Treatment algorithm and surgical outcome for primary and recurrent retroperitoneal sarcomas: A long-term single-center experience of 242 cases.

BACKGROUND AND OBJECTIVES: Retroperitoneal sarcomas (RPSs) are difficult to manage, rare malignant tumors. This single-center, retrospective study aimed to analyze the treatment algorithm and outcomes of aggressive surgical treatment in patients with primary and recurrent RPS. METHODS: Data of 242 consecutive patients with RPS who underwent surgical treatment at the Peking University Cancer Hospital Sarcoma Center between January 2010 and February 2021 were collected and analyzed. Indications for surgery were based on the treatment algorithm. RESULTS: A total of 145 patients with primary RPS and 97 with recurrent RPS were included. The recurrent cohort comprised more patients with multifocal tumors than the primary cohort (64.9% vs. 15.2%). R0/R1 resection was achieved in 94.5% and 81.4% of the primary and recurrent RPS cases, respectively. Major complication rates in the primary and recurrent cohorts were 17.9% and 30.9%, respectively. During a median follow-up of 51 months, the estimated 5-year overall survival, local recurrence, and distant metastasis rates for patients with primary and recurrent RPS were 61.0% versus 37.1%, 47.4% versus 71.3%, and 18.4% versus 17.6%, respectively. CONCLUSIONS: Aggressive surgical treatment achieved good local control and long-term survival in patients with primary RPS, whereas the prognosis in patients with recurrence were significantly worse.

Sequential sagittal alignment changes in the cervical spine after occipitocervical fusion.

BACKGROUND: There are few studies regarding sequential changes in the sagittal alignment of the upper and lower cervical regions of the spine after occipitocervical fusion (OCF). In addition, no comparisons of cervical sagittal alignment (CSA) between patients with craniocervical junction disorders (CJDs) and normal populations have been reported. AIM: To compare the CSA of patients with CJDs with that of normal controls and investigate the sequential changes in the CSA of the upper and lower cervical spine after OCF. METHODS: Eighty-four patients who underwent OCF (OCF group) and 42 asymptomatic volunteers (control group) were included. Radiographic parameters, including the occipital to C2 angle (O-C2a), occipital and external acoustic meatus to axis angle (O-EAa), C2-7 angle (C2-7a), and pharyngeal inlet angle (PIA), were measured and compared pre- and postoperatively. The correlations among the parameters were analyzed using Pearson's correlation test. RESULTS: The O-C2a and PIA of the OCF group were smaller than those of the control group, while their O-EAa and C2-7a values were larger than those of the normal controls. There were no significant differences in O-C2a, C2-7a, or PIA in the OCF group at baseline, 1 mo, or the final follow-up after surgery. The Pearson's correlation results showed that there were significant correlations between the O-C2a and C2Ta, C2-7a, C2-7 sagittal vertical axis (SVA), and PIA at 1 mo after OCF surgery and between O-C2a and O-EAa, C2Ta, C2-7a, C2-7 SVA, and PIA at the final follow-up. CONCLUSION: Patients with CJDs have a more kyphotic upper CSA and a more lordotic lower CSA than normal controls. The effectiveness of OCF surgery in restoring CSA may be limited by the realignment of the craniocervical junction being neglected. The reduction in O-C2a after OCF surgery may increase C2-7a and decrease PIA.

[Identifying the Sources of Groudwater NO3--N in Agricultural Region of Qingdao].

To increase crops yields, applying large amounts of fertilizers has become increasingly common in agricultural regions, resulting in NO3--N groundwater pollution. Agricultural non-point pollution is the main source of groundwater NO3--N pollution. To ensure drinking water safety and quality, it is crucial to clarify the sources of NO3--N pollution in agricultural regions. In this study, 35 sampling sites were randomly selected in the Qingdao agricultural area in 2009 and 2019. The spatial distribution of NO3--N concentration was analyzed by the inverse distance weighting method (IDW). The nitrogen and oxygen isotopes were used as a tool to trace sources of NO3--N and the SIAR model was used to quantify contribution proportion of pollution sources. The results showed that the concentration of NO3--N (average) in groundwater in Qingdao has been reduced from 38.49 mg·L-1 in 2009 to 22.37 mg·L-1 in 2019, but it is still higher than the maximum allowable concentration of NO3--N in drinking water set by the World Health Organization (WHO). The NO3--N concentration gradually increased from south to north both in 2009 and 2019. The cross diagram of δ15N-NO3- and δ18O-NO3- show that the main sources of NO3--N in groundwater in Qingdao are chemical fertilizers, soil nitrogen, and manure and sewage. Water isotopes indicate that precipitation was the main source of groundwater in Qingdao. The SIAR model results indicated that the contribution of each source ranked as follows:manure and sewage (47.42%) > soil nitrogen (27.80%) > chemical fertilizer (14.32%) > atmospheric nitrogen depositions (10.43%). From 2009 to 2019, the quality of groundwater in Qingdao has been improved, but NO3--N pollution still cannot be ignored. According to the results, prevention and control should be made to ensure the safety of drinking water and the sustainable development of agriculture.

Pilot Study of CT-Based Radiomics Model for Early Evaluation of Response to Immunotherapy in Patients With Metastatic Melanoma.

Objective: Determine the performance of a computed tomography (CT) -based radiomics model in predicting early response to immunotherapy in patients with metastatic melanoma. Methods: This retrospective study examined 50 patients with metastatic melanoma who received immunotherapy treatment in our hospital with an anti-programmed cell death-1 (PD-1) agent or an inhibitor of cytotoxic T lymphocyte antigen-4 (CTLA-4). Thirty-four patients who received an anti-PD-1 agent were in the training sample and 16 patients who received a CTLA-4 inhibitor were in the validation sample. Patients with true progressive disease (PD) were in the poor response group, and those with pseudoprogression, complete response (CR), partial response (PR), or stable disease (SD) were in the good response group. CT images were examined at baseline and after the first and second cycles of treatment, and the imaging data were extracted for radiomics modeling. Results: The radiomics model based on pre-treatment, post-treatment, and delta features provided the best results for predicting response to immunotherapy. Receiver operating characteristic (ROC) analysis for good response indicated an area under the curve (AUC) of 0.882 for the training group and an AUC of 0.857 for the validation group. The sensitivity, specificity, and accuracy of model were 85.70% (6/7), 66.70% (6/9), and 75% (12/16) for predicting a good response. Conclusion: A CT-based radiomics model for metastatic melanoma has the potential to predict early response to immunotherapy and to identify pseudoprogression.

Correlation of placental microbiota with fetal macrosomia and clinical characteristics in mothers and newborns.

Substantial studies indicated that fetal macrosomia was associated with detrimental pregnancy outcomes, and increased susceptibility to metabolic diseases in later life. However, investigations into the association between placental microbiota and fetal macrosomia are limited. We aimed to profile the placental microbiota of fetal macrosomia and study whether they relate to clinical characteristics. Placenta samples were collected from fetal macrosomias and newborns with normal birth weight. The clinical characteristics, umbilical cord blood parameters were measured, and placental microbiota were sequenced and further analysed. The clinical characteristics of infants and mothers and umbilical cord blood parameters were significantly different between macrosomias and controls. The relative abundance of microbiota sequences revealed that microbial structures of the placenta differed significantly between macrosomia and controls. Regression analysis showed a cluster of key operational taxonomic unit (OTUs), phyla and genera were significantly correlated with body length, ponderal index and placenta weight, body weight increase during pregnancy of mothers, and cord blood IGF-1 and leptin concentrations. In conclusion, our study for the first time explored the relationship between placental microbiota profile and fetal macrosomia. It is novel in showing that a distinct placental microbiota profile is present in fetal macrosomia, and is associated with clinical characteristics of mothers and newborns.

DNA Methylation and Birth Weight: a Genome-wide Analysis.

The study illustrate the inner correlation between global DNA methylation variation and different birth weights. Infant birth weight was used to identify cases and controls. Cord blood and placentas were collected. We performed DNA methylation profiling of bisulphite-converted DNA. We have identified many differentially methylated CpG sites in experimental groups; these sites involved in hundreds of signalings. Among these, more than ten pathways were referred to the glucose and lipid metabolism. Methylation changes in the insulin-signaling pathway (ISP), adipocytokine signaling pathway (ASP) and MAPK signaling pathway are involved in the fetal programming of diabetes..

Cardioprotective activity of placental growth factor in a rat model of acute myocardial infarction: nanoparticle-based delivery versus direct myocardial injection.

BACKGROUND: To comparatively evaluate the cardioprotective activity of placental growth factor (PGF) delivered through direct injection and a nanoparticle-based system respectively and to study the underlying mechanisms in a rat model of acute myocardial infarction (AMI). METHODS: Poly lactic-co-glycolic acid (PLGA)-based PGF-carrying nanoparticles (PGF-PLGANPs) were created. The mean size and morphology of particles were analyzed with particle size analyzer and transmission electronic microscopy (TEM). Encapsulation efficiency and sustained-release dose curve were analyzed by ELISA. Sprague-Dawley rats were randomized into four groups (n = 10). While animals in the first group were left untreated as controls, those in the other 3 groups underwent surgical induction of AMI, followed by treatment with physiological saline, PGF, and PGF-PLGANPs, respectively. Cardiac function was evaluated by transthoracic echocardiography at 4 weeks after treatment. At 6 weeks, rats were sacrificed, infarction size was analyzed with Masson trichrome staining, and protein contents of TIMP-2, MT1-MMP and MMP-2 at the infarction border were determined by immunohistochemistry and western blotting analysis. RESULTS: PGF was released for at least 15 days, showing successful preparation of PGF-PLGANPs. Coronary artery ligation successfully induced AMI. Compared to physiological saline control, PGF, injected to the myocardium either as a nude molecule or in a form of nanoparticles, significantly reduced infarction size, improved cardiac function, and elevated myocardial expression of TIMP-2, MT1-MMP, and MMP-2 (P < 0.05). The effect of PGF-PLGANPs was more pronounced than that of non-encapsulated PGF (P < 0.05). CONCLUSION: Target PGF delivery to myocardium may improve cardiac function after AMI in rats. PLGA-based nanoparticles appear to be a better approach to delivery PGF. PGF exerts its cardioprotective effect at least partially through regulating metalloproteinase-mediated myocardial tissue remodeling.

[Spatial distribution characteristics of China cotton fiber quality and climatic factors based on GIS].

By using geographical information system (GIS), the cotton fiber quality data from 2005 to 2011 and the daily meteorological data from 1981 to 2010 at 82 sites (counties and cities) in China major cotton production regions were collected and treated with spatial interpolation. The spatial information system of cotton fiber quality in China major cotton production regions was established based on GIS, and the spatial distribution characteristics of the cotton fiber quality and their relationships with the local climatic factors were analyzed. In the northwest region (especially Xinjiang) of China, due to the abundant sunlight, low precipitation, and low relative humidity, the cotton fiber length, micronaire, and grade ranked the first. In the Yangtze River region and Yellow River region, the specific strength of cotton fiber was higher, and in the Yangtze River region, the cotton fiber length and specific strength were higher, while the micronaire and grade were lower than those in the Yellow River region. The cotton fiber quality was closely related to the climate factors such as temperature, sunlight, rainfall, and humidity.

[Phase II clinical trial of sorafenib plus local chemotherapy in the treatment of metastatic renal cell carcinoma with pleural effusion].

OBJECTIVE: To evaluate the safety and efficacy of sorafenib plus cisplatin in the treatment of metastatic renal cell carcinoma (mRCC) with pleural effusion. METHODS: A total of 30 patients with mRCC (clear cell carcinoma) with pleural effusion from April 2009 to January 2011 were recruited. All received sorafenib 400 mg twice daily. And 11 patients in chemotherapy group received sorafenib plus local chemotherapeutic perfusion of cisplatin 40 mg weekly for 2 weeks while another 19 patients in control group received sorafenib alone. RESULTS: The response rate of pleural effusion was 10/11 for chemotherapy group versus 3/19 for control group (χ(2) = 13.097, P < 0.01). Followed up to April 30(th), 2011, 5 of 11 patients in chemotherapy group and 10 of 19 patients in control group died. Among those on sorafenib, the median overall survival time was 22 months (95%CI: 2.12 - 41.88) for local chemotherapy versus 9 months (95%CI: 8.20 - 9.80) without local therapy (P = 0.04). The most common events in local chemotherapy group were I-II thoracic pain, nausea and vomiting. And the incidence rates were 8/11 and 9/11 versus 4/19 and 3/19 respectively (P < 0.01). The main laboratory abnormalities were similar in two groups. CONCLUSION: The regimen of sorafenib plus pleural cavity perfusion of cisplatin is both effective and safe in the treatment of mRCC with pleural effusion. It may control local symptoms and achieve a better overall survival.

[Determination of trace mercury in wastewater by a flow injection analysis composed of immobilized ionic liquid enrichment and colorimetric detection].

Amberlite XAD-7 resin was modified by room temperature ionic liquid (1-hexyl-3-methylimidazolium hexafluorophosphate, [C6 mim]PF6) coating through a maceration method, gaining a new sort of hydrophobic adsorbent for the solid phase extraction mini-column. Trace inorganic mercury in wastewater samples was preconcentrated and determined by flow injection online mini-column sampling coupled with spectrophotometric determination. In acid medium, dithizone was employed as chelator with cetyltrimethylammonium bromide (CTMAB) to form a red neutral mercury-dithizone complex, which could be extracted quantificationally by solid phase extraction technique on the mini-column. Under the optimized conditions, the linearity and the detection limit of the proposed method were found to be 0.35 to 50.0 microg x L(-1) Hg2+ and 0.067 microg x L(-1) Hg2+, respectively. The enrichment factor of 25 times could be achieved with a 50 mL sampling volume and the developed procedure was successfully applied for the determination of mercury in the certified reference material (GSBZ50016-90) and the spiked dock wastewater samples with the recovery of 99%-103%.

Clinicopathological significance of PTEN and Caspase-3 expressions in breast cancer.

OBJECTIVE: To investigate the expressions of PTEN and Caspase-3 proteins in human breast carcinoma, and to evaluate their clinicopathological implications during the tumorigenesis and progression of breast cancer. METHODS: The expressions of PTEN and Caspase-3 proteins in 95 cases of breast cancer and 15 cases of benign breast diseases were investigated immunohistochemically. Correlations between the expression of PTEN protein, Caspase-3 protein, and clinicopathological features of breast cancers were analyzed. RESULTS: The loss expression rate of PTEN protein in tumor tissues was significantly higher than that in benign breast diseases (33.7% vs. 0, P < 0.01). Analysis of the clinicopathological features showed that PTEN expression level was negatively correlated with TNM stage, histological grade, axillary lymph node status, recurrence, and metastasis (P < 0.05). The positive expression level of Caspase-3 was negatively correlated with TNM stage (P < 0.01), but not related with histological grade, axillary lymph node status, recurrence, or metastasis (P > 0.05). In addition, the expression of PTEN protein had significantly positive correlation with the expression of Caspase-3 protein in breast cancer (P < 0.01). CONCLUSION: The combination detection of PTEN and Caspase-3 may serve as an important index to estimate the pathobiological behavior and prognosis of breast cancer.