Risk factors and clinical outcomes of incomplete endoscopic resection of small rectal neuroendocrine tumors in southern China:a 9-year data analysis

Background:The histologically complete resection(CR)rate of small rectal neuroendocrine tumors(RNETs)is unsatisfactory at the first endoscopy.Risk factors and clinical outcomes associated with incomplete resection(IR)have not been explicitly elucidated.This study aims to explore the relevant factors of IR.Methods:This retrospective study reviewed patients with small RNETs(10mm)in eight centers from January 2013 to December 2021.Clinicopathological characteristics and clinical outcomes were compared between the CR and IR groups,and the polypectomy and advanced treatment groups.Results:Of the 326 patients included,83(25.5%)were diagnosed with IR.Polypectomy(odds ratio[OR]=16.86),a central depression(OR=7.50),and treatment in the early period(OR=2.60)were closely associated with IR.Further analysis revealed that an atypical hyperemic appearance(OR=7.49)and treatment in the early period(OR=2.54)were significantly associated with the inappropriate use of polypectomy(both P<0.05).In addition,a total of 265(81.3%)were followed up with a median follow-up period of 30.9 months.No death,metastasis,or recurrence was found during the follow-up period.Conclusions:Polypectomy,a central depression,and treatment in the early period were risk factors for IR.Further,an atypical hyperemic appearance and treatment in the early period were significant predisposing factors for inappropriate choice of polypectomy.For histologically incompletely resected small RNETs,follow-up may be a safe and feasible alternative to rigorous salvage therapy.

Prediction of coronavirus 3C-like protease cleavage sites using machine-learning algorithms

The coronavirus 3C-like(3CL)protease,a cysteine protease,plays an important role in viral infection and immune escape.However,there is still a lack of effective tools for determining the cleavage sites of the 3CL protease.This study systematically investigated the diversity of the cleavage sites of the coronavirus 3CL protease on the viral polyprotein,and found that the cleavage motif were highly conserved for viruses in the genera of Alphacoronavirus,Betacoronavirus and Gammacoronavirus.Strong residue preferences were observed at the neighboring positions of the cleavage sites.A random forest(RF)model was built to predict the cleavage sites of the coronavirus 3CL protease based on the representation of residues in cleavage motifs by amino acid indexes,and the model achieved an AUC of 0.96 in cross-validations.The RF model was further tested on an independent test dataset which were composed of cleavage sites on 99 proteins from multiple coronavirus hosts.It achieved an AUC of 0.95 and predicted correctly 80%of the cleavage sites.Then,1,352 human proteins were predicted to be cleaved by the 3CL protease by the RF model.These proteins were enriched in several GO terms related to the cytoskeleton,such as the microtubule,actin and tubulin.Finally,a webserver named 3CLP was built to predict the cleavage sites of the coronavirus 3CL protease based on the RF model.Overall,the study provides an effective tool for identifying cleavage sites of the 3CL protease and provides insights into the molecular mechanism underlying the pathogenicity of coronaviruses.

Clinical Effects of the COVID-19 Pandemic Among the Uninfected Pregnant Women—6 PLADs,China,2019−2020

Summary What is already known about this topic?The coronavirus disease 2019(COVID-19)pandemic potentially affected prenatal care quality and maternal and fetal outcomes globally.What is added by this report?During COVID-19 pandemic period,the rates of caesarean sections(CS)and preterm birth for uninfected pregnant women increased slightly in areas that were relatively severely impacted by the pandemic in China.