Trajectory patterns and cumulative burden of CEA during follow-up with non-small cell lung cancer outcomes: A retrospective longitudinal cohort study.

BACKGROUND: Previous studies of non-small cell lung cancer (NSCLC) focused on CEA measured at a single time point, ignoring serial CEA measurements. METHODS: This retrospective cohort included 2959 patients underwent surgery for stage I-III NSCLC. CEA trajectory patterns and long-term cumulative CEA burden were evaluated using the latent class growth mixture model. RESULTS: Four CEA trajectory groups were identified, named as low-stable, decreasing, early-rising and later-rising. Compared with the low-stable group, the adjusted hazard ratios associated with death were 1.27, 4.50, and 3.68 for the other groups. Cumulative CEA burden were positively associated with the risk of death in patients not belonging to the low-stable group. The 5-year overall survival (OS) rates decreased from 62.3% to 33.0% for the first and fourth quantile groups of cumulative CEA burden. Jointly, patients with decreasing CEA trajectory could be further divided into the decreasing & low and decreasing & high group, with 5-year OS rates to be 77.9% and 47.1%. Patients with rising CEA trajectory and high cumulative CEA were found to be more likely to develop bone metastasis. CONCLUSIONS: Longitudinal trajectory patterns and long-term cumulative burden of CEA were independent prognostic factors of NSCLC. We recommend CEA in postoperative surveillance of NSCLC.

Multidimensional influencing factors of postpartum depression based on the perspective of the entire reproductive cycle: evidence from western province of China.

OBJECTIVE: China has a serious burden of Postpartum depression (PPD). In order to improve the current situation of high burden of PPD, this study explores the factors affecting PPD from the multidimensional perspectives with physiology, family support and social support covering the full-time chain of pre-pregnancy-pregnancy-postpartum. METHODS: A follow-up survey was conducted in the Qujing First People's Hospital of Yunnan Province from 2020 to 2022, and a total of 4838 pregnant women who underwent antenatal checkups in the hospital were enrolled as study subjects. Mothers were assessed for PPD using the Edinburgh Postnatal Depression Scale (EPDS), and logistic regression was used to analyse the level of mothers' postnatal depression and identify vulnerability characteristics. RESULTS: The prevalence of mothers' PPD was 46.05%, with a higher prevalence among those who had poor pre-pregnancy health, had sleep problems during pregnancy, and only had a single female fetus. In the family support dimension, only family care (OR = 0.52, 95% CI 0.42-0.64) and only other people care(OR = 0.78, 95% CI 0.64-0.96) were the protective factors of PPD. The experience risk of PPD was higher among mothers who did not work or use internet. CONCLUSION: The PPD level in Yunnan Province was significantly higher than the global and Chinese average levels. Factors affecting mothers' PPD exist in all time stages throughout pregnancy, and the influence of family support and social support on PPD shouldn't be ignored. There is an urgent need to extend the time chain of PPD, move its prevention and treatment forward and broaden the dimensions of its intervention.

Arginine affects growth and integrity of grass carp enterocytes by regulating TOR signaling pathway and tight junction proteins.

Dietary arginine (Arg) could improve the intestinal structure and absorption of grass carp (Ctenopharyngodon idellus); however, the mechanism of Arg on intestinal morphology improvement was unclear. The present study aimed to explain the possible mechanism of the positive effect of Arg on intestinal epithelial cells of grass carp. An in vitro study was conducted through a primary culture model to assess the growth, cell viability, mRNA expressions of TOR signal pathway, and tight junction proteins of enterocytes after culture in the medium with 6 levels of Arg (0, 0.1, 0.2, 0.5, 1.0, and 2.0 mmol/L). The results showed that 0.5 mmol/L Arg improved the cell number and decreased the lactate dehydrogenase and creatine kinase activities in culture medium (P < 0.05). The alkaline phosphatase activity in cell lysis buffer was depressed by 1 and 2 mmol/L Arg (P < 0.05). The nitric oxide (NO) content showed an increasing trend with the Arg content (P < 0.05), whereas the NO synthase activity showed an opposite trend to NO. TOR expression was higher in 0.2 and 0.5 mmol/L groups, whereas S6K1 expression in 1.0 mmol/L and 2.0 mmol/L groups were lower (P < 0.05). The mRNA expressions of occludin, claudin 3, and claudin c in 0.5 mmol/L group were the highest, while ZO-1 and claudin b expressions were higher in 0.2 and 0.5 mmol/L groups (P < 0.05). This study indicated that Arg enhanced the growth and integrity of intestinal epithelial cells of grass carp through upregulation of mRNA expression of TOR signal pathway and tight junction proteins at an optimal Arg content of 0.2-0.5 mmol/L.

Elevated postoperative carcinoembryonic antigen guides adjuvant chemotherapy for stage II colon cancer: a multicentre cohort retrospective study.

Most clinical doctors rely on high-risk factors recommended by guidelines to decide whether to undergo adjuvant chemotherapy for stage II colon cancer. However, these high-risk factors do not include postoperative carcinoembryonic antigen (CEA). This study aims to explore the elevation of postoperative CEA as a risk factor, in addition to other high-risk factors, to guide adjuvant chemotherapy for patients with stage II colon cancer. A retrospective analysis was conducted on stage II colon cancer patients who underwent curative surgery at Yunnan Cancer Hospital and The Sixth Affiliated Hospital of Sun Yat-Sen University from April 2008 to January 2019. Patients were classified into three groups based on high-risk factors recommended by guidelines and postoperative CEA levels: low-risk with normal postoperative CEA, low-risk with elevated postoperative CEA and high-risk. COX regression analysis was used to identify independent prognostic factors affecting patients' recurrence free survival (RFS). The Kaplan-Meier method was used to create the patients' RFS curve. The restricted cubic spline (RCS) curve was used to assess the correlation between postoperative CEA and RFS on a continuous scale. Among 761 patients, there were 444 males (62.01%), with a median [IQR] age of 58.0 (18.0-88.0) years. A group of 425 high-risk patients had a 3-year RFS of 82.2% (95% CI 78.5-86.1%), while a group of 291 low-risk patients had a 3-year RFS of 89.7% (95% CI 86.1-93.5%). There was a statistically significant difference between the two groups (HR 1.83; 95% CI 1.22-2.74; P = 0.0067). Among them, the 3-year RFS of 261 low-risk patients with normal postoperative CEA was 93.6% (95% CI 90.5-96.8%), while the 3-year RFS of 30 low-risk patients with elevated postoperative CEA was 57.3% (95% CI 41.8-71.4%). There was a significant difference compared to the 3-year RFS of 425 high-risk patients (overall log-rank P < 0.0001). The multivariate analysis adjusted by the COX proportional hazards model showed that low-risk patients with elevated postoperative CEA patients (HR 14.95, 95% CI 4.51-49.63, P < 0.0001) was independently associated with a 3-year RFS. The restricted cubic spline model showed that in stage II colon cancer patients with tumor diameter > 1.955 ng/mL, the risk of postoperative recurrence increased with increasing postoperative CEA levels. Patients with elevated postoperative CEA levels have a significantly increased risk of recurrence. They should be included as high-risk factors to guide adjuvant chemotherapy for stage II colon cancer.

Amniotic Fluid Proteomics Analysis and In Vitro Validation to Identify Potential Biomarkers of Preterm Birth.

This study aimed to investigate the regulation of amniotic fibroblast (AFC) function by vitamin K-dependent protein Z (PROZ) during preterm birth (PTB) and its potential role in adverse pregnancy outcomes. Proteomic samples were collected from amniotic fluid in the second trimester, and AFC were isolated from the amniotic membrane and cultured in vitro. The expression of extracellular and intracellular PROZ in AFC was modulated, and their biological properties and functions were evaluated. Clinical analysis revealed a significant upregulation of PROZ expression in amniotic fluid from preterm pregnant women. In vitro experiments demonstrated that PROZ stimulated AFC migration, enhanced their proliferative capacity, and reduced collagen secretion. Overexpression of PROZ further enhanced cell migration and proliferation, while knockdown of PROZ had the opposite effect. PROZ plays a crucial role in promoting the proliferation and migration of amniotic membrane fibroblasts. Increased PROZ expression in amniotic fluid is associated with the occurrence of PTB. These findings shed light on the potential involvement of PROZ in adverse pregnancy outcomes and provide a basis for further research on its regulatory mechanisms during PTB.

Hierarchical Fe3O4@TiO2 yolk-shell microspheres with enhanced microwave-absorption properties.

A facile and efficient strategy for the synthesis of hierarchical yolk-shell microspheres with magnetic Fe3O4 cores and dielectric TiO2 shells has been developed. Various Fe3O4@TiO2 yolk-shell microspheres with different core sizes, interstitial void volumes, and shell thicknesses have been successfully synthesized by controlling the synthetic parameters. Moreover, the microwave absorption properties of these yolk-shell microspheres, such as the complex permittivity and permeability, were investigated. The electromagnetic data demonstrate that the as-synthesized Fe3O4@TiO2 yolk-shell microspheres exhibit significantly enhanced microwave absorption properties compared with pure Fe3O4 and our previously reported Fe3O4@TiO2 core-shell microspheres, which may result from the unique yolk-shell structure with a large surface area and high porosity, as well as synergistic effects between the functional Fe3O4 cores and TiO2 shells.

Preoperative splenic area as a prognostic biomarker of early-stage non-small cell lung cancer.

BACKGROUND: The correlation between the preoperative splenic area measured on CT scans and the overall survival (OS) of early-stage non-small cell lung cancer (NSCLC) patients remains unclear. METHODS: A retrospective discovery cohort and validation cohort consisting of consecutive NSCLC patients who underwent resection and preoperative CT scans were created. The patients were divided into two groups based on the measurement of their preoperative splenic area: normal and abnormal. The Cox proportional hazard model was used to analyse the correlation between splenic area and OS. RESULTS: The discovery and validation cohorts included 2532 patients (1374 (54.27%) males; median (IQR) age 59 (52-66) years) and 608 patients (403 (66.28%) males; age 69 (62-76) years), respectively. Patients with a normal splenic area had a 6% higher 5-year OS (n = 727 (80%)) than patients with an abnormal splenic area (n = 1805 (74%)) (p = 0.007) in the discovery cohort. A similar result was obtained in the validation cohort. In the univariable analysis, the OS hazard ratios (HRs) for the patients with abnormal splenic areas were 1.32 (95% confidence interval (CI): 1.08, 1.61) in the discovery cohort and 1.59 (95% CI: 1.01, 2.50) in the validation cohort. Multivariable analysis demonstrated that abnormal splenic area was independent of shorter OS in the discovery (HR: 1.32, 95% CI: 1.08, 1.63) and validation cohorts (HR: 1.84, 95% CI: 1.12, 3.02). CONCLUSION: Preoperative CT measurements of the splenic area serve as a prognostic indicator for early-stage NSCLC patients, offering a novel metric with potential implications for personalized therapeutic strategies in top-tier oncology research.

The Prognostic Significance of Postoperative Adjuvant Chemotherapy in the Population Aged 75 Years and Older with Stage II-III Colorectal Cancer: A Retrospective Multi-Center Cohort Study.

Background: It is common for elderly patients to be underrepresented in clinical trials for cancer, which can result in a lack of efficacy data and unclear criteria to guide treatment decisions for clinical doctors. Therefore, one of the common challenges in oncology treatment is determining the extent to which patients aged 75 and older have benefited from postoperative chemotherapy. Purpose: The study aimed to explore the effect of adjuvant chemotherapy (AC) on 3-year recurrence-free survival (RFS) after curative resection in patients aged 75 years and older with stage II-III colorectal cancer (CRC). Methods: The retrospective cohort analysis was performed on patients with stage II-III CRC who received curative resection at three cancer centers in China between 2008 and 2017. Kaplan-Meier curves and Multivariable Cox regression models were used to analyze the impact of AC on RFS in patients. Finally, propensity-score matching was used to reduce selection bias and confounding factors in patients aged 75 years and older with stage II-III CRC. Results: A total of 2885 patients were included (1729 (59.9%) male; 1312 (61.5%) received AC). The pre-matching cohort was comprised of 151 patients aged 75 years and older (median age (IQR)77.00 (76.00, 79.00); 97 (64.2%) male, 51 (72.9%) received AC). Age (P=0.001), postoperative carcinoembryonic antigen (CEA)(P=0.02) level were associated with prognosis. But AC was not associated with 3-year RFS (HR, 1.27; 95% CI, 0.80-2.0; log-rank P=0.37). After a predisposition 1: 1 match (with or without AC, n = 42), AC remains uncorrelated with 3-year RFS (HR, 1.39; 95% CI, 0.52-3.70; log-rank P=0.66). Conclusion: Patients over the age of 75 with stage II-III CRC who receive AC or do not face the same risk of postoperative recurrence. As a result, patients with stage II-III postoperative adjuvant chemotherapy can make an informed decision regarding whether they want to undergo chemotherapy based on their age and reduce the unnecessary side effects of chemotherapy.

Phthalate esters in atmospheric PM2.5 and PM10 in the semi-arid city of Xi'an, Northwest China: Pollution characteristics, sources, health risks, and relationships with meteorological factors.

PM2.5 and PM10 samples were collected in the semi-arid city of Xi'an in Northwest China from November 2016 to November 2017 and analyzed to assess pollution characteristics, sources, health risks, and influencing factors of 6 priority phthalate esters (PAEs). The results showed that the sum of the 6 PAEs (Σ6PAEs) was 85.5 ng m-3 in PM2.5 and 94.5 ng m-3 in PM10, being higher at the suburban site than the urban site and winter > spring > summer > autumn. The most abundant PAE was bis(2-ethylhexyl phthalate) (DEHP). PM2.5- and PM10-bound PAEs were associated mainly with the use of plasticizers plus the uses of cosmetics and personal care products, construction materials, and home furnishings. Temperature, relative humidity, and visibility had stronger influences on the concentrations of PM and PM-bound PAEs than pressure and wind speed. Pressure and relative humidity were positively correlated with the concentrations of PM and most of the PM-bound PAEs, while temperature, visibility and wind speed had negative correlations with the concentrations of PM and PM-bound PAEs. The non-carcinogenic risks of human inhalation exposure to PM-bound PAEs were in the range of 10-7 to 10-3, suggesting low non-cancer risks, which were higher at the suburban site than the urban site and higher to children than adults. The cancer risks of human inhalation exposure to PM-bound DEHP and butyl benzyl phthalate (BBP) were in the range of 10-12 to 10-10, suggesting low carcinogenic risks, being in the order of the suburban site > the urban site and DEHP > BBP. Special attention should be paid to long-term low dose exposure to PAEs in the suburb, especially in winter and spring.

Pollution characteristics and health risk assessment of phthalate esters in urban soil in the typical semi-arid city of Xi'an, Northwest China.

A total of 62 urban soil samples were collected in the city of Xi'an in Northwest China, and analyzed for six U.S. Environmental Protection Agency priority phthalate esters (PAEs). Unlike earlier studies on PAEs in agricultural soil as well as urban soil in humid climates, this paper for the first time comprehensively assessed pollution characteristics and health risks of human exposure to PAEs in urban soil in a typical semi-arid climate. The total concentrations of the six PAEs (Σ6PAEs) in the urban soil varied between 193.0 and 19146.4 µg kg-1 with a mean of 1369.3 µg kg-1. The PAEs were dominated by di-n-butyl phthalate and di(2-ethylhexyl) phthalate. Magnetic susceptibility and soil texture were controlling factors influencing the concentrations of PAEs in the urban soil. The concentrations of benzyl butyl phthalate, di(2-ethylhexyl) phthalate, and Σ6PAEs increased from the first to third ring roads, while the concentrations of di-n-octyl phthalate decreased. Relatively higher levels of PAEs were observed in industrial, traffic, and residential areas. The PAEs in the urban soil originated mainly from the application of plasticizers or additives, use of cosmetics and personal care products, emissions of construction materials and home furnishings, industrial processes, and atmospheric deposition. The concentrations of some PAEs in the urban soil exceeded soil allowable concentrations and environmental risk levels. The non-cancer and carcinogenic risks of human exposure to the PAEs were relatively low.

Synthesis and microwave absorption properties of yolk-shell microspheres with magnetic iron oxide cores and hierarchical copper silicate shells.

Yolk-shell microspheres with magnetic Fe3O4 cores and hierarchical copper silicate shells have been successfully synthesized by combining the versatile sol-gel process and hydrothermal reaction. Various yolk-shell microspheres with different core size and shell thickness can be readily synthesized by varying the experimental conditions. Compared to pure Fe3O4, the as-synthesized yolk-shell microspheres exhibit significantly enhanced microwave absorption properties in terms of both the maximum reflection loss value and the absorption bandwidth. The maximum reflection loss value of these yolk-shell microspheres can reach -23.5 dB at 7 GHz with a thickness of 2 mm, and the absorption bandwidths with reflection loss lower than -10 dB are up to 10.4 GHz. Owing to the large specific surface area, high porosity, and synergistic effect of both the magnetic Fe3O4 cores and hierarchical copper silicate shells, these unique yolk-shell microspheres may have the potential as high-efficient absorbers for microwave absorption applications.

Ultrathin BaTiO3 nanowires with high aspect ratio: a simple one-step hydrothermal synthesis and their strong microwave absorption.

In this paper, we report the facile synthesis of ultrathin barium titanate (BaTiO3) nanowires with gram-level yield via a simple one-step hydrothermal treatment. Our BaTiO3 nanowires have unique features: single crystalline, uniform size distribution and ultra high aspect ratio. The synergistic effects including both Ostwald ripening and cation exchange reaction are responsible for the growth of the ultrathin BaTiO3 nanowires. The microwave absorption capability of the ultrathin BaTiO3 nanowires is improved compared to that of BaTiO3 nanotorus,1 with a maximum reflection loss as high as -24.6 dB at 9.04 GHz and an absorption bandwidth of 2.4 GHz (<-10 dB). Our method has some novel advantages: simple, facile, low cost and high synthesis yield, which might be developed to prepare other ferroelectric nanostructures. The strong microwave absorption property of the ultrathin BaTiO3 nanowires indicates that these nanowires could be used as promising materials for microwave-absorption and stealth camouflage techniques.