The worldwide survival rate of total hip arthroplasties is improving: a systematic comparative analysis using worldwide hip arthroplasty registers.

Purpose: The aim of this study was to evaluate the development of the worldwide survival rate of primary total hip arthroplasty (THA). The hypothesis was that survival improved over the last decade in worldwide arthroplasty registers. Methods: THA registers were screened in 2022 and compared between different countries with respect to the number of primary implantations per inhabitant, age, fixation type, and survival rate, and compared to similar data from 2009. The data from these reports were analyzed in terms of number, age distribution, and procedure type of primary THAs. Survival curves and a comparative analysis with respect to the development over time were calculated. Results: We identified nine hip arthroplasty registers that contained sufficient data to be included. A large variation was found in the annual number of primary THA implantations per inhabitant, with more than the factor 4 for all age groups across regions. The procedure type varied strongly as well, e.g. in Sweden, 50% were cemented THAs, whereas in Emilia-Romagna (Italy), 96% of THAs were implanted cementless. We found an improved survival rate of 5%, with 90% of survival after 15 years in the cohorts from 2021 compared to 85% in the cohorts from 2009. Conclusion: The present study revealed a significant improvement in the survival of THA in worldwide arthroplasty registers within different countries and regions over the period of one decade. We believe that it is safe to state that the success of THA is still rising with respect to this main outcome.

The survival and complication profiles of the Compress® Endoprosthesis: A systematic review and meta-analysis.

Background/purpose: This study aimed to summarize the survival and complication profiles of the compress® endoprosthesis (CPS) through a systematic review and meta-analysis. Methods: Online databases (PubMed, EMBASE and Web of Science) were searched from inception to November 2023. Trials were included that involved the use of CPS for endoprosthetic replacement in patients with massive segmental bone defects. Patients' clinical characteristics and demographic data were extracted using a standardized form. The methodological quality of included 13 non-comparative studies was assessed on basis of the Methodological Index for Non-Randomized Studies (MINORS). All the available Kaplan-Meier curves in the included studies were digitized and combined using Engauge-Digitizer software and the R Project for Statistical Computing. Results: The meta-analysis of thirteen included studies indicated: the all-cause failure rates of CPS were 26.3 % after surgery, in which the occurrence rates of aseptic loosening were 5.8 %. And the incidences of other complications were as follows: soft tissue failure (1.8 %), structure failure (8.2 %), infection (9.5 %), tumor progression (1.1 %). The 1-, 4-, and 8-year overall survival rates for all-cause failure with 95 % CI were 89 % (86 %-92 %), 75 % (71 %-79 %) and 65 % (60 %-70 %), respectively. The estimated mean survival time of all-cause failure was 145 months (95 % CI, 127-148 months), and the estimated median survival time of all-cause failure was 187 months (95 % CI, 135-198 months). The 1-, 4-, and 8-year overall survival rates of aseptic loosening with 95 % CI were 96 % (94 %-98 %), 91 % (87 %-95 %) and 88 % (83 %-93 %), respectively. The estimated mean survival time of aseptic loosening was 148 months (95 % CI, 137-153 months). Conclusion: CPS's innovative spring system promotes bone ingrowth by providing immediate and high-compression fixation, thereby reducing the risk of aseptic loosening caused by stress shielding and particle-induced osteolysis. CPS requires less residual bone mass for reconstructing massive segmental bone defects and facilitates easier revision due to its non-cemented fixation. In addition, the survival rate, estimated mean survival time, and complication rates of CPS are not inferior to those of common endoprosthesis.

The intestinal flora and nutritional status and immune function characteristics of obese colon cancer patients.

BACKGROUND: The research aims to explore the characteristics of intestinal flora, nutritional status and immune function in patients with different types of obese colon cancer. METHODS: A retrospective analysis is conducted on 64 cases of obese colon cancer diagnosed from June 2018 to January 2020. According to the histological staging of the cancer, they are classified into adenocarcinoma, adenosquamous carcinoma and undifferentiated carcinoma, with corresponding cases of 24, 22 and 18, respectively. The intestinal flora (Bifidobacterium, Lactobacillus, Enterococcus faecalis, Escherichia coli, and yeast), nutritional status (Hb, Alb, PA, TFN, and PNI), immune function (IgG, IgM, IgA, CD4+, CD8+, and CD4+/CD8+) are analyzed in the different groups of patients. Survival curves are evaluated by Kaplan-Meier method and log-rank test for tumour death, local recurrence, and distant metastasis. RESULTS: There were no statistically significant differences in intestinal flora (Bifidobacterium, Lactobacillus, Enterococcus faecalis, Escherichia coli, and yeast), nutritional status (Hb, Alb, PA, TFN, and PNI) and immune function (IgG, IgM, IgA, CD4+, CD8+, and CD4+/CD8+) between different groups. There was a significant correlation between intestinal flora, nutritional status and immune function for all three. The survival curves of tumour death, local recurrence and distant metastasis in different groups of obese colon cancer patients were statistically significant. The tumor mortality rate, local recurrence, and distant metastasis rate in adenocarcinoma were 78.65%, 54.25% and 48.26% respectively. CONCLUSION: There are differences in intestinal flora, nutritional status and immune function among different types of obese colon cancer patients, but adenocarcinoma has the least benefit in intestinal flora, poor nutritional status, and weakest immune function.

Long-term outcomes after aortic root replacement for bicuspid aortic valve-associated aneurysm.

OBJECTIVE: Patients with congenital bicuspid aortic valve often require root replacement. This study aims to describe their long-term rates of mortality and reoperation. METHODS: This is a multicenter retrospective study of 747 patients with bicuspid aortic valve who underwent aortic root replacement for aortic aneurysm between 2004 and 2020. Cumulative incidence curves for aortic valve and aortic reoperations were graphed. A Kaplan-Meier survival curve for the patient cohort was created alongside an age- and sex-matched curve for the US population. Multivariable Cox regression was used to determine characteristics associated with long-term mortality. RESULTS: The median age of our cohort was 54 [43-64] years old, and 101 (13.5%) patients were female. In patients with bicuspid aortic valve dysfunction, 274 (36.7%) had aortic insufficiency, 187 (25.0%) had aortic stenosis, and 142 (19.0%) had both. In-hospital mortality occurred in 10 (1.3%) patients. There were 56 aortic valve reoperations and 19 aortic reoperations, with a combined cumulative incidence of 35% (95% confidence interval [CI], 23%-46%) at 15 years. In addition, there was comparable survival between the patient cohort and the age- and sex-matched US population. Age (hazard ratio [HR], 1.04; 95% CI, 1.01-1.06), concomitant CABG (HR, 2.28; 95% CI, 1.29-4.04), and bypass time (HR, 1.01; 95% CI, 1.00-1.01) were associated with increased mortality. CONCLUSIONS: Patients who undergo aortic root replacement with bicuspid aortic valve have an increased rate of aortic reoperation (35%; 95% CI, 23%-46%) while their survival appears to be comparable to the general US population (79%; 95% CI, 73%-87%) at 15 years.

Validation of the interaction between PRDX4 and TXNDC5 in gastric cancer and the significance of the PRDX4 gene in gastric cancer based on a data mining analysis.

Background: We successfully screened the important interacting protein peroxiredoxin 4 (PRDX4) of thioredoxin domain-containing protein 5 (TXNDC5) in gastric cancer. However, its specific molecular mechanism in gastric cancer remains unclear. This study aimed to verify the interaction between PRDX4 and TXNDC5 protein molecules in gastric cancer and analyze the expression and functional significance of PRDX4 in gastric cancer using bioinformatics methods. Methods: The interaction between TXNDC5 and PRDX4 was verified by the coimmunoprecipitation (co-IP) of the total protein of gastric cancer cells, and tissues with high expressions of TXNDC5. The Human Protein Atlas (HPA) database, UCSC Xena (University of California Santa Cruz xenabrowser) platform, the Kaplan-Meier Plotter platform, and the TIMER (Tumor IMmune Estimation Resource) platform were used to analyze the expression and subcellular localization of the PRDX4 molecule in normal human gastric tissue, the difference in expression between gastric cancer tissue and normal gastric tissue, the relationship between the expression of PRDX4 and survival, its functional significance in gastric cancer cells, and its effect on the tumor immune microenvironment (TIME). Results: The data analysis results showed that the expression of PRDX4 messenger RNA (mRNA) in the gastric cancer tissues was significantly higher than that in the normal tissues (P<0.05). PRDX4 could affect the occurrence and development of tumors by participating in the neutrophil degranulation signaling pathway to regulate tumor immunity. The expression level of PRDX4 has a certain relationship with the TIME; that is, it is mainly negatively correlated with the infiltration of B lymphocytes and CD4+ T lymphocytes (P<0.05). The expression level of PRDX4 was positively correlated with the expression of LILRB2 (leukocyte immunoglobulin-like receptor subfamily B member 2), and negatively correlated with BLTA (B and T lymphocyte attenuation factor) and VISTA (V-type immunoglobulin domain-containing suppressor of T cell activation) (P<0.05). Conclusions: There is an interaction between PRDX4 and TXNDC5 protein molecules in gastric cancer. PRDX4 gene expression is significantly up-regulated in gastric cancer. It may reduce the infiltration of B lymphocytes and CD4+ T lymphocytes and affect the expression of LILRB2, BLTA, and VISTA immune checkpoints, leading to anti-tumor immunosuppression.

Modeling strain variability in Campylobacter jejuni thermal inactivation by quantifying the number of strains required.

There is a limited understanding of the survival responses of Campylobacter jejuni during thermal processing, which must be investigated for appropriate risk assessment and processing. Therefore, we aimed to elucidate the survival response of C. jejuni and develop a predictive model considering strain variability and uncertainty, which are important for quantitative microbial risk assessment (QMRA) or risk-based processing control measures. We employed the most probable curve (MPC) method to consider the uncertainty in cell concentrations. Further, the multivariate normal (MVN) distribution served as a model for strain variability in bacterial survival behavior. The prediction curves from the MVN successfully captured the parameter variability of the most probable curves of each strain. More than ten reference strains effectively described the strain variability in parameters using the MVN distribution. The findings indicated that, with sufficient strain data, the MVN could estimate the strain variability, including unknown strains. The multi-level model for strain variability can potentially become a specialized tool for QMRA and risk-based processing controls. The combined approach of MPC and MVN provides valuable insights into strain variability, emphasizing the importance of accounting for variability and uncertainty in predictive models for QMRA and risk-based processing control measures.

A lattice model based on percolation theory for cold atmospheric DBD plasma decontamination kinetics.

The tailing phenomenon, where the survival curve of bacteria shows a slow tailing period after a rapid decline, is a ubiquitous inactivation kinetics process in the advanced plasma sterilization field. While classical models suggest that bacterial resistance dispersion causes the tailing phenomenon, experiments suggest that the non-uniform spatial distribution of spores (clustered structure) is the cause. However, no existing inactivation kinetics model can accurately describe spatial heterogeneity. In this paper, we propose a lattice model based on percolation theory to explain the inactivation kinetics by considering the non-uniform spatial distribution of spores and plasma. Our model divides spores into non-clustered and clustered types and distinguishes between short-tailing and long-tailing compositions and their formation mechanisms. By systematically studying the effects of different spore and plasma parameters on the tailing phenomenon, we provide a reasonable explanation for the kinetic law of the plasma sterilization survival curve and the mechanism of the tailing phenomenon in various cases. As an example, our model accurately explains the 80-second kinetics of atmospheric pressure plasma inactivation of spores, a process that previous models struggled to understand due to its multi-stage and long-tail phenomena. Our model predicts that increasing the spatial distribution probability of plasma can shorten the complete killing time under the same total energy, and we validate this prediction through experiments. Our model successfully explains the seemingly irregular plasma sterilization survival curve and deepens our understanding of the tailing phenomenon in plasma sterilization. This study offers valuable insights for the sterilization of food surfaces using plasma technology, and could serve as a guide for practical applications.

Natural history of degenerative cervical myelopathy: a meta-analysis and neurologic deterioration survival curve synthesis.

BACKGROUND CONTEXT: Cervical spine surgery is rapidly increasing, and our knowledge of the natural history of degenerative cervical myelopathy (DCM) is limited. PURPOSE: To synthesize accurate time-based estimates of meaningful neurologic decline in patients with DCM managed conservatively and to provide formulae to help communicate survivorship estimates to patients. STUDY DESIGN: Systematic review and meta-analysis. METHODS: A systematic review and meta-analysis was conducted using Cochrane and PRISMA guidelines. A librarian-assisted search strategy using multiple databases with broad search terms and validated filter functions was used. All articles were reviewed in duplicate. RESULTS: A total of 9570 studies were captured in the initial search, which after deletion of duplicates and manual review of abstracts and full texts revealed 6 studies for analyses. All studies were prospective cohorts or randomized controlled trials. The pooled survival estimates for neurologic stability (95% CrI) for mild DCM patients are: 91% (83%-97%) at one year; 85% (72%-94%) at 2 years; 84% (70%-94%) at 3 years; 75% (54%-90%) at 5 years; 66% (40%-86%) at 15 years; and 65% (39%-86%) at 20 years. The pooled survival estimates for neurologic stability (95% CrI) for moderate/severe DCM patients are: 83% (76%-89%) at 1 year; 72% (62%-81%) at 2 years; 71% (60%-80%) at 3 years; 55% (41%-68%) at 5 years; 44% (27%-59%) at 15 years; and 43% (25%-58%) at 20 years. CONCLUSIONS: This is the first quantitative synthesis of the totality of published data on DCM natural history. Our review confirms a slow decline in neurologic function. We developed formulae which can be easily used by surgeons to communicate to patients their risk of neurologic deterioration. These formulae can be used to facilitate the shared decision-making process.

Development of application and surgical technique of total knee arthroplasties: a systematic comparative analysis using worldwide registers.

PURPOSE: The aim was to compare total knee arthroplasty (TKA) between countries with regard to epidemiologic data and surgical technique by the use of worldwide registers and compare findings with a previous report after one decade. METHODS: A systematic search was carried out in November 2022 and compared to previous reports from 2010. We extracted data regarding implanted TKAs, patients' age distribution, procedure types, fixation and revision rates. After identification of 28 national arthroplasty registers, 8of them, namely Australia, Canada, Denmark, England and Wales, New Zealand, Norway, Scotland and Sweden, offered sufficient data and were included in final analysis. RESULTS: A large variation was found in the annual number of implantations per 100,000 inhabitants with a range from 77 to 210.2 (mean 132.8). The fixation type varied strongly as well, e.g. over 95% of totally cemented TKAs in Sweden versus 61.2% cemented fixation in Denmark. Another significant difference was the use of patellar resurfacing in TKA, ranging from 47.3% (Canada) using a patellar button in TKA to less than 5% (Sweden). Within the period of one decade, the mean overall number of annual implantations increased (10%), whilst relative number of revisions decreased, the use of cemented TKA decreased from 87 to 74%, and the use of patella button remained largely inhomogeneous. CONCLUSION: Comparison of arthroplasty registers revealed large differences regarding the annual number of primary TKAs per inhabitant as well as primary TKA procedure types with an increase of annual implantations, decrease of relative number of revisions, and a decrease of the use of cemented systems over the period of one decade.

Factors affecting laryngeal cancer relapse after postoperative radiotherapy and relationship between relapse with radiotherapy dose / 中国医学物理学杂志

Objective To explore the factors associated with laryngeal cancer relapse after postoperative radiotherapy,discuss the relationship between radiotherapy dose under various surgical procedures and relapse,and analyze their effects on survival rate.Methods The clinical data of 134 patients with laryngeal cancer treated with postoperative radiotherapy in Shijiazhuang People's Hospital were retrospectively analyzed.The risk factors of postoperative relapse were analyzed with univariate analysis,followed by multivariate Logistic regression analysis.The relationships between radiotherapy doses under various surgical procedures and the relapse were discussed.Kaplan-meler method and Log rank test were used to analyze the 2-year survival rate of laryngeal cancer patients.Results Thirty out of the 134 patients relapsed after treatment,and there was no recurrence in the remaining 104 patients.Multivariate Logistic regression analysis identified clinical stage(Ⅲ-Ⅳ),T stage(T3-T4),N stage(N1-N3),radiotherapy dose(low-dose),thyroid cartilage invasion(yes)and surgical margin(positive)as independent risk factors for postoperative laryngeal cancer relapse(OR>1,P<0.05).The relapse rates of patients receiving high-dose radiotherapy after laser vocal cord mass resection/partial laryngectomy and total laryngectomy under self-retaining laryngoscope were lower than those of patients receiving low-dose radiotherapy,with a statistically significant difference in overall relapse rate(P<0.05).As of June 2023,the median follow-up time of 134 patients undergoing postoperative radiotherapy for laryngeal cancer was 14.23 months(1-24 months),and there were 8 deaths in low-dose group and 2 deaths in high-dose group.The estimated median survival times in low-and high-dose groups were 19.13 months and 22.13 months.The survival curves in two groups were different(Log rank P=0.20),with high-dose group outperforming low-dose group.Conclusion The overall therapeutic effect of surgery combined with postoperative radiotherapy for laryngeal cancer is favorable.However,clinical stage,T stage,N stage,low-dose radiotherapy,tumor invasion into thyroid cartilage,positive surgical margin,and>11 weeks from postoperation to radiotherapy completion were risk factors for disease relapse.In clinical practice,the radiotherapy dose should be appropriately increased based on the patient's condition to improve prognosis and extend survival duration.

Effect of NQO1 expression level on prognosis in patients with hepatitis B virus-related hepatocellular carcinoma / 国际检验医学杂志

Objective To study the effect of NAD(P)H:quinone oxidoreductase 1(NQO1)expression lev-el on prognosis in patients with hepatitis B virus-related hepatocellular carcinoma(HBV-HCC).Methods A total of 103 patients with HBV-HCC underwent surgical treatment in Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine from March 2019 to January 2020 were enrolled.The cancer tissue and adjacent normal tissues were extracted during surgery.Immunohistochemical staining was used to detect the expression of NQO1 in tissues.The clinical and pathological data of patients were collected,and the rela-tionships between high and low expression of NQO1 and pathological characteristics were discussed.A 3-year follow-up was conducted,and the Kaplan-Meier survival curve was drawn and Log-rank test was conducted on median survival time.Then COX model analysis was used to analyze the factors affecting the prognosis of HBV-HCC patients.Results The positive rate of NQO1 in HBV-HCC tissues was 84.47％(87/103)and the high expression rate was 59.22％(61/103).The positive rate and the high expression rate of NQO1 in HBV-HCC tissues were higher than those in adjacent normal tissues(P＜0.05).There were statistically significant differences in tumor maximum diameter,number of lesions,American Joint Committee on Cancer(AJCC)staging,and vascular invasion between patients with high and low expression of NQO1(P＜0.05).The 3-year follow-up results denoted that the median survival time of patients was 37 months,and no cases were lost in follow-up.Among 103 patients,there were 34 dead cases with an overall survival rate of 66.99％(69/103)and 42 recurrence cases with a recurrence-free survival rate of 59.23％(61/103).Kaplan-Meier survival curve re-sults showed that the overall survival rate and recurrence-free survival rate were 52.46％(32/61)and 50.82％(31/61)in NQO1 high expression group,which were lower than 88.10％(37/42)and 71.43％(30/42)in NQO1 low expression group(P＜0.05).COX model analysis results showed that high expression of NQO1,tumor maximum diameter ≥5 cm,multiple lesions,AJCC stage Ⅲ to Ⅳ and vascular invasion were independ-ent risk factors for prognosis(P＜0.05).Conclusion NQO1 is highly expressed in HBV-HCC tissue,and is related to the clinicopathological characteristics of patients,so it could be used as an independent biomarker for evaluating prognosis.

Acute NO2 Stress Shortens the Median Survival Period of Bougainvillea glabra 'Elizabeth Angus' by Disrupting Tissue Structure and Photosynthetic Response Centers.

The air pollutant NO2 is one of the major constraints on plant growth, and the ecological value of the ornamental plant Bougainvillea glabra can be weakened by NO2. In this study, an indoor 4 µL·L-1 NO2 simulated fumigation test was conducted with three treatments, CK (normal growth with clean air), T1 (4 µL·L-1 NO2 + 8 h/d), and T2 (4 µL·L-1 NO2 + 24 h/d), which were set up with considerations for time and concentration. The results demonstrated that most of the morphological parameters of B. glabra 'Elizabeth Angus', except for the floral organs, were decreased in the root, stem, leaf, and bract. Continuous fumigation significantly attenuated the growth rate and reduced the water and pigment contents of organs. Excessive NO2 reduced the number and transfer rate of photoelectrons by destroying the photosynthetic reaction center, which in turn weakened photosynthesis, but the plants with intermittent fumigation recovered after fumigation. The Kaplan-Meier (K-M) survival curve displayed median survival periods of 41 and 55.5 h for T1 and T2, respectively, and the morphological structure and most of the indicators of photosynthetic reaction centers changed significantly during stress. Acute injury to B. glabra 'Elizabeth Angus' was caused by 4 µL·L-1 NO2, and B. glabra 'Elizabeth Angus' had limited ability to regulate high concentrations of NO2 acute stress.

Maximum approximate likelihood estimation in accelerated failure time model for interval-censored data.

The approximate Bernstein polynomial model, a mixture of beta distributions, is applied to obtain maximum likelihood estimates of the regression coefficients, the baseline density and the survival functions in an accelerated failure time model based on interval censored data including current status data. The estimators of the regression coefficients and the underlying baseline density function are shown to be consistent with almost parametric rates of convergence under some conditions for uncensored and/or interval censored data. Simulation shows that the proposed method is better than its competitors. The proposed method is illustrated by fitting the Breast Cosmetic and the HIV infection time data using the accelerated failure time model.

Augmentation Therapy for Severe Alpha-1 Antitrypsin Deficiency Improves Survival and Is Decoupled from Spirometric Decline-A Multinational Registry Analysis.

Rationale: Intravenous plasma-purified alpha-1 antitrypsin (IV-AAT) has been used as therapy for alpha-1 antitrypsin deficiency (AATD) since 1987. Previous trials (RAPID and RAPID-OLE) demonstrated efficacy in preserving computed tomography of lung density but no effect on FEV1. This observational study evaluated 615 people with severe AATD from three countries with socialized health care (Ireland, Switzerland, and Austria), where access to standard medical care was equal but access to IV-AAT was not. Objectives: To assess the real-world longitudinal effects of IV-AAT. Methods: Pulmonary function and mortality data were utilized to perform longitudinal analyses on registry participants with severe AATD. Measurements and Main Results: IV-AAT confers a survival benefit in severe AATD (P < 0.001). We uncovered two distinct AATD phenotypes based on an initial respiratory diagnosis: lung index and non-lung index. Lung indexes demonstrated a more rapid FEV1 decline between the ages of 20 and 50 and subsequently entered a plateau phase of minimal decline from 50 onward. Consequentially, IV-AAT had no effect on FEV1 decline, except in patients with a Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage 2 lung index. Conclusions: This real-world study demonstrates a survival advantage from IV-AAT. This improved survival is largely decoupled from FEV1 decline. The observation that patients with severe AATD fall into two major phenotypes has implications for clinical trial design where FEV1 is a primary endpoint. Recruits into trials are typically older lung indexes entering the plateau phase and, therefore, unlikely to show spirometric benefits. IV-AAT attenuates spirometric decline in lung indexes in GOLD stage 2, a spirometric group commonly outside current IV-AAT commencement recommendations.

Foot Melanoma Localized to Subungual Toe Location Portends Poorer Prognosis.

Our group previously reported that melanoma of the foot is associated with advanced disease on diagnosis and decreased survival. Lesions localized to the toe appeared to have the worst outcomes. In this study, we both expanded our study to include a 10-year population of patient with invasive melanoma of the foot and ankle and investigated additional factors associated with prognosis. Between January 2007 and December 2016, 211 patients underwent biopsy diagnosis and surgery for invasive melanoma in the BLANK health care system. Demographic, pathologic, staging, and localization characteristics were studied for overall survival. Lesions were localized to dorsal foot, plantar foot, toe (nonsubungual), and toe (subungual) locations. Multivariable analysis found Breslow depth, ulceration, lymph node involvement, and subungual toe location to be associated with poorer survival. Overall survival rate for foot melanoma was 70.6%. Overall survival for nonsubungual toe melanoma was 60.7%, compared to 53.1% for subungual toe melanoma. Of the subungual melanomas, 37.5% of presented as deep lesions with a Breslow depth >4.0 mm. Subungual melanoma was statistically significant for and found to be an independent prognostic factor associated with poorer survival and advanced disease. Based on the results of this study, there should be a low threshold to biopsy suspicious lesions of the toe and foot with particular attention to be dedicated to subungual lesions.

Involvement of spleen is associated with shorter survival in patients with angioimmunoblastic T cell lymphoma.

BACKGROUND: The prognosis of patients with angioimmunoblastic T cell lymphoma (AITL) remains dismal, with their 5-year overall survival (OS) and progression-free survival (PFS) rates of 32-41% and 18-38%, respectively. Spleen involvement occurs in a proportion of patients with AITL. But still, it is unclear whether spleen involvement impacts the prognosis of AITL patients. In this study, we aim to establish new prognostic indicators for the identification of high-risk patients to draft optimal treatment regimens. METHODS: We collected and counted the clinical data of 54 patients with AITL treated with CHOP-based first-line chemotherapy regimen between 2010 and 2021 at Hubei Cancer Hospital and Hunan Cancer Hospital. In addition, all patients received PET-CT scan prior to receiving treatment. We performed univariate and multivariate analyses to assess the predictive role of tumor characteristics, laboratory, and radiographic data for the prognosis of AITL. RESULTS: We observed that PFS and OS are worse in patients with high ECOG scores, spleen involvement, and low serum albumin levels in patients with AITL. In univariate analysis, stage (HR 3.515 [1.142-10.822], p = 0.028) and spleen involvement (HR 8.378 [1.085-64.696, p = 0.042) were correlated with PFS in patients with AITL. Besides, stage (HR 3.439 [1.108-10.674], p = 0.033) and spleen involvement (HR 11.002 [1.420-85.254], p = 0.022) were significantly correlated with OS. Consistently, spleen involvement was correlated with OS (HR 16.571 [1.350-203.446], p = 0.028) and PFS (HR 10.905 [1.037-114.690], p = 0.047) in AITL patients in a multivariate analysis. CONCLUSION: This study demonstrates that spleen involvement might be used as a prognostic indicator for AITL patients.

The Incidence and Prevalence of Primary Central Nervous System (CNS) Tumours in Canada (2010-2017), and the Survival of Patients Diagnosed with CNS Tumours (2008-2017).

Primary central nervous system (CNS) tumours are heterogeneous, with different treatment pathways and prognoses depending on their histological and molecular classification. Due to their anatomical location, all CNS tumours, regardless of malignancy, can be debilitating. We used vital statistics linked to Canadian Cancer Registry data to estimate the age-standardized incidence rates (ASIR), Kaplan-Meier survival rates (SR), and limited-duration prevalence proportions (PP) of 25 histology-specific CNS tumour groups that were classified based on site and histology. During 2010-2017, 45,115 patients were diagnosed with 47,085 primary CNS tumours, of which 19.0% were unclassified. The average annual ASIR was 21.48/100,000 person-years and did not vary by sex. The ASIR increased with age, particularly for meningioma, unclassified tumours, and glioblastoma. The eight-year PP was 102.1/100,000 persons (index date 1 January 2018). The most common histology was meningioma (ASIR: 5.19; PP: 31.6). The overall five-year SR among 51,310 patients diagnosed during 2008-2017 was 57.2% (95% CI: 56.8-57.7%). SRs varied by tumour behaviour, histology, and patient age, with the lowest SR among glioblastoma patients (5-year SRs ranged from 1.3-25.7%). For non-malignant tumours, the 5-year SRs ranged from 37.4-100%. We provide the most up-to-date histology-specific surveillance estimates for primary CNS tumours in Canada.

Analysis of Significant Genes and Pathways in Esophageal Cancer Based on Gene Expression Omnibus Database.

Objective To screen antigen targets for immunotherapy by analyzing over-expressed genes, and to identify significant pathways and molecular mechanisms in esophageal cancer by using bioinformatic methods such as enrichment analysis, protein-protein interaction (PPI) network, and survival analysis based on the Gene Expression Omnibus (GEO) database.Methods By screening with highly expressed genes, we mainly analyzed proteins MUC13 and EPCAM with transmembrane domain and antigen epitope from TMHMM and IEDB websites. Significant genes and pathways associated with the pathogenesis of esophageal cancer were identified using enrichment analysis, PPI network, and survival analysis. Several software and platforms including Prism 8, R language, Cytoscape, DAVID, STRING, and GEPIA platform were used in the search and/or figure creation.Results Genes MUC13 and EPCAM were over-expressed with several antigen epitopes in esophageal squamous cell carcinoma (ESCC) tissue. Enrichment analysis revealed that the process of keratinization was focused and a series of genes were related with the development of esophageal cancer. Four genes including ALDH3A1, C2, SLC6A1,and ZBTB7C were screened with significant P value of survival curve.Conclusions Genes MUC13 and EPCAM may be promising antigen targets or biomarkers for esophageal cancer. Keratinization may greatly impact the pathogenesis of esophageal cancer. Genes ALDH3A1, C2, SLC6A1,and ZBTB7C may play important roles in the development of esophageal cancer.

Low Serum Vascular Endothelial Growth Factor Level Predicts Adverse Outcomes in Neonates with Respiratory Distress Syndrome.

Objective: Preterm neonates are susceptible to neonatal respiratory distress syndrome (NRDS). Lower levels of cord blood vascular endothelial growth factor (VEGF) are implicated in NRDS. This study aims to explore whether the serum VEGF level has prognostic values on neonates with respiratory distress syndrome (RDS). Methods: A total of 80 infants diagnosed with NRDS were enrolled, with 70 preterm neonates without NRDS as controls. Cord blood samples before treatment and venous blood samples after treatment were collected and clinical information was recorded. The serum VEGF level was measured using enzyme-linked immunosorbent assay kits. Receiver operating characteristic (ROC) curve was used to evaluate whether serum VEGF is a biomarker of NRDS. Newborns were followed up for 1 month to collect survival information. The influence of VEGF levels on overall survival was analyzed using the Kaplan-Meier method. The univariate and multivariate Cox regression models were adopted to assess the prognostic factor of NRDS. Results: VEGF level was decreased in sera of neonates with RDS. The area under the ROC curve of VEGF level in distinguishing neonates with RDS from neonates without RDS was 0.949, with a cutoff value of 39.72 (87.50% sensitivity, 87.14% specificity). Serum VEGF was a biomarker of NRDS. Neonates with RDS with high VEGF levels had longer periods of survival than those with low VEGF levels. NRDS grade and VEGF level were independent prognostic factors affecting the overall survival of neonates with RDS. Conclusion: Decreased serum VEGF level in RDS neonates can predict the poor prognosis of NRDS, and VEGF level might be an independent prognostic factor for the overall survival of RDS neonates. Clinical Trial Registration No. 201901A.

Effect Of Eight Hours Per Day Of Intermittent Self Prone Positioning For Seven Days On The Severity Of Covid-19 Pneumonia/ Acute Respiratory Distress Syndrome.

BACKGROUND: Prone positioning improves ventilation-perfusion mismatch, distribution of gravitational gradient in pleural pressure, and oxygen saturation significantly in patients with Covid pneumonia. We aimed to find out the efficacy of eight hours per day of intermittent selfprone positioning for seven days in patients affected with COVID-19 pneumonia/ ARDS. METHODS: This Randomized Clinical Trial was conducted in the Covid isolation wards of Ayub Teaching Hospital, Abbottabad. Patients suffering from COVID-19 pneumonia/ ARDS were enrolled with permuted block randomization into a control and an experimental group each consisting of 36 patients. Parameters of Pneumonia Severity Index (PSI) score along with other sociodemographic data was noted on a preformed structured questionnaire. Death was confirmed by requesting the death certificate of patients on the 90th day of enrolment. Data Analysis was done with SPSS Version 25. Tests of significance were applied to calculate the difference in the patients of the two groups with respect to respiratory physiology and survival. RESULTS: The mean age of the patients was 63.79±15.26 years. A total of 25 (32.9%) male and 47 (61.8%) female patients were enrolled. Statistically significant improvement was found in the respiratory physiology of the patients at 7th and 14th DOA between the groups. Pearson Chi-Square test of significance showed a difference in mortality between the two groups at 14th DOA (pvalue=0.011) but not at 90th DOA (p-value=0.478). Log Rank (Mantel-Cox) test of significance, applied on the Kaplan Meier curve and showed no statistically significant difference among the groups based on the survival of the patients. (p-value=0.349). CONCLUSIONS: Early transient improvement in respiratory physiology and mortality does occur with 8 hours of self-prone positioning for seven days but there is no effect on the 90-day survival of the patients. Thus, the impact of the manoeuvre on improving survival needs to be explored with studies having an application of the manoeuvre for a longer duration and period.