Factors associated with overall survival in early gastric cancer patients who underwent additional surgery after endoscopic submucosal dissection

BACKGROUND Controversy exists about the benefit of additional surgery after endoscopic submucosal dissection(ESD)for early gastric cancer(EGC).AIM To examine risk factors for overall survival(OS)after additional surgery in patients with EGC who initially underwent ESD.METHODS This was a retrospective analysis of patients with EGC who underwent additional surgery after ESD at the Beijing Friendship Hospital affiliated to Capital Medical University between August 2012 and August 2019.OS was the primary outcome.Lymph node metastasis and residual tumor were secondary outcomes.Logistic regression models and Kaplan-Meier curves were used for further analysis.RESULTS Forty-two patients were evaluated,including 35(83.3%)males and 7(16.7%)females.The mean age was 62(range,32-82)years.Male sex[hazard ratio(HR)=21.906,95%confidence interval(CI):3.762-229.250;P=0.039),T1b invasion(HR=3.965,95%CI:1.109-17.432;P=0.047),undifferentiated tumor(HR=9.455,95%CI:0.946-29.482;P=0.049),lymph node metastasis(HR=2.126,95%CI:0.002-13.266;P=0.031),and residual tumor(HR=4.275,95%CI:1.049-27.420;P=0.043)were independently associated with OS.The follow-up duration was 4-81 mo(median:50.7 mo).OS was 77.0±12.1 mo(95%CI:53.3-100.7 mo).The 3-year and 5-year OS rates were 94.1%and 85%,respectively.CONCLUSION Male sex,T1b invasion,undifferentiated tumor,lymph node metastasis,and residual tumor are independently associated with OS in patients with EGC who underwent additional surgery after ESD.

Artificial intelligence system of faster region-based convolutional neural network surpassing senior radiologists in evaluation of metastatic lymph nodes of rectal cancer

Background: An artificial intelligence system of Faster Region-based Convolutional Neural Network (Faster R-CNN) is newly developed for the diagnosis of metastatic lymph node (LN) in rectal cancer patients. The primary objective of this study was to comprehensively verify its accuracy in clinical use. Methods: Four hundred fourteen patients with rectal cancer discharged between January 2013 and March 2015 were collected from 6 clinical centers, and the magnetic resonance imaging data for pelvic metastatic LNs of each patient was identified by Faster R-CNN. Faster R-CNN based diagnoses were compared with radiologist based diagnoses and pathologist based diagnoses for methodological verification, using correlation analyses and consistency check. For clinical verification, the patients were retrospectively followed up by telephone for 36 months, with post-operative recurrence of rectal cancer as a clinical outcome;recurrence-free survivals of the patients were compared among different diagnostic groups, by methods of Kaplan-Meier and Cox hazards regression model. Results: Significant correlations were observed between any 2 factors among the numbers of metastatic LNs separately diagnosed by radiologists, Faster R-CNN and pathologists, as evidenced by rradiologist-Faster R-CNN of 0.912, rPathologist-radiologist of 0.134, and rPathologist-Faster R-CNN of 0.448 respectively. The value of kappa coefficient in N staging between Faster R-CNN and pathologists was 0.573, and this value between radiologists and pathologists was 0.473. The 3 groups of Faster R-CNN, radiologists and pathologists showed no significant differences in the recurrence-free survival time for stage N0 and N1 patients, but significant differences were found for stage N2 patients. Conclusion: Faster R-CNN surpasses radiologists in the evaluation of pelvic metastatic LNs of rectal cancer, but is not on par with pathologists.

Molecular characterization and expression profiles of nicotinic acetylcholine receptors in the rice striped stem borer, Chilo suppressalis （Lepidoptera： Crambidae）

Nicotinic acetylcholine receptors （nAChRs） are members of the cys-loop ligand- gated ion channel （cysLGIC） superfamily, mediating fast synaptic cholinergic transmission in the central nervous system in insects. Insect nAChRs are the molecular targets of economically important insecticides, such as neonicotinoids and spinosad. Identification and characterization of the nAChR gene family in the rice striped stem borer, Chilo suppressa[is, could provide beneficial information about this important receptor gene family and contribute to the investigation of the molecular modes of insecticide action and resistance for current and future chemical control strategies. We searched our C. suppressalis transcriptome database using Bombyx mori nAChR sequences in local BLAST searches and obtained the putative nAChR subunit complementary DNAs （cDNAs） via reverse transcription polymerase chain reaction （RT-PCR） and rapid amplification of cDNA ends methods. Similar to B. mori, C. suppressalis possesses 12 nAChR subunits, including nine c^-type and three/%type subunits. Quantitative RT-PCR analysis revealed the expression profiles of the nAChR subunits in various tissues, including the brain, subesophageal ganglion, thoracic ganglion, abdominal ganglion, hemocytes, fat body, foregut, midgut, hindgut and Malpighian tubules. Developmental expression analyses showed clear differential expression of nAChR subunits throughout the C. suppressalis life cycle. The identification of nAChR subunits in this study will provide a foundation for investigating the diverse roles played by nAChRs in C. suppressalis and for exploring specific target sites for chemicals that control agricultural pests while sparing beneficial species

Biological and biochemical characterization of a red-eye mutant in Nilaparvata lugens （Hemiptera： Delphacidae）

A red-eye colony was established in our laboratory in brown planthopper （BPH）, Nilaparvata lugens （Stal）, a major rice pest in Asia. Except for the red-eye phenotype, no other differences were observed between the wild-type （brown eye） and the mutant-type （red eye） in external characters. Genetic analysis revealed that the red-eye phenotype was controlled by a single autosomal recessive allele. Biological studies found that egg produc- tion and egg viability in the red-eye mutant colony were not significantly different from those in the wild-type BPH. Biochemical analysis and electronic microscopy examination revealed that the red-eye mutants contained decreased levels of both xanthommatin （brown） and pteridine （red） and reduced number of pigment granules. Thus, the changes of amount and ratio of the two pigments is the biochemical basis of this red-eye mutation. Our results indicate that the red-eye mutant gene （red） might be involved in one common gene locus shared by the two pigments in pigment transportation, pigment granule formation or some other processes.

Chinese guideline for the application of rectal cancer staging recognition systems based on artificial intelligence platforms (2021 edition)

Development and Application of Artificial Intelligence Recognition Systems in Rectal Cancer Staging Whether for surgical treatment or for neoadjuvant chemoradiotherapy,imaging evaluation has become an important basis to perform the treatment plans.[1]The reading of imaging results requires a large number of experienced radiologists to complete,but shortages and uneven distributions of personnel cause delays and biases in imaging results.Therefore,independent research and development of automatic recognition systems of rectal cancer staging based on artificial intelligence(AI)platforms aim to partially replace practitioners’work and achieve rapid and accurate identification of rectal cancer staging.

Re-examination of the standardization of colon cancer surgery

The standardization of colon cancer surgery has been an area of intense interest.The recent establishment of the complete mesocolic excision(CME)technique has defined the operative approach for colon cancer surgeries and enabled the collection of high-quality oncological specimens for histopathological evaluation.Standard for the Diagnosis and Treatment of Colorectal Cancer(2010),issued by the Ministry of Health of China,has provided legal bases for the treatment of colorectal cancers.However,certain confusions remain due to lack of detailed guidelines for operations.This raised the key question:‘‘What is the standardized colon cancer surgery?’’The present study re-examined the core ideas of General Rules for Clinical and Pathological Studies on Cancer of the Colon,Rectum and Anus(seventh edition)published by the Japanese Society for Cancer of the Colon and Rectum.CME-related studies published in English academic journals between April 2009 and July 2012 were surveyed and analysed.Several technical issues related to the requirement of R0 resection were analysed,including the theoretical basis for the safety range of bowel resection and the rational determination of the range of regional lymph node dissection.