Pelvimetric and Nutritional Factors Predicting Surgical Difficulty in Laparoscopic Resection for Rectal Cancer Following Preoperative Chemoradiotherapy.

AIM: Laparoscopic total mesorectal excision (LaTME) following preoperative chemoradiotherapy (PCRT) in locally advanced rectal cancer (LARC) is technically demanding. The present study is intended to evaluate predictive factors of surgical difficulty of LaTME following PCRT by using pelvimetric and nutritional factors. METHOD: Consecutive LARC patients receiving LaTME after PCRT were included. Surgical difficulty was classified based upon intraoperative (operation time, blood loss, and conversion) and postoperative outcomes (postoperative hospital stay and morbidities). Pelvimetry was performed using preoperative T2-weighted MRI. Nutritional factors such as albumin-to-globulin ratio (AGR) and prognostic nutritional index (PNI) were calculated. Multivariable logistic analysis was used to identify predictors of high surgical difficulty. A predictive nomogram was developed and validated internally. RESULTS: Among 294 patients included, 36 (12.4%) patients were graded as high surgical difficulty. Logistic regression analysis demonstrated that previous abdominal surgery (OR = 6.080, P = 0.001), tumor diameter (OR = 1.732, P = 0.003), intersphincteric resection (vs. low anterior resection, OR = 13.241, P < 0.001), interspinous distance (OR = 0.505, P = 0.009), and preoperative AGR (OR = 0.041, P = 0.024) were independently predictive of high surgical difficulty of LaTME after PCRT. Then, a predictive nomogram was built (C-index = 0.867). CONCLUSION: Besides previous abdominal surgery, type of surgery (intersphincteric resection), tumor diameter, and interspinous distance, we found that preoperative AGR could be useful for the prediction of surgical difficulty of LaTME after PCRT. A predictive nomogram for surgical difficulty may aid in planning an appropriate approach for rectal cancer surgery after PCRT.

A nomogram predicting the difficulty of laparoscopic surgery for rectal cancer.

PURPOSE: This study aimed to identify the risk factors associated with performing a difficult laparoscopic radical resection of rectal cancer, and to establish a predictive nomogram to help individual clinical treatment decisions. METHODS: A total of 977 patients with rectal cancer who underwent laparoscopic radical resection between January 2014 and December 2016 were enrolled in this study. The difficulty of laparoscopic-assisted rectal resection (LARR) was defined according to the scoring criteria reported by Escal. A logistic regression analysis was performed to identify the variables that may affect the difficulty of LARR, and a nomogram predicting the surgical difficulty was created. RESULTS: A multivariate analysis demonstrated that a BMI > 28 kg/m2, the distance between the tumor and the anal margin ≤ 5 cm, the maximum transverse tumor diameter > 3 cm tumor, interspinous distance < 10 cm, history of abdominal surgery, and preoperative radiotherapy were independent risk factors and they were, therefore, included in the predictive nomogram for identifying a difficult LARR. CONCLUSIONS: This study defined a difficult LARR and identified independent risk factors for a difficult operation and created a predictive nomogram for difficult LARR. This nomogram may facilitate the stratification of patients at risk for being associated with a difficult LARR for rectal cancer.

Batch preparation of nanofibers containing nanoparticles by an electrospinning device with multiple air inlets.

With the increasing application of electrospun nanofibers, the batch preparation of high-performance functional nanofibers containing nanoparticles has become a research hotspot. As the distribution uniformity of nanoparticles in functional nanofibers has a great impact on their performance, an electrospinning device with multiple air inlets, which has a copper porous spinneret, is proposed to obtain functional nanofibers with higher yield and more uniform distribution of nanoparticles. The mechanism of batch preparation of functional nanofibers containing ZnO nanoparticles by the device was studied through experiments and theoretical analysis. The experimental data are in good agreement with the theoretical analysis results, which showed that under the appropriate voltage (50 kV) and air flow (50 m3/h), the device could keep ZnO nanoparticles contained in the spinning solution evenly dispersed during the spinning process, thus obtaining functional nanofibers with more uniform distribution of ZnO nanoparticles, whose quality and yield were higher than those prepared by other high-yield electrospinning devices.

Boundary-enhanced semi-supervised retinal layer segmentation in optical coherence tomography images using fewer labels.

Automatic segmentation of multiple layers in retinal optical coherence tomography (OCT) images is crucial for eye disease diagnosis and treatment. Despite the success of deep learning algorithms, it still remains a challenge due to the blurry layer boundaries and lack of adequate pixel-wise annotations. To tackle these issues, we propose a Boundary-Enhanced Semi-supervised Network (BE-SemiNet) that exploits an auxiliary distance map regression task to improve retinal layer segmentation with scarce labeled data and abundant unlabeled data. Specifically, a novel Unilaterally Truncated Distance Map (UTDM) is firstly introduced to alleviate the class imbalance problem and enhance the layer boundary learning in the regression task. Then for the pixel-wise segmentation and UTDM regression branches, we impose task-level and data-level consistency regularization on unlabeled data to enrich the diversity of unsupervised information and improve the regularization effects. Pseudo supervision is incorporated in consistency regularization to bridge the task prediction spaces for consistency and expand training labeled data. Experiments on two public retinal OCT datasets show that our method can greatly improve the supervised baseline performance with only 5 annotations and outperform the state-of-the-art methods. Since it is difficult and labor-expensive to obtain adequate pixel-wise annotations in practice, our method has a promising application future in clinical retinal OCT image analysis.

NSUN5-FTH1 Axis Inhibits Ferroptosis to Promote the Growth of Gastric Cancer Cells.

Recent studies revealed that NOP2/Sun RNA methyltransferase 5 (NSUN5) - ferritin heavy chain (FTH1) pathway is associated with ferroptosis in stem cells, whereas its roles in gastric cancer are still unclear. Our study aims to investigate the roles of the NSUN5-FTH1 axis in gastric cancer (GC) and its molecular mechanisms. Stable cell lines were constructed on SGC7901 cells by using shRNAs and pcDNA3.1 expression vectors, respectively. CCK-8 kits were used to determine cell viability. Biochemicals assays were used to detect lipid reactive oxygen species (ROS) and intracellular Fe2+ levels. RNA immunoprecipitation assay, qPCR, and Western blotting were used to determine the changes in biomarkers. GC xenograft mouse model was established to confirm the observation in vivo. An elevation of NSUN5 was observed in GC tumor tissues. NSUN5 inhibited ferroptosis including decreasing cell viability and increasing levels of lipid ROS and Fe2+ in GC cells. Besides, a positive correlation was also observed between NSUN5 and FTH1. Interestingly, NSUN5 regulated the levels of FTH1, instead of FTH1 regulating NSUN5 in GC cells. NSUN5-FTH1 axis regulated erastin-induced ferroptosis in SGC7901 cells. Consistently, silencing NSUN5 or FTH1 inhibited the growth of the SGC7901 tumor in vivo. NSUN5-FTH1 axis promoted the growth of GC cells in part by the regulation of ferroptosis.

Sex differences in cancer-specific survival for locally advanced esophageal cancer after neoadjuvant chemoradiotherapy: A population-based analysis.

Objective: Neoadjuvant chemoradiotherapy (nCRT) is the recommended standard treatment for locally advanced esophageal cancer (LA-EC). This study aimed to determine whether sex makes a difference in cancer-specific survival (CSS) and construct a novel nomogram model to predict CSS for LA-EC after nCRT based on the SEER database. Methods: Patients coded by 04-15 were identified from the SEER database. Patients with systemic treatment and radiotherapy before surgery were defined as nCRT. We further divided this population into a training group and a verification group at a ratio of 7:3. Univariate and multivariate cox analyses were applied to determine the prognostic risk factors based on the training cohort, and then the Nomogram model was established. The area under the curve (AUC) was used to evaluate the predictive ability of the model. We used the calibration curve to evaluate the consistency between the predicted status and actual status and decision curve analysis (DCA) to evaluate the clinical value. We used X-tile software to determine the best cut-off value of nomogram scores and divided the population into low-risk, medium-risk, and high-risk groups, and Kaplan-Meier analysis was applied to compare the CSS. Results: A total of 2096 LA-EC patients were included for further analysis, with 1,540 in the training cohort and 656 in the validation group. Male (HR: 1.29, 95% CI, 1.04 -1.58), T stage, N stage, and M stage were identified as independent risk factors of CSS based on the training cohort. A Nomogram model was constructed to predict the 3-, 5- and 7-years CSS. ROC curve and AUC confirmed that this nomogram has median discrimination ability. The calibration curve showed good agreement between predicted status and actual status. The DCA curves confirmed the clinical value. Kaplan-Meier analysis indicated that patients in the high-risk subgroup had poorer CSS in both the training cohort and validation cohort (P < 0.001). Conclusion: Male patients had poorer CSS in LA-EC patients after nCRT. A nomogram model composed of sex, T stage, N stage, and M stage was constructed to identify the high-risk population and provide a personalized follow-up plan.

Structure and electrochemical performance of electrospun-ordered porous carbon/graphene composite nanofibers.

Ordered carbon/graphene composite nanofibers (CGCNFs) with different porous configurations were used as a material to fabricate supercapacitor electrodes. These nanofibers were synthesized by applying a modified parallel electrode to the electrospinning method (MPEM) in order to generate electrospun polyacrylonitrile (PAN) nanofibers containing graphene. After synthesis, these fibers were submitted to carbonization under a N2 atmosphere at 1100 °C. The influence of the ordering and porosity of CGCNFs on their electrochemical performance was studied. The results showed that by adding deionized water to the spinning solution one could increase the number of mesopores and the specific surface area of CGCNFs, thereby significantly increasing their specific capacitance. In addition, the ordering of CGCNFs within the electrode improved the electron transfer efficiency, resulting in a higher specific capacitance.

High SPRR1A expression is associated with poor survival in patients with colon cancer.

High expression of small proline-rich protein 1A (SPRR1A) has been shown to be associated with tumor prognosis; however, the association between SPRR1A expression and colon cancer prognosis remains unclear. The present study sought to evaluate the association between SPRR1A expression and the clinicopathological characteristics of colon cancer, and to examine its potential prognostic value. A total of 114 patients with colon cancer were included. SPRR1A expression was evaluated by immunohistochemical staining, and the association between SPRR1A expression and clinicopathological parameters was analyzed. The prognostic value of SPRR1A was analyzed by Cox regression analysis, the Oncomine database and the R2 platform. SPRR1A expression was significantly increased in cancerous tissues compared with that in adjacent non-cancerous tissues. SPPRR1A expression was significantly associated with lymph node invasion. High SPRR1A expression was significantly associated with worse overall and disease-free survival rate. Cox regression analysis revealed that T stage, pathological N stage and high SPRR1A expression remained independent predictors for overall survival rate. The Oncomine database analysis demonstrated that SPRR1A mRNA expression levels were significantly increased in colorectal cancer tissues compared with those in adjacent non-cancerous tissues, and high SPRR1A expression was associated with a significantly worse event- and relapse-free survival time in the R2 platform. The data indicate that SPRR1A may serve as a potential biomarker for the prognosis of colon cancer.

Analysis of local setup errors of sub-regions in cone-beam CT-guided post-mastectomy radiation therapy.

The purpose of the study was to quantify local setup errors and evaluate the planning target volume (PTV) margins for sub-regions in cone-beam computed tomography (CBCT)-guided post-mastectomy radiation therapy (PMRT). The local setup errors of 20 patients undergoing CBCT-guided PMRT were analysed retrospectively. Image registration between CBCT and planning CT was performed using four sub-regions of interest (ROIs): the supraclavicular area (SROI), ipsilateral chest wall region (CROI), ipsilateral chest wall plus supraclavicular region (SROI + CROI) and vertebral region (TROI). Bland-Altman analysis, correlation, local setup errors and PTV margins among these ROIs were evaluated. There was no significant consistency or correlation for registration results between the TROI and the CROI or SROI regions on any translational axis. When using the SROI + CROI as the ROI, the systematic error (Σ) and random error (σ) of the local setup errors for the CROI region were 1.81, 1.19 and 1.76 mm and 1.84, 2.64 and 3.00 mm along the medial-lateral (ML), superior-inferior (SI) and anterior-posterior (AP) directions, respectively. The PTV margins for the CROI region were 5.80, 4.82 and 6.50 mm. The Σ and σ of the local setup errors for the SROI region were 1.29, 1.15 and 0.77 mm and 1.96, 2.65 and 2.2 mm, respectively, and the PTV margins were 4.59, 4.73 and 3.47 mm. Large setup errors and local setup errors occur in PMRT. The vertebral body should not be a position surrogate for the supraclavicular region or chest wall. To compensate for the local setup errors, different PTV margins are required, even with CBCT guidance.

Hydrophobicity Influence on Swimming Performance of Magnetically Driven Miniature Helical Swimmers.

Helical microswimmers have been involved in a wide variety of applications, ranging from in vivo tasks such as targeted drug delivery to in vitro tasks such as transporting micro objects. Over the past decades, a number of studies have been established on the swimming performance of helical microswimmers and geometrical factors influencing their swimming performance. However, limited studies have focused on the influence of the hydrophobicity of swimmers' surface on their swimming performance. In this paper, we first demonstrated through theoretical analysis that the hydrophobicity of swimmer's surface material of the swimmer does affect its swimming performance: the swimmer with more hydrophobic surface is exerted less friction drag torque, and should therefore exhibit a higher step-out frequency, indicating that the swimmer with more hydrophobic surface should have better swimming performance. Then a series of experiments were conducted to verify the theoretical analysis. As a result, the main contribution of this paper is to demonstrate that one potential approach to improve the helical microswimmers' swimming performance could be making its surface more hydrophobic.

Overexpression of FZD7 is associated with poor survival in patients with colon cancer.

BACKGROUND: Overexpression of Frizzled-7 (FZD7) has been associated with tumor invasion and distant metastases, but little is known about the relationship between FZD7 expression and prognosis in colon cancer. PATIENTS AND METHODS: A total of 114 patients with colon cancer between June 2010 and December 2010 were enrolled in this study. The expression of FZD7 in cancerous and adjacent non-cancerous tissues was determined by immunohistochemistry, and the association between FZD7 expression and patient's clinicopathological characteristics was explored. The correlation between FZD7 expression and prognosis of colon cancer patients was analyzed using the Oncomine database and R2. RESULTS: FZD7 expression levels were significantly higher in colon cancer tissues compared with adjacent non-cancerous tissues (P < 0.001). High expression of FZD7 was significantly associated with metastatic or recurrent disease in colon cancer (P = 0.010). Kaplan-Meier survival analysis demonstrated that colon cancer patients with high expression of FZD7 had a significantly poorer OS (P = 0.013) and DFS (P = 0.010). Cox regression demonstrated that the expression of FZD7 was an independent prognostic factor for DFS (HR = 6.647, P = 0.023). A meta-analysis from the Oncomine database demonstrated that FZD7 mRNA levels were significantly higher in colorectal cancer tissues than in normal colorectal tissues, and FZD7 high expression was associated with a significantly poorer event and relapse-free survival time by analyzing the data from the R2: Genomics Analysis and Visualization Platform. CONCLUSIONS: Overexpression of FZD7 was associated with poor survival in patients with colon cancer. Our data suggest that FZD7 expression could be an effective prognostic biomarker for colon cancer.

Demethylation and Overexpression of CSF2 are Involved in Immune Response, Chemotherapy Resistance, and Poor Prognosis in Colorectal Cancer.

PURPOSE: This study aimed to evaluate the role of colony-stimulating factor 2 (CSF2) in chemotherapy resistance, prognosis, and immune response and to identify its possible mechanisms underlying drug resistance. METHODS: Drug-resistant cell lines were obtained by successively increasing drug concentration. RNA-Seq was performed to screen hub genes. CSF2 expression was analyzed via immunohistochemistry. Moreover, The Cancer Genome Atlas (TCGA), Tumor Immune Estimation Resource (TIMER) dataset, and R2 platform were used to explore the correlations among CSF2 expression, prognosis, and immune response. RESULTS: RNA-Seq indicated that microRNAs in cancer, P53 signaling pathway, and cell cycle were associated with FOLFOX chemotherapy resistance. Protein-protein interaction (PPI), molecular complex detection (MOCDE), and qRT-PCR analysis verified CSF2 as the hub gene in chemotherapy resistance. Moreover, CSF2 expression was lower in the normal tissue than in the cancerous tissue (P<0.05). Higher expression of CSF2 was associated with poor OS and DFS in colon cancer patients (P<0.05). We further found similar results in the Oncomine database and R2 platform (P<0.05). A higher expression of CSF2 in the CRC tissue may be caused by demethylation, which was verified using the TCGA datasets. Moreover, GSEA demonstrated that CSF2 was associated with immune response, which was consistent with results reported using TIMER datasets. CONCLUSION: CSF2 is a novel biomarker and a prognostic factor for the survival of CRC patients affecting the immune response, and an overexpression of CSF2 in CRC patients may be caused by DNA demethylation.

Swimming Characteristics of Bioinspired Helical Microswimmers Based on Soft Lotus-Root Fibers.

Various kinds of helical swimmers inspired by E. coli bacteria have been developed continually in many types of researches, but most of them are proposed by the rigid bodies. For the targeted drug delivery, the rigid body may hurt soft tissues of the working region with organs. Due to this problem, the biomedical applications of helical swimmers may be restricted. However, the helical microswimmers with the soft and deformable body are appropriate and highly adaptive in a confined environment. Thus, this paper presents a lotus-root-based helical microswimmer, which is fabricated by the fibers of lotus-root coated with magnetic nanoparticles to active under the magnetic fields. The helical microstructures are derived from the intrinsic biological structures of the fibers of the lotus-root. This paper aims to study the swimming characteristic of lotus-root-based microswimmers with deformable helical bodies. In the initial step under the uniform magnetic actuation, the helical microswimmers are bent lightly due to the heterogeneous distribution of the internal stress, and then they undergo a swimming motion which is a spindle-like rotation locomotion. Our experiments report that the microswimmers with soft bodies can locomote faster than those with rigid bodies. Moreover, we also find that the curvature of the shape decreases as a function of actuating field frequency which is related to the deformability of lotus-root fibers.