Transient dataset of household appliances with Intensive switching events.

With the development of Non-Intrusive Load Monitoring (NILM), it has become feasible to perform device identification, energy consumption decomposition, and load switching detection using Deep Learning (DL) methods. Similar to other machine learning problems, the research and validation of NILM necessitate substantial data support. Moreover, different regions exhibit distinct characteristics in their electricity environments. Therefore, there is a need to provide open datasets tailored to different regions. In this paper, we introduce the Transient Dataset of Household Appliances with Intensive Switching Events (TDHA25). This dataset comprises switch instantaneous data from 10 typical household appliances in China. The TDHA dataset features a high sampling rate, accurate labelling, and realistic representation of actual appliance start-up waveforms. Additionally, appliance switching is achieved through precise control of relay switches, thus mitigating interference caused by mechanical switches. By furnishing such a dataset, we aim not only to enhance the recognition accuracy of existing NILM algorithms but also to facilitate the application of NILM algorithms in regions sharing similar electricity consumption characteristics to those of China.

DDX3X interacts with SIRT7 to promote PD-L1 expression to facilitate PDAC progression.

Pancreatic ductal adenocarcinoma (PDAC) is recognized as the most aggressive and fatal malignancy. A previous study reported that PDAC patients who exhibit elevated levels of DDX3X have a poor prognosis and low overall survival rate. However, the underlying molecular mechanism remains unclear. This study aimed to investigate the specific roles of DDX3X in PDAC. Multiple bioinformatics analyses were used to evaluate DDX3X expression and its potential role in PDAC. In vitro and in vivo studies were performed to assess the effects of DDX3X on PDAC cell growth. Furthermore, Western blotting, quantitative PCR, immunohistochemistry, immunofluorescence, mass spectrometry, coimmunoprecipitation and multiplexed immunohistochemical staining were conducted to identify the specific regulatory mechanism in PDAC. The results verified that DDX3X expression is notably upregulated in the tumor tissue vs. normal tissue of PDAC patients. DDX3X knockdown markedly suppressed the proliferation, invasion and migration of PDAC cells in vitro and inhibited tumor growth in vivo. Conversely, overexpression of DDX3X induced the opposite effect. Further studies supported that the DDX3X protein can associate with sirtuin 7 (SIRT7) to stimulate PDAC carcinogenesis and progression. Furthermore, SIRT7 inhibition significantly impeded DDX3X-mediated tumor growth both ex vivo and in vivo. The results also revealed that programmed death ligand 1 (PD-L1) expression is positively correlated with DDX3X expression. These results reveal significant involvement of the DDX3X-SIRT7 axis in the initiation and advancement of PDAC and offer previously undiscovered therapeutic options for PDAC management.

Repositioning baloxavir marboxil as VISTA agonist that ameliorates experimental asthma.

V-type immunoglobulin domain-containing suppressor of T-cell activation (VISTA), a novel negative checkpoint regulator, plays an essential role in allergic pulmonary inflammation in mice. Treatment with a VISTA agonistic antibody could significantly improve asthma symptoms. Thus, for allergic asthma treatment, VISTA targeting may be a compelling approach. In this study, we examined the functional mechanism of VISTA in allergic pulmonary inflammation and screened the FDA-approved drugs for VISTA agonists. By using mass cytometry (CyTOF), we found that VISTA deficiency primarily increased lung macrophage infiltration in the OVA-induced asthma model, accompanied by an increased proportion of M1 macrophages (CD11b+F4/80+CD86+) and a decreased proportion of M2 macrophages (CD11b+F4/80+CD206+). Further in vitro studies showed that VISTA deficiency promoted M1 polarization and inhibited M2 polarization of bone marrow-derived macrophages (BMDMs). Importantly, we discovered baloxavir marboxil (BXM) as a VISTA agonist by virtual screening of FDA-approved drugs. The surface plasmon resonance (SPR) assays revealed that BXM (KD = 1.07 µM) as well as its active form, baloxavir acid (BXA) (KD = 0.21 µM), could directly bind to VISTA with high affinity. Notably, treatment with BXM significantly ameliorated asthma symptoms, including less lung inflammation, mucus secretion, and the generation of Th2 cytokines (IL-5, IL-13, and IL-4), which were dramatically attenuated by anti-VISTA monoclonal antibody treatment. BXM administration also reduced the pulmonary infiltration of M1 macrophages and raised M2 macrophages. Collectively, our study indicates that VISTA regulates pulmonary inflammation in allergic asthma by regulating macrophage polarization and baloxavir marboxil, and an old drug might be a new treatment for allergic asthma through targeting VISTA.

Development of Chinese food picture library for inducing food cravings.

Cue-induced food cravings are strong desires directed toward specific foods, usually ones with high caloric content, and can lead to overeating. However, although food cravings vary according to individual preferences for specific high-calorie food subtypes, a structured library of food craving-inducing pictures including multiple categories of high-calorie foods does not yet exist. Here, we developed and validated a picture library of Chinese foods (PLCF) consisting of five subtypes of high-calorie foods (i.e., sweets, starches, salty foods, fatty foods, and sugary drinks) to allow for more nuanced future investigations in food craving research, particularly in Chinese cultural contexts. We collected 100 food images representing these five subtypes, with four food items per subtype depicted in five high-resolution photographs each. We recruited 241 individuals with overweight or obesity to rate the food pictures based on craving, familiarity, valence, and arousal dimensions. Of these participants, 213 reported the severity of problematic eating behaviors as a clinical characteristic. Under the condition of mixing multiple subtypes of high-calorie foods, we did not observe significant differences in craving ratings for high- and low-calorie food images (p tukey > 0.05). Then, we compared each subtype of high-calorie food images to low-calorie ones, and found craving ratings were greater for the images of salty foods and sugary drinks (ps < 0.05). Furthermore, we conducted a subgroup analysis of individuals according to whether they did or did not meet the criteria for food addiction (FA) and found that greater cravings induced by the images of high-calorie food subtypes (i.e., salty foods and sugary drinks) only appeared in the subgroup that met the FA criteria. The results show that the PLCF is practical for investigating food cravings.

Convex Temporal Convolutional Network-Based Distributed Cooperative Learning Control for Multiagent Systems.

Due to its great efficiency, scalability, and inclusivity, distributed cooperative learning control has gotten a lot of attention. For complex uncertain multiagent systems, it is challenging to model the uncertainties and exploit the cooperative learning ability of the systems. To address these issues, we proposed a novel convex temporal convolutional network-based distributed cooperative learning control for uncertain discrete-time nonlinear multiagent systems. A new concept of using a convex temporal convolutional network (CTCNet) is proposed for estimating the uncertain agent dynamics in a cooperative way. Unlike previous methods that require adjustment of network weights for different control tasks, the proposed CTCNet can map the high-dimensional input-output space into a deep space spanned by basis features that represent the inherent properties of the system, so it has good robustness for different tasks. Consequently, to improve the control performance, a CTCNet-based distributed cooperative learning control method that shares learned knowledge through the communication topology among adaptive laws of CTCNet is proposed. Furthermore, the asymptotic convergence of system tracking errors to an arbitrarily small neighborhood of the origin is strictly proved. Finally, the simulation results are given to illustrate that our suggested method has higher control accuracy, stronger robustness, and anti-interference ability than the existing methods.

Functional evaluation of the insulin/insulin-like growth factor signaling pathway in determination of wing polyphenism in pea aphid.

Wing polyphenism is a common phenomenon that plays key roles in environmental adaptation of insects. Insulin/insulin-like growth factor signaling (IIS) pathway is a highly conserved pathway in regulation of metabolism, development, and growth in metazoans. It has been reported that IIS is required for switching of wing morph in brown planthopper via regulating the development of the wing pad. However, it remains elusive whether and how IIS pathway regulates transgenerational wing dimorphism in aphid. In this study, we found that pairing and solitary treatments can induce pea aphids to produce high and low percentage winged offspring, respectively. The expression level of ILP5 (insulin-like peptide 5) in maternal head was significantly higher upon solitary treatment in comparison with pairing, while silencing of ILP5 caused no obvious change in the winged offspring ratio. RNA interference-mediated knockdown of FoxO (Forkhead transcription factor subgroup O) in stage 20 embryos significantly increased the winged offspring ratio. The results of pharmacological and quantitative polymerase chain reaction experiments showed that the embryonic insulin receptors may not be involved in wing polyphenism. Additionally, ILP4 and ILP11 exhibited higher expression levels in 1st wingless offspring than in winged offspring. We demonstrate that FoxO negatively regulates the wing morph development in embryos. ILPs may regulate aphid wing polyphenism in a developmental stage-specific manner. However, the regulation may be not mediated by the canonical IIS pathway. The findings advance our understanding of IIS pathway in insect transgenerational wing polyphenism.

Neuroimaging and neuroendocrine insights into food cravings and appetite interventions in obesity.

This article reviews the previous studies on the distinction between food cravings and appetite, and how they are regulated by hormones and reflected in brain activity. Based on existing research, food cravings are defined as individual preferences influenced by hormones and psychological factors, which differ from appetite, as they are not necessarily related to hunger or nutritional needs. The article also evaluates the neuroimaging findings about food cravings, and interventions to reduce food cravings, such as mindfulness training, alternative sweeteners, non-invasive brain stimulation techniques, cognitive-behavioral therapy, and imaginal retraining, and points out their advantages, disadvantages, and limitations. Furthermore, the article delves into the potential future directions in the field, emphasizing the need for a neuroendocrine perspective, considerations for associated psychiatric disorders, innovative clinical interventions, and emerging therapeutic frontiers in obesity management. The article outlines the neuro-endocrine basis of food cravings, including ghrelin, leptin, melanocortin, oxytocin, glucagon-like peptide-1, baclofen, and other hormones and their brain regions of action. The article argues that food cravings are an important target for obesity, and more research is needed to explore their complex characteristics and mechanisms, and how to effectively interact with their neuro-endocrine pathways. The article provides a new perspective and approach to the prevention and treatment of obesity.

Synthesis and Characterization of Anatase TiO2 Microspheres Self-Assembled by Ultrathin Nanosheets.

In this paper, we report a novel anCd simple method for synthesizing the microspheres self-assembled from ultrathin anatase TiO2 nanosheets with a high percentage of (001) facets via the hydrolysis process of the single-reagent (potassium fluorotitanate). We then used optical microscopy, scanning electron microscopy, and high-resolution confocal laser Raman spectroscopy to characterize the microspheres generated under different conditions. The study found that the size of the anatase TiO2 microspheres synthesized was 0.5-3 µm. As the synthesis time increased, the corroded surface of the microspheres gradually increased, resulting in the gradual disappearance of the edges and corners of the anatase nanosheets. The exposure percentage of the (001) facets of ultrathin anatase nanosheets synthesized for 2 h at 180-200 °C are close to 100%. The microsphere whose surface is completely covered by these anatase nanosheets also has nearly 100% exposed (001) facets. This new anatase nanosheet-based self-assembled microsphere will have great application potential in pollution prevention, environmental protection, and energy fields.

The RNA-binding protein RBM47 inhibits non-small cell lung carcinoma metastasis through modulation of AXIN1 mRNA stability and Wnt/ß-catentin signaling.

BACKGROUND: Non-small-cell lung cancer (NSCLC) remains a highly prevalent and deadly form of cancer, with efforts to better understand the molecular basis of the progression of this disease being essential to its effective treatment. Several recent studies have highlighted the ability of RNA-binding proteins (RBPs) to regulate a wide range of cellular processes in both healthy and pathogenic contexts. Among these RBPs, RNA binding motif protein 47 (RBM47) has recently been identified as a tumor suppressor in both breast and colon cancers, whereas its role in NSCLC is poorly understood. METHODS: RBM47 expression in NSCLC samples was evaluated by RT-PCR, western blotting and immunohistochemistry analysis. Molecular and cellular techniques including lentiviral vector-mediated knockdown were used to elucidate the functions and mechanisms of RBM47. RESULTS: This study sought to analyze the expression and role of RBM47 in NSCLC. In the present study, we observed reduced levels of RBM47 expression in NSCLC, with these reductions corresponding to a poorer prognosis and more advanced disease including a higher TNM stage (p = 0.022), a higher likelihood of tumor thrombus (p = 0.001), and pleural invasion (p = 0.033). Through functional analyses in vitro and in vivo, we further demonstrated that these RBP was able to disrupt the proliferation, migration, and invasion of NSCLC cells. At a molecular level, we determined that RBM47 was able to bind the AXIN1 mRNA, stabilizing it and thereby enhancing the consequent suppression of Wnt/ß-catentin signaling. CONCLUSION: Together our findings reveal that RBM47 targets AXIN1 in order to disrupt Wnt/ß-catenin signaling in NSCLC and thereby disrupting tumor progression. These results thus offer new insights into the molecular biology of NSCLC, and suggest that RBM47 may also have value as a prognostic biomarker and/or therapeutic target in NSCLC patients.

Expression and clinical significance of p75NTR in esophageal squamous cell carcinoma.

Objectives: To analyze the expression and clinical significance of p75NTR in esophageal squamous cell carcinoma. Methods: Sixty patients with esophageal squamous cell carcinoma who underwent surgical resection in our hospital between January 2017 and January 2018 were selected as the study subjects. The content of the study was in accordance with medical ethics and approved by the medical ethics committee, and patients understood and signed an informed consent form. The clinical data of all patients were analyzed retrospectively. The positive rate of p75NTR in lymph node metastasis-positive patients, lymph node metastasis-negative patients and patients with invasion of the muscle layer was detected and statistically analyzed. Results: Lymph node metastasis-positive patients had a p75NTR-positive rate of 100.00% (30/30), which was significantly higher than that of lymph node metastasis-negative patients (20.00% (6/30)) (P < 0.05) The p75NTR-positive rate in patients with infiltration of the muscular layer was 73.33% (20/30), which was significantly higher than that of patients with infiltration of the whole layer (43.33% (13/30) (P < 0.05). Conclusions: The high expression of p75NTR in esophageal squamous cell carcinoma tissue can indicate the invasion depth of the cancerous tissue and lymph node metastasis, and the clinical introduction of the p75NTR index can be the basis for an effective prognosis prediction in patients with esophageal squamous cell carcinoma.

C188-9, a small-molecule STAT3 inhibitor, exerts an antitumor effect on head and neck squamous cell carcinoma.

Abnormal activation of signal transducer and activator of transcription 3 (STAT3) is complicated in the tumor progression of multiple cancers including human head and neck squamous cell carcinoma (HNSCC) and, therefore, serves as a potent therapeutic target. In this study, we identify that C188-9, a small-molecule STAT3 inhibitor, exhibits an antitumor effect on HNSCC in vitro. C188-9 significantly inhibits cell growth, arrests cell cycle at G0/G1 phase, and induces apoptosis in HNSCC. Besides, the capacities of migration and invasion of HNSCC cells are impaired with the exposure to C188-9. In addition, C188-9 treatment enhanced the chemosensitivity of HNSCC cellsin vitro. Moreover, C188-9 inactivates STAT3 by reducing its phosphorylation at Tyr705. Taken together, these results indicate that C188-9 could be a promising therapeutic strategy for patients suffered from HNSCC by suppressing the STAT3 pathway.

A prediction model for lymph node metastasis in T1 esophageal squamous cell carcinoma.

BACKGROUND: Endoscopic resection is widely used for the treatment of T1 esophageal cancer, but it cannot be used to treat lymph node metastasis (LNM). This study aimed to develop a prediction model for LNM in patients with T1 esophageal squamous cell carcinoma. METHODS: A prospectively maintained database of all patients who underwent surgery for esophageal cancer between January 2002 and June 2010 was retrospectively reviewed, and patients with T1 squamous cell carcinoma were included in this study. Correlations between LNM and clinicopathological variables were evaluated using univariable and multivariable logistic regression analyses. The penalized maximum likelihood method was used to estimate regression coefficients. A prediction model was developed and internally validated using a bootstrap resampling method. Model performance was evaluated in terms of calibration, discrimination, and clinical usefulness. RESULTS: A total of 240 patients (197 male, 43 female) with a mean age of 57.9 years (standard deviation ± 8.3 years) were included in the analysis. The incidence of LNM was 16.3%. The prediction model consisted of four variables: grade, T1 stage, tumor location and tumor length. The model showed good calibration and good discrimination with a C-index of 0.787 (95% confidence interval [CI], 0.711-0.863). After internal validation, the optimism-corrected C-index was 0.762 (95% CI, 0.686-0.838). Decision curve analysis demonstrated that the prediction model was clinically useful. CONCLUSIONS: Our prediction model can facilitate individualized prediction of LNM in patients with T1 esophageal squamous cell carcinoma. This model can aid surgical decision making in patients who have undergone endoscopic resection.

Effects of ulinastatin slow flow and no reflow phenomenon during emergency percutaneous coronary artery intervention / 中国介入心脏病学杂志

Objective To study the effect of ulinastatin on no reflow or slow flow in the infarct related artery in patient with acute ST-elevation myocardial infarction (STEMI) undergoing emergency percutaneous coronary interventional therapy (PCI).Methods 180 STEMI patients were divided into the control group (n=100) and the ulinastatin treatment group (n=80).The control group received conventional PCI treatment and the treatment group received conventional PCI treatment plus ulinastatin. The level of serum inflammatory factors IL-6,IL-10,superoxide converting enzyme,the infarct related coronary artery reperfusion TIMI flow grade (TFG) and myocardial perfusion grade (TMPG),the results of postoperative cardiac ultrasound examination and clinical outcomes were compared between the two groups.Results Compared with the control group,the level of IL-6 was decreased,while the levels of IL-10 and superoxide converting enzyme were increased significantly in the ulinastatin treatment group(P<0.05).The TFG and TMPG of the infarct related vessels were increased significantly in the ulinastatin treatment group. The left ventricular end diastolic diameter[(54.6 ± 5.2 mm vs. (50.4±4.6) mm,P=0.046)]and left ventricular ejection fraction [(58.4±10.2) % vs. (62.2±9.8) % P=0.048] showed statistical difference between the two groups.Compared to the control,the major cardiovascular event rate of the treatment group during hospitalization (1% vs. 5%, P=0.038), after one month (1.2% vs. 3%,P=0.046) and 6 months (3% vs 12%,P=0.018) were all significantly lower .There was no significant difference in mortality between the 2 groups.Conclusion Ulinastatin may lower the incidence of no flow and slow flow after emergency PCI,improve heart function and the lower the rates of MACE.

Effects of ulinastatin slow flow and no reflow phenomenon during emergency percutaneous coronary artery intervention / 中国介入心脏病学杂志

Objective To study the effect of ulinastatin on no reflow or slow flow in the infarct related artery in patient with acute ST-elevation myocardial infarction (STEMI) undergoing emergency percutaneous coronary interventional therapy (PCI).Methods 180 STEMI patients were divided into the control group (n=100) and the ulinastatin treatment group (n=80).The control group received conventional PCI treatment and the treatment group received conventional PCI treatment plus ulinastatin. The level of serum inflammatory factors IL-6,IL-10,superoxide converting enzyme,the infarct related coronary artery reperfusion TIMI flow grade (TFG) and myocardial perfusion grade (TMPG),the results of postoperative cardiac ultrasound examination and clinical outcomes were compared between the two groups.Results Compared with the control group,the level of IL-6 was decreased,while the levels of IL-10 and superoxide converting enzyme were increased significantly in the ulinastatin treatment group(P<0.05).The TFG and TMPG of the infarct related vessels were increased significantly in the ulinastatin treatment group. The left ventricular end diastolic diameter[(54.6 ± 5.2 mm vs. (50.4±4.6) mm,P=0.046)]and left ventricular ejection fraction [(58.4±10.2) % vs. (62.2±9.8) % P=0.048] showed statistical difference between the two groups.Compared to the control,the major cardiovascular event rate of the treatment group during hospitalization (1% vs. 5%, P=0.038), after one month (1.2% vs. 3%,P=0.046) and 6 months (3% vs 12%,P=0.018) were all significantly lower .There was no significant difference in mortality between the 2 groups.Conclusion Ulinastatin may lower the incidence of no flow and slow flow after emergency PCI,improve heart function and the lower the rates of MACE.

Expression of Human Epidermal Growth Factor Receptor-2 in Resected Rectal Cancer.

The addition of trastuzumab to chemotherapy was demonstrated to be beneficial for advanced human epidermal growth factor receptor-2 (HER-2) positive gastric cancer. However, the HER-2 status of rectal cancer remains uncertain. This study aimed to determine the HER-2 expression in a large multicenter cohort of rectal cancer patients. The clinical and pathological features of 717 patients were retrospectively reviewed. All the patients were diagnosed with primary rectal adenocarcinoma without distant metastasis and took surgery directly without any preoperative anticancer treatment. HER-2 status was assessed on resected samples. A total of 99 cases with IHC3+ and 16 cases with IHC 2+ plus gene amplification were determined as HER-2 positive. 22.6% of HER-2 positive patients had local recurrence, whereas 16.9% of HER-2 negative patients did (P = 0.146). HER-2 positive tumors were more likely to have distant metastasis (P = 0.007). Univariate analysis revealed that pathological tumor stage, pathological node stage, positive margin, and lymphovascular invasion were significantly correlated with 5-year disease-free survival (DFS) and 5-year overall survival (OS). The patients with >10 dissected lymph nodes showed significantly longer OS (P = 0.045) but not DFS (P = 0.054). HER-2 negative patients had significantly better 5-year DFS (P < 0.001) and 5-year OS (P = 0.013) than those of the HER-2 positive patients. In the subgroup analysis for the early rectal cancer and locally advanced rectal cancer, HER-2 was also a poor predictor for survival. Multivariate analysis revealed that HER-2 was an independent prognostic factor for 5-year DFS (hazard ratio [HR] = 1.919, 95% confidence interval [CI] 1.415-2.605, P < 0.001) and for 5-year OS (HR = 1.549, 95% CI 1.097-2.186, P = 0.013). When the treatment was included in the analysis for locally advanced patients, HER-2 was a prognostic factor for 5-year DFS (P = 0.001) but not for 5-year OS (P = 0.106). This study confirmed that HER-2 was expressed in a part of patients with rectal cancers and might be used as a negative predictor. The results may support the trials to assess the efficacy of trastuzumab in treating HER-2 positive rectal cancer patients.

[Effects of anti-survivin oligonucleotides on growth of peritoneally implanted ovarian cancer xenografts in nude mice].

OBJECTIVE: To observe the effect of anti-survivin oligonucleotides (ASODN) on the invasion and growth of peritoneally implanted ovarian cancer cell xenografts in nude mice. METHODS: Nude mouse models bearing peritoneally implanted ovarian cancer cell (SKOV3) xenografts were established and subjected to intraperitoneal injection of survivin ASODN or saline (control). The number and weight of the intraperitoneal xenografts were compared between the two groups.The expressions of interleukin (IL-6), signal transducer and activator of transcription3 (STAT3), phosphorylated STAT3 (p-STAT3), and survivin protein in the tumor tissues were detected with Western blotting in both groups. RESULTS: Compared with those in the control group, the number and weight of the intraperitoneal xenografts were significantly reduced in ASODN group (P<0.05). ASODN treatment also resulted in significantly lowered protein levels of IL-6, STAT3, p-STAT3, and survivin in the tumor tissues (P<0.05). CONCLUSION: Survivin ASODN can suppress the invasion and migration capacity of ovarian cancer cells and inhibit peritoneal metastasis of the tumor in nude mice possibly though down-regulation of IL-6/STAT3 signaling pathway.

Histological complete response to a combined docetaxel/cisplatin/fluorouracil neoadjuvant chemotherapy for T4 stage gastric adenocarcinoma.

Local advanced gastric carcinoma has a very poor prognosis. When a T4 gastric carcinoma has invaded the surrounding tissues and organs, curative resection is unlikely. We present here a case of a 63-year-old woman with a T4 unresectable gastric adenocarcinoma. She underwent two 3-week cycles of docetaxel/cisplatin/fluorouracil chemotherapy, followed by radical gastric resection. Each cycle consisted of 75 mg/m2 docetaxel and 75 mg/m2 cisplatin on day 1, and 200 mg/m2 leucovorin and 500 mg/m2 fluorouracil on days 1 through 5. The patient exhibited a complete histologic response. Our results indicate that docetaxel/cisplatin/fluorouracil neoadjuvant chemotherapy is a promising method of treatment for advanced gastric cancer.

[Reevaluating the role of dilation and curettage in the diagnosis of ectopic pregnancy].

OBJECTIVE: To evaluate the clinical role of dilation and curettage (DC) in the diagnosis of ectopic pregnancy (EP). METHODS: We retrospectively reviewed the clinical data of 108 patients with pregnancy of unknown location who underwent a DC with an abnormal rise in ß-human chorionic gonadotropin (ß-HCG) level and without visible intrauterine pregnancy (IUP) on transvaginal ultrasound and 24 patients who did not receive DC with ß-HCG>5 000 IU/L.The final diagnosis depended on ß-HCG trend review after DC and the pathologic and laparoscopic findings. RESULTS: Overall, 65.3% of the patients were finally diagnosed with EP and 34.7% were found to have a nonviable IUP.Those with EP had significantly higher initial ß-HCG than those with nonviable IUP.IUP patients were more likely to have had a history of delivery.Among the patients with ß-HCG<2 000 IU/L, 40.0% of EP and 11.0% of IUP had endometrial echo complex no more than 5 mm (P=0.035). In ß-HCG<2 000 IU/L and 2 000 IU/L<ß-HCG<5 000 IU/L groups, the diagnostic rate of EP was 42.6% and 68.3% respectively (P=0.012). Among the patients with ß-HCG>5 000 IU/L, there was no significant difference between those with DC and those without DC (96.7% vs.96%, P=0.915). CONCLUSIONS: Ultrasound findings such as a thin endometrial echo complex and the presence of pelvic mass are associated with but are not diagnostic of an ectopic pregnancy.The patients with the suspected diagnosis of EP are 2 000 IU/L<ß-HCG<5 000 IU/L, whereas DC remains important valuable to differentiate EP from nonviable IUP and to avoid misdiagnosis and unnecessary exposure to methotrexate. Because EP is the common final diagnosis in most of the patients with ß-HCG>5 000 IU/L and pelvic mass and without intrauterine gestational sac, the value of DC decreases and laparoscopy can be considered directly.

Factors associated with mortality risk for malignant colonic obstruction in elderly patients.

BACKGROUND: Acute colonic obstruction is the most common complication of colorectal cancer (CRC) in elderly patients. Medical treatment has been associated with higher perioperative morbidity and mortality rates. There is a need for identification of elderly CRC patients who will do poorly so that results can be improved. The purpose of this study is to assess the 30-day outcome of elderly patients undergoing malignant colonic obstruction procedures and identify the associated factors of mortality. METHODS: A review of 233 elderly patients who received medical procedures for malignant colonic obstruction between April 2000 and April 2012 was conducted. Data regarding clinical variables, surgical procedures and outcomes, complications, and mortality were studied. Univariate and logistic regression analyses were performed on mortality risk factors. RESULTS: Patients had a mean age of 78.2 years (range 70-95). A total of 126 (54.1%) patients were classified ASA III and above. Eighty (34.3%) patients had right-sided colonic obstruction. In the 153 (65.7%) patients with left-sided colonic obstruction, 40 patients received self-expandable metallic stent (SEMS) treatment and 193 patients received surgery. A total of 62.2% (n = 145) patients had post operation complications. The overall 30-day mortality was 24.5% (n = 57). ASA grading, peritonitis and Dukes staging were independent risk factors for mortality. CONCLUSIONS: Medical procedures in elderly patients with malignant colonic obstruction are associated with significant complications and mortality. Identifying these high-risk patients and treating promptly may improve outcomes. SEMS treatment provides a useful alternative to surgical intervention.

Prevalence, clinicopathological characteristics, treatment, and prognosis of intestinal metastasis of primary lung cancer: a comprehensive review.

AIM: Lung cancer is mostly diagnosed at the advanced stage of disease. This review focused on prevalence, clinicopathological characteristics, treatment, and prognosis of intestine metastasis of primary lung cancer. METHODS: Published literature was searched using PubMed/Medline databases to extract studies on primary lung cancer metastasized to the intestine and then analyzed statistically. RESULTS: A total of 57 case reports and 3 retrospective studies were obtained from PubMed database. The prevalence of small bowel metastasis of primary lung cancer ranged between 2.6 and 10.7%. Histologically, poor tumor differentiation and advanced T and N stages of primary lung cancer associated with intestinal metastasis. Clinically, primary lung cancer metastasized to the intestine led to three frequent clinical presentations, i.e., intestine perforation, obstruction, and bleeding. The time interval between diagnosis of primary tumor and manifestation of intestinal metastasis ranged between 2 week and 4 years, while the time was within one year for 36 reported cases. 70% (45 of 63 cases) of patients did have an extra-intestinal metastasis at diagnosis of intestine metastasis. The median survival rate of 79 patients with follow-up data was 2.3 month and the old age, extra-intestinal metastasis, and intestine perforation were associated with poor prognosis. CONCLUSION: This study suggests that the primary lung cancer metastasized to the small bowel is not so rare as it is thought. Clinical management and treatment decision will be warranted and considered accordingly.