Combining pathological risk factors and T, N staging to optimize the assessment for risk stratification and prognostication in low-risk stage III colon cancer.

BACKGROUND: This study aimed to investigate the combined pathological risk factors (PRFs) to stratify low-risk (pT1-3N1) stage III colon cancer (CC), providing a basis for individualized treatment in the future. PATIENTS AND METHODS: PRFs for low-risk stage III CC were identified using COX model. Low-risk stage III CC was risk-grouped combining with PRFs, and survival analysis were performed using Kaplan-Meier. The Surveillance, Epidemiology, and End Results (SEER) databases was used for external validation. RESULTS: Nine hundred sixty-two stage III CC patients were included with 634 (65.9%) as low risk and 328 (34.1%) as high risk. Poor differentiation (OS: P = 0.048; DFS: P = 0.011), perineural invasion (OS: P = 0.003; DFS: P < 0.001) and tumor deposits (OS: P = 0.012; DFS: P = 0.003) were identified as PRFs. The prognosis of low-risk CC combined with 2 PRFs (OS: HR = 3.871, 95%CI, 2.004-7.479, P < 0.001; DFS: HR = 3.479, 95%CI, 2.158-5.610, P < 0.001) or 3 PRFs (OS: HR = 5.915, 95%CI, 1.953-17.420, P = 0.002; DFS: HR = 5.915, 95%CI, 2.623-13.335, P < 0.001) was similar to that of high-risk CC (OS: HR = 3.927, 95%CI, 2.317-6.656, P < 0.001; DFS: HR = 4.132, 95%CI, 2.858-5.974, P < 0.001). In the SEER database, 18,547 CC patients were enrolled with 10,023 (54.0%) as low risk and 8524 (46.0%) as high risk. Low-risk CC combined with 2 PRFs (OS: HR = 1.857, 95%CI, 1.613-2.139, P < 0.001) was similar to that of high-risk CC without PRFs (HR = 1.876, 95%CI, 1.731-2.033, P < 0.001). CONCLUSION: Combined PRFs improved the risk stratification of low-risk stage III CC, which could reduce the incidence of undertreatment and guide adjuvant chemotherapy.

Construction and Validation of a Novel Prognosis Model in Colon Cancer Based on Cuproptosis-Related Long Non-Coding RNAs.

Colon cancer (CC) is one of the most common (6%) malignancies and leading cause of cancer-associated death (more than 0.5 million) worldwide, which demands reliable prognostic biomarkers. Cuproptosis is a novel modality of regulated cell death triggered by the accumulation of intracellular copper. LncRNAs have been reported as prognostic signatures in different types of tumors. However, the correlation between cuproptosis-related lncRNAs (CRLs) and CC remains unclear. Data of CC patients were downloaded from public databases. The prognosis-associated CRLs were identified by co-expression analysis and univariate Cox. Least absolute shrinkage and selection operator were utilized to construct the CRLs-based prognostic signature in silico for CC patients. CRLs level was validated in human CC cell lines and patient tissues. ROC curve and Kaplan-Meier curve results revealed that high CRLs-risk score was associated with poor prognosis in CC patients. Moreover, the nomogram revealed that this model possessed a steady prognostic prediction capability with C-index as 0.68. More importantly, CC patients with high CRLs-risk score were more sensitive to eight targeted therapy drugs. The prognostic prediction power of the CRLs-risk score was further confirmed by cell lines, tissues and two independent CC cohorts. This study constructed a novel ten-CRLs-based prognosis model for CC patients. The CRLs-risk score is expected to serve as a promising prognostic biomarker and predict targeted therapy response in CC patients.

Prognostic Implications of Endoscopic Obstruction in Patients with Pathological Stage II Colon Cancers: a Single-Center Retrospective Cohort Study.

BACKGROUND: The prognostic effect of endoscopic obstruction (eOB) on the survival of stage II colon cancer patients and the role of eOB in guiding postoperative adjuvant chemotherapy of stage II colon cancer are little known. METHODS: In this retrospective, single-center cohort study, patients who had undergone curative surgery and preoperative colonoscope for stage II colon carcinoma were included. The eOB was defined as severe luminal colon obstruction that prevented the standard colonoscope from passing beyond the tumor. The association between eOB and stage II colon cancer survival and the predictive role of eOB for adjuvant chemotherapy were evaluated using multivariate Cox regression analysis. RESULTS: Of 1102 included patients, 616 (55.9%) had eOB and 486 (44.1%) had no eOB. The median follow-up was 49 months (interquartile range, 38-68 months). Kaplan-Meier curves showed that patients with eOB had poor 5-year overall survival (OS; 85.3% vs. 95.3%, p < 0.001) compared to patients without eOB. Five-year disease-free survival (DFS; 78.5% vs. 87.6%, p = 0.004) was also poor in these patients. Multivariate analysis demonstrated eOB was a significant prognostic factor for poor OS (hazard ratio [HR] = 2.531, p < 0.001), but not for DFS (p = 0.081). Even when patients with clinical colonic obstruction were excluded from the population with eOB, the worse OS (HR = 2.262, p = 0.001) was observed. The OS and DFS of eOB patients improved slightly after adjuvant chemotherapy, but there was no statistical significance. CONCLUSIONS: Stage II colon cancer patients with eOB have a poor prognosis. However, whether eOB can guide adjuvant chemotherapy still needs further study.

A Novel m7G-Related Gene Signature Predicts the Prognosis of Colon Cancer.

Colon cancer (CC), one of the most common malignancies worldwide, lacks an effective prognostic prediction biomarker. N7-methylguanosine (m7G) methylation is a common RNA modification type and has been proven to influence tumorigenesis. However, the correlation between m7G-related genes and CC remains unclear. The gene expression levels and clinical information of CC patients were downloaded from public databases. Twenty-nine m7G-related genes were obtained from the published literature. Via unsupervised clustering based on the expression levels of m7G-related genes, CC patients were divided into three m7G clusters. Based on differentially expressed genes (DEGs) from the above three groups, CC patients were further divided into three gene clusters. The m7G score, a prognostic model, was established using principal component analysis (PCA) based on 15 prognosis-associated m7G genes. KM curve analysis demonstrated that the overall survival rate was remarkably higher in the high-m7G score group, which was much more significant in advanced CC patients as confirmed by subgroup analysis. Correlation analysis indicated that the m7G score was associated with tumor mutational burden (TMB), PD-L1 expression, immune infiltration, and drug sensitivity. The expression level of prognosis-related m7G genes was further confirmed in human CC cell lines and samples. This study established an m7G gene-based prognostic model (m7G score), which demonstrated the important roles of m7G-related genes during CC initiation and progression. The m7G score could be a practical biomarker to predict immunotherapy response and prognosis in CC patients.

Risk factors for metachronous peritoneal carcinomatosis after radical resection for patients with nonmetastatic pT3-4 colon cancer.

BACKGROUND: Patients with nonmetastatic pT3-4 colon cancers are prone to develop metachronous peritoneal carcinomatosis (mPC). Risk factors for mPC and the influence of mutant kirsten rat sarcoma viral oncogene (KRAS)/neuroblastoma rat sarcoma (NRAS)/v-raf murine sarcoma viral oncogene homolog B1 (BRAF) and DNA mismatch repair (MMR) status on mPC remain to be described in these patients. METHOD: All enrolled patients were identified from the prospectively collected colorectal cancer database of a tertiary referral hospital between 2013 and 2018. Multivariate analysis was used to identify risk factors associated with mPC. RESULTS: Of the 1689 patients with nonmetastatic pT3-4 colon carcinoma, 8.4% (142/1689) progressed to mPC. Endoscopic obstruction (HR = 3.044, p < 0.001), elevated CA125 (HR = 1.795, p = 0.009), pT (T4a vs. T3, HR = 2.745, p < 0.001; T4b vs. T3, HR = 3.167, p = 0.001), pN (N1 vs. N0, HR = 2.592, p < 0.001; N2 vs. N0, HR = 4.049, p < 0.001), less than 12 lymph nodes harvested (HR = 2.588, p < 0.001), mucinous or signet ring cell carcinoma (HR = 1.648, p = 0.038), perineural invasion (HR = 1.984, p < 0.001), and adjuvant chemotherapy (HR = 1.522, p = 0.039) were strongly related to mPC but that mutant KRAS/NRAS/BRAF and MMR status was not associated with mPC. CONCLUSION: This study identified the high-risk factors for mPC in patients with nonmetastatic pT3-4 colon carcinoma, and these factors should be considered in selective preventive therapy and close follow-up for patients subsequently deemed to have high risk for mPC.

Risk factors for recurrence after bowel resection for Crohn's disease.

BACKGROUND: Complications of Crohn's disease such as intestinal obstruction, fistula or perforation often need surgical treatment. Nearly 70%-80% patients with Crohn's disease would receive surgical treatment during the lifetime. However, surgical treatment is incurable for Crohn's disease. The challenge of recurrence postoperatively troubles both doctors and patients. Over 50% patients would suffer recurrence postoperatively. Some certain risk factors are associated with recurrence of Crohn's disease. AIM: To evaluate the risk factors for endoscopic recurrence and clinical recurrence after bowel resection in Crohn's disease. METHODS: Patients diagnosed Crohn's disease and received intestinal resection between April 2007 and December 2013 were included in this study. Data on the general demographic information, preoperative clinical characteristics, surgical information, postoperative clinical characteristics were collected. Continuous data are expressed as median (inter quartile range), and categorical data as frequencies and percentages. Kaplan-Meier method was applied to estimate the impact of the clinical variables above on the cumulative rate of postoperative endoscopic recurrence and clinical recurrence, then log-rank test was applied to test the homogeneity of those clinical variables. Multivariate Cox proportional hazard regression analysis was performed to identify the risk factors of postoperative endoscopic recurrence and clinical recurrence. RESULTS: A total of 64 patients were included in this study. The median follow-up time for the patients was 17 (9.25-25.75) mo. In this period, 41 patients (64.1%) had endoscopic recurrence or clinical recurrence. Endoscopic recurrence occurred in 34 (59.6%) patients while clinical recurrence occurred in 28 (43.8%) patients, with the interval between the operation and recurrence of 13.0 (8.0-24.5) months and 17.0 (8.0-27.8) mo, respectively. In univariate analysis, diagnosis at younger age (P < 0.001), disease behavior of penetrating (P = 0.044) and preoperative use of anti-tumor necrosis factor (TNF) (P = 0.020) were significantly correlated with endoscopic recurrence, while complication with perianal lesions (P = 0.032) and preoperative use of immunomodulatory (P = 0.031) were significantly correlated with clinical recurrence. As to multivariate analysis, diagnostic age (P = 0.004), disease behavior (P = 0.041) and preoperative use of anti-TNF (P = 0.010) were independent prognostic factors for endoscopic recurrence, while complication with perianal lesions (P = 0.023) was an independent prognostic factor for clinical recurrence. CONCLUSION: Diagnostic age, disease behavior, preoperative use of anti-TNF and complication with perianal lesions were independent risk factors for postoperative recurrence in Crohn's disease.

Conversion is a risk factor for postoperative anastomotic leak in rectal cancer patients - A retrospective cohort study.

AIM: The impact of conversion from laparoscopic surgery to laparotomy on the development of anastomotic leak (AL) in rectal cancer patients following laparoscopic low anterior resection (LAR) with total mesorectal excision (TME) has not been evaluated. The aim of this study was to evaluate the impact of conversion on the risk of AL and develop a prediction nomogram for postoperative AL. METHODS: All rectal cancer patients following laparoscopic LAR with TME from January 2010 to October 2014 were enrolled in the primary cohort. Comparisons of the postoperative anastomotic leak incidence rate between converted patients and non-converted patients were performed using both univariate and multivariate logistic regression analyses. The result of multivariable analysis was used to develop the predicting model and the performance of nomogram was assessed with respect to its calibration, discrimination, and clinical usefulness. An independent validation cohort containing 200 patients from November 2014 to October 2015 was assessed. RESULTS: Of all patients enrolled (n=646), 592 (91.6%) patients underwent totally laparoscopic surgery, and 54 (8.4%) were converted from laparoscopic surgery to laparotomy. Converted group patients were more likely to have a higher body mass index (BMI), prolonged length of stay (LOS), increased overall postoperative complication rates and advanced clinical T stage (T3 or T4), pathological N stage (N1 or N2) and pathological TNM stage (III or IV). The percentage of patients who had preoperative radiotherapy for rectal cancer was higher in non-converted patients. Patients who underwent conversion to laparotomy (n=10, 18.5%) were more likely to suffer from postoperative AL than those undergoing totally laparoscopic surgery (n=38, 6.4%) (P=0.004). Multivariate logistic regression analyses confirmed the association between conversion and postoperative AL (Odds ratio [OR], 95% confidence interval [CI]: 2.71 [1.31-5.63], P=0.007). Conversion, gender, and clinical N stage incorporated in the individualized prediction nomogram showed good discrimination, with a C-index of 0.697 (C-index, 0.621 and 0.772 through internal validation), and good calibration. In the validation cohort, the main results were consistent with the findings of the primary cohort, with a C-index of 0.670 (C-index, 0.562 and 0.777 through internal validation). Decision curve analysis demonstrated that the prediction nomogram was clinically useful. CONCLUSION: Conversion during laparoscopic LAR was found to be associated with an increased risk for the postoperative AL in RC patients. A nomogram model incorporating conversion, gender and patient's clinical N stage seems to offers a useful tool for predicting postoperative AL in these patients.

[Response of biocrust-soil system respiration to winter low temperature and simulated warming]. / 生物结皮-土壤呼吸对冬季低温及模拟增温的响应.

To study the effects of low temperature and simulated warming on respiration of biocrust-soil systems, intact soil columns covered by two dominant types of biocrusts (moss and algae-lichen crusts), were collected in a natural vegetation area in the southeast fringe of the Tengger Desert. Automated soil respiration system (Li-8150) was used to measure respiration rates in biocrust-soil systems under warming (by placing them in an open top chamber) and non-warming treatments in winter (from November 2015 to January 2016). During the whole observation period, soil respiration rates covered by moss crusts were significantly higher than those covered by algae-lichen crusts, which were -0.052 to 0.418 and -0.032 to 0.493 µmol·m-2·s-1, respectively. The respiration rates of the two types of biocrust-soil systems showed significant positive linear correlations with soil temperature and volumetric soil water content at 5 cm depth. Through speeding-up the evaporation rates of soil moisture, imitated warming in winter impeded respiration rates of the two biocrust-soil systems. During the whole observation period, the cumulative carbon (C) release by moss crust-soil system (9.90 g C·m-2) was dramatically higher than that of algae-lichen crust-soil system (7.00 g C·m-2). The cumulative C release by the biocrust-soil systems in this region in winter was 7.40 g C·m-2, thus comprising an important part of annual C budget in the desert ecosystems.

[Nitrification of biological soil crusts and soil system during drought process and its response to temperature and moisture: A case study in the Shapotou region, Northwest China].

Two types of soil covered by biological soil crusts (BSCs) , i.e. moss and algae, and moving sand in the natural vegetation area at the southeast fringe of the Tengger Desert were collected intactly. They were incubated continuously for 20 days under two different temperatures (15 degrees C and 25 degrees C) and moistures (10% and 25%) condition in the laboratory, and soil NO3(-)-N contents were measured after 1, 2, 5, 8, 12, 20 days of incubation and net nitrification rate was evaluated during dehydration. The results showed that NO3(-)-N content of the moss-covered soil (2.29 mg x kg(-1)) was higher than that of the algae-covered soil (1.84 mg x kg(-1)) and sand (1.59 mg x kg(-1)). Net nitrification rate of the three soil types ranged from -3.47 to 2.97 mg x kg(-1) x d(-1). For the moss-covered soil and algae-covered soil at 10% and 25% moisture levels, the net nitrification rates at 15 degrees C were 75.1%, 0.7% and 99.1%, 21.3% higher than those at 25 degrees C, respectively. Also, the net nitrification rates at 15 degrees C and 10% moisture levels were 193.4% and 107.3% higher than those at 25 degrees C and 25% moisture levels, respectively. The results suggested that regardless of soil moisture increasing or decreasing under the global warming senior, the net nitrification rate of BSCs-soil system in the desert would probably be limited to some extent during drought process.

Dual Lewis Base Functionalization of Ionic Liquids for Highly Efficient and Selective Capture of H2 S.

Three dual Lewis base functionalized ionic liquids (DLB-ILs) tethered with both carboxyl and tertiary amine groups on their anions were designed for highly efficient and selective absorption of H2 S. It was found that the DLB-ILs could reversibly absorb 0.39-0.84 mol of H2 S per mole of IL at 1 bar and 60 °C, which is significantly higher than that of other ILs. On the contrary, the CO2 absorption in this class of DLB-ILs was shown to be quite limited relative to H2 S owing to the coupling effect of the two Lewis base groups. It is the dual Lewis base functionalization that enables the significantly high values calculated for the ideal absorption selectivity for H2 S/CO2 , that is, 13-26 at 1 bar and 29-70 at 0.1 bar (60 °C). The selectivity even goes up to >100 at low pressures and high temperatures. It was further illustrated from DFT calculations and spectroscopy studies that the cooperation interaction of carboxyl⋅⋅⋅H2 S⋅⋅⋅amine and the reduced binding with CO2 were the major contributions to the high H2 S absorption capacity and H2 S/CO2 selectivity.

[Expression of serum sICAM-1 in patients with primary hepatocellular carcinoma and its relationship with liver fibrosis].

AIM: To explore the clinical value of serum soluble intercellular adhesion molecule-1 (sICAM-1) in patients with primary hepatocellular carcinoma (PHC) and its relationship with liver fibrosis. METHODS: The serun sICAM-1, PC III, IV-C, LN and HA level of 45 cases of patients with PHC, 30 cases of benign tumor and 35 cases of healthy people were determined by ELISA, the relationship between sICAM-1 and liver fibrosis was analyzed. RESULTS: The serum sICAM-1, PC III, IV-C, LN and HA levels of the PHC group were significantly higher than that of the benign tumor group and normal control group, compared the difference was significant (P<0.05); The serum markers was no significant difference between the benign tumor group and normal control group (P>0.05); The serum sICAM-1 was positively correlated with the PC III, IV-C, LN and HA (γ= 0.683, 0.575, 0.573 and 0.539, P<0.05). CONCLUSION: Detection of serum sICAM-1 has important clinical significance for assessing the PHC patient's condition, early diagnosing and treating liver cancer.

[Effects of incubation temperature and substrate humidity on embryonic development of Mauremys mutica].

Yellow pond turtle (Mauremys mutica) eggs were incubated in vermiculite under nine combinations of temperature and humidity, i. e., 25 degrees C and -12 kPa, 29 degrees C and -12 kPa, 33 degrees C and -12 kPa, 25 degrees C and -150 kPa, 29 degrees C and -150 kPa, 33 degrees C and -150 kPa, 25 degrees C and -300 kPa, 29 degrees C and -300 kPa, and 33 degrees C and -300 kPa, aimed to study the effects of incubation temperature and its interaction with substrate humidity on the embryonic development of M. mutica. The initial egg mass, incubation temperature, substrate humidity, and the interaction of incubation temperature and substrate humidity had significant effects on the mass increment of egg in the course of hatching. At the same temperature, eggs incubated in wetter substrates (-12 kPa) gained more mass than those incubated in drier substrates (-150 kPa and -300 kPa). Incubation temperature affected hatching period significantly, while substrate humidity and its interaction with temperature did not. Both incubation temperature and substrate humidity affected hatching success and shell crack rate significantly. Abnormal hatchlings were found when incubated at 25 degrees C and 33 degrees C, but not at 29 degrees C. Incubation temperature had significant effects on the hatchling mass, carapace length and width, plastron length and width, body height, and tail length; while substrate humidity only affected hatchlings plastron length. The interaction of incubation temperature and substrate humidity did not affect the morphology of hatchlings.