RESUMO
Anaplastic lymphoma kinase (ALK) fusion-positive colorectal cancer (CRC) is a rare and chemotherapy-refractory subtype that lacks established and effective treatment strategies. Additionally, the efficacy and safety of ALK inhibitors (ALKi) in CRC remain undetermined. Herein, we examined a series of ALK-positive CRC patients who underwent various lines of ALKi treatment. Notably, we detected an ALK 1196M resistance mutation in a CRC patient who received multiple lines of chemotherapy and ALKi treatment. Importantly, we found that Brigatinib and Lorlatinib demonstrated some efficacy in managing this patient, although the observed effectiveness was not as pronounced as in non-small cell lung cancer cases. Furthermore, based on our preliminary analyses, we surmise that ALK-positive CRC patients are likely to exhibit inner resistance to Cetuximab. Taken together, our findings have important implications for the treatment of ALK-positive CRC patients.
RESUMO
The increasing demands for real-time marine monitoring call for the wide deployment of Marine Monitoring Networks (MMNs). The low-rate underwater communications over a long distance, long propagation delay of underwater acoustic channel, and high deployment costs of marine sensors in a large-scale three-dimensional space bring great challenges in the network deployment and management of MMN. In this paper, we first propose a multitier, hierarchical network architecture of MMN with the support of edge computing (HMMN-EC) to enable efficient monitoring services in a harsh marine environment, taking into consideration the salient features of marine communications. Specifically, HMMN-EC is composed of three subnetworks, i.e., underwater acoustic subnetwork, the sea-surface wireless subnetwork, and the air wireless subnetwork, with a diversity of network nodes with different capabilities. We then jointly investigate the deployment diverse network nodes with various constraints in different subnetworks of HMMN-EC. To this end, we formulate a Multiobjective Optimization (MO) problem to minimize the network deployment cost while achieving the maximal network lifetime, subject to the limited energy of different marine nodes and the complex deployment environment. To solve the formulated problem, we present an Ant-Colony-based Efficient Topology Optimization (AC-ETO) algorithm to find the optimal locations of nodes in different subnetworks of MMN in a large-scale deployment. The time complexity of the proposed algorithm is also analyzed. Finally, extensive simulations are carried out to validate the superior performance of the proposed algorithm compared with some existing solutions.
RESUMO
BACKGROUND: The treatment of ketamine-induced bladder contractures remains poorly studied. We therefore evaluated the efficacy of cystectasia with a sodium hyaluronate balanced solution in this kind of bladder contracture. METHODS: Eighteen patients presenting with ketamine-induced bladder contracture between July 2010 and February 2018 were selected and analysed. Ketamine was discontinued in all patients, who were then treated with weekly cystectasia (0.09% sodium hyaluronate balanced solution) 3 times. The volume of the first perfusion was twice the preoperatively measured bladder capacity, and the volume of the subsequent two perfusions was increased by 100 mL each time. The Pelvic Pain and Urgency/Frequency (PUF) symptom score, O'Leary-Sant Interstitial Cystitis (IC) Symptom Index (ICSI), IC Problem Index (ICPI), Quality of Life (QOL) score, and bladder capacity were recorded before surgery and 3 and 12 months after the 3rd expansion. RESULTS: No significant complications were observed during the 3 expansions. Fourteen patients completed the full follow-up schedule. Preoperatively and at the 3- and 12-month follow-up evaluations performed after the 3rd expansion, the PUF symptom scores were 20.4±3.6, 11.5±3.1, and 13.2±3.3, respectively; the mean ICSI was 13.6±2.8, 7.7±2.3, and 8.2±2.5, respectively; the mean ICPI was 10.6±2.6, 7.3±2.1, and 7.7±2.5, respectively; and the mean QOL scores were 6.0±0, 2.1±0.5, and 2.7±0.8, respectively; and the mean bladder catheter volume was 83±27, 234±56, and 228±52 mL, respectively. There were significant differences between all preoperative and postoperative values. CONCLUSIONS: Cystectasia with a sodium hyaluronate balanced solution is an effective treatment modality for ketamine-induced bladder contracture.
