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

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

Effect of VirD4 on gastric epithelial-1 cells and its mechanism

The gene of Helicobacter pylori can encode three to four type IV secretory systems,of which a new gene region has been found in the H.pylori plasticity region.The coding products of this region can form a new T4SS named tfs3,but its function is unclear.This study investigated the effect of VirD4 recombinant protein in the tfs3 secretory system of the H.pylori clinical strain SBK on GES-1 cells.We observed changes in cell morphology after VirD4 treatment.Further analysis indicated that VirD4 increased inflammation by increasing the activation of NF-κB.VirD4 can also inhibited proliferation,and induced migration of cells.Moreover,VirD4 caused apoptosis in GES-1 cells in caspase and ERK1/2/Ras dependent signaling events.Our study laid a foundation for further research on the biological function of VirD4 and the detection and treatment of H.pylori-related diseases.

The Spectrum and Age-Sex Patterns Among Outpatients with Allergic Diseases—Yichang City,Hubei Province,China,2018–2021

What is already known about this topic?Allergic diseases have affected an estimated 40%of the population in China.However,our understanding of the full spectrum of these diseases remains insufficient.What is added by this report?Between 2018 and 2021,Yichang City documented 625,929 outpatient visits mainly related to skin and mucous membrane allergies(77.90%)and allergic respiratory conditions(19.64%).In 2021,the occurrence of outpatient visits for conditions such as allergic rhinitis,acute atopic conjunctivitis,and atopic dermatitis increased.The demographic analysis revealed that male patients comprised the majority of the under 18 age bracket(56.05%),while female patients were predominantly represented in the 18 to 65 age bracket(61.79%).What are the implications for public health practice?This constitutes the first analysis of the spectrum of allergic diseases,utilizing regional outpatient data,which has substantial implications for understanding the disease burden.

基于人工智能的全自动化一站式CT血流储备分数在冠心病患者中的诊断与预后价值

Currently,clinically available coronary CT angiography(CCTA)derived fractional flow reserve(CT-FFR)is time-consuming and complex.We propose a novel artificial intelligence-based fully-automated,on-site CT-FFR technology,which combines the automated coronary plaque segmentation and luminal extraction model with reduced order 3 dimentional(3D)computational fluid dynamics.A total of 463 consecutive patients with 600 vessels from the updated China CT-FFR study in Cohort 1 undergoing both CCTA and invasive fractional flow reserve(FFR)within 90 d were collected for diagnostic performance evaluation.For Cohort 2,a total of 901 chronic coronary syndromes patients with index CT-FFR and clinical outcomes at 3-year follow-up were retrospectively analyzed.In Cohort 3,the association between index CT-FFR from triple-rule-out CTA and major adverse cardiac events in patients with acute chest pain from the emergency department was further evaluated.The diagnostic accuracy of this CT-FFR in Cohort 1 was 0.82 with an area under the curve of 0.82 on a per-patient level.Compared with the manually dependent CT-FFR techniques,the operation time of this technique was substantially shortened by 3 times and the number of clicks from about 60 to 1.This CT-FFR technique has a highly successful(>99%)calculation rate and also provides superior prediction value for major adverse cardiac events than CCTA alone both in patients with chronic coronary syndromes and acute chest pain.Thus,the novel artificial intelligencebased fully automated,on-site CT-FFR technique can function as an objective and convenient tool for coronary stenosis functional evaluation in the real-world clinical setting.

Sintilimab versus docetaxel as second-line treatment in advanced or metastatic squamous non-small-cell lung cancer:an open-label,randomized controlled phase 3 trial(ORIENT-3)

Background:Treatment options for Chinese patients with locally advanced or metastatic squamous-cell non-small-cell lung cancer(sqNSCLC)after failure of first-line chemotherapy are limited.This study(ORIENT-3)aimed to evaluate the efficacy and safety of sintilimab versus docetaxel as second-line treatment in patients with locally advanced or metastatic sqNSCLC.Methods:ORIENT-3 was an open-label,multicenter,randomized controlled phase 3 trial that recruited patients with stage IIIB/IIIC/IV sqNSCLC after failure with first-line platinum-based chemotherapy.Patients were randomized in a 1:1 ratio to receive either 200 mg of sintilimab or 75 mg/m^(2) of docetaxel intravenously every 3 weeks,stratified by the Eastern Cooperative Oncology Group performance status.The primary endpoint was overall survival(OS)in the full analysis set(FAS).Secondary endpoints included progression-free survival(PFS),objective response rate(ORR),disease control rate(DCR),duration of response(DoR)and safety.Results:Between August 25,2017,and November 7,2018,290 patients were randomized.For FAS,10 patients fromthe docetaxel armwere excluded.Themedian OS was 11.79(n=145;95%confidence interval[CI],10.28-15.57)months with sintilimab versus 8.25(n=135;95%CI,6.47-9.82)months with docetaxel(hazard ratio[HR]:0.74;95%CI,0.56-0.96;P=0.025).Sintilimab treatment significantly prolonged PFS(median 4.30 vs.2.79 months;HR:0.52;95%CI,0.39-0.68;P<0.001)and showed higher ORR(25.50%vs.2.20%,P<0.001)and DCR(65.50%vs.37.80%,P<0.001)than the docetaxel arm.The median DoRwas 12.45(95%CI,4.86-25.33)months in the sintilimab arm and 4.14(95%CI,1.41-7.23)months in the docetaxel arm(P=0.045).Treatment-related adverse events of grade≥3were reported in 26(18.1%)patients in the sintilimab arm and 47(36.2%)patients in the docetaxel arm.Exploratory biomarker analysis showed potential predictive values of expression levels of two transcription factors,including OVOL2(HR:0.35;P<0.001)and CTCF(HR:3.50;P<0.001),for sintilimab treatment.Conclusions:Compared with docetaxel,sintilimab significantly improved the OS,PFS,and ORR of Chinese patients with previously treated locally advanced or metastatic sqNSCLC.

MED12 mutations in human diseases

The Mediator Complex plays key roles in activating gene transcription in eukaryotes.Mediator of RNA polymerase II transcription subunit 12 homolog(MED12)is a subunit of the Mediator Complex and regu-lates the activity of the complex.MED12 is involved in a variety of cellular activities,and mutations in MED12 gene impair MED12 activities and are associated with several diseases,including Opitz-Kaveggia syndrome,Lujan syndrome,uterine leiomyomas and prostate cancer.This review will discuss the bio-logical function of MED12 and the relationship between MED12 mutations and diseases.