Comparison of Self-Perception of Esthetics and Orthodontic Treatment Needs among Dental and Non-Dental Students with Assessment by Orthodontist

Objectives: The present study was conducted to compare the self-perception of esthetics and wish for seeking orthodontic treatment among dental and non-dental students. The realistic orthodontic treatment needs were confirmed by expert orthodontist. Methods: A cross-sectional study was conducted among 255 male students (Dental—75, Medical—93 and Pharmacy—87 students). The questionnaire included 20 items covering dental esthetics self-perception (10 questions), self-confidence and psychological impact (5 questions), and the need for seeking orthodontic treatment (5 questions) on a five-point Likert scale. The realistic orthodontic treatment needs were confirmed by photographs using aesthetic component of IOTN and clinical examination for the participants and analysis of jaw models using Dental aesthetic index (DAI). Kruskal-Wallis ANOVA was used to check the significant difference between groups. Results: The overall average esthetic self-perception score for total sample was 3.83. The overall average psychological impact score for the whole sample was 2.67. The total percentage of participants who either agree or strongly agree with the question related to their perception of need for seeking orthodontic treatment was 70%. According to the assessment of orthodontic needs using AC-IOTN, 19.8% required definitive treatment. According to the assessment of orthodontic treatment needs based on DAI, 20.3% and 9.9% needed highly desirable (DAI 31 - 35) and definite need of treatment (DAI ≥ 36) respectively. Conclusion: It can be concluded that there was no difference between the esthetic perception of dental and non-dental students. The self-perception for seeking orthodontic treatment was over-reported by participants compared to real requirement as assessed by orthodontic specialist. Dental esthetics has no psychological impact on academic performance and self-confidence as perceived by study participants.

Evaluation of Orthodontic Treatment Needs among Widou Schoolchildren in Ferlo (SENEGAL): A Transversal Study

The aim of this study was to evaluate orthodontic treatment needs among Ferlo scholars. The design of the study was descriptive and transversal. For Inclusion criteria, children must live in Widou or live around Widou’s school at least 6 km, be students at primary school of Widou Thiengoly, have a general health state which permits a clinical oral examination and teacher’s and/or parent’s agreement. The investigation was exhaustive and concerned the only school of the locality. More of 4/5 schoolchildren was 10.25 years ± 2.15 old. The majority (83.74%) of children presented an overjet between 0 and 3.5 mm, 1.63% presented a crossbite and 15.45% had OIM and RC different over to 2 mm. More of 30% of schoolchildren presented an overbite between 1 and 2 mm. More of 1/10 of them had an aesthetic teeth perception classified levels 8.9 and 10 corresponding to an orthodontic treatment needed according to IOTN while 20.33% had a score of 4 and 3.25% recorded score of 5 corresponding to a high treatment needed according to IOTN. The results of this study reveal that people need to be informed better about the therapeutic possibilities that orthodontics offer.

Objective and Subjective Dental Treatment Needs among Nursing Home Residents

Objective: The aim of the study was to analyze oral, dental and denture hygiene, and the current treatment needs in nursing home residents. Design: Cross-sectional design. Setting: Nursing homes in Saxony, Germany. Participants and Intervention: Participating dentists recorded the frequency of oral, dental and denture care, dental treatment needs, and the request for treatment in 11,144 nursing home residents by using standardized checklists. Results: Mean age of the residents was 82.5 years, and 74.6% were females. For 54.0% of those examined, nursing staff did care for oral, dental, and denture hygiene. 77.5% of the residents performed oral hygiene more frequently than once daily, 19.8% only once a day, and 2.6% performed oral hygiene less frequent. A need for dental treatment was identified in 64.1% of the residents, of which 34.5% were missing dentures, and 29.7% suffered from dental diseases. 58.3% of the residents not requesting treatment had a clinical need for dental therapy. Objective and subjective need for treatment correlated positively (p < 0.001). Conclusion: Nursing home staff should be aware of the poor oral hygiene and health care conditions in residents. In addition to regular dental check-ups, nursing home residents should be given advice on dental care. Furthermore, dentists and health insurances should develop an action plan to improve oral health of nursing home residents, and to reduce additional costs due to lack of dental care.

Factors Influencing Subjective Orthodontic Treatment Need and Culture-related Differences among Chinese Natives and Foreign Inhabitants

Aim The aim of this survey was to compare Chinese natives and foreign inhabitants in Chengdu, China, with respect to： （1） attitudes towards dental appearance, （2） subjective orthodontic treatment need, and （3） the main factors influencing orthodontic treatment need. Methodology A total of 522 subjects, including 227 foreign inhabitants and 295 Chinese natives in Chengdu participated in the survey. A simple random sampling method was adopted and a face-to-face interview was conducted at some public sites using a questionnaire. Data was entered by two persons synchronously using Epidata 3.0, and SPSS 13.0 was used to analyze these data. Results 89.0% of foreign inhabitants were satisfied with their teeth compared to only 46.8% of Chinese natives. Females were more dissatisfied with their teeth than males. Chinese natives put improving appearance as the top priority （55.9%） for seeking orthodontic treatment; however, in foreign inhabitants, the main reason for seeking treatment was to improve masticatory function（44.1%）, followed by ＂to be pretty＂ （35.2%）. The importance of well-aligned teeth and self-perception of psychosocial impact of malocclusion were the same two main factors influencing subjective orthodontic treatment need （P〈0.05） in foreign inhabitants and Chinese natives. Sub- jective orthodontic treatment need between the two target groups was significantly different （P〈0.05）. Conclusion （1） It was very common that Chinese natives were dissatisfied with their dental appearance, and their subjective orthodontic treatment needs were high. （2） There were some differences in orthodontic treatment motives between the two target groups. （3） There were differences in subjective orthodontic treatment needs between foreign inhabitants and Chinese natives. However, the prominent influential factors were almost the same. There may be benefit to understanding subjective orthodontic needs of different races.

Influence of Tooth Loss and Unmet Treatment Needs on the Social Aspects of Quality of Life and Self-esteem in Adolescents

Adolescence represents specific period of life and development,when young person is going through physical,emotional and mental changes,risking poor general and oral health outcome that might affect quality of life.Negative effects of poor oral health are various:difficulties with speaking and eating,pain and malfunction.This might cause emotional and mental problems,leading to avoidance of speaking,smiling and socializing with friends.Cross-sectional study included 234 participants(15-16 years old).The research instruments used in the study were questionnaire and clinical examination.Questionnaire referred to socio-demographic characteristics of participants,their oral and general health related habits,self-evaluation of confidence and successfulness and effect of oral impacts on daily performances.Clinical examination was used to determine dental status in terms of tooth loss,need for prosthodontic rehabilitation and presence of dental malocclusion.Results:24.6%(58)of adolescents had at least one tooth missing.Significant difference between the genders was obtained,as 32.5%girls had at least one tooth extracted compared to 8.1%of boys.Normative need for prosthodontic rehabilitation was present in 22.0%of subjects.Dental problems negatively affected their sleep and emotions(14.4%and 10.2%few times in period of one month).Data analyses pointed one correlation between extracted teeth and psychosocial aspect of participants'life(difficulties and embarrassment when smiling,talking and spending time with friends,emotional problems).Unmet normative need for prosthodonic or orthodontic treatment affected participants'ability to sleep and relax.Percentage of adolescents with extracted teeth was high,as well as normative treatment need for prosthodontic rehabilitation.Poor dental status affected quality of life of adolescents,especially emotional and mental well-being.Dental service should provide sufficient information to adolescents about prevention of tooth loss and consequences of teeth extraction,not only within masticatory function but also concerning oral health related quality of life.

Antiviral treatment standards for hepatitis B:An urgent need for expansion

The present letter to the editor is related to the review with the title“Past,present,and future of long-term treatment for hepatitis B virus.”Chronic hepatitis B(CHB)represents an important and pressing public health concern.Timely identification and effective antiviral therapy hold the potential to reduce liver-related mortality attributable to chronic infection with hepatitis B virus(HBV)substantially.However,the current global treatment rates for CHB remain conspicuously low,with the excessively stringent treatment criteria advocated by national CHB guidelines being a contributing factor to these low rates.Nevertheless,recent strides in comprehending this malady and the emergence of novel antiviral agents prompt the imperative re-evaluation of treatment standards to extend the sphere of potential beneficiaries.An impending need arises for a novel paradigm for the classification of patients with CHB,the expansion of antiviral treatment eligibility for HBV-infected individuals,and even the streamlining of the diagnostic process for CHB to amplify cost-effectiveness and augment survival prospects.

Advancing Evaluation of Microplastics Thresholds to Inform Water Treatment Needs and Risks

Although human health impacts of microplastics are not well understood,concern regarding chemical contaminants retained on or within them is growing.Drinking water providers are increasingly asked about these risks,but strategies for evaluating them and the extent of treatment needed to manage them are currently lacking.Microplastics can potentially induce health effects if the concentration of contaminants adsorbed to them exceeds predetermined drinking water guidelines(e.g.,Maximum Contaminant Levels).The risk posed by microplastics due to adsorbed contaminants is difficult to determine,but a worst-case scenario can be evaluated by using adsorption capacity.Here,a“Threshold Microplastics Concentration”(TMC)framework is developed to evaluate whether waterborne microplastic concentrations can potentially result in the intake of regulated contaminants on/in microplastics at levels of human health concern and identify treatment targets for managing associated health risk.Exceeding the TMC does not indicate an immediate health risk;it informs the need for detailed risk assessment or further treatment evaluation to ensure particle removal targets are achieved.Thus,the TMC concept and framework provide an updateable,science-based screening tool to determine if there is a need for detailed risk assessment or treatment modification due to waterborne microplastics in supplies used for potable water production.

Pathogenesis, diagnosis, and treatment of epilepsy: electromagnetic stimulation-mediated neuromodulation therapy and new technologies

Epilepsy is a severe,relapsing,and multifactorial neurological disorder.Studies regarding the accurate diagnosis,prognosis,and in-depth pathogenesis are crucial for the precise and effective treatment of epilepsy.The pathogenesis of epilepsy is complex and involves alterations in variables such as gene expression,protein expression,ion channel activity,energy metabolites,and gut microbiota composition.Satisfactory results are lacking for conventional treatments for epilepsy.Surgical resection of lesions,drug therapy,and non-drug interventions are mainly used in clinical practice to treat pain associated with epilepsy.Non-pharmacological treatments,such as a ketogenic diet,gene therapy for nerve regeneration,and neural regulation,are currently areas of research focus.This review provides a comprehensive overview of the pathogenesis,diagnostic methods,and treatments of epilepsy.It also elaborates on the theoretical basis,treatment modes,and effects of invasive nerve stimulation in neurotherapy,including percutaneous vagus nerve stimulation,deep brain electrical stimulation,repetitive nerve electrical stimulation,in addition to non-invasive transcranial magnetic stimulation and transcranial direct current stimulation.Numerous studies have shown that electromagnetic stimulation-mediated neuromodulation therapy can markedly improve neurological function and reduce the frequency of epileptic seizures.Additionally,many new technologies for the diagnosis and treatment of epilepsy are being explored.However,current research is mainly focused on analyzing patients’clinical manifestations and exploring relevant diagnostic and treatment methods to study the pathogenesis at a molecular level,which has led to a lack of consensus regarding the mechanisms related to the disease.

A novel solution treatment and aging for powder bed fusion-laser beam Ti-6Al-2Sn-4Zr-6Mo alloy:Microstructural and mechanical characterization

Ti-6Al-4Zr-2Sn-6Mo alloy is one of the most recent titanium alloys processed using powder bed fusion-laser beam(PBF-LB)technology.This alloy has the potential to replace Ti-6Al-4V in automotive and aerospace applications,given its superior mechanical properties,which are approximately 10%higher in terms of ultimate tensile strength(UTS)and yield strength after appropriate heat treatment.In as-built conditions,the alloy is characterized by the presence of soft orthorhombicα″martensite,necessitating a postprocessing heat treatment to decompose this phase and enhance the mechanical properties of the alloy.Usually,PBFed Ti6246 components undergo an annealing process that transforms theα″martensite into anα-βlamellar microstructure.The primary objective of this research was to develop a solution treatment and aging(STA)heat treatment tailored to the unique microstructure produced by the additive manufacturing process to achieve an ultrafine bilamellar microstructure reinforced by precipitation hardening.This study investigated the effects of various solution temperatures in theα-βfield(ranging from 800 to 875℃),cooling media(air and water),and aging time to determine the optimal heat treatment parameters for achieving the desired bilamellar microstructure.For each heat treatment condition,differentα-βmicrostructures were found,varying in terms of theα/βratio and the size of the primaryα-phase lamellae.Particular attention was given to how these factors were influenced by increases in solution temperature and how microhardness correlated with the percentage of the metastableβphase present after quenching.Tensile tests were performed on samples subjected to the most promising heat treatment parameters.A comparison with literature data revealed that the optimized STA treatment enhanced hardness and UTS by13%and 23%,respectively,compared with those of the annealed alloy.Fracture surface analyses were conducted to investigate fracture mechanisms.

Late effects of the treatment of childhood cancer

Excellent progress has been made in the last few decades in the cure rates of pediatric malignancies,with more than 80%of children with cancer who have access to contemporary treatment being cured.However,the therapies responsible for this survival can also produce adverse physical and psychological long-term outcomes,referred to as late effects,which appear months to years after the completion of cancer treatment.Research has shown that 60%to 90%of childhood cancer survivors(CCSs)develop one or more chronic health conditions,and 20%to 80%of survivors experience severe or life-threatening complications during adulthood.Therefore,understanding the late side effects of such treatments is important to improve the health and quality of life of the growing population of CCSs.

Controversies around the treatment of peritoneal metastases of colorectal cancer

In this editorial we examine the article by Wu et al published in the World Journal of Gastrointestinal Oncology.Surgical resection for peritoneal metastases from colorectal cancer(CRC)has been gradually accepted in the medical oncology community.A randomized trial(PRODIGE 7)on cytoreductive surgery(CRS)with hyperthermic intraperitoneal chemotherapy(HIPEC)failed to prove any benefit of oxaliplatin in the overall survival of patients with peritoneal metastases from colorectal origin.Nevertheless,isolated systemic chemotherapy for CRC stage IV has demonstrated a reduced response in peritoneal metastases than that obtained in other metastatic sites such as the liver.Another tool is required in those patients to achieve more local control of the disease.Surgical groups in peritoneal surgery continue to use HIPEC in their procedures,using other agents than oxaliplatin for peritoneal cavity infusion,such as mitomycin C.These patients present with complex surgical issues to manage,and consequently a large burden of complications has to be anticipated.Therefore,identifying patients who will benefit from CRS with or without HIPEC would be of great interest.

The emerging role of mesenchymal stem cell-derived extracellular vesicles to ameliorate hippocampal NLRP3 inflammation induced by binge-like ethanol treatment in adolescence

Our previous studies have reported that activation of the NLRP3(NOD-,LRR-and pyrin domain-containing protein 3)-inflammasome complex in ethanol-treated astrocytes and chronic alcohol-fed mice could be associated with neuroinflammation and brain damage.Mesenchymal stem cell-derived extracellular vesicles(MSC-EVs)have been shown to restore the neuroinflammatory response,along with myelin and synaptic structural alterations in the prefrontal cortex,and alleviate cognitive and memory dysfunctions induced by binge-like ethanol treatment in adolescent mice.Considering the therapeutic role of the molecules contained in mesenchymal stem cell-derived extracellular vesicles,the present study analyzed whether the administration of mesenchymal stem cell-derived extracellular vesicles isolated from adipose tissue,which inhibited the activation of the NLRP3 inflammasome,was capable of reducing hippocampal neuroinflammation in adolescent mice treated with binge drinking.We demonstrated that the administration of mesenchymal stem cell-derived extracellular vesicles ameliorated the activation of the hippocampal NLRP3 inflammasome complex and other NLRs inflammasomes(e.g.,pyrin domain-containing 1,caspase recruitment domain-containing 4,and absent in melanoma 2,as well as the alterations in inflammatory genes(interleukin-1β,interleukin-18,inducible nitric oxide synthase,nuclear factor-kappa B,monocyte chemoattractant protein-1,and C–X3–C motif chemokine ligand 1)and miRNAs(miR-21a-5p,miR-146a-5p,and miR-141-5p)induced by binge-like ethanol treatment in adolescent mice.Bioinformatic analysis further revealed the involvement of miR-21a-5p and miR-146a-5p with inflammatory target genes and NOD-like receptor signaling pathways.Taken together,these findings provide novel evidence of the therapeutic potential of MSC-derived EVs to ameliorate the hippocampal neuroinflammatory response associated with NLRP3 inflammasome activation induced by binge drinking in adolescence.

Advancing treatment strategies:Insights from network meta-analysis of hepatic arterial infusion chemotherapy for advanced hepatocellular carcinoma

This study examines the pivotal findings of the network meta-analysis of Zhou et al,which evaluated the efficacy of hepatic arterial infusion chemotherapy and combination therapies for advanced hepatocellular carcinoma(HCC).This meta-analysis suggests that therapeutic combinations have greater efficacy than do standard treatments.The article highlights the key insights that have the potential to shift current clinical practice and enhance outcomes for patients with advanced HCC.Additionally,this article discusses further research that can be conducted to optimize these treatments and achieve personalized care for patients with HCC.

Scalable Ir‑Doped NiFe_(2)O_(4)/TiO_(2) Heterojunction Anode for Decentralized Saline Wastewater Treatment and H_(2) Production

Wastewater electrolysis cells(WECs)for decentralized wastewater treatment/reuse coupled with H_(2) production can reduce the carbon footprint associated with transportation of water,waste,and energy carrier.This study reports Ir-doped NiFe_(2)O_(4)(NFI,~5 at%Ir)spinel layer with TiO_(2) overlayer(NFI/TiO_(2)),as a scalable heterojunction anode for direct electrolysis of wastewater with circumneutral pH in a single-compartment cell.In dilute(0.1 M)NaCl solutions,the NFI/TiO_(2) marks superior activity and selectivity for chlorine evolution reaction,outperforming the benchmark IrO_(2).Robust operation in near-neutral pH was confirmed.Electroanalyses including operando X-ray absorption spectroscopy unveiled crucial roles of TiO_(2) which serves both as the primary site for Cl−chemisorption and a protective layer for NFI as an ohmic contact.Galvanostatic electrolysis of NH4+-laden synthetic wastewater demonstrated that NFI/TiO_(2)not only achieves quasi-stoichiometric NH_(4)^(+)-to-N_(2)conversion,but also enhances H_(2)generation efficiency with minimal competing reactions such as reduction of dissolved oxygen and reactive chlorine.The scaled-up WEC with NFI/TiO_(2)was demonstrated for electrolysis of toilet wastewater.

Efficacy,safety and treatment satisfaction of transition to a regimen of insulin degludec/aspart:A pilot study

BACKGROUND There is a lack of clinical evidence on the efficacy and safety of transitioning from a thrice-daily pre-mixed insulin or basal-prandial regimen to insulin degludec/aspart(IDegAsp)therapy,with insufficient data from the Chinese population.AIM To demonstrate the efficacy,safety,and treatment satisfaction associated with the transition to IDegAsp in type 2 diabetes mellitus(T2DM).METHODS In this 12-week open-label,non-randomized,single-center,pilot study,patients with T2DM receiving thrice-daily insulin or intensive insulin treatment were transitioned to twice-daily injections of insulin IDegAsp.Insulin doses,hemoglobin A1c(HbA1c)levels,fasting blood glucose(FBG),hypoglycemic events,a Diabetes Treatment Satisfaction Questionnaire,and other parameters were assessed at baseline and 12-weeks.RESULTS This study included 21 participants.A marked enhancement was observed in the FBG level(P=0.02),daily total insulin dose(P=0.03),and overall diabetes treatment satisfaction(P<0.01)in the participants who switched to IDegAsp.There was a decrease in HbA1c levels(7.6±1.1 vs 7.4±0.9,P=0.31)and the frequency of hypoglycemic events of those who switched to IDegAsp decreased,however,there was no statistically significant difference.CONCLUSION The present findings suggest that treatment with IDegAsp enhances clinical outcomes,particularly FBG levels,daily cumulative insulin dose,and overall satisfaction with diabetes treatment.

Mechanism of cryorolling and aging treatment for enhancing corrosion properties of 2195 Al−Li alloy

The impact of cryorolling(CR)and room temperature rolling(RTR)followed by artificial aging on the corrosion characteristics of 2195 Al−Li alloy(AA2195)was studied.Transmission electron microscope,scanning electron microscope,optical microscope,intergranular corrosion experiment,and electrochemical experiment were used.Throughout different stages of aging treatment,the corrosion behavior of both CR and RTR samples exhibited a sequential progression of pitting corrosion,followed by intergranular corrosion,and then pitting corrosion again.The corrosion rates of both samples initially showed an increase,followed by a gradual stabilization over time.The size and density of T1 phase significantly influenced the corrosion performance of the alloy.During the peak aging and over-aging stages,the CR sample exhibited superior corrosion resistance to the RTR sample,attributed to its finer T1 phase.

Variations in quantifying patient reported outcome measures to estimate treatment effect

In the practice of healthcare,patient-reported outcomes(PROs)and PRO measures(PROMs)are used as an attempt to observe the changes in complex clinical situations.They guide us in making decisions based on the evidence regarding patient care by recording the change in outcomes for a particular treatment to a given condition and finally to understand whether a patient will benefit from a particular treatment and to quantify the treatment effect.For any PROM to be usable in health care,we need it to be reliable,encapsulating the points of interest with the potential to detect any real change.Using structured outcome measures routinely in clinical practice helps the physician to understand the functional limitation of a patient that would otherwise not be clear in an office interview,and this allows the physician and patient to have a meaningful conver-sation as well as a customized plan for each patient.Having mentioned the rationale and the benefits of PROMs,understanding the quantification process is crucial before embarking on management decisions.A better interpretation of change needs to identify the treatment effect based on clinical relevance for a given condition.There are a multiple set of measurement indices to serve this effect and most of them are used interchangeably without clear demarcation on their differences.This article details the various quantification metrics used to evaluate the treatment effect using PROMs,their limitations and the scope of usage and implementation in clinical practice.

Clinicopathological features and treatment of gastrointestinal schwannomas

BACKGROUND Gastrointestinal schwannomas(GIS)are rare neurogenic tumors arising from Schwann cells in the gastrointestinal tract.Studies on GIS are limited to small case reports or focus on specific tumor sites,underscoring the diagnostic and thera-peutic challenges they pose.AIM To comprehensively examine the clinical features,pathological characteristics,treatment outcomes,associated comorbidities,and prognosis of GIS.METHODS The study population included patients diagnosed with GIS at the First Affiliated Hospital,Zhejiang University School of Medicine,between June 2007 and April 2024.Data were retrospectively collected and analyzed from medical records,including demographic characteristics,endoscopic and imaging findings,treatment modalities,pathological evaluations,and follow-up information.RESULTS In total,229 patients with GIS were included,with a mean age of 56.00 years and a male-to-female ratio of 1:1.83.The mean tumor size was 2.75 cm,and most(76.9%)were located in the stomach.Additionally,6.6%of the patients had other malig-nant tumors.Preoperative imaging and endoscopy frequently misdiagnosed GIS as gastrointestinal stromal tumors.However,accurate preoperative diagnosis was achieved using endoscopic ultrasound-guided fine-needle aspiration combined with immunohistochemical analysis,in which S100 and SOX-10 markers were mostly positive.Smaller tumors were typically managed with endoscopic resection,while larger lesions were treated with surgical resection.Follow-up results showed that most patients experienced favorable outcomes.CONCLUSION Preoperative diagnosis of GIS via clinical characteristics,endoscopy,and imaging examinations remains challenging but crucial.Endoscopic therapy provides a minimally invasive and effective option for patients.

Treatment of thymoma with low-dose glucocorticoids before surgery for significant tumor shrinkage: A case report

BACKGROUND Thymic epithelial neoplasms are rare malignant neoplasms originating in the thymus gland.There have been case reports of patients with advanced thymomas treated with a methylprednisolone pulse or with glucocorticoid(GCs)shock be-fore surgery,followed by surgical treatment,all of whom achieved good results.The effect of GCs on thymomas is related mainly to the action on GC receptors in thymic lymphocytes and epithelial cells.GC receptor expression has been asso-ciated with a better prognosis in patients with thymomas,including those with surgically removed thymomas.CASE SUMMARY We report a case of a patient with thymoma who had a significant response to preoperative low-dose GC therapy.A mediastinal tumor was detected in the patient via computerized tomography upon admission.The tumor was initially suspected to be a thymic tumor,but lymphoma could not be ruled out.The tumor shrank significantly after low-dose(5 mg/day)GC therapy.Thoracoscopic thy-moma resection was performed after puncture pathology was confirmed.The patient recovered well after the operation and is currently performing well with no recurrence of the tumor.CONCLUSION This case highlights that low-dose GCs are effective in the treatment of thymomas,and we believe that GCs should be applied more frequently and studied more thoroughly in the treatment of thymomas.

Pancreatic primitive neuroectodermal tumors:Clinical features,treatment,and influencing factors

BACKGROUND Data on clinical characteristics,treatment outcomes,and prognosis of pancreatic primitive neuroectodermal tumors(PNETs)are limited.AIM To analyze the clinical data of 30 patients with pancreatic PNETs to identify their clinical characteristics and factors associated with prognosis.METHODS We used the keywords"primary neuroectodermal tumor,""digestive tract,""pancreas,""pancreatic,"and"gastrointestinal,"individually or in combination,to collect data from a global database for all patients with pancreatic PNET to date.Univariate and Cox regression analyses were performed to identify prognostic factors for patient survival.RESULTS A total of 30 cases of pancreatic PNET were included in this study:15 males and 15 females with a mean age of 24 years.The main symptom was abdominal pain(73.3%),and the median tumor size was 7.85 cm.Twenty-four patients(80.0%)underwent surgery and nineteen patients received adjuvant therapy.Local metastasis was observed in 13 patients(43.3%),lymph node metastasis in 10 patients(33.3%),and distant metastasis in 6 patients(20.0%).Local recurrence was observed in 13 patients(43.3%).The median survival time of all patients was 29.4 months,and the overall estimated 1-year and 3-year survival rates were approximately 66.0%and 36.4%,respectively.Univariate analysis showed that chemotherapy(P=0.036),local metastasis(P=0.041),lymph node metastasis(P=0.003),distant metastasis(P=0.049),and surgical margins(P=0.048)were the prognostic factors affecting survival.Multivariate analysis revealed only lymph node metastasis(P=0.012)as a prognostic factor.CONCLUSION Pancreatic PNET is extremely rare,occurs in young adults,has no apparent sex predisposition,has a high rate of metastasis and early recurrence,and has a very poor prognosis.The diagnosis of pancreatic PNET requires a combination of clinical symptoms,pathologic features,immunohistochemistry,and cytogenetic analysis.Univariate analysis suggested that chemotherapy,metastasis,and surgical margins were prognostic factors affecting survival,and multivariate analysis suggested that lymph node metastasis is an important prognostic factor.Therefore,early diagnosis,early and extensive resection,and adjuvant chemoradiotherapy may help improve prognosis.