gray matter regions.

Thermal conductivity of an ultracold Fermi gas in the BCS-BEC crossover.

Recent experiments on sound waves in a unitary Fermi gas reveal many transport properties about strongly interacting fermions. Sound propagates through the coupling of momentum and heat transport, and attenuates strongly with the presence of a phase transition. In this work, focusing on the temperature regimes near and below the superfluid critical temperature [Formula: see text] in the BCS-BEC crossover, we present a Kubo-based microscopic calculation of thermal conductivity [Formula: see text], which has not attracted much attention compared to the shear viscosity. Our approach primarily addresses the contributions of the fermionic quasiparticles to thermal transport and our results return to the kinetic descriptions at high temperatures. [Formula: see text] drops upon crossing the pseudogap temperature [Formula: see text], and its temperature dependence changes below [Formula: see text]. The drops become more pronounced on the weakly coupled BCS side, where the Pauli blocking causes the upturn of [Formula: see text] above [Formula: see text]. Our calculations fit well with the sound measurement on the damping rate.

An increase in AMPK/e-NOS signaling and attenuation of MMP-9 may contribute to remote ischemic perconditioning associated neuroprotection in rat model of focal ischemia.

Remote ischemic perconditioning (RIPerC) results in collateral enhancement and a reduction in middle cerebral artery occlusion (MCAO) induced ischemia. RIPerC likely activates multiple metabolic protective mechanisms, including effects on matrix metalloproteinases (MMPs) and protein kinases. Here we explore if RIPerC improves neuroprotection and collateral flow by modifying the activities of MMP-9 and AMPK/e-NOS. Age matched adult male Sprague Dawley rats were subjected to MCAO followed one hour later by RIPerC (3 cycles of 15 min ischemia). Animals were euthanized 24 h post-MCAO. Haematoxylin and Eosin (H&E) staining 24 h post-MCAO revealed a significant (p < 0.02) reduction in the infarction volume in RIPerC treated animals (24.9 ± 5.4%) relative to MCAO controls (42.5 ± 4.2, %). TUNEL staining showed a 42.6% reduction in the apoptotic cells with RIPerC treatment (p < 0.01). Immunoblotting in congruence with RT-PCR and Zymography showed that RIPerC significantly reduced MMP-9 expression and activity in RIPerC + MCAO group compared to MCAO group (218.3 ± 19.1% vs. 148.9 ± 12.05% (p < 0.01). Immunoblotting revealed that RIPerC was associated with a significant 2.5-fold increase in activation of p-AMPK compared to the MCAO group (p < 0.01) which was also associated with a significant increase in the e-NOS activity (p < 0.01). RIPerC resulted in reduction of infarction volume, decreased apoptotic cell death and attenuated MMP-9 activity. This together with the increased activity of p-AMPK and increase in p-eNOS may, in part explain the neuroprotection and sustained increase in blood flow observed with RIPerC following acute stroke.

Transition and Damping of Collective Modes in a Trapped Fermi Gas between BCS and Unitary Limits near the Phase Transition.

We investigate the transition and damping of low-energy collective modes in a trapped unitary Fermi gas by solving the Boltzmann-Vlasov kinetic equation in a scaled form, which is combined with both the T-matrix fluctuation theory in normal phase and the mean-field theory in order phase. In order to connect the microscopic and kinetic descriptions of many-body Feshbach scattering, we adopt a phenomenological two-fluid physical approach, and derive the coupling constants in the order phase. By solving the Boltzmann-Vlasov steady-state equation in a variational form, we calculate two viscous relaxation rates with the collision probabilities of fermion's scattering including fermions in the normal fluid and fermion pairs in the superfluid. Additionally, by considering the pairing and depairing of fermions, we get results of the frequency and damping of collective modes versus temperature and s-wave scattering length. Our theoretical results are in a remarkable agreement with the experimental data, particularly for the sharp transition between collisionless and hydrodynamic behaviour and strong damping between BCS and unitary limits near the phase transition. The sharp transition originates from the maximum of viscous relaxation rate caused by fermion-fermion pair collision at the phase transition point when the fermion depair, while the strong damping due to the fast varying of the frequency of collective modes from BCS limit to unitary limit.

Association of fibrinogen and fibrinogen gene beta148 and beta854 polymorphisms with coronary heart disease.

BACKGROUND: The aim of this study was to observe the association between fibrinogen C148T, G854A polymorphisms and plasma fibrinogen levels in a large cohort of Chinese patients with coronary heart disease (CHD). METHODS: Fibrinogen gene beta148/beta854 polymorphisms were screened and plasma fibrinogen levels and lipids were measured in patients with angiographically confirmed CHD (n = 836) and in controls without CHD (n = 418). RESULTS: Age, sex, smoking, hypertension, diabetes mellitus, blood lipids and fibrinogen levels were related to CHD (all p < 0. 05) while the frequencies of fibrinogen beta148 and beta854 alleles, gene and genotypes between the two groups were similar (all p > 0.05). CONCLUSION: This study demonstrates that the plasma fibrinogen level, but not fibrinogen beta148 and beta854 genotypes, was associated with CHD in the Chinese population.

[Beta-blocker therapy in the management of malignant ventricular arrhythmia in patients with acute myocardial infarction].

OBJECTIVE: To evaluate the clinical effectiveness of beta-blocker therapy on malignant ventricular arrhythmia in patients with acute myocardial infarction (AMI). METHODS: Beta-blockers, atenolol or betaloc, were given at the doses of 3.125 to 12.500 mg twice or 3 times a day (Bid or Tid) for management of malignant ventricular arrhythmia in 6 patients with AMI on the basis of conventional therapy. Increasing dosage of 25 to 50 mg was later initiated according to the patients' condition. In 2 cases that failed to respond to conventional antiarrhythmic, esmolol was administered via intravenous injection (5-10 mg) to control malignant ventricular arrhythmia within approximately 30 min, followed by a 2-day course of intravenous infusion at the rate of 1 to 2 mg/min. RESULTS: Five AMI patients survived while death occurred in 1 case due to heart failure. No deterioration of the cardiac function or proarrhythmic effect was observed in the 5 survival cases, but the occurrence of transient hypotension in 2 cases in the early stage of beta-blocker application and death due to cardioc insufficiency in one. CONCLUSION: Adequate use of beta-blockers is necessary in the early stage of AMI for effective control of malignant ventricular arrhythmia and lowering the mortality.