Survival analysis and individualized prediction of survival benefit for pancreatic signet ring cell carcinoma: a population study based on the SEER database.

OBJECTIVES: This study aimed to compare the incidence, clinicopathological characteristics and survival results of pancreatic signet ring cell carcinoma (PSRCC) and pancreatic adenocarcinomas (PDAC), as well as to analyze the clinical characteristics related to the overall survival (OS) of PSRCC, and to establish an effective prognostic nomogram to predict the risks associated with patient outcomes. METHODS: A total of 85,288 eligible patients including 425 PSRCC and 84,863 PDAC cases were retrieved from the Surveillance, Epidemiology, and End Results database. The survival curve was calculated using the Kaplan-Meier method and differences in them were measured by Log-rank tests. The Cox proportional hazards regression model was used to identify independent predictors of OS in patients with PSRCC. A nomogram was constructed to predict 1-, 3-, and 5-year OS. The performance of the nomogram was measured by C-index, receiver operating characteristic (ROC) curve, decision curve analysis (DCA). RESULTS: The incidence of PSRCC is much lower than that of PDAC (10.798 V.S. 0.349 per millions). PSRCC is an independent predictor of pancreatic cancer with a poorer histological grade, a higher rate of lymph node and distant metastasis, and a poorer prognosis. We identified four independent prognostic factors including grade, American Joint Committee on Cancer Tumor-Node-Metastasis (TNM) stage, surgery and chemotherapy based on the Cox regression model. The C-index and DCA curves showed better performance of the nomogram than TNM stage. ROC curve analysis also showed that the nomogram had good discrimination, with an area under the curve of 0.840, 0.896, and 0.923 for 1-, 3-, and 5-year survival. The calibration curves showed good agreement between the prediction by the nomogram and actual observations. CONCLUSION: PSRCC is a rare but fatal subtype of pancreatic cancer. The constructed nomogram in this study accurately predicted the prognosis of PSRCC, performed better than the TNM stage.

Correlation of Glucose Metabolism with Cancer and Intervention with Traditional Chinese Medicine.

Cancer is a complex disease with several distinct characteristics, referred to as "cancer markers" one of which is metabolic reprogramming, which is a common feature that drives cancer progression. Over the last ten years, researchers have focused on the reprogramming of glucose metabolism in cancer. In cancer, the oxidative phosphorylation metabolic pathway is converted into the glycolytic pathway in order to meet the growth requirements of cancer cells, thereby creating a microenvironment that promotes cancer progression. The precise mechanism of glucose metabolism in cancer cells is still unknown, but it is thought to involve the aberrant levels of metabolic enzymes, the influence of the tumor microenvironment (TME), and the activation of tumor-promoting signaling pathways. It is suggested that glucose metabolism is strongly linked to cancer progression because it provides energy to cancer cells and interferes with antitumor drug pharmacodynamics. Therefore, it is critical to unravel the mechanism of glucose metabolism in tumors in order to gain a better understanding of tumorigenesis and to lay the groundwork for future research into the identification of novel diagnostic markers and therapeutic targets for cancer treatment. Traditional Chinese Medicine (TCM) has the characteristics of multiple targets, multiple components, and less toxic side effects and has unique advantages in tumor treatment. In recent years, researchers have found that a variety of Chinese medicine monomers and compound recipes play an antitumor role by interfering with the reprogramming of tumor metabolism. The underlying mechanisms of metabolism reprogramming of tumor cells and the role of TCM in regulating glucose metabolism are reviewed in this study, so as to provide a new idea for antitumor research in Chinese medicine.

Identifying Active Substances and the Pharmacological Mechanism of Houttuynia cordata Thunb. in Treating Radiation-Induced Lung Injury Based on Network Pharmacology and Molecular Docking Verification.

Background: Houttuynia cordata Thunb. is a traditional Chinese herb widely used mainly because of the pharmacological effects related to heat clearance and detoxification. Emerging clinical evidence indicates that the efficacy of Houttuynia cordata Thunb. on RILI is upstanding. Nevertheless, its underlying therapeutic mechanism remains unclear and warrants further elucidation. Methods: The major active components and corresponding targets of Houttuynia cordata Thunb. were retrieved from the traditional Chinese medicine system pharmacology database (TCMSP) and literature review. The related targets of RILI were retrieved from the GeneCards database. Common targets among the active compounds and diseases were identified through Venn diagram analysis. Cytoscape was employed to construct and visualize the network relationship among the drug, active compounds, targets, and disease. The protein interaction network (PPI) was constructed by STRING. The reliability (the binding affinity) of the core targets and active compounds was verified by molecular docking. Results: A search of the TCMSP database and related literature revealed 12 active compounds of Houttuynia cordata Thunb. against RILI. The core active compounds included quercetin, kaempferol, hyperoside, and rutin. Hub nodes including TP53, VEGFA, JUN, TNF, and IL-6 were identified in the PPI network. The GO categories were classified into three functional categories: 112 biological processes, 9 molecular functions, and 32 cellular components of the active compounds of Houttuynia cordata Thunb. The KEGG pathway enrichment analysis demonstrated the enrichment of target genes in several key cancer-related signaling pathways, including the cancer pathways, TNF signaling pathway, PI3K-Akt signaling pathway, and HIF-1 signaling pathway. Molecular docking analysis validated the effective binding capacity of the main active compounds with the core targets. Conclusion: The main active components of Houttuynia cordata Thunb. have a potential pharmacological effect against RILI via the cancer pathways, TNF signaling pathway, and PI3K-Akt signaling pathway.

DUSP10 upregulation is a poor prognosticator and promotes cell proliferation and migration in glioma.

Dual-specificity phosphatase 10 (DUSP10) correlates with inflammation, cytokine secretion, cell proliferation, survival, and apoptosis. However, its role in glioma is unclear. Herein, we sought to examine the expression and the underlying carcinogenic mechanisms of DUSP10 action in glioma. DUSP10 expression in glioma was significantly higher than that in normal brain tissues. High DUSP10 expression indicated adverse clinical outcomes in glioma patients. Increased DUSP10 expression correlated significantly with clinical features in glioma. Univariate Cox analysis showed that high DUSP10 expression was a potential independent marker of poor prognosis in glioma. Furthermore, DUSP10 expression in glioma correlated negatively with its DNA methylation levels. DNA methylation level of DUSP10 also correlated negatively with poor prognosis in glioma. More importantly, DUSP10 expression correlated positively with the infiltration of B cells, CD4+ T cells, CD8+ T cells, neutrophils, macrophages, and dendritic cells in glioma. Gene set enrichment analysis (GSEA) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis confirmed that DUSP10 participated in signaling pathways involved in focal adhesion, TNF cascade, Th17 cell differentiation, and NF-kappa B cascade. Finally, we uncovered that DUSP10 was dramatically upregulated in glioblastoma (GBM) cells and that the knockdown of DUSP10 inhibited glioma cell proliferation and migration. Our findings suggested that DUSP10 may serve as a potential prognostic biomarker in glioma.

Individualized Prediction of Survival Benefits of Pancreatectomy Plus Chemotherapy in Patients With Simultaneous Metastatic Pancreatic Cancer.

BACKGROUND: Metastatic pancreatic cancer (mPC) is a highly lethal malignancy with poorer survival. However, chemotherapy alone was unable to maintain long-term survival. This study aimed to evaluate the individualized survival benefits of pancreatectomy plus chemotherapy (PCT) for mPC. METHODS: A total of 4546 patients with mPC from 2004 to 2015 were retrieved from the Surveillance, Epidemiology, and End Results database. The survival curve was calculated using the Kaplan-Meier method and differences in survival curves were tested using log-rank tests. Cox proportional hazards regression analyses were performed to evaluate the prognostic value of involved variables. A new nomogram was constructed to predict overall survival based on independent prognosis factors. The performance of the nomogram was measured by concordance index, calibration plot, and area under the receiver operating characteristic curve. RESULTS: Compared to pancreatectomy or chemotherapy alone, PCT can significantly improve the prognosis of patients with mPC. In addition, patients with well/moderately differentiated tumors, age ≤66 years, tumor size ≤42 mm, or female patients were more likely to benefit from PCT. Multivariate analysis showed that age at diagnosis, sex, marital status, grade, tumor size, and treatment were independent prognostic factors. The established nomogram has a good ability to distinguish and calibrating. CONCLUSION: PCT can prolong survival in some patients with mPC. Our nomogram can individualize predict OS of pancreatectomy combined with chemotherapy in patients with concurrent mPC.

Hidden hyperchaotic attractors in a new 4D fractional order system and its synchronization.

The research of finding hidden attractors in nonlinear dynamical systems has attracted much consideration because of its practical and theoretical importance. A new fractional order four-dimensional system, which can exhibit some hidden hyperchaotic attractors, is proposed in this paper. The predictor-corrector method of the Adams-Bashforth-Moulton algorithm and the parameter switching algorithm are used to numerically study this system. It is interesting that three different kinds of hidden hyperchaotic attractors with two positive Lyapunov exponents are found, and the fractional order system can have a line of equilibria, no equilibrium point, or only one stable equilibrium point. Moreover, a self-excited attractor is also recognized with the change of its parameters. Finally, the synchronization behavior is studied by using a linear feedback control method.

Anterior and pan-endophthalmitis caused by Candida albicans and Aspergillus fumigatus: report of two cases.

We report two posttraumatic fungal endophthalmitis cases with anterior and entire segment involvement caused, respectively, by Candida albicans and Aspergillus fumigatus. The anterior endophthalmitis induced by C. albicans presented multifocal lesions with hyphael structures in anterior chamber, but without involvement of posterior vitreous. The pan-endophthalmitis caused by A. fumigatus displayed significant hypopyon and vitritis. Treatment strategies are anterior chamber cleaning for anterior endophthalmitis and vitrectomy for pan-endophthalmitis, excepting systemic and topical antifungal drug applications including intravitreal injection for both types of endophthalmitis. There is a much better outcome in the case with anterior segment involvement than that with entire segment involvement. This case report provides evidence that the different types of posttraumatic fungal endophthalmitis related to different fungal infections indeed existed and should be managed with different strategies.

Combination surgery for management of perforating eye injury with retained magnetic intraorbital foreign body.

PURPOSE: The objective of this study was to evaluate the feasibility and safety of vitrectomy combined with magnetic intraorbital foreign body (IOrFB) removal in the patients with perforating eye injury and retained magnetic IOrFBs. METHODS: A consecutive series of 7 patients with perforating eye injury and retained magnetic IOrFBs were included to perform secondary combination surgery (vitrectomy combined with IOrFB removal) after primary repair. Clinical data such as age, sex, hours and cause of injury, site and size of penetrating wound and IOrFB, involved intraocular tissues, surgical intervention, interval between surgeries, length of follow-up, anatomic recovery, visual outcome, and so on were recorded. RESULTS: Except for an unsuccessful IOrFB removal in case 6 in which IOrFB was finally extracted after 3 months, the remaining 6 cases had been operated on successfully both in vitrectomy and IOrFB removal. All the cases resulted in not only anatomic recovery but also good visual outcomes. No complications occurred. Seven cases revealed flat retina after silicone oil removal at a 3- to 12-month follow-up. Final best correct visual acuity equal to or better than 0.05 and 0.2 were 6 (85.7%) and 4 (57%) cases, respectively, and only 1 case was without improvement because of macular involvement. CONCLUSIONS: A combination surgery of vitrectomy with IOrFB removal is a highly efficient and safe procedure for the management of perforating eye injury with magnetic IOrFB. Prompt and proper management, such as preoperative exact localization of IOrFB, thoroughly cleaning of vitreous hemorrhage, complete sealing of retinal hole, and so on, is crucial for the successful achievement.

[Postoperative complications of microscopic versus Palomo varicocelectomy for varicocele in army personnel].

OBJECTIVE: To evaluate the postoperative complications of microscopic and conventional Palomo varicocelectomy in the treatment of varicocele in army personnel. METHODS: A total of 260 army personnel with varicocele were randomized to receive microscopic varicocelectomy (group A, n=130) and conventional Palomo varicocelectomy (group B, n=130). The postoperative recurrence and complications (scrotal edema, testicular pain and testicular atrophy) were compared between the two groups. RESULTS: After 1 year of follow-up, the recurrence rates in groups A and B were statistically comparable (5.3% vs 3.8%, P>0.05). The incidences of testicular atrophy and scrotal edema were significantly lower in group A than in group B (0.7% vs 3.1%, P<0.05; 3.1% vs 14.6%, P<0.05), and the rate of testicular pain relief was significantly higher in group A (90.7% vs 67.7%, P<0.05). CONCLUSION: Microscopic varicocelectomy can be a good choice in the treatment of varicocele in army personnel.

[Design of the micro-controller in-circuit emulator using FPGA].

Applying FPGA technology in the emulator design becomes more and more popular. This paper describes the hardware and firmware design for SHIC HR6P series emulator based on FPGA structure and technical characteristics, which provides an emulator design method with high integration, high reliability, low cost and easy portability.