Background:Low-grade endometrial stromal sarcoma(LG-ESS)is a rare tumor that lacks a prognostic prediction model.Our study aimed to develop a nomogram to predict overall survival of LG-ESS patients.Methods:A total of ...Background:Low-grade endometrial stromal sarcoma(LG-ESS)is a rare tumor that lacks a prognostic prediction model.Our study aimed to develop a nomogram to predict overall survival of LG-ESS patients.Methods:A total of 1172 patients confirmed to have LG-ESS between 1988 and 2015 were selected from the Surveillance,Epidemiology and End Results(SEER)database.They were further divided into a training cohort and a validation cohort.The Akaike information criterion was used to select variables for the nomogram.The discrimination and calibration of the nomogram were evaluated using concordance index(C-index),area under time-dependent receiver operating characteristic curve(time-dependent AUC),and calibration plots.The net benefits of the nomogram at different threshold probabilities were quantified and compared with those of the International Federation of Gynecology and Obstetrics(FIGO)criteria-based tumor staging using decision curve analysis(DCA).Net reclassification index(NRI)and integrated discrimination improvement(IDI)were also used to compare the nomogram’s clinical utilitywith that of the FIGO criteria-based tumor staging.The risk stratifications of the nomogram and the FIGO criteria-based tumor staging were compared.Results:Seven variables were selected to establish the nomogram for LG-ESS.The C-index(0.814 for the training cohort and 0.837 for the validation cohort)and the time-dependent AUC(>0.7)indicated satisfactory discriminative ability of the nomogram.The calibration plots showed favorable consistency between the prediction of the nomogram and actual observations in both the training and validation cohorts.The NRI values(training cohort:0.271 for 5-year and 0.433 for 10-year OS prediction;validation cohort:0.310 for 5-year and 0.383 for 10-year OS prediction)and IDI(training cohort:0.146 for 5-year and 0.185 for 10-year OS prediction;validation cohort:0.177 for 5-year and 0.191 for 10-year OS prediction)indicated that the established nomogram performed significantly better than the FIGO criteria-based 展开更多
Global urbanization is exerting severe stress and having far-reaching impacts on the eco-environment, and yet there exists a complex non-linear coupling relationship between the two. Research on the interactive coupli...Global urbanization is exerting severe stress and having far-reaching impacts on the eco-environment, and yet there exists a complex non-linear coupling relationship between the two. Research on the interactive coupling effect between urbanization and the eco-environment will be a popular area of study and frontier in international earth system science and sustainability science in the next 10 years, while also being a high-priority research topic of particular interest to international organizations. This paper systematically collates and summarizes the international progress made in research on interactive coupling theory, coupling relationships, coupling mechanisms, coupling laws, coupling thresholds, coupling models and coupling optimization decision support systems. The research shows that urbanization and eco-environment interactive coupling theories include the Kuznets curve theory, telecoupling theory, planetary boundaries theory, footprint family theory and urban metabolism theory; most research on interactive coupling relationships is concerned with single- element coupling relationships, such as those between urbanization and water, land, atmosphere, climate change, ecosystems and biodiversity; the majority of research on interactive coupling mechanisms and laws focuses on five research paradigms, including coupled human and nature systems, complex social-ecological systems, urban ecosystems, social-economic-natural complex ecosystems, and urbanization development and eco-environment constraint ring; the majority of interactive coupling simulations use STIRPAT models, coupling degree models, multi-agent system models and big data urban computer models; and research has been carried out on urbanization and eco-environment coupling thresholds, coercing risk and optimal decision support systems. An objective evaluation of progress in international research on interactive coupling between urbanization and the eco-environment suggests that there are six main research focal points and six areas lacking resea展开更多
AIM:To determine the risk factors for hepatocellular carcinoma(HCC) rupture,and report the management and long-term survival results of patients with spontaneous rupture of HCC.METHODS:Among 4209 patients with HCC who...AIM:To determine the risk factors for hepatocellular carcinoma(HCC) rupture,and report the management and long-term survival results of patients with spontaneous rupture of HCC.METHODS:Among 4209 patients with HCC who were diagnosed at Eastern Hepatobiliary Surgery Hospital from April 2002 to November 2006,200(4.8%) patients with ruptured HCC(case group) were studied retrospectively in term of their clinical characteristics and prognostic factors.The one-stage therapeutic approach to manage ruptured HCC consisted of initial management by conservative treatment,transarterial embolization(TACE) or hepatic resection.Results of various treatments in the case group were evaluated and compared with the control group(202 patients) without ruptured HCC during the same study period.Continuous data were expressed as mean ± SD or me-dian(range) where appropriate and compared using the unpaired t test.Categorical variables were compared using the Chi-square test with Yates correction or the Fisher exact test where appropriate.The overall survival rate in each group was determined using the Kaplan-Meier method and a log-rank test.RESULTS:Compared with the control group,more patients in the case group had underlying diseases of hypertension(7.5% vs 3.0%,P =0.041) and liver cirrhosis(87.5% vs 56.4%,P < 0.001),tumor size >5 cm(83.0% vs 57.4%,P < 0.001),tumor protrusion from the liver surface(66.0% vs 44.6%,P < 0.001),vascular thrombus(30.5% vs 8.9%,P < 0.001) and extrahepatic invasion(36.5% vs 12.4%,P < 0.001).On multivariate logistic regression analysis,underlying diseases of hypertension(P = 0.002) and liver cirrhosis(P < 0.001),tumor size > 5 cm(P < 0.001),vascular thrombus(P = 0.002) and extrahepatic invasion(P < 0.001) were predictive for spontaneous rupture of HCC.Among the 200 patients with spontaneous rupture of HCC,105 patients underwent hepatic resection,33 received TACE,and 62 were managed with conservative treatment.The median survival time(MST) of all patients with spontaneous rupture of HCC was 6 mo(range,1-72 mo)展开更多
AIM To investigate the efficacy and safety of postoperative adjuvant transcatheter arterial chemoembolization(PA-TACE) in preventing tumor recurrence and improving survival in Barcelona Clinic Liver Cancer(BCLC) early...AIM To investigate the efficacy and safety of postoperative adjuvant transcatheter arterial chemoembolization(PA-TACE) in preventing tumor recurrence and improving survival in Barcelona Clinic Liver Cancer(BCLC) early(A) and intermediate(B) stage hepatocellular carcinoma(HCC) patients with microvascular invasion(MVI).METHODS A total of 519 BCLC A or B HCC patients treated by liver resection alone or followed by PA-TACE between January 2012 and December 2015 were studied retrospectively. Univariate and multivariate analyses were performed to investigate the risk factors for recurrence-free survival(RFS) and overall survival(OS). Multiple logistic regression was used to identify the clinicopathological characteristics associated with MVI. The rates of RFS and OS were compared among patients with or without MVI treated with liver resection alone or followed by PA-TACE. RESULTS Univariate and multivariate analyses demonstrated that serum AFP level > 400 ng/m L, tumor size > 5 cm, tumor capsule invasion, MVI, and major hepatectomy were risk factors for poor OS. Tumor capsule invasion, MVI, tumor size > 5 cm, HBV-DNA copies > 1 x 104 IU/m L, and multinodularity were risk factors for poor RFS. Multiple logistic regression identified serum AFP level > 400 ng/m L, tumor size > 5 cm, and tumor capsule invasion as independent predictors of MVI. Both OS and DFS were significantly improved in patients with MVI who received PA-TACE as compared to those who underwent liver resection alone. Patients without MVI did not show a significant difference in OS and RFS between those treated by liver resection alone or followed by PA-TACE.CONCLUSION PA-TACE is a safe adjuvant intervention and can efficiently prevent tumor recurrence and improve the survival of BCLC early-and intermediate-stage HCC patients with MVI.展开更多
Background:N6-methyladenosine(m6A)RNA modification has been demonstrated to be a significant regulatory process in the progression of various tumors,including breast cancer.Fat mass and obesity-associated(FTO)enzyme,i...Background:N6-methyladenosine(m6A)RNA modification has been demonstrated to be a significant regulatory process in the progression of various tumors,including breast cancer.Fat mass and obesity-associated(FTO)enzyme,initially known as the obesity-related protein,is the first identified m6A demethylase.However,the relationship between FTO and breast cancer remains controversial.In this study,we aimed to elucidate the role and clinical significance of FTO in breast cancer and to explore the underlying mechanism.Methods:We first investigated the expression of FTO in breast cancer cell lines and tissues by quantitative reverse transcription-PCR(qRT-PCR),Western blotting,and immunohistochemistry.Wound healing assay and Transwell assay were performed to determine the migration and invasion abilities of SKBR3 and MDAMB453 cells with either knockdown or overexpression of FTO.RNA sequencing(RNA-seq)was conducted to decipher the downstream targets of FTO.qRT-PCR,luciferase reporter assay,and Western blotting were employed to confirm the existence of the FTO/miR-181b-3p/ARL5B axis.The biological function of ADP ribosylation factor like GTPase 5B(ARL5B)in breast cancer cells was evaluated by wound healing assay and Transwell invasion assay.Results:High FTO expression was observed in human epidermal growth factor receptor 2(HER2)-positive breast cancer,predicting advanced progression(tumor size[P<0.001],nuclear grade[P=0.001],peritumoral lymphovascular invasion[P<0.001),lymph node metastasis[P=0.002],and TNM stage[P=0.001])and poor prognosis.Moreover,FTO promoted cell invasion and migration in vitro.Mechanistically,RNA-seq and further confirmation studies suggested that FTO up-regulated ARL5B by inhibiting miR-181b-3p.We further verified that ARL5B also displayed carcinogenic activity in breast cancer cells.Conclusion:Our work demonstrated the carcinogenic activity of FTO in promoting the invasion and migration of breast cancer cells via the FTO/miR-181b-3p/ARL5B signaling pathway.展开更多
An investigation was conducted on the overall burst-instability of isolated coal pillars by means of the possibility index diagnosis method（PIDM）. First, the abutment pressure calculation model of the gob in side di...An investigation was conducted on the overall burst-instability of isolated coal pillars by means of the possibility index diagnosis method（PIDM）. First, the abutment pressure calculation model of the gob in side direction was established to derive the abutment pressure distribution curve of the isolated coal pillar. Second, the overall burst-instability ratio of the isolated coal pillars was defined. Finally, the PIDM was utilized to judge the possibility of overall burst-instability and recoverability of isolated coal pillars.The results show that an overall burst-instability may occur due to a large gob width or a small pillar width. If the width of the isolated coal pillar is not large enough, the shallow coal seam will be damaged at first, and then the high abutment pressure will be transferred to the deep coal seam, which may cause an overall burst-instability accident. This approach can be adopted to design widths of gobs and isolated coal pillars and to evaluate whether an existing isolated coal pillar is recoverable in skip-mining mines.展开更多
Background The continual and rapid development of techniques which are used for diagnosis and treatment makes management of colorectal cancer more difficult depending on single discipline.Colorectal cancer multidiscip...Background The continual and rapid development of techniques which are used for diagnosis and treatment makes management of colorectal cancer more difficult depending on single discipline.Colorectal cancer multidisciplinary team （MDT） working model is recommended by UK and other countries,but there is little information on the impact of MDT working on management of colorectal cancer in China.The aim of this study was to assess the effect on management of colorectal cancer after the inception of an MDT.Methods A total of 595 consecutive colorectal cancer patients were referred to the Department of Gastroenterological Surgery,the pre-MDT cohort include 297 patients,recruited from January 1999 to November 2002,and the MDT cohort had 298 patients enrolled from December 2002 to September 2006.Information recorded included：TNM stage from histological reports,degree of differentiation,the number of examined lymph nodes and CT TNM staging performed or not,and its accuracy,including local and distant recurrence.Results The number of examined lymph nodes and the accuracy of TNM staging by CT in the MDT group were significantly more than those in pre-MDT group.CT TNM staging was more accurate in the MDT group compared to the pre-MDT group （P=-0.044）.The rate of tumor recurrence in the MDT group was lower than pre-MDT group （log-rank test,P 〈0.001）.Multivariate analysis revealed that age （P=0.001）,management after inception of the MDT （P=0.002）,degree of differentiation （P=0.003）,number of examined lymph nodes （P=0.002）,and TNM stage （P=0.000） were important factors that independently influence overall survival.Conclusions The inception of MDT working improved the diagnostic accuracy and overall survival of colorectal cancer patients.MDT working promoted communication and cooperation between disciplines and ensured high-quality diagnosis,evidence-based decision making,and optimal treatment planning.展开更多
The development of efficient, low-cost, for water splitting, particularly those stable, non-noble-metal electrocatalysts that can catalyze both the hydrogen evolution reaction （HER） at the cathode and oxygen evoluti...The development of efficient, low-cost, for water splitting, particularly those stable, non-noble-metal electrocatalysts that can catalyze both the hydrogen evolution reaction （HER） at the cathode and oxygen evolution reaction （OER） at the anode, is a challenge. We have developed a facile method for synthesizing CoSe2 nanoparticles uniformly anchored on carbon fiber paper （CoSe2/CF） via pyrolysis and selenization of in situ grown zeolitic imidazolate framework-67 （ZIF-67）. CoSe2/CF shows high and stable catalytic activity in both the HER and OER in alkaline solution. At a low cell potential, i.e., 1.63 V, a water electrolyzer equipped with two CoSe2/CF electrodes gave a water-splitting current of 10 mA.cm-2. At a current of 20 mA-cm-2, it can operate without degradation for 30 h. This study not only offers a cost-effective solution for water splitting but also provides a new strategy for developing various catalytic nanostructures by changing the metal-organic framework precursors.展开更多
Background Neoadjuvant chemotherapy has been used as a primary treatment for locally advanced or inflammatory breast cancer, and recently extended to operable breast cancer. However, only a few studies have published ...Background Neoadjuvant chemotherapy has been used as a primary treatment for locally advanced or inflammatory breast cancer, and recently extended to operable breast cancer. However, only a few studies have published data concerning the outcomes of patients with stages II and III breast cancer after neoadjuvant chemotherapy. Methods This study retrospectively investigated the clinical value of neoadjuvant chemotherapy for patients with stages II and III breast cancer. The patients in Group 1 （n=54） were treated with neoadjuvant chemotherapy, followed by definitive surgery and adjuvant therapy. The patients in Group 2 （n=-43） initially received definitive surgery, followed by adjuvant chemotherapy and other therapies. The operability rates for breast conservation and dermatoplasty were observed in Group 1 after neoadjuvant chemotherapy. After follow-up, the recurrence and overall and disease-free survival rates of the two groups were analyzed. Results Neoadjuvant chemotherapy increased the operability rates for breast conservation from 17.1% to 40.0% in stage II （P=0.034） and 0% to 12.6% in stage III （P=0.016）, and decreased the dermatoplasty rates from 17.1% to 2.8% in stage II （P=0.046） and 28.1% to 8.1% in stage Ill （P=0.026）. After a median follow-up of 46.8 months, there were 11 deaths and 13 recurrences in Group 1, and 15 deaths and 19 recurrences in Group 2. The overall and disease-free survival rates of stage III disease were significantly higher in Group 1 than in Group 2 （68.4% vs 31.2%, P=0.028, and 63.2% vs 25.0%, P=0.024, respectively）. There were no significant differences in the overall and disease-free survival rates of stage II disease for Group 1 compared with Group 2 （85.7% vs 85.2%, P=0.953, and 80.6% vs 74.1%, P=0.400, respectively）. Conclusions Neoadjuvant chemotherapy resulted in increased operability for breast conservation and decreased dermatoplasty. Neoadjuvant chemotherapy exhibited better recurrence control, and overall and disease-free survival rates in展开更多
AIM: To systematically review the survival outcomes relating to extramural venous invasion in rectal cancer.METHODS: A systematic review was conducted using PRISMA guidelines. An electronic search was carried out usin...AIM: To systematically review the survival outcomes relating to extramural venous invasion in rectal cancer.METHODS: A systematic review was conducted using PRISMA guidelines. An electronic search was carried out using MEDLINE, EMBASE, CINAHL, Cochrane library databases, Google scholar and Pub Med until October 2014. Search terms were used in combination to yield articles on extramural venous invasion in rectal cancer. Outcome measures included prevalence and 5-year survival rates. These were graphically displayed using Forest plots. Statistical analysis of the data was carried out.RESULTS: Fourteen studies reported the prevalence of extramural venous invasion(EMVI) positive patients. Prevalence ranged from 9%-61%. The pooled prevalence of EMVI positivity was 26% [Random effects: Event rate 0.26(0.18, 0.36)]. Most studies showed that EMVI related to worse oncological outcomes. The pooled overall survival was 39.5% [Random effects: Event rate 0.395(0.29, 0.51)].CONCLUSION: Historically, there has been huge variation in the prevalence of EMVI through inconsistent reporting. However the presence of EMVI clearly leads to worse survival outcomes. As detection rates become more consistent, EMVI may be considered as part of risk-stratification in rectal cancer. Standardised histopathological definitions and the use of magnetic resonance imaging to identify EMVI will improve detection rates in the future.展开更多
Background:A growing body of evidence supports the use of laparoscopic pancreaticoduodenectomy(LPD)as an efficient and feasible surgical technique.However,few studies have investigated its applicability in pancreatic ...Background:A growing body of evidence supports the use of laparoscopic pancreaticoduodenectomy(LPD)as an efficient and feasible surgical technique.However,few studies have investigated its applicability in pancreatic ductal adenocarcinoma(PDAC),and the long-term efficacy of LPD on PDAC remains unclear.This study aimed to compare the short-and long-term outcomes between LPD and open pancreaticoduodenectomy(OPD)for PDAC.Methods:The data of patients who had OPD or LPD for PDAC between January 2013 and September 2017 were retrieved.Their postoperative outcomes and survival were compared after propensity score matching.Results:A total of 309 patients were included.After a 2:1 matching,93 cases in the OPD group and 55 in the LPD group were identified.Delayed gastric emptying(DGE),particularly grade B/C DGE,occurred less frequently in the LPD group than in the OPD group(1.8%vs.36.6%,P<0.001;1.8%vs.22.6%,P=0.001).The overall complication rates were significantly lower in the LPD group than in the OPD group(49.1%vs.71.0%,P=0.008),whereas the rates of major complications were similar(10.9%vs.14.0%,P=0.590).In addition,the median overall survival was comparable between the two groups(20.0 vs.18.7 months,P=0.293).Conclusion:LPD was found to be technically feasible with efficacy similar to OPD for patients with PDAC.展开更多
Large scale synthesis of high-efficiency bifunctional electrocatalyst based on cost-effective and earth-abundant transition metal for overall water splitting in the alkaline environment is indispensable for renewable ...Large scale synthesis of high-efficiency bifunctional electrocatalyst based on cost-effective and earth-abundant transition metal for overall water splitting in the alkaline environment is indispensable for renewable energy conversion.In this regard,meticulous design of active sites and probing their catalytic mechanism on both cathode and anode with different reaction environment at molecular-scale are vitally necessary.Herein,a coordination environment inheriting strategy is presented for designing low-coordination Ni^(2+)octahedra(L-Ni-8)atomic interface at a high concentration(4.6 at.%).Advanced spectroscopic techniques and theoretical calculations reveal that the self-matching electron delocalization and localization state at L-Ni-8 atomic interface enable an ideal reaction environment at both cathode and anode.To improve the efficiency of using the self-modification reaction environment at L-Ni-8,all of the structural features,including high atom economy,mass transfer,and electron transfer,are integrated together from atomic-scale to macro-scale.At high current density of 500 mA/cm2,the samples synthesized at gram-scale can deliver low hydrogen evolution reaction(HER)and oxygen evolution reaction(OER)overpotentials of 262 and 348 mV,respectively.展开更多
Objective:This study aimed to investigate the potential determining epidemiological and clinical risk factors affecting the survival of esophageal cancer(EC)patients across multiple hospitals in China.Methods:This was...Objective:This study aimed to investigate the potential determining epidemiological and clinical risk factors affecting the survival of esophageal cancer(EC)patients across multiple hospitals in China.Methods:This was a multicenter study comprising of newly diagnosed EC cases from Beijing,Hebei,Henan,Hubei,Zhejiang,and Guangdong Province of China.Their baseline characteristics and treatment methods data were collected from their medical records.The EpiData software was used for data quality control.The Kaplan-Meier method was used to estimate their overall survival(OS),and the Cox’s proportional hazard regression model was used to estimate hazard ratios(HR)and 95%confidence interval(CI).Results:The 3-and 5-year OS rates of the 5283 investigated EC patients were 49.98%and 39.07%,respectively.Their median survival was 36.00 months.The median survival time of females was longer than that of males(females vs.males:45.00 vs.33.00,P<0.001).The 5-year OS rate of patients who never-smoked was higher than that of smokers(never-smokers vs smokers:40.73%vs.37.84%,P=0.001).There was no significant difference in the 5-year OS rate between drinkers and never-drinkers(drinkers vs never-drinkers:34.22%vs.29.65%,P=0.330).In multivariate analysis,pathological stage(stage II:HR=1.80,95%CI=1.40-2.31;stage III:HR=2.62,95%CI=2.06-3.34;stage IV:HR=3.90,95%CI=2.98-5.09),poor differentiation/undifferentiated(HR=1.34,95%CI=1.11-1.63),not married status(HR=2.45,95%CI=1.49-4.04),production and service personnel(HR=1.36,95%CI=1.01-1.83)and farming/fishing(HR=1.40,95%CI=1.12-1.76)were independent prognostic risk factors for poor EC survival.Tumors in the thoracic or abdominal part of the esophagus,female and family history of any cancer were independent factors predictive of a good EC OS.Conclusion:Gender,marital status,occupation,family history of any cancer,tumor topographical site,differentiation status,and pathological stage were associated with the survival rate of EC.This study reveals important clinical characteristics of esophageal 展开更多
Background:Hepatoblastoma is a rare disease that nevertheless accounts for the majority of liver malignancies in children.Due to limited epidemiological data,therapy for hepatoblastoma tends to be individualized.This ...Background:Hepatoblastoma is a rare disease that nevertheless accounts for the majority of liver malignancies in children.Due to limited epidemiological data,therapy for hepatoblastoma tends to be individualized.This study aimed to evaluate incidence trends of hepatoblastoma and to develop a nomogram to predict the survival of children with newly diagnosed hepatoblastoma on a population-based level.Methods:Individuals up to 18 years of age with hepatoblastoma recorded in 18 registries of the Surveillance,Epi-demiology,and End Results(SEER)database between 2004 and 2015 were examined.Joinpoint regression analyses were applied to assess incidence trends in annual percentage change(APC).Multivariable Cox regression was used to identify factors associated with overall survival(OS).A nomogram was constructed to predict OS in individual cases based on independent predictors.Concordance index(C-index)and calibration curves were used to evaluate predic-tive performance.Results:Between 2004 and 2015,hepatoblastoma incidence increased significantly(APC,2.2%;95%confidence interval[CI]0.5%to 3.8%,P<0.05).In particular,this increase was observed among 2-to 4-year-old patients,males,and African-Americans.The 5-and 10-year OS rates were 81.5%and 81.0%,respectively.Age of 2 to 4 years,Afri-can-American ethnicity,and no surgery were independent predictors for short OS.Distant disease at presentation was found not to be an independent factor of survival.The nomogram had a C-index of 0.79(95%CI 0.74-0.84)with appropriate calibration curve fitting.Conclusions:We constructed a nomogram that integrates common factors associated with survival for hepatoblas-toma patients.It provides accurate prognostic prediction for children with hepatoblastoma.展开更多
基金supported by grants no.81670123 and no.81670144 from the National Natural Science Foundation of China(NSFC).
文摘Background:Low-grade endometrial stromal sarcoma(LG-ESS)is a rare tumor that lacks a prognostic prediction model.Our study aimed to develop a nomogram to predict overall survival of LG-ESS patients.Methods:A total of 1172 patients confirmed to have LG-ESS between 1988 and 2015 were selected from the Surveillance,Epidemiology and End Results(SEER)database.They were further divided into a training cohort and a validation cohort.The Akaike information criterion was used to select variables for the nomogram.The discrimination and calibration of the nomogram were evaluated using concordance index(C-index),area under time-dependent receiver operating characteristic curve(time-dependent AUC),and calibration plots.The net benefits of the nomogram at different threshold probabilities were quantified and compared with those of the International Federation of Gynecology and Obstetrics(FIGO)criteria-based tumor staging using decision curve analysis(DCA).Net reclassification index(NRI)and integrated discrimination improvement(IDI)were also used to compare the nomogram’s clinical utilitywith that of the FIGO criteria-based tumor staging.The risk stratifications of the nomogram and the FIGO criteria-based tumor staging were compared.Results:Seven variables were selected to establish the nomogram for LG-ESS.The C-index(0.814 for the training cohort and 0.837 for the validation cohort)and the time-dependent AUC(>0.7)indicated satisfactory discriminative ability of the nomogram.The calibration plots showed favorable consistency between the prediction of the nomogram and actual observations in both the training and validation cohorts.The NRI values(training cohort:0.271 for 5-year and 0.433 for 10-year OS prediction;validation cohort:0.310 for 5-year and 0.383 for 10-year OS prediction)and IDI(training cohort:0.146 for 5-year and 0.185 for 10-year OS prediction;validation cohort:0.177 for 5-year and 0.191 for 10-year OS prediction)indicated that the established nomogram performed significantly better than the FIGO criteria-based
基金Major Program of the National Natural Science Foundation of China,No.41590840,No.41590842
文摘Global urbanization is exerting severe stress and having far-reaching impacts on the eco-environment, and yet there exists a complex non-linear coupling relationship between the two. Research on the interactive coupling effect between urbanization and the eco-environment will be a popular area of study and frontier in international earth system science and sustainability science in the next 10 years, while also being a high-priority research topic of particular interest to international organizations. This paper systematically collates and summarizes the international progress made in research on interactive coupling theory, coupling relationships, coupling mechanisms, coupling laws, coupling thresholds, coupling models and coupling optimization decision support systems. The research shows that urbanization and eco-environment interactive coupling theories include the Kuznets curve theory, telecoupling theory, planetary boundaries theory, footprint family theory and urban metabolism theory; most research on interactive coupling relationships is concerned with single- element coupling relationships, such as those between urbanization and water, land, atmosphere, climate change, ecosystems and biodiversity; the majority of research on interactive coupling mechanisms and laws focuses on five research paradigms, including coupled human and nature systems, complex social-ecological systems, urban ecosystems, social-economic-natural complex ecosystems, and urbanization development and eco-environment constraint ring; the majority of interactive coupling simulations use STIRPAT models, coupling degree models, multi-agent system models and big data urban computer models; and research has been carried out on urbanization and eco-environment coupling thresholds, coercing risk and optimal decision support systems. An objective evaluation of progress in international research on interactive coupling between urbanization and the eco-environment suggests that there are six main research focal points and six areas lacking resea
基金Supported by National Science and Technology Major Project Foundation, No. 2008ZX10002-025
文摘AIM:To determine the risk factors for hepatocellular carcinoma(HCC) rupture,and report the management and long-term survival results of patients with spontaneous rupture of HCC.METHODS:Among 4209 patients with HCC who were diagnosed at Eastern Hepatobiliary Surgery Hospital from April 2002 to November 2006,200(4.8%) patients with ruptured HCC(case group) were studied retrospectively in term of their clinical characteristics and prognostic factors.The one-stage therapeutic approach to manage ruptured HCC consisted of initial management by conservative treatment,transarterial embolization(TACE) or hepatic resection.Results of various treatments in the case group were evaluated and compared with the control group(202 patients) without ruptured HCC during the same study period.Continuous data were expressed as mean ± SD or me-dian(range) where appropriate and compared using the unpaired t test.Categorical variables were compared using the Chi-square test with Yates correction or the Fisher exact test where appropriate.The overall survival rate in each group was determined using the Kaplan-Meier method and a log-rank test.RESULTS:Compared with the control group,more patients in the case group had underlying diseases of hypertension(7.5% vs 3.0%,P =0.041) and liver cirrhosis(87.5% vs 56.4%,P < 0.001),tumor size >5 cm(83.0% vs 57.4%,P < 0.001),tumor protrusion from the liver surface(66.0% vs 44.6%,P < 0.001),vascular thrombus(30.5% vs 8.9%,P < 0.001) and extrahepatic invasion(36.5% vs 12.4%,P < 0.001).On multivariate logistic regression analysis,underlying diseases of hypertension(P = 0.002) and liver cirrhosis(P < 0.001),tumor size > 5 cm(P < 0.001),vascular thrombus(P = 0.002) and extrahepatic invasion(P < 0.001) were predictive for spontaneous rupture of HCC.Among the 200 patients with spontaneous rupture of HCC,105 patients underwent hepatic resection,33 received TACE,and 62 were managed with conservative treatment.The median survival time(MST) of all patients with spontaneous rupture of HCC was 6 mo(range,1-72 mo)
基金Supported by Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor,Ministry of Education,No.GKZ201604Key Project of Guangxi Health and Family Planning Commission,China,No.S201513Key Project of Guangxi Science and Technology Department,China,No.Gui Ke AB16380242
文摘AIM To investigate the efficacy and safety of postoperative adjuvant transcatheter arterial chemoembolization(PA-TACE) in preventing tumor recurrence and improving survival in Barcelona Clinic Liver Cancer(BCLC) early(A) and intermediate(B) stage hepatocellular carcinoma(HCC) patients with microvascular invasion(MVI).METHODS A total of 519 BCLC A or B HCC patients treated by liver resection alone or followed by PA-TACE between January 2012 and December 2015 were studied retrospectively. Univariate and multivariate analyses were performed to investigate the risk factors for recurrence-free survival(RFS) and overall survival(OS). Multiple logistic regression was used to identify the clinicopathological characteristics associated with MVI. The rates of RFS and OS were compared among patients with or without MVI treated with liver resection alone or followed by PA-TACE. RESULTS Univariate and multivariate analyses demonstrated that serum AFP level > 400 ng/m L, tumor size > 5 cm, tumor capsule invasion, MVI, and major hepatectomy were risk factors for poor OS. Tumor capsule invasion, MVI, tumor size > 5 cm, HBV-DNA copies > 1 x 104 IU/m L, and multinodularity were risk factors for poor RFS. Multiple logistic regression identified serum AFP level > 400 ng/m L, tumor size > 5 cm, and tumor capsule invasion as independent predictors of MVI. Both OS and DFS were significantly improved in patients with MVI who received PA-TACE as compared to those who underwent liver resection alone. Patients without MVI did not show a significant difference in OS and RFS between those treated by liver resection alone or followed by PA-TACE.CONCLUSION PA-TACE is a safe adjuvant intervention and can efficiently prevent tumor recurrence and improve the survival of BCLC early-and intermediate-stage HCC patients with MVI.
文摘Background:N6-methyladenosine(m6A)RNA modification has been demonstrated to be a significant regulatory process in the progression of various tumors,including breast cancer.Fat mass and obesity-associated(FTO)enzyme,initially known as the obesity-related protein,is the first identified m6A demethylase.However,the relationship between FTO and breast cancer remains controversial.In this study,we aimed to elucidate the role and clinical significance of FTO in breast cancer and to explore the underlying mechanism.Methods:We first investigated the expression of FTO in breast cancer cell lines and tissues by quantitative reverse transcription-PCR(qRT-PCR),Western blotting,and immunohistochemistry.Wound healing assay and Transwell assay were performed to determine the migration and invasion abilities of SKBR3 and MDAMB453 cells with either knockdown or overexpression of FTO.RNA sequencing(RNA-seq)was conducted to decipher the downstream targets of FTO.qRT-PCR,luciferase reporter assay,and Western blotting were employed to confirm the existence of the FTO/miR-181b-3p/ARL5B axis.The biological function of ADP ribosylation factor like GTPase 5B(ARL5B)in breast cancer cells was evaluated by wound healing assay and Transwell invasion assay.Results:High FTO expression was observed in human epidermal growth factor receptor 2(HER2)-positive breast cancer,predicting advanced progression(tumor size[P<0.001],nuclear grade[P=0.001],peritumoral lymphovascular invasion[P<0.001),lymph node metastasis[P=0.002],and TNM stage[P=0.001])and poor prognosis.Moreover,FTO promoted cell invasion and migration in vitro.Mechanistically,RNA-seq and further confirmation studies suggested that FTO up-regulated ARL5B by inhibiting miR-181b-3p.We further verified that ARL5B also displayed carcinogenic activity in breast cancer cells.Conclusion:Our work demonstrated the carcinogenic activity of FTO in promoting the invasion and migration of breast cancer cells via the FTO/miR-181b-3p/ARL5B signaling pathway.
基金supported by The National Natural Science Foundation of China(Grant No.51427804)National Key Technology Support Program(Grant No.2012BAF14B00)Natural Science Foundation of Anhui Province(Grant Nos.1408085MKL92,1408085MKL93)
文摘An investigation was conducted on the overall burst-instability of isolated coal pillars by means of the possibility index diagnosis method（PIDM）. First, the abutment pressure calculation model of the gob in side direction was established to derive the abutment pressure distribution curve of the isolated coal pillar. Second, the overall burst-instability ratio of the isolated coal pillars was defined. Finally, the PIDM was utilized to judge the possibility of overall burst-instability and recoverability of isolated coal pillars.The results show that an overall burst-instability may occur due to a large gob width or a small pillar width. If the width of the isolated coal pillar is not large enough, the shallow coal seam will be damaged at first, and then the high abutment pressure will be transferred to the deep coal seam, which may cause an overall burst-instability accident. This approach can be adopted to design widths of gobs and isolated coal pillars and to evaluate whether an existing isolated coal pillar is recoverable in skip-mining mines.
文摘Background The continual and rapid development of techniques which are used for diagnosis and treatment makes management of colorectal cancer more difficult depending on single discipline.Colorectal cancer multidisciplinary team （MDT） working model is recommended by UK and other countries,but there is little information on the impact of MDT working on management of colorectal cancer in China.The aim of this study was to assess the effect on management of colorectal cancer after the inception of an MDT.Methods A total of 595 consecutive colorectal cancer patients were referred to the Department of Gastroenterological Surgery,the pre-MDT cohort include 297 patients,recruited from January 1999 to November 2002,and the MDT cohort had 298 patients enrolled from December 2002 to September 2006.Information recorded included：TNM stage from histological reports,degree of differentiation,the number of examined lymph nodes and CT TNM staging performed or not,and its accuracy,including local and distant recurrence.Results The number of examined lymph nodes and the accuracy of TNM staging by CT in the MDT group were significantly more than those in pre-MDT group.CT TNM staging was more accurate in the MDT group compared to the pre-MDT group （P=-0.044）.The rate of tumor recurrence in the MDT group was lower than pre-MDT group （log-rank test,P 〈0.001）.Multivariate analysis revealed that age （P=0.001）,management after inception of the MDT （P=0.002）,degree of differentiation （P=0.003）,number of examined lymph nodes （P=0.002）,and TNM stage （P=0.000） were important factors that independently influence overall survival.Conclusions The inception of MDT working improved the diagnostic accuracy and overall survival of colorectal cancer patients.MDT working promoted communication and cooperation between disciplines and ensured high-quality diagnosis,evidence-based decision making,and optimal treatment planning.
基金The project is supported by the National Natural Science Foundation of China （Nos. 21275076 and 61328401）, Jiangsu Provincial Founds for Distinguished Young Scholars （No. BK20130046）, Key University Science Research Project of Jiangsu Province （No. 15KJA430006）, Program for New Century Excellent Talents in University （No. NCET-13-0853）, QingLan Project, Nantong Key Laboratory of New Materials Industrial Technology, SERC Grant （#102170 0142） from A＇STAR Singapore, the scholarship from China Scholarships Council （No. 201508320304）.
文摘The development of efficient, low-cost, for water splitting, particularly those stable, non-noble-metal electrocatalysts that can catalyze both the hydrogen evolution reaction （HER） at the cathode and oxygen evolution reaction （OER） at the anode, is a challenge. We have developed a facile method for synthesizing CoSe2 nanoparticles uniformly anchored on carbon fiber paper （CoSe2/CF） via pyrolysis and selenization of in situ grown zeolitic imidazolate framework-67 （ZIF-67）. CoSe2/CF shows high and stable catalytic activity in both the HER and OER in alkaline solution. At a low cell potential, i.e., 1.63 V, a water electrolyzer equipped with two CoSe2/CF electrodes gave a water-splitting current of 10 mA.cm-2. At a current of 20 mA-cm-2, it can operate without degradation for 30 h. This study not only offers a cost-effective solution for water splitting but also provides a new strategy for developing various catalytic nanostructures by changing the metal-organic framework precursors.
文摘Background Neoadjuvant chemotherapy has been used as a primary treatment for locally advanced or inflammatory breast cancer, and recently extended to operable breast cancer. However, only a few studies have published data concerning the outcomes of patients with stages II and III breast cancer after neoadjuvant chemotherapy. Methods This study retrospectively investigated the clinical value of neoadjuvant chemotherapy for patients with stages II and III breast cancer. The patients in Group 1 （n=54） were treated with neoadjuvant chemotherapy, followed by definitive surgery and adjuvant therapy. The patients in Group 2 （n=-43） initially received definitive surgery, followed by adjuvant chemotherapy and other therapies. The operability rates for breast conservation and dermatoplasty were observed in Group 1 after neoadjuvant chemotherapy. After follow-up, the recurrence and overall and disease-free survival rates of the two groups were analyzed. Results Neoadjuvant chemotherapy increased the operability rates for breast conservation from 17.1% to 40.0% in stage II （P=0.034） and 0% to 12.6% in stage III （P=0.016）, and decreased the dermatoplasty rates from 17.1% to 2.8% in stage II （P=0.046） and 28.1% to 8.1% in stage Ill （P=0.026）. After a median follow-up of 46.8 months, there were 11 deaths and 13 recurrences in Group 1, and 15 deaths and 19 recurrences in Group 2. The overall and disease-free survival rates of stage III disease were significantly higher in Group 1 than in Group 2 （68.4% vs 31.2%, P=0.028, and 63.2% vs 25.0%, P=0.024, respectively）. There were no significant differences in the overall and disease-free survival rates of stage II disease for Group 1 compared with Group 2 （85.7% vs 85.2%, P=0.953, and 80.6% vs 74.1%, P=0.400, respectively）. Conclusions Neoadjuvant chemotherapy resulted in increased operability for breast conservation and decreased dermatoplasty. Neoadjuvant chemotherapy exhibited better recurrence control, and overall and disease-free survival rates in
文摘AIM: To systematically review the survival outcomes relating to extramural venous invasion in rectal cancer.METHODS: A systematic review was conducted using PRISMA guidelines. An electronic search was carried out using MEDLINE, EMBASE, CINAHL, Cochrane library databases, Google scholar and Pub Med until October 2014. Search terms were used in combination to yield articles on extramural venous invasion in rectal cancer. Outcome measures included prevalence and 5-year survival rates. These were graphically displayed using Forest plots. Statistical analysis of the data was carried out.RESULTS: Fourteen studies reported the prevalence of extramural venous invasion(EMVI) positive patients. Prevalence ranged from 9%-61%. The pooled prevalence of EMVI positivity was 26% [Random effects: Event rate 0.26(0.18, 0.36)]. Most studies showed that EMVI related to worse oncological outcomes. The pooled overall survival was 39.5% [Random effects: Event rate 0.395(0.29, 0.51)].CONCLUSION: Historically, there has been huge variation in the prevalence of EMVI through inconsistent reporting. However the presence of EMVI clearly leads to worse survival outcomes. As detection rates become more consistent, EMVI may be considered as part of risk-stratification in rectal cancer. Standardised histopathological definitions and the use of magnetic resonance imaging to identify EMVI will improve detection rates in the future.
基金This study was supported by Technology Program of Zhejiang Province,China(2015C03049)
文摘Background:A growing body of evidence supports the use of laparoscopic pancreaticoduodenectomy(LPD)as an efficient and feasible surgical technique.However,few studies have investigated its applicability in pancreatic ductal adenocarcinoma(PDAC),and the long-term efficacy of LPD on PDAC remains unclear.This study aimed to compare the short-and long-term outcomes between LPD and open pancreaticoduodenectomy(OPD)for PDAC.Methods:The data of patients who had OPD or LPD for PDAC between January 2013 and September 2017 were retrieved.Their postoperative outcomes and survival were compared after propensity score matching.Results:A total of 309 patients were included.After a 2:1 matching,93 cases in the OPD group and 55 in the LPD group were identified.Delayed gastric emptying(DGE),particularly grade B/C DGE,occurred less frequently in the LPD group than in the OPD group(1.8%vs.36.6%,P<0.001;1.8%vs.22.6%,P=0.001).The overall complication rates were significantly lower in the LPD group than in the OPD group(49.1%vs.71.0%,P=0.008),whereas the rates of major complications were similar(10.9%vs.14.0%,P=0.590).In addition,the median overall survival was comparable between the two groups(20.0 vs.18.7 months,P=0.293).Conclusion:LPD was found to be technically feasible with efficacy similar to OPD for patients with PDAC.
基金supported by the National Natural Science Foundation of China(No.21676300)the Shandong Provincial Natural Science Foundation(No.ZR2018MB035)+3 种基金the Fundamental Research Funds for the Central Universities(Nos.19CX02008A and 16CX06007A)PetroChina Innovation Foundation(No.2019D-5007-0401)Taishan Scholars Program of Shandong Province(No.tsqn201909065)Tsinghua University Initiative Scientific Research Program.
文摘Large scale synthesis of high-efficiency bifunctional electrocatalyst based on cost-effective and earth-abundant transition metal for overall water splitting in the alkaline environment is indispensable for renewable energy conversion.In this regard,meticulous design of active sites and probing their catalytic mechanism on both cathode and anode with different reaction environment at molecular-scale are vitally necessary.Herein,a coordination environment inheriting strategy is presented for designing low-coordination Ni^(2+)octahedra(L-Ni-8)atomic interface at a high concentration(4.6 at.%).Advanced spectroscopic techniques and theoretical calculations reveal that the self-matching electron delocalization and localization state at L-Ni-8 atomic interface enable an ideal reaction environment at both cathode and anode.To improve the efficiency of using the self-modification reaction environment at L-Ni-8,all of the structural features,including high atom economy,mass transfer,and electron transfer,are integrated together from atomic-scale to macro-scale.At high current density of 500 mA/cm2,the samples synthesized at gram-scale can deliver low hydrogen evolution reaction(HER)and oxygen evolution reaction(OER)overpotentials of 262 and 348 mV,respectively.
基金This study was funded by the National Key Research and Development Program of China(2018YFC1313100)a grant from the National Natural Scientific Foundation of China(81871922).
文摘Objective:This study aimed to investigate the potential determining epidemiological and clinical risk factors affecting the survival of esophageal cancer(EC)patients across multiple hospitals in China.Methods:This was a multicenter study comprising of newly diagnosed EC cases from Beijing,Hebei,Henan,Hubei,Zhejiang,and Guangdong Province of China.Their baseline characteristics and treatment methods data were collected from their medical records.The EpiData software was used for data quality control.The Kaplan-Meier method was used to estimate their overall survival(OS),and the Cox’s proportional hazard regression model was used to estimate hazard ratios(HR)and 95%confidence interval(CI).Results:The 3-and 5-year OS rates of the 5283 investigated EC patients were 49.98%and 39.07%,respectively.Their median survival was 36.00 months.The median survival time of females was longer than that of males(females vs.males:45.00 vs.33.00,P<0.001).The 5-year OS rate of patients who never-smoked was higher than that of smokers(never-smokers vs smokers:40.73%vs.37.84%,P=0.001).There was no significant difference in the 5-year OS rate between drinkers and never-drinkers(drinkers vs never-drinkers:34.22%vs.29.65%,P=0.330).In multivariate analysis,pathological stage(stage II:HR=1.80,95%CI=1.40-2.31;stage III:HR=2.62,95%CI=2.06-3.34;stage IV:HR=3.90,95%CI=2.98-5.09),poor differentiation/undifferentiated(HR=1.34,95%CI=1.11-1.63),not married status(HR=2.45,95%CI=1.49-4.04),production and service personnel(HR=1.36,95%CI=1.01-1.83)and farming/fishing(HR=1.40,95%CI=1.12-1.76)were independent prognostic risk factors for poor EC survival.Tumors in the thoracic or abdominal part of the esophagus,female and family history of any cancer were independent factors predictive of a good EC OS.Conclusion:Gender,marital status,occupation,family history of any cancer,tumor topographical site,differentiation status,and pathological stage were associated with the survival rate of EC.This study reveals important clinical characteristics of esophageal
基金This work was supported by the China Scholarship Council[File No.201708080137]We acknowledge additional financial support by the Deutsche Forschungsgemeinschaft,within the funding program Open Access Publishing+1 种基金by the Baden-Württemberg Ministry of Science,Researchthe Arts,and by Ruprecht-Karls-Universität Heidelberg
文摘Background:Hepatoblastoma is a rare disease that nevertheless accounts for the majority of liver malignancies in children.Due to limited epidemiological data,therapy for hepatoblastoma tends to be individualized.This study aimed to evaluate incidence trends of hepatoblastoma and to develop a nomogram to predict the survival of children with newly diagnosed hepatoblastoma on a population-based level.Methods:Individuals up to 18 years of age with hepatoblastoma recorded in 18 registries of the Surveillance,Epi-demiology,and End Results(SEER)database between 2004 and 2015 were examined.Joinpoint regression analyses were applied to assess incidence trends in annual percentage change(APC).Multivariable Cox regression was used to identify factors associated with overall survival(OS).A nomogram was constructed to predict OS in individual cases based on independent predictors.Concordance index(C-index)and calibration curves were used to evaluate predic-tive performance.Results:Between 2004 and 2015,hepatoblastoma incidence increased significantly(APC,2.2%;95%confidence interval[CI]0.5%to 3.8%,P<0.05).In particular,this increase was observed among 2-to 4-year-old patients,males,and African-Americans.The 5-and 10-year OS rates were 81.5%and 81.0%,respectively.Age of 2 to 4 years,Afri-can-American ethnicity,and no surgery were independent predictors for short OS.Distant disease at presentation was found not to be an independent factor of survival.The nomogram had a C-index of 0.79(95%CI 0.74-0.84)with appropriate calibration curve fitting.Conclusions:We constructed a nomogram that integrates common factors associated with survival for hepatoblas-toma patients.It provides accurate prognostic prediction for children with hepatoblastoma.
