Dalian Jinzhou First People's Hospital

Background: Large Borrmann type III and IV gastric cancer (GC) is a special type of GC characterized by poor prognosis and high mortality. Immunotherapy has been demonstrated to have acceptable efficacy and safety in metastatic GC. However, it was unclear whether large Borrmann type III and IV GC patients could benefit from neoadjuvant immunotherapy plus chemotherapy (IC). Aim: The aim is to explore safety and efficacy of neoadjuvant immunotherapy plus chemotherapy in large Borrmann type III and IV GC patients. Method: This multi-center retrospective comparative cohort study included 124 patients with large Borrmann type III and IV GC who received neoadjuvant therapy at several large-scale hospitals in Western China between January 2020 and June 2024. Patients were divided into the chemotherapy C group and the IC group. The drug adverse events and surgical complications, major pathological response (MPR), and pathological complete response (pCR) were compared between the two groups. Results: It was not significantly different in terms of drug adverse events of any grade (53.7% vs. 47%, P > 0.05), and in terms of surgical complications (25% vs. 22.9%, P >0.05) between the IC group and the C group. The pCR rate and the MPR rate were 12.2% versus 6% and 22.0% versus 14.5% for the IC group and the C group, respectively. These differences were not statistically significant. No pCR patient was found in the Borrmann IV group and the large Borrmann type III esophagogastric junction cancer group. For clinical stage III GC, the MPR rate was higher in the IC group than that in the C group (22.5% vs. 8.2%, P = 0.03). Conclusion: Neoadjuvant IC could be well tolerated and did not significantly improve the pCR or MPR rates in the overall population of large Borrmann type III and IV GC.

ABSTRACTHypertension is one of the most common comorbidities associated with diabetes. The standardized diagnosis and treatment of hypertension in diabetic patients, along with achieving blood pressure targets, is of great significance for reducing long‐term complications, extending lifespan, and improving quality of life. Recent high‐quality multicenter large‐sample intervention studies have provided important evidence‐based grounds for setting blood pressure targets in diabetic patients. Therefore, based on a comprehensive summary of important domestic and international research literature, and in combination with clinical practice experience, this management guideline is now formulated.

Abstract Background: Osteosarcoma(OS) is the most common primary bone malignancy in ado-lescents. The function of lipid metabolism-related lncRNAs in disease progression and prognosis of osteosarcoma remains unclear. This study aimed to explore the role of lipid metabolism-related lncRNAs in osteosarcoma development and prognosis. Methods: Pearson correlation was used for identification of lipid metabolism-related lncRNAs, and univariate and multivariate Cox regression analyses were used to construct and validate a risk signature to predict the prognosis of OS patients. Functional analysis using Gene set enrichment analysis (GSEA) to elucidate underlying mechanisms. Analysis of potential regulatory mechanisms of lipid metabolism-related lncRNAs using ceRNA networks, and they were preliminarily verified in our tissues using immunohistochemistry (IHC). Results: We screened two lipid metabolism-related lncRNAs (SNHG17 and LINC00837) to con-struct a risk signature and validated them in the GEO database. The results showed that this risk model was an independent prognostic factor for OS patients. GSEA analysis showed that this signature may be associated with cell proliferation and metabolism-related pathways in OS patients. Cox regression, ROC curve analysis, and a nomogram indicated that the risk model was an independent prognostic factor and it showed potent potential for survival prediction in osteosarcoma. Nomogram integrating risk model and clinical characteristics could predict the prognosis of osteosarcoma patients accurately. Immunohistochemical results showed that CSNK2A2, MIF and VDAC2 were up-regulated in tumor tissues. Conclusions: In summary, our study demonstrates that lipid-metabolism related-lncRNA could be applied to predict the prognosis of in osteosarcoma accurately.

The Chinese herbal formula TiaoGanYiPi (TGYP) showed effective against chronic hepatitis B (CHB) caused by hepatitis B virus (HBV) infection. Hence, we aimed to clarify the mechanisms and potential targets between TGYP and CHB. The active compounds and related putative targets of TGYP, and disease targets of CHB were obtained from the public databases. The key targets between TGYP and CHB were identified through the network construction and module analysis. The expression of the key targets was detected in Gene Expression Omnibus (GEO) dataset and normal hepatocyte cell line LO2. We first obtained 11 key targets which were predominantly enriched in the Cancer, Cell cycle and HBV-related pathways. And the expression of the key targets was related to HBV infection and liver inflammation verified in GSE83148 database. Furthermore, the results of real-time quantitative PCR and CCK-8 assay indicated that TGYP could regulate the expression of key targets including CCNA2, ABL1, CDK4, CDKN1A, IGFR and MAP2K1, and promote proliferation of LO2 cells. In coclusion, we identified the active compounds and key targets btween TGYP and CHB, and found that the TGYP might exhibite curative effect on CHB via promoting hepatocyte proliferation and inhibiting the liver inflammatory processes.

Abstract Background: Occult metastases in axillary lymph nodes have been reported to be associated with poor prognosis in patients with breast cancer. However, studies on the prognostic value of occult metastases remain controversial. This meta-analysis aimed to evaluate the prognostic significance of occult lymph node metastases in breast cancer.Methods: Studies published published until May, 2020, which retrospectively examined negative lymph nodes by step sectioning and/or immunohistochemistry, were retrieved from MEDLINE, EMBASE, CNKI, and Cochrane Library. The pooled Relative risk (RR) with 95% confidence interval (95% CI) for overall survival (OS) and disease-free survival (DFS) were calculated to appraise the associations between occult metastases and prognosis.Results: The results showed patients with occult metastases in axillary lymph nodes had poorer five-year DFS (RR = 0.930; 95% CI = 0.907–0.954) and OS (RR = 0.972; 95% CI = 0.954–0.990). Furthermore, the DFS (RR = 0.887; 95% CI = 0.810–0.972) and OS (RR = 0.896; 95% CI = 0.856–0.939) of patients with occult metastases were much lower after a ten-year follow-up.Conclusions: Occult metastases in the axillary lymph nodes of patients with breast cancer are associated with poorer disease-free and overall survival. Occult metastases might serve as a predictive factor of survival outcomes in patients with breast cancer.

Mesenteric fibromatosis is a locally invasive myofibroblastic proliferation and rarely metastasize to other organs. Hollow organ perforation and acute diffuse peritonitis caused by mesenteric fibromatosis rarely occurred. Here we report a case of huge mesenteric fibromatosis who complained a paroxysmal epigastric pain, and CT scan showed a huge mass, pneumoperitoneum and ascites. An urgent laparotomy showed an intro-abdominal mass and perforation locating at the jejunum. Postoperative histology confirmed it to be mesenteric fibromatosis. With one-year follow-up, the patient had no recurrence. We wish to share our treating experience of this interesting case because it did not belong to a typical type but presenting with acute diffuse peritonitis, and total resection and R0 margin is a key to treat acute case. This atypical one has not been reported in the literature till now.

Use of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) cytology to detect pancreatic cancer is limited, with a high false negative rate mainly due to the relatively fewer number of completely cancerous cells. To improve the accuracy of EUS-FNA cytological diagnosis, we evaluated a novel optical system—spatial-domain low-coherence quantitative phase microscopy (SL-QPM)—to analyze nanoscale nuclear architecture on original cytology samples, especially those diagnosed as indeterminate for malignancy, with the goal of maintaining high specificity and reducing false positive rate. We performed SL-QPM on original cytology samples obtained by EUS-FNA from 40 patients with suspicious pancreatic solid lesions (27 adenocarcinomas, 5 neuroendocrine tumor, 8 chronic pancreatitis), including 13 cases that were cytologically indeterminate. Each diagnosis had been confirmed by follow-up surgical pathology. The SL-QPM-derived nanoscale nuclear architectural parameters distinguished pancreatic cancer from cytologically indeterminate cells. A logistic regression model using nuclear entropy and SD increased the sensitivity of cytology in identifying pancreatic cancer from 72% to 94% while maintaining 100% specificity. The SL-QPM-derived nanoscale nuclear architecture properties show great promise in improving the cytological diagnosis of EUS-FNA for pancreatic cancer and could be used when traditional cytopathology does not get an accurate diagnosis, and can be easily translated into a traditional clinical device.

Background:In cardiology, it is controversial whether different therapy strategies influence prognosis after acute coronary syndrome. We examined and compared the long-term outcomes of invasive and conservative strategies in patients with non-ST-segment elevation myocardial infarction (NSTEMI) and characterized the patients selected for an invasive approach.Methods:A total of 976 patients with acute NSTEMI were collected from December 2006 to October 2012 in the First Affiliated Hospital of Dalian Medical University Hospital. They are divided into conservative strategy (586 patients) and invasive strategy (390 patients) group. Unified follow-up questionnaire was performed by telephone contact (cut-off date was November, 2013). The long-term clinical events were analyzed and related to the different treatment strategies.Results:The median follow-up time was 29 months. Mortality was 28.7% (n = 168) in the conservative group and 2.1% (n = 8) in the invasive management at long-term clinical follow-up. The secondary endpoint (the composite endpoint) was 59.0% (n = 346) in the conservative group and 30.3% (n = 118) in the invasive management. Multivariate analysis showed that patients in the conservative group had higher all-cause mortality rates than those who had the invasive management (adjusted risk ratio [RR] = 7.795; 95% confidence interval [CI]: 3.796–16.006, P < 0.001), and the similar result was also seen in the secondary endpoint (adjusted RR = 2.102; 95% CI: 1.694–2.610, P < 0.001). In the subgroup analysis according to each Thrombolysis in Myocardial Infarction risk score (TRS), log-rank analysis showed lower mortality and secondary endpoint rates in the invasive group with the intermediate and high-risk patients (TRS 3–7).Conclusions:An invasive strategy could improve long-term outcomes for NSTEMI patients, especially for intermediate and high-risk ones (TRS 3–7).

Objective To analyze the cause of dry eye in children is clinically misdiagnosed as amblyopia; to gain a better understanding of dry eye in children in order to avoid and reduce the occurrence of misdiagnosis.Methods This was a retrospective cases analysis.Optometric testing was performed on 15 children who had been diagnosed as amblyopic in outpatient clinic.Children aged 4 to 7 years were included in this study.When optometric prescriptions for the treatment of amblyopia are not effective and some symptoms are present,the children then were checked for dry eye.Results After testing for dry eye,all the children were diagnosed as dry eye and recovered after medical treatment.Conclusion A diagnosis of dry eye is often overlooked in children.Systematic investigations and careful tests for dry eye should be performed on high-risk children. Key words: Children ; Xerophthalmia; Diagnostic error