Objective:Systemic chemotherapy has limited efficacy in the treatment of peritoneal metastasis(PM)in gastric cancer(GC).Hyperthermic intraperitoneal chemotherapy(HIPEC)combined with complete cytoreductive surgery(CRS)...Objective:Systemic chemotherapy has limited efficacy in the treatment of peritoneal metastasis(PM)in gastric cancer(GC).Hyperthermic intraperitoneal chemotherapy(HIPEC)combined with complete cytoreductive surgery(CRS)has shown promising outcomes but remains controversial.The present study aimed to evaluate the safety and efficacy of HIPEC without CRS in GC patients with PM.Methods:This retrospective propensity score-matched multicenter cohort study included GC patients with PM treated with either chemotherapy alone(Cx group)or with HIPEC combined with chemotherapy(HIPEC-Cx group)in four Chinese high-volume gastric medical centers between 2010 and 2017.The primary outcomes were median survival time(MST)and 3-year overall survival(OS).Propensity score matching was performed to compensate for controlling potential confounding effects and selection bias.Results:Of 663 eligible patients,498 were matched.The MST in the Cx and HIPEC-Cx groups was 10.8 and 15.9 months,respectively[hazard ratio(HR)=0.71,95%confidence interval(95%CI),0.58-0.88;P=0.002].The 3-year OS rate was 10.1%(95%CI,5.4%-14.8%)and 18.4%(95%CI,12.3%-24.5%)in the Cx and HIPEC-Cx groups,respectively(P=0.017).The complication rates were comparable.The time to first flatus and length of hospital stay for patients undergoing HIPEC combined with chemotherapy was longer than that of chemotherapy alone(4.6±2.4 d vs.2.7±1.8 d,P<0.001;14.2±5.8 d vs.11.4±7.7 d,P<0.001),respectively.The median follow-up period was 33.2 months.Conclusions:Compared with standard systemic chemotherapy,HIPEC combined with chemotherapy revealed a statistically significant survival benefit for GC patients with PM,without compromising patient safety.展开更多
Energy storage is an important component in the life history of species that directly inlfuences survival and reproduction. The energetic demands of amphibian reproduction can differ between the sexes, with environmen...Energy storage is an important component in the life history of species that directly inlfuences survival and reproduction. The energetic demands of amphibian reproduction can differ between the sexes, with environmental conditions, reproductive pattern or process of the species, and depending upon the timing of breeding, and the reproductive season for a species. Surprisingly, comparative studies of pre-hibernation energy storage for anuran populations from different latitudes are relatively few in Asia, especially in China. Here we investigated the patterns of pre-hibernation energy storage of Heilongjiang brown frogsRana amurensis, based on ifve populations along a ifnely latitudinal gradient in north China （40.7–43.7°N）. We found that pre-hibernation energy storage of the frogs did not show a clear latitudinal cline, but differed strongly between the sexes, with males depositing more energy reserves into the muscle and liver, whereas females accumulate more energy in the gonads. The sexual differences in energy storage may result from differential timing of energy allocation for reproduction.展开更多
Background and Aims:Correct identification of small hepa-tocellular carcinomas(HCCs)and benign nodules in cirrhosis remains challenging,quantitative apparent diffusion coeffi-cients(ADCs)have shown potential value in ...Background and Aims:Correct identification of small hepa-tocellular carcinomas(HCCs)and benign nodules in cirrhosis remains challenging,quantitative apparent diffusion coeffi-cients(ADCs)have shown potential value in characterization of benign and malignant liver lesions.We aimed to explore the added value of ADCs in the identification of small(≤3 cm)HCCs and benign nodules categorized as Liver Imag-ing Reporting and Data System(LI-RADS)3(LR-3)and 4(LR-4)in cirrhosis.Methods:Ninety-seven cirrhosis patients with 109 small nodules(70 HCCs,39 benign nodules)of LR-3 and 4 LR-4 based on major and ancillary magnetic resonance imaging features were included.Multiparametric quantitative ADCs of the lesions,including the mean ADC(ADCmean),min-imum ADC(ADCmin),maximal ADC(ADCmax),ADC standard deviation(ADCstd),and mean ADC value ratio of lesion-to-liv-er parenchyma(ADCratio)were calculated.Regarding the joint diagnosis,a nomogram model was plotted using multivariate logistic regression analysis.The performance was assessed using the area under the receiver operating characteristic curve(AUC).Results:The ADCmean,ADCmin,ADCratio,and ADCstd were significantly associated with the identification of small HCC and benign nodules(p<0.001).For the joint diagnosis,the LI-RADS category(odds ratio[OR]=12.50),ADCmin(OR=0.14),and ADCratio(OR=0.12)were identified as independent factors for distinguishing HCCs from benign nodules.The joint nomogram model showed good calibration and discrimination,with a C-index of 0.947.Compared with the LI-RADS category alone,this nomogram model demon-strated a significant improvement in diagnostic performance,with AUC increasing from 0.820 to 0.967(p=0.001).Con-clusions:The addition of quantitative ADCs could improve the identification of small HCC and benign nodules catego-rized as LR-3 and 4 LR-4 in patients with cirrhosis.展开更多
The flagship species conservation strategy is widely practiced in nature reserves.However,few studies have quantitatively explored whether the current functional zoning adequately conserves the habitats of other speci...The flagship species conservation strategy is widely practiced in nature reserves.However,few studies have quantitatively explored whether the current functional zoning adequately conserves the habitats of other species.To examine this problem,we selected the Tangjiahe,Xuebaoding,and Wanglang national nature reserves in southwest China and tested the protective efficiency of the giant panda(Ailuropoda melanoleuca)reserves on a local herbivore—Sichuan takin(Budorcas taxicolor tibetana)in functional zoning.We predicted that the habitat distribution of the Sichuan takin with Maxent and habitat suitability would be classified as very low,low,moderately,or highly suitable.We calculated the percentage of each type of habitat class across the core,buffer,and experimental zones in these reserves and introduced an economic index present value index to further assess the efficacy of the functional zoning in conserving the habitat of Sichuan takin.Our findings indicate that suitable habitat distributions of Sichuan takin are multicore and influenced by diverse variables in different nature reserves.The percentage of moderately suitable and highly suitable habitat in the core zone is 69%and 54%in Tangjiahe,76%and 75%in Wanglang,and 47%and 28%in Xuebaoding,respectively.The present value index of moderately and highly suitable habitat is 1.01 and 0.79(Tangjiahe),0.87 and 0.86(Wanglang),0.76 and 0.44(Xuebaoding),respectively.The efficiency of functional zoning on Sichuan takin seems lower than imagined in giant panda reserves,and species that have important impacts on local ecosystem need further estimation and greater focus.展开更多
基金the Guangzhou Key Medical Discipline Construction Project Fundthe Guangzhou High-Level Clinical Key Specialty Construction+2 种基金the Clinical Research Promotion Project of Guangzhou Medical University for Building High Level Universitythe National Natural Science Foundation of China(No.81972918)the Guangzhou Major Clinical Technology Program(No.2019ZD16)。
文摘Objective:Systemic chemotherapy has limited efficacy in the treatment of peritoneal metastasis(PM)in gastric cancer(GC).Hyperthermic intraperitoneal chemotherapy(HIPEC)combined with complete cytoreductive surgery(CRS)has shown promising outcomes but remains controversial.The present study aimed to evaluate the safety and efficacy of HIPEC without CRS in GC patients with PM.Methods:This retrospective propensity score-matched multicenter cohort study included GC patients with PM treated with either chemotherapy alone(Cx group)or with HIPEC combined with chemotherapy(HIPEC-Cx group)in four Chinese high-volume gastric medical centers between 2010 and 2017.The primary outcomes were median survival time(MST)and 3-year overall survival(OS).Propensity score matching was performed to compensate for controlling potential confounding effects and selection bias.Results:Of 663 eligible patients,498 were matched.The MST in the Cx and HIPEC-Cx groups was 10.8 and 15.9 months,respectively[hazard ratio(HR)=0.71,95%confidence interval(95%CI),0.58-0.88;P=0.002].The 3-year OS rate was 10.1%(95%CI,5.4%-14.8%)and 18.4%(95%CI,12.3%-24.5%)in the Cx and HIPEC-Cx groups,respectively(P=0.017).The complication rates were comparable.The time to first flatus and length of hospital stay for patients undergoing HIPEC combined with chemotherapy was longer than that of chemotherapy alone(4.6±2.4 d vs.2.7±1.8 d,P<0.001;14.2±5.8 d vs.11.4±7.7 d,P<0.001),respectively.The median follow-up period was 33.2 months.Conclusions:Compared with standard systemic chemotherapy,HIPEC combined with chemotherapy revealed a statistically significant survival benefit for GC patients with PM,without compromising patient safety.
基金provided by the Scientific Research Foundation of Mianyang Normal University (No. QD2012A13)the Key Foundation of the Sichuan Provincial Department of Education (No.15ZA0298)Innovation Team Project of Education Department of Sichuan Province (No. 13TD0015)
文摘Energy storage is an important component in the life history of species that directly inlfuences survival and reproduction. The energetic demands of amphibian reproduction can differ between the sexes, with environmental conditions, reproductive pattern or process of the species, and depending upon the timing of breeding, and the reproductive season for a species. Surprisingly, comparative studies of pre-hibernation energy storage for anuran populations from different latitudes are relatively few in Asia, especially in China. Here we investigated the patterns of pre-hibernation energy storage of Heilongjiang brown frogsRana amurensis, based on ifve populations along a ifnely latitudinal gradient in north China （40.7–43.7°N）. We found that pre-hibernation energy storage of the frogs did not show a clear latitudinal cline, but differed strongly between the sexes, with males depositing more energy reserves into the muscle and liver, whereas females accumulate more energy in the gonads. The sexual differences in energy storage may result from differential timing of energy allocation for reproduction.
基金This work was supported by the Guangzhou Health and Family Planning Science and Technology Project(20192A010020).
文摘Background and Aims:Correct identification of small hepa-tocellular carcinomas(HCCs)and benign nodules in cirrhosis remains challenging,quantitative apparent diffusion coeffi-cients(ADCs)have shown potential value in characterization of benign and malignant liver lesions.We aimed to explore the added value of ADCs in the identification of small(≤3 cm)HCCs and benign nodules categorized as Liver Imag-ing Reporting and Data System(LI-RADS)3(LR-3)and 4(LR-4)in cirrhosis.Methods:Ninety-seven cirrhosis patients with 109 small nodules(70 HCCs,39 benign nodules)of LR-3 and 4 LR-4 based on major and ancillary magnetic resonance imaging features were included.Multiparametric quantitative ADCs of the lesions,including the mean ADC(ADCmean),min-imum ADC(ADCmin),maximal ADC(ADCmax),ADC standard deviation(ADCstd),and mean ADC value ratio of lesion-to-liv-er parenchyma(ADCratio)were calculated.Regarding the joint diagnosis,a nomogram model was plotted using multivariate logistic regression analysis.The performance was assessed using the area under the receiver operating characteristic curve(AUC).Results:The ADCmean,ADCmin,ADCratio,and ADCstd were significantly associated with the identification of small HCC and benign nodules(p<0.001).For the joint diagnosis,the LI-RADS category(odds ratio[OR]=12.50),ADCmin(OR=0.14),and ADCratio(OR=0.12)were identified as independent factors for distinguishing HCCs from benign nodules.The joint nomogram model showed good calibration and discrimination,with a C-index of 0.947.Compared with the LI-RADS category alone,this nomogram model demon-strated a significant improvement in diagnostic performance,with AUC increasing from 0.820 to 0.967(p=0.001).Con-clusions:The addition of quantitative ADCs could improve the identification of small HCC and benign nodules catego-rized as LR-3 and 4 LR-4 in patients with cirrhosis.
基金Our research was funded by open project(ESP15004)from the Ecological Security and Protection Key Laboratory of Sichuan Province,Mianyang Normal University.
文摘The flagship species conservation strategy is widely practiced in nature reserves.However,few studies have quantitatively explored whether the current functional zoning adequately conserves the habitats of other species.To examine this problem,we selected the Tangjiahe,Xuebaoding,and Wanglang national nature reserves in southwest China and tested the protective efficiency of the giant panda(Ailuropoda melanoleuca)reserves on a local herbivore—Sichuan takin(Budorcas taxicolor tibetana)in functional zoning.We predicted that the habitat distribution of the Sichuan takin with Maxent and habitat suitability would be classified as very low,low,moderately,or highly suitable.We calculated the percentage of each type of habitat class across the core,buffer,and experimental zones in these reserves and introduced an economic index present value index to further assess the efficacy of the functional zoning in conserving the habitat of Sichuan takin.Our findings indicate that suitable habitat distributions of Sichuan takin are multicore and influenced by diverse variables in different nature reserves.The percentage of moderately suitable and highly suitable habitat in the core zone is 69%and 54%in Tangjiahe,76%and 75%in Wanglang,and 47%and 28%in Xuebaoding,respectively.The present value index of moderately and highly suitable habitat is 1.01 and 0.79(Tangjiahe),0.87 and 0.86(Wanglang),0.76 and 0.44(Xuebaoding),respectively.The efficiency of functional zoning on Sichuan takin seems lower than imagined in giant panda reserves,and species that have important impacts on local ecosystem need further estimation and greater focus.
