Evolutionary and immune-activating character analyses of NLR genes in algae suggest the ancient origin of plant intracellular immune receptors.

Nucleotide-binding leucine-rich repeat (NLR) proteins are crucial intracellular immune receptors in plants, responsible for detecting invading pathogens and initiating defense responses. While previous studies on the evolution and function of NLR genes were mainly limited to land plants, the evolutionary trajectory and immune-activating character of NLR genes in algae remain less explored. In this study, genome-wide NLR gene analysis was conducted on 44 chlorophyte species across seven classes and seven charophyte species across five classes. A few but variable number of NLR genes, ranging from one to 20, were identified in five chlorophytes and three charophytes, whereas no NLR gene was identified from the remaining algal genomes. Compared with land plants, algal genomes possess fewer or usually no NLR genes, implying that the expansion of NLR genes in land plants can be attributed to their adaptation to the more complex terrestrial pathogen environments. Through phylogenetic analysis, domain composition analysis, and conserved motifs profiling of the NBS domain, we detected shared and lineage-specific features between NLR genes in algae and land plants, supporting the common origin and continuous evolution of green plant NLR genes. Immune-activation assays revealed that both TNL and RNL proteins from green algae can elicit hypersensitive responses in Nicotiana benthamiana, indicating the molecular basis for immune activation has emerged in the early evolutionary stage of different types of NLR proteins. In summary, the results from this study suggest that NLR proteins may have taken a role as intracellular immune receptors in the common ancestor of green plants.

A Shuttle-Free Solid-State Cu-Li Battery Based on a Sandwich-Structured Electrolyte.

Cu-Li batteries leveraging the two-electron redox property of Cu can offer high energy density and low cost. However, Cu-Li batteries are plagued by limited solubility and a shuttle effect of Cu ions in traditional electrolytes, which leads to low energy density and poor cycling stability. In this work, we rationally design a solid-state sandwich electrolyte for solid-state Cu-Li batteries, in which a deep-eutectic-solvent gel with high Cu-ion solubility is devised as a Cu-ion reservoir while a ceramic Li1.4 Al0.4 Ti1.6 (PO4 )3 interlayer is used to block Cu-ion crossover. Because of the high ionic conductivity (0.55 mS cm-1 at 25 °C), wide electrochemical window (>4.5 V vs. Li+ /Li), and high Cu ion solubility of solid-state sandwich electrolyte, a solid-state Cu-Li battery demonstrates a high energy density of 1 485 Wh kgCu -1 and long-term cyclability with 97 % capacity retention over 120 cycles. The present study lays the groundwork for future research into low-cost solid-state Cu-Li batteries.

General Synthesis of Tube-like Nanostructured Perovskite Oxides with Tunable Transition Metal-Oxygen Covalency for Efficient Water Electrooxidation in Neutral Media.

Hydrogen production from water electrolysis in neutral-pH electrolytes can not only avoid the corrosion and safety issues and expand the catalyst option but also potentially integrate with artificial photosynthesis and bioelectrocatalysis. However, heterogeneous catalysts that can efficiently negotiate the sluggish oxygen evolution reaction (OER) in neutral solutions are considerably lacking. Herein, we report a template-assisted strategy for the synthesis of 13 kinds of tube-like nanostructured perovskite oxides (TNPOs) with markedly high Brunauer-Emmett-Teller surface areas. By systematic examination of these TNPOs, we found that the OER activity of TNPOs in neutral solution exhibits a volcano shape as a function of the covalency of transition metal-oxygen bonds. Consequently, our designed Sm-doped LaCoO3 catalyst yields a geometric current density of 8.5 mA cm-2 at 1.75 V versus the reversible hydrogen electrode in 1 M phosphate buffer solution (pH 7) due to the optimized covalency of Co 3d and O 2p states, representing the most active noble-metal-free OER catalyst in neutral electrolytes reported as yet.

Influence of Sulfur Atoms on TADF Properties from Through-Space Charge Transfer Excited States.

The harnessing of heavy atom effect of chalcogen elements offers a way for boosting the thermally activated delayed fluorescence (TADF) of purely organic luminescent materials that can harvest triplet excitons. However, the conformational and electronic variations induced by the heavy and large atoms may also have adverse effects on the TADF properties. Herein, the design, synthesis, and structures of a new type of through-space charge transfer (TSCT) emitters containing benzothiazino[2,3,4-kl]phenothiazine (DPTZ) as the donor unit are reported. The influences of S atoms on the emission properties have been systematically investigated by means of theoretical simulations, electrochemical and spectroscopic studies. Although the presence of π-stacking interactions and calculated spin-orbit coupling (SOC) values are beneficial for TSCT-TADF properties, the triplet TSCT states are uplifted to above the locally excited (LE) state of the acceptor moieties. As a result, the new emitters display longer delayed fluorescence lifetimes (τDF ) of 255.0-114.3 µs and lower PLQYs of 45-61 % in comparison with the O-containing congeners (τDF =26.9-6.8 µs; PLQYs=74-71 %). This work highlights that a full consideration of various effects is essential when making use of heavy chalcogen atoms for the design of TADF emitters.

Health-related quality of life and associated factors in Chinese menstrual migraine patients: a cross-sectional study.

BACKGROUND: Menstrual migraine is a particular form of migraine with a significant impact on the quality of life for women afflicted. Presently, no study has reported the quality of life in menstrual migraine patients. This work aims to assess the health-related quality of life and identify its associated factors among Chinese menstrual migraine patients. METHODS: The cross-sectional study group consisted of 109 patients with menstrual migraine, and the control group consisted of 397 female patients with non-menstrual migraine. In total, 506 patients completed questionnaires for demographic and clinical information, the Self-rating Idea of Suicide Scale, the Hamilton Depression Scale, the Hamilton Anxiety Scale, the Headache Impact Test-6, the Perceived Social Support Scale, the Pittsburgh Sleep Quality Index. Health-related quality of life was measured using the 36-Item Short Form Survey. RESULTS: Compared with non-menstrual migraine patients, five dimensions of health-related quality of life were all found to be significantly impaired in menstrual migraine patients. Headache frequency (ß = - 0.218, P = 0.014), the impact of headache on daily life (ß = - 0.270, P = 0.002), depression symptoms (ß = - 0.345, P < 0.001) were significantly associated with physical component summary, depression symptoms (ß = - 0.379, P < 0.001), social support (ß = 0.270, P < 0.001), suicidal ideation (ß = - 0.344, P < 0.001) were closely related to mental component summary. CONCLUSION: Menstrual migraine patients had a significantly poorer health-related quality of life in many domains than non-menstrual migraine patients. Headache frequency, the impact of headache on daily life, depression symptoms, social support, and suicidal ideation were significantly associated with health-related quality of life in menstrual migraine patients. TRIAL REGISTRATION: ChiCTR1800014343. This study was registered prospectively on 7 January 2018 at Chinese Clinical Trial registry. http://www.chictr.org.cn/showproj.aspx?proj=24526.

Circular RNA circCTNNA1 is downregulated in osteoarthritis and sponges miR-29a to suppress LPS-induced apoptosis of synoviocytes.

OBJECTIVE: CircRNA circCTNNA1 has been characterized as a critical player in cancer biology, while its role in other human diseases is unknown. This study was carried out to study the role of circCTNNA1 in osteoarthritis (OA). MATERIALS AND METHODS: RNA was extracted from synovial fluid samples donated by OA patients (n = 62). RT-qPCRs were then performed to determine the expression of circCTNNA1 and miR-29a in these synovial fluid samples. The interaction between circCTNNA1 and miR-29a was predicted using an online program IntaRNA 2.0 and confirmed by RNA pull-down assay. Overexpression of circCTNNA1 and miR-29a was achieved in synoviocytes to analyze their effects on each other's expression. The role of circCTNNA1 and miR-29a in regulating synoviocyte apoptosis was explored by cell apoptosis assay. RESULTS: CircCTNNA1 was downregulated in OA, while miR-29a was overexpressed in OA. CircCTNNA1 and miR-29a were not significantly correlated. RNA pull-down assay illustrated the direct interaction between circCTNNA1 and miR-29a. In synoviocytes, overexpression of circCTNNA1 and miR-29a failed to regulate the expression of each other. CircCTNNA1 overexpression suppressed the enhancing effects of miR-29a overexpression on cell apoptosis induced by LPS. CONCLUSIONS: CircCTNNA1 is downregulated in OA, and its overexpression suppresses synoviocyte apoptosis via sponging miR-29a.

Au⋠⋠⋠H-C Interactions Support a Robust Thermally Activated Delayed Fluorescence (TADF) Gold(I) Complex for OLEDs with Little Efficiency Roll-Off and Good Stability.

The practical use of luminescent mononuclear gold(I) complexes as optoelectronic materials has been limited by their inferior stability. Herein we demonstrate a strategy to improve the stability of gold(I) complexes which display thermally activated delayed fluorescence (TADF). A highly rigid and groove-like σ-donating aryl ligand has been used to form dual Au⋅⋅⋅H-C hydrogen bonds. The secondary metal-ligand interactions have been authenticated by single-crystal structure, NMR spectroscopy and theoretical simulations. The TADF AuI complex exhibits appealing emission properties (photoluminescence quantum yield=76 %; delayed fluorescence lifetime=1.2 µs) and much improved thermal and photo-stability. Vacuum-deposited organic light-emitting diodes (OLEDs) show promising electroluminescence with a maximum external quantum efficiency (EQE) over 23 % and negligible efficiency roll-off even at 10 000 cd m-2 . An estimated LT50 longer than 77 000 h with initial luminance of 100 cd m-2 reveals good operational stability. This work suggests a way for design of stable luminescent gold(I) complexes.

Laparoscopic vs. open surgery for gastrointestinal stromal tumors of esophagogastric junction: A multicenter, retrospective cohort analysis with propensity score weighting.

OBJECTIVE: Laparoscopic resection is increasingly performed for gastrointestinal stromal tumors (GISTs). However, the laparoscopic approach for GISTs located in the esophagogastric junction (EGJ-GIST) is surgically challenging. This study compares the efficacy of laparoscopic surgery and the open procedure for EGJ-GIST through the propensity score weighting (PSW) method. METHODS: Between April 2006 and April 2018, 1,824 surgical patients were diagnosed with primary gastric GIST at four medical centers in South China. Of these patients, 228 were identified as EGJ-GISTs and retrospectively reviewed clinicopathological characteristics, operative information, and long-term outcomes. PSW was used to create the balanced cohorts. RESULTS: PSW was carried out in laparoscopic and open-surgery cohorts according to year of surgery, sex, age, body mass index (BMI), tumor size, mitotic rates and recurrence risk. After PSW, 438 patients consisting of 213 laparoscopic (L group) and 225 open surgery (O group) patients were enrolled. After PSW, the following measures in the L group were superior to those in the O group: median operative time [interquartile range (IQR)]: 100.0 (64.5-141.5)vs. 149.0 (104.0-197.5) min, P<0.001; median blood loss (IQR): 30.0 (10.0-50.0)vs. 50.0 (20.0-100.0) mL, P=0.002; median time to liquid intake (IQR): 3.0 (2.0-4.0)vs. 4.0 (3.0-5.0) d, P<0.001; median hospital stay (IQR): 6.0 (4.0-8.0)vs. 7.0 (5.0-12.0) d, P<0.001; and postoperative complications (10.3%vs. 22.7%, P=0.001). The median follow-up was 55 (range, 2-153) months in the entire cohort. No significant differences were detected in either relapse-free survival (RFS) [hazard ratio (HR): 0.372, 95% confidence interval (95% CI): 0.072-1.910, P=0.236) or overall survival (OS) (HR: 0.400, 95% CI: 0.119-1.343, P=0.138) between the two groups. CONCLUSIONS: Laparoscopic surgery for EGJ-GIST is associated with the advantages of shorter operative time, reduced blood loss, shorter time to liquid intake, and shorter length of stay, all without compromising postoperative outcomes and long-term survival.

Nomogram for individually predicting overall survival in rectal neuroendocrine tumours.

BACKGROUND: This study aimed to develop a nomogram that predicts the overall survival (OS) of rectal neuroendocrine tumours (NETs). METHODS: We retrospectively analysed 310 patients with rectal neuroendocrine tumours in 5 hospitals in southern China. All of the patients were assigned to the training set. A multivariable analysis using Cox proportional hazards regression was performed using the training set, and a nomogram was constructed. It was validated on a dataset obtained from the Surveillance, Epidemiology, and End Result (SEER) database of America (n = 547). RESULTS: In the training set, the nomogram exhibited improved discrimination power compared with the WHO grade guidelines (Herrell's C-index, 0.872 vs 0.794; p < 0.001) and was also better than the seventh AJCC TNM classification (Herrell's C-index, 0.872 vs 0.817; p < 0.001). In the SEER validation dataset, the discrimination was also excellent (C-index, 0.648 vs 0.583, p < 0.001 and 0.648 vs 0.603, p = 0.016, respectively, compared with G grade and TNM classification). Calibration of the nomogram predicted individual survival corresponding closely with the actual survival. CONCLUSIONS: We developed a nomogram predicting 1- and 3-year OS of patients with rectal neuroendocrine tumours. Validation revealed excellent discrimination and calibration, suggesting good clinical utility.

Morphological dissection and cellular and transcriptome characterizations of bamboo pith cavity formation reveal a pivotal role of genes related to programmed cell death.

Pith cavity formation is critical for bamboo to overcome the bending force during its fast growth; however, the underlying molecular mechanisms remain largely unknown. Multiple approaches, including anatomical dissection, mathematical modelling and transcriptome profiling, were employed in this study to investigate the biology of pith cavity formation in bamboo Pseudosasa japonica. We found that the corruption of pith tissue occurred sequentially and asymmetrically from the top-centre of the internode down to the bottom, which might be caused by the combined effects of asymmetrical radial and axial tensile forces during shoot-wall cell elongation and spiral growth of bamboo internodes. Programmed cell death (PCD) in pitch manifested by TUNEL positive nuclei, DNA cleavage and degraded organelles, and potentially regulated by ethylene and calcium signalling pathway, ROS burst, cell wall modification, proteolysis and nutrient recycle genes, might be responsible for pith tissue corruption of Ps. japonica. Although similar physiological changes and transcriptome profiles were found in different bamboo species, different formation rates of pith cavity were observed, which might be caused by different pith cells across the internode that were negatively correlated with the culm diameter. These findings provided a systematical view on the formation of bamboo pith cavity and revealed that PCD plays an important role in the bamboo pith cavity formation.

Radiomics nomogram for predicting the malignant potential of gastrointestinal stromal tumours preoperatively.

OBJECTIVE: To develop and evaluate a radiomics nomogram for differentiating the malignant risk of gastrointestinal stromal tumours (GISTs). METHODS: A total of 222 patients (primary cohort: n = 130, our centre; external validation cohort: n = 92, two other centres) with pathologically diagnosed GISTs were enrolled. A Relief algorithm was used to select the feature subset with the best distinguishing characteristics and to establish a radiomics model with a support vector machine (SVM) classifier for malignant risk differentiation. Determinant clinical characteristics and subjective CT features were assessed to separately construct a corresponding model. The models showing statistical significance in a multivariable logistic regression analysis were used to develop a nomogram. The diagnostic performance of these models was evaluated using ROC curves. Further calibration of the nomogram was evaluated by calibration curves. RESULTS: The generated radiomics model had an AUC value of 0.867 (95% CI 0.803-0.932) in the primary cohort and 0.847 (95% CI 0.765-0.930) in the external cohort. In the entire cohort, the AUCs for the radiomics model, subjective CT findings model, clinical index model and radiomics nomogram were 0.858 (95% CI 0.807-0.908), 0.774 (95% CI 0.713-0.835), 0.759 (95% CI 0.697-0.821) and 0.867 (95% CI 0.818-0.915), respectively. The nomogram showed good calibration. CONCLUSIONS: This radiomics nomogram predicted the malignant potential of GISTs with excellent accuracy and may be used as an effective tool to guide preoperative clinical decision-making. KEY POINTS: • CT-based radiomics model can differentiate low- and high-malignant-potential GISTs with satisfactory accuracy compared with subjective CT findings and clinical indexes. • Radiomics nomogram integrated with the radiomics signature, subjective CT findings and clinical indexes can achieve individualised risk prediction with improved diagnostic performance. • This study might provide significant and valuable background information for further studies such as response evaluation of neoadjuvant imatinib and recurrence risk prediction.

Low expression of CD80 predicts for poor prognosis in patients with gastric adenocarcinoma.

AIM: To study the expression and prognostic significance of CD80 in patients with gastric adenocarcinoma. Materials & methods: Real-time quantitative PCR, western blot and immunohistochemistry were performed to detect the expression of CD80 in gastric cancer tissues and matched adjacent normal tissues. Double immunohistochemical staining was performed to preliminary examine the relationship between CD80+ cells and CD8+ cytotoxic T lymphocytes. RESULTS: The expression of CD80 was downregulated in tumor tissues compared with normal tissues (p = 0.002). Immunohistochemistry analysis showed that 49 (39.8%) of 123 patients with gastric cancer demonstrated reduced CD80 expression, which was correlated with the tumor differentiation grade. CONCLUSION: Our data suggest that reduced CD80 expression independently predicts a poor prognosis in patients with gastric adenocarcinoma.

Clinicopathological features and prognosis of 276 cases of primary small (≤ 2 cm) gastric gastrointestinal stromal tumors: a multicenter data review.

BACKGROUND: Till present, there are still controversies over the epidemiology, pathological features, types of surgical treatment, and prognoses of primary small gastric GISTs (gGISTs). METHODS: From January 1998 to January 2015, patients with primary small gGIST admitted from four high-volume medical centers of the Southern China were enrolled and their data were analyzed to evaluate their clinicopathological features, treatment and prognostic factors to provide evidence-based medical experience for clinical practice. RESULTS: A total of 276 primary small gGIST cases over a period of 18 years were investigated and had a median age of 60 years (range 27-91 years old). Regarding the tumor sites, 24 (8.7%) cases were in the cardia of the stomach, 107 (38.8%) in the fundus, 117 (42.4%) in the gastric body, and 28 (10.1%) in the gastric antrum. Eleven patients (4.0%) underwent a preoperative biopsy. A total of 137 (49.6%), 75 (27.2%), and 64 (23.2%) patients underwent laparoscopic, open resection, and endoscopic resection, respectively. Sixty-four patients (23.2%) had local endoscopic resection, 172 (62.3%) had wedge resection, 7 (2.5%) had proximal gastrectomy, 19 (6.9%) had distal gastrectomy, and 14 (5.1%) had total gastrectomy. Mitotic counts were ≤ 5/50, (5-10)/50, and > 10/50 per HPF in 259 (93.8%), 7 (2.5%), and 10 (3.6%) cases, respectively. There were 259 cases (97.1%) of spindle cell type, 7 (2.5%) epithelial cell types and one case (0.4%) of mixed type. Immunohistochemistry showed 74.6% (206/276), 98.2% (271/276), and 97.4% (269/276) of the patients had co-expression of CD34+, CD117+, and DOG-1+, respectively. Thirty-nine patients underwent genetic testing (39/276, 14.1%). Three patients (1.1%) had positive resection margin. Five high-risk patients received follow-up treatment with imatinib with a median follow-up time of 38 months (range 3-156 months). The overall 1-, 3-, and 5-year overall survival rates were 100%, 99.6%, and 99.1%, respectively. CONCLUSION: Though the incidence of primary small gGISTs increased per annum, the overall survival prognoses were high. Surgery or endoscopic resection was the primary mode of treatment. Pathological features of primary small gGISTs were similar to large gGISTs, and to achieve a timely surgical intervention, the identification of intermediate- and high-risk cases should be a future focus of study.

Highly Sensitive Microstructure-Based Flexible Pressure Sensor for Quantitative Evaluation of Motor Function Recovery after Spinal Cord Injury.

Behavioral assessment, such as systematic scoring or biomechanical measurement, is often used to evaluate the extent of the damage and the degree of recovery after spinal cord injury. However, the use of these methods in standardized evaluation is limited because they are subjective and require complex test systems to implement. Here, we report a novel, flexible, microstructure-based pressure sensor and demonstrate its superior sensitivity (235.12 kPa-1 for 5.5~135 Pa and 2.24 kPa-1 for 0.6~25 kPa), good waterproofness, fast response and recovery times (response time: 8 ms, recovery time: 12 ms), stable response over 8000 loading/unloading cycles, and wide sensing range. These features readily allow the sensor to be comfortably attached to the hindlimbs of mice for full-range, real-time detection of their behavior, such as crawling and swimming, helping to realize quantitative evaluation of animal motor function recovery after spinal cord injury.

Analysis of risk factors of lymph node metastasis in rectal neuroendocrine neoplasms using multicenter data.

AIM: This study was conducted to analyze the risk factors associated with lymph node metastasis in rectal neuroendocrine neoplasms (NENs). MATERIALS & METHODS: A total of 419 patients with rectal NENs were enrolled. A univariate analysis of risk factors of lymph node metastasis was conducted using a χ2 test, and a multivariate analysis was conducted using a logistic regression analysis. RESULTS: Univariate and multivariate regression analysis revealed that tumor size, G grade and the depth of tumor invasion were independent risk factors for lymph node metastasis (p < 0.05). CONCLUSION: Rectal NENs patients with a larger tumor size, deeper tumor invasion or a higher G grade had a higher risk of regional lymph node metastasis.

Prognostic factors of primary gastrointestinal stromal tumors: a cohort study based on high-volume centers.

Objective: We aimed to evaluate the clinicopathologic characteristics, immunohistochemical expression and prognostic factors of patients with primary gastrointestinal stromal tumors (GISTs). Methods: Data from 2,570 consecutive GIST patients from four medical centers in China (January 2001-December 2015) were reviewed. Survival curves were constructed by the Kaplan-Meier method, and Cox regression models were used to identify independent prognostic factors. Results: Of the included patients, 1,375 (53.5%) were male, and the patient age range was 18 to 95 (median, 58) years. The tumors were mostly found in the stomach (64.5%), small intestine (25.1%) and colorectal region (5.1%). At the time of diagnosis, the median tumor size was 4.0 (range: 0.1-55.0) cm, and the median mitotic index per 50 high power fields (HPFs) was 3 (range: 0-254). Of the 2,168 resected patients, 2,009 (92.7%) received curative resection. According to the modified National Institutes of Health (NIH) classification, 21.9%, 28.9%, 14.1% and 35.1% were very low-, low-, intermediate- and high-risk tumors, respectively. The rate of positivity was 96.4% for c-Kit, 87.1% for CD34, 96.9% for delay of germination 1 (DOG-1), 8.0% for S-100, 31.0% for smooth muscle actin (SMA) and 5.1% for desmin. However, the prognostic value of each was limited. Multivariate analysis showed that age, tumor size, mitotic index, tumor site, occurrence of curative resection and postoperative imatinib were independent prognostic factors. Furthermore, we found that high-risk patients benefited significantly from postoperative imatinib (P<0.001), whereas intermediate-risk patients did not (P=0.954). Conclusions: Age, tumor size, mitotic index, tumor site, occurrence of curative resection and postoperative imatinib were independent prognostic factors in patients with GISTs. Moreover, determining whether intermediate-risk patients can benefit from adjuvant imatinib would be of considerable interest in future studies.

Nomogram individually predicts the overall survival of patients with gastroenteropancreatic neuroendocrine neoplasms.

BACKGROUND: The current study aimed to establish a novel nomogram to predict the overall survival of individual Chinese patients with gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs). Furthermore, this study sought to externally validate this nomogram using the Surveillance, Epidemiology, and End Results (SEER) database. METHODS: The records of 1183 patients with GEP-NENs treated at five high-capacity institutions in China between 2005 and 2015 were retrospectively analysed. In addition, 10 236 GEP-NEN cases from the SEER database were included as an external validation set. RESULTS: A multivariate analysis using Cox proportional hazards (PHs) regression was performed, and a nomogram was constructed. Discrimination, calibration, and external validation were performed using the SEER data set. The multivariate Cox model indicated that age, tumour size, differentiation, lymph node metastases, and distant metastases were independent covariates associated with survival. With respect to the training set, the nomogram exhibited better discrimination power than TNM classification (Harrell's concordance index (C-index): 0.837 vs 0.784, P=0.006). Discrimination was also excellent and superior to that of TNM classification for the SEER-based validation set (C-index: 0.808 vs 0.717, P<0.001). The calibrated nomogram predicted a survival rate that closely corresponded to the actual survival rate. CONCLUSIONS: We developed a nomogram that predicted the 3- and 5-year overall survival rates of patients with GEP-NENs. Validation revealed excellent discrimination and calibration for this nomogram, suggesting that it exhibits satisfactory clinical utility that might improve individualised predictions of survival risks and lead to the creation of additional clinical therapies.

Prognostic potential of an immune score based on the density of CD8+ T cells, CD20+ B cells, and CD33+/p-STAT1+ double-positive cells and HMGB1 expression within cancer nests in stage IIIA gastric cancer patients.

OBJECTIVE: There is heterogeneity in the prognosis of gastric cancers staged according to the tumornodes- metastasis (TNM) system. This study evaluated the prognostic potential of an immune score system to supplement the TNM staging system. METHODS: An immunohistochemical analysis was conducted to assess the density of T cells, B cells, and myeloid-derived suppressor cells (MDSCs) in cancer tissues from 100 stage IIIA gastric cancer patients; the expression of the high-mobility group protein B1 (HMGB1) was also evaluated in cancer cells. The relationship between the overall survival (OS), disease-free survival (DFS), and immunological parameters was analyzed. RESULTS: An immune score system was compiled based on the prognostic role of the density of T cells, B cells, MDSCs, and the expression of HMGB1 in cancer tissues. The median 5-year survival of this group of patient was 32%. However, the 5-year survival rates of 80.0%, 51.7%, 0%, 5.8%, and 0% varied among the patients with an immune score of 4 to those with an immune score of 0 based on the immune score system, respectively. Similarly, differences in DFS rates were observed among the immune score subgroups. CONCLUSIONS: An immune score system could effectively identify the prognostic heterogeneity within stage IIIA gastric cancer patients, implying that this immune score system may potentially supplement the TNM staging system, and help in identifying a more homogeneous group of patients who on the basis of prognosis can undergo adjuvant therapy.

TiCNet: Transformer in Convolutional Neural Network for Pulmonary Nodule Detection on CT Images.

Lung cancer is the leading cause of cancer death. Since lung cancer appears as nodules in the early stage, detecting the pulmonary nodules in an early phase could enhance the treatment efficiency and improve the survival rate of patients. The development of computer-aided analysis technology has made it possible to automatically detect lung nodules in Computed Tomography (CT) screening. In this paper, we propose a novel detection network, TiCNet. It is attempted to embed a transformer module in the 3D Convolutional Neural Network (CNN) for pulmonary nodule detection on CT images. First, we integrate the transformer and CNN in an end-to-end structure to capture both the short- and long-range dependency to provide rich information on the characteristics of nodules. Second, we design the attention block and multi-scale skip pathways for improving the detection of small nodules. Last, we develop a two-head detector to guarantee high sensitivity and specificity. Experimental results on the LUNA16 dataset and PN9 dataset showed that our proposed TiCNet achieved superior performance compared with existing lung nodule detection methods. Moreover, the effectiveness of each module has been proven. The proposed TiCNet model is an effective tool for pulmonary nodule detection. Validation revealed that this model exhibited excellent performance, suggesting its potential usefulness to support lung cancer screening.

The prognosis of gastric cancer patients with marginally elevated carcinoembryonic antigen (CEA) values after D2 radical gastrectomy.

AIM: To investigate the clinical significance of the postoperative serum carcinoembryonic antigen (CEA) levels in gastric cancer patients who underwent D2 radical gastrectomy and to identify the prognostic factors for patients with marginally elevated postoperative CEA levels. METHODS: We performed a retrospective study of 480 patients who were histologically diagnosed with gastric cancer and who underwent D2 radical surgery at the Sun Yat-sen University Cancer Center between January 2004 and December 2009. The follow-up lasted until June 2011. Chi-squared tests and Kaplan-Meier methods were employed to compare the adverse events and prognoses. RESULTS: In this group of gastric cancer patients, the postoperative serum CEA level (P = 0.002) was an independent prognostic factor; the same was true for the histological T and N staging (P < 0.001 and P = 0.045, respectively). In the group of marginally elevated postoperative CEA level gastric cancer patients, univariate analysis demonstrated that tumor position (P = 0.042); histological grade (P = 0.002); and Boarrmann type (P = 0.003) were significant prognostic factors. Multivariate analysis showed that the tumor position (P = 0.003) and histological grade (P = 0.007) were independent prognostic factors for these patients. CONCLUSION: Our study showed that patients with normal postoperative CEA levels have a better prognosis. Furthermore, for marginally elevated postoperative CEA level gastric cancer patients, the tumor position and histological grade were two important factors for predicting the prognosis and the need for aggressive therapy.