Clinical implications of C-reactive protein-albumin-lymphocyte (CALLY) index in patients with esophageal cancer.

PURPOSE: The C-reactive protein-albumin-lymphocyte (CALLY) index is a novel inflammatory nutritional biomarker. This study aimed to investigate the potential clinical significance and oncological prognostic role of the preoperative CALLY index in patients with esophageal cancer. METHODS: We analyzed the preoperative CALLY index in 146 patients with esophageal cancer. The CALLY index and clinicopathological variables were analyzed by the Mann-Whitney U test, and associations between the CALLY index and survival outcomes were analyzed by Kaplan-Meier analysis and log-rank tests. Univariate and multivariate analyses of prognostic variables were conducted using Cox proportional hazards regression. RESULTS: A lower preoperative CALLY index was significantly correlated with patient age, advanced T stage, presence of lymph node metastasis, neoadjuvant therapy, lymphatic invasion, and advanced stage classification. The preoperative CALLY index decreased significantly in a stage-dependent manner. Patients with esophageal cancer with a low CALLY index had poorer overall survival, disease-free survival than those with a high CALLY index. Multivariate analysis showed that a low CALLY index was an independent prognostic factor for overall survival, disease-free survival and an independent predictor of postoperative surgical site infection. CONCLUSIONS: Preoperative CALLY index is a useful marker to guide the perioperative and postoperative management of patients with esophageal cancer.

Clinical significance of the preoperative inflammatory burden index in esophageal cancer.

INTRODUCTION: The inflammatory burden index (IBI) serves as a prognostic marker for several cancers. Here, we evaluated the predictive value of preoperative IBI associated with the surgical and oncological outcomes of patients with esophageal cancer (EC). METHODS: The IBI was formulated as C-reaction protein x neutrophil/lymphocyte. We retrospectively analyzed preoperative IBI of 147 EC patients receiving esophagectomy between 2008 and 2018. Cox proportional hazards models and multivariable logistic regression were employed to identify independent risk factors of surgical site infection and prognosis. RESULTS: Increased preoperative IBI significantly correlated with higher tumor stage. Patients with high IBI experienced shorter overall survival (P = 0.0002) and disease-free survival (P = 0.002) compared with those with low IBI. In the adjusted Cox-proportional hazards regression models, increased IBI served as an independent prognostic factor for overall survival (hazard ratio, 3.56; 95% confidence interval, 1.79-7.34; P = 0.0003) and disease-free survival (hazard ratio, 3.03; 95% confidence interval, 1.60-5.92; P = 0.007). Multivariable analysis identified preoperative high IBI served as an independent risk factor for overall surgical site infection (odds ratio, 2.53; 95% confidence interval, 1.00-6.38; P = 0.049). CONCLUSION: Preoperative IBI may serve as a useful predictor of prognosis and surgical site infection of patients with EC after esophagectomy.

Effects of Shoe Midfoot Bending Stiffness on Multi-Segment Foot Kinematics and Ground Reaction Force during Heel-Toe Running.

We investigated how midfoot stiffness of running shoes influences foot segment kinematics and ground reaction force (GRF) during heel-toe running. Nineteen male rearfoot strike runners performed overground heel-toe running at 3.3 m/s when wearing shoes with different midfoot bending stiffnesses (low, medium, and high) in a randomized order. A synchronized motion capture system (200 Hz) and force plate (1000 Hz) were used to collect the foot-marker trajectories and GRF data. Foot kinematics, including rearfoot-lab, midfoot-rearfoot, forefoot-rearfoot, and forefoot-midfoot interactions, and kinetics, including GRF characteristics, were analyzed. Our results indicated that high midfoot stiffness shoes reduced the forefoot-rearfoot range of motion (mean ± SD; high stiffness, 7.8 ± 2.0°, low stiffness, 8.7 ± 2.1°; p < 0.05) and forefoot-midfoot range of motion (mean ± SD; high stiffness, 4.2 ± 1.1°, medium stiffness, 4.6 ± 0.9°; p < 0.05) in the frontal plane. No differences were found in the GRF characteristics among the shoe conditions. These findings suggest that an increase in midsole stiffness only in the midfoot region can reduce intersegmental foot medial-lateral movements during the stance phase of running. This may further decrease the tension of the foot muscles and tendons during prolonged exercises.

The effect of arch-support insole on knee kinematics and kinetics during a stop-jump maneuver.

BACKGROUND: Anterior cruciate ligament injuries commonly occur during sports that involve sudden stops or direction changes. Although athletes often use arch-support insoles in competition and training, little is known about the effect of foot insoles on knee biomechanics and jump take-off performances. OBJECTIVE: This study aimed to investigate the effects of arch-support insoles on knee kinematics and kinetics during the stop-braking phase and the subsequent jump take-off performances. STUDY DESIGN: That is a quasi-experimental study, repeated-measures design. METHODS: Twenty male healthy recreational university basketball athletes performed stop-jump with maximum effort in both arch-support and flat insole conditions. Paired t -tests were performed on knee kinetics and kinematics and jump performance variables to determine whether there were significant differences between insole conditions. RESULTS: Wearing arch-support insoles experienced larger ground reaction forces (GRFs), loading rates of peak vertical and posterior GRFs, peak knee adduction and rotation moments, and knee flexion angular velocity than the flat insoles ( P < 0.05). CONCLUSIONS: The increased GRFs and knee loading in arch-support insoles are indicative of a higher risk of anterior cruciate ligament injuries. The findings could be insightful to the knee mechanics that are related to performance and injury potential during stop-jump maneuvers.

Antitumor effects of Andrographis via ferroptosis-associated genes in gastric cancer.

The overall prognosis of advanced/metastatic gastric cancer (GC) remains poor despite the development of pharmacotherapy. Therefore, other treatment options, such as complementary and alternative medicine, should be considered to overcome this aggressive malignancy. Andrographis, which is a generally unharmful botanical compound, has gained increasing interest for its anticancer effects in multiple malignancies via the regulation of cancer progression-associated signaling pathways. In the present study, a series of in vitro experiments (cell proliferation, colony formation and apoptosis assays) was designed to elucidate the antitumor potential and mechanism of Andrographis in GC cells. The present study demonstrated that Andrographis exerted antitumor effects in GC cell lines (MKN74 and NUGC4) by inhibiting proliferation, reducing colony formation and enhancing apoptotic activity. Furthermore, it was demonstrated that the expression levels of the ferroptosis-associated genes heme oxygenase-1, glutamate-cysteine ligase catalytic and glutamate-cysteine ligase modifier were significantly upregulated after Andrographis treatment in both GC cell lines in reverse transcription-quantitative PCR experiments (P<0.05); this finding was further confirmed by immunoblotting assays (P<0.05). In conclusion, to the best of our knowledge, the present study was the first to demonstrate that Andrographis possessed antitumor properties by altering the expression levels of ferroptosis-associated genes, thereby providing novel insights into the potential of Andrographis as an adjunctive treatment option for patients with metastatic GC.