Clinical value of combining epirubicin with mindfulness intervention in patients with urinary system tumors and depression

BACKGROUND Urinary system tumors often cause negative psychological symptoms,such as depression and dysphoria which significantly impact immune function and indirectly affect cancer prognosis.While epirubicin(EPI)is recommended by the European Association of Urology and can improve prognosis,its long-term use can cause toxic side effects,reduce treatment compliance,and increase psycho-logical burden.Therefore,an appropriate intervention mode is necessary.METHODS This was a retrospective study including 110 patients with urinary system tumors and depression admitted to Zhumadian Central Hospital between March 2021 and July 2023.Patients were divided into conventional(n=55)and joint inter-vention(n=55)groups.The conventional group received mitomycin and routine nursing,while the joint intervention group received EPI and mindfulness intervention.Both groups underwent three cycles of chemotherapy.Immune function(CD4+cells,CD8+cells,CD4+/CD8+ratio),tumor marker levels[urinary bladder cancer antigen(UBC),bladder tumor antigen(BTA)and nuclear matrix protein 22(NMP22)],quality of life questionnaire-core 30(QLQ-C30),17-item Hamilton depression scale(HAMD-17),and cancer-related fatigue[cancer fatigue scale(CFS)]were assessed.Adverse reactions and nursing satisfaction were recorded and evaluated.RESULTS Post-intervention,CD4+,CD8+,and CD4+/CD8+levels increased in both groups,with the joint intervention group showing more significant improvement(P<0.05).Tumor marker levels(NMP22,BTA,and UBC)were lower in the joint intervention group compared to the conventional group(P<0.05).The joint intervention group also showed a greater reduction in HAMD-17 scores(9.38±3.12 vs 15.45±4.86,P<0.05),higher QLQ-C30 scores,and lower CFS scores(both P<0.05).Additionally,the joint intervention group had a lower incidence of adverse reactions and higher nursing satisfaction(P<0.05).CONCLUSION EPI combined with mindfulness intervention significantly improved clinical outcomes in patients with urinary system tumors and depression and is worthy of clinical application.

Metformin and pancreatic neuroendocrine tumors:A systematic review and meta-analysis

BACKGROUND Most patients with advanced pancreatic neuroendocrine tumors(pNETs)die due to tumor progression.Therefore,identifying new therapies with low toxicity and good tolerability to use concomitantly with the established pNET treatment is relevant.In this perspective,metformin is emerging as a molecule of interest.Retrospective studies have described metformin,a widely used agent for the treatment of patients with type 2 diabetes mellitus(T2DM),to be effective in modulating different tumor-related events,including cancer incidence,recurrence and survival by inhibiting mTOR phosphorylation.This systematic review evaluates the role of T2DM and metformin in the insurgence and post-treatment outcomes in patients with pNET.AIM To systematically analyze and summarize evidence related to the diagnostic and prognostic value of T2DM and metformin for predicting the insurgence and posttreatment outcomes of pNET.METHODS A systematic review of the published literature was undertaken,focusing on the role of T2DM and metformin in insurgence and prognosis of pNET,measured through outcomes of tumor-free survival(TFS),overall survival and progression free survival.RESULTS A total of 13 studies(5674 patients)were included in this review.Analysis of 809 pNET cases from five retrospective studies(low study heterogeneity with I^(2)=0%)confirms the correlation between T2DM and insurgence of pNET(OR=2.13,95%CI=1.56-4.55;P<0.001).The pooled data from 1174 pNET patients showed the correlation between T2DM and post-treatment TFS in pNET patients(hazard ratio=1.84,95%CI=0.78-2.90;P<0.001).The study heterogeneity was intermediate,with I^(2)=51%.A few studies limited the possibility of performing pooled analysis in the setting of metformin;therefore,results were heterogeneous,with no statistical relevance to the use of this drug in the diagnosis and prognosis of pNET.CONCLUSION T2DM represents a risk factor for the insurgence of pNET and is a significant predictor of poor post-treatment TFS of pNET patients.Unfortunately,a few studies with heterogeneous results limited the possibility of exploring the effect of metformin in the diagnosis and prognosis of pNET.

Solid pseudopapillary tumor of the pancreas:A systematic review of clinical,surgical and oncological characteristics of 1384 patients underwent pancreatic surgery

Background:Pancreatic solid pseudopapillary tumors(SPTs)are rare clinical entity,with low malignancy and still unclear pathogenesis.They account for less than 2%of exocrine pancreatic neoplasms.This study aimed to perform a systematic review of the main clinical,surgical and oncological characteristics of pancreatic SPTs.Data sources:MEDLINE/PubMed,Web of Science and Scopus databases were systematically searched for the main clinical,surgical and oncological characteristics of pancreatic SPTs up to April 2021,in accordance with the preferred reporting items for systematic reviews and meta-analyses(PRISMA)standards.Primary endpoints were to analyze treatments and oncological outcomes.Results:A total of 823 studies were recorded,86 studies underwent full-text reviews and 28 met inclusion criteria.Overall,1384 patients underwent pancreatic surgery.Mean age was 30 years and 1181 patients(85.3%)were female.The most common clinical presentation was non-specific abdominal pain(52.6%of cases).Mean overall survival was 98.1%.Mean recurrence rate was 2.8%.Mean follow-up was 4.2 years.Conclusions:Pancreatic SPTs are rare,and predominantly affect young women with unclear pathogenesis.Radical resection is the gold standard of treatment achieving good oncological impact and a favorable prognosis in a yearly life-long follow-up.

Ovarian-adnexal reporting and data system ultrasound evaluation and pathological characteristics of ovarian collision tumor

BACKGROUND Collision tumor are neoplasms,including two histologically distinct tumors that coexist in the same mass without histological admixture.The incidence of collision tumor is low and is rare clinically.AIM To investigate ultrasound images and application of ovarian-adnexal reporting and data system(O-RADS)to evaluate the risk and pathological characteristics of ovarian collision tumor.METHODS This study retrospectively analyzed 17 cases of ovarian collision tumor diagnosed pathologically from January 2020 to December 2023.All clinical features,ultrasound images and histopathological features were collected and analyzed.The O-RADS score was used for classification.The O-RADS score was determined by two senior doctors in the gynecological ultrasound group.Lesions with O-RADS score of 1-3 were classified as benign tumors,and lesions with O-RADS score of 4 or 5 were classified as malignant tumors.RESULTS There were 17 collision tumors detected in 16 of 6274 patients who underwent gynecological surgery.The average age of 17 women with ovarian collision tumor was 36.7 years(range 20-68 years),in whom,one occurred bilaterally and the rest occurred unilaterally.The average tumor diameter was 10 cm,of which three were 2-5 cm,11 were 5-10 cm,and three were>10 cm.Five(29.4%)tumors with O-RADS score 3 were endometriotic cysts with fibroma/serous cystadenoma,and unilocular or multilocular cysts contained a small number of parenchymal components.Eleven(64.7%)tumors had an O-RADS score of 4,including two in category 4A,six in category 4B,and three in category 4C;all of which were multilocular cystic tumors with solid components or multiple papillary components.One(5.9%)tumor had an O-RADS score of 5.This case was a solid mass,and a small amount of pelvic effusion was detected under ultrasound.The pathology was high-grade serous cystic cancer combined with cystic mature teratoma.There were nine(52.9%)tumors with elevated serum carbohydrate antigen(CA)125 and two(11.8%)with elevated serum CA19-9.Histological and pathological results showed that epithelial-cell-derived tumors combined with other tumors were the most common,which was different from previous results.CONCLUSION The ultrasound images of ovarian collision tumor have certain specificity,but diagnosis by preoperative ultrasound is difficult.The combination of epithelial and mesenchymal cell tumors is one of the most common types of ovarian collision tumor.The O-RADS score of ovarian collision tumor is mostly≥4,which can sensitively detect malignant tumors.

Effect and safety of ripretinib in the treatment of advanced gastrointestinal stromal tumor:A systematic review and metaanalysis

BACKGROUND Imatinib(IMA)has received approval as the primary treatment for gastrointestinal stromal tumors(GIST).Nonetheless,approximately half of the patients with advanced GIST show disease advancement following IMA treatment.Presently,the efficacy of secondary and tertiary medications in addressing various GIST secondary mutations is somewhat restricted.Consequently,there is a significant medical demand for the creation of kinase inhibitors that extensively block secondary drug-resistant mutations in advanced GIST.Ripretinib(RPT)is a new,switch-control tyrosine kinase inhibitors that can suppress different mutations of KIT and PDGFRA via a dual mechanism of action.AIM To investigate the literature on RPT to assess an effective,safe,and successful treatment strategy against advanced GIST.METHODS The present systematic review and meta-analysis was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.PubMed,Embase,Cochrane,Web of Science and ClinicalTrials.gov databases were screened from January 1,2003 to May 1,2024.RESULTS A total of 4 studies were included,with a total of 507 patients enrolled.The objective response rate(ORR)of the RPT-treated advanced GIST was 17%(95%CI:0.11-0.27),while the disease control rate(DCR)was 66%(95%CI:0.59-0.73).The overall occurrence of adverse events with varying degrees was 97%(95%CI:0.93-1),whereas that of grade≥3 adverse reactions was 42%(95%CI:0.28-0.63).The sensitivity analysis revealed that omitting some studies did not yield statistically notable variances in the aggregate data regarding the ORR,DCR,and the occurrence of adverse events of grade 3 or higher.The publication bias was absent because no significant asymmetry was observed in Begg’s funnel plot in all studies.CONCLUSION RPT has favorable efficacy profiles in GIST patients,but the adverse reactions are obvious,and patient management needs to be strengthened to achieve better safety and tolerability.

Systemic therapy in gastrointestinal stromal tumors

Gastrointestinal stromal tumors(GISTs)are the most common type of soft tissue sarcoma in the gastrointestinal tract.Most GISTs have been attributed to activated gain-of-function mutations in either KIT or platelet-derived growth factor receptorα,making these molecular features essential targets for therapeutic interventions.Although surgery is the standard treatment for localized GISTs,patients often experience relapse and disease progression even after surgery.In recent years,targeted therapy has significantly improved the prognosis of patients with advanced GISTs.Imatinib mesylate,a KIT inhibitor,is the first-line treatment for advanced GISTs and has revolutionized the treatment of this disease.However,drug resistance remains a major issue with imatinib treatment,as a significant majority of patients become resistant to imatinib either after initiation or after 2–3 years of treatment.Consequently,novel tyrosine kinase inhibitors such as sunitinib,regorafenib,ripretinib,and avapritinib have been introduced to address drug resistance.Immunotherapy has emerged as a potential approach for the treatment of advanced GISTs.This review comprehensively summarizes the pathogenesis of GISTs and the development of targeted therapies and immunotherapies,provides an overview of the emergence of drug resistance in advanced GISTs,and discusses the challenges and prospects associated with the treatment of GISTs.

Transjugular intrahepatic portosystemic shunt for esophagogastric variceal bleeding in patients with hepatocellular carcinoma and portal vein tumor thrombus

BACKGROUND Whether hepatocellular carcinoma(HCC)with portal vein tumor thrombus(PVTT)and acute esophagogastric variceal bleeding(EGVB)can improve the success rate of endoscopic hemostasis and overall survival(OS)from transjugular intrahepatic portosystemic shunt(TIPS)remains controversial.AIM To compare the clinical outcomes between TIPS and standard treatment for such HCC patients.METHODS This monocenter,retrospective cohort study included patients diagnosed as HCC with PVTT and upper gastrointestinal bleeding.Patients were grouped by the treatment(TIPS or standard conservative treatment).The success rate of en-doscopic hemostasis,OS,rebleeding rates,and main causes of death were ana-lyzed.RESULTS Between July 2015 and September 2021,a total of 77 patients(29 with TIPS and 48 with standard treatment)were included.The success rate of endoscopic hemostasis was 96.6%in the TIPS group and 95.8%in the standard treatment group.All the 29 patients in TIPS group successful underwent TIPS procedure and had a better OS compared with standard treatment within the first 160 days after treatment(68 days vs 43 days,P=0.022),but shorter OS after 160 days(298 days vs 472 days, P = 0.022). Cheng’s Classification of PVTT, total bilirubin and Child-Pugh class wereindependently negative associated with OS (all P < 0.05). The main causes of death were liver failure or hepaticencephalopathy (75.9%) in the TIPS group and rebleeding (68.8%) in the standard treatment.CONCLUSIONTIPS could reduce the risk of early death due to rebleeding and prolong short-term survival in HCC patients withPVTT and acute EGVB, which deserves further investigation.

Cost analysis of radical resection of malignant breast tumors under the China Healthcare Security Diagnosis Related Groups payment system

BACKGROUND Breast cancer is one of the most common malignant tumors in women worldwide and poses a severe threat to their health.Therefore,this study examined patients who underwent breast cancer surgery,analyzed hospitalization costs and structure,and explored the impact of China Healthcare Security Diagnosis Related Groups(CHS-DRG)management on patient costs.It aimed to provide medical institutions with ways to reduce costs,optimize cost structures,reduce patient burden,and improve service efficiency.AIM To study the CHS-DRG payment system’s impact on breast cancer surgery costs.METHODS Using the CHS-DRG(version 1.1)grouping criteria,4073 patients,who underwent the radical resection of breast malignant tumors from January to December 2023,were included in the JA29 group;1028 patients were part of the CHS-DRG payment system,unlike the rest.Through an independent sample t-test,the length of hospital stay as well as total hospitalization,medicine and consumables,medical,nursing,medical technology,and management expenses were compared.Pearson’s correlation coefficient was used to test the cost correlation.RESULTS In terms of hospitalization expenses,patients in the CHS-DRG payment group had lower medical,nursing,and management expenses than those in the diagnosis-related group(DRG)non-payment group.For patients in the DRG payment group,the factors affecting the total hospitalization cost,in descending order of relevance,were medicine and consumable costs,consumable costs,medicine costs,medical costs,medical technology costs,management costs,nursing costs,and length of hospital stay.For patients in the DRG nonpayment group,the factors affecting the total hospitalization expenses in descending order of relevance were medicines and consumable expenses,consumable expenses,medical technology expenses,the cost of medicines,medical expenses,nursing expenses,length of hospital stay,and management expenses.CONCLUSION The CHS-DRG system can help control and reduce unnecessary medical expenses by controlling medicine costs,medical consumable costs,and the length of hospital stay while ensuring medical safety.

Extended Deep Learning Algorithm for Improved Brain Tumor Diagnosis System

At present,the prediction of brain tumors is performed using Machine Learning(ML)and Deep Learning(DL)algorithms.Although various ML and DL algorithms are adapted to predict brain tumors to some range,some concerns still need enhancement,particularly accuracy,sensitivity,false positive and false negative,to improve the brain tumor prediction system symmetrically.Therefore,this work proposed an Extended Deep Learning Algorithm(EDLA)to measure performance parameters such as accuracy,sensitivity,and false positive and false negative rates.In addition,these iterated measures were analyzed by comparing the EDLA method with the Convolutional Neural Network(CNN)way further using the SPSS tool,and respective graphical illustrations were shown.The results were that the mean performance measures for the proposed EDLA algorithm were calculated,and those measured were accuracy(97.665%),sensitivity(97.939%),false positive(3.012%),and false negative(3.182%)for ten iterations.Whereas in the case of the CNN,the algorithm means accuracy gained was 94.287%,mean sensitivity 95.612%,mean false positive 5.328%,and mean false negative 4.756%.These results show that the proposed EDLA method has outperformed existing algorithms,including CNN,and ensures symmetrically improved parameters.Thus EDLA algorithm introduces novelty concerning its performance and particular activation function.This proposed method will be utilized effectively in brain tumor detection in a precise and accurate manner.This algorithm would apply to brain tumor diagnosis and be involved in various medical diagnoses aftermodification.If the quantity of dataset records is enormous,then themethod’s computation power has to be updated.

Advancements in Liver Tumor Detection:A Comprehensive Review of Various Deep Learning Models

Liver cancer remains a leading cause of mortality worldwide,and precise diagnostic tools are essential for effective treatment planning.Liver Tumors(LTs)vary significantly in size,shape,and location,and can present with tissues of similar intensities,making automatically segmenting and classifying LTs from abdominal tomography images crucial and challenging.This review examines recent advancements in Liver Segmentation(LS)and Tumor Segmentation(TS)algorithms,highlighting their strengths and limitations regarding precision,automation,and resilience.Performance metrics are utilized to assess key detection algorithms and analytical methods,emphasizing their effectiveness and relevance in clinical contexts.The review also addresses ongoing challenges in liver tumor segmentation and identification,such as managing high variability in patient data and ensuring robustness across different imaging conditions.It suggests directions for future research,with insights into technological advancements that can enhance surgical planning and diagnostic accuracy by comparing popular methods.This paper contributes to a comprehensive understanding of current liver tumor detection techniques,provides a roadmap for future innovations,and improves diagnostic and therapeutic outcomes for liver cancer by integrating recent progress with remaining challenges.

DCS, a novel classifier system based on disulfidptosis reveals tumor microenvironment heterogeneity and guides frontline therapy for clear cell renal carcinoma

Background: Emerging evidence suggests that cell deaths are involved in tumorigenesis and progression, which may be treated as a novel direction of cancers. Recently, a novel type of programmed cell death, disulfidptosis, was discovered. However, the detailed biological and clinical impact of disulfidptosis and related regulators remains largely unknown. Methods: In this work, we first enrolled pancancer datasets and performed multi-omics analysis, including gene expression, DNA methylation, copy number variation and single nucleic variation profiles. Then we deciphered the biological implication of disulfidptosis in clear cell renal cell carcinoma (ccRCC) by machine learning. Finally, a novel agent targeting at disulfidptosis in ccRCC was identified and verified. Results: We found that disulfidptosis regulators were dysregulated among cancers, which could be explained by aberrant DNA methylation and genomic mutation events. Disulfidptosis scores were depressed among cancers and negatively correlated with epithelial mesenchymal transition. Disulfidptosis regulators could satisfactorily stratify risk subgroups in ccRCC, and a novel subtype, DCS3, owning with disulfidptosis depression, insensitivity to immune therapy and aberrant genome instability were identified and verified. Moreover, treating DCS3 with NU1025 could significantly inhibit ccRCC malignancy. Conclusion: This work provided a better understanding of disulfidptosis in cancers and new insights into individual management based on disulfidptosis.

Construction and application of a three-dimensional vascular variation-based nephrometry scoring system for completely endophytic renal tumors

Background:Completely endophytic renal tumors(CERT)pose significant challenges due to their anatomical complexity and loss of visual clues about tumor location.A facile scoring model based on three-dimensional(3D)reconstructed images will assist in better assessing tumor location and vascular variations.Methods:In this retrospective study,80 patients diagnosed with CERT were included.Forty cases underwent preoperative assessment using 3D reconstructed imaging(3D-Cohort),while the remaining 40 cases were assessed using two-dimensional imaging(2D-Cohort).Vascular variations were evaluated by ascertaining the presence of renal arteries>1,prehilar branching arteries,and arteries anterior to veins.The proposed scoring system,termed RAL,encompassed three critical components:(R)adius(maximal tumor diameter in cm),(A)rtery(occurrence of arterial variations),and(L)ocation relative to the polar line.Comparison of the RAL scoring system was made with established nephrometry scoring systems.Results:A total of 48(60%)patients exhibited at least one vascular variation.In the 2D-Cohort,patients with vascular variations experienced significantly prolonged operation time,increased bleeding volume,and extended warm ischemia time compared with those without vascular variations.Conversely,the presence of vascular vari-ations did not significantly affect operative parameters in the 3D-Cohort.Furthermore,the 2D-Cohort demon-strated a notable decline in both short-and long-term estimated glomerular filtration rate(eGFR)changes com-pared with the 3D-Cohort,a trend consistent across patients with warm ischemia time≥25 min and those with vascular variations.Notably,the 2D-Cohort exhibited a larger margin of normal renal tissue compared with the 3D-Cohort.Elevated RAL scores correlated with larger tumor size,prolonged operation time,extended warm is-chemia time,and substantial postoperative eGFR decrease.The RAL scoring system displayed superior predictive capabilities in assessing postoperative eGFR changes compared with conventional nephrometry scoring systems.Conclusions:Our proposed 3D vascular variation-based nephrometry scoring system offers heightened proficiency in preoperative assessment,precise prediction of surgical complexity,and more accurate evaluation of postoper-ative renal function in CERT patients.

Unraveling the landscape of pediatric pancreatic tumors:Insights from Japan

Pediatric pancreatic tumors,though rare,pose significant diagnostic and manage-ment challenges.The recent,22-year nationwide survey on pediatric pancreatic tumors in Japan by Makita et al offers valuable insights into this uncommon enti-ty,revealing striking geographical variations and questioning current treatment paradigms.This editorial commentary analyzes the study's key findings,inclu-ding the predominance of solid pseudopapillary neoplasms and their younger age of onset,which contrast sharply with Western data.It explores the implications for clinical practice and research,emphasizing the need for population-specific approaches to diagnosis and treatment.The revealed limited institutional expe-rience and surgical management patterns prompt a reevaluation of optimal care delivery for these complex cases,suggesting benefits of centralizing healthcare services.Furthermore,the commentary advocates for international collaborative studies to elucidate the genetic,environmental,and lifestyle factors influencing the development and progression of pediatric pancreatic tumors across diverse populations.It also outlines future directions,calling for advancements in precision medicine and innovative care delivery models to improve global patient outcomes.Unraveling Makita et al's findings within the broader landscape of pediatric oncology can stimulate further research and clinical advancements in managing pancreatic and other rare tumors in children.

Liposomes as versatile agents for the management of traumatic and nontraumatic central nervous system disorders:drug stability,targeting efficiency,and safety

Various nanoparticle-based drug delivery systems for the treatment of neurological disorders have been widely studied.However,their inability to cross the blood–brain barrier hampers the clinical translation of these therapeutic strategies.Liposomes are nanoparticles composed of lipid bilayers,which can effectively encapsulate drugs and improve drug delivery across the blood–brain barrier and into brain tissue through their targeting and permeability.Therefore,they can potentially treat traumatic and nontraumatic central nervous system diseases.In this review,we outlined the common properties and preparation methods of liposomes,including thin-film hydration,reverse-phase evaporation,solvent injection techniques,detergent removal methods,and microfluidics techniques.Afterwards,we comprehensively discussed the current applications of liposomes in central nervous system diseases,such as Alzheimer's disease,Parkinson's disease,Huntington's disease,amyotrophic lateral sclerosis,traumatic brain injury,spinal cord injury,and brain tumors.Most studies related to liposomes are still in the laboratory stage and have not yet entered clinical trials.Additionally,their application as drug delivery systems in clinical practice faces challenges such as drug stability,targeting efficiency,and safety.Therefore,we proposed development strategies related to liposomes to further promote their development in neurological disease research.

Correlation between gut microbiota and tumor immune microenvironment:A bibliometric and visualized study

BACKGROUND In recent years,numerous reports have been published regarding the relationship between the gut microbiota and the tumor immune microenvironment(TIME).However,to date,no systematic study has been conducted on the relationship between gut microbiota and the TIME using bibliometric methods.AIM To describe the current global research status on the correlation between gut microbiota and the TIME,and to identify the most influential countries,research institutions,researchers,and research hotspots related to this topic.METHODS We searched for all literature related to gut microbiota and TIME published from January 1,2014,to May 28,2024,in the Web of Science Core Collection database.We then conducted a bibliometric analysis and created visual maps of the published literature on countries,institutions,authors,keywords,references,etc.,using CiteSpace(6.2R6),VOSviewer(1.6.20),and bibliometrics(based on R 4.3.2).RESULTS In total,491 documents were included,with a rapid increase in the number of publications starting in 2019.The country with the highest number of publications was China,followed by the United States.Germany has the highest number of citations in literature.From a centrality perspective,the United States has the highest influence in this field.The institutions with the highest number of publications were Shanghai Jiao Tong University and Zhejiang University.However,the institution with the most citations was the United States National Cancer Institute.Among authors,Professor Giorgio Trinchieri from the National Institutes of Health has the most local impact in this field.The most cited author was Fan XZ.The results of journal publications showed that the top three journals with the highest number of published papers were Frontiers in Immunology,Cancers,and Frontiers in Oncology.The three most frequently used keywords were gut microbiota,tumor microenvironment,and immunotherapy.CONCLUSION This study systematically elaborates on the research progress related to gut microbiota and TIME over the past decade.Research results indicate that the number of publications has rapidly increased since 2019,with research hotspots including“gut microbiota”,“tumor microenvironment”and“immunotherapy”.Exploring the effects of specific gut microbiota or derived metabolites on the behavior of immune cells in the TIME,regulating the secretion of immune molecules,and influencing immunotherapy are research hotspots and future research directions.

Clinical Research on the Changes of Plasma TFPI and uPA System in Malignant Tumor

Objective: To investigate the expression levels and significance of TFPI, uPA, uPAR and PAI in malignant patients. Methods: The levels of TFPI, uPA and uPAR were measured by using ELISA and the level of PAI was determined by method of chromogenic substrates in 44 patients with malignant solid tumors (group A1) and 30 patients with acute leukemia (AL, group A2). Results: The levels of TFPI, uPA, and uPAR in group A1 were higher than those in normal control group (group B). TFPI, uPAR levels in group A2 were higher than those in group B, while the level of PAI in group A2 was lower than that in group B. Among the groups, TFPI was increased in the combined infection group; PAI decreased in the hemorrhage group; TFPI, uPA, uPAR and PAI increased in relapsing and metastasis group; TFPI decreased in one-week dead group, while uPA and uPAR increased. Conclusion: The patients with malignant solid tumor and AL had different anticoagulation or fibrinolysis states. TFPI, uPA, Upar and PAI can be used to evaluate the disease condition and the prognosis.

Study on Internet-based Expert Prevention System against Diseases, Pests and Weeds of Tumorous Stem Mustard

With the acknowledgement of species, symptoms and control measures for diseases, pests and weeds in tumorous stem mustard, the expert prevention system has been studied and developed based on internct, and the system mainly includes knowledge database, inference engine, browser web and so on. The knowledge database has been established by Micrsoft Access 2003 software; the procedure of inference engine has been compiled by JavaScript; the pages of browser web have been made by Dreamweaver MX software. The expert system is fuR-featured and user-friendly, which can provide control knowledge against the diseases, pests and weeds of tumorous stem mustard for the majority of farmers, scientific technological person and grass-roots level managers quickly and conveniently,

Neuroendocrine tumors of the gastro-entero-pancreatic system

Gastro-entero-pancreatic (GEP) neuroendocrine tumors (NETs) are rare neoplasms, although their prevalence has increased substantially over the past three decades. Moreover, there has been an increased clinical recognition and characterization of these neoplasms. They show extremely variable biological behavior and clinical course. Most NETs have endocrine function and secrete peptides and neuroamines that cause distinct clinical syndromes, including carcinoid syndrome; however, many are clinically silent until late presentation with mass effects. Investigation and management should be individualized for each patient, taking into account the likely natural history of the tumor and general health of the patient. Management strategies include surgery for cure or palliation, and a variety of other cytoreductive techniques, and medical treatment including chemotherapy, and biotherapy to control symptoms due to hormone release and tumor growth, with somatostatin analogues (SSAs) and alphainterferon. New biological agents and somatostatintagged radionuclides are under investigation. Advances in the therapy and development of centers of excellence which coordinate multicenter studies, are needed to improve diagnosis, treatment and therefore survival of patients with GEP NETs.

Scoring system for prediction of metastatic spine tumor prognosis

Assessing the prognosis before treatment for metastatic spine tumor is extremely important in therapy selection.Therefore,we review some prognostic scoring systems and their outcomes.Articles with combinations of two keywords among"metastatic spine tumor"and"prognosis","score","scoring system","predicting",or"life expectancy"were searched for in Pub Med.As a result,236 articles were extracted.Those referring to representative scoring systems about predicting the survival of patients with metastatic spine tumors were used.The significance and limits of these scoring systems,and the future perspectives were described.Tokuhashi score,Tomita score,Baur score,Linden score,Rades score,and Katagiri score were introduced.They are all scoring systems prepared by combining factors that affect prognosis.The primary site of cancer and visceral metastasis were common factors in all of these scoring systems.Other factors selected to influence the prognosis varied.They were useful to roughly predict thesurvival period,such as,"more than one year or not"or"more than six months or not".In particular,they were utilized for decision-making about operative indications and avoidance of excessive medical treatment.Because the function depended on the survival period in the patients with metastatic spine tumor,it was also utilized in assessing functional prognosis.However,no scoring system had more than 90%consistency between the predicted and actual survival periods.Future perspectives should adopt more oncological viewpoints with adjustment of the process of treatment for metastatic spine tumor.

Effect of autotransfusion system on tumor recurrence and survival in hepatocellular carcinoma patients

AIM:To investigate the therapeutic efficacy and safety of continuous autotransfusion system(CATS) during liver transplantation of hepatocellular carcinoma patients.METHODS:Eighty-three hepatocellular carcinoma(HCC) patients who underwent liver transplantation with intraoperative CATS(n = 24,CATS group) and without(n = 59,non-CATS group) between April 2006 and November 2011 at the Liver Transplant Institute of Inonu University were analyzed retrospectively.Postoperative HCC recurrence was monitored by measuring alpha-fetoprotein(AFP) levels at 3-mo intervals and performing imaging analysis by thoracoabdominal multidetector computed tomography at 6-month intervals.Inter-group differences in recurrence and correlations between demographic,clinical,and pathological data were assessed by ANOVA and χ 2 tests.Overall and disease-free survivals were calculated by the univariate Kaplan-Meier method.RESULTS:Of the 83 liver transplanted HCC patients,89.2% were male and the overall mean age was 51.3 ± 8.9 years(range:18-69 years).The CATS and nonCATS groups showed no statistically significant differences in age,sex ratio,body mass index,underlying disease,donor type,graft-to-recipient weight ratio,Child-Pugh and Model for End-Stage Liver Disease scores,number of tumors,tumor size,AFP level,Milan and University of California San Francisco selection criteria,tumor differentiation,macrovascular invasion,median hospital stay,recurrence rate,recurrence site,or mortality rate.The mean follow-up time of the nonCATS group was 17.9 ± 12.8 mo,during which systemic metastasis and/or locoregional recurrence developed in 25.4% of the patients.The mean follow-up time for the CATS group was 25.8 ± 15.1 mo,during which systemic metastasis and/or locoregional recurrence was detected in 29.2% of the patients.There was no significant difference between the CATS and non-CATS groups in recurrence rate or site.Additionally,no significant differences existed between the groups in overall or disease-free survival.CONCLUSION:CATS is a safe procedure and may decrease the risk of tumor recurrence in HCC patients.