Genomic landscape defines peritoneal metastatic pattern and related target of peritoneal metastasis in colorectal cancer.

The primary objective of this study is to develop a prediction model for peritoneal metastasis (PM) in colorectal cancer by integrating the genomic features of primary colorectal cancer, along with clinicopathological features. Concurrently, we aim to identify potential target implicated in the peritoneal dissemination of colorectal cancer through bioinformatics exploration and experimental validation. By analyzing the genomic landscape of primary colorectal cancer and clinicopathological features from 363 metastatic colorectal cancer patients, we identified 22 differently distributed variables, which were used for subsequent LASSO regression to construct a PM prediction model. The integrated model established by LASSO regression, which incorporated two clinicopathological variables and seven genomic variables, precisely discriminated PM cases (AUC 0.899; 95% CI 0.860-0.937) with good calibration (Hosmer-Lemeshow test p = .147). Model validation yielded AUCs of 0.898 (95% CI 0.896-0.899) and 0.704 (95% CI 0.622-0.787) internally and externally, respectively. Additionally, the peritoneal metastasis-related genomic signature (PGS), which was composed of the seven genes in the integrated model, has prognostic stratification capability for colorectal cancer. The divergent genomic landscape drives the driver genes of PM. Bioinformatic analysis concerning these driver genes indicated SERINC1 may be associated with PM. Subsequent experiments indicate that knocking down of SERINC1 functionally suppresses peritoneal dissemination, emphasizing its importance in CRCPM. In summary, the genomic landscape of primary cancer in colorectal cancer defines peritoneal metastatic pattern and reveals the potential target of SERINC1 for PM in colorectal cancer.

Endoscopic treatment for a huge self-inserted foreign body impacted in colon.

A 37-year-old male suffered from abdominal pain and distention for 8 hours after a huge long foreign body was inserted through anorectum by self-masturbation. The colonoscope with the polypectomy snare griped the foreign body was pulled out slowly along with the dragged foreign body. However, when we reached at 20 cm from the anal margin, it got stuck because of the turn point in the sigmoid colon. Different methods were tried to remove the foreign body. At last, We asked the patient to turn to supine position, take deep breath and defecation. More air was insufflated to make the colon cavity larger to facilitate removal, and slowly the colonoscope dragged the foreign body (35 cm in length) out from the anus successfully. No bleeding or perforation occurred during the procedure. Although the foreign body was huge, effort was made to help the patient avoid taking operation.

Lewis acid-promoted formation of benzoselenazole derivatives using SeO2 as a selenium source.

A new one-pot method of using both ortho-inactivated anilines and acetophenones (or methylquinolines) which possess an active H in the α-position of ketones (or benzyl positions) as starting materials to make benzoselenazole derivatives has been developed, which uses SeO2 as a selenium agent. This method first establishes SeO2 as a source of selenium to form benzoselenazole derivatives, which enriches the synthesis method of benzoselenazole. This method has several advantages, including good yields, simple operation, and availability of raw materials. Furthermore, the reaction could be easily scaled and its practical value in organic synthesis is displayed.

Threshold-Based Hierarchical Clustering for Person Re-Identification.

Unsupervised domain adaptation is a challenging task in person re-identification (re-ID). Recently, cluster-based methods achieve good performance; clustering and training are two important phases in these methods. For clustering, one major issue of existing methods is that they do not fully exploit the information in outliers by either discarding outliers in clusters or simply merging outliers. For training, existing methods only use source features for pretraining and target features for fine-tuning and do not make full use of all valuable information in source datasets and target datasets. To solve these problems, we propose a Threshold-based Hierarchical clustering method with Contrastive loss (THC). There are two features of THC: (1) it regards outliers as single-sample clusters to participate in training. It well preserves the information in outliers without setting cluster number and combines advantages of existing clustering methods; (2) it uses contrastive loss to make full use of all valuable information, including source-class centroids, target-cluster centroids and single-sample clusters, thus achieving better performance. We conduct extensive experiments on Market-1501, DukeMTMC-reID and MSMT17. Results show our method achieves state of the art.

Optimal Extraction Study of Gastrodin-Type Components from Gastrodia Elata Tubers by Response Surface Design with Integrated Phytochemical and Bioactivity Evaluation.

Gastrodia elata tuber (GET) is a popular traditional Chinese medicines (TCMs). In this study, response surface methodology (RSM) with a Box⁻Behnken design (BBD) was performed to optimize the extraction parameters of gastrodin-type components (gastrodin, gastrodigenin, parishin A, parishin B, parishin C and parishin E). Different from the conventional studies that merely focused on the contents of phytochemical, we gave consideration to both quantitative analysis of the above six components by HPLC and representative bioactivities of GET, including antioxidation and protection of human umbilical vein endothelial cells (HUVEC). Four independent variables (ethanol concentration, liquid-material ratio, soaking time and extraction time) were investigated with the integrated evaluation index of phytochemical contents. With the validation experiments, the optimal extraction parameters were as follows: ethanol concentration of 41%, liquid⁻solid ratio of 28.58 mL/g, soaking time of 23.91 h and extraction time of 46.60 min. Under the optimum conditions, the actual standardized comprehensive score was 1.8134 ± 0.0110, which was in accordance with the predicted score of 1.8100. This firstly established method was proved to be feasible and reliable to optimize the extraction parameters of the bioactive components from GET. Furthermore, it provides some reference for the quality control and extraction optimization of TCMs.

Mechanical Behavior and Microstructure Evaluation of Quicklime-Activated Cement Kiln Dust-Slag Binder Pastes.

Cement kiln dust (CKD) is a by-product of cement production, which has the shortcomings of low utilization and high-temperature activation. This study combined CKD and slag as precursors for preparing pastes through quicklime activation under ambient conditions. The effects of quicklime and CKD content on the workability (flowability and setting time), macro-mechanical properties, and micro-structure of the CKD-slag binders were analyzed. The experimental results showed that the rapid precipitation of Ca2+, Si4+, and Al3+ ions from the CKD provided more nucleation sites for the formation of calcium aluminosilicate hydrate (C-(A)-S-H) gel and enhanced the reactivity of the binder system under the influence of the activator (CaO). The specimens had the highest unconfined compressive strength (UCS) (24.6 MPa) after 28 days with 10% quicklime content and 60% CKD content; scanning electron microscopy with energy-dispersive X-ray (SEM-EDX) analysis showed that the Ca/Si ratio of the C-(A)-S-H gel was minimized, leading to a denser microstructure and better binding ability under this mixing proportion. Therefore, this study may provide novel binder materials with a high proportion of CKD under ambient conditions.

Association Between Maternal Thyroid Function in Early Pregnancy and Gestational Diabetes: A Prospective Cohort Study.

CONTEXT: Previous studies on the relationship between thyroid gland function and the development of gestational diabetes mellitus (GDM) have reported different results, leading to the need for a cohort study design with a large sample size. OBJECTIVE: We aimed to investigate the relationship between thyroid function in early pregnancy and GDM. METHODS: This was a prospective cohort study based on the China Birth Cohort Study (CBCS), from February 2018 to December 2020. The study took place at a tertiary maternal and child health hospital. A total of 36 256 pregnant women were successfully recruited based on the CBCS. The main outcome measure was GDM. RESULTS: This study consisted of 26 742 pregnant women who met the inclusion criteria, of whom 3985 (14.90%) were diagnosed with GDM, and the women with GDM were older than their healthy counterparts (33.26 ± 4.01 vs 31.51 ± 3.76 years, P < .001). After removing potential influencing variables, we found that increased thyroid-stimulating hormone (TSH) (adjusted odds ratio [aOR] 1.030, 95% CI 1.007, 1.054, P = .012) and subclinical hypothyroidism (aOR 1.211, 95% CI 1.010, 1.451, P = .039), but not free thyroxine or thyroid peroxidase antibody, were associated with the occurrence of GDM. Further analysis indicated a nonlinear relationship between TSH and GDM (P < .05): when TSH ≤ 1.24 mIU/L, the occurrence of GDM was elevated with increasing TSH, but when TSH > 1.24 mIU/L, this trend was not obvious. CONCLUSION: High TSH might be associated with increased risk of GDM.

Levothyroxine treatment in pregnant women with thyroid stimulating hormone levels ranging between 2.5 and 10 mIU/L: A propensity score matched analysis.

OBJECTIVE: To clarify the association between levothyroxine (LT-4) treatment and various adverse pregnancy outcomes in pregnant women with thyroid stimulating hormone (TSH) levels ranging between 2.5 to 10.0 mIU/L in the first trimester, stratified according to thyroid peroxidase antibody (TPOAb) positivity and TSH level. METHODS: This retrospective analysis of retrospectively and prospectively collected cohort data included Chinese pregnant women with TSH levels of 2.5-10 mIU/L and normal free thyroxine levels (11.8-18.4 pmol/L) in the first trimester. All participants were followed up until the completion of pregnancy, and information on LT-4 treatment, pregnancy complications, and pregnancy outcomes was recorded. A 1:1 nearest-neighbor propensity score matching (PSM) between the LT-4-treated and -untreated groups with a caliper distance of 0.02 was performed using a multivariable logistic regression model. Multivariable-adjusted modified Poisson regression was used to estimate the relative risk (RR) and 95% confidence interval (CI) of LT-4 treatment for adverse pregnancy outcomes. Subgroup analyses were also performed in four subgroups simultaneously stratified by TPOAb status (negative or positive) and TSH levels (2.5-4.0 mIU/L as high-normal group and 4.0-10.0 mIU/L as SCH group). The study was registered in the Chinese Clinical Trial Registry (ChiCTR2100047394). RESULTS: Among the 4,370 pregnant women in the study, 1,342 received LT-4 treatment, and 3,028 did not. The 1:1 PSM yielded 668 pairs of individuals and revealed that LT-4 treatment was significantly associated with a decreased risk of pregnancy loss (RR=0.528, 95% CI: 0.344-0.812) and an increased risk of small-for-gestational-age infants (RR=1.595, 95% CI: 1.023-2.485). Subgroup analyses suggested that the above effects of LT-4 treatment were mainly from TPOAb-negative participants. LT-4 treatment was associated with an increased risk of preterm birth (RR=2.214, 95% CI: 1.016-4.825) in TPOAb-positive pregnant women with high-normal TSH levels. CONCLUSION: LT-4 treatment was significantly associated with a lower risk of pregnancy loss and a higher risk of small-for-gestational-age infants in pregnant women with TSH levels of 2.5-10 mIU/L. An increased risk of preterm birth was observed in the LT-4-treated group among TPOAb-positive participants with TSH levels of 2.5-4.0 mIU/L.

Artificial Intelligence in the Prediction of Gastrointestinal Stromal Tumors on Endoscopic Ultrasonography Images: Development, Validation and Comparison with Endosonographers.

Background/Aims: The accuracy of endosonographers in diagnosing gastric subepithelial lesions (SELs) using endoscopic ultrasonography (EUS) is influenced by experience and subjectivity. Artificial intelligence (AI) has achieved remarkable development in this field. This study aimed to develop an AI-based EUS diagnostic model for the diagnosis of SELs, and evaluated its efficacy with external validation. Methods: We developed the EUS-AI model with ResNeSt50 using EUS images from two hospitals to predict the histopathology of the gastric SELs originating from muscularis propria. The diagnostic performance of the model was also validated using EUS images obtained from four other hospitals. Results: A total of 2,057 images from 367 patients (375 SELs) were chosen to build the models, and 914 images from 106 patients (108 SELs) were chosen for external validation. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the model for differentiating gastrointestinal stromal tumors (GISTs) and non-GISTs in the external validation sets by images were 82.01%, 68.22%, 86.77%, 59.86%, and 78.12%, respectively. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy in the external validation set by tumors were 83.75%, 71.43%, 89.33%, 60.61%, and 80.56%, respectively. The EUS-AI model showed better performance (especially specificity) than some endosonographers. The model helped improve the sensitivity, specificity, and accuracy of certain endosonographers. Conclusions: We developed an EUS-AI model to classify gastric SELs originating from muscularis propria into GISTs and non-GISTs with good accuracy. The model may help improve the diagnostic performance of endosonographers. Further work is required to develop a multi-modal EUS-AI system.

Easily-injectable shear-thinning hydrogel provides long-lasting submucosal barrier for gastrointestinal endoscopic surgery.

Submucosal injection material has shown protective effect against gastrointestinal injury during endoscopic surgery in clinic. However, the protective ability of existing submucosal injection material is strictly limited by their difficult injectability and short barrier time. Herein, we report a shear-thinning gellan gum hydrogel that simultaneously has easy injectability and long-lasting barrier function, together with good hemostatic property and biocompatibility. Shear-thinning property endows our gellan gum hydrogel with excellent endoscopic injection performance, and the injection pressure of our gellan gum hydrogel is much lower than that of the small molecule solution (50 wt% dextrose) when injected through the endoscopic needle. More importantly, our gellan gum hydrogel shows much stronger barrier retention ability than normal saline and sodium hyaluronate solution in the ex vivo and in vivo models. Furthermore, our epinephrine-containing gellan gum hydrogel has a satisfactory hemostatic effect in the mucosal lesion resection model of pig. These results indicate an appealing application prospect for gellan gum hydrogel utilizing as a submucosal injection material in endoscopic surgery.

Real-Time Artificial Intelligence-Based Histologic Classifications of Colorectal Polyps Using Narrow-Band Imaging.

Background and Aims: With the development of artificial intelligence (AI), we have become capable of applying real-time computer-aided detection (CAD) in clinical practice. Our aim is to develop an AI-based CAD-N and optimize its diagnostic performance with narrow-band imaging (NBI) images. Methods: We developed the CAD-N model with ResNeSt using NBI images for real-time assessment of the histopathology of colorectal polyps (type 1, hyperplastic or inflammatory polyps; type 2, adenomatous polyps, intramucosal cancer, or superficial submucosal invasive cancer; type 3, deep submucosal invasive cancer; and type 4, normal mucosa). We also collected 116 consecutive polyp videos to validate the accuracy of the CAD-N. Results: A total of 10,573 images (7,032 images from 650 polyps and 3,541 normal mucous membrane images) from 478 patients were finally chosen for analysis. The sensitivity, specificity, PPV, NPV, and accuracy for each type of the CAD-N in the test set were 89.86%, 97.88%, 93.13%, 96.79%, and 95.93% for type 1; 93.91%, 95.49%, 91.80%, 96.69%, and 94.94% for type 2; 90.21%, 99.29%, 90.21%, 99.29%, and 98.68% for type 3; and 94.86%, 97.28%, 94.73%, 97.35%, and 96.45% for type 4, respectively. The overall accuracy was 93%. We also built models for polyps ≤5 mm, and the sensitivity, specificity, PPV, NPV, and accuracy for them were 96.81%, 94.08%, 95%, 95.97%, and 95.59%, respectively. Video validation results showed that the sensitivity, specificity, and accuracy of the CAD-N were 84.62%, 86.27%, and 85.34%, respectively. Conclusions: We have developed real-time AI-based histologic classifications of colorectal polyps using NBI images with good accuracy, which may help in clinical management and documentation of optical histology results.

Thermal stability of Mg/Co multilayer with B4C, Mo or Zr diffusion barrier layers.

The efficiency of B(4)C, Mo and Zr barrier layers to improve thermal stability of Mg/Co multilayer up to 400 °C is investigated. Multilayers were deposited by direct current magnetron sputtering and characterized using X-ray and extreme ultraviolet reflection. The results suggest that B(4)C barrier layer is not effective due to drastic diffusion at Mg-B(4)C interface. Although introducing Mo barriers improves the thermal stability from 200 to 300 °C, it increases the interface roughness and thus degrades the optical performances. On the contrary, Zr barriers can significantly increase the thermal stability of Mg/Co up to 400 °C without optical performance degradation. Thus, Mg/Zr/Co/Zr is suitable for EUV applications requiring both optimal optical performances and heat resistance.

Diagnostic, Therapeutic, and Prognostic Value of the Thrombospondin Family in Gastric Cancer.

Background: Gastric cancer (GC) is the fifth leading cancer in the world. The dysregulated expressions of the thrombospondin (THBS) family were reported to associate with GC, but their relations with tumor stage, prognosis, and correlations with tumor immunity have not been systematically reported. Methods: We used versatile public databases such as Oncomine, GEPIA, UALCAN, Kaplan-Meier Plotter, LinkedOmics, STRING, cBioPortal, TIMER, and TISIDB to analyze the expression and mutations of different THBSs in GC, along with their functional networks, survival analysis, and tumor-immune interactions. Results: The mRNA levels of THBS2, THBS4, and COMP were significantly higher in the tumor tissues; the expression levels of THBS1, THBS2, and THBS4 were higher in stages 2-4 than that of stage 1; patients with high expression of THBS1, THBS2, THBS4, and COMP had poor OS; the genes correlated with THBSs were enriched in focal adhesion, glycosaminoglycan biosynthesis, ECM-receptor interaction, and hedgehog signaling pathway; THBS1 and THBS4 expression had significant correlations with tumor purity, and all the THBSs expression correlated with macrophage and dendritic cells infiltration. Conclusions: THBS2, THBS4, and COMP were potentially diagnostic markers for GC; THBS1, THBS2, THBS4, and COMP were potentially prognostic markers for GC; investigating the relations of THBSs and tumor immunology might help in immunotherapy of GC, while more studies are needed to confirm these results.

Temporary impairment of renal function in patients with rectal cancer treated with diverting ileostomy.

BACKGROUND: Fluid and electrolyte disturbance, which impairs renal function, has been reported in patients with temporary ileostomy. However, the dynamic changes in serum electrolytes and renal function in rectal cancer patients with ileostomy have not been well described. In the present study, we aimed to evaluate alterations in serum electrolytes and renal function in rectal cancer patients undergoing ileostomy creation and closure. METHODS: The levels of serum potassium, serum sodium, serum blood urea nitrogen, serum creatinine and estimated glomerular filtration rate (eGFR) were analyzed in 320 patients with rectal cancer including 156 patients with an ileostomy (the ileostomy group) and 164 patients without an ileostomy (the control group). RESULTS: After index surgery, the levels of serum potassium and serum creatinine in the ileostomy group were significantly higher than those in the control group (P<0.05). In contrast, the levels of serum sodium and the eGFR showed decreases in the ileostomy group compared to the control group after index surgery (P<0.05). At 3 months after ileostomy creation, the ileostomy group had a significantly increased rate of eGFR <60 mL/min/1.73 m2 compared to the control group (5.8% vs. 1.2%, P=0.032). In line with the results of univariate analysis, multivariable analysis identified ileostomy and diabetes as independent risk factors for a decreased eGFR (P=0.005 and P=0.022, respectively). Furthermore, a significantly rebound of eGFR was observed in patients after ileostomy closure (P=0.013). CONCLUSIONS: Ileostomy can cause temporary electrolyte disturbance and renal function impairment in patients with rectal cancer. Diabetes is an independent risk factor for renal function damage in patients with rectal cancer who receive a temporary ileostomy.

Structural properties of Al/Mo/SiC multilayers with high reflectivity for extreme ultraviolet light.

We present the results of an optical and chemical, depth and surface study of Al/Mo/SiC periodic multilayers, designed as high reflectivity coatings for the extreme ultra-violet (EUV) range. In comparison to the previously studied Al/SiC system, the introduction of Mo as a third material in the multilayer structure allows us to decrease In comparison to the previously studied Al/SiC system with a reflectance of 37% at near normal incidence around 17 nm, the introduction of Mo as a third material in the multilayer structure allows us to decrease the interfacial roughness and achieve an EUV reflectivity of 53.4%, measured with synchrotron radiation. This is the first report of a reflectivity higher than 50% around 17 nm. Time-of-flight secondary ion mass spectrometry (ToF-SIMS) and x-ray photoelectron spectroscopy (XPS) measurements are performed on the Al/Mo/SiC system in order to analyze the individual layers within the stack. ToF-SIMS and XPS results give evidence that the first SiC layer is partially oxidized, but the O atoms do not reach the first Mo and Al layers. We use these results to properly describe the multilayer stack and discuss the possible reasons for the difference between the measured and simulated EUV reflectivity values.

Comparison of Mg-based multilayers for solar He II radiation at 30.4 nm wavelength.

Mg-based multilayers, including SiC/Mg, Co/Mg, B(4)C/Mg, and Si/Mg, are investigated for solar imaging and a He II calibration lamp at a 30.4 nm wavelength. These multilayers were fabricated by a magnetron sputtering method and characterized by x-ray reflection. The reflectivities of these multilayers were measured by synchrotron radiation. Near-normal-incidence reflectivities of Co/Mg and SiC/Mg multilayer mirrors are as high as 40.3% and 44.6%, respectively, while those of B(4)C/Mg and Si/Mg mirrors are too low for application. The measured results suggest that SiC/Mg, Co/Mg multilayers are promising for a 30.4 nm wavelength.

Network Pharmacology Analysis to Uncover the Potential Mechanisms of Lycium barbarum on Colorectal Cancer.

BACKGROUND: Studies have shown that extracts from Lycium barbarum exerted protective effects against colorectal cancer (CRC) cells. We used the network pharmacology method to determine the effects of L. barbarum on CRC and to predict core targets, biological functions, pathways, and mechanisms of action. METHOD: We obtained the active compounds and their targets in L. barbarum via use of the Traditional Chinese Medicine System Pharmacology Database (TCMSP), gathered the CRC targets from Malacards, TTD, GeneCards, and DisGeNET, and chosen the overlapped targets as the candidate targets. After protein-protein interaction (PPI) network analysis, 20 with the highest node degree were selected as the core targets, and their enrichment and pathways were analyzed. Furthermore, we employed iGEMDOCK to validate the compound-target relation. RESULT: Eventually, 103 overlapped targets were chosen as the candidate targets. Targets with the top 20 highest node degree were selected as the core targets. Gene Ontology (GO) enrichment analysis indicated that the core targets were enriched in cell proliferation regulation, extracellular space, cytokine receptor binding, and so on. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis proved that the core targets were significantly enriched in bladder cancer, pathways in cancer. The docking results demonstrated that beta-sitosterol, glycitein, and quercetin had good binding activity to CRC putative targets. CONCLUSION: Our work successfully predicted the functioning ingredients and potential targets of L. barbarum in CRC and illustrated the potential pathways and mechanisms comprehensively. Nevertheless, these results still call for in vitro and in vivo experiments to validate.

Transanal versus nontransanal surgery for the treatment of primary rectal gastrointestinal stromal tumors: a 10-year experience in a high-volume center.

BACKGROUND: Rectal gastrointestinal stromal tumor (GIST) is a rare digestive disease that has a distinct malignant tendency compared to that of gastric-derived GIST. At present, there is still no standard, and the surgical approach to rectal GIST is controversial. METHODS: The clinicopathological data and prognosis of rectal GIST patients admitted to the Sixth Affiliated Hospital of Sun Yat-sen University from 1998.01.01 to 2018.12.31 were collected retrospectively. All cases were divided into either the transanal (TA) group or the nontransanal (NTA) group. RESULTS: A total of 537 GIST cases were treated in 10 years, including 82 rectal GIST cases (64 cases underwent surgical resection, including 29 cases in the TA group and 35 cases in the NTA group). Preoperative neoadjuvant therapy (P=0.003), postoperative adjuvant therapy (P=0.017), operative time (P=0.013), blood loss (P=0.038), anus-preserver (P=0.048), 30-day complication rate (P=0.000), time to flatus (P=0.036), hospital stays (P=0.011), distance from the anus (P=0.047), tumor size (P=0.002), mitotic count (P=0.035) and National Institutes of Health (NIH) criteria (P=0.000) were significantly different between these two groups (all P<0.05). The median follow-up time was 41 (range, 1-122) months. Twelve patients had recurrence and metastasis, and 4 patients died. The 5-year disease-free survival (DFS) and overall survival (OS) were 74.4% and 91.2%, respectively, in the whole group. There were no statistically significant differences between the TA group and the NTA group at 5-year DFS (81.3% vs. 79.0%, P=0.243) and OS (88.7% vs. 93.3%, P=0.308). CONCLUSIONS: In the treatment of rectal GIST, TA resection has a minimally invasive effect, less postoperative complications, high anal sphincter preservation rate, and R0 resection rate and a better prognosis. How to improve the proportion of neoadjuvant therapy and choose the appropriate cases for TA surgery is still a challenge.

Radical excision versus local resection for primary rectal gastrointestinal stromal tumors. Cohort Study.

BACKGROUND: Rectal gastrointestinal stromal tumor (GIST) is a rare digestive disease that originates in mesenchymal tissues and has malignant tendencies. At present, no standard treatment has been developed, and surgical approaches and the resection scope for rectal GISTs are controversial. METHODS: The clinical, surgical, pathological and prognosis data of patients with primary rectal GIST in our center from January 2008 to January 2019 were retrospectively collected. The patients were divided into the radical excision (RE) and local resection (LR) groups. RESULTS: A total of 537 GIST cases were collected, and 64 patients with primary rectal GIST were included in this study, including 25 cases in the RE group and 39 cases in the LR group. Tumor size (p = 0.013), distance from the anus (p = 0.038), National Institutes of Health (NIH) criteria (p = 0.001), preoperative adjuvant therapy (p = 0.016), postoperative adjuvant therapy (p = 0.028), blood loss (p = 0.048), operative time (p = 0.020) and the duration of hospitalization (p = 0.021) were statistically different between these 2 groups. The mean overall follow-up time was 46 months (range, 1-122 months). Disease recurrence was observed in 12 patients. No statistical differences were observed in 5-year disease-free survival (DFS) (93.3% vs 92.6%, p = 0.952) or overall survival (OS) (90.0% vs 91.6%, p = 0.832) between the RE group and the LR group. CONCLUSION: Our study showed that LR has a similar prognosis to that of RE with respect to DFS and OS. For appropriate cases, LR has the advantages of a short operative time, less bleeding, and a quick recovery. Especially when combined with neoadjuvant therapy, LR can also achieve better perioperative efficacy. Therefore, LR is an effective method for resection of rectal GISTs and warrants clinical endorsement.

Chemical profiling of Banxia-Baizhu-Tianma decoction by ultra-fast liquid chromatography with tandem mass spectrometry.

Banxia-Baizhu-Tianma decoction (BBTD) is a compound formulae of traditional Chinese medicine (TCM), which has been clinically used for treatments of neural vertigo, hypertension and epilepsy with a long history. In this study, with an ultra-fast liquid chromatography coupled with quadrupole time of flight mass spectrometry (UFLC-Q-TOF-MS) method, a total of 88 components in BBTD were identified by the accurate masses and fragmentation pathways including 19 flavonoids, 8 lactones, 12 triterpenoids, 10 phenolics, 14 amino acids, 13 nucleobases and nucleosides, 7 organic acids, and 5 other compounds. In addition, under the same chromatographic conditions, we developed an ultra-fast liquid chromatography coupled with quadrupole linear ion trap mass spectrometry (UFLC-Q-TRAP-MS) method to simultaneously quantify 20 bioactive components in multiple-reaction monitoring (MRM) mode. The assay method was validated in terms of linearity, precision, repeatability, recovery and was successfully applied for determination of 12 batches of BBTD. We hope that this study work would help to reveal the chemical profiling and provide a valuable and reliable approach for quality evaluation and even efficacy material basis study of BBTD.