Tumour response following preoperative chemotherapy is affected by body mass index in patients with colorectal liver metastases

BACKGROUND Colorectal cancer is the third most prevalent malignancy globally and ranks second in cancer-related mortality,with the liver being the primary organ of metastasis.Preoperative chemotherapy is widely recommended for initially or potentially resectable colorectal liver metastases(CRLMs).Tumour pathological response serves as the most important and intuitive indicator for assessing the efficacy of chemotherapy.However,the postoperative pathological results reveal that a considerable number of patients exhibit a poor response to preoperative chemotherapy.Body mass index(BMI)is one of the factors affecting the tumori-genesis and progression of colorectal cancer as well as prognosis after various antitumour therapies.Several studies have indicated that overweight and obese patients with metastatic colorectal cancer experience worse prognoses than those with normal weight,particularly when receiving first-line chemotherapy regimens in combination with bevacizumab.AIM To explore the predictive value of BMI regarding the pathologic response following preoperative chemotherapy for CRLMs.METHODS A retrospective analysis was performed in 126 consecutive patients with CRLM who underwent hepatectomy following preoperative chemotherapy at four different hospitals from October 2019 to July 2023.Univariate and multivariate logistic regression models were applied to analyse potential predictors of tumour pathological response.The Kaplan-Meier method with log rank test was used to compare progression-free survival(PFS)between patients with high and low BMI.BMI<24.0 kg/m^(2) was defined as low BMI,and tumour regression grade 1-2 was defined as complete tumour response.RESULTS Low BMI was observed in 74(58.7%)patients and complete tumour response was found in 27(21.4%)patients.The rate of complete tumour response was significantly higher in patients with low BMI(29.7%vs 9.6%,P=0.007).Multivariate analysis revealed that low BMI[odds ratio(OR)=4.56,95%confidence interval(CI):1.42-14.63,P=0.011],targeted therapy with bevacizumab(OR=3.02,95%CI:1.10-8.33,P=0.033),preoperative carcinoembryonic antigen level<10 ng/mL(OR=3.84,95%CI:1.19-12.44,P=0.025)and severe sinusoidal dilatation(OR=0.17,95%CI:0.03-0.90,P=0.037)were independent predictive factors for complete tumour response.The low BMI group exhibited a significantly longer median PFS than the high BMI group(10.7 mo vs 4.7 mo,P=0.011).CONCLUSION In CRLM patients receiving preoperative chemotherapy,a low BMI may be associated with better tumour response and longer PFS.

Visit-to-visit Systolic Blood Pressure Variability and Stroke Risk: A Systematic Review and Meta-analysis

Visit-to-visit variability in systolic blood pressure(SBP)may have an important additional role in increasing the risk of vascular complications,including stroke.We conducted a meta-analysis to assess the relationship between visit-to-visit SBP variability(SBPV)and stroke risk.PubMed,EMBASE,and the Cochrane library databases were searched for cohort studies with data on visit-to-visit SBPV and stroke risk.Studies that reported adjusted relative risks(RRs)with 95%Cis of stroke associated with SBPV were included.Fourteen cohort studies met the inclusion criteria and were included in our meta-analysis.After adjustment for age,sex,and existing vascular risk factors,the analysis showed that the risk of stroke in patients with SBPV was significantly increased compared with patients with a small baseline SBPV[SD(RR=1.20,95%CI=(1.07-1.35),P=0.0005),CV(RR=1.12,95%CI=(1.00-1.26),P=0.008)].In addition,follow-up variations of more than 5 years were associated with a higher risk of stroke than those of less than 5 years[RR=1.08,95%CI=(1.04-1.11)].Visit-to-visit SBPV was associated with an increased risk of stroke,especially in terms of the time of variation.Taken together,SBPV data may be useful as a preventative diagnostic method in the management of stroke.

Super-hydrophobic film deposition by an atmospheric-pressure plasma process and its anti-icing characteristics

In this work,the super-hydrophobic(SH)surface was prepared through chemical vapor deposition process by an argon atmospheric pressure plasma jet source with HMDSN(hexamethyldisilazane)as the polymerization precursor.Plasma synthesized organosilicon(SiOxCyHz)thin films with water contact angle over 160°and sliding angle below 5°,were able to be achieved.FTIR and XPS analysis indicates a large number of hydrocarbon compositions were polymerized in the thin films enduing the latter very-low surface free energy.SEM shows the SH films display micro-nanostructure and with high degree of averaged surface roughness 190 nm evaluated by AFM analysis.From experiments under controlled low-temperature and moisture conditions,the prepared SH surface exhibits good anti-icing effects.Significantly prolonging freezing time was achievable on the SH thin films for both static and sliding water droplets.This investigation demonstrates the anti-icing potentials of SH surface prepared through low-cost simple atmospheric-pressure plasma polymerization process.

Effects of Three Kinds of Sewage Sludge on Physiological Characteristics of Flower Plants

Effects of dried sludge, digested sludge and composted sludge(obtained from the raw sludge of a large sewage treatment plant in Chongqing City) on the physiological characteristics of Salvia splendens, Tagetes patula and Petunia hybrida were studied. The results showed that the application of sludge could significantly promote the growth of three kinds of flowers and improve their quality. The effects of sludge application rate on the biological characteristics of three kinds of flowers were significant. The optimal application rate of the sludge for the growth of three kinds of flowers was 50%(mass percentage) for S. splendens and 37.5% for P. hybrida and T. patula. The effect of sludge type on the biological characteristics was not significant. However, among the three types of sludge, composted sludge had the highest organic matter content and cation exchange capacity and the lowest salt content, so the improvement of garden soil by composted sludge was relatively significant and safe.

Magnetic resonance spectroscopy findings of central pontine myelinolysis in an alcohol abuser

To the Editor:Central pontine myelinolysis(CPM),a form of osmotic demyelination syndrome(ODS)typically-occurring in the central pons,was first described in alcoholic and malnourished individuals by Adams et al[1]in 1959.ODS is frequently associated with alcohol abuse,liver transplantation,and rapid correction of hyponatremia.[2]The clinical manifestations of CPM are variable,including dysarthria,dysphagia,oculomotor dysfunction,variable degrees of quadriparesis and even locked-in syndrome.addition,some patients may be asymptomatic.The size of myelinolysis in the central pons on brain magnetic resonance imaging(MRI)is not always matched with the severity of clinical symptoms.Previously,a limited number of case reports focued on the magnetic resonance spectroscopy(MRS)findings of CPM.