Predictive efficacy of combined tumor markers and gastrin for recurrence after endoscopic submucosal dissection in early gastric cancer patients.

OBJECTIVE: This study aims to evaluate the predictive value of tumor markers combined with gastrin for tumor recurrence after endoscopic submucosal dissection (ESD) in patients with early gastric cancer. METHODS: The clinicopathological data of 169 patients with early gastric cancer treated with ESD between March 2019 and January 2021 were retrospectively analyzed. The patients were divided into a relapse group (n=45) and a non-recurrence group (n=124). Clinical data such as carcinoembryonic antigen (CEA), cancer antigen 19-9 (CA19-9), alpha-fetoprotein (AFP), gastrin 17, pepsinogen I and pepsinogen II, as well as tumor size and degree of infiltration were examined to construct a recurrence prediction model using lasso regression. RESULTS: The comprehensive model showed superior predictive power (AUC=0.958, C-index=0.966) over biomarker-only models (AUC=0.925), indicating a significant improvement in the prediction of recurrence risk. Decision curve analysis confirmed the clinical utility of the model with a maximum net benefit of 73.37%. Key indicators such as CEA, CA19-9, AFP, gastrin 17 and pepsinogens I and II were statistically significant in predicting recurrence with P values < 0.01. CONCLUSION: The comprehensive model combining tumor markers with clinical data provides a more accurate and clinically valuable tool for predicting recurrence in early gastric cancer patients after ESD. This approach facilitates personalized risk assessment and may significantly improve prognostic management, emphasizing the importance of a multifaceted strategy in the management of early gastric cancer.

Mendelian randomization suggests a causal relationship between gut microbiota and nonalcoholic fatty liver disease in humans.

Targeting the gut microbiota is an emerging strategy to treat nonalcoholic fatty liver disease (NAFLD). Nonetheless, the causal relationship between specific gut microbiota and NAFLD remains unclear. We first obtained genome-wide association study statistics on gut microbiota and NAFLD from publicly available databases. We then performed the Mendelian randomization (MR) analysis to determine the potential causal relationship between the gut microbiota and NAFLD by 5 different methods, and conducted a series of sensitivity analyses to validate the robustness of the MR analysis results. Furthermore, we investigated the direction of causality by bidirectional MR analysis. For 211 gut microbiota, 2 MR methods confirmed that phylum Tenericutes, class Deltaproteobacteria and class Mollicutes were significantly associated with the risk of NAFLD. Heterogeneity (P > .05) and pleiotropy (P > .05) analyses validated the robustness of the MR results. There was no causal effect of NAFLD on these bacterial taxa in the reverse MR analysis. We identified specific gut microbiota with causal effects on NAFLD through gene prediction, which may provide useful guidance for targeting the gut microbiota to intervene and treat NAFLD.

Laboratory Investigation of the Low-Temperature Crack Resistance of Wood Tar-Based Rejuvenated Asphalt Mixture Based on the Semi-Circular Bend and Trabecular Bending Test.

Low-temperature crack resistance is the core issue affecting the promotion of rejuvenated asphalt, but most current studies do not consider the creep relaxation characteristics of rejuvenated asphalt mixture at low temperatures, which is inconsistent with the actual situation. To explore the low-temperature crack resistance of a wood tar-based rejuvenated asphalt mixture, we observed the low-temperature crack resistance of styrene butadiene styrene (SBS) modified asphalt, wood tar-based rejuvenated asphalt, and RA-102 rejuvenated asphalt and their mixtures using laboratory tests. Our results showed that the low temperature crack resistance of the wood tar-based rejuvenated asphalt mixture was better than that of the RA-102 rejuvenated asphalt mixture, but slightly worse than that of the original SBS asphalt mixture. After the synergistic action of wood tar and biomass fiber, wood tar can be fully mixed into the new asphalt, effectively alleviating the bonding failure between asphalt and aggregate and improving the stiffness of the mixture, so that the toughness and crack resistance of rejuvenated asphalt mixture at low temperatures are evidently improved. Wood tar-based rejuvenated asphalt mixture has a good creep deformation ability at low temperatures. The established creep damage model can better describe the flexural creep performance of rejuvenated asphalt mixtures at low temperatures, and can be used to infer the deformation characteristics at other low temperatures.