BRAFV600E mutation does not predict lymph node metastases and recurrence in Chinese papillary thyroid microcarcinoma patients.

OBJECT: Previous studies suggest BRAFV600E mutation is a marker for poor prognosis in papillary thyroid cancer, however, its ability to further risk stratify papillary thyroid microcarcinoma (PTMC) remains controversial. We aimed to explore the association between BRAFV600E mutation and the clinicopathological features and recurrence in Chinese PTMC patients. METHODS: We retrospectively reviewed 2094 PTMC patients who underwent surgery and had a valid BRAFV600E mutation test result. Among them, 1292 patients had complete follow-up data. The mutation incidence was determined. Moreover, the clinicopathological characteristics, disease-free survival (DFS), and response to therapy distribution were compared between the mutation and non-mutation groups. RESULTS: BRAFV600E mutation was observed in 90.6 % of all patients and 89.2 % of patients with complete follow-up data. No significant difference was observed in lymph node metastases (LNM) number categories between the mutation and non-mutation groups among all patients (P = 0.329) and 1292 patients (P = 0.408). Neither the 3-year DFS (97.9 % vs. 98.0 %, P = 0.832) nor the response to therapy distribution (P > 0.05) indicated a significant difference between the mutation and non-mutation groups. The 3-year DFS differs among patients having different LNM number categories (99.8 % vs. 98.5 % vs. 77.3 %, P < 0.001). Multivariate analysis revealed that high-volume (over 5) LNM (Total thyroidectomy (TT): OR = 4.000, 95 % CI 2.390-6.694, P < 0.001; Unilateral thyroidectomy (UT): OR = 4.183, 95 % CI 1.565-11.190, P = 0.004), rather than BRAFV600E mutation (P > 0.05), was an independent risk factor of response to therapy. CONCLUSIONS: Our results suggested that BRAFV600E mutation could not accurately predict LNM or the recurrence of Chinese PTMC patients. Moreover, high-volume LNM is significantly associated with PTMC prognosis.

RhB-Embedded Mn-MOF with Cyclotriphosphazene Skeleton as Dual-Emission Sensor for Putrescine as well as Smart Fluorescent Response of Aromatic Diamines and Nitrophenol.

Luminescent metal-organic framework composites with multiple luminescence emissions have been efficient sensing platforms. Herein, a fluorescent sensor (RhB@1-0.4) with dual-emission fluorescence properties was prepared by introducing rhodamine B (RhB) into the framework of complex 1, [Mn2.5(HCPCP)(H2O)4]·(CH3CN)0.5 [HCPCP = hexa-(4-carboxyl-phenoxy)-cyclotriphosphazene and CH3CN = acetonitrile), which is a novel crystalline two-dimensional (2D) coordinated organic framework material. It is a highly desirable material, realizing a ratiometric fluorescence response to putrescine with a high signal-to-noise ratio, and the detection limit can be as low as 6.8 µM. In addition, RhB@1-0.4 exhibited a better fluorescent sensing performance for aromatic diamines and nitrophenols compared with that of complex 1. It is a potential functionalized MOF material for the application of multichannel fluorescence sensing.

Use of Vaginal Reconstructive Surgery in Cervical Cancer Patients to Prevent Vaginal Stump Contracture.

PURPOSE: The life quality of cervical cancer patients is severely compromised due to the vaginal stump contracture after surgery combined with radiotherapy. Therefore, our study focuses on ameliorating or preventing postoperative vaginal contracture. The objectives of this study were (1) to evaluate the method of ileal graft with vascular pedicle to extend the length of vagina and (2) to investigate the effect of the operation to prevent vaginal stump contracture after cervical cancer surgery combined with radiotherapy. METHODS: Twenty-five patients with vaginal stump contracture after cervical cancer radical resection with sequential radiotherapy were recruited for the study between 2011 and 2014. The therapy includes releasing the adhesion between vaginal stump and rectum as well as bladder, resecting the vaginal stump but reserving the exterior orifice of vagina, and extending the vaginal length using vascularized ileal graft. RESULTS: No postoperative complications such as infection and bleeding were observed in all 25 patients. The patients were satisfied with the length and width of vagina after extension; the discharge of reconstructed vagina was acceptable. All patients had sexual intercourse on the follow-up examination, and five patients complained of vaginal bleeding during or after sexual intercourse, although no abnormality was found on colposcopy. CONCLUSIONS: The patients demonstrated a high level of safety, efficacy, and satisfaction with the ileal-vaginal extension for treating vaginal stump contracture after cervical cancer surgery combined with radiotherapy, suggesting that this method is valid for broad clinical application to improve the life quality of cervical cancer patients after surgery.

No-Go Theorems for Quantum Resource Purification.

The manipulation of quantum "resources" such as entanglement, coherence, and magic states lies at the heart of quantum science and technology, empowering potential advantages over classical methods. In practice, a particularly important kind of manipulation is to "purify" the quantum resources since they are inevitably contaminated by noise and thus often lose their power or become unreliable for direct usage. Here we prove fundamental limitations on how effectively generic noisy resources can be purified enforced by the laws of quantum mechanics, which universally apply to any reasonable kind of quantum resource. More explicitly, we derive nontrivial lower bounds on the error of converting any full-rank noisy state to any target pure resource state by any free protocol (including probabilistic ones)-it is impossible to achieve perfect resource purification, even probabilistically. Our theorems indicate strong limits on the efficiency of distillation, a widely used type of resource purification routine that underpins many key applications of quantum information science. In particular, this general result induces the first explicit lower bounds on the resource cost of magic state distillation, a leading scheme for realizing scalable fault-tolerant quantum computation. Implications for the standard error-correction-based methods are specifically discussed.

Experimental Quantification of Coherence of a Tunable Quantum Detector.

Quantum coherence is a fundamental resource that quantum technologies exploit to achieve performance beyond that of classical devices. A necessary prerequisite to achieve this advantage is the ability of measurement devices to detect coherence from the measurement statistics. Based on a recently developed resource theory of quantum operations, here we quantify experimentally the ability of a typical quantum-optical detector, the weak-field homodyne detector, to detect coherence. We derive an improved algorithm for quantum detector tomography and apply it to reconstruct the positive-operator-valued measures of the detector in different configurations. The reconstructed positive-operator-valued measures are then employed to evaluate how well the detector can detect coherence using two computable measures. As the first experimental investigation of quantum measurements from a resource theoretical perspective, our work sheds new light on the rigorous evaluation of the performance of a quantum measurement apparatus.

One-Shot Operational Quantum Resource Theory.

A fundamental approach for the characterization and quantification of all kinds of resources is to study the conversion between different resource objects under certain constraints. Here we analyze, from a resource-nonspecific standpoint, the optimal efficiency of resource formation and distillation tasks with only a single copy of the given quantum state, thereby establishing a unified framework of one-shot quantum resource manipulation. We find general bounds on the optimal rates characterized by resource measures based on the smooth max- or min-relative entropies and hypothesis testing relative entropy, as well as the free robustness measure, providing them with general operational meanings in terms of optimal state conversion. Our results encompass a wide class of resource theories via the theory-dependent coefficients we introduce, and the discussions are solidified by important examples, such as entanglement, coherence, superposition, magic states, asymmetry, and thermal nonequilibrium.

Retrospective analysis of seven cases of pancreatic mixed adenoneuroendocrine carcinoma from a high-volume center and review of the literature.

BACKGROUNDS: The clinicopathologic features and biological behaviors of pancreatic mixed adenoneuroendocrine carcinoma (pMANEC) and its impacts on survival are poorly known. METHODS: We retrospectively reviewed seven pMANEC cases from a single institution from September 2010 to January 2017 along with twenty-one previously reported cases from the literature. Survival and prognostic analyses were conducted using Kaplan-Meier estimates and Cox regression, respectively. RESULTS: Seven pMANEC cases were identified during the study interval. Among the six patients who underwent operations, five reached R0 resections, one experienced postoperative pancreatic fistula, and two suffered other complications. The median progression-free survival (PFS) and disease-specific survival (DSS) were 7.5 months (2 to 36 months) and 15 months (6 to 36 months), respectively. A total analysis of twenty-eight pMANEC cases showed that patients were mostly older (median age, 59.5 years) and male (64.3%). The two most common symptoms were abdominal pain (53.6%) and obstructive jaundice (35.7%). The majority of pMANECs were non-functional (89.3%) and located in the pancreatic head (64.3%). The median diameter of pMANEC was 3.0 cm, with a wide range (0.5 to 19.0 cm). Lymph node metastasis (P = 0.015) was associated with decreased DSS, while age (P = 0.414), sex (P = 0.125), tumor size (P = 0.392), location (P = 0.913), functional status (P = 0.313), CA19-9 level (P = 0.608), and liver metastasis (P = 0.935) did not show significant prognoses on DSS. CONCLUSIONS: We reported seven pMANEC cases and outlined their clinical behaviors and prognoses with a review of twenty-one cases from the literature. Lymph node metastasis was found to be a negative prognostic factor of DSS based on the present study.

Operational Advantage of Quantum Resources in Subchannel Discrimination.

One of the central problems in the study of quantum resource theories is to provide a given resource with an operational meaning, characterizing physical tasks in which the resource can give an explicit advantage over all resourceless states. We show that this can always be accomplished for all convex resource theories. We establish in particular that any resource state enables an advantage in a channel discrimination task, allowing for a strictly greater success probability than any state without the given resource. Furthermore, we find that the generalized robustness measure serves as an exact quantifier for the maximal advantage enabled by the given resource state in a class of subchannel discrimination problems, providing a universal operational interpretation to this fundamental resource quantifier. We also consider a wider range of subchannel discrimination tasks and show that the generalized robustness still serves as the operational advantage quantifier for several well-known theories such as entanglement, coherence, and magic.

Sonographic features of papillary thyroid microcarcinoma predicting high-volume central neck lymph node metastasis.

OBJECTIVE: To study the correlations between the sonographic features of papillary thyroid microcarcinoma (PTMC) and the presence of high-volume lymph node metastasis. METHOD: Medical records of 2363 PTMC patients were reviewed form October 2013 to December 2015. All the patients with lymph node metastasis identified by histopathology were included. Preoperative sonographic features, such as multifocality, tumour size, echogenicity, calcification, vascularity of papillary microcarcinoma, and capsule invasion, were recorded. Univariate and multivariate analyses were performed to investigate the relationships between sonographic features and high-volume lymph node metastasis (number of metastatic lymph nodes >5). RESULTS: In total, 152 patients had high-volume central lymph node metastasis (6.4%, 152/2363). Multiple logistic regression analysis showed that the preoperative ultrasonic features of microcalcifications (OR = 3.33, p = 0.022), larger tumour size (>7 mm) (OR = 2.802, p < 0.001), and capsule invasion (OR = 2.141, p = 0.006) were independent risk factors for high-volume lymph node metastasis in the central compartment of PTMC. CONCLUSION: The sonographic features of primary papillary microcarcinoma of the thyroid are correlated with high-volume central lymph node metastasis.

Generalized Entanglement Entropies of Quantum Designs.

The entanglement properties of random quantum states or dynamics are important to the study of a broad spectrum of disciplines of physics, ranging from quantum information to high energy and many-body physics. This Letter investigates the interplay between the degrees of entanglement and randomness in pure states and unitary channels. We reveal strong connections between designs (distributions of states or unitaries that match certain moments of the uniform Haar measure) and generalized entropies (entropic functions that depend on certain powers of the density operator), by showing that Rényi entanglement entropies averaged over designs of the same order are almost maximal. This strengthens the celebrated Page's theorem. Moreover, we find that designs of an order that is logarithmic in the dimension maximize all Rényi entanglement entropies and so are completely random in terms of the entanglement spectrum. Our results relate the behaviors of Rényi entanglement entropies to the complexity of scrambling and quantum chaos in terms of the degree of randomness, and suggest a generalization of the fast scrambling conjecture.

Resource Destroying Maps.

Resource theory is a widely applicable framework for analyzing the physical resources required for given tasks, such as computation, communication, and energy extraction. In this Letter, we propose a general scheme for analyzing resource theories based on resource destroying maps, which leave resource-free states unchanged but erase the resource stored in all other states. We introduce a group of general conditions that determine whether a quantum operation exhibits typical resource-free properties in relation to a given resource destroying map. Our theory reveals fundamental connections among basic elements of resource theories, in particular, free states, free operations, and resource measures. In particular, we define a class of simple resource measures that can be calculated without optimization, and that are monotone nonincreasing under operations that commute with the resource destroying map. We apply our theory to the resources of coherence and quantum correlations (e.g., discord), two prominent features of nonclassicality.

Advances in understanding the molecular mechanism of pancreatic cancer metastasis.

BACKGROUND: Pancreatic cancer (PC) is usually diagnosed at the late-stage and therefore, has widespread metastasis and a very high mortality rate. The mechanisms underlying PC metastasis are not well understood. Recent advances in genomic sequencing have identified groups of gene mutations that affect PC metastasis, but studies elucidating their roles are lacking. The present review was to investigate the molecular mechanisms of PC metastasis. DATA SOURCES: Relevant articles on PC metastasis were searched in MEDLINE via PubMed prior to April 2015. The search was limited in English publications. RESULTS: PC metastatic cascades are multi-factorial events including both intrinsic and extrinsic elements. This review highlights the most important genetic alterations and other mechanisms that account for PC invasion and metastasis, with particular regard to epithelial-mesenchymal transition, inflammation, stress response, and circulating tumor cells. CONCLUSIONS: Analyses of relevant gene functions and signaling pathways are needed to establish the gene regulatory network and to define the pivotal modulators. Another promising area of study is the genotyping and phenotyping of circulating tumor cells, which could lead to a new era of personalized therapy by identifying specific markers and targets.

Filamin A: Insights into its Exact Role in Cancers.

Filamin A (FlnA) is a well-known actin cross-linking protein. It serves as a scaffold for over 90 binding partners and involves in multiple cell functions, of which cell migration and adhesion is especially critical. Recently, its role in the cell has come under scrutiny for FlnA's involvement in cancer development. Originally revealed as a cancer-promoting protein, FlnA actually plays a dual role in cancers. When localized to the cytoplasm, FlnA has a tumor-promoting effect by interacting with signaling molecules. While once localized to the nucleus, it may act to suppress tumor growth and inhibit metastasis by interacting with transcription factors. Thus drugs that can cause FlnA to transpose from cytoplasm to nucleus could be a promising treatment for cancers. Study to this end is on the way in prostate cancer and the results are encouraging. FlnA has been studied in large categories of cancers, such as prostate cancer, breast cancer, melanoma, lung cancer, etc. However, most studies did not evaluate the differences that arise from the localization of the protein, which was a great pity! What's more, although FlnA's is undoubtedly important in cancer invasion and metastasis, both preclinical and clinical researches are very rare in some highly metastatic cancers, such as pancreatic cancer. In this mini-review, we give a comprehensive summary of FlnA' s expression in cancers. Where available, we also indicate the correlation of FlnA with cancer stages and patient prognosis, and clarify its localization (nucleus/cytoplasm) and its dual role (promote/suppress) in different cancers.

Risk Factors for Nodal Metastasis in cN0 Papillary Thyroid Microcarcinoma.

BACKGROUND: Despite the majority of papillary thyroid microcarcinoma (PTMC) patients having an excellent prognosis, cervical lymph node metastases are common. The purpose of this study was to investigate the incidence and the predictive risk factors for occult central compartment lymph node metastasis (CLNM) in PTMC patients. MATERIALS AND METHODS: 178 patients with clinically node-negative (cN0) PTMC undergoing prophylactic central compartment neck dissection in our hospital from January 2008 to Jun 2010 were enrolled. The relationship between CLNM and the clinical and pathological factors such as gender, age, tumor size, tumor number, tumor location, extracapsular spread (ECS), and coexistance of chronic lymphocytic thyroiditis was analyzed. RESULTS: Occult CLNM was observed in 41% (73/178) of PTMC patients. Multivariate analysis showed that male gender, tumor size (≥6mm) and ECS were independent variables predictive of CLNM in PTMC patients. CONCLUSIONS: Male gender, tumor size (≥6mm) and ECS were risk factors of CLNM. We recommend a prophylactic central lymph node dissection (CLND) should be considered in PTMC patients with such risk factors.

[Clinical study of the improvement gastrostomy in pancreaticoduodenectomy].

OBJECTIVE: To explore the clinical significance of improvement gastrostomy in pancreaticoduodenectomy. METHODS: Clinical data of 82 patients who underwent pancreaticoduodenectomy and jejunostomy from November 2004 to December 2006 were collected, among which 36 patients received improvement gastrostomy (treatment group), 24 patients accepted traditionary gastrostomy (control group 1) and 22 patients without any gastrostomy (control group 2). Operative time, postoperative duration of gastrointestinal decompression tube, postoperative gastroparesis, pancreatic fistula, biliary fistula, and abdominal cavity infection were compared. RESULTS: The incidence of postoperative gastroparesis in the treatment group and control group 2 were can significantly lower than that in the control group 1 (P < 0.05). The postoperative duration of gastrointestinal decompression tube of the treatment group was significant shorter than that of control group 2 (P < 0.01). There were no significant difference in other items. CONCLUSIONS: The improvement gastrostomy in pancreaticoduodenectomy is simple and secure. It can significantly shorten the postoperative duration of gastrointestinal decompression tube and also obviously reduce the incidence of postoperative gastroparesis compared with traditionary gastrostomy.

[Laparoscopic distal pancreatectomy: current indications and surgical results].

OBJECTIVE: To evaluate the safety, feasibility indications, prognosis and follow-up of laparoscopic distal pancreatectomy. METHODS: Retrospective study was employed on 10 patients collected from Feb. to Oct. 2005 with diagnosis of masses located at pancreatic body/tail. The mean age was 43 years and ratio between male and female was 1:9. Preoperative diagnosis: nine patients with cystic lesion located at pancreatic body and tail, one patient with pancreatic endocrine tumor with liver metastasis, which located at pancreatic tail. The mean size of the tumor was 4.0 cm. All patients received adjuvant examinations including CT contrast scan, abdominal ultrasound or endoscopic ultrasound. The serum levels of tumor markers (including CA19-9, CA242, CA50 and CEA) of the patients were all normal. RESULTS: All patients received distal pancreatectomy by laparoscope successfully. Among them, seven procedures were spleen-preserved and three with splenectomy. Mean operative time was 228 +/- 26 min, and mean blood lose volume was 173 +/- 100 ml. One patient suffered with pancreatic fistula after operation but was successfully managed by conservative therapy in one month, pancreatic pseudocyst was detected in one patient and disappeared spontaneously in one month, no other morbidity occurred. The postoperative hospital stay was 12 - 16 d (mean, 13.5 d). The serum glucoses of 10 patients after operation were normal. The mean time of follow-up was 8 months (2 - 22 months). During the follow-up, nine patients with benign cystic lesions did not relapse. And the other one patient with malignant metastasis kept stable, not recurrence was detected in one year after operation. CONCLUSIONS: Laparoscopic distal pancreatectomy was safe and feasible for benign cystic tumors located at the body or tail of the pancreas.

[Relationship between apoptosis induced by 2-butylamino-2-demethoxy-hypocrellin B in human pancreatic cancer cells Capan-1 and photosensitization of mitochondria].

OBJECTIVE: To explore the possible mechanism of apoptosis induced by photodynamic therapy (PDT) in human pancreatic cancer cells Capan-1 with 2-butylamino-2-demethoxy-hypocrellin B (BAHB) as photosensitizer. METHODS: The localization of BAHB in Capan-1 cells was studied, apoptosis was determined by DNA gel electrophoresis after PDT. The mitochondria membrane potential (DYm) and cytochrome C release were observed by laser scan confocal microscopy and Western blotting. RESULTS: The low concentration photosensitizer was mainly localized in mitochondria and also in lysosomes when the concentration is high. DNA ladder analysis showed characteristic of apoptosis. The mitochondria membrane potential (DYm) showed a loss of 30% around, after 6 hours by PDT under laser scan confocal microscopy, which is caused by a sudden increase in the permeability of mitochondria membrane accompanied with apoptosis. In Western blotting, cytochrome C release was observed from the mitochondria into the cytoplasm during BAHB-induced apoptosis. CONCLUSION: The research suggests that BAHB-induced apoptosis is related to photosensitization of mitochondria.

[Surgical treatment of pancreatic insulinoma by laparoscopy].

OBJECTIVE: To evaluate the safety and outcome of laparoscopic insulinoma resection. METHODS: Twenty-five patients with insulinoma were admitted and divided into two groups: laparoscopic group (10 patients) and laparotomy group (15 patients). All tumors of two groups were located at the body or tail of pancreas preoperatively by abdominal CT and digital subtraction angiography (DSA). Laparoscopic enucleation was performed for patients in laparoscopic group, open enucleation was performed for patients in laparotomy group. There were no differences in preoperative location and size of tumors between two groups. Statistical method was used to compare the discrepancy from operation time, the volume of blood loss, hospital stay and morbidity of complication between two groups. RESULTS: There were no discrepancies from operation time, blood loss, hospital stay after operation between two groups (P > 0.05). However, one case of pancreatic leakage developed in laparoscopic group, comparably, 3 cases of pancreatic leakage, 2 cases of celiac sepsis and 5 cases of fluid accumulation in thoracic cavity developed in laparotomy group. There were significant discrepancies in morbidity of complication between two groups. CONCLUSIONS: Laparoscopic resection of pancreatic insulinoma is safe and feasible for tumors located at the body or tail of the pancreas. Its application for tumors located at the pancreatic head needs further evaluation.

[Perioperative nutrition support of the patients with pancreatic head cancer].

OBJECTIVE: To explore the effect of perioperative nutrition support on nutritional condition and complications of the patients with postoperative pancreatic head cancer. METHODS: Thirty four patients received perioperative nutrition support, including enteral nutrition and parenteral nutrition (treatment group). Forty eight patients received routine postoperative parenteral nutrition (control group). According to the operative method, these two groups were further divided into two sub-groups: (1) pancreaticoduodenectomy (PD) subgroup, including 13 cases from treatment group, and 24 cases from control group; (2) palliative operation subgroup, including 21 cases from treatment group, and 24 cases from control group. Body weight, total protein (TP), serum albumin (ALB), and the complications after operation were compared. RESULTS: The concentrations of ALB and TP in the treatment group were significantly higher than those in the control group (P< 0.05). Body weight and TP of the patients received PD in the treatment group were significantly better than those of the control group (P < 0.05). CONCLUSION: Perioperative nutrition support can improve postoperative nutritional condition and reduce the postoperative complications in patients with pancreatic head cancer.