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OBJECTIVE: To compare oncologic outcomes after laparoscopic or laparotomic surgery to treat epithelial ovarian carcinoma in FIGO stage I. DESIGN: Retrospective cohort study. SETTING: Gynecological cancer ward in a tertiary hospital. PARTICIPANTS: A total of 85 patients with FIGO stage I epithelial ovarian carcinoma who underwent laparoscopic staging surgery and 206 who underwent laparotomic staging surgery at West China Second Hospital, Sichuan University (Chengdu, China) between January 1, 2013 and December 31, 2019. INTERVENTIONS: laparoscopic surgery or laparotomic staging surgery. RESULTS: Before propensity score-based matching, the laparotomy group showed higher prevalence of preoperative elevated CA125 level (48.5% vs 35.3%, pâ¯=â¯.045) and tumors > 15 cm (27.2% vs 5.9%, p < .001). Multivariate analysis associated higher body mass index with better overall survival (adjusted HR 0.83, 95%CI 0.70-0.99, pâ¯=â¯.043). Among propensity score-matched patients (82 per group) who were matched to each other according to propensity scoring based on age, body mass index, CA125 level, largest tumor diameter, FIGO stage, history of abdominal surgery, and American Society of Anesthesiologists grade, the rate of progression-free survival at 5 years was similar between the laparoscopy group (87.1%, 95%CI 79.3-95.7%) and the laparotomy group (90.9%, 95%CI 84.7-97.6%, pâ¯=â¯.524), as was the rate of overall survival at 5 years (93.9%, 95%CI 88.0-100.0% vs 94.7%, 95%CI 89.8-99.9%, pâ¯=â¯.900). Regardless of whether patients were matched, the two groups showed similar rates of recurrence of 9-11% during follow-up lasting a median of 54.9 months. CONCLUSIONS: Rates of recurrence and survival may be similar between laparoscopy or laparotomy to treat stage I epithelial ovarian cancer. Since laparoscopy is associated with less bleeding and faster recovery, it may be a safe, effective alternative to laparotomy for appropriate patients.
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Background: Silicosis shows an increasing trend with the development of new industries. However, the potential biomarkers for predicting the disease severity are lacking. A novel inflammatory marker, the systemic immune-inflammation Index (SII), has not been studied in silicosis. Methods: In this retrospective study, we used data from a big database platform of a tertiary general hospital in Beijing, which was established based on the electronic medical records of the hospital. The clinical data of adult patients diagnosed with silicosis at the Department of Occupational Medicine and Toxicology from 2013 to 2022 were collected. The data extracted from the database were in de-identified form. Only patients with a first diagnosis of silicosis and without conditions that might affect the parameters of routine blood tests were included in the analysis. Analyses were performed to assess the relationship between SII and the advanced stage of silicosis. Results: A total of 246 participants were included in the study. Most of the patients were exposed to silica particles during excavation and digging (n = 149, 60.6%). SII level was significantly higher in patients with advanced stages of silicosis. A multivariate logistic regression analysis revealed that a higher SII level was associated with the advanced stage of silicosis [odds ratio (OR) = 1.002; 95% confidence interval (CI): 1.000-1.003, p < 0.001] after adjusting for all covariates. The best cutoff value of SII was 444.1. The results of the subgroup analysis also showed a significant correlation between SII level over 444.1 and the advanced stage of silicosis in groups stratified by gender, history of smoking, and duration of silica exposure. Moreover, our results showed a significant but weak negative correlation between the level of SII and some lung function parameters in silicosis. Conclusion: Higher SII is associated with the advanced stage of silicosis and impaired lung function. More long-term, large-scale studies are needed to confirm these findings.
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OBJECTIVE: To compare recurrence and survival in patients with stage III endometrial cancer after radical surgery, followed by either adjuvant chemoradiotherapy (ACR) or adjuvant chemotherapy (AC). METHODS: We searched for relevant studies in PubMed Central, Embase and the Cochrane Central Register of Controlled Trials. Data were pooled on rates of recurrence as well as rates of progression-free, disease-free and overall survival. Heterogeneity was evaluated using the I2 test. Subgroup and sensitivity analyses were performed to identify potential sources of heterogeneity. RESULTS: Data from 18,375 patients in 15 retrospective studies and one randomized controlled trial were meta-analyzed. Compared to the AC group, the ACR showed significantly lower risk of local recurrence (OR 0.43, 95%CI 0.32-0.59) and total recurrence (OR 0.72, 95%CI 0.58-0.89). ACR was also associated with significantly better overall survival (HR 0.66, 95%CI 0.57-0.76), progression-free survival (HR 0.56, 95%CI 0.39-0.81) and disease-free survival (HR 0.66, 95%CI 0.53-0.83). CONCLUSIONS: Adding adjuvant radiotherapy to adjuvant chemotherapy after radical surgery may significantly reduce risk of local and overall recurrence, while significantly improving survival of patients with stage III endometrial cancer.
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Neoplasias do Endométrio , Feminino , Humanos , Estudos Retrospectivos , Estadiamento de Neoplasias , Neoplasias do Endométrio/cirurgia , Neoplasias do Endométrio/tratamento farmacológico , Quimioterapia Adjuvante , Quimiorradioterapia Adjuvante , Quimiorradioterapia , Radioterapia AdjuvanteRESUMO
In recent years, the Fenton-like (Fe2+-PMS/PS) advanced oxidation technology of persulfate activated by ferrous ions has been increasingly developed, but the difficulty of Fe3+ reduction, which stops the reaction, still restricts its large-scale application. In this study, it was found that when some organic compounds represented by bisphenol A (BPA) were mixed with Fe3+ and pristine TiO2, some surface structures could broaden the light response range of TiO2, capture visible light, and transfer the photoelectrons to Fe3+ through TiO2 for reduction, so as to achieve an infinite cycle of Fe3+/Fe2+. According to the above principle, a BPA-TiO2-Fe3+-PS composite system under visible light was constructed to degrade BPA, and its catalytic performance, catalytic mechanism, and influencing factors were discussed. The results showed that the system had outstanding catalytic performance, the degradation efficiency of BPA (50 mg·L-1) reached 93.1%, and the mineralization efficiency reached 70% within 60 min. At the same time, it verified that the system could reduce Fe3+ by the authigenic photoelectron of bisphenol A, and the steady-state concentration of Fe2+ obtained by 60 min reduction was 3.5 µmol·L-1. The main active oxidizing species in the system were sulfate radicals (SO4-[KG-*2/3]·) and hydroxyl radicals (·OH), of which the contribution rate of·OH was more than 60%. An appropriate increase in TiO2, Fe3+, and PS dosage and light intensity could improve the degradation effect. The system had the best treatment efficiency under weak acid conditions, and the degradation efficiency reached 96.5%. It also had a good effect under neutral conditions. CO32-, H2PO4-, and SO42- had a certain inhibitory effect on the system.
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Compostos Benzidrílicos , Poluentes Químicos da Água , Catálise , Ferro , Oxirredução , FenóisRESUMO
Actual domestic sewage has a complex composition and relatively low carbon and nitrogen content. Anaerobic plug-flow influent can enhance the utilization of COD by aerobic granular sludge by providing a locally high concentration of substrate. In this study, intermittent aeration was used to cultivate aerobic granular sludge in a sequencing batch reactor (SBR), and actual domestic sewage was used as the feed water to inoculate the sewage plant sludge. In the R1 experiment, rapid anaerobic feeding was adopted, while in R2, anaerobic plug-flow feeding was adopted, to explore the impact of different feeding modes on the aerobic granular sludge system of domestic sewage. Under rapid anaerobic feeding in R1, the particle structure appeared earlier, but particle breakage occurred after 71 days of operation; the particle structure generated in R2 was denser than that of R1, the particle surfaces were smoother, and the denitrifying phosphorous accumulating organisms (DPAO) had a more enriching effect. In the final R1 and R2 reactors, the proportion of DPAO to phosphorous accumulating organisms (PAO) was 14.17% and 22.07%, respectively. The results show that the anaerobic plug-flow feeding mode can enhance the use of influent COD by granular sludge, which is conducive to enriching DPAO, generating denser and more stable particles, realizing "one carbon dual purpose" operation, and removing more nitrogen and phosphorus.
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Nitrificação , Esgotos , Anaerobiose , Reatores Biológicos , FósforoRESUMO
SBR reactors R1 and R2 were used to inoculate activated sludge from a sewage treatment plant, and domestic sewage was used as the influent. The operation was carried out using a single and multiple influent-aeration operation strategy, respectively, and the particle size change and removal effect during the operation was studied. The results show that R1 and R2 successfully achieved sludge granulation after 56 days and 39 days of operation, respectively. The concentrations (mg·L-1) of chemical oxygen demand, total nitrogen, and total phosphorus (TP) in the effluent of R1 and R2 after stable operation were 29.7, 13.7, 0.31, 19.2, 8.1, and 0.37, respectively. The removal rates were respectively 87.7%, 75.6%, 95.1%, and 90.1%, 85.6%, and 94.2%, and the average particle size of the particles reached 740 µm for R1 and 791 µm for R2. The results showed that for the same running time, the effluent NO3--N concentration and TP concentration in R2 were lower than those in R1. In the later stage of operation, the ratio of denitrifying phosphorus-accumulating organisms (DPAO) to total phosphorus-accumulating organisms (PAOs) in R1 and R2 increased from an initial 11.17% to 25.47% and 34.08%, respectively. Compared with the one influent-aeration operation strategy, the multiple influent-aeration operation strategy had a lower concentration of NO3--N in the initial stage of the startup, the PAOs received less impact, the DPAO enrichment was better, the phosphorus removal performance was better, and it helped to form aerobic granular sludge.
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To initiate the domestic sewage aerobic granular sludge (AGS) process, the experiment is operated by intermittent influent-effluent aeration to reduce the concentration of nitrate and the inhibition of PAO, and realize granulation by phosphate precipitation and positive electricity particles generated during phosphorus removal. The sludge from a sewage treatment plant is inoculated into the SBR reactors R1, R2, R3, and R4, for durations of 30, 60, 90, and 120 min total anaerobic time. This was used to study the effect of anaerobic time on the aerobic granular sludge system in domestic sewage. The experiment shows that reactors R1, R2, R3, and R4 are started successfully with 56, 48, 39, and 35 days, respectively. After 105 days of the operation, the respective average particle sizes reached 750, 764, 791, and 650 µm. During the operational period, at the 43rd and 47th day, phosphorus removal performance deteriorated in R1 and R2, and it recovered after the anaerobic time was extended to 90 min. The effect of nitrogen and phosphorus removal in R3 is good; at the 63-77 day the granular sludge in R4 disintegrates, and the effect of nitrogen and phosphorus removal and DPAO enrichment is decreased. During the later stage of operation, the effluent in R1, R2, R3, and R4 reaches the IA standard of the discharge standard of pollutants for municipal wastewater treatment plant. The results show that a long anaerobic time can quickly achieve granulation, however the particles easily disintegrate during a long-term operation. Longer anaerobic time can reduce the inhibition of phosphorus accumulating organisms release phosphorus by nitrate, help enrich DPAO, and obtain a better nitrogen and phosphorus removal effect.
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Ulcerative colitis (UC), a chronic inflammatory disease affecting the colon, has a rising incidence worldwide. The known pathogenesis is multifactorial and involves genetic predisposition, epithelial barrier defects, dysregulated immune responses, and environmental factors. Nowadays, the drugs for UC include 5-aminosalicylic acid, steroids, and immunosuppressants. Long-term use of these drugs, however, may cause several side effects, such as hepatic and renal toxicity, drug resistance and allergic reactions. Moreover, the use of traditional Chinese medicine (TCM) in the treatment of UC shows significantly positive effects, low recurrence rate, few side effects and other obvious advantages. This paper summarizes several kinds of active compounds used in the experimental research of anti-UC effects extracted from TCM, mainly including flavonoids, acids, terpenoids, phenols, alkaloids, quinones, and bile acids from some animal medicines. It is found that the anti-UC activities are mainly focused on targeting inflammation or oxidative stress, which is associated with increasing the levels of anti-inflammatory cytokine (IL-4, IL-10, SOD), suppressing the levels of pro-inflammatory cytokines (TNF-α, IL-1ß, IL-6, IL-8, IL-23, NF-κB, NO), reducing the activity of MPO, MDA, IFN-γ, and iNOS. This review may offer valuable reference for UC-related studies on the compounds from natural medicines.
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Colite Ulcerativa/tratamento farmacológico , Medicamentos de Ervas Chinesas/química , Medicamentos de Ervas Chinesas/uso terapêutico , Medicina Tradicional Chinesa , Animais , Colite Ulcerativa/patologia , Citocinas/metabolismo , Modelos Animais de Doenças , Medicamentos de Ervas Chinesas/farmacologia , Humanos , Inflamação/tratamento farmacológico , Inflamação/metabolismo , Estresse Oxidativo/efeitos dos fármacos , Compostos Fitoquímicos/farmacologiaRESUMO
Background: MRE11 plays an important role in DNA damage response for the maintenance of genome stability, and is becoming a prognostic marker for cancers, including colorectal cancer (CRC). However, the correlations of MRE11 to prognosis and tumor-infiltrating inflammatory cells (TIICs) in different locations of CRC remains unclear. Methods: Among Swedish and TCGA-COREAD patients, we investigated the association of MRE11 expression, tumor-infiltrating inflammatory cells (TIICs) and microsatellite status with survival in right-sided colon cancer (RSCC) and left-sided colon and rectal cancer (LSCRC). The signaling of MRE11-related was further analyzed using weighted gene co-expression network analysis and ClueGO. Results: High MRE11 expression alone or combination of high MRE11 expression with high TIICs was related to favorable prognosis in LSCRC. Moreover, high MRE11 expression was associated with favorable prognosis in LSCRC with microsatellite stability. The relationships above were adjusted for tumor stage, differentiation, and/or TIICs. However, no such evidence was observed in RSCC. Several signaling pathways involving MRE11 were found to be associated with cell cycle and DNA repair in RSCC and LSCRC, whereas, the activation of the immune response and necrotic cell death were specifically correlated with LSCRC. Conclusions: High MRE11 expression is an independent prognostic marker in LSCRC and enhanced prognostic potency of combining high MRE11 with high TIICs in LSCRC, mainly due to differential immune signaling activated by MRE11 in RSCC and LSCRC, respectively.