Atomic Insight into the Local Structure and Microenvironment of Isolated Co-Motifs in MFI Zeolite Frameworks for Propane Dehydrogenation.

Embedding metal species into zeolite frameworks can create framework-bond metal sites in a confined microenvironment. The metals sitting in the specific T sites of zeolites and their crystalline surroundings are both committed to the interaction with the reactant, participation in the activation, and transient state achievement during the whole catalytic process. Herein, we construct isolated Co-motifs into purely siliceous MFI zeolite frameworks (Co-MFI) and reveal the location and microenvironment of the isolated Co active center in the MFI zeolite framework particularly beneficial for propane dehydrogenation (PDH). The isolated Co-motif with the distorted tetrahedral structure ({(≡SiO)2Co(HO-Si≡)2}, two Co-O-Si bonds, and two pseudobridging hydroxyls (Co···OH-Si) is located at T1(7) and T3(9) sites of the MFI zeolite. DFT calculations and deuterium-labeling reactions verify that the isolated Co-motif together with the MFI microenvironment collectively promotes the PDH reaction by providing an exclusive microenvironment to preactivate C3H8, polarizing the oxygen in Co-O-Si bonds to accept H* ({(≡SiO)CoHδ- (Hδ+O-Si≡)3}), and a scaffold structure to stabilize the C3H7* intermediate. The Co-motif active center in Co-MFI goes through the dynamic evolutions and restoration in electronic states and coordination states in a continuous and repetitive way, which meets the requirements from the series of elementary steps in the PDH catalytic cycle and fulfills the successful catalysis like enzyme catalysis.

Multiclass retinal disease classification and lesion segmentation in OCT B-scan images using cascaded convolutional networks.

Disease classification and lesion segmentation of retinal optical coherence tomography images play important roles in ophthalmic computer-aided diagnosis. However, existing methods achieve the two tasks separately, which is insufficient for clinical application and ignores the internal relation of disease and lesion features. In this paper, a framework of cascaded convolutional networks is proposed to jointly classify retinal diseases and segment lesions. First, we adopt an auxiliary binary classification network to identify normal and abnormal images. Then a novel, to the best of our knowledge, U-shaped multi-task network, BDA-Net, combined with a bidirectional decoder and self-attention mechanism, is used to further analyze abnormal images. Experimental results show that the proposed method reaches an accuracy of 0.9913 in classification and achieves an improvement of around 3% in Dice compared to the baseline U-shaped model in segmentation.

Experimental research on a Raman-based distributed temperature sensor assisted by PCA for locating the temperature abnormal event of nuclear waste drums.

Aimed at locating the temperature abnormal event of nuclear waste drums in a nuclear waste temporary storage repository by a Raman-based distributed temperature sensor, a principal component analysis (PCA)-based method for application is proposed. The effectiveness of the proposed method is verified in the physical simulation device of the nuclear waste drums. First, some samples of the temperature abnormal event with known location are taken as the reference samples, and their features are extracted by PCA. Then, the features of the test sample data to be located are also extracted by PCA. The Euclidean distance is used to measure the similarity between the features of the test sample and the feature of each reference sample. Finally, we find the reference sample that is most similar to a test sample, the location of which is considered the location of the temperature anomaly event for the test sample. The experimental results show that the proposed method can accurately locate the temperature abnormal event of the nuclear waste drums, and the accuracy rate can reach 96%. The method that is proposed in this paper can reliably locate the temperature abnormal event generated by the nuclear waste temporary storage repository induced by external factors such as landslides or earthquakes, and provide technical support for nuclear safety.

Secular trends and urban-rural disparities in the median age at menarche among Chinese han girls from 1985 to 2019.

BACKGROUND: Menarche is a substantial milestone of female puberty. Timing of age at menarche is considered the key to understanding the potential linkages with women's health outcomes later in life. This study aimed to explore the secular trends and urban‒rural disparities in the median age at menarche among Chinese Han girls from 1985 to 2019. METHODS: Data were extracted from the 1985, 1995, 2005, 2014, and 2019 Chinese National Surveys on Students' Constitution and Health, which were nationally representative cross-sectional studies, and a total of 173,535 Han girls aged 9-18 years were examined. Girls were asked whether menarche had occurred. The median age at menarche was estimated by probit analysis. Z tests were used to compare the differences between survey years and between urban and rural areas. RESULTS: The median age at menarche among Chinese Han girls decreased from 13.37 years in 1985 to 12.00 years in 2019, and the overall decrease was more significant in rural areas (1.77 years) than in urban areas (0.99 years). The average five-year change in the decrease in the median age at menarche showed an accelerating and then slowing pace; and it was observed similarly in both urban and rural areas. The urban‒rural disparities shrank from 0.64 years in 1985 to 0.44 years in 1995, then to 0.27 years in 2005, 0.24 years in 2014, and finally to - 0.14 years in 2019. CONCLUSIONS: The median age at menarche among Chinese Han girls continued to decline from 1985 to 2019 but at a slowing pace in the last five years. Urban‒rural disparities gradually narrowed. Sexual and reproductive health education and interventions to prevent the decline in the age of menarche are needed, especially in rural areas.

PINE: Universal Deep Embedding for Graph Nodes via Partial Permutation Invariant Set Functions.

Graph node embedding aims at learning a vector representation for all nodes given a graph. It is a central problem in many machine learning tasks (e.g., node classification, recommendation, community detection). The key problem in graph node embedding lies in how to define the dependence to neighbors. Existing approaches specify (either explicitly or implicitly) certain dependencies on neighbors, which may lead to loss of subtle but important structural information within the graph and other dependencies among neighbors. This intrigues us to ask the question: can we design a model to give the adaptive flexibility of dependencies to each node's neighborhood. In this paper, we propose a novel graph node embedding method (named PINE) via a novel notion of partial permutation invariant set function, to capture any possible dependence. Our method 1) can learn an arbitrary form of the representation function from the neighborhood, without losing any potential dependence structures, and 2) is applicable to both homogeneous and heterogeneous graph embedding, the latter of which is challenged by the diversity of node types. Furthermore, we provide theoretical guarantee for the representation capability of our method for general homogeneous and heterogeneous graphs. Empirical evaluation results on benchmark data sets show that our proposed PINE method outperforms the state-of-the-art approaches on producing node vectors for various learning tasks of both homogeneous and heterogeneous graphs.

Bone marrow mesenchymal stem cell-derived extracellular vesicles containing miR-181d protect rats against renal fibrosis by inhibiting KLF6 and the NF-κB signaling pathway.

Recent studies have investigated the ability of extracellular vesicles (EVs) in regulating neighboring cells by transferring signaling molecules, such as microRNAs (miRs) in renal fibrosis. EVs released by bone marrow mesenchymal stem cells (BMSCs) contain miR-181d, which may represent a potential therapy for renal fibrosis. miR-181d has been speculated to regulate Krüppel-like factor 6 (KLF6), which activates the nuclear factor-kappa B (NF-κB) signaling pathway. Luciferase assays were performed to confirm the relationship between miR-181d and KLF6. Gain- and loss-of-function studies in vivo and in vitro were performed to assess the effect of BMSC-derived EVs (BMSC-EVs), which contained miR-181d, on KLF6, NF-κB, and renal fibrosis. Transforming growth factor-ß (TGF-ß)-induced renal tubular epithelial HK-2 cells were treated with EVs derived from BMSCs followed by evaluation of collagen type IV α1 (Col4α1), Collagen I and α-smooth muscle actin (α-SMA) as indicators of the extent of renal fibrosis. Renal fibrosis was induced in rats by unilateral ureteral obstruction (UUO) followed by the subsequent analysis of fibrotic markers. BMSC-EVs had higher miR-181d expression. Overexpression of miR-181d correlated with a decrease in KLF6 expression as well as the levels of IκBα phosphorylation, α-SMA, Col4α1, TGF-ßR1 and collagen I in HK-2 cells. In vivo, treatment with miR-181d-containing BMSC-derived EVs was able to restrict the progression of fibrosis in UUO-induced rats. Together, BMSC-EVs suppress fibrosis in vitro and in vivo by delivering miR-181d to neighboring cells, where it targets KLF6 and inhibits the NF-κB signaling pathway.

Iron-Salt Thermally Emitted Strategy to Prepare Graphene-like Carbon Nanosheets with Trapped Fe Species for an Efficient Electrocatalytic Oxygen Reduction Reaction in the All-pH Range.

Earth-abundant, highly active, and durable electrocatalysts toward oxygen reduction reaction (ORR) in the all-pH range are highly required for practical application of electrochemical energy conversion technologies. Here, non-noble-metal graphene-like carbon nanosheets with trapped Fe species (Fe-N/GPC) are developed by an iron-salt thermally emitted strategy, which integrates the modulation of the electronic structure for boosted intrinsic activity with the engineering of hierarchical porosity for enriched active sites. The ORR electrocatalytic performance of Fe-N/GPC-800 achieves the half-wave potentials of 0.86 and 0.77 V with limiting current densities of 6.1 and 4.7 mA cm-2 in 0.1 M KOH and 0.1 M PBS solutions, respectively, as well as respectable stability. Furthermore, Fe-N/GPC-800 also shows considerable ORR catalytic activity in acid media accompanied by stability superior to those of Pt/C catalysts. The as-prepared Fe-N/GPC-800, as a cathodic catalyst, is assessed in a Zn-air battery test and delivers an open-circuit voltage of 1.44 V with a power density of 134 mW cm-2 as well as the outstanding durability after 350 cycles at 10 mA cm-2, demonstrating appreciable promise in application of metal-air batteries. This work provides an enabling and versatile strategy for facile and scale-up preparation of high-performance non-noble-metal electrocatalysts.

Single-center study of different treatment for advanced or unresectable angiosarcoma patients / 中华肿瘤杂志

Objective: To evaluate the efficacy and safety of different medical treatment in advanced or unresectable angiosarcoma. Methods: This study was a single-center retrospective clinical study. Fifty-five advanced or unresectable angiosarcoma patients treated in Sun-Yat Sen University Cancer Center from January 2005 to August 2020 were enrolled. There were 34 patients who received first-line doxorubicin-based chemotherapy (doxorubicin group), 12 patients received first-line doxorubicin or liposome doxorubicin plus paclitaxel or albumin bound paclitaxel chemotherapy (combination therapy group), and 4 patients received first-line paclitaxel-based treatment (paclitaxel group). There were 6 patients who received anti-angiogenesis targeted therapy, another 2 patients received anti-PD-1 antibody plus anti-angiogenesis targeted therapy. Targeted therapy and immunotherapy plus targeted therapy included 5 cases of first-line therapy and 3 cases of second-line therapy. The therapeutic effect was evaluated by RECIST 1.1 standard. The adverse reactions were evaluated by CTCAE4.0 standard. Kaplan-Meier survival analysis was evaluated with Log rank test. Cox proportional hazard model was used to analyze the influencing factors. Results: There were 18 patients achieved partial response (PR) in 34 patients in the doxorubicin group, median progression-free survival (mPFS) was 4.5 months, and median overall survival (mOS) was 15 months. Four patients achieved PR in 12 patients in the combination therapy group, mPFS and mOS were 4 months and 19 months. Two patients achieved PR in 4 patients in the paclitaxel group, mPFS and mOS were 3 months and 9 months. However, only 1 in 6 patients achieved PR for anti-angiogenesis targeted therapy, mPFS and mOS were 3 months and 16 months. Two patients who received anti-PD-1 immunotherapy combined with anti-angiogenesis targeted therapy acquired PR for 17 months and more than 16 months. Median PFS (7.5 months) were longer in those with primary liver, lung and spleen angiosarcoma than in those with other primary site (3.0 months, P=0.028). The mOS (20 months) was longer in females than that in males (12 months, P=0.045). Primary tumor site, sex, age and treatment were not independent prognostic factors for angiosarcoma patients (P>0.05). Grade 3-4 cardiac toxicity was found in 2 patients in the combination therapy group. Conclusions: Doxorubicin-based and paclitaxel-based chemotherapy are the most important treatment for advanced angiosarcoma. Potential efficacy for targeted therapy combined with anti-PD-1 immunotherapy are showed in some patients with long duration of response and moderate adverse event.

Progress in diagnosis and treatment of gastroparesis after colon cancer surgery / 中华胃肠外科杂志

At present, comprehensive treatment dominated by surgical procedures is an important measure for colon cancer to obtain the chance of cure. Surgical intervention, while removing the tumor, carries the risk of postoperative gastroparesis (PG) . Because of the low incidence rate and insignificant early clinical symptoms, early stage PG is often overlooked clinically. However, PG can increase the risk of malnutrition, delay postoperative antitumor treatment, and increase the risk of tumor recurrence and metastasis. This review focuses on the mechanisms, clinical risk factors, preventive measures, and advances in treatment of PG due to colon cancer. Aim to increase the clinician's adequate attention to PG in colon cancer and from a surgical point to reduce the risk of gastroparesis in colon cancer by optimizing the surgical strategy.

Prognostic factors affecting the success of conversion chemotherapy in patients with unresectable liver metastases from initially colorectal cancer / 中华胃肠外科杂志

Objective: To investigate the factors affecting the success of conversion therapy in patients with initially unresectable colorectal cancer liver metastases (CRLM) in order to provide evidence-based medical evidence for formulating individualized treatment strategies for patients. Methods: A retrospective case-control study was used in this study. Clinical data of 232 patients with initially unresectable CRLM receiving first-line systemic treatment in Sun Yat-sen University Cancer Center from January 2013 to January 2020 were collected, including 98 patients of successful conversion and 134 patients of failed conversion as control. Conversion therapy scheme: 38 patients received FOLFOXIRI regimen chemotherapy (irinotecan, oxaliplatin, calcium folinate and fluorouracil), 152 patients received FOLFOX regimen (oxaliplatin, calcium folinate and fluorouracil), 19 patients received FOLRIRI regimen (irinotecan, calcium folinate and fluorouracil), 23 patients received systemic chemotherapy combined with fluorouridine hepatic artery infusion chemotherapy; 168 patients received targeted therapy, including 68 of bevacizumab and 100 of cetuximab. Logistics analysis was used to compare the factors affecting the success of conversion therapy. The Kaplan-Meier method was used to calculate progression-free survival (PFS), and the Log-rank test was used for survival comparison. Results: Among 232 patients, 98 patients had successful conversions and 134 patients had failed conversions with a successful conversion rate of 42.2%, meanwhile 30 patients underwent simple hepatectomy and 68 underwent hepatectomy combined with intraoperative radiofrequency ablation. After first-line chemotherapy, 111 patients (47.8%) were partial remission, 57 patients (24.6%) were stable disease, and 64 patients (27.6%) were progression disease. During the median follow-up of 18.8 (1.0-87.9) months, 148 patients were dead or with tumor progression. The median PFS time of patients with successful conversion was longer than that of patients with failed conversion (31.0 months vs. 9.9 months, P<0.001). Univariate analysis found that the bilobar distribution of liver tumors (P=0.003), elevated baseline carcinoembryonic antigen (CEA) levels (P=0.024), tumor invasion of the portal vein (P=0.001), number of metastatic tumor>8 (P<0.001), non-FOLFOXIRI (P=0.005), and no targeted therapy (P=0.038) were high risk factors for the failed conversion therapy. The results of multivariate logistics analysis indicated that the number of metastatic tumor >8 (OR=2.422, 95%CI: 1.291-4.544, P=0.006), portal vein invasion (OR=2.727, 95%CI: 1.237-4.170, P=0.008) were the independent risk factors for failed conversion therapy, while FOLFOXIRI regimen (OR=0.300, 95%CI: 0.135-0.666, P=0.003) and targeted drugs (OR=0.411, 95%CI: 0.209-0.809, P=0.010) were independent protective factors for successful conversion therapy. Conclusions: The number of metastatic tumor and portal vein invasion are key factors that affect the outcomes of conversion therapy for initially unresectable CRLM. If a patient can tolerate chemotherapy, a combination program of three-drug and targeted therapy is preferred for the active conversion therapy.

Advances and challenges in neoadjuvant treatment for colorectal cancer liver metastasis / 中华胃肠外科杂志

Liver metastasis is the leading cause of death in patients with colorectal cancer. Since surgical resection alone has a high postoperative recurrence rate, neoadjuvant therapy as an important means is widely applied in order to reduce recurrence and improve survival. Progress has been achieved in many aspects of neoadjuvant therapy in colorectal cancer liver metastasis, such as eligible patients selection, optimal regimens and courses of chemotherapy. However, controversies still remain regarding the standards of resectability of lesions and the application of targeted drugs. Individualized treatments could be developed based on multidisciplinary teamwork to achieve the goal of 'resources integration and treatment stratification'.

A frameshift mutation in exon 19 of MLH1 in a Chinese Lynch syndrome family: a pedigree study / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Lynch syndrome (LS), an autosomal dominantly inherited disease previously known as hereditary non-polyposis colorectal cancer (HNPCC), leads to a high risk of colorectal cancer (CRC) as well as malignancy at certain sites including endometrium, ovary, stomach, and small bowel (Hampel et al., 2008; Lynch et al., 2009). Clinically, LS is considered the most common hereditary CRC-predisposing syndrome, accounting for about 3% of all CRC cases (Popat et al., 2005). LS is associated with mutations of DNA mismatch repair (MMR) genes such as MLH1, MSH2, MSH6, PMS2, and EPCAM (Ligtenberg et al., 2009; Lynch et al., 2009), which can trigger a high frequency of replication errors in both microsatellite regions and repetitive sequences in the coding regions of various cancer-related genes. Immunohistochemistry (IHC) tests followed by genetic analysis of these mutations play a significant role in diagnosis, treatment determination, and therapeutic response prediction of LS (Lynch et al., 2009; Alex et al., 2017; Ryan et al., 2017). Here, we report substitution of one base-pair in exon 1 of MLH3 (c.1397C>A) and a frameshift mutation in exon 19 of MLH1 (c.2250_2251ins AA) in a 43-year-old Chinese male with an LS pedigree.

Clinical Study on Mind-regulating Acupuncture in Treating Primary Trigeminal Neuralgia / 上海针灸杂志

Objective To observe the clinical efficacy of mind-regulating acupuncture in treating primary trigeminal neuralgia.Method Sixty-one patients with primary trigeminal neuralgia were randomized into a treatment group of 31 cases and a control group of 30 cases by using random number table method. The control group was intervened by oral administration of Carbamazepine, while the treatment group was additionally given mind-regulating acupuncture. The pain intensity, pain flare-up frequency and quality of life in the two groups were evaluated before and after the treatment, and the clinical efficacies were compared.Result The total effective rate was 90.3％ in the treatment group, versus 70.0％ in the control group, and the between-group difference was statistically significant (P<0.05). The pain score, pain flare-up frequency and quality of life score after the treatment were significantly different from those before the treatment in both groups (P<0.05); there were no significant between-group differences in comparing the pain score and flare-up frequency after the treatment (P>0.05); there was significant between-group difference in comparing the quality of life score after the treatment(P<0.05). The pain score, pain flare-up frequency and quality of life score at the 6-month follow-up were significantly different from those before and after the treatment in both groups (P<0.05); there were significant between-group differences in comparing the pain score, flare-up frequency and the quality of life score at the 6-month follow-up (P<0.05). Conclusion Mind-regulating acupuncture can produce a significant efficacy in treating primary trigeminal neuralgia and obviously enhance the quality of life.

Clinical Study on Mind-regulating Acupuncture in Treating Primary Trigeminal Neuralgia / 上海针灸杂志

Objective To observe the clinical efficacy of mind-regulating acupuncture in treating primary trigeminal neuralgia.Method Sixty-one patients with primary trigeminal neuralgia were randomized into a treatment group of 31 cases and a control group of 30 cases by using random number table method. The control group was intervened by oral administration of Carbamazepine, while the treatment group was additionally given mind-regulating acupuncture. The pain intensity, pain flare-up frequency and quality of life in the two groups were evaluated before and after the treatment, and the clinical efficacies were compared.Result The total effective rate was 90.3％ in the treatment group, versus 70.0％ in the control group, and the between-group difference was statistically significant (P<0.05). The pain score, pain flare-up frequency and quality of life score after the treatment were significantly different from those before the treatment in both groups (P<0.05); there were no significant between-group differences in comparing the pain score and flare-up frequency after the treatment (P>0.05); there was significant between-group difference in comparing the quality of life score after the treatment(P<0.05). The pain score, pain flare-up frequency and quality of life score at the 6-month follow-up were significantly different from those before and after the treatment in both groups (P<0.05); there were significant between-group differences in comparing the pain score, flare-up frequency and the quality of life score at the 6-month follow-up (P<0.05). Conclusion Mind-regulating acupuncture can produce a significant efficacy in treating primary trigeminal neuralgia and obviously enhance the quality of life.

Change of peripheral blood Th17 cells and its signiifcance in patients with different kinds of chronic rhinosinusitis with nasal polyps / 中国耳鼻咽喉头颈外科

OBJECTIVETo observe the change of peripheral blood Th17 cells in patients with different kinds of CRSwNPs and the relationship between the frequency of Th17 cells and inflammatory cell density in nasal polyps tissue, and to explore the correlation between levels of peripheral blood Th17 cells and prognosis of patients with CRSwNPs.METHODSEighty one patients with CRSwNPs and 20 controls were recruited in this research. Flow cytometer was used to detect the expression of peripheral blood Th17 cells. The number per 10000μm2 of infiltrated inflammatory cells in nasal polyp tissue (including eosinophils, neutrophils, lymphocytes and plasma cells) was counted at a high-power field. The CT scores were evaluated by Lund-Mackay system and the nasal endoscopy scores were graded according to Lund-Mackay methods. RESULTSThe percentages of Th17 cells in patients with E-CRSwNPs and NE-CRSwNPs were 2.10% (3.75%, 1.40%)和1.10% (1.70%, 0.73%). There was significant difference between the two groups (Mann-WhitneyU=358.0,Z=-2.965, P=0.001). Furthermore, a positive association between the percentage of Th17 cells in peripheral blood and the eosinophil density of nasal polyp (r=0.408,P<0.001) was demonstrated. The percentage of Th17 cell in peripheral blood was significantly correlated with the endoscopic score of CRSwNPs at third month after the operation (r=0.458, P<0.001).CONCLUSIONThl7 might be involved in the pathogenesis and prognosisof eosinophilic CRSwNPs.

The recurrent rate of nasal endoscopic microsurgical skills for the treatment of nasal inverted papilloma: a meta-analysis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the recurrence rate of nasal inverted papilloma treating by endoscopic and non-endoscopic approach.@*METHOD@#A search on Pubmed, Medline, Springer and Elsevier databases was done to collect the reports (2001-2013) concerning different surgery treating nasal inverted papillomas, and meta-analysis was performed with RevMan 5.0 software.@*RESULT@#Twelve papers (2001-2013) concerning the different surgery approach treating nasal inverted papillomas were retrieved. The heterogeneity test indicated that the 12 studies were consistent statistically (Q = 14.64, df = 11, P = 0.20), the data from these 12 studies could be analyzed by fixed effect model. After combination of these data, those of 1012 subjects accepted endoscopic surgical intervention and 359 subjects treating by non-endoscopic surgical intervention were collected. Test of overall effect by fixed effect model showed that the recurrence rate of inverted papilloma was significantly lower in endoscopic group than in non-endoscopic group (OR = 0.49, 95% CI was 0.35-0.69, P < 0.01). Funnel plot implied that publication bias was not obvious.@*CONCLUSION@#The recurrence rate of inverted papilloma was significantly lower in endoscopic group than in non-endoscopic group.

Surgery with versus without preoperative concurrent chemoradiotherapy for mid/low rectal cancer: an interim analysis of a prospective, randomized trial / 癌症

<p><b>INTRODUCTION</b>Multimodality therapy, including preoperative chemoradiotherapy (CRT) and total mesorectal excision (TME), has effectively reduced local recurrence rates of rectal cancer over the past decade. However, the benefits and risks of the addition of neoadjuvant CRT to surgery need to be evaluated. This study was to compare the efficacy of TME with versus without preoperative concurrent chemoradiotherapy (CCRT) involving XELOX regimen (oxaliplatin plus capecitabine) in Chinese patients with stages II and III mid/low rectal adenocarcinoma.</p><p><b>METHODS</b>We randomly assigned patients to the TME group (TME without preoperative CCRT) or CCRT + TME group (TME with preoperative CCRT). The primary endpoint was disease-free survival (DFS); the secondary endpoints were overall survival (OS), local and distant recurrence, tumor response to CRT, toxicity, sphincter preservation, and surgical complications. An interim analysis of the potential inferiority of DFS in the CCRT + TME group was planned when the first 180 patients had been followed up for at least 6 months.</p><p><b>RESULTS</b>A total of 94 patients in the TME group and 90 patients in the CCRT + TME group were able to be evaluated. The 3-year DFS and OS rates were 86.3 % and 91.5 % in the whole cohort, respectively. The 3-year DFS rates of the TME and CCRT + TME groups were 85.7% and 87.9 % (P = 0.766), respectively, and the 3-year OS rates were 90.7 % and 92.3 % (P = 0.855), respectively. The functional sphincter preservation rates of the TME and CCRT + TME groups were 71.3 % and 70.0 % (P = 0.849), respectively. In the TME group, 16 (17.0 %) patients were proven to have pTNM stage I disease after surgery. In the CCRT + TME group, 32 (35.6 %) patients achieved a pathologic complete response (pCR).</p><p><b>CONCLUSIONS</b>Preliminary results indicated no significant differences in the DFS, OS, or functional sphincter preservation rates between the TME and CCRT + TME groups. However, preoperative CCRT with XELOX yielded a high pCR rate. Newer techniques are needed to improve the staging accuracy, and further investigation is warranted.</p><p><b>CLINICAL TRIAL REGISTRATION NUMBER</b>Chi CTR-TRC-08000122.</p>

New prospective on adjuvant treatment for gastrointestinal stromal tumors / 中华胃肠外科杂志

Gastrointestinal stromal tumor (GIST) represents the most common mesenchymal tumor of the gastrointestinal tract. With decades of development, surgical excision combined with molecular targeted agents is becoming the mode for the GIST treatment. Imatinib mesylate (IM) is the first-line therapy medicine for GIST adjuvant treatment, and it significantly reduces recurrence or metastasis and increases survival. According to the recently results of SSGXVIII/AIO study, imatinib adjuvant therapy should be administered for at least 3 years for the GIST patients with a high estimated risk of recurrence and metastasis after surgery. Nevertheless, the optimal duration of the adjuvant therapy or the follow-up policy remains unclear, and we look forward to standard assessment criteria for individualized treatment.

Disputes about surgical treatment of colorectal liver metastasis / 中华胃肠外科杂志

As the most common metastasis in colorectal cancer, liver metastasis is the primary cause of treatment failure. Resection plays a dominant role in multidisciplinary treatment of colorectal liver metastases. However, this surgical field is still filled with disputes and challenges. Literature on liver metastasis of colorectal cancer were reviewed and clinical trials were collected. Different opinions were analyzed according to clinical evidence and personal experience. There are many disputes about surgical treatment of colorectal liver metastases, including incomplete staging system, inconsistent criteria of potential resectability, neoadjuvant chemotherapy for resectable liver metastases, adjuvant chemotherapy regimen after radical resection, and treatment of asymptomatic primary lesion in patients with unresectable liver metastasis.

Study on associated biomarkers influencing recurrence, metastasis and prognosis in patients with gastrointestinal stromal tumors after complete resection / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the associated biomarkers influencing recurrence, metastasis and prognosis in patients with gastrointestinal stromal tumors (GIST) after complete resection.</p><p><b>METHODS</b>Tumor tissue samples of 148 patients with GIST undergoing complete resection from January 1990 to December 2008 in Sun Yat-sen University Cancer Center were collected. The expressions of Ki-67, E-cadherin, MMP7, CD44, nm23, P53, survivin, Cyclin D1, COX-2, and VEGF in tumor tissue samples were detected by tissue microarray and immunohistochemistry (IHC). The association of above factors expressions with recurrence, metastasis and prognosis was examined.</p><p><b>RESULTS</b>Log-rank test showed that Ki-67, E-cadherin, MMP7, CD44, P53 and survivin were associated to disease-free duration after complete GIST resection (all P<0.05), and the Ki-67, E-cadherin, P53 and survivin were associated to overall survival (all P<0.05). Cox multivariate analysis revealed that disease-free survival was associated with Ki-67, CD44 and P53 (all P<0.05), and the overall survival was only associated with Ki-67 (P<0.05).</p><p><b>CONCLUSION</b>Ki-67, CD44 and P53 are closely associated with recurrence and metastasis after complete GIST resection, and Ki-67 can predict the prognosis of GIST.</p>