Taxane combined with lobaplatin or anthracycline for neoadjuvant chemotherapy of triple-negative breast cancer: a randomized, controlled, phase II study.

BACKGROUND: Previous studies have shown that the addition of platinum to neoadjuvant chemotherapy (NAC) improved outcomes for patients with triple-negative breast cancer (TNBC). However, no studies have assessed the efficacy and safety of the combination of taxane and lobaplatin. In this study, we conducted a randomized controlled phase II clinical study to compare the efficacy and safety of taxane combined with lobaplatin or anthracycline. METHODS: We randomly allocated patients with stage I-III TNBC into Arm A and Arm B. Arm A received six cycles of taxane combined with lobaplatin (TL). Arm B received six cycles of taxane combined with anthracycline and cyclophosphamide (TEC) or eight cycles of anthracycline combined with cyclophosphamide and sequential use of taxane (EC-T). Both Arms underwent surgery after NAC. The primary endpoint was the pathologic complete response (pCR). Secondary endpoints were event-free survival (EFS), overall survival (OS), and safety. RESULTS: A total of 103 patients (51 in Arm A and 52 in Arm B) were assessed. The pCR rate of Arm A was significantly higher than that of Arm B (41.2% vs. 21.2%, P = 0.028). Patients with positive lymph nodes and low neutrophil-to-lymphocyte ratio (NLR) benefited significantly more from Arm A than those with negative lymph nodes and high NLR (Pinteraction = 0.001, Pinteraction = 0.012, respectively). There was no significant difference in EFS (P = 0.895) or OS (P = 0.633) between the two arms. The prevalence of grade-3/4 anemia was higher in Arm A (P = 0.015), and the prevalence of grade-3/4 neutropenia was higher in Arm B (P = 0.044). CONCLUSIONS: Neoadjuvant taxane plus lobaplatin has shown better efficacy than taxane plus anthracycline, and both regimens have similar toxicity profiles. This trial may provide a reference for a better combination strategy of immunotherapy in NAC for TNBC in the future.

Application of Acoustic Radiation Force Pulse Imaging Technology in the Evaluation of the Efficacy of Calf Intermuscular Vein Thrombosis.

BACKGROUND: The continuous advancement in ultrasound technology has given rise to Acoustic Radiation Force Impulse (ARFI) elastography, which boasts non-invasiveness, ease of operation, rapid inspection, and high accuracy. It has been successfully employed in detecting tissue hardness across various diseases. This study aims to investigate the application of acoustic radiation force pulse imaging technology in evaluating the efficacy of calf intermuscular vein thrombosis. METHODS: This study is retrospective in nature, involving a total of 120 patients diagnosed with calf intermuscular venous thrombosis (MCVT) who were admitted to our hospital. These patients were selected retrospectively as the subjects for our research. They were subsequently divided into two groups: the control group and the observation group. The control group received standard nursing care and simple pressure therapy, while the observation group underwent anticoagulant drug treatment. The shear wave elastic hardness of both groups was measured, with the recording of ultrasonic elasticity scores and the average elastic modulus value (E-mean, in kPa). Furthermore, a comparison was made between the two groups regarding thrombus disappearance time, blood flow patency, and the clinical treatment effect. RESULTS: At the 1, 3, and 6-month marks of the treatment period, the ultrasonic elasticity scores in the observation group were consistently higher compared to those in the control group. Additionally, the shear wave elastic hardness in the observation group was consistently lower than that in the control group, and these differences were found to be statistically significant (p < 0.05). The total effective rates for the control and observation groups were 83.33% and 95.00%, respectively. Notably, the clinical total effective rate in the observation group was significantly higher than that in the control group, and this difference was statistically significant (p < 0.05). The thrombus disappearance time in the observation group was significantly shorter than that in the control group, and the blood flow rate was significantly higher than in the control group, with both differences being statistically significant (p < 0.05). CONCLUSION: ARFI plays a crucial role in assessing the efficacy of MCVT by effectively revealing the hardness and location of the patient's thrombus tissue. This technology aids doctors in gaining a more precise understanding of the deep vein thrombosis condition. Notably, ARFI is characterized by high safety levels and exhibits positive effects due to its painless and non-invasive nature.

Uncovering brain functional connectivity disruption patterns of lung cancer-related pain.

Pain is a pervasive symptom in lung cancer patients during the onset of the disease. This study aims to investigate the connectivity disruption patterns of the whole-brain functional network in lung cancer patients with cancer pain (CP+). We constructed individual whole-brain, region of interest (ROI)-level functional connectivity (FC) networks for 50 CP+ patients, 34 lung cancer patients without pain-related complaints (CP-), and 31 matched healthy controls (HC). Then, a ROI-based FC analysis was used to determine the disruptions of FC among the three groups. The relationships between aberrant FCs and clinical parameters were also characterized. The ROI-based FC analysis demonstrated that hypo-connectivity was present both in CP+ and CP- patients compared to HC, which were particularly clustered in the somatomotor and ventral attention, frontoparietal control, and default mode modules. Notably, compared to CP- patients, CP+ patients had hyper-connectivity in several brain regions mainly distributed in the somatomotor and visual modules, suggesting these abnormal FC patterns may be significant for cancer pain. Moreover, CP+ patients also showed increased intramodular and intermodular connectivity strength of the functional network, which could be replicated in cancer stage IV and lung adenocarcinoma. Finally, abnormal FCs within the prefrontal cortex and somatomotor cortex were positively correlated with pain intensity and pain duration, respectively. These findings suggested that lung cancer patients with cancer pain had disrupted connectivity in the intrinsic brain functional network, which may be the underlying neuroimaging mechanisms.

Patterns of Anticoagulation Use and All-Cause of Mortality in Cancer Patients with Atrial Fibrillation.

BACKGROUND: There is uncertainty regarding the clinical benefit of anticoagulant (AC) treatment in patients with cancer with atrial fibrillation (AF). We aimed to evaluate the distribution and patterns of AC use and its impact on all-cause mortality in cancer patients with AF. METHODS: A total of 1,653 patients with cancer diagnosed with AF were included in this retrospective cohort analysis. Multivariable logistic regression was applied to identify the clinical predictors of anticoagulant prescription. Kaplan-Meier curve with a log-rank test was used to compare the probability of survival between the AC and non-AC groups. Multivariate Cox proportional hazard regression models were implemented to evaluate the influences of various variables on all-cause death. RESULTS: Of 1,653 patients with cancer with AF, 971 (58.7%) did not receive a prescription for AC. Among patients with CHA2DS2-VASC ≥2 in men or ≥3 in women and HAS-BLED <3, 56.5% were not prescribed AC. Rivaroxaban and warfarin are more frequently used than dabigatran, mainly in patients with lung and breast cancer. Over a median follow-up of 36 months, 776 deaths were identified. The Kaplan-Meier curve suggested that patients with AC prescriptions had better clinical outcomes. On multivariate Cox proportional risk regression analysis, AC prescription was significantly associated with a lower risk of all-cause mortality (hazard ratio, 0.78; 95% confidence interval, 0.66-0.91; P = 0.002). CONCLUSIONS: The prescription of anticoagulants in patients with cancer with AF was suboptimal. AC prescription at discharge was associated with a decreased risk of all-cause mortality. IMPACT: This study highlights the importance of AC prescriptions in patients with cancer with AF.

Essential Oils from Different Parts of Magnolia laevifolia: Chemical Constituents and Insecticidal Activities against Liposcelis bostrychophila.

Many synthetic pesticides were used to control a severe storage pest, booklouse (Liposcelis bostrychophila). However, considering the environmental impact, plant secondary metabolites were acceptable alternatives. An endemic plant, Magnolia laevifolia, has a significant and unique odour, so its essential oil (EO) could be an option for bio-pesticide development. This study extracted EOs from leaves, flowers, carpels and seeds of M. laevifolia. The common and major compound of EOs was isocapnell-9-en-8-one, which was present at 17.7 to 91.6 % in these four parts. We found no regular pattern in the composition of EO in terms of parts and collection time according to principal component analysis. The contact and repellent activities of EOs against the booklouse were then conducted. Leaves and flowers' EOs collected in the flowering stage had the best contact toxicity. The percent repellency values of the EOs from different parts of M. laevifolia reached above 80 % after 2 and 4 h exposure at 63.17 nL/cm2 , with the same levels as DEET (p<0.05). It was shown that parts of plants and collecting time could influence the insecticidal activities of M. laevifolia EOs against booklouse, but collecting time played a significant decisive role in the contact test.

Comparative Analysis of Laparoscopic Pancreatoduodenectomy in Elderly Patients: Safety, Efficacy, and Cost Evaluation.

BACKGROUND The use of laparoscopic pancreatoduodenectomy in elderly patients has sparked debate due to concerns about its safety. This study evaluates its safety and efficacy for elderly patients. MATERIAL AND METHODS We retrospectively analyzed data from 250 patients who underwent pancreatoduodenectomy between January 2015 and April 2022. Group A consisted of 100 non-elderly patients (under 70) who had laparoscopic procedures; Group B had 60 elderly patients (70 and above) with laparoscopic surgeries; and Group C included 90 elderly patients with open surgeries. Clinical outcomes were then compared across the groups. RESULTS Elderly patients undergoing laparoscopic pancreatoduodenectomy experienced a higher conversion rate (35% vs 19%), increased ICU admissions post-operation (45% vs 23%), a prolonged ICU stay, greater hospital expenses (¥118,782.48 vs ¥106,698.38), and a lower post-operative adjuvant therapy rate (31.91% vs 69.23%). However, they had fewer B-C pancreatic fistulas (5% vs 24%). Compared to open surgery in elderly patients, laparoscopic procedure showed benefits such as reduced blood loss (median of 200 ml) and fewer wound infections (3.33% vs 17.78%). On the downside, laparoscopy had a longer operation time (462.5 minutes vs 315 minutes), took longer before patients could resume oral intake (median of 5.5 days vs 5 days), and incurred higher hospitalization costs (¥118,782.48 vs ¥111,541.60). CONCLUSIONS While laparoscopic pancreatoduodenectomy in elderly patients may not match the outcomes seen in younger patients, it doesn't possess marked drawbacks when compared to open surgery. It is a safe and viable option for the elderly.

The application of radiofrequency ablation in pancreatic cancer liver-only recurrence after radical pancreatectomy.

To evaluate the safety, feasibility, and survival benefit of radiofrequency ablation in liver-only recurrence pancreatic cancer patients after radical pancreatectomy. The data and follow-up of pancreatic cancer patients who suffered liver-only recurrence after radical pancreatectomy from 2015 to 2021 were retrospectively collected. Finally, 19 liver metastases radiofrequency ablation patients were assigned to radiofrequency ablation group, and 41 patients were to systemic treatment group. (1) the baseline, perioperative characteristics, and pathological outcomes were well-balanced. (2) Recurrence pattern showed there were more multiple (> 3) recurrence tumors in systemic treatment patients (multiple one vs. 19, P = 0.005). (3) Median radiofrequency ablation operation time was 30.0 min, median blood loss was 1.0 ml, 4 (21.05%) patients suffered postoperative complications, and 94.74% liver metastases tumors got complete necrosis. The first efficacy evaluation showed a significantly better effect of radiofrequency ablation, complete and partial response rate 72.22% vs. 27.78%, P < 0.001. Overall survival from the initial surgery and after liver recurrence was significantly longer in the radiofrequency ablation group (43.0 vs. 22.0 months, 29.0 vs. 14.0 months, P = 0.003, 0.006, respectively). Progression-free survival after treatment was longer in the radiofrequency ablation group (6.0 vs. 5.0 months, P = 0.029). For liver recurrence tumor ≤ 3, overall survival from the initial surgery and after liver recurrence was significantly longer in radiofrequency ablation patients (43.0 vs. 22.0 months, 29.0 vs. 14.0 months, P = 0.011, 0.013, respectively). Progression-free survival after treatment was longer in the radiofrequency ablation group (7.0 vs. 4.0 months, P = 0.042). Radiofrequency ablation could get a curative purpose for patients with liver-only recurrence after pancreatectomy, improve progression-free survival and overall survival, and with minor surgery damage and risk.

Application of well logging technology in geothermal resource evaluation: A case study of geothermal water wells in the Qianjiang sag, Jianghan Basin.

Geothermal resources are green and environmentally friendly renewable energy. An accurate evaluation of geothermal resources will help subsequent efficient exploitation. However, to save costs and improve efficiency, core-free drilling and without mud logging are adopted in the actual exploration, which results in an inability to directly obtain the relevant evaluation parameters of a geothermal reservoir for exploration and evaluation. Well logging technology can effectively delineate the geothermal reservoir and determine the location of the major aquifer, while also allowing for the accurate measurement of key reservoir evaluation parameters, such as the shale content, porosity, and well temperature. Moreover, coupled with the calculated logging parameters, a volumetric method can be used to determine the regional geothermal reserves. This research takes the geothermal wells of the Guanghuasi Formation in the Qianjiang sag, Jianghan Basin as an example to conduct the application research. The findings can be of reference for similar geothermal wells in China and facilitate the development of "carbon neutrality."

Altered brain functional activity and connectivity in bone metastasis pain of lung cancer patients: A preliminary resting-state fMRI study.

Bone metastasis pain (BMP) is one of the most prevalent symptoms among cancer survivors. The present study aims to explore the brain functional activity and connectivity patterns in BMP of lung cancer patients preliminarily. Thirty BMP patients and 33 healthy controls (HCs) matched for age and sex were recruited from inpatients and communities, respectively. All participants underwent fMRI data acquisition and pain assessment. Low-frequency fluctuations (ALFF) and regional homogeneity (ReHo) were applied to evaluate brain functional activity. Then, functional connectivity (FC) was calculated for the ALFF- and ReHo-identified seed brain regions. A two-sample t-test or Manny-Whitney U-test was applied to compare demographic and neuropsychological data as well as the neuroimaging indices according to the data distribution. A correlation analysis was conducted to explore the potential relationships between neuroimaging indices and pain intensity. Receiver operating characteristic curve analysis was applied to assess the classification performance of neuroimaging indices in discriminating individual subjects between the BMP patients and HCs. No significant intergroup differences in demographic and neuropsychological data were noted. BMP patients showed reduced ALFF and ReHo largely in the prefrontal cortex and increased ReHo in the bilateral thalamus and left fusiform gyrus. The lower FC was found within the prefrontal cortex. No significant correlation between the neuroimaging indices and pain intensity was observed. The neuroimaging indices showed satisfactory classification performance between the BMP patients and HCs, and the combined ALFF and ReHo showed a better accuracy rate (93.7%) than individual indices. In conclusion, altered brain functional activity and connectivity in the prefrontal cortex, fusiform gyrus, and thalamus may be associated with the neuropathology of BMP and may represent a potential biomarker for classifying BMP patients and healthy controls.

Altered Functional Connectivity in Pain-Related Brain Regions and Its Correlation with Pain Duration in Bone Metastasis with Cancer Pain.

Bone metastatic pain is thought to be a severe type of cancer pain that has refractory characteristics and a long duration. This study is aimed at exploring the brain functional connectivity (FC) pattern in lung cancer patients with bone metastatic pain. In this study, 27 lung cancer patients with bone metastatic pain (CP+), 27 matched lung cancer patients without pain-related complaints (CP-), and 27 matched healthy controls (HC) were recruited. All participants underwent fMRI data acquisition and clinical assessments. One-way ANOVA or a Mann-Whitney U test was applied to compare clinical data according to data distribution. Seventeen hypothesis-driven pain-related brain regions were selected as regions of interest (ROIs). FC values among pain-related brain regions across the three groups were computed by using ROI-ROI functional connectivity analysis. ANCOVA with a post hoc test was applied to compare FC differences among the three groups. p < 0.05 indicated statistical significance. Correlation analysis was conducted to explore the potential relationship between the FC values and clinical characteristics. Except for years of education, no significant differences were revealed among the three groups in age, gender, or neuropsychological assessment. In the CP+ group, FC alterations were mainly concentrated in the dorsal lateral prefrontal cortex (DLPFC), anterior cingulate cortex (ACC), secondary somatosensory cortex (SII), and amygdala compared to the CP- group. Among these brain regions with statistical differences, FC between the right DLPFC and the right ACC showed a positive correlation with the duration of cancer pain in the CP+ group. In addition, in the CP- group, altered FC was found in the bilateral SII, ACC, and thalamus compared to the HC group. Altered FC in pain-related brain regions may be a brain pattern of bone metastatic pain and may be associated with the long duration of cancer pain.

Postmenopausal Women with Breast, Endometrial, and Ovarian Cancers Have an Increased Risk for Cardiovascular Conditions prior to Active Endocrine Therapy.

Background: Patients with active cancer have an increased risk of cardiovascular diseases (CVDs) among cancer patients receiving endocrine therapy. However, little research has explored the distribution of CVD comorbidities and cardiovascular risk factors (CVRFs) among postmenopause women with breast, endometrial, or ovarian cancer prior to active treatment with endocrine therapy. We aimed to explore the distribution of CVD comorbidities and associated CVRF in patients suffering from breast, endometrial, or ovarian cancer prior to the use of endocrine therapy and to assess whether there was compliance with existing hospital recommendations, particularly on the use of lipid-lowering agents to prevent the development of CVD comorbidities in postmenopause women. Methods: A total of 10,731 postmenopause women with primary breast, endometrial, or ovarian cancer were enrolled between 30th May 2008 and 31st July 2021 from an electronic health record database at the first affiliated hospital of Dalian Medical University. Dyslipidemia was defined according to 2016 Chinese guidelines for adults. Multivariate logistic regression analysis was used to identify the independent predictors of CVD comorbidities in breast, endometrial, and ovarian cancers separately. Results: Overall, 18.9% of the included women had at least one CVD record before endocrine therapy. The highest prevalence of CVD was identified for hypertension (16.5%), followed by coronary heart disease (4.5%), stroke (2.1%), heart failure (1.2%), and atrial fibrillation (1.1%). The most common CVRF among total cancer patients was dyslipidemia, with a remarkable prevalence of 62.8%, followed by diabetes mellitus (8.6%). Notably, only 11.1% of cancer patients were receiving lipid-lowering agents. Conclusion: Cancer patients with potential eligibility for endocrine therapy use had an increased risk for CVD comorbidities. Dyslipidemia was the common CVRF. Compliance with recommendations for preventing and managing these comorbidities requires serious attention.

Research update on cell membrane camouflaged nanoparticles for cancer therapy.

Cell membrane-camouflaged biomimetic functionalization of nanoparticles has emerged as a promising strategy for cancer theranostics. These cell membranes used for camouflaging are generally isolated from natural or engineered erythrocytes, neutrophils, macrophages, T lymphatic cells, stem cells, and cancer cells. The camouflaging strategy of coating nanoparticles with cell membranes allows for tumor homotypic targeting through self-recognition as source cells, immune evasion, and a prolonged blood circulation time, thereby improving the effective payload delivery and tumor therapy. More so, some engineered cell membranes with functionalized peptides, proteins and moieties on membrane surface can be transferred for therapy in the same time. In this review, we summarize the latest research on various types of cell membrane-camouflaged nanoparticles aimed at anti-cancer therapy, focusing on the biological advantages of different cell membranes, constitutions of nanoparticles, fabrication processes, key findings, potential therapies, and discuss the major challenges and future opportunities.

Early alterations in cortical morphology after neoadjuvant chemotherapy in breast cancer patients: A longitudinal magnetic resonance imaging study.

There is growing evidence that chemotherapy may have a significant impact on the brains of breast cancer patients, causing changes in cortical morphology. However, early morphological alterations induced by chemotherapy in breast cancer patients are unclear. To investigate the patterns of those alterations, we compared female breast cancer patients (n = 45) longitudinally before (time point 0, TP0) and after (time point 1, TP1) the first cycle of neoadjuvant chemotherapy, using voxel-based morphometry (VBM) and surface-based morphometry (SBM). VBM and SBM alteration data underwent correlation analysis. We also compared cognition-related neuropsychological tests in the breast cancer patients between TP0 and TP1. Reductions in gray matter volume, cortical thickness, sulcal depth, and gyrification index were found in most brain areas, while increments were found to be mainly concentrated in and around the hippocampus. Reductions of fractal dimension mainly occurred in the limbic and occipital lobes, while increments mainly occurred in the anterior and posterior central gyrus. Significant correlations were found between altered VBM and altered SBM mainly in the bilateral superior frontal gyrus. We found no significant differences in the cognition-related neuropsychological tests before and after chemotherapy. The altered brain regions are in line with those associated with impaired cognitive domains in previous studies. We conclude that breast cancer patients showed widespread morphological alterations soon after neoadjuvant chemotherapy, despite an absence of cognitive impairments. The affected brain regions may indicate major targets of early brain damage after chemotherapy.

Metabolic Dysfunction-Associated Fatty Liver Disease Increases the Risk of Gastroesophageal Reflux Symptoms.

OBJECTIVE: The present study aimed to explore the relationship between metabolic dysfunction-associated fatty liver disease (MAFLD) and gastroesophageal reflux symptoms (GERS). METHODS: The present study was a cross-sectional observational study. The study population was 3002 subjects from a single hospital who underwent a health checkup from September 1, 2019, to December 31, 2020. The diagnosis of MAFLD was based on the diagnosis of fatty liver in the subject by ultrasound or computed tomography (CT) and the presence of one of the following conditions: overweight or obesity (body mass index [BMI] ≥ 23), type 2 diabetes mellitus, and metabolic abnormalities. The subjects were divided into the GERS group (n = 305) and the non-GERS group (n = 2697) based on the presence or absence of GERS, based on the GerdQ score. RESULTS: The prevalence of MAFLD was significantly higher in the GERS group than in the non-GERS group (p = 0.001). In the univariate analysis of risk factors for GERS, MAFLD was identified as a risk factor for GERS (OR 1.5; 95% CI 1.176-1.913; p = 0.001). With adjustment of confounding factors such as BMI, waist circumference, lipid levels, and blood pressure, the correlation between MAFLD and GERS was attenuated but still significant (OR 1.408; 95% CI 1.085-1.826; p = 0.010). CONCLUSION: MAFLD might be an independent risk factor for GERS.

Long-term inhibition of UCHL1 decreases hypertension and retinopathy in spontaneously hypertensive rats.

OBJECTIVE: To investigate the role of the deubiquitinase ubiquitin C-terminal hydrolase L1 (UCHL1) in hypertension and retinopathy in the spontaneously hypertensive rat (SHR). METHODS: Wistar-Kyoto (WKY) rats and SHRs were administered the UCHL1 inhibitor LDN57444 (20 µg/kg/day) for 4 months. Pathological changes were detected with hematoxylin and eosin, immunofluorescence, and dihydroethidium staining. The mRNA and protein expression of UCHL1 were examined by real-time PCR and immunoblotting analysis. RESULTS: At 6 months of age, SHRs showed significantly increased mRNA and protein levels of UCHL1 in the retina compared with WKY rats. Moreover, SHRs exhibited significantly increased central retinal thickness, inflammation, and reactive oxygen species production compared with WKY rats, and these effects were markedly attenuated by systemic administration of the UCHL1 inhibitor LDN57444. The beneficial effects of LDN57444 were possibly associated with reduced blood pressure and the inactivation of several signaling pathways. CONCLUSION: UCHL1 is involved in hypertension and retinopathy in SHRs, suggesting that UCHL1 may be used as a potential therapeutic target for treating hypertensive retinopathy.

A taxonomic revision of the genus Conidiobolus (Ancylistaceae, Entomophthorales): four clades including three new genera.

The genus Conidiobolus is an important group in entomophthoroid fungi and is considered to be polyphyletic in recent molecular phylogenies. To re-evaluate and delimit this genus, multi-locus phylogenetic analyses were performed using the large and small subunits of nuclear ribosomal DNA (nucLSU and nucSSU), the small subunit of the mitochondrial ribosomal DNA (mtSSU) and the translation elongation factor 1-alpha (EF-1α). The results indicated that the Conidiobolus is not monophyletic, being grouped into a paraphyletic grade with four clades. Consequently, the well-known Conidiobolus is revised and three new genera Capillidium, Microconidiobolus and Neoconidiobolus are proposed along with one new record and 22 new combinations. In addition, the genus Basidiobolus is found to be basal to the other entomophthoroid taxa and the genus Batkoa locates in the Entomophthoraceae clade.

Comparison of Perioperative and Oncological Outcomes of Hybrid and Totally Laparoscopic Pancreatoduodenectomy.

BACKGROUND Laparoscopic pancreatoduodenectomy (LPD) is a complicated procedure accompanied with high morbidity. Hybrid LPD is usually used as an alternative/transitional approach. This study aimed to prove whether the hybrid procedure is a safe procedure during a surgeon's learning curve of LPD. MATERIAL AND METHODS There were 48 hybrid LPD patients and 62 TLPD patients selected from January 2016 to December 2018; their demographics, surgical outcomes, and oncological data were retrospectively collected. Patient follow-up for the study continued until February 2020. RESULTS Patient demographics and baseline parameters were well balanced between the 2 groups. Intraoperative conditions, overall operation time was shorter for TLPD compared to hybrid LPD (407.79 minutes versus 453.29 minutes, respectively; P=0.035) and blood loss was less in TLPD patients compared to hybrid LPD patients (100.00 mL versus 300.00 mL, respectively; P<0.001). There was no difference in transfusion rates between the 2 groups (hybrid LPD 16.7% versus TLPD 4.8%; P=0.084). Postoperative outcomes and intensive care unit (ICU) stay was longer in the hybrid LPD patient group (hybrid LPD 1-day versus TLPD 0-day, P=0.002) and postoperative hospital stay was similar between the 2 groups (P=0.503). Reoperation rates, in-hospital, 30-day mortality, and 90-day mortality rates were comparable between the 2 groups (P=0.276, 1.000, 1.000, 0.884, respectively). Surgical site infection, bile leak, Clavien-Dindo classification (CDC) ≥3, delayed gastric emptying, grade B/C postoperative pancreatic fistulae, and grade B/C post pancreatectomy hemorrhage were not different between the 2 groups (P=0.526, 0.463, 0.220, 0.089, 0.165, 0.757, respectively). The tumor size, margin status, lymph nodes harvested, and metastasis were similar in the 2 groups (P=0.767, 0.438, 0.414, 0.424, respectively). In addition, the median overall survival rates were comparable between the 2 groups (hybrid LPD 29.0 months versus TLPD 30.0 months, P=0.996) as were the progression-free survival rates (hybrid LPD 11.0 months versus TLPD 12.0 months, P=0.373) CONCLUSIONS Hybrid LPD was comparable to TLPD. Hybrid LPD could be performed safely when some surgeons first started LPD (during the operative learning curve), while for skilled surgeons, TLPD could be applied initially.

Generation and application of patient-derived xenograft models in pancreatic cancer research.

OBJECTIVE: Pancreatic ductal adenocarcinoma cancer (PDAC) is one of the leading causes of cancer-related death worldwide. Hence, the development of effective anti-PDAC therapies is urgently required. Patient-derived xenograft (PDX) models are useful models for developing anti-cancer therapies and screening drugs for precision medicine. This review aimed to provide an updated summary of using PDX models in PDAC. DATA SOURCES: The author retrieved information from the PubMed database up to June 2019 using various combinations of search terms, including PDAC, pancreatic carcinoma, pancreatic cancer, patient-derived xenografts or PDX, and patient-derived tumor xenografts or PDTX. STUDY SELECTION: Original articles and review articles relevant to the review's theme were selected. RESULTS: PDX models are better than cell line-derived xenograft and other models. PDX models consistently demonstrate retained tumor morphology and genetic stability, are beneficial in cancer research, could enhance drug discovery and oncologic mechanism development of PDAC, allow an improved understanding of human cancer cell biology, and help guide personalized treatment. CONCLUSIONS: In this review, we outline the status and application of PDX models in both basic and pre-clinical pancreatic cancer researches. PDX model is one of the most appropriate pre-clinical tools that can improve the prognosis of patients with pancreatic cancer in the future.

Effect of laparoscopic splenectomy on portal vein thrombosis and serum YKL-40 in patients with cirrhotic portal hypertension.

INTRODUCTION AND OBJECTIVES: Laparoscopic splenectomy (LS) is a supportive intervention for cirrhotic patients. However, its efficacy for patients with cirrhotic portal hypertension (CPH) still needs clarification. Studies indicated YKL-40 might be effective targets for treatment of splenomegaly, however deeper insights are unclear. The aim of this study was to investigate the effect of LS on the formation of portal vein thrombosis (PVT) and serum levels of a fibrosis marker, YKL-40, in patients with CPH. MATERIALS AND METHODS: A total of 80 patients who underwent LS and 30 healthy controls were investigated in this study. Serum levels of YKL-40 were measured by enzyme-linked immunosorbent assay (ELISA). Demographic characteristics including age and gender were recorded. Clinicopathological and laboratory examinations included the severity of esophageal varices and the presence of viral hepatitis. The liver function was assessed according to the Child-Pugh classification. The incidence of PVT before and after operation was also monitored. RESULTS: Serum YKL-40 was significantly increased in CPH patients, and was associated with Child-Pugh score and HBV infection. Furthermore, elderly patients had an increased risk for postoperative PVT. Higher serum YKL-40 was observed in patients with thrombus at postoperative 7, 14 and 21 days than those without thrombus. CONCLUSIONS: LS could reduce serum YKL-40 levels and PVT progression and was a useful treatment for patients <40 years of age with CPH.

Ecdysone oxidase and 3-dehydroecdysone-3ß-reductase contribute to the synthesis of ecdysone during early embryonic development of the silkworm.

Maternal ecdysteroids regulate a variety of cellular processes during early embryonic development of insects, yet little is known about the genes involved in the biosynthesis of these hormones. In this study, we found that ecdysone oxidase (EO) gene, which encodes an enzyme to catalyze ecdysone (or 20-hydroxyecdysone, 20E) to 3-dehydroecdysone (3DE), was highly expressed in the mature ovaries of the domestic silkworm, Bombyx mori. B. mori EO (BmEO) was localized in the cytoplasm around the yolk granules of oocyte. Furthermore, the down-regulated expression of the BmEO gene using RNA interference could not affect normal development of the female silkworm, but lower the 20E titer and hatching rate of its offspring. Rescue experiments by injecting the product (3DE) of BmEO can significantly elevate the 20E level and hatching rate of the BmEO RNAi offspring. Meanwhile, during embryonic stage, the down-regulating expression of 3DE-3ß-reductase, which can reduce 3DE into ecdysone, also lowered the 20E titer. Taken together, our results prove that 3DE can be synthesized from ecdysone in maternal ovary yolk granules, and then the maternal 3DE is converted into active ecdysone during the early embryonic development of offspring. Thus, our findings reveal a new pathway to explain the origin of high 20E level before the formation the prothoracic gland in the silkworm.