Cost of Medical Treatment for Primary Open-Angle Glaucoma in Relation to Patients’ Income and Its Impact on the Prognosis of the Disease, in Bouaké University Hospital

Introduction: Medical treatment for POAG is continuous and lifelong treatment. The aim of this study was to evaluate the relationship between the cost of this treatment and patients’ income and the impact of this relationship on treatment compliance. Materials and Methods: Prospective cross-sectional study with a descriptive aim covering sociodemographic data, average incomes, and direct and indirect costs of treatment of 57 patients followed for POAG during the period from January 1, 2012, to December 31, 2016 (5 years). Results: The patients were aged 25 to 77 years (mean = 54.4 years) with a male predominance (sex ratio = 1.5). Retirees were the most represented (26.32%), followed by workers in the informal sector (14.04%) and housewives (12.28%). Patients who had an annual income less than or equal to 900,000 CFA francs (€1370.83) per year represented 56.14% and those who did not have health coverage represented 57.89%. The treatment was monotherapy (64.91%), dual therapy (31.58%) or triple therapy (3.05%) and the average ratio of “annual cost of treatment to annual income” was 0.56 with for maximum 2.23 and 0.02 as minimum. Patients who considered the cost of treatment unbearable for their income represented 78.95%. Conclusion: Prevention of blindness due to glaucoma requires early detection but also the establishment of health coverage mechanisms to improve compliance with medical treatment. In addition, consideration should be given to the development of glaucoma surgery in our country, the indication of which could be the first intention in certain patients, considering for those patients, the geographical and financial accessibility of medical treatment. .

Monogenic gene therapy for glaucoma and optic nerve injury

The prevalence of glaucoma, the second leading cause of global blindness, is increasing due to aging populations. In glaucoma, degeneration of the optic nerve and retinal ganglion cells(RGCs) causes visual field defects and eventual blindness.

Clinical Application of Cataract Ultrasonic Emulsification Combined with Atrial Angle Segmentation in the Treatment of Primary Angle-Closure Glaucoma

Objective:To evaluate the therapeutic effect of cataract ultrasonic emulsification(PE)combined with atrial angle separation(CSS)for primary angle-closure glaucoma(PACG).Methods:78 patients with PACG admitted to the hospital between October 2021 and October 2023 were selected and grouped by randomized numerical table;39 cases were counted in the observation group and selected PE combined with CSS surgery;39 cases were counted in the reference group and selected PE combined with trabeculectomy and the total effective rate,the state of the atrial angle,the clinical indexes,the degree of ocular symptoms,and the complication rate were compared.Results:The total effective rate of the observation group was higher than that of the reference group,and the percentage of the wide atrial angle of the atrial angle status was higher than that of the reference group;3 months after the operation,the logarithm of the minimum angle of resolution(Log MAR)and intraocular pressure of the observation group was lower than that of the reference group,and the central anterior chamber depth(ACD)was greater than that of the reference group;the scores of the degree of ocular symptoms of the observation group were lower than that of the reference group,and the rate of complication was lower than that of the reference group(P<0.05).Conclusion:PE combined with CSS surgical treatment for PACG patients can improve the efficacy of treatment,improve the state of the patients’atrial angles,and restore the ocular function indexes.It can alleviate the ocular symptoms as soon as possible and has a high surgical safety.

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.

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.

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.

Assessing microcatheter-assisted 360-degree trabeculotomy combined with trabeculectomy for refractory glaucoma:1-year results

AIM:To evaluate the efficacy and safety of microcatheterassisted 360-degree trabeculotomy combined with trabeculectomy(MATT-Trab)for treating refractory glaucoma.METHODS:Patients with refractory glaucoma who underwent MATT-Trab were retrospectively examined.Efficacy indicators for research statistics included the intraocular pressure(IOP)level,degree of decrease,changes in medication dosage,and success rate.Safety indicators included the best-corrected visual acuity and incidence of complications.RESULTS:This study comprised 31 patients,including 11 males and 20 females,with ages ranging from 8mo to 67y(mean age:29.40±22.10y).The average postoperative IOP at 1d,1wk,1mo,3mo,6mo,1y,and the last followup was significantly lower than the average preoperative IOP(31.33±9.24 mm Hg,P<0.05).The average number of postoperative medications at 1y was 0.48±1.51,which was significantly reduced compared to that used preoperatively(3.77±0.99,P=0.00).The absolute and qualified success rates were 45.16% and 83.87%,respectively.Visual acuity exhibited no statistically significant difference between the postoperative and preoperative follow-up time points,except for the first day after surgery.The most common postoperative complications were anterior chamber hemorrhage(25 cases,86.21%)and high IOP(10 cases,34.48%).CONCLUSION:Our results indicate that MATT-Trab is effective and safe for treating refractory glaucoma.

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.

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.

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.

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.

Outcomes of a non-diffractive extended depth of focus intraocular lens in patients with well-controlled glaucoma and ocular hypertension

AIM:To assess visual outcomes and satisfaction of a non-diffractive extended depth of focus(EDOF)intraocular lens(IOL)in individuals with ocular hypertension(OHT)and well-controlled mild glaucoma undergoing cataract surgery.METHODS:An investigator-initiated,single-center,prospective,interventional,noncomparative study conducted in Montreal,Canada.The study enrolled 31 patients(55 eyes)with OHT or mild glaucoma who received a non-diffractive EDOF IOL(Acrysof IQ Vivity).Participants underwent sequential cataract surgery with the Vivity IOL.Follow-up evaluations occurred at 1d,1,and 3mo postoperatively,assessing uncorrected distance,intermediate,and near visual acuity.Questionnaires(QUVID:Questionnaire for visual disturbances and IOLSAT:Intraocular lens satisfaction)were administered pre and post-operatively to measure visual disturbances and spectacle independence in various lighting.Safety parameters included intraocular pressure(IOP),glaucoma medications,spherical equivalence,mean deviation and pattern standard deviation or square root of lost variance on Octopus visual field.RESULTS:At 1 and 3mo postoperatively,significant improvements were observed in uncorrected distance and intermediate visual acuity.Spectacle independence was enhanced for distance and intermediate vision,especially in bright light settings.Spectacle-free intermediate vision was improved even in dim lighting.Visual disturbances,particularly glare symptoms,were reduced,and there was a notable decrease in IOP and glaucoma medication burden at 3mo.There was more hazy vision postoperatively with no impact on visual acuity and visual satisfaction.CONCLUSION:The non-diffractive EDOF lens improves distance and intermediate spectacle-free visual function in patients with OHT and well-controlled glaucoma.The findings highlight significant improvements in visual acuity,reduced glare,enhanced spectacle independence,and improved visual performance in different lighting conditions.

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.

Glaucomatous retinal ganglion cells:death and protection

Glaucoma is a group of diseases characterized by progressive optic nerve degeneration,with the characteristic pathological change being death of retinal ganglion cells(RGCs),which ultimately causes visual field loss and irreversible blindness.Elevated intraocular pressure(IOP)remains the most important risk factor for glaucoma,but the exact mechanism responsible for the death of RGCs is currently unknown.Neurotrophic factor deficiency,impaired mitochondrial structure and function,disrupted axonal transport,disturbed Ca2+homeostasis,and activation of apoptotic and autophagic pathways play important roles in RGC death in glaucoma.This review was conducted using Web of Science,PubMed,Project,and other databases to summarize the relevant mechanisms of death of RGCs in glaucoma,in addition to outlining protective treatments to improve the degradation of RGCs.

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.

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 and safety of combined Kahook Dual Blade goniotomy with phacoemulsification in Chinese patients with primary open angle glaucoma

AIM:To report the one-year surgical outcome Kahook Dual Blade goniotomy combined with phacoemulsification(KDB-Phaco)in Chinese patients with primary open angle glaucoma(POAG).METHODS:This is a retrospective study included 43 eyes of 28 Chinese POAG patients with cataract who accepted KDB-Phaco and followed-up for 12mo.Intraocular pressure(IOP),glaucoma medications and surgical complications were recorded.Success 1 and success 2 was defined as 5-21 mm Hg and 5-18 mm Hg,and success plus was determined if additional criteria of IOP reduction≥20%from baseline was reached.A corrected IOP by adding 3 mm Hg for each medication was used to do correlation test.Cox’s proportional hazards regression model was used to test the hazard ratio for factors associated with surgical success.RESULTS:After a 12-month follow up,the IOP decreased from 28.1±6.3 to 13.8±3.0 mm Hg(47.92%reduction,P<0.001),and the medications used decreased from 2.0(1.0)to 0.0(0.0)(95%reduction,P<0.001).The mean IOP of all postoperative visits were lower than preoperative IOP(all P<0.001),so as the number of glaucoma medications(all P<0.001).Complete success 1 and qualified success 1 were 87.80%and 100.00%respectively.The complete success 1 plus and qualified success 1 plus were 85.37%and 97.56%,respectively.Totally 82.93%and 90.24%of patients got complete success 2 and qualified success 2 while 80.49%and 87.80%of patients satisfied complete success 2 plus and qualified success 2 plus.Age(r=-0.511,P=0.001)and visual acuity(VA;r=-0.321,P=0.041)were negatively correlated with postoperative corrected IOP at 12mo,while anterior chamber depth(r=0.432,P=0.005),mean deviation(r=0.617,P<0.001)and visual field index(r=0.524,P<0.001)were positively correlated with it.Preoperative VA(OR=33.092,P=0.004)and MD(OR=1.481,P=0.018)were hazard factors associated with failure based on qualified success as 18 mm Hg.The main complications of KDB were hyphema(9.30%),IOP spike(11.63%)and peripheral anterior synechia(6.98%).CONCLUSION:KDB goniotomy is a safe and effective in the treatment for Chinese POAG patients.Preoperative VA and mean deviation may predict the surgical success.

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.

Advances in radiotherapy in the treatment of esophageal cancer

Recent advancements in radiotherapy for esophageal cancer have significantly improved treatment outcomes and patient quality of life.Traditional radiotherapy techniques have been enhanced by the integration of advanced imaging and precision targeting technologies,such as intensity-modulated radiotherapy and proton therapy,which allow for more accurate tumor targeting while minimizing damage to surrounding healthy tissues.Additionally,combining radiotherapy with immunotherapy has shown promising results,leveraging the body’s im-mune response to enhance the effectiveness of cancer treatment.Studies have also highlighted the benefits of neoadjuvant chemoradiation followed by surgical resection,which has been associated with improved overall survival rates com-pared to radiotherapy alone.These innovations are paving the way for more effe-ctive and personalized treatment strategies,offering new hope for patients with esophageal cancer.