Circulating tumor cells as potential prognostic biomarkers for earlystage pancreatic cancer:A systematic review and meta-analysis

BACKGROUND Pancreatic cancer is difficult to be diagnosed early clinically,while often leads to poor prognosis.If optimal personalized treatment plan can be provided to pancreatic cancer patient at an earlier stage,this can greatly improve overall survival(OS).Circulating tumor cells(CTCs)are a collective term for various types of tumor cells present in the peripheral blood(PB),which are formed by detachment during the development of solid tumor lesions.Most CTCs undergo apoptosis or are phagocytosed after entering the PB,whereas a few can escape and anchor at distal sites to develop metastasis,increasing the risk of death for patients with malignant tumors.AIM To investigate the significance of CTCs in predicting the prognosis of early pancreatic cancer patients.METHODS The PubMed,EMBASE,Web of Science,Cochrane Library,China National Knowledge Infrastructure,China Biology Medicine,and ChinaInfo databases were searched for articles published through December 2022.Studies were considered qualified if they included patients with early pancreatic cancer,analyzed the prognostic value of CTCs,and were full papers reported in English or Chinese.Researches were selected and assessed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol and the Newcastle-Ottawa Scale criteria.We used a funnel plot to assess publication bias.RESULTS From 1595 publications,we identified eight eligible studies that collectively enrolled 355 patients with pancreatic cancer.Among these original studies,two were carried out in China;three in the United States;and one each in Italy,Spain,and Norway.All eight studies analyzed the relevance between CTCs and the prognosis of patients with early-stage pancreatic cancer after surgery.A meta-analysis showed that the patients that were positive pre-treatment or post-treatment for CTCs were associated with decreased OS[hazard ratio(HR)=1.93,95% confidence interval(CI):1.197-3.126,P=0.007]and decreased relapse-free/disease-free/progressionfree survival(HR=1.27,95%CI:1.137-1.419,P<0.001)in early-stage pancreatic cancer.Additionally,the results suggest no statistically noticeable publication bias for overall,disease-free,progression-free,and recurrence-free survival.CONCLUSION This pooled meta-analysis shows that CTCs,as biomarkers,can afford reliable prognostic information for patients with early-stage pancreatic cancer and help develop individualized treatment plans.

Heterotopic ossification after arthroscopy for hip impingement syndrome

Background:Heterotopic ossification(HO)is a known complication of hip arthroscopy.We investigated incidence of HO after hip arthroscopy and determined whether revision for HO improved outcome.Methods:A retrospective study was conducted on 242 patients(140 men and 102 women,mean age:36.2±9.5 years)who underwent hip arthroscopy for femoroacetabular impingement(FAI)between January 2016 and January 2018.The average followup period was 22.88±11.74 months(range:11-34 months).Thirteen(5.37%)cases of HO(six men and seven women,five left hips and eight right hips;mean age:37.5±4.7 years)were observed.Among them,four cases with HO with obvious pain symptoms and persistent non-remission underwent revision surgery to remove HO.Monthly follow-up was conducted.Visual analog scale(VAS),modified Harris Hip Score(mHHS),and non-Arthritis Hip Score(NAHS)were evaluated and compared between HO and non-HO patients.Independent sample t test,Mann-Whitney U test and the Chi-square test were used for inter-group comparisons.HO degree was evaluated using Brooker classification.Symptoms and function were evaluated before and after revision.Results:A total of 242 patients were involved in this study.Thirteen cases(5.4%)had imaging evidence of HO.Nine(9/13)were classified as Brooker stageⅠ,three(3/13)Brooker stageⅡ,and one(1/13)Brooker stageⅢ.HO was detected by ultrasonography as early as 3 weeks after operation.After primary surgery,the mHHS of the HO group and non-HO group increased by 13.00(8.50,25.50)and 24.00(14.00,34.50)points(Z=-1.80,P=0.08),NAHS increased by 18.00(9.50,31.50)and 26.00(13.50,36.00)points(Z=-1.34,P=0.18),and VAS decreased by 3.00(2.00,4.00)and 4.00(3.00,4.50)points(Z=-1.55,P=0.12).Average follow-up time after revision was 9.00±2.94 months;mHHS increased by 34.75 points t=-55.23,P<0.01)and NAHS by 28.75 points t=-6.03,P<0.01),and VAS decreased by 4 points t=9.80,P<0.01).HO and non-HO patients were similar for demographic and surgical data,and clinical and functional scores.Conclusion:HO incidence after arthroscopic treatment of FAI is similar to that found in previous studies.Most HO have no effect on clinical symptoms.Patients who undergo revision HO resection show improvement in pain and joint function.

Fast emergency control strategy calculation based on dynamic equivalence and integral sensitivity

To simplify the transient stability analysis of a large-scale power system and realize real-time emergency control,a fast transient stability simulation algorithm based on real-time dynamic equivalence is proposed.Generator models are grouped and aggregated according to a fast numerical integration.A fast calculation method of the admittance matrix is then proposed to calculate the parameters of an equivalent system,and numerical integration is performed using the obtained equivalent system.Then,based on integral sensitivity,a new fast emergency control strategy is proposed for the equivalent system.The final emergency control strategy is obtained by mapping the control strategy for the equivalent system back to the original system.The results of a simulation on an East China Power System that includes 496 generators and 5075 buses show that the suggested algorithm can output an accurate transient stability simulation result and form an effective emergency control strategy.The proposed algorithm is much faster than the existing solutions and has the potential to be used for online pre-decision.