Preliminary security investigation and short-time follow-up of intraoperative intraperitoneal chemotherapy with lobaplatin for advanced colorectal cancer

Objective The aim of this study was to conduct a security assessment of intraoperative intraperitoneal chemotherapy using lobaplatin for advanced colorectal cancer.Methods From February 2015 to February 2016,143 patients with colorectal cancer who underwent surgery in our department were selected prospectively.All patients were randomly screened and enrolled into the intraperitoneal chemotherapy(IPC)(74 cases)and control(69 cases)groups,depending on the distribution of cases in the random table.In the trial group,patients were administered 40 mg lobaplatin by intraperitoneal implantation intraoperatively,together with intravenous chemotherapy post-operatively using a typical FOLFOX strategy with oxaliplatin,fluorouracil,and leucovorin.In the control group,only FOLFOX was administered.Bowel function recovery time,adverse reactions and complications,and preand post-chemotherapy laboratory examinations were compared.In addition,a 5-year-long follow-up was performed.Results Recovery times of bowel function were 73.5±9.7 h and 74.8±10.3 h respectively,and the difference was not significant(P>0.05).Wound fat liquefaction was observed in five cases in both groups(6.8%vs.7.2%,P>0.05).The outcomes of nausea and vomiting(57 cases,77.0%vs.50 cases,72.5%),constipation(43 cases,58.1%vs.36 cases,52.2%),and diarrhea(5 cases,6.8%vs.5 cases,7.2%)were not statistically significant(all P>0.05).Indices of white blood cell count,blood platelet count,and hepatorenal function were not significantly different(all P>0.05)neither post-operatively nor post-chemotherapy.The 5-year survival rate was not significantly different between the groups(58.1%vs.56.5%,P>0.05).Conclusion Intraoperative chemotherapy with lobaplatin for advanced colorectal cancer is safe and tolerable.

癌结节与结直肠癌患者临床病理因素及预后关系的研究

目的:分析结直肠癌中与癌结节(tumordeposits,TD)状态及数目相关的临床病理因素,探讨与验证第8版TNM分期中TD 分期方法的合理性。方法:回顾性分析2013年8月至2017年12月于西南医科大学附属医院行根治术的结直肠癌患者病例资料, 对患者生存情况进行随访,分析不同TD状态及数目下各临床病理因素的分布差异及预后区别,并从预后的角度验证第8版TNM 分期中TD分期方法的合理性。结果:T分期是TD发生的独立危险因素,肿瘤分化程度是TD数目的独立危险因素。TD阴性组预 后优于TD阳性组,差异具有统计学意义(P<0.001)。 生存曲线随着TD数目的增加而逐渐降低(P<0.05),但 TD=2组与TD=3组间 生存曲线差异无统计学意义(P=0.186)。 依据cutoff值将TD分为TD=1、TD=2~ 3与TD≥4具有明显预后差异的三组。同属于ⅢB 期的T3~ 4aN1c期与T3~ 4aN1a/1b期预后不同(P=0.022)。 相同数量TD与区域淋巴结转移预后不完全相同。结论:结直肠癌合 并TD提示预后不良。不同TD数目对预后的影响不同,TD=1、TD=2~ 3及TD≥4是三个可能的分层标准。第8版TNM分期中的 TD分期方法可能不甚合理。

急腹症罕见诱因:巨大胃间质瘤自发破裂(英文)

A case of spontaneous rupture of giant gastrointestinal stromal tumor(GIST) of stomach causing acute abdomen is described below. A male patient with abdominal mass presented with symptoms and signs of acute abdomen after admitting for 1 day. After preoperative management and evaluation, an exploratory laparotomy was performed, where rupture of a huge tumor in the stomach was found. A subtotal gastrectomy including the mass was performed and the final immunohistochemical examination verified that the neoplasm was a high risk GIST. The postoperative period was uneventful and the patient received treatment with imatinib mesylate, and regular follow-up without recurrence.

HIGH-ORDER NUMERICAL METHOD FOR SOLVING A SPACE DISTRIBUTED-ORDER TIME-FRACTIONAL DIFFUSION EQUATION

This article proposes a high-order numerical method for a space distributed-order time-fractional diffusion equation.First,we use the mid-point quadrature rule to transform the space distributed-order term into multi-term fractional derivatives.Second,based on the piecewise-quadratic polynomials,we construct the nodal basis functions,and then discretize the multi-term fractional equation by the finite volume method.For the time-fractional derivative,the finite difference method is used.Finally,the iterative scheme is proved to be unconditionally stable and convergent with the accuracy O(σ^(2)+τ^(2-β)+h^(3)),whereτand h are the time step size and the space step size,respectively.A numerical example is presented to verify the effectiveness of the proposed method.

Risk factors for anastomotic leakage after low anterior resection without diversional stomas

Objective The most important complication after low anterior resection(LAR) for mid-low rectal cancer is symptomatic anastomotic leakage(AL). More than one-third of patients with rectal cancer who underwent LAR will have functional stomas during primary operation. The aim of this retrospective study was to evaluate the risk factors associated with clinical AL following LAR without diversional stomas.Methods Between 2012 and 2017, information about 578 consecutive patients with rectal tumors less than 12 cm from the anal verge who underwent LAR without diversional stomas by the same surgical team was collected retrospectively. A standardized extraperitonealized anastomosis and pelvic drainage were conducted for all patients during primary operations, and the outcome of interest was clinical AL. The associations between AL and 14 patient-related and surgical variables were examined by both univariate chi-square test and multivariate logistic regression analysis.Results The AL rate was 7.27%(42 of 578). Univariate and multivariate analyses showed that male sex(P = 0.018), mid-low rectal cancer(located 10 cm or less above the anal verge)(P = 0.041), presence of diabetes(odds ratio = 2.117), longer duration of operation(odds ratio = 1.890), and intraoperative contamination(odds ratio = 2.163) were risk factors of AL for LAR without diversional stoma and independently predictive of clinical AL. Nearly 83.3%(35 of 42) of leakage could be cured by persistent pelvic irrigation-suction-drainage without surgical intervention. Only 7 patients(16.7%) with severe complications, such as peritonitis, and fistula, required reoperation, and functional stoma was used as a salvage treatment.Conclusion From the findings of this retrospective survey, we identified that mid-low rectal cancer and male sex were independent risk factors for developing clinical AL after LAR without diversional stomas, as well as longer duration of operation, presence of diabetes, and contamination of the operative field. Moreover, we deemed that LAR without diversional stomas for mid-low rectal cancers was safe, effective, and feasible. Extraperitonealized anastomosis and pelvic drainage obtained a relatively low rate of AL and avoided unnecessary functional stomas. Pelvic irrigation-suction-drainage was an effective procedure to resolve AL, and functional stoma was potentially used as a salvage modality for serious leakage.

SMARCC1 copy number variation is related to metastatic colon cancer:an investigation based on TCGA data

Objective There are no well-defined genetic indicators for distant metastatic illness in patients with colon cancer(CC).The discovery of genetic changes linked to metastatic CC might aid in the development of systemic and local therapeutic approaches.Using The Cancer Genome Atlas(TCGA),we examined the relationship between copy number variation(CNV)of SWI/SNF-related matrix-associated actin-dependent regulator of chromatin subfamily C member 1(SMARCC1)and distant metastatic illness in patients with CC.Methods Genetic sequencing data of all relevant CC patients and clinical features were collected from TCGA using R.There were 506 CC patients with CNV and clinical outcome data.The CNV of SMARCC1 was examined for its correlation with distant metastatic disease using the TCGA CC dataset(M1 vs.M0).After adjusting for age,sex,T stage,N stage,adjuvant chemotherapy,microsatellite instability(MSI),and surgical margin status,univariate and multivariate logistic regression analyses were performed.Results SMARCC1 CNV was linked to distant metastatic disease(P=0.012 and 0.008 in univariate and multivariate analysis,respectively);positive lymph nodes and margin status were also associated with distal metastases(all P<0.01).MSI,T stage,N stage,adjuvant treatment,sex,race,and MSI were not associated with metastases(all P>0.05).Conclusion SMARCC1 CNV is associated with distant metastatic disease in patients with CC.In individuals with CC,such genetic profiles might be utilized therapeutically to support optimal systemic treatment options against local treatments for CC,such as radiation therapy,pending additional confirmation.

Bioinformatics analysis of potential hub genes associated with biological characteristics and survival in patients with gastric cancer

Objective Gastric cancer(GC)is a serious threat to human health.In this study,we aimed to explore the differentially expressed genes(DEGs)and identify potential targets for the treatment of GC.Methods The gene expression profile of GSE79973 which compared tissue samples from gastric cancer patients and healthy individuals,downloaded from the GEO database,was submitted to the GCBI online analysis platform to screen for DEGs.Gene ontology(GO)analysis,pathway analysis,and construction of networks,including gene signal and gene co-expression networks,were performed to identify the core DEGs.Survival analysis was performed to determine the relationship between these genes and patient survival time.Results Nine hundred eighty-three genes were identified as DEGs(P<0.001;FC>2).GO analysis showed that DEGs were primarily involved in processes such as angiogenesis,cell metabolism,cell adhesion,redox processes,and cell migration.The metabolism of xenobiotics by cytochrome P450,ECM-receptor interaction,drug metabolism by cytochrome P450,metabolic pathways,and the PI3K-Akt signaling pathway were significantly enriched in pathway analysis.Genes such as UGT2B15,Hepatocyte growth factor(HGF),Nidogen-2(NID2),Follistatin-like protein 1(FSTL1),and Inhibin beta A chain(INHBA)were closely linked to other genes in the network.Survival analyses indicated that HGF,NID2,FSTL1,and INHBA expression levels were inversely correlated with survival time in patients with gastric cancer.Conclusion HGF,NID2,FSTL1,and INHBA may be potential key genes associated with the biological characteristics and survival in patients with gastric cancer.

System architecture for high-performance permissioned blockchains

Blockchain(BC),as an emerging distributed database technology with advanced security and reliability,has attracted much attention from experts who devoted to efinance,intellectual property protection,the internet of things(IoT)and so forth.However,the inefficient transaction processing speed,which hinders the BC’s widespread,has not been well tackled yet.In this paper,we propose a novel architecture,called Dual-Channel Parallel Broadcast model(DCPB),which could address such a problem to a greater extent by using three methods which are dual communication channels,parallel pipeline processing and block broadcast strategy.In the dual-channel model,one channel processes transactions,and the other engages in the execution of BFT.The parallel pipeline processing allows the system to operate asynchronously.The block generation strategy improves the efficiency and speed of processing.Extensive experiments have been applied to BeihangChain,a simplified prototype for BC system,illustrates that its transaction processing speed could be improved to 16K transaction per second which could well support many real-world scenarios such as BC-based energy trading system and Micro-film copyright trading system in CCTV.

Memory dependent anomalous diffusion in comb structure under distributed order time fractional dual-phase-lag model

This paper considers a novel distributed order time fractional dual-phase-lag model to analyze the anomalous diffusion in a comb structure,which has a widespread application in medicine and biology.The newly proposed constitution model is a generalization of the dual-phase-lag model,in which a spectrum of the time fractional derivatives with the memory characteristic governed by the weight coefficient is considered and the formulated governing equation contains both the diffusion and wave characteristics.With the L1-formula to discrete the time Caputo fractional derivatives,the finite difference method is used to discretize the model and the related numerical results are plotted graphically.By adding a source term,an exact solution is defined to verify the correctness of the numerical scheme and the convergence order of the error in spatial direction is presented.Finally,the dynamic characteristics of the particle distributions and the effects of involved parameters on the total number of particles in the x-direction are analyzed in detail.