Spinal metastases from non-small cell lung cancer - Is surgical extent enough by following suggestions of the Tomita and Tokuhashi scores?

BACKGROUND/OBJECTIVE: The Tomita, revised Tokuhashi and Tokuhashi lung scores are commonly used tools to predict the survival of patients with spinal metastases and to guide decisions regarding surgical treatment. These prognostic scores, however, tend to underestimate the prognosis of patients with lung cancer. We examined surgical outcome and hopefully provide a more accurate reference for management. METHODS: The consistency between predicted and actual survival was examined using the Tomita and Tokuhashi scores. Various factors that may influence survival were analyzed. Primary outcomes were overall survival (OS) and progression-free survival (PFS), defined as the ambulatory time after the initial surgery. Secondary outcomes included reoperation events, blood loss, and hospitalization days. RESULTS: One hundred seventy-two patients were enrolled. Correct survival predictions were made for 28%, 42%, and 56% with the Tomita, revised Tokuhashi, and Tokuhashi lung scores, respectively. The Tokuhashi lung scores underestimated OS by 35%-40%. Body mass index ≥20, systemic treatment-naïve, good general condition, the use of denosumab, and adenocarcinoma were found to positively affect OS and PFS. There was no significant difference between palliative decompression and excisional surgery regarding OS and PFS. CONCLUSION: Patients with spinal metastases from lung cancer had better prognosis than that predicted by the Tomita and Tokuhashi scores. Spine surgeons should acknowledge this discrepancy and treat these patients with at least the aggressiveness suggested. Patients with adenocarcinoma, amenable to target therapy, denosumab, good general condition, systemic treatment-naïve are better candidates for surgery. Those with cachexic status and unresectable visceral metastases are worse candidates.

Overall Survival of Non-Small Cell Lung Cancer With Spinal Metastasis: A Systematic Review and Meta-Analysis.

OBJECTIVE: The long-term survival data of lung cancer patients with spinal metastases are crucial for informed treatment decision-making. However, most studies in this field involve small sample sizes. Moreover, survival benchmarking and an analysis of changes in survival over time are required, but data are unavailable. To meet this need, we performed a metaanalysis of survival data from small studies to obtain a survival function based on largescale data. METHODS: We performed a single-arm systematic review of survival function following a published protocol. Data of patients who received surgical, nonsurgical, and mixed modes of treatment were meta-analyzed separately. Survival data were extracted from published figures with a digitizer program and then processed in R. Median survival time was used as an effect size for moderator analysis to explain the heterogeneity. RESULTS: Sixty-two studies with 5,242 participants were included for pooling. The survival functions showed a median survival of 6.72 months for surgery (95% confidence interval [CI], 61.9-7.01; 2,367 participants; 36 studies), 5.99 months for nonsurgery (95% CI, 5.33-6.47; 891 participants; 12 studies), and 5.96 months for mixed (95% CI, 5.67-6.43; 1,984 participants; 18 studies). Patients enrolled since 2010 showed the highest survival rates. CONCLUSION: This study provides the first large-scale data for lung cancer with spinal metastasis that allows survival benchmarking. Data from patients enrolled since 2010 had the best survival and thus may more accurately reflect current survival. Researchers should focus on this subset in future benchmarking and remain optimistic in the management of these patients.

Analysis of force and displacement of anchor systems under the non-limit active state.

This paper proposes a concept of soil shear strength exertion around an anchorage section to analyze and calculate the anchor's force and displacement. First, based on the Mohr stress circle, the numerical relationship between the value of the internal friction angle exertion, the value of the cohesion exertion, and the displacement are established under the non-limit active state. According to the interaction mechanism between the anchorage section and the surrounding soil, this paper obtains the corresponding relationship between the value of the soil's shear strength exertion and displacement under the non-limit active state. Then, according to the load transfer principle of the anchorage section, the basic differential equation is established. The differential equation of the relative displacement distribution along the length of the anchorage section under the non-limit active state is further derived. And the calculation and analysis formula of the shear stress and relative displacement in the anchorage section considering the process of the soil shear strength exertion is also obtained. Finally, this paper compares the calculation method with the hyperbolic model calculation method for the same example. The results verify the accuracy of the calculation method.

Antisiphon device: A review of existing mechanisms and clinical applications to prevent overdrainage in shunted hydrocephalic patients.

Overdrainage of cerebrospinal fluid is one of the most notorious complications after ventriculoperitoneal shunt implantation. Siphon effect plays a major role in the development of overdrainage. Various overdrainage-preventing devices have been invented to counteract the siphon effect. Though some of the devices are designed to reduce the flow instead of providing antisiphoning effect, they are generally called antisiphon devices (ASDs). The basics of siphoning, the mechanisms and physical properties of currently available devices are described in this article. The clinical efficacy, shunt survival, and considerations on patient factors are also discussed. There are three kinds of ASD design, diaphragm, gravitational, and flow reducing devices. Flow reducing ASD is always open and the flow it controls is relatively stable. On the other hand, it may not provide sufficient flow in nocturnal intracranial pressure elevations. Diaphragm and gravitational devices are sensitive to the position of the patients. Diaphragm device is sensitive to the external pressure and the relative position of the device to the mastoid process. The gravitational device is sensitive to the angle between the axis of the device and the head. Many studies showed encouraging results with gravitational devices. Studies regarding diaphragm devices either showed better or similar outcomes comparing to differential pressure valves. Clinical studies regarding flow-reducing devices and head-to-head comparison between different mechanisms are warranted. This review aims to provide a useful reference for clinical practice of hydrocephalus.

GaOx@GaN Nanowire Arrays on Flexible Graphite Paper with Tunable Persistent Photoconductivity.

Flexible optoelectronic synaptic devices that functionally imitate the neural behavior with tunable optoelectronic characteristics are crucial to the development of advanced bioinspired neural networks. In this work, amorphous oxide-decorated GaN nanowire arrays (GaOx@GaN NWAs) are prepared on flexible graphite paper. A GaOx@GaN NWA-based flexible device has tunable persistent photoconductivity (PPC) and shows a conversible fast/slow decay process (SDP). Photoconductivity can be modulated by single or double light pulses with different illumination powers and biases. PPC gives rise to the high-performance SDP such as a long decay time of 2.3 × 105 s. The modulation mechanism is proposed and discussed. Our results reveal an innovative and efficient strategy to produce decorated NWAs on a flexible substrate with tunable optoelectronic properties and exhibit potential for flexible neuromorphic system applications.

Systemic identification and analyses of genes potentially involved in chemosensory in the devastating tea pest Basilepta melanopus.

Basilepta melanopus is a serious insect pest of tea plantations in southern China. This tea pest poses a great threat to the tea industry in China. No effective and environmentally friendly methods have been established to control this pest at present. Olfactory genes play key roles in insect behaviour, and can potentially be used as targets for developing environmentally-friendly approaches for pest control. In this study, we produced a transcriptome derived from dissected antennae from B. melanopus using high-throughput sequencing. We identified gene families that are potentially involved in odorant reception and detection, including unigenes encoding 63 odorant receptors (ORs), 16 gustatory receptors (GRs), 18 ionotropic receptors (IRs), four sensory neuron membrane proteins (SNMPs), 46 odorant binding proteins (OBPs), and 19 chemosensory proteins (CSPs). Analyses of tissue expression profiles revealed that all 63 OR transcripts, 14 antennal IRs, one SNMP and six OBPs were predominately expressed in antennae. Real-time quantitative PCR assays were also adapted to examine sex-biased expression of selected antenna-predominant genes. Our results provide valuable information for further functional studies of olfactory genes in B. melanopus and potential novel targets for developing new pest control measures.

Electroantennogram responses of the tea slug moth, Iragoides fasciata to some plant volatiles associated with tea, Camellia sinensis.

Electroantennogram responses to a wide range of plant volatile compounds that have been identified in tea plants Camellia sinensis L. (Ericales: Theaceae) were recorded from males and females of the tea slug moth, Iragoides fasciata Moore (Lepidoptera: Limacodidae). The responses to 26 compounds, belonging to several chemical classes, and two mixtures were evaluated. The results showed significantly different electroantennogram responses to the different chemicals, as well as significantly different responses according to gender. The green leaf volatile components elicited significantly greater responses in males. In general, the antennae of males were more sensitive, and responded more strongly, to most of the compounds. Responses to sesquiterpenoids were lower in both males and females. Dose-dependent response studies indicated differences in response between genders and concentrations, suggesting the existence of sexual dimorphism. Compounds belonging to the green leaf volatiles class appeared to be important clues in host-plant selection by this oligophagous species.