The Frequency of Skin Tumors and Infections in Patients with Autoimmune Diseases

Background: Autoimmune diseases are a vast array of organ-specific as well as systemic diseases, whose pathogenesis results from the activation of B and T lymphocytes reacting against antigens of the body’s own tissues (defined as self). Objective: To record skin tumors and infections in all autoimmune diseases gathered together in a one pathological state, compared with renal transplant recipients and normal control. Patients and Methods: Four hundred patients with different autoimmune diseases were examined. Fifty patients with pemphigus (15 males, 35 females) are aged from 20 - 70 (41.23 ± 3.89) years. Fifty patients with systemic lupus erythematosus (50 females) are aged from 17 - 45 (30.58 ± 10.08) years. One hundred patients with vitiligo (59 males, 41 females) are aged from 9 - 71 (42.89 ± 5.28) years. One hundred patients with alopecia areata (42 males, 58 females) are aged from 7 - 52 (38.67 ± 9.52) years. One hundred patients with psoriasis (56 males, 44 females) are aged from 7 - 71 (47.36 ± 8.62) years were evaluated. One hundred twenty kidney transplant recipients’ (101 males, 19 females) ages ranged from 14 - 70 (45.43 ± 4.63) years. All patients were examined thoroughly for any cutaneous manifestations and tumors and the findings were compared with the general population as a control group, which consisted of 500 healthy control individuals whose ages ranged from 20 - 71 (44.53 ± 11.48) years. This case series, descriptive, controlled study was performed in Baghdad Teaching Hospital from June 2014 to October 2015. Results: In renal transplant recipients, the findings were observed as follow herpetic infection in 30(25%), bacterial 12(10%) while fungal 24(20%) patients. These infections appeared early in the course of immunosuppression. While the tumors were noticed, the benign tumors were the commonest manifestations, which included viral warts in 45(37.5%) followed by actinic keratosis 15(12.5%), seborrheic keratosis 14(11.6%), sebaceous hyperplasia 13(10.8%) and keratoacanthoma 1(0.8%). While the malignant tumors were basal cell carcinoma 4(3.3%) followed by squamous cell carcinoma 3(2.5%), and kaposi’s sarcoma 4(3.3%), Bowen’s disease 1(0.8%). These malignancy usually appeared late in the course of immunosuppression. In pemphigus, viral warts were observed in 4(8%) cases;fungal infection was seen in 4(8%) cases and bacterial infections in 2(4%) of cases and herpetic infection in only 1(2%) of case;no tumors were found in all patients. In vitiligo, viral warts were observed in 2(2%) cases, while seborrhic keratosis and sebaceous hyperplasia were observed in 1(1%) case;herpetic and fungal infections were seen in 3(3%) of cases while bacterial infections were recorded in 2(2%) of cases but no tumors were found in all patients. In alopecia areata viral warts were observed in 9(9%) of cases, sebaceous hyperplasia in 1(1%) case, herpetic and bacterial in 3(3%) of cases and fungal in 4(4%) of cases;no tumors were found in all patients. In systemic lupus erythymatosus (SLE) viral warts were observed in 4(8%) of cases, herpetic infection in 12(12%) of cases, fungal infection in 10(20%) of cases, bacterial infection in 3(3%) of cases and sebaceous hyperplasia in only 1(2%) of case, but no tumors were seen. In psoriasis, viral warts were observed in 14(14%) of cases, herpetic infection in 10(10%) of cases, bacterial infection in 3(3%) of cases, fungal infection in 2(2%) of cases, sebaceous hyperplasia in 2(2%) of cases and seborrhiec hyperkeratosis in 1(1%) case, while no tumors were demonstrated. In healthy control individuals, herpetic infection was present in 36(7.2%) and viral warts in 52(10.4%) individuals, fungal infection in 29(5.8%) of individuals and regarding tumors solar keratosis was present in 24(4.8%);basal cell carcinoma and squamous cell carcinoma were present in 2(0.4%) individuals of each. Conclusions: Patients with autoimmune diseases were protected against infections and tumors while kidney transplant recipients had no such protection although all these groups were on prolonged immunosuppression.

Expression of p63 and Cyclooxygenase-2 and Their Correlation in Skin Tumors

To study the expression of p63 and cyclooxygenase-2 （cox-2） in skin tumors and evaluate the correlation between p63 and cox-2, the expressions of cox-2 and p63 were measured by streptavidin-peroxidase complex immunohistochemical technique in 17 cases of skin squamous cell carcinoma （ SCC ） , 19 cases of Bowen＇s disease（Bowen）, 11 cases of actinic keratosis（AK）, 12 cases of seborreic keratosis（SK） and 13 specimens of normal skin. Our results showed that the expression of p63 in skin squamous cell carcinoma, Bowen＇s disease and actinic keratosis were significantly higher than that in seborreic keratosis, while the expression of p63 in seborreic keratosis was significantly higher than that in normal skin. The expression of cox-2 in skin squamous cell carcinoma, Bowen＇s disease and actinic keratosis were significantly higher than that in seborreic keratosis, while no statistical difference was noted in the expression of cox-2 between seborreic keratosis and normal skin. Cox-2 expression was positively correlated with the high p63 expression in malignant skin tu- mors. The increased expression of cox-2 and p63 may play an important role in the development of skin tumors and work synergetically in malignant skin tumors.

Contour Extraction of Skin Tumors Using Visual Attention and GVF-Snake Model

Contour extraction of skin tumors accurately is an important task for further feature generation of their borders and sur-faces to early diagnose melanomas. An integrated approach, combining visual attention model and GVF-snake, is pro-posed in the paper to provide a general framework for locating tumor boundaries in case of noise and boundaries with large concavity. For any skin image, the visual attention model is implemented to locate the Region of Interests (ROIs) based on saliency maps. Then an algorithm called GVF-snake is utilized to iteratively drive an initial contour, deriving from the extracted ROIs, towards real boundary of skin tumors by minimizing an energy function. It is shown from ex-periments that the proposed approach exceeds in two aspects compared with other contour-deforming methods: 1) ini-tial contours generated from saliency maps are definitely located at neighboring regions of real boundaries of skin tu-mors to speed up converges of contour deformation and achieve higher accuracy;2) the method is not sensitive to nois-es on skins and initial contours extracted.

Clinical Efficacy and Adverse Reactions of Photodynamic Therapy in the Treatment of Malignant Skin Tumors and Precancerous Skin Diseases

The purpose of the study was to investigate the efficacy and safety of photodynamic therapy in the treatment of malignant skin tumors and precancerous skin diseases.First of all,100 patients with malignant skin tumor and pre-cancer skin disease admitted to our hospital from January 20,2018 to September 18,2018 were selected,and all of them adopted photodynamic therapy.The 100 patients included 40 cases of basal cell carcinoma,14 cases of squamous cell carcinoma,7 cases of proliferative erythema,9 cases of Bowen’s disease and 39 cases of solar keratosis.Among the 100 patients,77 cases had excellent curative effect,18 cases had good effect and 5 cases had poor effect,and the overall effective rate was 95%(95/100).After 6 months of follow-up,5 cases of basal cell carcinoma,2 cases of squamous cell carcinoma,0 cases of proliferative erythra,1 case of Bowen’s disease and 3 cases of solar keratosis recurred,with an overall recurrence rate of 14%(14/100).The adverse reactions of pruritus were 90%(90/100),81%(81/100),90%(90/100)and 3%(3/100).Therefore,the application of photodynamic therapy in the treatment of malignant skin tumors and precancerous skin diseases is not only effective,but also safe and not easy to relapse.

Laparoscopic step 1 ALPPS with microwave transection of theliver for Klatskin tumors:Is it worthwhile?

To the Editor：Associating liver partition and portal vein ligation for stagedhepatectomy （ALPPS） was introduced in 2007 [1]. This techniqueis now used worldwide and has a wide spectrum of indications.However, scientific debate and un-regulated surgical experimentationconcerning the application of this technique led the surgeons to organize the first Consensus Meeting [2] to build a scientificconsensus. One of the most controversial indications to ALPPS isits application for Klatskin tumors. The aim of this letter is to analyzethe critical aspects of laparoscopic microwave ALPPS for radicalsurgical treatment of Klatskin tumors.

Outcome of surgical resection in Klatskin tumors

Cholangiocarcinomas are the second most frequent primary hepatic malignancy,and make up from 5% to 30% of malignant hepatic tumours.Hilar cholangiocarcinoma(HCC) is the most common type,and accounts for approximately 60% to 67% of all cholangiocarcinoma cases.There is not a staging system that permits us to compare all series and extract some conclusions to increase the long-survival rate in this dismal disease.Neither the extension of resection,according to the sort of HCC,is a closed topic.Some authors defend limited resection(mesohepatectomy with S1,S1 plus S4b-S5,local excision for papillary tumours,etc.) while others insist in the compulsoriness of an extended hepatic resection with portal vein bifurcation removed to reach cure.As there is not an ideal adjuvant therapy,R1 resection can be justified to prolong the survival rate.Morbidity and mortality rates changed along the last decade,but variability is the rule,with morbidity and mortality rates ranging from 14% to 76% and from 0% to 19%,respectively.Conclusion:Surgical resection continues to be the main treatment of HCC.Negative resection margins achieved with major hepatic resections are associated with improved outcome.Preresectional management with biliary drainage,portal vein embolization and staging laparoscopy should be considered in selected patients.Additional evidence is needed to fully define the role of orthotopic liver transplant.Portal and lymph node involvement worsen the prognosis and long-term survival,and surgery is the only option that can lengthen it.Improvements in adjuvant therapy are essential for improving long-term outcome.Furthermore,the lack of effective chemotherapy drugs and radiotherapy approaches leads us to can consider R1 resection as an option,because operated patients have a longer survival rate than those who not undergo surgery.

Solid,non-skin,post-liver transplant tumors:Key role oflifestyle and immunosuppression management

Liver transplantation has been the treatment of choice for end-stage liver disease since 1983.Cancer has emerged as a major long-term cause of death for liver transplant recipients.Many retrospective studies that have explored standardized incidence ratio have reported increased rates of solid organ cancers postliver transplantation;some have also studied risk factors.Liver transplantation results in a two to five-fold mean increase in the rate of solid organ cancers.Risk of head and neck,lung,esophageal,cervical cancers and Kaposi’s sarcoma is high,but risk of colorectal cancer is not clearly demonstrated.There appears to be no excess risk of developing breast or prostate cancer.Environmental risk factors such as viral infection and tobacco consumption,and personal risk factors such as obesity play a key role,but recent data also implicate the role of calcineurin inhibitors,whose cumulative and dose-dependent effects on cell metabolism might play a direct role in oncogenesis.In this paper,we review the results of studies assessing the incidence of non-skin solid tumors in order to understand the mechanisms underlying solid cancers in post-liver transplant patients and,ultimately,discuss how to prevent these cancers.Immunosuppressive protocol changes,including a calcineurin inhibitor-free regimen,combined with dietary guidelines and smoking cessation,are theoretically the best preventive measures.

Modified ALPPS as an individual rescue treatment strategy for resection of Klatskin tumors

Surgery for Klatskin tumors is a complex procedure often requiring extended hepatectomy combined with vascular and bileduct reconstruction in the setting of cholestasis,cholangitis,impaired liver regeneration and small future liver remnant(FLR)usually measured on computed tomography(CT)volumetry in a standardized(s FLR)fashion.Major morbidity is as high as 70%,andpublished literature estimates mortality around 15%[1].Carefulstrategic planning and modulation of the FLR are factors improving outcomes.

The impact of intensity modulated radiotherapy on the skin dose for deep seated tumors

Objective: The purpose of this study was to investigate the impact of intensity modulated radiotherapy (IMRT) on surface doses for brain, abdomen and pelvis deep located tumors treated with 6 MV photon and to evaluate the skin dose calculation accuracy of the XIO 4.04 treatment planning system. Methods: More investigations for the influences of IMRT on skin doses would increase its applications for many treatment sites. Measuring skin doses in real treatment situations would reduce the uncertainty of skin dose prediction. In this work a pediatric human phantom was covered by a layer of 1 mm bolus at three treatment sites and thermoluminescent dosimeter (TLD) chips were inserted into the bolus at each treatment site before CT scan. Two different treatment plans [three-dimensional conformal radiation therapy (3DCRT) and IMRT] for each treatment sites were performed on XIO 4.04 treatment planning system using superposition algorism. Results: The results showed that the surface doses for 3DCRT were higher than the surface doses in IMRT by 1.6%, 2.5% and 3.2% for brain, abdomen and pelvis sites respectively. There was good agreement between measured and calculated surface doses, where the calculated surface dose was 15.5% for brain tumor calculated with 3DCRT whereas the measured surface dose was 12.1%. For abdomen site the calculated surface dose for IMRT treatment plan was 16.5% whereas the measured surface dose was 12.6%. Conclusion: The skin dose in IMRT for deep seated tumors is lower than that in 3DCRT which is another advantage for the IMRT. The TLD readings showed that the difference between the calculated and measured point dose is negligible. The superposition calculation algorism of the XIO 4.04 treatment planning system modeled the superficial dose well.

Scoring system supporting suture decision-making for duodenal submucosal tumors

BACKGROUND In recent years,endoscopic resection(ER)has been employed for the excision of submucosal tumors(SMTs).Nonetheless,ER in the duodenum is linked to ele-vated risks of both immediate and delayed hemorrhagic complications and perforations.Satisfactory suturing is crucial for reducing the occurrence of complications.AIM To establish a clinical score model for supporting suture decision-making of duodenal SMTs.METHODS This study included 137 individuals diagnosed with duodenal SMTs who under-went ER.Participants were evenly divided into two groups:A training cohort(TC)comprising 95 cases and an internal validation cohort(VC)with 42 cases.Subsequently,a scoring system was formulated utilizing multivariate logistic regression analysis within the TC,which was then subjected to evaluation in the VC.RESULTS The clinical scoring system incorporated two key factors:Extraluminal growth,which was assigned 2 points,and endoscopic full-thickness resection,which was given 3 points.This model demonstrated strong predictive accuracy,as evidenced by the area under the receiver operating characteristic curve of 0.900(95%confidence interval:0.823-0.976).Additionally,the model’s goodness-of-fit was validated by the Hosmer-Lemeshow test(P=0.404).The probability of purse-string suturing in low(score 0-2)and high(score>3)categories were 3.0%and 64.3%in the TC,and 6.1%and 88.9%in the VC,respectively.CONCLUSION This scoring system may function as a beneficial instrumentality for medical practitioners,facilitating the decision-making process concerning suture techniques in the context of duodenal SMTs.

Hepatic hemangiomas mimicking gastrointestinal stromal tumors: A case report

BACKGROUND Hepatic hemangiomas can be challenging to diagnose,particularly when they present with atypical features that mimic other conditions,such as gastrointestinal stromal tumors(GISTs).This case highlights the diagnostic difficulties encountered when imaging subepithelial lesions,especially when conventional methods such as computed tomography(CT)and endoscopic ultrasound(EUS)are used.CASE SUMMARY A 44-year-old woman presented with intermittent abdominal distension and heartburn for three months.Her medical history included iron deficiency anemia,menorrhagia,and previous cholecystectomy.One week prior to admission,an endoscopy suggested a bulging gastric fundus,which was likely a GIST,along with chronic nonatrophic gastritis and bile reflux.CT and EUS revealed nodules in the gastric fundus,which were initially considered benign tumors with a differential diagnosis of stromal tumor or leiomyoma.During surgery,unexpected lesions were found in the liver pressing against the gastric fundus,leading to laparoscopic liver resection.Postoperative pathology confirmed the diagnosis of hepatic cavernous hemangiomas.The patient recovered well and was discharged five days later,with normal follow-up results at three months.CONCLUSION This case underscores the challenges in the preoperative diagnosis of GISTs,particularly the limitations of the use of CT and EUS for the evaluation of subepithelial lesions.While CT is the primary tool for visualizing abdominal tumors,it is difficult to detect smaller lesions and assess the layers of the gastrointestinal wall on CT.EUS is recommended for the evaluation of nodules smaller than 2 cm and is useful for distinguishing GISTs from other lesions;however,its accuracy with regard to the differential diagnosis is relatively low.In this case,the gastric distension observed on imaging led to the compression of a liver tumor against the stomach,resulting in the misinterpretation of the tumor as a gastric wall lesion.

Artificial self-powered and self-healable neuromorphic vision skin utilizing silver nanoparticle-doped ionogel photosynaptic heterostructure

Artificial skin should embody a softly functional film that is capable of self-powering,healing and sensing with neuromorphic processing.However,the pursuit of a bionic skin that combines high flexibility,self-healability,and zero-powered photosynaptic functionality remains elusive.In this study,we report a self-powered and self-healable neuromorphic vision skin,featuring silver nanoparticle-doped ionogel heterostructure as photoacceptor.The localized surface plasmon resonance induced by light in the nanoparticles triggers temperature fluctuations within the heterojunction,facilitating ion migration for visual sensing with synaptic behaviors.The abundant reversible hydrogen bonds in the ionogel endow the skin with remarkable mechanical flexibility and self-healing properties.We assembled a neuromorphic visual skin equipped with a 5×5 photosynapse array,capable of sensing and memorizing diverse light patterns.

Dendrobium officinale extract exerts antioxidant effects against skin photoaging through MMP9-TNF pathway

Background:Skin photoaging is a physiological or pathological process caused by multiple factors.Developing anti-skin photoaging drugs is a hot topic in cosmetology research fields.The purpose of this study was to explore the therapeutic effect of Dendrobium officinale(D.officinale)on skin aging.Methods:The ingredients of D.officinale were detected by UHPLC-Q-TOF/MS.The targets of D.officinale were screened by Swiss Target Prediction database.GeneCards,NCBI,and OMIM databases were utilized to find out the targets associated with skin photoaging.Overlapping targets of D.officinale and skin photoaging were obtained by Venn analysis.The ingredient-disease target network and protein-protein interaction network were constructed by using the STRING database and Cytoscape software.The key compounds and hub genes were obtained by analyzing networks.The DAVID database was applied for Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analysis of the overlapping targets.Autodock Vina software was used to simulate molecular docking and the results were visualized using Pymol.Finally,the skin photoaging models of cells and mice were established to validate the results predicted by network pharmacology.Results:In D.officinale,a total of 59 compounds and 595 targets were detected,of which 59 proteins were intersectional with skin photoaging targets.The top 10 active ingredients(Dendrophenol,Herbacetin,Lyoniresinol,Trans-ferulaldehyde,Naringenin,and so on)and 8 hub genes(AKT1,TNF,VEGFA,MAPK3,CASP3,MMP9,CTNNB1,and EGFR)were identified.All the key active compounds could bind well with core protein targets(binding energy<-5 kcal/mol).The potential therapeutic targets were related to the response to reactive oxygen species,collagen catabolic process,extracellular matrix organization,and apoptotic process,mainly.We also found that D.officinale could enhance the cell viability and activity of anti-oxidases,reduce reactive oxygen species and MMP9 levels,and stable mitochondrial membrane potential.Furthermore,D.officinale could alleviate skin photoaging injury and reduce malondialdehyde level in mice.Conclusion:D.officinale alleviated skin photoaging via regulating oxidative stress,apoptosis,and collagen catabolic process.

Innovative approaches in predicting outcomes for rectal neuroendocrine tumors

Rectal neuroendocrine neoplasms pose significant challenges due to their varied presentations and prognoses.Traditional prognostic models,while useful,often fall short of accurately predicting clinical outcomes for these patients.This article discusses the development and implications of a novel prognostic tool,the GATIS score,which aims to enhance predictive accuracy and guide treatment strategies more effectively than current methods.Utilizing data from a large cohort and employing sophisticated statistical models,the GATIS score integrates clinical and pathological markers to provide a nuanced assessment of prognosis.We evaluate the potential of this score to transform clinical decision-making processes,its integration into current medical practices,and future directions for its develo-pment.The integration of genetic markers and other biomarkers could further refine its predictive power,highlighting the ongoing need for innovation in the management of rectal neuroendocrine neoplasms.

Rectal neuroendocrine tumors: Can we predict their behavior?

Rectal neuroendocrine tumors(r-NETs)are the second most common type of neuroendocrine tumor in the gastrointestinal tract,with an increase in incidence in the last decades.They are low-grade tumors and,given their low risk of meta-stasis,current guidelines recommend endoscopic resection for small lesions.The GATIS predicting score,proposed by Zeng et al,represents an innovative model designed to predict individualized survival outcomes for patients with r-NETs,analyzing the relationship between clinicopathological features and patient prog-noses.The authors identified tumor grade,T stage,tumor size,age,and progno-stic nutritional index as key prognostic factors,demonstrating that the GATIS Score provides a more accurate prognosis assessment compared to the World Health Organization classification or the tumor-node-metastasis staging system.Nevertheless,further larger prospective studies are necessary,and the scientific community's efforts in this context should be directed toward developing interna-tional multicentric prospective studies,with the ultimate aim of accurately de-fining and understanding the behavior of these conditions.

A Comprehensive Systematic Review: Advancements in Skin Cancer Classification and Segmentation Using the ISIC Dataset

The International Skin Imaging Collaboration(ISIC)datasets are pivotal resources for researchers in machine learning for medical image analysis,especially in skin cancer detection.These datasets contain tens of thousands of dermoscopic photographs,each accompanied by gold-standard lesion diagnosis metadata.Annual challenges associated with ISIC datasets have spurred significant advancements,with research papers reporting metrics surpassing those of human experts.Skin cancers are categorized into melanoma and non-melanoma types,with melanoma posing a greater threat due to its rapid potential for metastasis if left untreated.This paper aims to address challenges in skin cancer detection via visual inspection and manual examination of skin lesion images,processes historically known for their laboriousness.Despite notable advancements in machine learning and deep learning models,persistent challenges remain,largely due to the intricate nature of skin lesion images.We review research on convolutional neural networks(CNNs)in skin cancer classification and segmentation,identifying issues like data duplication and augmentation problems.We explore the efficacy of Vision Transformers(ViTs)in overcoming these challenges within ISIC dataset processing.ViTs leverage their capabilities to capture both global and local relationships within images,reducing data duplication and enhancing model generalization.Additionally,ViTs alleviate augmentation issues by effectively leveraging original data.Through a thorough examination of ViT-based methodologies,we illustrate their pivotal role in enhancing ISIC image classification and segmentation.This study offers valuable insights for researchers and practitioners looking to utilize ViTs for improved analysis of dermatological images.Furthermore,this paper emphasizes the crucial role of mathematical and computational modeling processes in advancing skin cancer detection methodologies,highlighting their significance in improving algorithmic performance and interpretability.

Extragastrointestinal stromal tumors with diffuse membranous distribution with bleeding:A case report

BACKGROUND Extragastrointestinal stromal tumors(EGIST)and gastrointestinal stromal tumors are of similar pathological type and form.Here we report a rare case of EGIST diffusely distributed in membranous tissue in abdominal cavity,the feature of which included diffuse tumors at membranous tissue in entire abdominal cavity and spontaneous bleeding of the tumors.CASE SUMMARY The patient was a 71-year man and hospitalized due to continuous pain at lower abdomen for more than 10 days.Upon physical examination,the patient had flat and tough abdomen with mild pressing pain at lower abdomen,no obvious abdominal mass was touchable,and shifting dullness was positive.Positron emission tomography-computed tomography(CT)showed that in his peritoneal cavity,there were multiple nodules of various sizes,seroperitoneum,multiple enlarged lymph nodes in abdominal/pelvic cavity and right external ilium as well as pulmonary nodules.Plain CT scanning at epigastrium/hypogastrium/pelvic cavity+enhanced three-dimensional reconstruction revealed multiple soft tissue nodules in abdominal/pelvic cavity,peritoneum and right groin.Tumor marker of carbohydrate antigen 125 was 808 U/mL,diffuse tuberous tumor was seen in abdominal/pelvic cavity during operation with hematocelia,and postoperative pathological examination confirmed EGIST.Imatinib was administered with better therapeutic effect.CONCLUSION Gene testing showed breast cancer susceptibility gene 1 interacting protein C-terminal helicase 1 and KIT genovariation,and the patient was treated with imatinib follow-up visit found that his clinical symptoms disappeared and the tumor load alleviated obviously via imageological examination.

Precision oncology: The role of minimally-invasive ablation therapy in the management of solid organ tumors

Solid organ tumors present a significant healthcare challenge,both economically and logistically,due to their high incidence and treatment complexity.In 2023,out of the 1.9 million new cancer cases in the United States,over 73%were solid organ tumors.Ablative therapies offer minimally invasive solutions for malignant tissue destruction in situ,often with reduced cost and morbidity compared to surgical resection.This review examines the current Food and Drug Administration-approved locoregional ablative therapies(radiofrequency,microwave,cryogenic,high-intensity focused ultrasound,histotripsy)and their evolving role in cancer care.Data were collected through a comprehensive survey of the PubMed-inde-xed literature on tumor ablation techniques,their clinical indications,and outco-mes.Over time,emerging clinical data will help establish these therapies as the standard of care in solid organ tumor treatment,supported by improved long-term outcomes and progression-free survival.

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.

Ultraconformable Integrated Wireless Charging Micro-Supercapacitor Skin

Conformable and wire-less charging energy storage devices play important roles in enabling the fast development of wearable,non-contact soft electronics.However,current wire-less charging power sources are still restricted by limited flexural angles and fragile connection of components,resulting in the failure expression of performance and constraining their fur-ther applications in health monitoring wearables and moveable artificial limbs.Herein,we present an ultracompatible skin-like integrated wireless charging micro-supercapacitor,which building blocks(including electrolyte,electrode and substrate)are all evaporated by liquid precursor.Owing to the infiltration and permeation of the liquid,each part of the integrated device attached firmly with each other,forming a compact and all-in-one configuration.In addition,benefitting from the controllable volume of electrode solution precursor,the electrode thickness is easily regulated varying from 11.7 to 112.5μm.This prepared thin IWC-MSC skin can fit well with curving human body,and could be wireless charged to store electricity into high capacitive micro-supercapacitors(11.39 F cm-3)of the integrated device.We believe this work will shed light on the construction of skin-attachable electronics and irregular sensing microrobots.