RESUMO
BACKGROUND: Data on the long-term oncological outcomes of patients who undergo conversion surgery (CS) in gastric cancer (GC) patients with peritoneal metastasis (PM) are limited. METHODS: GC patients with PM who received intraperitoneal (ip) and systemic chemotherapy between April 2015 and January 2021 were enrolled. Multivariate analysis was performed to identify risk factors associated with survival. Clinicopathological and survival outcomes were compared between those with CS and those without CS (NCS). The paclitaxel (PTX) plus tegafur-gimeracil-oteracil potassium capsules (S-1) (PS) + ip PTX and oxaliplatin plus S-1 (SOX) + ip PTX groups were matched in a 1:1 ratio using propensity score matching. Oncological and survival data were collected and analyzed. RESULTS: A total of 540 patients who received ip chemotherapy via subcutaneous port and systemic chemotherapy were analyzed and 268 patients were enrolled, including 113 who underwent CS and 155 who did not. Overall survival (OS) were 27.0 months and 11.8 months in the CS and NCS groups (P < 0.0001), respectively. R0 resection was an independent prognostic factor for patients who underwent CS. The OS of patients with or without ovariectomy was 21.3 or 12.0 months (P < 0.0001). No difference of clinicopathological and survival outcomes was found between the PS + ip PTX and SOX + ip PTX groups. CONCLUSION: Conversion therapy is safe and adverse events were manageable. CS improves the survival of GC patients with PM after ip and systemic chemotherapy. R0 is an important prognostic factor. Furthermore, outcomes are comparable between the PS + ip PTX and SOX + ip PTX groups.
Assuntos
Neoplasias Peritoneais , Neoplasias Gástricas , Feminino , Humanos , Neoplasias Gástricas/patologia , Neoplasias Peritoneais/secundário , Estudos Retrospectivos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Paclitaxel/uso terapêuticoRESUMO
Stereo matching and instrument segmentation of laparoscopic surgical scenarios are key tasks in robotic surgical automation. Many researchers have been studying the two tasks separately for stereo matching and instrument segmentation. However, the relationship between these two tasks is often neglected. In this paper, we propose a model framework for multi-tasking with complementary functions for stereo matching and surgical instrument segmentation (MCF-SMSIS). We aim to complement the features of instrument prediction segmentation to the parallax matching block of stereo matching. We also propose two new evaluation metrics (MINPD and MAXPD) for assessing how well the parallax range matches the migrated domain when the model used for the stereo matching task undergoes domain migration. We performed stereo matching experiments on the SCARED , SERV-CT dataset as well as instrumentation segmentation experiments on the AutoLaparo dataset. The results demonstrate the effectiveness of the proposed method. In particular, stereo matching supplemented with instrument features reduced EPE, >3px and RMSE Depth in the surgical instrument section by 9.5%, 12.7% and 6.51%, respectively. The instrumentation segmentation performance also achieves a DSC value of 0.9233. Moreover, MCF-SMSIS takes only 0.14 s to infer a set of images. The model code and model weights for each stage are available from https://github.com/wurenkai/MCF-SMSIS.
Assuntos
Procedimentos Cirúrgicos Robóticos , Humanos , Procedimentos Cirúrgicos Robóticos/métodos , Laparoscopia , Imageamento Tridimensional/métodos , AlgoritmosRESUMO
In this study, Brassica chinensis L seedlings after 6 weeks of soil cultivation were treated with foliar application of TiO2 NPs (20 mg/L) for different times. Transcriptomics analysis was employed to investigate the impact of TiO2 NPs on the physiology, growth, and yield of B. chinensis L. Results showed that TiO2 NPs' exposure significantly increased the biomass, total phosphorus, and catalase enzyme activity by 23.60, 23.72, and 44.01%, respectively, compared to the untreated ones (not bulk or ion).TiO2 NPs increased the leaf chlorophyll content by 4.9% and photosynthetic rate by 16.62%, which was attributed to the upregulated expression of seven genes (PetH, PetF, PsaF, PsbA, PsbB, PsbD, and Lhcb) associated with electron transport in photosystem I and light-harvesting in leaves. The water balance of B. chinensis was improved correlating with the altered expressions of 19 aquaporin genes (e.g., PIP2;1 and NIP6;1). The expressions of 58 genes related to plant hormone signaling and growth were dysregulated, with notable downregulations in GA20, SnRK2, and PP2C and upregulations of DELLAs, SAM, and ETR. Moreover, the 11 tricarboxylic acid cycle genes and 13 glycolysis genes appear to stimulate pathways involved in promoting the growth and physiology of B. chinensis. This research contributes valuable insights into new strategies for increasing the yield of B. chinensis.