BACKGROUND Ampullary adenocarcinoma is a rare malignant tumor of the gastrointestinal tract.Currently,only a few cases have been reported,resulting in limited information on survival.AIM To develop a dynamic nomogram ...BACKGROUND Ampullary adenocarcinoma is a rare malignant tumor of the gastrointestinal tract.Currently,only a few cases have been reported,resulting in limited information on survival.AIM To develop a dynamic nomogram using internal and external validation to predict survival in patients with ampullary adenocarcinoma.METHODS Data were sourced from the surveillance,epidemiology,and end results stat database.The patients in the database were randomized in a 7:3 ratio into training and validation groups.Using Cox regression univariate and multivariate analyses in the training group,we identified independent risk factors for overall survival and cancer-specific survival to develop the nomogram.The nomogram was validated with a cohort of patients from the First Affiliated Hospital of the Army Medical University.RESULTS For overall and cancer-specific survival,12(sex,age,race,lymph node ratio,tumor size,chemotherapy,surgical modality,T stage,tumor differentiation,brain metastasis,lung metastasis,and extension)and 6(age;surveillance,epidemiology,and end results stage;lymph node ratio;chemotherapy;surgical modality;and tumor differentiation)independent risk factors,respectively,were incorporated into the nomogram.The area under the curve values at 1,3,and 5 years,respectively,were 0.807,0.842,and 0.826 for overall survival and 0.816,0.835,and 0.841 for cancer-specific survival.The internal and external validation cohorts indicated good consistency of the nomogram.CONCLUSION The dynamic nomogram offers robust predictive efficacy for the overall and cancer-specific survival of ampullary adenocarcinoma.展开更多
With the increasing incidence of salivary gland tumors, partial parotidectomy has become more common, leading to a rise in the occurrence of parotid fistula post-surgery. Parotid fistula can cause redness and erosion ...With the increasing incidence of salivary gland tumors, partial parotidectomy has become more common, leading to a rise in the occurrence of parotid fistula post-surgery. Parotid fistula can cause redness and erosion of the surrounding skin, resulting in delayed wound healing, and it is a common postoperative complication that troubles both patients and healthcare providers. Various methods for the prevention and treatment of parotid fistula exist, each with its own advantages and disadvantages, typically requiring different approaches based on the type of fistula. The overall strategies for prevention and treatment can be divided into two categories: pharmacological and non-pharmacological treatments. Pharmacological options include anticholinergics, botulinum toxin injections, and hypertonic saline, while non-pharmacological options include low-dose radiotherapy, bandage compression, and biomembrane therapy. These methods can effectively prevent and treat parotid fistula, thereby reducing the concerns of both patients and healthcare providers.展开更多
Tropical forests store more than half of the world's terrestrial carbon(C)pool and account for one-third of global net primary productivity(NPP).Many terrestrial biosphere models(TBMs)estimate increased productivi...Tropical forests store more than half of the world's terrestrial carbon(C)pool and account for one-third of global net primary productivity(NPP).Many terrestrial biosphere models(TBMs)estimate increased productivity in tropical forests throughout the 21st century due to CO_(2)fertilization.However,phosphorus(P)liaitations on vegetation photosynthesis and productivity could significantly reduce the CO_(2)fertilization effect.Here,we used a carbon-nitrogen-phosphorus coupled model(Dynamic Land Ecosystem Model;DLEM-CNP)with heterogeneous maximum carboxylation rates to examine how P limitation has affected C fluxes in tropical forests during1860-2018.Our model results showed that the inclusion of the P processes enhanced model performance in simulating ecosystem productivity.We further compared the simulations from DLEM-CNP,DLEM-CN,and DLEMC and the results showed that the inclusion of P processes reduced the CO_(2)fertilization effect on gross primary production(GPP)by 25%and 45%,and net ecosystem production(NEP)by 28%and 41%,respectively,relative to CN-only and C-on ly models.From the 1860s to the 2010s,the DLEM-CNP estimated that in tropical forests GPP increased by 17%,plant respiration(Ra)increased by 18%,ecosystem respiration(Rh)increased by 13%,NEP increased by 121%per unit area,respectively.Additionally,factorial experiments with DLEM-CNP showed that the enhanced NPP benefiting from the CO_(2) fertilization effect had been offset by 135%due to deforestation from the 1860s to the 2010s.Our study highlights the importance of P limitation on the C cycle and the weakened CO_(2)fertilization effect resulting from P limitation in tropical forests.展开更多
BACKGROUNDAdvanced gastric tumors are extremely prone to metastasize the in 20%–30% ofgastric cancer, and patients have a poor prognosis despite systemic chemotherapy.Peritoneal metastases from gastric cancer usually...BACKGROUNDAdvanced gastric tumors are extremely prone to metastasize the in 20%–30% ofgastric cancer, and patients have a poor prognosis despite systemic chemotherapy.Peritoneal metastases from gastric cancer usually indicate the end stageof the disease without curative treatment.AIMTo peritoneal metastasis for facilitating clinical therapy are urgently needed.METHODSImmunohistochemical staining and immunofluorescence staining were used todemonstrate the high expression of cathepsin L (CTSL) in human gastric cancertissues and its localization in cells. Lentivirus transfection was used to construct stable cell lines. Transwell invasion assays, wound healing assays, and animal tests were used to determine therelationships between CTSL and epithelial-mesenchymal transition (EMT) and tumorigenic potential in vivo.RESULTSWe observed that macrophage-derived CTSL promoted gastric cancer cell migration and metastasis via the EMTpathway in vitro and in vivo, which involved macrophage polarization. Our findings suggest that macrophagesimprove extracellular matrix remodeling and hence facilitate tumor metastasis. Ablation of CTSL in macrophageswithin the tumor microenvironment may improve tumor therapy and the prognosis of patients with gastric cancerperitoneal metastasis.CONCLUSIONIn consideration of our findings, tumor-associated macrophage-derived CTSL is an important factor that promotesthe metastasis and invasion of gastric cancer cells, and the targeting of CTSL may potentially improve the prognosisof patients with gastric cancer with peritoneal metastasis.展开更多
基金Supported by the Appropriate Technology Promotion Program in Chongqing,No.2023jstg005.
文摘BACKGROUND Ampullary adenocarcinoma is a rare malignant tumor of the gastrointestinal tract.Currently,only a few cases have been reported,resulting in limited information on survival.AIM To develop a dynamic nomogram using internal and external validation to predict survival in patients with ampullary adenocarcinoma.METHODS Data were sourced from the surveillance,epidemiology,and end results stat database.The patients in the database were randomized in a 7:3 ratio into training and validation groups.Using Cox regression univariate and multivariate analyses in the training group,we identified independent risk factors for overall survival and cancer-specific survival to develop the nomogram.The nomogram was validated with a cohort of patients from the First Affiliated Hospital of the Army Medical University.RESULTS For overall and cancer-specific survival,12(sex,age,race,lymph node ratio,tumor size,chemotherapy,surgical modality,T stage,tumor differentiation,brain metastasis,lung metastasis,and extension)and 6(age;surveillance,epidemiology,and end results stage;lymph node ratio;chemotherapy;surgical modality;and tumor differentiation)independent risk factors,respectively,were incorporated into the nomogram.The area under the curve values at 1,3,and 5 years,respectively,were 0.807,0.842,and 0.826 for overall survival and 0.816,0.835,and 0.841 for cancer-specific survival.The internal and external validation cohorts indicated good consistency of the nomogram.CONCLUSION The dynamic nomogram offers robust predictive efficacy for the overall and cancer-specific survival of ampullary adenocarcinoma.
文摘With the increasing incidence of salivary gland tumors, partial parotidectomy has become more common, leading to a rise in the occurrence of parotid fistula post-surgery. Parotid fistula can cause redness and erosion of the surrounding skin, resulting in delayed wound healing, and it is a common postoperative complication that troubles both patients and healthcare providers. Various methods for the prevention and treatment of parotid fistula exist, each with its own advantages and disadvantages, typically requiring different approaches based on the type of fistula. The overall strategies for prevention and treatment can be divided into two categories: pharmacological and non-pharmacological treatments. Pharmacological options include anticholinergics, botulinum toxin injections, and hypertonic saline, while non-pharmacological options include low-dose radiotherapy, bandage compression, and biomembrane therapy. These methods can effectively prevent and treat parotid fistula, thereby reducing the concerns of both patients and healthcare providers.
基金partially supported by the US National Science Foundation(1903722,1243232)。
文摘Tropical forests store more than half of the world's terrestrial carbon(C)pool and account for one-third of global net primary productivity(NPP).Many terrestrial biosphere models(TBMs)estimate increased productivity in tropical forests throughout the 21st century due to CO_(2)fertilization.However,phosphorus(P)liaitations on vegetation photosynthesis and productivity could significantly reduce the CO_(2)fertilization effect.Here,we used a carbon-nitrogen-phosphorus coupled model(Dynamic Land Ecosystem Model;DLEM-CNP)with heterogeneous maximum carboxylation rates to examine how P limitation has affected C fluxes in tropical forests during1860-2018.Our model results showed that the inclusion of the P processes enhanced model performance in simulating ecosystem productivity.We further compared the simulations from DLEM-CNP,DLEM-CN,and DLEMC and the results showed that the inclusion of P processes reduced the CO_(2)fertilization effect on gross primary production(GPP)by 25%and 45%,and net ecosystem production(NEP)by 28%and 41%,respectively,relative to CN-only and C-on ly models.From the 1860s to the 2010s,the DLEM-CNP estimated that in tropical forests GPP increased by 17%,plant respiration(Ra)increased by 18%,ecosystem respiration(Rh)increased by 13%,NEP increased by 121%per unit area,respectively.Additionally,factorial experiments with DLEM-CNP showed that the enhanced NPP benefiting from the CO_(2) fertilization effect had been offset by 135%due to deforestation from the 1860s to the 2010s.Our study highlights the importance of P limitation on the C cycle and the weakened CO_(2)fertilization effect resulting from P limitation in tropical forests.
基金Supported by The National Natural Science Foundation of China,No.82272087 and No.82103150The Guangdong Natural Science Foundation Outstanding Youth Project,China,No.2021B1515020055The Guangdong Provincial Key Laboratory of Precision Medicine for Gastrointestinal Cancer,China,No.2020B121201004.
文摘BACKGROUNDAdvanced gastric tumors are extremely prone to metastasize the in 20%–30% ofgastric cancer, and patients have a poor prognosis despite systemic chemotherapy.Peritoneal metastases from gastric cancer usually indicate the end stageof the disease without curative treatment.AIMTo peritoneal metastasis for facilitating clinical therapy are urgently needed.METHODSImmunohistochemical staining and immunofluorescence staining were used todemonstrate the high expression of cathepsin L (CTSL) in human gastric cancertissues and its localization in cells. Lentivirus transfection was used to construct stable cell lines. Transwell invasion assays, wound healing assays, and animal tests were used to determine therelationships between CTSL and epithelial-mesenchymal transition (EMT) and tumorigenic potential in vivo.RESULTSWe observed that macrophage-derived CTSL promoted gastric cancer cell migration and metastasis via the EMTpathway in vitro and in vivo, which involved macrophage polarization. Our findings suggest that macrophagesimprove extracellular matrix remodeling and hence facilitate tumor metastasis. Ablation of CTSL in macrophageswithin the tumor microenvironment may improve tumor therapy and the prognosis of patients with gastric cancerperitoneal metastasis.CONCLUSIONIn consideration of our findings, tumor-associated macrophage-derived CTSL is an important factor that promotesthe metastasis and invasion of gastric cancer cells, and the targeting of CTSL may potentially improve the prognosisof patients with gastric cancer with peritoneal metastasis.
