Nomogram predicts survival and surgical benefits for patients with breast cancer with initial bone metastasis: A population-based study.

BACKGROUND: Primary stage IV breast cancer is associated with a poor prognosis. At present, the value of local surgical treatment for patients with stage IV breast cancer remains uncertain; therefore, treatment principles remain controversial. Because of the high heterogeneity of these patients, it is often difficult to evaluate their prognoses. As a result, this study aimed to establish a prognostic nomogram to evaluate the prognosis of patients with breast cancer experiencing primary bone metastasis. METHODS: The clinical characteristics and follow-up data of patients with primary breast cancer and bone metastasis from 2010 to 2018 were collected from the Surveillance, Epidemiology, and End Results database and from 2013 to 2021 at the Peking Union Medical College Hospital. Patients were divided into training and validation groups. Multivariate Cox regression analysis was used to identify the independent prognostic variables for predicting cancer-specific survival (CSS). On the basis of these independent risk factors, a nomogram was developed and used calibration curves to evaluate its accuracy. Patients were divided into three risk groups according to their scores and surgery-related survival curves plotted using the log-rank test. RESULTS: Overall, 6372 patients were included, with 6319 from the Surveillance, Epidemiology, and End Results database and 53 from the Peking Union Medical College Hospital Breast Surgery Department. Multivariate analysis showed that age, race, marital status, grade, tumor stage, estrogen receptor status, progesterone receptor status, human epidermal growth factor receptor 2 status, and burden of other metastatic lesions were all associated with CSS. Based on these results, a nomogram that predicted the 1-, 3-, and 5-year CSS rates in patients with primary breast cancer and bone metastasis (concordance index > 0.69) was developed. After dividing patients into low-risk, high-risk, or super-high-risk groups based on nomogram scoring criteria, survival analysis revealed that patients in the low- and high-risk groups had significant survival benefits from primary focal surgery. CONCLUSION: Independent risk factors for primary breast cancer in patients with bone metastasis were analyzed and a nomogram established to predict CSS. The prognostic tool derived in this study can assist clinicians in predicting the survival and surgical benefits of these patients through scoring, thereby providing further guidance for treatment strategies.

A Microfluidic Chip-Based Automated System for Whole-Course Monitoring the Drug Responses of Organoids.

Tumor patients-derived organoids, as a promising preclinical prediction model, have been utilized to evaluate ex vivo drug responses for formulating optimal therapeutic strategies. Detecting adenosine triphosphate (ATP) has been widely used in existing organoid-based drug response tests. However, all commercial ATP detection kits containing the cell lysis procedure can only be applied for single time point ATP detection, resulting in the neglect of dynamic ATP variations in living cells. Meanwhile, due to the limited number of viable organoids from a single patient, it is impractical to exhaustively test all potential time points in search of optimal ones. In this work, a multifunctional microfluidic chip was developed to perform all procedures of organoid-based drug response tests, including establishment, culturing, drug treatment, and ATP monitoring of organoids. An ATP sensor was developed to facilitate the first successful attempt on whole-course monitoring the growth status of fragile organoids. To realize a clinically applicable automatic system for the drug testing of lung cancer, a microfluidic chip based automated system was developed to perform entire organoid-based drug response test, bridging the gap between laboratorial manipulation and clinical practices, as it outperformed previous methods by improving data repeatability, eliminating human error/sample loss, and more importantly, providing a more accurate and comprehensive evaluation of drug effects.

Clonal expansion of shared T cell receptors reveals the existence of immune commonality among different lesions of synchronous multiple primary lung cancer.

The increase in the detection rate of synchronous multiple primary lung cancer (MPLC) has posed remarkable clinical challenges due to the limited understanding of its pathogenesis and molecular features. Here, comprehensive comparisons of genomic and immunologic features between MPLC and solitary lung cancer nodule (SN), as well as different lesions of the same patient, were performed. Compared with SN, MPLC displayed a lower rate of EGFR mutation but higher rates of BRAF, MAP2K1, and MTOR mutation, which function exactly in the upstream and downstream of the same signaling pathway. Considerable heterogeneity in T cell receptor (TCR) repertoire exists among not only different patients but also among different lesions of the same patient. Invasive lesions of MPLC exhibited significantly higher TCR diversity and lower TCR expansion than those of SN. Intriguingly, different lesions of the same patient always shared a certain proportion of TCR clonotypes. Significant clonal expansion could be observed in shared TCR clonotypes, particularly in those existing in all lesions of the same patient. In conclusion, this study provided evidences of the distinctive mutational landscape, activation of oncogenic signaling pathways, and TCR repertoire in MPLC as compared with SN. The significant clonal expansion of shared TCR clonotypes demonstrated the existence of immune commonality among different lesions of the same patient and shed new light on the individually tailored precision therapy for MPLC.

Ba3Lu(BO3)3:Ce3+,Tb3+/Mn2+: Dual-Functional Material for WLEDs and Optical Pressure Sensing.

Ba3Lu(BO3)3(BLB):Ce3+,Tb3+/Mn2+ phosphors were designed to explore effective and multifunctional applications. Under the excitation of near-ultraviolet (n-UV) light, the BLB:Ce3+ phosphor showed broad-band blue emission. After codoping with Mn2+ ions, the single-phase white light phosphor is achieved through the energy transfer (ET) between Ce3+ and Mn2+. In addition, thermal stability is significantly enhanced by the addition of Tb3+ (BLB:0.02Ce3+,0.20Tb3+) compared to that codoped with Mn2+ (BLB:0.02Ce3+,0.10Mn2+). The light-emitting diode (LED) device with warm white light emission is fabricated with UV-chip-coated BLB:0.02Ce3+,0.05Tb3+ and Sr2Si5N8:Eu2+ phosphors, showing a good potential application value for LEDs. Additionally, the spectral properties of borate-based phosphors (BLB:0.02Ce3+) under high pressure were studied for the first time. Surprisingly, the change of pressure enabled the emission peak of BLB:0.02Ce3+ to be tuned from 485 to 552 nm, and dλ/dP is 3.51 nm GPa-1. The color changes from blue to yellow with an increase of pressure. Compared with the reported data, the pressure-sensing sensitivity based on the central peak shift in this work is the highest in all Ce3+ single-doped samples. In addition, the emitting color and intensity were gradually regained after decompression. The intensity can reach 80% of the initial intensity. All data demonstrate that the BLB:0.02Ce3+ phosphor has the potential to be utilized as an optical pressure sensor due to the high-pressure sensitivity and visible color tuning.

Pressure-Triggered Fluorescence Intensity Ratio Variations of YNbO4:Bi3+/Ln3+ (Ln = Eu or Sm) for High-Sensitivity Optical Pressure Sensing.

Optical pressure sensing by phosphors is a growing area of research. However, the main pressure measurement methods rely on the movement of the central peak position, which has significant drawbacks for practical applications. This paper demonstrates the feasibility of using the fluorescence intensity ratio (FIR) of different emission peaks for pressure sensing. The FIR (IBi3+/ILn3+) values of the synthesized YNbO4:Bi3+/Ln3+ (Ln = Eu or Sm) phosphors are all first-order exponentially related to pressure, and YNbO4:Bi3+/Ln3+ (Ln = Eu or Sm) phosphors have high pressure-sensing sensitivities (Sp and Spr), which are 6 times higher than those from our previously reported work. In addition, the changes in FIR values during the decompression process were also calculated, and the trend was similar to that during the compression process. The YNbO4:Bi3+,Eu3+ phosphor has better pressure recovery performance. In summary, the YNbO4:Bi3+/Ln3+ (Ln = Eu or Sm) phosphors reported in this paper are expected to be applied in the field of optical pressure sensing, and this study provides a new approach and perspective for designing new phosphors for pressure measurement.

Synthesis and Characterization of Phenazine-Based Redox Center for High-Performance Polymer Poly(aryl ether sulfone)-5,10-Diphenyl-dihydrophenazine.

Phenazine-based redox-active centers are capable of averting chemical bond rearrangements by coupling during the reaction process, leading to enhanced stabilization of the material. When introduced into a high-performance polymer with excellent physicochemical properties, they can be endowed with electrochemical properties and related prospective applications while maintaining the capabilities of the materials. In this study, a facile C-N coupling method was chosen for the synthesis of serial poly(aryl ether sulfone) materials containing phenazine-based redox-active centers and to explore their electrochemical properties. As expected, the cyclic voltammetry curves of PAS-DPPZ-60, which basically overlap after thousands of cycles, indicate the stability of the electrochemical properties. As an electrochromic material, the transmittance change in PAS-DPPZ-60 exhibits only a slight attenuation after as long as 600 cycles. Meanwhile, as an organic battery cathode material, PAS-DPPZ has a theoretical specific capacity of 126 mAh g-1, and the capacity retention rate is 82.6% after 100 cycles at a 0.1 C current density. The perfect combination of advantageous features between phenazine and poly(aryl ether sulfone) is considered to be the reason for the favorable electrochemical performance of the material series.

Eu2+-Doped Ca4Y3Si7O15N5 Phosphor with High Thermal Stability and Pressure Sensitivity for Dual-Functional Applications in W-LEDs and Pressure Sensors.

A novel green-light-emitting silicon-based oxynitride phosphor Ca4Y3Si7O15N5:Eu2+ with low thermal quenching and ideal pressure sensitivity is reported. The Ca3.99Y3Si7O15N5:0.01Eu2+ phosphor can be efficiently excited by 345 nm ultraviolet light and shows very low thermal quenching (integrated and peak emission intensities at 373 and 423 K were 96.17, 95.86, and 92.73, 90.66% of those at 298 K, respectively). The correlation between high thermal stability and structural rigidity is investigated in detail. The white-light-emitting diode (W-LED) is assembled by depositing the obtained green-light-emitting phosphor Ca3.99Y3Si7O15N5:0.01Eu2+ and commercial phosphors on a ultraviolet (UV)-emitting chip (λ = 365 nm). The CIE color coordinates, color rendering index (Ra), and corrected color temperature (CCT) of the obtained W-LED are (0.3724, 0.4156), 92.9, and 4806 K, respectively. In addition, when subjected to in situ high-pressure fluorescence spectroscopy, the phosphor exhibits an evident red shift of 40 nm with an increase in pressure from 0.2 to 32.1 GPa. The phosphor has the advantage of high-pressure sensitivity (dλ/dP = 1.13 nm GPa-1) and visualization with pressure changes. The possible reasons and mechanisms are deeply discussed in detail. Based on the above advantages, Ca3.99Y3Si7O15N5:0.01Eu2+ phosphor is expected to have potential applications in W-LEDs and optical pressure sensing.

[Simiaotongzhuo Decoction for the treatment of type III prostatitis: A clinical observation].

OBJECTIVE: To observe the clinical effect of Simiaotongzhuo Decoction (SMTZD) on the symptoms of type III prostatitis with damp-heat stagnation syndrome. METHODS: Using the randomized control method, we divided 140 cases of type III prostatitis with damp-heat stagnation syndrome into two groups and treated them orally with SMTZD at 200 ml per time bid (n = 65) and Tamsulosin Hydrochloride Sustained Release Capsules (THSRC) at 0.2 mg per time qd (n = 75), both for 6 weeks. Before and after medication, we recorded the counts of white blood cells (WBC) and lecithin bodies in the prostatic fluid, NIH-CPSI scores and traditional Chinese medicine syndrome (TCMS) scores, and compared them between the two groups of patients. RESULTS: Compared with the baseline, the WBC count and NIH-CPSI scores were decreased and the number of lecithin bodies increased in both the SMTZD (NIH-CPSI score: ï¼»18±6.47ï¼½ vs ï¼»9±5.02ï¼½) and THSRC groups after medication, with statistically significant difference only in the former group (P<0.05), the TCMS scores were significantly reduced in both the SMTZD (ï¼»21.97±5.12ï¼½ vs ï¼»6.4±4.88ï¼½, P<0.05) and the THSRC group (ï¼»20.73±4.97ï¼½ vs ï¼»11.33±5.93ï¼½, P<0.05), even more significantly in the former. No statistically significant difference was observed in the incidence of adverse reactions between the SMTZD and THSRC groups (9.2% vs 9.3%, P>0.05), and all the adverse reactions were mild. CONCLUSION: Simiaotongzhuo Decoction is safe and effective for the treatment of type III prostatitis with damp-heat stagnation syndrome, which can reduce the WBC count in the prostatic fluid, increase the number of lecithin bodies and improve the NIH-CPSI and TCMS scores of the patient.

[Identification of quality markers of Gei Herba based on analytic hierarchy process-entropy weight method and network pharmacology].

Analytic hierarchy process(AHP)-entropy weight method(EWM) and network pharmacology were employed to identify the potential quality markers(Q-markers) of Gei Herba. According to the new concept of Q-markers in traditional Chinese medicine(TCM), the AHP-EWM was applied to quantitatively identify the Q-markers of Gei Herba. The AHP was used for the weight analysis of primary indicators(factor layer), and the EWM for the analysis of literature and experimental data of secondary indicators(control layer). In addition, network pharmacology was employed to build the "component-target-disease-efficacy" network for Gei Herba, and the components showing strong associations with the Qi-replenishing, spleen-invigorating, blood-tonifying, Yin-nourishing, lung-moistening, and phlegm-resolving effects of Gei Herba were screened out. According to the results of AHP-EWM and network pharmacology, four components, i.e., ellagic acid, gallic acid, gemin G, and gemin C, were finally identified as potential Q-markers of Gei Herba. In this study, the AHP-EWM and network pharmacology were employed to screen the Q-markers of Gei Herba, which provided ideas for the quantitative evaluation and identification of Q-markers of TCM.

A Triple-Doped Phosphor Strategy for the Conversion of Cool and Warm White Light.

This work proposes a new type of Eu2+, Ce3+, Mn2+ codoped strategy that can be adapted to both ultraviolet (UV) and blue chips to achieve high-quality white light illumination. Primarily, the target sample was confirmed by X-ray diffraction (XRD) and Rietveld refinement, and the surface morphology and element distribution were observed by scanning electron microscopy (SEM). Second, the energy transfer behavior and mechanism were determined by studying double-doped samples. Lu2Mg2Al2Si2O12: Eu2+,Ce3+ (LMAS: Eu2+,Ce3+) can realize an emission color adjustment from blue to yellow. The emission color of LMAS: Ce3+,Mn2+ can be adjusted from light yellow to orange yellow. Afterward, the triple-doped sample exhibits full-spectrum emission under the excitation at 365 nm, and yellow emission under the excitation at 450 nm. When combined with a 365 nm chip, the obtained light-emitting diode (LED) devices can achieve warm white light with a color rendering index (Ra) of 96.6, light emission (LE) of 1.79 lm/W, and correlated color temperature (CCT) of 4874 K. When this phosphor was combined with a 460 nm chip, cold white light with Ra = 70, LE = 13.57 lm/W, and CCT = 5782 K can be achieved. Finally, according to the properties of the phosphor, a conceptual diagram of a new type parallel device was designed, which can easily and effectively realize the conversion of cold and warm white light. This work provides a new idea for the design of single-substrate white light phosphor and proposes a new parallel device concept, which is expected to be applied in the field of lighting.

The Effect of Allopurinol on Renal Outcomes in Patients with Diabetic Kidney Disease: A Systematic Review and Meta-Analysis.

BACKGROUND: Hyperuricemia is an independent risk factor for diabetic kidney disease (DKD) progression. Previous animal and cohort studies have reported that allopurinol administration could be of therapeutic benefit in diabetic subjects. However, there has been controversy regarding the effects of allopurinol on DKD. OBJECTIVES: The aim of our study was to investigate the efficacy of allopurinol on renal function in patients with DKD by meta-analysis of randomized controlled trials. METHOD: PubMed, EMBASE, and the Cochrane Library were searched from inception to October 2020. The primary outcome was a change in glomerular filtration rate (GFR). The secondary outcome was the change in albuminuria and serum uric acid (UA). Two reviewers independently assessed for risk of bias and extracted data. Standardized mean difference (SMD) or weighted mean difference (WMD) was calculated with random effects models and was reported with corresponding 95% confidence intervals (CIs). Grading of Recommendations Assessment, Development, and Evaluation (GRADE) of the evidence was performed after meta-analysis. International prospective register of systematic reviews registration CRD42020219132. RESULTS: From 642 potentially relevant citations, 3 studies were ultimately included. Our results showed evident reduction in serum UA after allopurinol intervention (WMD = -103.80, 95% CI -159.05, -48.55, I2 = 76%; p = 0.04), with a high GRADE of evidence. However, allopurinol did not significantly improve GFR (WMD = 1.07, 95% CI -1.68, 3.82, I2 = 33%; p = 0.45), with a moderate GRADE of evidence. There was no significant difference on improvement of albuminuria in patients of allopurinol and those in placebo groups (SMD = -0.26, 95% CI -1.03, 0.52, I2 = 94%; p = 0.52), with a moderate GRADE of evidence. CONCLUSIONS: The present research showed that allopurinol did not significantly improve renal function and albuminuria in patients with DKD.

Morphology characters of resected femoral and tibial surface in chinese population: intraoperative anthropometric study in patients at a tertiary hospital.

BACKGROUNDS: Mismatch between knee surface and prosthesis components is related to postoperative complications. Morphological differences between ethnicity and gender may affect prosthesis coverage. The purpose of this study is to describe morphological characters of resected knee surface (distal femur, proximal tibia) in the Chinese population, analyze the influence of gender and other demographical factors, and validate the effect of ethnic difference by calculating the coverage of Western-designed knee prostheses on Chinese knee surface. METHODS: Intraoperative anthropometries were performed during total knee arthroplasty performed by one single team. After screening out severe deformities and bone defects, data were separated via prosthesis system. Multiple linear regression and partial correlation analysis of morphological parameters on age, gender, height, weight were used to find out independent factors influencing morphology. Based on the 5 mm-tolerance in the prosthesis, simulation on scatter plots was brought out to calculate the prosthesis coverage to the resected bone surface. RESULTS: A total of 865 cases of total knee arthroplasty were involved in this study. Though gender differences were found in all knee morphological parameters regardless of the type of prosthesis, significant association was only found between gender and mediolateral width of femoral surface after adjusting demographical factors (p < 0.001). The two included prosthesis systems, Genesis-II and Scorpio NRG covered most cases in at least one dimension. Males had lower complete coverage and higher no coverage rate on femurs. Asymmetry prostheses had higher lateral coverage on tibiae. CONCLUSIONS: Based on our analysis, the only confirmed demographical factor in knee morphology is gender on femoral mediolateral length. Wider femoral prostheses for males may improve results of gender-specific prostheses. The overall fitness between Western-designed prostheses and Chinese knee surface is appliable, but the ratio of complete coverage is low. Further modification of prostheses systems can aim at the number of sizes and geometrical shapes.

The clinical features and prognosis of patients with mucinous breast carcinoma compared with those with infiltrating ductal carcinoma: a population-based study.

BACKGROUND: At present, the characteristics of mucinous breast carcinoma (MBC) and the factors affecting its prognosis are controversial. We compared the clinical features of MBC with those of infiltrating ductal carcinoma (IDC) and summarized the relevant prognostic factors. METHODS: The Surveillance, Epidemiology, and End Results (SEER) database includes information on 10,593 patients diagnosed with MBC between 2004 and 2016. Chi-square tests and analyses were used to analyze differences in variables between the MBC and IDC groups. Univariate and multivariate Cox proportional hazards models were used to assess the relative impacts of risk factors on cancer-specific survival (CSS) in patients. Kaplan-Meier survival curves were constructed to assess cancer-specific mortality and were compared using the log-rank test. RESULTS: From 2004 to 2016, 10,593 people were diagnosed with MBC, and 402,797 were diagnosed with IDC. Patients with MBC had significantly higher 5-/10-year CSS rates (96.4%/93.4%) than those with IDC (89%/83.8%). Compared with IDC patients, MBC patients had less lymph node metastasis, an earlier stage, a higher rate of hormone receptor positivity and a lower expression rate of HER2. Univariate and multivariate analyses showed that age ≥ 60 years old (HR = 1.574, 95%CI: 1.238-2.001, P < 0.001), singled status (HR = 1.676, 95%CI: 1.330-2.112, P < 0.001) and advanced TNM/SEER stage were independent prognostic risk factors for MBC. In addition, positive estrogen receptor (HR = 0.577, 95%CI: 0.334-0.997, P = 0.049), positive progesterone receptor (HR = 0.740, 95%CI: 0.552-0.992, P = 0.044), surgical treatment (HR = 0.395, 95%CI: 0.288-0.542, P < 0.001) and radiotherapy (HR = 0.589, 95%CI: 0.459-0.756, P < 0.001) were identified as protective factors. CONCLUSION: Compared with IDC, MBC has a better prognosis. For patients with MBC, we identified prognostic factors that can help clinicians better assess patient outcomes and guide individualized treatment.

Clinical characteristics and prognostic factors of male yolk sac tumor: a Surveillance, Epidemiology, and End Results program study.

INTRODUCTION: Yolk sac tumor (YST) is a rare malignant germ cell tumor, which usually affects young males. Because of the low incidence, few studies on YST have been published. In our study, we aim to investigate the clinical characteristics, survival and risk factors of male YST patients based on the Surveillance, Epidemiology, and End Results (SEER) program. METHODS: We identified 569 male YST patients from the SEER-18 database with additional treatment fields. Clinical characteristics, survival and prognostic factors were described in the study. Chi-square tests were applied to analyze categorical and continuous variables between different groups. Univariate and multivariate Cox proportional hazard model were performed to assess the relative impacts of risk factors on cancer-specific survival (CSS) in YST patients. Kaplan-Meier method and the log-rank test were used to analyze differences in survival that were significant. RESULTS: The major primary sites of YST were testis (74.69%), mediastinum (15.47%), retroperitoneum (2.64%) and central nervous system (1.24%). The 3-year and 5-year CSS was 70.0%, 56.5% vs. 97.2%, 96.0% for the mediastinal and testicular YST patients, respectively (p < 0.001). Primary site of mediastinum, distant SEER Summary stage were independent factors of poor prognosis (hazard ratio (HR) = 2.010 (1.094-3.695), p = 0.025; HR = 6.501 (2.294-18.424), p < 0.001, respectively). Receiving surgery was a good prognosis factor for all patients (HR = 0.495 (0.260-0.940), p = 0.032) and for the mediastinal group (p = 0.0019). Being treated with chemotherapy indicated poor outcome in all patients (HR = 3.624 (1.050-12.507), p = 0.042) and in the localized testicular YST patients (p = 0.0077). CONCLUSION: For the first time, our study revealed the primary site distribution of male YST, and summarized the clinical characteristics, survival and prognostic factors based on the SEER database, which provided important epidemiological evidence for clinical practice.

Luminescence and Energy Transfer of Color-Tunable Y2Mg2Al2Si2O12:Eu2+,Ce3+ Phosphors.

Color-tunable phosphors can be obtained through codoping strategies and energy transfer regulation. Ce3+ and Eu2+ are the most common and effective activator ions used in phosphor materials. However, the energy transfer from Eu2+ to Ce3+ is rarely reported. In this work, Y2Mg2Al2Si2O12(YMAS):Eu2+,Ce3+ phosphors were successfully synthesized, which was confirmed by X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS), Rietveld refinement, scanning electron microscopy (SEM) and element mapping images, and spectral information. The luminescent color of YMAS:Eu2+,Ce3+ phosphors could be tuned from blue to cyan to light green to yellow-green and finally to green-yellow, which was achieved by adjusting the energy transfer between different dopants. The energy transfer from Eu2+ to Ce3+ was confirmed by photoluminescence spectra and fluorescence decay curves. Within the experimental gradient, the energy transfer efficiency could reach up to 48%. At 373 K, the Y1.99Mg1.99Al2Si2O12:0.01Eu2+,0.01Ce3+ (YMAS:0.01Eu2+,0.01Ce3+) phosphor exhibited a total integral emission loss of only 8%, and the emission peak intensity decreased to 95%, indicating the excellent thermal stability. The white light-emitting diode (WLED) fabricated by the YMAS:0.01Eu2+,0.01Ce3+ phosphor has the same level correlated color temperature (CCT = 5841 K), greatly improved color rendering index (Ra = 87.8), and higher quality white light color (CIE = (0.3258, 0.3214)) than the WLED made by the YMAS:0.01Eu2+ phosphor, indicating that the performance of the phosphor was significantly improved by introducing Ce3+. This work provides an effective guide for the design and development of highly efficient color-tunable phosphors involving energy transfer from Eu2+ to Ce3+ in some specific materials, such as garnet structures.

Nomograms predict survival of patients with small bowel adenocarcinoma: a SEER-based study.

BACKGROUND AND OBJECTIVE: Small bowel adenocarcinoma (SBA) is a rare malignant tumor with a poor prognosis. Most patients with SBA are diagnosed with advanced-stage disease. Due to the lack of randomized controlled trials and prospective studies, it is difficult to predict the prognosis of patients with SBA. Thus, this study aimed to establish a prognostic nomogram for evaluating the prognosis of SBA patients. METHODS: The clinical features and follow-up data of all patients diagnosed with SBA during 2004-2016 were summarized from the Surveillance, Epidemiology, and End Results (SEER) database. We separated these patients into training and validation groups. Multivariate Cox regression analyses were performed to identify independent prognostic variables for predicting cancer-specific survival (CSS) and overall survival (OS). According to the independent risk factors, we established nomograms and used the calibration curves to evaluate the accuracy. RESULTS: The data of 3301 patients with SBA were collected from the SEER database. The multivariate analysis showed that age, marital status, tumor site, grade, TNM stage and surgical history were associated with CSS and OS (P < 0.05). Based on these results, we established nomograms of CSS and OS that can predict the 3- and 5-year survival rates of SBA patients (C-index > 0.7). The calibration curves showed that the predicted survival was very close to the actual survival. CONCLUSION: We analyzed the independent risk factors for prognosis of SBA patients, and established nomograms to predict the 3- and 5-year survival rates of OS and CSS. These new prognostic tools can help clinicians to predict the survival of patients with SBA, further to guide treatment strategy.

Chondrocytes-derived exosomal miR-8485 regulated the Wnt/ß-catenin pathways to promote chondrogenic differentiation of BMSCs.

In indirect co-culture system, chondrocytes can induce differentiation of bone marrow mesenchymal stem cells (BMSCs) to chondrocytes without additional inducer. The participation of microRNAs (miRNAs) may take part in the chondrogenic differentiation. Present study aimed to investigate the effect and mechanism of chondrocytes-derived exosomal miRNA in BMSCs chondrogenic differentiation. Our data showed that miR-8485 was the exosomal miRNA derived from chondrocytes and transmitted to BMSCs. Functionally, miR-8485 silence in chondrocytes impaired exosome-induced chondrogenic differentiation of BMSCs. Mechanistically, exosomal miR-8485 targeted GSK3B to repress GSK-3ß expression and targeted DACT1 to induce p-GSK-3ß (Ser9), activating Wnt/ß-catenin pathways. Our study firstly showed that chondrocytes-derived exosomal miR-8485 regulated the Wnt/ß-catenin pathways to promote chondrogenic differentiation of BMSCs, providing innovative thoughts for cartilage reconstruction.

Tumor characteristics, treatments, and survival outcomes in prostate cancer patients with a PSA level < 4 ng/ml: a population-based study.

BACKGROUND: To examine the tumor characteristics, treatments and survival outcomes of prostate cancer (PCa) patients with a prostate-specific antigen (PSA) level < 4 ng/ml. METHODS: Of 205,913 men with primary prostate adenocarcinoma in the Surveillance, Epidemiology and End Results (SEER) database (2010 to 2015), 24,054 (11.68%) patients were diagnosed with a PSA level < 4 ng/ml. Comparisons of categorical variables among different groups were performed by using the Chi square test. Multivariate Cox regression analysis was adjusted for age, ethnicity, marital status, insurance status, TNM stage, Gleason grade, treatment and survival. Kaplan-Meier survival curves were constructed for overall mortality and tested by the log-rank test. RESULTS: PCa patients with a PSA level < 4 ng/ml generally had more favorable tumor characteristics: younger, lower T stage, lower Gleason grade and lower lymph node metastasis rate. However, there were more patients in stage M1 in the group of PSA level < 4 ng/ml than that in the groups of PSA level of 4-10 ng/ml, 10-20 ng/ml and > 20 ng/ml. The multivariate Cox regression model revealed that overall mortality was associated with age, marital status, race, Gleason grade, M stage and treatment approach. CONCLUSIONS: In conclusion, PCa patients with a PSA level < 4 ng/ml have more favorable tumor characteristics at diagnosis and receive more benefit from active treatment. However, those patients with advanced TNM stage and high Gleason grade should be paid more attention in clinical application.

Clinical characteristics and prognostic factors of Hurthle cell carcinoma: a population based study.

BACKGROUND: Thyroid Hurthle cell carcinoma (HCC) is a rare disease with high risk of invasion and metastasis and poor prognosis. The clinical characteristics, prognosis and treatment of HCC are still controversial, and clinical data are still limited to some case reports. Therefore, understanding the characteristics and survival factors of HCC is clinically necessary. METHODS: This study collected data from HCC patients diagnosed pathologically from 2004 to 2015, including basic population characteristics, tumor characteristics, and epidemiological and survival data. The data were extracted from the Surveillance, Epidemiology, and End Results (SEER) database to conduct a population cohort study. RESULTS: A total of 2101 HCC patients with an average age of 55.42 ± 15.27 years were enrolled in this study. Of them, 1740 (82.82%) patients had local disease, 245 (11.66%) had regional disease, and 89 (4.24%) had distant disease. Total thyroidectomy was performed in 1669 (79.44%) patients, partial thyroidectomy was performed in 382 (18.18%) patients, and radioactive iodine (RAI) was used in 1155 (54.97%) patients. The 5-year and 10-year cancer-specific survival rate was 95.4 and 92.6%, respectively. The distant disease group had significantly more male patients, multifocal tumors, and extensive tumors compared to the local disease group. Multivariate survival analysis showed that age (P < 0.05), SEER stage (P < 0.001), and T-stage (P = 0.001) had significant effects on survival. There was no significant difference in survival between total and partial thyroidectomy (P = 0.078), or between RAI and non-RAI (P = 0.733). CONCLUSION: Male gender, multifocal tumors, and extended tumors are associated with increased risk of late stage HCC. Age over 45 years, distant SEER stage, and late T-stage are independent risk factors for mortality in HCC.

Pancreatic VIPomas from China: Case reports and literature review.

Vasoactive intestinal polypeptide-secreting tumors (VIPomas) are rare neuroendocrine tumors that often present as watery diarrhea, hypokalemia, and achlorhydria or hypochlorhydria. In this study, we present our institutional experience of diagnosis and treatment of VIPomas, along with a review of the Chinese literature since 1980. Patient #1, diagnosed in 1984 and with intact clinical records, shows the natural history of this disease. Patient #2, diagnosed in 2015, shows the results of evaluation by nuclear medicine techniques and the outcomes of standardized treatment. Comprehensive review of 41 cases allows evaluation of clinical characteristics, treatments and outcomes of pancreatic VIPoma patients. All patients presented with watery diarrhea. The average stool volume reached 3247 mL per day. Average serum VIP level was 839.3 ng/L. Twelve of the 41 cases were reported to have metastases at diagnosis. Somatostatin receptor scintigraphy and 18FDG PET-CT are efficient methods for detection of VIPoma. Surgical excision can promptly alleviate hormonal symptoms.