Reoperation for heterochronic intraductal papillary mucinous neoplasm of the pancreas after bile duct neoplasm resection:A case report

BACKGROUND Intraductal papillary neoplasm of the bile duct(IPNB)and intraductal papillary mucinous neoplasm(IPMN)of the pancreas have similar pathological manifestations.However,they often develop separately and it is rare for both to occur together.Patients presenting with heterochronic IPMN after IPNB are prone to be misdiagnosed with tumor recurrence.CASE SUMMARY A 67-year-old male patient was admitted 8.5 years after IPNB carcinoma and 4 years after the discovery of a pancreatic tumor.A left hepatic bile duct tumor with distal bile duct dilatation was found 8.5 years ago by the computed tomography;therefore,a left hepatectomy was performed.The postoperative pathological diagnosis was malignant IPNB with negative cutting edge and pathological stage T1N0M0.Magnetic resonance imaging 4 years ago showed cystic lesions in the pancreatic head with pancreatic duct dilatation,and carcinoembryonic antigen continued to increase.Positron emission tomography showed a maximum standard uptake value of 11.8 in the soft tissue mass in the pancreatic head,and a malignant tumor was considered.Radical pancreatoduodenectomy was performed.Postoperative pathological diagnosis was pancreatic head IPMN with negative cutting edge,pancreaticobiliary type,stage T3N0M0.He was discharged 15 d after the operation.Follow-up for 6 mo showed no tumor recurrence,and quality of life was good.CONCLUSION IPNB and IPMN are precancerous lesions with similar pathological characteristics and require active surgery and long-term follow-up.

Anti-fatigue Effect of Water Extract from Centella asiatica(L.)Urban on Mice

[Objectives]To study the anti-fatigue effect of water extract from Centella asiatica(L.)Urban on mice.[Methods]After intragastric administration of low,medium and high concentration of water extract from Centella asiatica(L.)Urban for 14 d,the rotarod time and the content of serum lactic acid in mice were determined,respectively.[Results]Compared with the control group,the rotarod time of mice in the low and medium concentration groups was significantly prolonged(P<0.05),but there was no significant difference between the control group and the high concentration group;the content of serum lactic acid in the medium concentration group was significantly lower than that in the control group(P<0.01),but there was no significant difference between low concentration group and high concentration group and the control group.[Conclusions]A certain concentration of water extract from Centella asiatica(L.)Urban had a good anti-fatigue effect.

Integrin-linked kinase in gastric cancer cell attachment,invasion and tumor growth

AIM： To investigate the effects of integrin-linked kinase （ILK） on gastric cancer cells both in vitro and in vivo. METHODS： ILK small interfering RNA （siRNA） was transfected into human gastric cancer BGC-823 cells and ILK expression was monitored by real-time quan- titative polymerase chain reaction, Western blotting analysis and immunocytochemistry. Cell attachment, proliferation, invasion, microfilament dynamics and the secretion of vascular endothelial growth factor （VEGF） were also measured. Gastric cancer cells treated with ILK siRNA were subcutaneously transplanted into nude mice and tumor growth was assessed. RESULTS： Both ILK mRNA and protein levels were significantly down-regulated by ILK siRNA in human gastric cancer cells. This significantly inhibited cell attachment, proliferation and invasion. The knockdown of ILK also disturbed F-actin assembly and reduced VEGF secretion in conditioned medium by 40% （P 〈 0.05）. Four weeks after injection of ILK siRNA-transfected gastric cancer cells into nude mice, tumor volume and weight were significantly reduced compared with that of tumors induced by cells treated with non-silencing siRNA or by untreated cells （P 〈 0.05）. CONCLUSION： Targeting ILK with siRNA suppresses the growth of gastric cancer cells both in v/tro and /n vivo. ILK plays an important role in gastric cancer progression.

Superior adsorption performance of graphitic carbon nitride nanosheets for both cationic and anionic heavy metals from wastewater

Water pollution caused by highly toxic Cd(II), Pb(II), and Cr(VI) is a serious problem. In the present work,a green and low-cost adsorbent of g-C_3N_4 nanosheets was developed with superior capacity for both cationic and anionic heavy metals. The adsorbent was easily fabricated through one-step calcination of guanidine hydrochloride with thickness less than 1.6 nm and specific surface area of 111.2 m^2·g^(-1). Kinetic and isotherm studies suggest that the adsorption is an endothermic chemisorption process, occurring on the energetically heterogeneous surface based on a hybrid mechanism of multilayer and monolayer adsorption. The tri-s-triazine units and surface N-containing groups of g-C_3N_4 nanosheets are proposed to be responsible for the adsorption process.Further study on pH demonstrates that electrostatic interaction plays an important role. The maximum adsorption capacity of Cd(II), Pb(II), and Cr(VI) on g-C_3N_4 nanosheets is 123.205 mg·g^(-1), 136.571 mg·g^(-1),and 684.451 mg·g^(-1), respectively. The better adsorption performance of the adsorbent than that of the recently reported nanomaterials and low-cost adsorbents proves its great application potential in the removal of heavy metal contaminants from wastewater. The present paper developed a promising adsorbent which will certainly find applications in wastewater treatment and also provides guiding significance in designing adsorption processes.

High levels of serum platelet-derived growth factor-AA and human epidermal growth factor receptor-2 are predictors of colorectal cancer liver metastasis

AIM To develop predictive markers in blood for colorectal cancer liver metastasis.METHODS Twenty colorectal cancer patients were selected and divided into two groups. Group A consisted of 10 patients whose pathological TNM stage was ⅢC(T3-4N2M0), while another 10 patients with synchronous liver metastasis(TNM stage Ⅳ) were recruited for group B. During the surgical procedure, a 10-ml drainage vein(DV) blood sample was obtained from the DV of the tumor-bearing segment prior to the ligation of the DV. At the same time, a 10-ml peripheral vein(PV) blood sample was collected via peripheral venipuncture. The serum levels of 24 molecules that are potentially involved in the mechanism of liver metastasis in both DV blood and PV blood were analyzed by using high-throughput enzyme-linked immunosorbent assay technology.RESULTS Univariate analysis revealed that platelet-derivedgrowth factor AA(PDGFAA) in DV blood(d PDGFAA)(P = 0.001), PDGFAA in PV blood(p PDGFAA)(P = 0.007), and human epidermal growth factor receptor-2 in PV blood(p HER2)(P = 0.001), p MMP7(P = 0.028), pR ANTES(P = 0.013), and pE GF(P = 0.007) were significantly correlated with synchronous liver metastasis. Multivariate analysis identified d PDGFAA(HR = 1.001, P = 0.033) and p HER2(HR = 1.003, P = 0.019) as independent predictive factors for synchronous liver metastasis. Besides, high peripheral HER2 level may also be a risk factor for metachronous liver metastasis, although the difference did not reach statistical significance(P = 0.06). Significant correlations were found between paired DV and PV blood levels for PDGFAA(r = 0.794, P < 0.001), but not for HER2(r = 0.189, P = 0.424).CONCLUSION PDGFAA in tumor drainage and HER2 in PV blood may be useful predictive factors for synchronous liver metastasis of colorectal cancer.

Postoperative chemotherapy with S-1 plus oxaliplatin versus S-1alone in locally advanced gastric cancer(RESCUE-GC study): a protocol for a phase Ⅲ randomized controlled trial

Background： The ACTS-GC study had shown postoperative adiuvant therapy with S-1 improved survival of patients with locally advanced gastric cancer. Addition of oxaliplatin to S-1 is considered to be acceptable as one of the treatment options for gastric cancer patients after radical gastrectomy with D2 lymph node excision. Methods： We have commenced a randomized phase III trial in December 2016 to evaluate S-I plus oxaliplatin compared with S-1 alone in the adjuvant setting for locally advanced gastric cancer. A total of 564 patients will be accrued from 13 Chinese institutions in two years. The primary endpoint is 3-year relapse-free survival. The secondary endpoints are 5-year overall survival, proportion of patients who complete the postoperative chemotherapy and incidence of adverse events. Ethic and dissemination： The trial has been approved by the institutional review board of each participating institution and it was activated on December, 2016. The enrollment will be finished in December, 2018. Patient＇s follow-up will be ended until December, 2023. Trial registration： ClinicalTrials.gov, identifier： NCT02867839. Registered on August 4, 2016.

c-Fos enhances the survival of thymocytes during positive selection by upregulating Bcl-2

T cells are derived from progenitor thymocytes, of which only a minority receive the appropriate TCR signal, undergo positive selection and mature. Owing to the very short lifespan of thymocytes, the prerequisite for posi- tive selection is survival. TCR signal-induced Bcl-2 expression is believed to play a dominant role in the survival of positively selecting thymocytes, but how Bcl-2 is directly regulated is unknown. Here we report that the immediate early gene （IEG） c-Fos can stimulate the expression of Bcl-2, depending on a specific AP-l-binding site in the Bcl-2 promoter. In c-Fos transgenic （Fos-Tg） mice, c-Fos binds to this site and promotes the expression of Bcl-2. As a result, Fos-Tg thymocytes exhibited enhanced survival, and more mature single-positive （SP） thymocytes were generated, even on a unique TCR background. The TCR repertoire remained normal in Fos-Tg mice. Our results identified c-Fos as the mediator of the stimulatory effect of TCR signaling on Bcl-2 expression. Therefore, c-Fos, as an IEG, because of its early response ability, can quickly rescue the survival of short-lived thymocytes during positive selection. Our results provide novel insight into the mechanism regulating the survival of positively selecting thymocytes.

Fabrication of biomaterial/TiO2 composite photocatalysts for the selective removal of trace environmental pollutants

Trace environmental pollutants have become a serious problem with special attention on the hazardous heavy metals, refractory organics, and pathogenic microorganisms. With coupling biosorption and photocatalysis to develop biomaterial/TiO2 composite photocatalysts is a promising method to remove these trace pollutants because of the synergistic effect. Biomaterials provide multiple function groups which can selectively and efficiently enrich trace pollutants onto the surface of the photocatalysts, thus facilitating the following transformation mediated by TiO2 photocatalysis. Biomaterials can also help the dispersion and recovery of TiO2, or even modify the band structure of TiO2. The fabrication of chitosan/TiO2, cellulose/TiO2, as well as other biomaterial/TiO2 composite photocatalysts is discussed in detail in this review. The application significance of these composite photocatalysts for the selective removal of trace pollutants is also addressed. Several problems should be solved before the realistic applications can be achieved as discussed in the final section.

Cobalt valence modulating in CoO_(x) incorporated carbon nanofiber for enhanced glucose electrooxidation

Glucose fuel cells(GFCs)driven by abiotic catalysts are promising green power sources for portable or wearable devices.In this work,a CoO_(x)incorporated carbon nanofiber(CoO_(x)@CNF)catalyst with mixed valences cobalt oxides have been developed through partial oxidation of pyrolyzed electrospun Co^(2+)/poly acrylonitrile fibers.The cobalt valence modulating could be achieved via regulating the incorporation ratio of cobalt acetate in precursors or the oxidation temperature of the pyrolyzed fibers.Electrocatalytic analyses show that the presence of CoO in CoO_(x)@CNF will provide more active sites for glucose electrooxidation,and thus enhance the electrocatalytic performance significantly.As a result,the glucose fuel cell built with the CoO.@CNF anode containing both CoO and Co_(3)O_(4)delivered a maximum power density of 270μW cm^(-2),which is higher than that of other reported Co_(3)O_(4)based GFCs.This work provides a simple strategy to develop excellent transition metal catalysts for GFCs to expand their applications in portable and wearable energy devices.

NAT2 Involed in the Susceptibility to Antituberculosis Drug-Induced Liver Injury

Objective: To investigate whether the N-acetyltransferase 2 (NAT2) gene is involved in the development of susceptibility to antituberculosis drug-induced liver damage (ATDLI) in patients with pulmonary tuberculosis in the Han nationality. Methods: We retrospectively analyzed 300 cases of tuberculosis patients without liver damage (control group) and 221 cases of tuberculosis patients with liver damage after antituberculosis treatment (case group). After antituberculosis treatment, genetic polymorphisms of NAT2 were analyzed in those patients using MassARRAY method. Results: Of the 10 tagged SNPs selected, In the promoter area of NAT2, the frequencies of T allele in rs4646243 and A allele in rs4646246 were significantly higher in the patients with ATDLI than controls (0.569 vs. 0.483, p=0.0062 and 0.567 vs 0.487, p=0.0103). The A allele of rs1115784 in the intron area showed a significant association with the development of ATDLI (0.389 vs 0.305, p = 0.0043). The frequencies of the mutated genes T and A in rs1041983 and rs1799930 in the second exon region were significantly higher than those in the control group (0.491 vs 0.360, p<0.00001 and 0.336 vs 0.212, respectively;p<0.00001). Two monomer domains were found in the 10 tag SNP sites, haplotype ht [TGAA] in monomeric domain 1 and haplotype ht [TAG] in monomeric domain 2, both were significantly more likely to be detected in the liver injury group than in the control group(p=0.0038, p<0.001, respectively). Two haplotypes were also found on the NAT2 gene: haplotype ht [CGGG] in monomeric domain 1 and ht [CGG] in block 2, and their presence means a lower risk of liver damage. Conclusion: NAT2 genotypes might have significant association with the risk of ATDLI in the Chinese Han nationality. By detecting the NAT2 gene and its haplotype, we can screen patients with a higher risk of liver damage before anti-TB treatment and take measures for the protection of patients.

Relationship between CYP2E1 Gene Polymorphism and Anti-tuberculosis Drug-induced Liver Injury

Objective: To investigate the relationship between cytochrome P450 E1 (CYP2E1) gene polymorphisms and susceptibility to anti-tuberculosis drug-induced liver damage (ATDLI) in tuberculosis patients in the Chinese Han nationality. Methods: A retrospective analysis was performed on 360 patients with tuberculosis who had liver damage after tuberculosis treatment (case group) and 360 patients with tuberculosis who did not develop liver injury after treatment (control group). MassARRAY were used to detect CYP2E1 gene polymorphisms. Results: In a total of 8 tagged SNP loci selected, the rs8192773 locus failed to pass the test, and therefore, it is not included in subsequent analysis. At the remaining seven SNP sites, the difference in alleles was not statistically significant between the case group and the control group, suggesting that these sites may not be related to liver damage caused by anti-tuberculosis drugs. Three monomer domains were found in the seven tags SNP loci mentioned above. However, it was found that these haplotypes are not closely related to anti-tuberculosis drug-induced liver damage. Conclusion: The CYP2E1 gene polymorphism in the Chinese Han nationality is not related to the occurrence of anti-tuberculosis drug-induced liver injury.

Polysaccharide from Fruits of Physalis Alkekengi L. Enhances Antitumor Efficacy by a DNA Vaccine

Physalis. alkekengi fruit has long been used in traditional Chinese medicine for tumor therapy. In the present study, using plasmids that encode ovalbumin (OVA) gene, we investigate the adjuvant activity of a polysaccharide fraction (PPSB) isolated from P.alkekengi fruit. Formulation by simple procedures of mixing of the OVA-encoding pCI-neo-sOVA plasmid with PPSB not only induced specific antibody responses, but also induced antigen-specific cytotoxic T lymphocyte (CTL) responses (Graph abstract). Furthermore, immunization using this vaccine prevented the growth of OVA-expressing B16-OVA tumor cell growth in the immunized mice. Thus, we provide evidence supporting the adjuvant activity of PPSB in DNA vaccine against tumor.

Association of Genetic Polymorphism of GSTM1 and GSTT1 with the Susceptibility to Antituberculosis Drug-induced Hepatotoxicity in Chinese Population

Objective To investigate the relationship between the polymorphism of glutathione S transferase M1, T1(GSTM1, GSTT1) gene and the susceptibility to antituberculosis drug induced hepatotoxicity (ATDH) in patients with tuberculosis. Methods GSTM1 and GSTT1 gene polymorphisms in patients with or without liver toxicity after antituberculous treatment were analyzed using multiple PCR method. Results In ATDH group and control group, the proportion of GSTM1 gene deletion was 58.0% and 50.7% respectively, and the difference was not statistically significant (OR=1.322, 95%CI=0.921~1.878), the frequencies of GSTT1 deletion were 46.3% and 49.3%, respectively, and there was no significant difference between them. There was no significant difference in frequency of GSTM1 and GSTT1 variation between case group and control group (P> 0.05), and no synergistic effect of those two gene polymorphism were detected in the occurrence of antituberculosis drug-induced hepatotoxicity. Conclusion The polymorphisms of GSTM1 and GSTT1 genes may not be associated with the risk of ATDH.

Isolates of Cryptococcus Neoformans from Non-HIV and Non-Transplant Hospitalized Patients

A retrospective cross-sectional study for patients with confirmed Cryptococcus neoformans meningitis(CM)in non-HIV-infected and non-transplant hosts in two class-A tertiary hospitals in Guangzhou,China is reported.181 CM patients were enrolled during the study period,48%(87/181)of which died.Underlying diseases were risk factor associated with higher mortality,among which diabetes mellitus ranked first for the incidence of CM.The mortality was not related to antifungal drug susceptibility.All strains were considered susceptible to amphotericin B,although interpretative breakpoints for amphotericin B have not yet been established.According to the CLSI guidelines,most of the strains in our study were susceptible to voriconazole,fluconazole,fluorocytosine and dose-dependently susceptible to itraconazle.

Hydrophobicity gradient optimization of fuel cell gas diffusion media for its application in vehicles

During Fuel Cell Vehicle(FCV)operation,the liquid water in gas diffusion media(GDM)prevents the reaction gas from reaching the reaction zone and lead to output power fluctuation and reduce the lifespan of FCV.In the present research,hydrophobicity gradient settings of micro-porous layer(MPL)and gas diffusion layer(GDL)are optimized to improve the water removal ability of GDM.Computational fluid dynamics(CFD)model is constructed for numerical simulations to analyze the fuel cell power output and the water content in the GDM with different hydrophobicity gradients.Experiments with different hydrophobicity gradients,which are specifically prepared with corresponding concentrations of polytetrafluoroethylene(PTFE)solutions,are conducted for validation of simulation results.It is shown that the positive hydrophobicity gradient of MPL and GDL provides a better capacity for water removal and oxygen transport.The contact angles of MPL and GDL are further optimized as 147.9°-138.6°by genetic algorithm integrated with the CFD simulations.

Cancer stem cells: advances in knowledge and implications for cancer therapy

Cancer stem cells(CSCs),a small subset of cells in tumors that are characterized by self-renewal and continuous proliferation,lead to tumorigenesis,metastasis,and maintain tumor heterogeneity.Cancer continues to be a significant global disease burden.In the past,surgery,radiotherapy,and chemotherapy were the main cancer treatments.The technology of cancer treatments continues to develop and advance,and the emergence of targeted therapy,and immunotherapy provides more options for patients to a certain extent.However,the limitations of efficacy and treatment resistance are still inevitable.Our review begins with a brief introduction of the historical discoveries,original hypotheses,and pathways that regulate CSCs,such as WNT/β-Catenin,hedgehog,Notch,NFkB,JAK/STAT,TGF-β,PI3K/AKT,PPAR pathway,and their crosstalk.We focus on the role of CSCs in various therapeutic outcomes and resistance,including how the treatments affect the content of CSCs and the alteration of related molecules,CSCs-mediated therapeutic resistance,and the clinical value of targeting CSCs in patients with refractory,progressed or advanced tumors.In summary,CSCs affect therapeutic efficacy,and the treatment method of targeting CSCs is stll difficult to determine.Clarifying regulatory mechanisms and targeting biomarkers of CSCs is currently the mainstream idea.

3D Path Planning of the Solar Powered UAV in the Urban-Mountainous Environment with Multi-Objective and Multi-Constraint Based on the Enhanced Sparrow Search Algorithm Incorporating the Levy Flight Strategy

In response to practical application challenges in utilizing solar-powered unmanned aerial vehicle(UAV)for remote sensing,this study presents a three-dimensional path planning method tailored for urban-mountainous environment.Taking into account constraints related to the solar-powered UAV,terrain,and mission objectives,a multi-objective trajectory optimization model is transferred into a single-objective optimization problem with weight factors and multiconstraint and is developed with a focus on three key indicators:minimizing trajectory length,maximizing energy flow e±ciency,and minimizing regional risk levels.Additionally,an enhanced sparrow search algorithm incorporating the Levy flight strategy(SSA-Levy)is introduced to address trajectory planning challenges in such complex environments.Through simulation,the proposed algorithm is compared with particle swarm optimization(PSO)and the regular sparrow search algorithm(SSA)across 17 standard test functions and a simplified simulation of urban-mountainous environments.The results of the simulation demonstrate the superior effectiveness of the designed improved SSA based on the Levy flight strategy for solving the established single-objective trajectory optimization model.

Bismuth doped Sr_(2)Fe_(1.5)Mo_(0.5)O_(6-δ) double perovskite as a robust fuel electrode in ceramic oxide cells for direct CO_(2)electrolysis

Electrochemical conversion of CO_(2)to CO is an economically feasible method for mitigating greenhouse gas emissions.Among various electrochemical approaches,solid oxide electrolysis cells(SOECs)show high potential for CO_(2)reduction reaction(CO_(2)-RR)due to their ability to operate at high temperatures,resulting in fast reaction kinetics and increased efficiency.Considering their main energy loss is still associated with the large overpotential at the fuel electrode,the development of the highly efficient and durable cathode for SOECs has been extensively searched after.Here,we propose an A-site doping strategy to enhance the properties of Sr_(2)Fe_(1.5)Mo_(0.5)O_(6−δ)(SFM),which improve its performance as a cathode in SOECs for CO_(2)-RR,demonstrating favorable activity and durability.The structural and physiochemical characterizations,together with DFT calculations,show that the partial replacement of Sr by Bi in the SFM double perovskite not only improves CO_(2) adsorption capability at the catalyst surface but also enhances oxygen ionic conduction inside the bulk oxide,resulting in enhanced CO_(2)electrocatalysis performance in SOECs.Specifically,a La_(0.8)Sr_(0.2)Ga_(0.8)Mg_(0.2)O_(3−δ) (LSGM)electrolyte-supported single cell with the new Bi-doped SFM cathode demonstrates a large current density of 1620 mA cm^(−2) at a cell potential of 1.6 V at 850°C with good operational stability up to 200 h.Bi-doped SFM thus represents a highly promising cathode for ceramic CO_(2)electrolyzers and could accelerate our transition towards a carbon-neutral society.

First detection of cutavirus DNA in stools of patients with rheumatic diseases in Guangzhou,China

Cutavirus(CuV)is a novel protoparvovirus possibly associated with diarrhea and cutaneous T-cell lymphomas.Patients with rheumatic disease are immunosuppressed and may be more vulnerable to pathogenic viruses.A descriptive study was conducted among hospitalized patients with rheumatic diseases and individuals undergoing medical health check-ups between June 2019 and June 2022 in Guangzhou,China.Stool samples of subjects were tested for CuV DNA.Demographic and fecal examination data of patients were obtained from electronic medical records.A total of 505 patients with rheumatic diseases and 244 individuals who underwent medical health check-ups were included in the study.Of the patients with rheumatic disease,5.74%[95%confidence interval(CI):4.03%–8.12%]were positive for CuV DNA,while no individual in the medical health check-up group was positive,indicating a close correlation between CuV and rheumatic disease.Men and patients with rheumatoid arthritis or ankylosing spondylitis,according to the disease classification,were more susceptible to being infected with CuV(P<0.01).After adjustments,being male remained the only significant factor,with an adjusted odd ratio(OR)of 4.4(95%CI:1.7–11.4,P=0.002).Phylogenetic analysis of the CuV VP2 sequences showed three diverse clades,one of which was segregated to be a single branching independent of previously known sequences,which is possible a new genotype.

A novel robust nomogram based on peripheral monocyte counts for predicting lymph node metastasis of prostate cancer

Accurate methods for identifying pelvic lymph node metastasis(LNM)of prostate cancer(PCa)prior to surgery are still lacking.We aimed to investigate the predictive value of peripheral monocyte count(PMC)for LNM of PCa in this study.Two hundred and ninety-eight patients from three centers were divided into a training set(n=125)and a validation set(n=173).In the training set,the independent predictors of LNM were analyzed using univariate and multivariate logistic regression analyses,and the optimal cutoff value was calculated by the receiver operating characteristic(ROC)curve.The sensitivity and specificity of the optimal cutoff were authenticated in the validation cohort.Finally,a nomogram based on the PMC was constructed for predicting LNM.Multivariate analyses of the training cohort demonstrated that clinical T stage,preoperative Gleason score,and PMC were independent risk factors for LNM.The subsequent ROC analysis showed that the optimal cutoff value of PMC for diagnosing LNM was 0.405×10^(9)l^(−1)with a sensitivity of 60.0%and a specificity of 67.8%.In the validation set,the optimal cutoff value showed significantly higher sensitivity than that of conventional magnetic resonance imaging(MRI)(0.619 vs 0.238,P<0.001).The nomogram involving PMC,free prostate-specific antigen(fPSA),clinical T stage,preoperative Gleason score,and monocyte-to-lymphocyte ratio(MLR)was generated,which showed a robust predictive capacity for predicting LNM before the operation.Our results indicated that PMC as a single agent,or combined with other clinical parameters,showed a robust predictive capacity for LNM in PCa.It can be employed as a complementary factor for the decision of whether to conduct pelvic lymph node dissection.