Prognostic factors in patients with thymoma who underwent surgery.

PURPOSE: Thymoma is the most common primary tumor in the anterior mediastinum. The prognostic factors of patients with thymoma still need to be clarified. In this study, we aimed to investigate the prognostic factors of patients with thymoma who received radical resection and establish the nomogram to predict the prognosis of these patients. MATERIALS AND METHODS: Patients who underwent radical resection for thymoma with complete follow-up data between 2005 and 2021 were enrolled. Their clinicopathological characteristics and treatment methods were retrospectively analyzed. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan-Meier method and compared by the log-rank test. Univariate and multivariate Cox proportional hazards regression analyses were performed to identify the independent prognostic factors. According to the results of the univariate analysis in the Cox regression model, the predictive nomograms were created. RESULTS: A total of 137 patients with thymoma were enrolled. With a median follow-up of 52 months, the 5-year and 10-year PFS rates were 79.5% and 68.1%, respectively. The 5-year and 10-year OS rates were 88.4% and 73.1%, respectively. Smoking status (P = 0.022) and tumor size (P = 0.039) were identified as independent prognostic factors for PFS. Multivariate analysis showed that a high level of neutrophils (P = 0.040) was independently associated with OS. The nomogram showed that the World Health Organization (WHO) histological classification contributed more to the risk of recurrence than other factors. Neutrophil count was the most important predictor of OS in patients with thymoma. CONCLUSION: Smoking status and tumor size are risk factors for PFS in patients with thymoma. A high level of neutrophils is an independent prognostic factor for OS. The nomograms developed in this study accurately predict PFS and OS rates at 5 and 10 years in patients with thymoma based on individual characteristics.

Omega-3 index and type 2 diabetes: Systematic review and meta-analysis.

BACKGROUND AND OBJECTIVES: The relationship between omega-3 index and type 2 diabetes (T2D) is not well established. It is unclear if the change of omega-3 index will affect T2D. Aiming of the present systematic review was to elucidate the correlation between omega-3 index and T2D. METHODS AND STUDY DESIGN: A comprehensive search on PubMed, EMBASE and Web of Science (from 1948 to May 2021) was conducted. The overall effect size (standard mean difference) was combined using a random-effect model. RESULTS: Eight eligible case-control studies were identified, and there were 1,357 patients with T2D and 1,616 non-diabetic controls. The result showed that the omega-3 index was significantly lower in diabetic cases than that in controls (SMD= -1.31; 95% confidence interval (CI): -1.40, -1.22), but with significant heterogeneity (I2 = 99.0%). In subgroup analysis based on race, a negative correlation was found in Asians (SMD = -1.71; 95% CI: -1.82, -1.60), and heterogeneity was substantially decreased (I2=0). CONCLUSIONS: omega-3 index is negatively correlated with T2D, which indicated that increased dietary intake of omega-3 fatty acids might have beneficial on T2D prevention.

Learning curve associated with thoraco-laparoscopic esophagectomy for esophageal cancer patients in the prone position.

OBJECTIVE: To observe the surgical index at the different learning stages of thoraco-laparoscopic esophagectomy in the prone position for esophageal cancer and to investigate the learning curve of this surgical procedure. METHODS: Sixty thoraco-laparoscopic esophagectomies in the prone position for esophageal cancer conducted by the same group of surgeons between January 2014 and December 2015 were retrospectively analyzed. The surgeries were divided into 5 groups, A, B, C, D, and E, in chronological order. The duration of surgery, intraoperative blood loss, total number of lymph nodes removed, rate of the intraoperative conversion to open surgery, complication rate, and length of postoperative hospitalization were recorded and analyzed. RESULTS: The general information of the patients did not significantly differ among the 5 groups (P > 0.05). The duration of surgery, intraoperative blood loss, number of lymph node removed, rate of intraoperative conversion to open surgery, and number of injuries to the recurrent laryngeal nerve all significantly differed (P < 0.05). The rates of postoperative pulmonary infection, anastomotic fistula, pneumothorax, and hospitalization did not significantly differ (P > 0.05). CONCLUSION: Thoracic physicians with some endoscopic experience can meet the requirements of the thoraco-laparoscopic esophagectomy in the prone position for esophageal cancer after completing 24-30 surgeries.

[Contamination and Ecological Risk Assessment of Mercury in Hengshuihu Wetland, Hebei Province].

Investigation on the concentrations and the distribution characteristics of total mercury in atmosphere, water surface and soil/ sediments of Hengshuihu wetland was carried out based on a uniform set point sampling method. The geoaccumulation index and potential ecological risk index methods were simultaneously used to assess the mercury pollution in Hengshuihu wetland ecosystem. The results showed that: the total mercury content in Hengshuihu wetland atmosphere ranged from 1.0 to 5.0 ng · m⁻³, with an average of (2.9 ± 0.85) ng · m⁻³; the total mercury content in water surface ranged from 0.010 to 0.57 µg · L⁻¹, with the average value of (0.081 ± 0.053) µg · L⁻¹; the total mercury content in soil/sediment ranged from 0.001 0 to 0.058 mg · kg⁻¹, with an average of (0.027 ± 0.013) mg · kg⁻¹. The distribution features of total mercury in Hengshuihu wetland were as follows: the total mercury concentration in surface water of the shore was significantly higher than that in the center (P < 0.05), but the total mercury concentration of sediments in the center of the lake was significantly higher than that at the shore (P < 0.05); the total mercury in the soil of shore had a consistent trend with that in the atmosphere; high concentrations of total mercury pollution were accompanied by severe human activities. The geoaccumulation index showed that mercury pollution in Hengshuihu wetland was at clean level; potential ecological risk index showed mercury contamination had a low ecological risk in Hengshuihu wetland.

[Effect of promoter polymorphism of organic cation transporter OCTN1/2 on the susceptibility to Crohns disease: a Meta-analysis].

OBJECTIVE: To investigate the associations between polymorphisms of organic cation transporter OCTN1/2 (organic cation transporter 1/2) and the susceptibility of Crohn's disease (CD) through a meta-analysis. METHODS: Databases of PubMed, EMBASE, MedLine, and CNKI (Chinese), Wanfang (Chinese) were searched for published case control studies on the association between polymorphisms of OCTN1/2 gene and the susceptibility of CD which were published before September 2012. The meta-analysis was applied with Review Manager 4.2 software and Stata 10.0 software. RESULTS: Nineteen eligible studies, including 14 from Europeans, 3 from Asians, 1 from Oceania, and 1 from the US were included in the meta-analysis. In total, significant associations were found between OCTN1/2 polymorphisms and the susceptibility of CD for all genetic models. In subgroup analyses, significant associations were found in the European population for OCTN1/2. Associations were not significant in the non-European population for OCTN1 (TT vs. CT: OR = 1.25, 95%CI: 0.75 - 1.98, P = 0.34; TT vs. CC + CT: OR = 1.48, 95%CI: 0.95 - 2.29, P = 0.08) and for OCTN2 (CC vs. GC: OR = 1.03, 95%CI: 0.68 - 1.56, P = 0.89; CC vs. GG + GC: OR = 1.23, 95%CI: 0.83 - 1.82, P = 0.31). However, there were significant associations found between OCTN1/2 (TT vs. CC, TT + CT vs. CC, CC vs. GG, CC + GC vs. GG) polymorphisms and the susceptibility of CD found in the non-European population. CONCLUSION: Results from this meta-analysis suggested that OCTN1/2 polymorphisms were associated with the susceptibility of CD in the European population. Associations between OCTN1/2 polymorphisms and the susceptibility of CD in the non-European population required searching for large samples to confirm the findings.

[Influence of central obesity on clustering of other risk variables on metabolic syndrome among adults with normal body mass index].

OBJECTIVE: To study the influence of central obesity on clustering of other metabolic syndrome (MS) risk variables among adults with normal body mass index. METHODS: Through cluster multistage and random sampling methods, local people aged>35 years old with normal body mass index (BMI=18.5-24.9 kg/m2) in Lanxi country were selected. Overnight fasting blood specimens of these people were collected. Chi-square test, analysis of covariance, and logistic regression analyses were performed. RESULTS: (1) 1821 residents were surveyed including 844 male and 977 female subjects. The overall prevalence of MS was 8.68% and the overall prevalence of central obesity was 15.87%. Both prevalence rates of the two diseases appeared to be lower in males than in females (MS: 3.32% vs. 13.31%; center obesity: 5.57% vs. 24.77%, all P<0.001). (2) The overall positive rate of clustering on other MS risk variable was 36.02%, with 34.12% in males and 37.67% in females. Comparing the subjects who did not have central obesity, those subjects wth central obesity had higher positive rate in other MS risk variables. (3) Data from analysis of covariance showed that the level of waist circumference appeared an upward trend along with the count of other MS risk variables (all P<0.001). (4) Data from multivariable logistic regression analysis showed that central obesity was a risk factor on clustering of other MS risk variables. CONCLUSION: Control the level of waist circumference among normal body mass index was an effective method in preventing metabolic syndrome and cardiovascular disease in adults.