A new radiomics approach combining the tumor and peri-tumor regions to predict lymph node metastasis and prognosis in gastric cancer

Objective The development of non-invasive methods for evaluating lymph node metastasis(LNM)preoperatively in gastric cancer(GC)is necessary.In this study,we developed a new radiomics model combining features from the tumor and peritumor regions for predicting LNM and prognoses.Methods This was a retrospective observational study.In this study,two cohorts of patients with GC treated in Zhongshan Hospital Fudan University(Shanghai,China)were included.In total,193 patients were assigned to the internal training/validation cohort;another 98 patients were assigned to the independent testing cohort.The radiomics features were extracted from venous phase computerized tomography(CT)images.The radiomics model was constructed and the output was defined as the radiomics score(RS).The performance of the RS and CT-defined N status(ctN)for predicting LNM was compared using the area under the curve(AUC).The 5-year overall survival and progression-free survival were compared between different subgroups using Kaplan–Meier curves.Results In both cohorts,the RS was significantly higher in the LNM-positive group than that in the LNM-negative group(all P<0.001).The radiomics model combining features from the tumor and peri-tumor regions achieved the highest AUC in predicting LNM(AUC,0.779 and 0.724,respectively),which performed better than the radiomics model based only on the tumor region and ctN(AUC,0.717,0.622 and 0.710,0.603,respectively).The differences in 5-year overall survival and progression-free survival between high-risk and low-risk groups were significant(both P<0.001).Conclusions The radiomics model combining features from the tumor and peri-tumor regions could effectively predict the LNM in GC.Risk stratification based on the RS was capable of distinguishing patients with poor prognoses.

Design, synthesis and biological evaluation of chalcone analogues with novel dual antioxidant mechanisms as potential anti-ischemic stroke agents

Scavenging reactive oxygen species(ROS) by antioxidants is the important therapy to cerebral ischemia-reperfusion injury(CIRI) in stroke. The antioxidant with novel dual-antioxidant mechanism of directly scavenging ROS and indirectly through antioxidant pathway activation may be a promising CIRI therapeutic strategy. In our study, a series of chalcone analogues were designed and synthesized, and multiple potential chalcone analogues with dual antioxidant mechanisms were screened. Among these compounds, the most active 33 not only conferred cytoprotection of H2 O2-induced oxidative damage in PC12 cells through scavenging free radicals directly and activating NRF2/ARE antioxidant pathway at the same time, but also played an important role against ischemia/reperfusion-related brain injury in animals. More importantly, in comparison with mono-antioxidant mechanism compounds, 33 exhibited higher cytoprotective and neuroprotective potential in vitro and in vivo. Overall, our findings showed compound 33 couldemerge as a promising anti-ischemic stroke drug candidate and provided novel dual-antioxidant mechanism strategies and concepts for oxidative stress-related diseases treatment.

Author correction to ‘Design, synthesis and biological evaluation of chalcone analogues with novel dual antioxidant mechanisms as potential anti-ischemic stroke agents’ [Acta Pharmaceutica Sinica B 9 (2019) 335e350]

The authors regret that there was a picture error in Fig.5D and Fig.5E,owing to the authors’mistakes of copying and pasting in the process of assembling figures and making a diagram.In Fig.5D,the image of the edaravone 6 h group(ED-6h group)was repeated with the model group(NS group),and thus the image of the ED-6h group needs to be corrected.In Fig.5E,the data of the edaravone 3h group(ED-3h group)was repeated with the 336h group(33-6h group),and thus the data of the ED-3h group needs to be corrected.

Predictors of mortality in patients with acute smallbowel perforation transferred to ICU after emergency surgery:a single-centre retrospective cohort study

Background Although small-bowel perforation is a life-threatening emergency even after immediate surgical intervention,studies have rarely investigated surgical outcomes due to its relatively low incidence.This study aimed to investigate the outcomes of emergency surgery for patients with small-bowel perforation transferred to the intensive care unit(ICU)and the risk factors for mortality.Methods Consecutive patients with small-bowel perforation who were confirmed via emergency surgery and transferred to the ICU in Zhongshan Hospital,Fudan University(Shanghai,China)between February 2011 and May 2020 were retrospectively analysed.Medical records were reviewed to determine clinical features,laboratory indicators,surgical findings,and pathology.Results A total of 104 patients were included in this study,among whom 18(17.3%),59(56.7%),and 27(26.0%)underwent perforation repair,segmental resection with primary anastomosis,and small-bowel ostomy,respectively.Malignant tumours were the leading cause of perforation in these patients(40.4%,42/104).The overall post-operative complication rate and mortality rates were 74.0%(77/104)and 19.2%(20/104),respectively.Malignant tumour-related perforation(odds ratio[OR],4.659;95%confidence interval[CI],1.269–17.105;P=0.020)and high post-operative arterial blood-lactate level(OR,1.479;95%CI,1.027–2.131;P=0.036)were identified as independent risk factors for post-operative mortality in patients with small-bowel perforation transferred to the ICU.Conclusions Patients with small-bowel perforation who are transferred to the ICU after emergency surgery face a high risk of post-operative complications and mortality.Moreover,those patients with malignant tumour-related perforation and higher post-operative blood-lactate levels have poor prognosis.