BACKGROUND Survival benefit of neoadjuvant chemotherapy(NAC)for advanced gastric cancer(AGC)is a debatable issue.Studies have shown that the survival benefit of NAC is dependent on the pathological response to chemoth...BACKGROUND Survival benefit of neoadjuvant chemotherapy(NAC)for advanced gastric cancer(AGC)is a debatable issue.Studies have shown that the survival benefit of NAC is dependent on the pathological response to chemotherapy drugs.For those who achieve pathological complete response(pCR),NAC significantly prolonged prolapsed-free survival and overall survival.For those with poor response,NAC yielded no survival benefit,only toxicity and increased risk for tumor progression during chemotherapy,which may hinder surgical resection.Thus,predicting pCR to NAC is of great clinical significance and can help achieve individualized treatment in AGC patients.AIM To establish a nomogram for predicting pCR to NAC for AGC patients.METHODS Two-hundred and eight patients diagnosed with AGC who received NAC followed by resection surgery from March 2012 to July 2019 were enrolled in this study.Their clinical data were retrospectively analyzed by logistic regression analysis to determine the possible predictors for pCR.Based on these predictors,a nomogram model was developed and internally validated using the bootstrap method.RESULTS pCR was confirmed in 27 patients(27/208,13.0%).Multivariate logistic regression analysis showed that higher carcinoembryonic antigen level,lymphocyte ratio,lower monocyte count and tumor differentiation grade were associated with higher pCR.Concordance statistic of the established nomogram was 0.767.CONCLUSION A nomogram predicting pCR to NAC was established.Since this nomogram exhibited satisfactory predictive power despite utilizing easily available pretreatment parameters,it can be inferred that this nomogram is practical for the development of personalized treatment strategy for AGC patients.展开更多
A stacked lateral double-diffused metal–oxide–semiconductor field-effect transistor(LDMOS) with enhanced depletion effect by surface substrate is proposed(ST-LDMOS), which is compatible with the traditional CMOS pro...A stacked lateral double-diffused metal–oxide–semiconductor field-effect transistor(LDMOS) with enhanced depletion effect by surface substrate is proposed(ST-LDMOS), which is compatible with the traditional CMOS processes. The new stacked structure is characterized by double substrates and surface dielectric trenches(SDT). The drift region is separated by the P-buried layer to form two vertically parallel devices. The doping concentration of the drift region is increased benefiting from the enhanced auxiliary depletion effect of the double substrates, leading to a lower specific on-resistance(Ron,sp). Multiple electric field peaks appear at the corners of the SDT, which improves the lateral electric field distribution and the breakdown voltage(BV). Compared to a conventional LDMOS(C-LDMOS), the BV in the ST-LDMOS increases from 259 V to 459 V, an improvement of 77.22%. The Ron,sp decreases from 39.62 m?·cm^2 to 23.24 m?·cm^2 and the Baliga's figure of merit(FOM) of is 9.07 MW/cm^2.展开更多
基金Supported by the Guangzhou Science and Technology Project,No.201803010040Natural Science Foundation of Guangdong Province,No.2016A030310187Nation Key Clinical Discipline。
文摘BACKGROUND Survival benefit of neoadjuvant chemotherapy(NAC)for advanced gastric cancer(AGC)is a debatable issue.Studies have shown that the survival benefit of NAC is dependent on the pathological response to chemotherapy drugs.For those who achieve pathological complete response(pCR),NAC significantly prolonged prolapsed-free survival and overall survival.For those with poor response,NAC yielded no survival benefit,only toxicity and increased risk for tumor progression during chemotherapy,which may hinder surgical resection.Thus,predicting pCR to NAC is of great clinical significance and can help achieve individualized treatment in AGC patients.AIM To establish a nomogram for predicting pCR to NAC for AGC patients.METHODS Two-hundred and eight patients diagnosed with AGC who received NAC followed by resection surgery from March 2012 to July 2019 were enrolled in this study.Their clinical data were retrospectively analyzed by logistic regression analysis to determine the possible predictors for pCR.Based on these predictors,a nomogram model was developed and internally validated using the bootstrap method.RESULTS pCR was confirmed in 27 patients(27/208,13.0%).Multivariate logistic regression analysis showed that higher carcinoembryonic antigen level,lymphocyte ratio,lower monocyte count and tumor differentiation grade were associated with higher pCR.Concordance statistic of the established nomogram was 0.767.CONCLUSION A nomogram predicting pCR to NAC was established.Since this nomogram exhibited satisfactory predictive power despite utilizing easily available pretreatment parameters,it can be inferred that this nomogram is practical for the development of personalized treatment strategy for AGC patients.
基金supported by the National Natural Science Foundation of China(Grant No.61464003)the Guangxi Natural Science Foundation,China(Grant Nos.2015GXNSFAA139300 and 2018JJA170010)
文摘A stacked lateral double-diffused metal–oxide–semiconductor field-effect transistor(LDMOS) with enhanced depletion effect by surface substrate is proposed(ST-LDMOS), which is compatible with the traditional CMOS processes. The new stacked structure is characterized by double substrates and surface dielectric trenches(SDT). The drift region is separated by the P-buried layer to form two vertically parallel devices. The doping concentration of the drift region is increased benefiting from the enhanced auxiliary depletion effect of the double substrates, leading to a lower specific on-resistance(Ron,sp). Multiple electric field peaks appear at the corners of the SDT, which improves the lateral electric field distribution and the breakdown voltage(BV). Compared to a conventional LDMOS(C-LDMOS), the BV in the ST-LDMOS increases from 259 V to 459 V, an improvement of 77.22%. The Ron,sp decreases from 39.62 m?·cm^2 to 23.24 m?·cm^2 and the Baliga's figure of merit(FOM) of is 9.07 MW/cm^2.
