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1.
J Cell Physiol ; 235(1): 494-503, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31236962

RESUMO

Dilated cardiomyopathy (DCM) is a heart disease that injured greatly to the people wordwide. Systemic co-expression analysis for this cancer is still limited, although massive clinic experiments and gene profiling analyses had been well performed previously. Here, using the public RNA-Seq data "GSE116250" and gene annotation of Ensembl database, we built the co-expression modules for DCM by Weighted Gene Co-Expression Network Analysis, and investigated the function enrichment and protein-protein interaction (PPI) network of co-expression genes of each module by Database for Annotation, Visualization, and Integrated Discovery and Search Tool for the Retrieval of Interacting Genes/Proteins database, respectively. First, 5,000 genes in the 37 samples were screened and 11 co-expression modules were conducted. The number of genes for each module ranged from 77 to 936, with a mean of 455. Second, interaction relationships of hub-genes between pairwise modules showed great differences, suggesting relatively high-scale independence of the modules. Third, functional enrichments of the co-expression modules exhibited great differences. We found that genes in module 3 were significantly enriched in the pathways of focal adhesion and ubiquitin-mediated proteolysis. This module was inferred as the key module involved in DCM. In addition, PPI analysis revealed that the genes HSP90AA1, CTNNB1, MAPK1, GART, and PPP2CA owned the largest number of adjacency genes, unveiling that they may function importantly during the occurrence of DCM. Focal adhesion and ubiquitin-mediated proteolysis play important roles in human DCM.

2.
Opt Express ; 27(21): 29838-29853, 2019 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-31684240

RESUMO

A single-pixel compressive imaging technique that uses differential modulation based on the transformation of discrete orthogonal Krawtchouk moments is proposed. In this method, two sets of Krawtchouk basis patterns are used to differentially modulate the light source, then the Krawtchouk moments of the target object are acquired from the light intensities measured by a single-pixel detector. The target image is reconstructed by applying an inverse Krawtchouk moment transform represented in the matrix form. The proposed technique is verified by both computational simulations and laboratory experiments. The results show that this technique can retrieve an image from compressive measurements and the real-time reconstruction. The background noise can be removed by the differential measurement to realize the excellent image quality. Moreover, the proposed technique is especially suitable for the single-pixel imaging application that requires the extraction of the characteristics at the region-of-interest.

3.
World J Pediatr ; 2019 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-31686366

RESUMO

BACKGROUND: Pulmonary hemorrhage (PH) is a life-threatening respiratory complication of extremely low-birth-weight infants (ELBWIs). However, the risk factors for PH are controversial. Therefore, the purpose of this study was to analyze the perinatal risk factors and short-term outcomes of PH in ELBWIs. METHODS: This was a retrospective cohort study of live born infants who had birth weights that were less than 1000 g, lived for at least 12 hours, and did not have major congenital anomalies. A logistic regression model was established to analyze the risk factors associated with PH. RESULTS: There were 168 ELBWIs born during this period. A total of 160 infants were included, and 30 infants were diagnosed with PH. Risk factors including gestational age, small for gestational age, intubation in the delivery room, surfactant in the delivery room, repeated use of surfactant, higher FiO2 during the first day, invasive ventilation during the first day and early onset sepsis (EOS) were associated with the occurrence of PH by univariate analysis. In the logistic regression model, EOS was found to be an independent risk factor for PH. The mortality and intraventricular hemorrhage rate of the group of ELBWIs with PH were significantly higher than those of the group of ELBWIs without PH. The rates of periventricular leukomalacia, moderate-to-severe bronchopulmonary dysplasia and severe retinopathy of prematurity, and the duration of the hospital stay were not significantly different between the PH and no-PH groups. CONCLUSIONS: Although PH did not extend hospital stay or increase the risk of bronchopulmonary dysplasia, it increased the mortality and intraventricular hemorrhage rate in ELBWIs. EOS was the independent risk factor for PH in ELBWIs.

4.
Small ; : e1905731, 2019 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-31668013

RESUMO

Memristors are emerging as a rising star of new computing and information storage techniques. However, the practical applications are severely challenged by their instability toward harsh conditions, including high moisture, high temperatures, fire, ionizing irradiation, and mechanical bending. In this work, for the first time, lead-free double perovskite Cs2 AgBiBr6 is utilized for environmentally robust memristors, enabling highly efficient information storage. The memory performance of the typical indium-tin-oxide/Cs2 AgBiBr6 /Au sandwich-like memristors is retained after 1000 switching cycles, 105 s of reading, and 104 times of mechanical bending, comparable to other halide perovskite memristors. Most importantly, the memristive behavior remains robust in harsh environments, including humidity up to 80%, temperatures as high as 453 K, an alcohol burner flame for 10 s, and 60 Co γ-ray irradiation for a dosage of 5 × 105 rad (SI), which is not achieved by any other memristors and commercial flash memory techniques. The realization of an environmentally robust memristor from Cs2 AgBiBr6 with a high memory performance will inspire further development of robust electronics using lead-free double perovskites.

5.
J Plant Physiol ; 243: 153056, 2019 Oct 10.
Artigo em Inglês | MEDLINE | ID: mdl-31704533

RESUMO

Plant wax n-alkanes are a major constituent of the leaf and grain surface. In this study, we explored what can be learned from the abundance and carbon isotopic composition (δ13C) of n-alkanes in historical winter wheat cultivars. We investigated leaf and grain wax n-alkane concentration (ΣalkLand ΣalkG) and carbon isotopes (δ13CalkL and δ13CalkG) on C29 as well as bulk leaf and grain carbon isotopes (δ13CbulkL and δ13CbulkG) to assess if these wax components changed across five wheat cultivars released from the 1950s to the early 2010s. Results showed that ΣalkL and grain yield increased, while δ13CalkL and δ13CbulkL decreased across the historical wheat cultivars. We found a significant correlation between ΣalkL and shoot biomass at the early growth stage, and a strong correlation between ΣalkL at the grain-filling stage and grain yield. Grain measures, including ΣalkG, δ13CalkG, and δ13CbulkG did not correlate with crop production. Although δ13CalkL and grain yield were not correlated at the flowering stage, they were correlated at the grain-filling stage under dry conditions. Our results indicate that increased ΣalkL has been indirectly selected in breeding efforts to improve crop production in winter wheat, suggesting that greater leaf waxiness confers advantages for crop growth.

6.
CNS Neurosci Ther ; 2019 Nov 14.
Artigo em Inglês | MEDLINE | ID: mdl-31729196

RESUMO

Epilepsy is a neurological disease, and the main clinical manifestation is recurrent seizures. The exact etiology of epilepsy and the pathogenesis of the disorder are not yet fully understood. Atlastin-1, a dynamin-like GTPase, interacts with microtubules and is responsible for vesicle formation, both of which are highly associated with the development of epilepsy. Here, we reported that the expression level of atlastin-1 protein was reduced in the temporal neocortex of patients with temporal lobe epilepsy and in the hippocampus and adjacent cortex of a pentylenetetrazol-kindled epileptic mouse model. Cells expressing atlastin-1 coexpressed the inhibitory synaptic marker GAD67 in the temporal cortex and hippocampus of patients with epilepsy and an epileptic mouse model. The lentivirus-mediated overexpression of atlastin-1 protein in the hippocampus of mice suppressed seizure activity in behavioral experiments. Patch-clamp recordings in the Mg2+ -free epilepsy cell model showed that atlastin-1 overexpression inhibited neuronal excitability by suppressing the discharge frequency of spontaneous action potentials rather than by changing the passive and active properties of action potentials. Inhibitory synaptic transmission, but not excitatory synaptic currents, increased after atlastin-1 overexpression. These findings suggest that atlastin-1 likely contributes to the occurrence and development of epilepsy through inhibitory synaptic transmission.

7.
Neuroscience ; 2019 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-31704493

RESUMO

Sensitivity and reliability of animal behavioral assessment methods are critical for successful translation of in vitro findings to in vivo. Here we report a data transformation process in the elevated open platform task that generates a novel parameter, namely peak tolerance of fear (PTF) or its inversely correlated equivalent of anxiety quotient (AQ), to measure anxiogenic tendency in rodent. As compared to traditional parameters such as travel distance, time, or entries, PTF or AQ displays largely reduced data dispersion not only ingroup but also cross-study and cross-cohort, therefore representing a significant improvement of the methodology for rodent anxiety assessment.

8.
Mar Pollut Bull ; 150: 110600, 2019 Oct 26.
Artigo em Inglês | MEDLINE | ID: mdl-31669980

RESUMO

An Illumina-based next-generation sequencing was employed to characterise the sediment microbiome adjacent to coastal industrial and tourist cities, Taizhou and Xiamen, in China, and their associations with chemical pollution were explored. The results indicated that chemical pollution of sediments from Taizhou was higher than that from Xiamen. The number of sediment bacterial genera was negatively (Taizhou) or positively (Xiamen) correlated with offshore distance, owing to shifts in the primary and secondary status of organic matter and chemical pollutants for the promotion or inhibition of the sediment microbiome. The total number of the operational taxonomic units (OTUs) in sediments from Taizhou was larger than from Xiamen, while the number of core OTUs was smaller indicating that Taizhou had more impact on core microbes in sediments than Xiamen. This study suggests that chemical pollutants and organic matter result in different co-regulation of the off-shore sediment microbiome of coastal industrial and tourist cities.

10.
Vet Microbiol ; : 108483, 2019 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-31699469

RESUMO

Colisepticemia caused by bloodstream infection of the extraintestinal pathogenic Escherichia coli (ExPEC) has become a serious public health problem. The recent emergence of the colistin-resistant Enterobacteriaceae, especially mcr-1-positive E. coli (MCRPEC) exerts great concern around the world. The molecular epidemiology and zoonosis risk of avian-origin MCRPEC are reported to be substantially lower. Here, we presented a system-wide analysis of emerging trends and zoonotic risk of MCRPEC recovered from avian colibacillosis in China. Our results showed the majority of avian-source MCRPEC isolates were classified as ExPECs. We also found that not only MCRPEC in phylogroups B2 and D, but also several E. coli populations in groups B1 and F possessed high virulence in the two models of avian colibacillosis and three rodent models for ExPEC-associated human infections. The high-virulent MCRPEC clones belong to ST131, as well as ST-types (such as ST48, ST117, ST162, ST501, ST648, and ST2085). Our data suggested the zoonotic risk of MCRPEC appeared to be a close association with ColV/ColBM type virulence plasmids. A comprehensive genomic analysis showed the overlapped of ColV/ColBM plasmids contents between MCRPEC isolates from humans and poultry. Identification of ColV/ColBM plasmids among human MCRPEC isolates revealed the potential transmission of avian-source mcr-1-positive ExPECs to humans. Moreover, the presence of ColV/ColBM plasmid-encoded virulence determinants, could be used as a predictive label for pathogenic MCRPEC. These findings highlighted avian-origin MCRPEC isolates could be recognized as a foodborne pathogen.

11.
Medicine (Baltimore) ; 98(45): e17851, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31702644

RESUMO

To evaluate the safety and efficacy of the novel technique, transjugular portal vein embolization (TPVE).A single-center retrospective review of 18 patients (12 males and 6 females; mean age, 62 years) who underwent TPVE between January 2012 and January 2013 was conducted. The technical success rate, future liver remnant (FLR) volume, total liver volume (TLV) and FLR/TLV ratio after PVE were analyzed. Liver function, including total bilirubin (TB), aspartate aminotransferase (AST), alanine aminotransferase (ALT) and International Normalized Ratio (INR), was assessed before and after PVE. Any complications of TPVE and liver resection after TPVE were recorded.TPVE was performed on 18 patients before right hepatic resection for both primary and secondary hepatic malignancies (10 hepatocellular carcinomas, 4 cases of colorectal liver metastasis, and 4 cholangiocarcinomas). Technical success was achieved in 100% of patients (18 of 18). The mean FRL significantly increased to 580 ±â€Š155 mL (P < .001) after PVE. The mean FLR/TLV ratio (%) significantly increased to 34 ±â€Š4 (P < .001) after PVE. One patient suffered septicemia after TPVE. A small number patients experienced mild to moderate abdominal pain during TPVE. No other major complications occurred after TPVE in our study. The patient who developed septicemia died 3 days after the surgery as a result of this complication and subsequent multiple organ dysfunction syndrome (MODS).Transjugular portal vein embolization is a safe, efficacious, and promising novel technique to induce hypertrophy of the FLR.

12.
J Cell Biochem ; 2019 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-31709644

RESUMO

BACKGROUND: Colon cancer is the third most commonly diagnosed cancer with high morbidity and mortality. Calmodulin-binding transcription activator 2 (CAMTA2) belongs to the calmodulin-binding transcription activator protein family. The functional role of CAMTA2 in colon cancer development remains unclear. Our research found out that CAMTA2 was high-level expressed in colon cancer, and the upregulated CAMTA2 expression was markedly correlated with poor survival. Functional experiments showed that knockdown of CAMTA2 repressed colon cancer cell proliferation/migration in vitro and attenuated proliferation in vivo. In additional, CAMTA2 expression was controlled by miR-28-5p via posttranscriptional regulation and miR-28-5p expression was reversely correlated with CAMTA2 expression in colon cancer. Moreover, enforced miR-28-5p expression downregulated the expression of CAMTA2 significantly and the restoration of CAMTA2 expression abolished the inhibitory effect of miR-28-5p on colon cancer cell proliferation and metastasis. Mechanistically, overexpression of miR-28-5p suppressed Wnt/ß-catenin signaling and the inhibitory could be partly abolished by overexpression of CAMTA2. In summary, our findings reveal that miR-28-5p/CAMTA2 axis plays a critical role in human colon cancer, which might be a promising diagnosis and therapeutic target for colon cancer treatment.

13.
Artigo em Inglês | MEDLINE | ID: mdl-31580250

RESUMO

BACKGROUND: Large-scale studies showed that the SNP rs1764391 of Cx37 gene plays a pivotal role in the occurrence and development of AMI. Published results, however, were highly controversial. OBJECTIVE: This study aimed to examine the association between SNP rs1764391 of Cx37 and disease-susceptibility, several risk factors, gene-environment interactions of AMI in Guangxi Han Chinese. METHODS: In this study, 344 healthy controls and 344 AMI patients of Han Chinese were enrolled. The TaqMan assay was implemented to confirm the genotypes. Differences in genotype and allele frequencies of SNP rs1764391 were compared in both the AMI and control groups. RESULTS: Significant differences in TT genotype frequencies of SNP rs1764391 between the AMI and control groups were detected (P < 0.05). In the context of gender stratification, the result was also statistically different in women (P < 0.05). Age, BMI, diabetes, high blood pressure, smoking and TC were closely correlated to the risk of AMI (P < 0.05 for each). HDL-C was negatively correlated to the risk of AMI (P < 0.001). Significant interactions were observed between presence of the SNP rs1764391 CC genotype and BMI, smoking or alcohol consumed (P < 0.017 for each). CONCLUSIONS: The TT genotype of Cx37 SNP rs1764391 was identified as a predisposing factor for AMI, especially in women. This genetic variant may prove to be an important tool for AMI risk stratification, and thus might be a useful target for therapeutic intervention to further improve prognosis in high-risk patients.

14.
Phys Rev Lett ; 123(10): 106803, 2019 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-31573305

RESUMO

The spin states of magnetic molecules have advantageous attributes as carriers of quantum information. However, spin-vibration coupling in molecules causes a decay of excited spin states and a loss of spin coherence. Here, we detect excitations of spin-vibration states in single nickelocene molecules on Ag(110) with a scanning tunneling microscope. By transferring a nickelocene to the tip, the joint spin-vibration states with an adsorbed nickelocene were measured. Chemical variations in magnetic molecules offer the opportunity to tune spin-vibration coupling for controlling the spin coherence.

15.
Angew Chem Int Ed Engl ; 58(46): 16390-16394, 2019 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-31568623

RESUMO

Vapor phase ligand treatment (VPLT) of 2-aminobenzimidazole (2abIm) for 2-methylimidazole (2mIm) in ZIF-8 membranes prepared by two different methods (LIPS: ligand induced permselectivation and RTD: rapid thermal deposition) results in a notable shift of the molecular level cut-off to smaller molecules establishing selectivity improvements from ca. 1.8 to 5 for O2 /N2 ; 2.2 to 32 for CO2 /CH4 ; 2.4 to 24 for CO2 /N2 ; 4.8 to 140 for H2 /CH4 and 5.2 to 126 for H2 /N2 . Stable (based on a one-week test) oxygen-selective air separation performance at ambient temperature, 7 bar(a) feed, and 1 bar(a) sweep-free permeate with a mixture separation factor of 4.5 and oxygen flux of 2.6×10-3  mol m-2 s-1 is established. LIPS and RTD membranes exhibit fast and gradual evolution upon a 2abIm-VPLT, respectively, reflecting differences in their thickness and microstructure. Functional reversibility is demonstrated by showing that the original permeation properties of the VPLT-LIPS membranes can be recovered upon 2mIm-VPLT.

16.
Artigo em Inglês | MEDLINE | ID: mdl-31589358

RESUMO

Modulation of the electronic structure of metal catalysts is an effective approach to optimize the electrocatalytic activity. Herein, we show a surprisingly strong activation effect of black phosphorus (BP) on platinum (Pt) catalysts to give greatly enhanced catalytic activity in the hydrogen evolution reaction (HER). The unique and negative binding energy between BP and Pt leads to spontaneous formation of Pt-P bonds producing strong synergistic ligand effects on the Pt nanoparticles. No Pt-P bonds are formed with red phosphorus which is another allotrope of P. By controlling the number of Pt-P bonds, 3.5-fold enhancement in the HER activity can be achieved from the BP-activated Pt catalyst and the activity is 6.1 times higher than that of the state-of-the-art commercial Pt/C catalyst. The BP-activated Pt catalyst exhibits a current density of 82.89 mA cm-2 with only 1 µg of Pt in 1 m KOH at an overpotential of 70 mV.

17.
BMC Cancer ; 19(1): 988, 2019 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-31647032

RESUMO

BACKGROUND: Laparoscopic surgery, fast-track perioperative treatment and XELOX chemotherapy are effective strategies for shortening the duration of hospital stay for cancer patients. This trial aimed to clarify the safety and efficacy of the fast-track multidisciplinary treatment (FTMDT) model compared to conventional surgery combined with chemotherapy in Chinese colorectal cancer patients. METHODS: This trial was a prospective randomized controlled study with a 2 × 2 balanced factorial design and was conducted at six hospitals. Patients in group 1 (FTMDT) received fast-track perioperative treatment and XELOX adjuvant chemotherapy. Patients in group 2 (conventional treatment) received conventional perioperative treatment and mFOLFOX6 adjuvant chemotherapy. Subgroups 1a and 2a had laparoscopic surgery and subgroups 1b and 2b had open surgery. The primary endpoint was total length of hospital stay during treatment. RESULTS: A total of 374 patients were randomly assigned to the four subgroups, and 342 patients were finally analyzed, including 87 patients in subgroup 1a, 85 in subgroup 1b, 86 in subgroup 2a, and 84 in subgroup 2b. The total hospital stay of group 1 was shorter than that of group 2 [13 days, (IQR, 11-17 days) vs. 23.5 days (IQR, 15-42 days), P = 0.0001]. Compared to group 2, group 1 had lower surgical costs, fewer in-hospital complications and faster recovery (all P < 0.05). Subgroup 1a showed faster surgical recovery than that of subgroup 1b (all P < 0.05). There was no difference in 5-year overall survival between groups 1 and 2 [87.1% (95% CI, 80.7-91.5%) vs. 87.1% (95% CI, 80.8-91.4%), P = 0.7420]. CONCLUSIONS: The FTMDT model, which integrates laparoscopic surgery, fast-track treatment, and XELOX chemotherapy, was the superior model for enhancing the recovery of Chinese patients with colorectal cancer. TRIAL REGISTRATION: ClinicalTrials.gov: NCT01080547 , registered on March 4, 2010.

18.
World J Gastroenterol ; 25(36): 5505-5514, 2019 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-31576096

RESUMO

BACKGROUND: Bilioenteric Roux-en-Y anastomosis is one of the most complicated approaches for reconstructing the gastrointestinal tract, and endoscopic retrograde cholangiopancreatography (ERCP) is technically challenging in patients after bilioenteric Roux-en-Y anastomosis. The optimal endoscopic strategies for such cases remain unknown. AIM: To explore the feasibility and effectiveness of single balloon enteroscopy-assisted (SBE-assisted) therapeutic ERCP in patients after bilioenteric Roux-en-Y anastomosis based on multi-disciplinary collaboration between endoscopists and surgeons as well as report the experience from China. METHODS: This is a single center retrospective study. All of the SBE-assisted therapeutic ERCP procedures were performed by the collaboration between endoscopists and surgeons. The operation time, success rate, and complication rate were calculated. RESULTS: Forty-six patients received a total of 64 SBE-assisted therapeutic ERCP procedures, with successful scope intubation in 60 (93.8%) cases and successful diagnosis in 59 (92.2%). All successfully diagnosed cases received successful therapy. None of the cases had perforation or bleeding during or after operation, and no post-ERCP pancreatitis occurred. CONCLUSION: Based on multi-disciplinary collaboration, SBE-assisted therapeutic ERCP in patients after bilioenteric Roux-en-Y anastomosis is relatively safe and effective and has a high success rate.

19.
Mol Cancer Ther ; 2019 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-31582534

RESUMO

Hepatocellular carcinoma (HCC), the most prevalent primary liver cancer, is a leading cause of cancer-related death worldwide because of rising incidence and limited therapy. Although treatment with sorafenib or lenvatinib is the standard of care in advanced-stage HCC patients, the survival benefit from sorafenib is limited due to low response rate and drug resistance. Ibrutinib, an irreversible tyrosine kinase inhibitor (TKI) of TEC (e.g. BTK) and ErbB (e.g. EGFR) families, is an approved treatment for B cell malignancies. Here, we demonstrate that ibrutinib inhibits proliferation, spheroid formation and clonogenic survival of HCC cells including sorafenib resistant cells. Mechanistically, ibrutinib inactivated EGFR and its downstream Akt and ERK signaling in HCC cells, and downregulated a set of critical genes involved in cell proliferation, migration, survival and stemness, and upregulated genes promoting differentiation. Moreover, ibrutinib showed synergy with sorafenib or regorafenib, a sorafenib congener by inducing apoptosis of HCC cells. In vivo, this TKI combination significantly inhibited HCC growth and prolonged survival of immune-deficient mice bearing human HCCLM3 xenograft tumors and immune competent mice bearing orthotopic mouse Hepa tumors at a dose that did not exhibit systemic toxicity. In immune competent mice, the ibrutinib-sorafenib combination reduced the numbers of BTK+ immune cells in the tumor microenvironment. Importantly, we found that the BTK+ immune cells were also enriched in the tumor microenvironment in a subset of primary human HCCs. Collectively, our findings implicate BTK signaling in hepatocarcinogenesis and support clinical trials of the sorafenib-ibrutinib combination for this deadly disease.

20.
World J Gastroenterol ; 25(37): 5655-5666, 2019 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-31602165

RESUMO

BACKGROUND: The factors affecting the prognosis and role of adjuvant therapy in advanced gallbladder carcinoma (GBC) after curative resection remain unclear. AIM: To provide a survival prediction model to patients with GBC as well as to identify the role of adjuvant therapy. METHODS: Patients with curatively resected advanced gallbladder adenocarcinoma (T3 and T4) were selected from the Surveillance, Epidemiology, and End Results database between 2004 and 2015. A survival prediction model based on Bayesian network (BN) was constructed using the tree-augmented naïve Bayes algorithm, and composite importance measures were applied to rank the influence of factors on survival. The dataset was divided into a training dataset to establish the BN model and a testing dataset to test the model randomly at a ratio of 7:3. The confusion matrix and receiver operating characteristic curve were used to evaluate the model accuracy. RESULTS: A total of 818 patients met the inclusion criteria. The median survival time was 9.0 mo. The accuracy of BN model was 69.67%, and the area under the curve value for the testing dataset was 77.72%. Adjuvant radiation, adjuvant chemotherapy (CTx), T stage, scope of regional lymph node surgery, and radiation sequence were ranked as the top five prognostic factors. A survival prediction table was established based on T stage, N stage, adjuvant radiotherapy (XRT), and CTx. The distribution of the survival time (>9.0 mo) was affected by different treatments with the order of adjuvant chemoradiotherapy (cXRT) > adjuvant radiation > adjuvant chemotherapy > surgery alone. For patients with node-positive disease, the larger benefit predicted by the model is adjuvant chemoradiotherapy. The survival analysis showed that there was a significant difference among the different adjuvant therapy groups (log rank, surgery alone vs CTx, P < 0.001; surgery alone vs XRT, P = 0.014; surgery alone vs cXRT, P < 0.001). CONCLUSION: The BN-based survival prediction model can be used as a decision-making support tool for advanced GBC patients. Adjuvant chemoradiotherapy is expected to improve the survival significantly for patients with node-positive disease.

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