Evaluation of ultrasound-guided PFO occlusion in the treatment of vestibular migraine.

BACKGROUND: Currently, surgery is the mainstay of the clinical treatment of vestibular migraine. OBJECTIVE: To investigate the clinical efficacy and safety of using transesophageal echocardiography-guided interventional closure of the patent foramen ovale (PFO) in the treatment of vestibular migraine. METHODS: The study included 52 patients with vestibular migraine who were admitted to our hospital between June 2019 and June 2021. All selected patients underwent a transesophageal echocardiography-guided interventional closure of the PFO and were followed up for one year after surgery. We observed the clinical efficacy and surgical success rate one year after surgery and compared the improvement in clinical symptoms and perioperative safety at different time points. RESULTS: The overall remission rate and the surgical success rate for the 52 patients with vestibular migraine one year after surgery were 86.54% and 96.15%, respectively. Compared to the pre-surgery levels, there was a significant progressively decreasing trend in the scores on the Headache Impact Test-6 (HIT-6), Visual Analogue Scale (VAS), Migraine Disability Assessment (MIDAS) questionnaire, frequency of headaches, and duration of headaches in patients with vestibular migraine at 1, 3, and 6 months after surgery (P< 0.05). Among the 52 patients, one developed atrial fibrillation three hours after surgery, which then spontaneously converted to sinus rhythm, and none of the other patients had adverse outcomes such as hematoma at the puncture site during the perioperative period. CONCLUSION: Transesophageal echocardiography-guided interventional closure of the PFO for treating vestibular migraine significantly improved the symptoms of migraine in patients, with a high surgical success rate, significant clinical efficacy, and favorable safety.

Privacy preserving IoT-based crowd-sensing network with comparable homomorphic encryption and its application in combating COVID19.

IoT-based crowd-sensing network, which aims to achieve data collection and task allocation to mobile users, become more and more popular in recent years. This data collected by IoT devices may be private and directly transmission of these data maybe incur privacy leakage. With the help of homomorphic encryption (HE), which supports the additive and/or multiplicative operations over the encrypted data, privacy preserving crowd-sensing network is now possible. Until now several such secure data aggregation schemes based on HE have been proposed. In many cases, ciphertext comparison is an important step for further secure data processing. However efficient ciphertext comparison is not supported by most such schemes. In this paper, aiming at enabling ciphertext comparison among multiple users in crowd-sensing network, with Lagrange's interpolation technique we propose comparable homomorphic encryption (CompHE) schemes. We also prove our schemes' security, and the performance analysis show our schemes are practical. We also discuss the applications of our IoT based crowd-sensing network with comparable homomorphic encryption for combatting COVID19, including the first example of privacy preserving close contact determination based on the spatial distance, and the second example of privacy preserving social distance controlling based on the spatial difference of lockdown zones, controlled zones and precautionary zones. From the analysis we see our IoT based crowd-sensing network can be used for contact tracing without worrying about the privacy leakage. Compared with the existing CompHE schemes, our proposals can be collusion resistance or secure in the semi-honest model while the previous schemes cannot achieve this easily. Our schemes only need 4 or 5 modular exponentiation when implementing the most important comparison algorithm, which are better than the existing closely related scheme with advantage of 50% or 37.5%.

Prognostic Impact of Pretreatment Elevated and Normalized Carcinoembryonic Antigen Levels After Neoadjuvant Chemoradiotherapy in Resected Locally Advanced Rectal Cancer Patients.

PURPOSE: The prognostic significance of pretreatment elevated and normalized CEA after neoadjuvant chemoradiotherapy (nCRT) was evaluated. MATERIALS AND METHODS: The characteristics of 951 locally advanced rectal cancer patients with nCRT were retrieved and were analyzed retrospectively. Pretreatment CEA levels were defined as CEA evaluated one week prior to the nCRT. CEA after nCRT was deemed as CEA measured one week before surgery. The normal CEA levels were set at <5 ng/mL. The normal CEA group was defined as patients with normal pretreatment CEA levels. The normalized CEA group was defined as patients with elevated pretreatment CEA levels and normal CEA levels after nCRT. The elevated CEA group was defined as patients with elevated pretreatment CEA levels and elevated CEA levels after nCRT. RESULTS: Compared with the elevated CEA group, the normalized CEA group was associated with better overall survival (OS) (HR: 0.625, 95%CI: 0.416-0.938, P=0.022). There was no difference between the normalized CEA group and the normal CEA group (HR: 1.143, 95%CI: 0.84-1.557, P=0.395). CONCLUSION: In conclusion, the study indicated that OS of the normalized CEA group and the normal CEA group was better than the elevated CEA group.

Prognostic Value of Pretreatment Serum CA199 in Patients with Locally Advanced Rectal Cancer Treated with CRT Followed by TME with Normal Pretreatment Carcinoembryonic Antigen Levels.

BACKGROUND: Elevated pretreatment carcinoembryonic antigen (CEA) levels are related to poor prognosis in patients with locally advanced rectal cancer (LARC) treated with neo-CRT followed by TME. In patients with normal pretreatment CEA levels, the prognostic significance of carbohydrate antigen 199 (CA199) is controversial. OBJECTIVES: The aim of this study was to explore the prognostic value of pretreatment serum CA199 in patients with LARC who had normal pretreatment CEA levels treated with neo-CRT followed by curative surgery. METHODS: A retrospective study of 456 patients with LARC treated with neo-CRT followed by TME between January 2006 and May 2017 was performed. We employed the maximal χ2 method to determine the CA199 threshold of 9.1 U/mL based on the difference in survival and divided patients into 2 groups. Group 1: patients with pretreatment s-CEA < 5 ng/mL and CA199 ≥ 9.1 U/mL. Group 2: patients with pretreatment s-CEA < 5 ng/mL and CA199 < 9.1 U/mL. Overall survival (OS) across CA199 was assessed using Cox proportional hazard regression models (PS:CEA ≥ 5 ng/mL was seen as elevated). RESULTS: Multivariate analyses demonstrated that the following factors were significantly related to OS in patients with LARC with normal pretreatment CEA levels: ypT (odds ratio [OR] 1.863, p = 0.030), ypN (OR 1.622, p = 0.026), and pretreatment CA199 levels (OR 1.886, p = 0.048). CONCLUSION: Pretreatment CA199 is an independent factor for OS in patients with LARC with normal pretreatment CEA levels, which may reach the clinic to guide individualized decision-making.

Chemotherapy-based split stereotactic body radiation therapy for borderline resectable and locally advanced pancreatic cancer: study protocol of a prospective, single-arm phase II trial.

INTRODUCTION: The question of how to administer adequate chemotherapy to synchronise stereotactic body radiation therapy (SBRT) treatment strategy to maximise the benefits of neoadjuvant therapy for the improved prognosis of patients with borderline resectable (BRPC) and locally advanced (LAPC) pancreatic cancer is a challenging and debatable issue. No studies have yet evaluated the efficacy of split-course SBRT as the neoadjuvant chemoradiotherapy regimen. We aimed to study whether neoadjuvant chemotherapy plus split-course SBRT results in better outcomes in BRPC and LAPC patients. METHODS AND ANALYSIS: Treatment-naïve patients with radiographically confirmed BRPC or LAPC, supporting biopsy results and no severe comorbidities will be enrolled. They will be treated with nab-paclitaxel plus gemcitabine (nab-P+Gem) chemotherapy plus split-course SBRT, followed by an investigator's choice of continuation of treatment with nab-P+Gem or surgery. nab-P+Gem chemotherapy will commence on day 1 for each of six cycles: nab-paclitaxel 125 mg/m2 intravenous infusion over approximately 30-45 min, followed by gemcitabine 1000 mg/m2 intravenous infusion over about 30 min on days 1 and 15 of each 28-day cycle. During the first and second cycles of chemotherapy, SBRT will be given as a single irradiation of 10 Gy four times (days 2 and 16 of each 28-day cycle). The primary endpoint is progression-free survival; while the secondary outcomes are the time to treatment failure, disease control rate, overall response rate, overall survival, R0 resection rate and incidence of adverse effects. ETHICS AND DISSEMINATION: The study protocol was approved by the Ethics Committee of Xiehe Affiliated Hospital of Fujian Medical University (No. 2019YF015-01). Results from our study will be disseminated in international peer-reviewed journals. All study procedures were developed in order to assure data protection and confidentiality. TRIAL REGISTRATION NUMBER: NCT04289792.

Nomogram Predicting Overall Survival of Resected Locally Advanced Rectal Cancer Patients with Neoadjuvant Chemoradiotherapy.

PURPOSE: The overall survival (OS) of resected locally advanced rectal cancer patients who underwent neoadjuvant chemoradiotherapy (nCRT) was significantly different, even among patients with the same tumor stage. The nomogram was designed to predict OS of rectal cancer with nCRT and divide the patients into different risk groups. MATERIALS AND METHODS: Based on materials from 911 rectal cancer patients with nCRT, the multivariable Cox regression model was carried out to select the significant prognostic factors for overall survival. And then, the nomogram was formulated using these independent prognostic factors. The discrimination of the nomogram was assessed by concordance index (C-index), calibration curves and time-dependent area under curve (AUC). The patients respective risk scores were calculated through the nomogram. The best cut-off risk score was calculated to stratify the patients. The survival curves of the two different risk cohorts were performed, which assessed the predictive ability of the nomogram. RESULTS: Age, cT stage, pretreatment CEA, pretreatment CA19-9, surgery, posttreatment CEA, posttreatment CA19-9, pT stage, pN stage and adjuvant chemotherapy were selected for the construction of the nomogram. And then the nomogram was constructed with independent prognostic factors. The C-index of the nomogram was 0.724, which showed the nomogram provided good discernment. The acceptable agreement between the predictions of nomogram and actual observations was illustrated by calibration plots for 3-, 5- and 10-year OS in the cohort. Time-dependent AUC with 6-fold cross-validation also showed consistent results of the nomogram. Risk group stratification confirmed that the nomogram had great capacity for distinguishing the prognosis. CONCLUSION: The nomogram was developed and validated to predict overall survival of resected locally advanced rectal cancer patients with nCRT. The proposed nomogram might help clinicians to develop individualized treatment strategies. However, further studies are warranted to optimize the nomogram by finding out other unknown prognostic factors, and more external validation is still required.

[Rapid determination of 55 fungicides in siraitia grosvenoriis by QuEChERS and high performance liquid chromatography-tandem mass spectrometry].

A method for the determination of 55 fungicides in siraitia grosvenoriis by QuEChERS and high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) was established. The samples were extracted with acetonitrile containing 1%(v/v) acetic acid, then dehydrated by anhydrous magnesium sulfate and purified by anhydrous sodium sulfate, N-propyl ethylenediamine (PSA) and C18. Then, 95% (v/v) acetonitrile aqueous solution (organic phase) and water (aqueous phase), both containing 0.005 mol/L ammonium formate and 0.01% (v/v) formic acid, were used as mobile phases with gradient elution. The compounds were tested by positive electrospray ion source (ESI+) and dynamic multiple reaction monitoring (DMRM) mode. Fifty-five fungicides were quantified by external standard method considering matrix effects. The correlation coefficients (R2) were greater than 0.99, which indicated that the linear dependence of the 55 fungicides were good in the range of 1.0-100.0 µg/kg. The LODs (S/N>3) and LOQs (S/N>10) of all the fungicides were 1.0 µg/kg and 10.0 µg/kg, respectively. The recoveries were in the range of 76.96%-118.45% and the relative standard deviations (RSDs) ranged from 3.44% to 19.63% (n=6). This method has the advantages of rapidity, accuracy and sensitivity for the high-throughput detection of fungicides residues in siraitia grosvenoriis.

[Determination of endosulfan pesticide residues in Litopenaeus vannamai by capillary gas chromatography].

A method is described for the determination of endosulfan pesticide residues in Litopenaeus vannamai by capillary gas chromatography. The residues of alpha-endosulfan and beta-endosulfan were extracted from the sample with ethyl acetate, and the extract was cleaned up using a neutral alumina column and an active carbon column after concentrated and then eluted with a mixture of n-hexane-ethyl acetate (1 : 1, v/v). During the process of purification, the flow rate of eluent was controlled within 3 mL/min. The eluate was collected and evaporated to 1 mL for analysis. The determination was performed on a gas chromatograph equipped with an electron capture detector. The retention time was used for qualification and the external calibration standard was used for quantitation. The results obtained showed that the recoveries were 80.5% - 97.3% for alpha-endosulfan and 81.1% - 109.5% for beta-endosulfan. The limit of detection (LOD) was 0. 002 mg/kg, and the limit of quantitation (LOQ) was 0. 007 mg/kg for both. The precision of the method, expressed as the relative standard deviation for the within-laboratory repeatability, was generally below 8.5%. The method was used for the analysis of Litopenaeus vannamai samples from Guangxi Province, a Litopenaeus vannamai aquiculture area in south China.