Network meta-analysis of the prognosis of curative treatment strategies for recurrent hepatocellular carcinoma after hepatectomy

BACKGROUND Recurrent hepatocellular carcinoma(rHCC)is a common outcome after curative treatment.Retreatment for rHCC is recommended,but no guidelines exist.AIM To compare curative treatments such as repeated hepatectomy(RH),radiofrequency ablation(RFA),transarterial chemoembolization(TACE)and liver transplantation(LT)for patients with rHCC after primary hepatectomy by conducting a network meta-analysis(NMA).METHODS From 2011 to 2021,30 articles involving patients with rHCC after primary liver resection were retrieved for this NMA.The Q test was used to assess heterogeneity among studies,and Egger’s test was used to assess publication bias.The efficacy of rHCC treatment was assessed using disease-free survival(DFS)and overall survival(OS).RESULTS From 30 articles,a total of 17,11,8,and 12 arms of RH,RFA,TACE,and LT subgroups were collected for analysis.Forest plot analysis revealed that the LT subgroup had a better cumulative DFS and 1-year OS than the RH subgroup,with an odds ratio(OR)of 0.96(95%CI:0.31-2.96).However,the RH subgroup had a better 3-year and 5-year OS compared to the LT,RFA,and TACE subgroups.Hierarchic step diagram of different subgroups measured by the Wald test yielded the same results as the forest plot analysis.LT had a better 1-year OS(OR:1.04,95%CI:0.34-03.20),and LT was inferior to RH in 3-year OS(OR:10.61,95%CI:0.21-1.73)and 5-year OS(OR:0.95,95%CI:0.39-2.34).According to the predictive P score evaluation,the LT subgroup had a better DFS,and RH had the best OS.However,meta-regression analysis revealed that LT had a better DFS(P<0.001)as well as 3-year OS(P=0.881)and 5-year OS(P=0.188).The differences in superiority between DFS and OS were due to the different testing methods used.CONCLUSION According to this NMA,RH and LT had better DFS and OS for rHCC than RFA and TACE.However,treatment strategies should be determined by the recurrent tumor characteristics,the patient’s general health status,and the care program at each institution.

Current status and progress in laparoscopic surgery for gallbladder carcinoma

Gallbladder carcinoma(GBC)is the most common biliary tract malignancy associated with a concealed onset,high invasiveness and poor prognosis.Radical surgery remains the only curative treatment for GBC,and the optimal extent of surgery depends on the tumor stage.Radical resection can be achieved by simple cholecystectomy for Tis and T1a GBC.However,whether simple cholecystectomy or extended cholecystectomy,including regional lymph node dissection and hepatectomy,is the standard surgical extent for T1b GBC remains controversial.Extended cholecystectomy should be performed for T2 and some T3 GBC without distant metastasis.Secondary radical surgery is essential for incidental gallbladder cancer diagnosed after cholecystectomy.For locally advanced GBC,hepatopancreatoduodenectomy may achieve R0 resection and improve long-term survival outcomes,but the extremely high risk of the surgery limits its implementation.Laparoscopic surgery has been widely used in the treatment of gastrointestinal malignancies.GBC was once regarded as a contraindication of laparoscopic surgery.However,with improvements in surgical instruments and skills,studies have shown that laparoscopic surgery will not result in a poorer prognosis for selected patients with GBC compared with open surgery.Moreover,laparoscopic surgery is associated with enhanced recovery after surgery since it is minimally invasive.

Identification and characterization of a curly-leaf locus CL1 encoding an IAA2 protein in Brassica napus

The leaf is the main organ for rapeseed photosynthesis,and its morphology influences photosynthetic efficiency and supports increased planting density and yield.However,the molecular regulatory mechanism of leaf morphology in Brassica napus is poorly understood,restricting progress in breeding for the trait.We describe a novel dominant mutation,curly leaf 1(cl1),which confers uneven dorsal–ventral axis development,irregular cellular structure and influenced gravitropic response in the seedling stage.The CL1 locus was mapped to a 1.573-Mb interval on chromosome A05 using simple sequence repeat(SSR)markers,and co-segregated with the phenotype of plants in the curly F2 population.A substitution(P62S)was identified in the highly conserved degron motif(GWSPV)of the IAA2 protein in the cl1mutant,and the P62S substitution impaired the interaction between IAA2 and TIR1 in the presence of auxin,influencing auxin signaling.The P62S substitution-induced curly leaf phenotype was verified by ectopic expression of Bna A05.iaa2 in Arabidopsis and B.napus.Our findings explain the function of IAA2 in rapeseed,providing a foundation for future investigation of auxin signaling and the mechanisms underlying leaf development in B.napus.

Intensive follow-up vs conventional follow-up for patients with nonmetastatic colorectal cancer treated with curative intent:A metaanalysis

BACKGROUND The frequency and content of follow-up strategies remain controversial for colorectal cancer(CRC),and scheduled follow-ups have limited value.AIM To compare intensive and conventional follow-up strategies for the prognosis of non-metastatic CRC treated with curative intent using a meta-analysis.METHODS PubMed,Embase,and the Cochrane Library databases were systematically searched for potentially eligible randomized controlled trials(RCTs)from inception until April 2023.The Cochrane risk of bias was used to assess the methodological quality of the included studies.The hazard ratio,relative risk,and 95%confidence interval were used to calculate survival and categorical data,and pooled analyses were performed using the random-effects model.Additional exploratory analyses were performed for sensitivity,subgroups,and publication bias.RESULTS Eighteen RCTs involving 8533 patients with CRC were selected for the final analysis.Intensive follow-up may be superior to conventional follow-up in improving overall survival,but this difference was not statistically significant.Moreover,intensive follow-up was associated with an increased incidence of salvage surgery compared to conventional follow-up.In addition,there was no significant difference in the risk of recurrence between intensive and conventional follow-up strategies,whereas intensive follow-up was associated with a reduced risk of interval recurrence compared to conventional follow-up.Finally,the effects of intensive and conventional follow-up strategies differed when stratified by tumor location and follow-up duration.CONCLUSION Intensive follow-up may have a beneficial effect on the overall survival of patients with non-metastatic CRC treated with curative intent.

Construction of curcumin-loaded micelles and evaluation of the anti-tumor effect based on angiogenesis

Objective:Inhibition of tumor angiogenesis has become a new targeted tumor therapy.In this study,we established a micellar carrier with a tumor neovascularization-targeting effect modified by the neovascularization-targeting peptide NGR.Methods:The targeted polymer poly(ethylene glycol)-b-poly(lactide-co-glycolide)(PEG-PLGA)modified with Asn–Gly–Arg(NGR)peptide was prepared and characterized by 1H nuclear magnetic resonance and Fourier-transform infrared spectrometry.NGR-PEG-PLGA was used to construct curcumin(Cur)-loaded micelles by the solvent evaporation method.The physicochemical properties of the micelles were also investigated.Additionally,we evaluated the antitumor efficacy of the polymer micelles(PM)using in vitro cytology experiments and in vivo animal studies.Results:The particle size of Cur-NGR-PM was 139.70±2.51 nm,and the drug-loading capacity was 14.37±0.06%.In vitro cytological evaluation showed that NGR-modified micelles showed higher cellular uptake through receptor-mediated endocytosis pathways than did unmodified micelles,leading to the apoptosis of tumor cells.Then,in vivo antitumor experiments showed that the modified micelles significantly inhibited tumor growth and were safe.Conclusions:NGR-modified micelles significantly optimized the therapeutic efficacy of Cur.This strategy offers a viable avenue for cancer treatment.

Characteristics of gastric cancer recurrence five or more years after curative gastrectomy

Objective： To investigate the characteristics of recurrences that occurred 5 or more years after curative resection for gastric cancer.Methods： We analyzed recurrences among 1,299 patients with gastric cancer who underwent curative operations at the Department of Surgery, Inje University Seoul Paik Hospital between September 1998 and December 2002. Recurrences were classified as within 2 years （early）, 2-5 years （intermediate）, and more than 5 years （late） after gastrectomy. The clinicopathologic findings of the patients with late recurrence were compared with those of patients in the other two recurrence groups, with special reference to the patterns of recurrence. Both univariate and multivariate analyses were performed, incorporating factors such as operation type, T-stage, N-stage, stage, lymphatic invasion, neural invasion, histology, tumor size, and recurrence site.Results： At the time of last follow-up, recurrence occurred in 266 （20.5%） patients. Recurrence times were classified as 〈2 years （182 patients）, 2-5 years （61 patients）, or 〉5 years （23 patients）. The late recurrence rate was 8.6%. The occurrence of recurrence 〉5 years after gastrectomy was significantly correlated with age, operation type, T-stage, N-stage, stage, lymphatic invasion, neural invasion, histology, tumor size, location and recurrence site （P〈0.05）. The main recurrence patterns in the 23 patients with late recurrence were locoregional metastasis （10 patients, 43.5%）, peritoneal seeding （8 patients, 34.8%）, hematogenous metastasis （2 patients, 8.7%）, and multiple metastasis （3 patients, 13.0%）. A multivariate analysis showed that larger tumor size and younger age were independent prognostic factors for late recurrence. Additionally, locoregional and peritoneal recurrences were significantly more common than hematogenous recurrences. Conclusions： Although late recurrence was uncommon, younger age and larger tumor size were associated with high risk. Follow-up surveillance is recommended for locoregional and peritoneal metastasis.

基本线性计算模型的CUR分析与并行程序有效速度的实用测定方法

具有巨量数据的科学计算程序在并行计算机上的有效速度往往是很低的,因此需要尽可能地借助算法来改善这种状况。基于高性能科学计算中对某些基本线性计算模型的处理要耗费大部分CPU时间以及cache具有较高速度这一事实,文章着重对这些计算模型的cache利用率CUR(CacheUsingRatio)进行了分析与实验比较,同时也对用户如何获取程序的浮点运算速度的方法进行了讨论。

Role of hepatectomy for recurrent or initially unresectable hepatocellular carcinoma

As a result of donor shortage and high postoperative morbidity and mortality after liver transplantation,hepatectomy is the most widely applicable and reliable option for curative treatment of hepatocellular carcinoma(HCC).Because intrahepatic tumor recurrence is frequent after loco-regional therapy,repeated treatments are advocated provided background liver function is maintained.Among treatments including local ablation and transarterial chemoembolization,hepatectomy provides the best long-term outcomes,but studies comparing hepatectomy with other nonsurgical treatments require careful review for selection bias.In patients with initially unresectable HCC,transarterial chemo-or radio-embolization,and/or systemic chemotherapy can down-stage the tumor and conversion to resectable HCC is achieved in approximately 20%of patients.However,complete response is rare,and salvage hepatectomy is essential to help prolong patients’survival.To counter the short recurrence-free survival,excellent overall survival is obtained by combining and repeating different treatments.It is important to recognize hepatectomy as a complement,rather than a contraindication,to other nonsurgical treatments in a mul-tidisciplinary approach for patients with HCC,including recurrent or unresectable tumors.

基于CUR矩阵分解的多核学习正则化路径近似算法

多核学习在解决不规则、大规模数据问题时表现出良好的优越性。正则化路径是一种多次求解多核学习,选择最优模型的措施。针对多核学习正则化路径算法处理大规模数据时,核矩阵规模较大,计算代价高,影响优化模型效率的问题,提出一种基于CUR矩阵分解的多核学习正则化路径近似算法(Multiple kernel learning regularization path approximation algorithm with CUR,MKLRPCUR)。该算法首先采用CUR算法获得核矩阵的低秩近似矩阵的多个分解矩阵,然后在求解过程中利用低维的分解矩阵相乘替代核矩阵,调整相关矩阵计算的顺序,从而简化算法中核矩阵和拉格朗日乘子向量乘积的计算。MKLRPCUR算法降低了矩阵的计算规模,优化了矩阵计算,提高了精确算法的计算效率。从理论上分析低秩近似矩阵的相对误差和算法的时间复杂度,验证了近似算法的合理性。同时,在UCI数据集、ORL和COIL图像数据库上的实验结果表明,本文提出的近似算法不仅保证了学习的准确率,并且降低了算法的运行时间,提高了模型的效率。

mPGES-1 expression in non-cancerous liver tissue impacts on postoperative recurrence of HCC

AIM:To investigate whether microsomal prostaglandin E synthase-1 (mPGES-1) expression in hepatocellular carcinoma (HCC) and in non-cancerous liver affects HCC prognosis after hepatectomy. METHODS: The relationship between patient clinical prof iles, tumor factors, surgical determinants, and mPGES-1 expression and the recurrence-free survival rate were examined in 64 patients who underwent curative hepatectomy between March 2003 and December 2006. RESULTS: The scores for mPGES-1 expression were higher in well differentiated and moderately differentiated HCC tissues than in poorly differentiated HCC tissues (well differentiated, 5.1 ± 2.7; moderately differentiated, 5.1 ± 1.7; poorly differentiated, 3.0 ± 1.8). In noncancerous liver tissues, the mPGES-1 levels were higher in injured liver tissues than in normal tissues. Cirrhotic livers had higher mPGES-1 levels than livers with chronic hepatitis (normal livers, 3.3 ± 0.7; chronic hepatitic livers, 5.4 ± 1.9; cirrhotic livers, 6.4 ± 1.6). A univariate analysis revealed that the recurrence-free survival rate was signif icantly lower in patients with vascular invasion,a higher mPGES-1 level in non-cancerous liver tissue,a larger tumor diameter (≥5 cm), and a lower serum albumin level (≤3.7 g/dL). The mPGES-1 expression in HCC tissues did not correlate well with postoperative recurrence. A multivariate analysis demonstrated that the presence of vascular invasion and higher mPGES-1 levels were statistically significant independent predictors for early postoperative recurrence of HCC.CONCLUSION: Increased mPGES-1 expression in noncancerous liver tissues is closely associated with the early recurrence of HCC after curative resection.

System security of hybrid AC-HVDC-systems challenges and new approaches for combined security assessment,preventive optimization and curative actions

The intense application of Voltage Source Converter based HVDC interconnections and grids will result in a hybrid AC-HVDC-system. The operation of such a system becomes complex regarding system security and system operation. This paper describes major challenges and proposes potential solutions, including a combined security assessment, preventive optimization and curative actions. A coordination of both systems enables an efficient application of existing transport capacity.

Bone metastasis from early gastric cancer following non-curative endoscopic submucosal dissection

A 67-year-old male underwent endoscopic submucosal dissection(ESD)to treat early gastric cancer(EGC)in 2001.The lesion(50 mm × 25 mm diameter)was histologically diagnosed as poorly differentiated adenocarcinoma,with an ulcer finding.Although the tumor was confined to the mucosa with no evidence of lymphovascular involvement,the ESD was regarded as a noncurative resection due to the histological type,tumor size,and existence of an ulcer finding(as indicated by the 2010 Japanese gastric cancer treatment guidelines,ver.3).Despite strong recommendation for subsequent gastrectomy,the patient refused surgery.An alternative follow-up routine was designed,which included five years of biannual clinical examinations to detect and measure serum tumor markers and perform visual assessment of recurrence by endoscopy and computed tomography scan after which the examinations were performed annually.The patient's condition remained stable for eight years,until a complaint of back pain in 2010 prompted further clinical investigation.Bone scintigraphy indicated increased uptake.Histological examination of biopsy specimens taken from the lumbar spine revealed adenocarcinoma resembling the carcinoma cells from the EGC that had been treated previously by ESD,and which was consistent with immunohistochemical findings of gastrointestinal tract cancer.Thus,the diagnosis of bone metastasis from EGC was made.The reported rates of EGC recurrence in surgically resected cases range 1.4%-3.4%,but among these bone metastasis is very rare.To our knowledge,this is the first reported case of bone metastasis from EGC following a non-curative ESD and occurring after an eight-year disease-free interval.

基于CUR矩阵分解的网络异常大数据检测算法

大数据通过网络储存与使用信息,若没有相应的安全防护手段,其信息网络内会出现部分异常数据,使用户隐私安全受到威胁,对此提出一种基于CUR矩阵分解的网络异常大数据检测算法,通过二进尺度参数分析数据信号特性,依靠小波模极大值去除数据内干扰噪声,拟定正常区间与观测区间描述数据特征,构建异常大数据检测指标,将大数据转变成二进制表示形式组建邻接矩阵,重构数据获得残差矩阵,以上述两种矩阵和对应参数当作输入,交替更新矩阵,得到数据内残差数值,结合检测指标实现对网络异常大数据的检测。实验证明,所提方法的检测精准度高,在存在白噪声的状况下依然能够成功检测出网络大数据内存在的异常数据,抗干扰性强。

OBSERVATION OF CURATIVE EFFECT ON EOSINOPHILIC GASTROENTERITIS BY TREATMENT WITH METHOD OF REINFORCEMENT OF ESSENCE OF THE KIDNEY

12 patients with eosinophilic gastroenteritis were treated with prescriptions and drugs based mainly on the method of reinforcement of essence of the kidney. Remarkable curative effect was achieved in 9 cases and eutherapeutk effect in 3, Le, the cure rate was 100%. The efficacy began to appear hi a minimum of 7 days and a maximum of 12 days. There was no recurrence over 1 to 3 years’ follow-up observation.

基于2-RCU/CUR并联机构的运动学分析

目的随着产品的种类的丰富,出现了各类产品喷码方式不同的问题。为使得喷码机适用于不同产品,文中提出一种转动幅度较大的2-RCU/CUR机构,用于多种类产品喷码。方法应用螺旋理论对2-RCU/CUR机构进行自由度分析,并用改进的G-K公式进行验证,用闭环矢量法对机构的位置分析进行反解,在SolidWorks软件中绘制出机构模型,最后用Matlab软件对机构工作空间编程求解并绘制出工作空间。结果 2-RCU/CUR并联机构具有3个自由度,分别为2个转动自由度和1个移动自由度,在机构的工作空间内,动平台绕y轴的转动可达90°,且在工作空间内没有奇异位型。结论 2-RCU/CUR并联机构结构简单且稳定,工作精度高,工作空间较大,可以适用于多种产品喷码流程,可以提高经济效益。

高维数据降维中SVD与CUR分解对比分析

在大数据分析和处理中有许多常用的降维方法,在线性降维中典型的方法有SVD分解和CUR分解,但是对这两种方法的使用条件和实际效果研究甚少。基于此,通过对SVD与CUR分解原理和实验结果的探讨,分析了这两种降维方法的使用条件和实际效果。

Promote the Compression Efficiency of Digital Images by Using Improved CUR Matrix Decomposition Algorithm

In order to overcome the problem that the CUR matrix decomposition algorithm loses a large amount of information when compressing images, the quality of reconstructed images is not high, we propose a CUR matrix decomposition algorithm based on standard deviation sampling. Because of retaining more image information, the reconstructed image quality is higher under the same compression ratio. At the same time, in order to further reduce the amount of image information lost during the sampling process of the CUR matrix decomposition algorithm, we propose the SVD-CUR algorithm. The experimental results verify that our algorithm can achieve high image compression efficiency, and also demonstrate the high precision and robustness of CUR matrix decomposition algorithm in dealing with low rank sparse matrix data.

3-CUR并联分拣机器人的运动学分析与仿真

目的我国传统的食品生产行业,以人工分拣为主,自动化程度低,需耗费大量的劳动力,设计一种3-CUR并联机器人,用于食品生产的快速分拣。方法运用螺旋理论分析了该机构的自由度数目和类型,并且用修正的Grubler-Kutzbach公式对该机构的自由度进行了验证。接着使用D-H运动链参数表示法和欧拉角表示法,求解该机构的位置反解,采用三维动态法和Matlab软件对该并联分拣机器人的工作空间进行了分析与仿真,最后利用ADAMS软件对该机器人的运动性能进行了仿真分析。结果该机构可以实现一平(沿z轴的平动)两转(绕x轴y轴的转动)的运动,工作空间大,可达范围广,没有出现奇异点,末端执行器各参数的运动曲线呈有规律的周期性变化,可满足分拣机器人所需的运动和工作范围。结论该机构运动性能优越,稳定性好,具有良好的工作空间,可实现食品生产过程中的高速自动扫描和分拣,在包装自动化领域具有潜在的应用价值。

Current opinion on lymphadenectomy in pancreatic cancer surgery

BACKGROUND:Adenocarcinoma of the pancreas exhibits aggressive behavior in growth,inducing an extremely poor prognosis with an overall median 5-year survival rate of only 1%-4%.Curative resection is the only potential therapeutic opportunity. DATA SOURCES:A PubMed search of relevant articles published up to 2009 was performed to identify information about the value of lymphadenectomy and its extent in curative resection of pancreatic adenocarcinoma. RESULTS:Despite recent advances in chemotherapy,radio-therapy or even immunotherapy,surgery still remains the major factor that affects the outcome.The initial promising performance in Japan gave conflicting results in Western countries for the extended and more radical pancreatectomy; it has failed to prove beneficial.Four prospective,randomized trials on extended versus standard lymphadenectomy during pancreatic cancer surgery have shown no improvement in long-term survival by the extended resection.The exact lymph node status,including malignant spread and the total number retrieved as well as the lymph node ratio,is the most important prognostic factor.Positive lymph nodes after pancreatectomy are present in 70%.Paraaortic lymph node spread indicates poor prognosis. CONCLUSIONS:Undoubtedly,a standard lymphadenectomy including>15 lymph nodes must be no longer preferred in patients with the usual head location.The extended lymphadenectomy does not have any place,unless in randomized trials.In cases with body or tail location,the radical antegrade modular pancreatosplenectomy gives promising results.Nevertheless,accurate localization and detailed examination of the resected specimen are required for better staging.

Risk factors of poor prognosis and portal vein tumor thrombosis after curative resection of solitary hepatocellular carcinoma

BACKGROUND:Predictors of poor prognosis of solitary hepatocellular carcinoma(SHCC),a subgroup encompassing most patients with the malignancy,are still controversial.Hence,risk factors for portal vein tumor thrombosis(PVTT) in SHCC are obscure.The present study was designed to address this issue.METHOD:Clinicopathological and follow-up data for 156 consecutive patients with SHCC following curative hepatic resection were analyzed using uni-and multi-variate analyses.RESULTS:Univariate analysis showed that PVTT,tumornode-metastasis(TNM) stage,Edmondson-Steiner grade and preoperative serum alpha-fetoprotein(AFP) level were associated with the overall and disease-free survival,whereas tumor size only influenced the overall survival.In multivariate Cox regression tests,Edmondson-Steiner grade and TNM stage were independent prognostic markers for both overall and diseasefree survival.In addition,the Chi-square test showed that AFP level and Edmondson-Steiner grade were correlated with PVTT.Among them,only Edmondson-Steiner grade was shown to be of independent significance for PVTT in multi-variate logistic regression analysis.Additionally,AFP,the sole preoperative factor for PVTT,was not adequately sensitive and specific.CONCLUSIONS:Factors relating to post-surgical prognosis and PVTT in SHCC are all tumor-related.Of these,EdmondsonSteiner grade and TNM stage might be of particular importance in survival analysis.In addition,accurate prediction of PVTT by clinicopathological parameters before surgery remains difficult.