bluuebunny/crossref_metadata_2025 huggingface dataset:
Virtuelle Stabsarbeit in Zeiten der Pandemie – Entwicklung digitaler Übungsformate in der zivilen Gefahrenabwehr während der Coronapandemie
Authors: Heuser Julian , Tolg Boris , Loer Karsten , Klein Angelina , Sprössel Nadine , Klein Jonas , Haralambiev Lyubomir , Oldenburg Marcus , Militzer Kristina Carolin , Belz Lukas , von Münster Thomas , Harth Volker , Ehlers Lena , de Boer Jens , Kleine-Kampmann Scarlett , Boldt Matthias , Dirksen-Fischer Martin , Wiedemann Markus , Ekkernkamp Axel , Bakir Mustafa Sinan
Published: June 2023

Hintergrund

Im Bereich der Gefahrenabwehr von Großschadensereignissen, wie einem Massenanfall von Verletzten (MANV) oder von Erkrankten (MANE), sind regelmäßige Übungen essenziell, um im Ereignisfall erfahrene Einsatzkräfte zur Verfügung zu haben. Pandemiebedingt mussten Übungen häufig abgesagt werden oder waren nur in kleinen Personengruppen möglich. Die Abbildung einer Großschadenslage mit Darstellern war häufig nicht möglich, sodass den Übenden keine realitätsnahen Szenarien eines MANV oder MANE angeboten werden konnten. Im Rahmen zweier Forschungsprojekte wurde zur Vermeidung eines Infektionsrisikos von Übungsteilnehmenden eine digitale Plattform zur Durchführung von Übungen genutzt, um den Personaleinsatz vor Ort auf ein Minimum reduzieren zu können. Ziel dieser Arbeit war die Evaluation der digitalen Lösungsansätze in Bezug auf ihre Endnutzerakzeptanz.

Methoden

Im Rahmen des Projekts „Adaptives Resilienz Management im Hafen“ (ARMIHN) wurde eine digitale Übungsplattform angewendet und mithilfe von Teilnehmendenbefragungen nach den Schwerpunkten „Umsetzung“, „Alternativmöglichkeiten“, „Lerneffekt“ und „Nutzbarkeit“ evaluiert. Die Teilnehmenden nutzten die digitale Plattform zum Informationsaustausch sowie zur Kommunikation. Hierfür wurden verschiedene Kollaborationstools in die Plattform eingebettet, welche einen simultanen Austausch von Informationen in Echtzeit ermöglichten. Eine stetige Videokommunikation zu eigenen und auswärtigen Kräften wurde ebenfalls etabliert.

Ergebnis

Das Potenzial der digitalen Plattform als Alternative zu Übungen in Präsenz wurde durch die beteiligten Endanwender im ARMIHN-Projekt mit 90 %iger Zustimmung bestätigt. Auch die Steigerung der subjektiven Fähigkeiten und des Kenntnisgewinns bei einem MANE wurde überwiegend zustimmend bewertet (bis zu 70 %). Teilnehmende, die die Umsetzung des Online-Formats als gut gelungen bewerteten, gaben signifikant häufiger an, dass sich subjektiv ihre Fähigkeiten zum Umgang mit einem MANE verbessert hätten (p = 0,016). Dahingegen wurde eine virtuelle Stabsarbeit in realen Krisensituationen von ungefähr der Hälfte der Befragten kritisch gesehen.

Diskussion

Die Evaluationsergebnisse weisen insgesamt auf die hohe Endnutzerakzeptanz des entwickelten Konzepts hin. Auch wenn angestrebt ist, das System über einen längeren Zeitraum mit größerer Anzahl von Teilnehmenden weiter zu evaluieren, so bestätigen die bereits durchgeführten Untersuchungen die positiven Erfahrungen in den jeweiligen Projekten.
Adult-onset Still’s disease complicated by macrophage activation syndrome during pregnancy: a case-based review
Authors: Wise Leanna , Zell Monica
Published: June 2023

Adult-onset Still’s disease is a rare, systemic inflammatory rheumatic disease characterized by recurrent fevers, arthritis, and an evanescent rash. One of the most serious hematologic derangements that can be seen with adult-onset Still’s disease is macrophage activation syndrome. Macrophage activation syndrome is characterized by activation of lymphocytes, resulting in a cytokine storm and hemophagocytosis in the bone marrow, along with multi-organ failure. Adult-onset Still’s disease with macrophage activation syndrome first presenting during pregnancy is exceptionally rare; here, we report two unique cases of such a presentation and review the pertinent literature. Both of our cases presented critically ill with end-organ failure, and responded to immunosuppression; fetal demise was present in one and an emergency caesarean section with a viable fetus was performed in the other patient. Maternal outcomes were favorable in both cases and both patients did well long-term with systemic therapy. Systemic immunosuppression, particularly anti-IL1 therapy, may be considered as treatment for this rare and life-threatening condition when presenting during pregnancy.
A technical characterization of APTs by leveraging public resources
Authors: González-Manzano Lorena , de Fuentes José M. , Lombardi Flavio , Ramos Cristina
Published: June 2023

Advanced persistent threats (APTs) have rocketed over the last years. Unfortunately, their technical characterization is incomplete—it is still unclear if they are advanced usages of regular malware or a different form of malware. This is key to develop an effective cyberdefense. To address this issue, in this paper we analyze the techniques and tactics at stake for both regular and APT-linked malware. To enable reproducibility, our approach leverages only publicly available datasets and analysis tools. Our study involves 11,651 regular malware and 4686 APT-linked ones. Results show that both sets are not only statistically different, but can be automatically classified with F1 > 0.8 in most cases. Indeed, 8 tactics reach F1 > 0.9. Beyond the differences in techniques and tactics, our analysis shows thats actors behind APTs exhibit higher technical competence than those from non-APT malwares.
Systemic chemotherapy for metastatic breast cancer
Authors: Zhao Yannan , Wang Biyun
Published: June 2023

Breast cancer is the leading cause of cancer among women worldwide and the most common cancer in China. Many factors influence the treatment strategy for metastatic breast cancer (MBC). Chemotherapy should be administered to patients with hormone receptor-negative tumors, symptomatic visceral metastasis, and a short disease-free interval. Sequential single-agent chemotherapy has similar efficacy as combination agents in terms of overall survival and quality of life. Anthracyclines are the cornerstone of first-line treatment for MBC, and taxanes represent the second treatment option after resistance. When progression or intolerable toxicity occurs after optimal treatment, the alternative treatments include capecitabine, vinorelbine, and gemcitabine. Ixabepilone and eribulin are relatively new effective single agents. A combination of cytotoxic agents for patients with rapid clinical progression can further improve the overall response rate and time to progression compared to single-agent treatment. For patients with MBC who were pretreated with anthracyclines in the neoadjuvant/adjuvant setting, a taxane-containing regimen such as docetaxel plus capecitabine or gemcitabine plus paclitaxel should be administered. Platinum-based therapies such as cisplatin or carboplatin have a role in the treatment of triple-negative breast cancer. Meanwhile, the efficacy of the addition of targeted drugs such as iniparib, bevacizumab, and cetuximab to chemotherapy remains unproven. Maintenance chemotherapy is routinely recommended in clinical practice at present. Patients who were previously treated with paclitaxel and gemcitabine have better progression-free and overall survival with maintenance chemotherapy according to a Korean phase III clinical trial. Sequential maintenance treatment with capecitabine monotherapy after capecitabine-based combination chemotherapy (X-based X) appears favorable based on a series of domestic studies.
Dosimetric consequences of tumor volume changes after kilovoltage cone-beam computed tomography for non-operative lung cancer during adaptive intensity-modulated radiotherapy or fractionated stereotactic radiotherapy
Authors: Hu Jian , Xu Ximing , Yuan Guangjin , Ge Wei , Xu Liming , Zhang Aihua , Deng Junjian
Published: June 2023

Objective

The aim of this study was to investigate tumor volume changes with kilovoltage cone-beam computed tomography (kV-CBCT) and their dosimetric consequences for non-operative lung cancer during intensity-modulated radiotherapy (IMRT) or fractionated stereotactic radiotherapy.

Methods

Eighteen patients with non-operative lung cancer who received IMRT consisting of 1.8-2.2 Gy/fraction and five fractions per week or stereotactic radiotherapy with 5-8 Gy/fraction and three fractions a week were studied. kV-CBCT was performed once per week during IMRT and at every fraction during stereotactic radiotherapy. The gross tumor volume (GTV) was contoured on the kV-CBCT images, and adaptive treatment plans were created using merged kV-CBCT and primary planning computed tomography image sets. Tumor volume changes and dosimetric parameters, including the minimum dose to 95% (D95) or 1% (D1) of the planning target volume (PTV), mean lung dose (MLD), and volume of lung tissue that received more than 5 (V5), 10 (V10), 20 (V20), and 30 (V30) Gy were retrospectively analyzed.

Results

The average maximum change in GTV observed during IMRT or fractionated stereotactic radiotherapy was -25.85% (range, -13.09% - -56.76%). The D95and D1 of PTV for the adaptive treatment plans in all patients were not significantly different from those for the initial or former adaptive treatment plans. In patients with tumor volume changes of >20% in the third or fourth week of treatment during IMRT, adaptive treatment plans offered clinically meaningful decreases in MLD and V5, V10, V20, and V30; however, in patients with tumor volume changes of < 20% in the third or fourth week of treatment as well as in patients with stereotactic radiotherapy, there were no significant or clinically meaningful decreases in the dosimetric parameters.

Conclusion

Adaptive treatment planning for decreasing tumor volume during IMRT may be beneficial for patients who experience tumor volume changes of >20% in the third or fourth week of treatment.
Advancements in radiotherapy for lung cancer in China
Authors: Zhao Lujun , Wang Luhua
Published: June 2023

Lung cancer is the leading cause of death due to cancer in China. In recent years, great progress has been made in radiotherapy for lung cancer patients in China. The main advancements include the following aspects: (1) stereotactic ablative radiotherapy for early stage nonsmall cell lung cancer (NSCLC), (2) post-operative radiotherapy for NSCLC, (3) combined chemotherapy and radiotherapy for locally advanced NSCLC, (4) improved radiotherapy for advanced NSCLC, and 5) prediction of radiation-induced lung toxicity.
Clinicopathological characteristics and treatment of carcinosarcoma of the female genital tract
Authors: Zhu Jun , Wen Hao , Wu Xiaohua
Published: June 2023

Carcinosarcomas of the female genital tract are highly aggressive and rare tumors, differing from other malignant gynecological tumors in that they contain both malignant carcinomatous and sarcomatous elements. Because carcinosarcomas are rapidly progressive, less sensitive to chemotherapy or radiotherapy, and have a high probability of recurrence, patients with advanced uterine and ovarian carcinosarcomas have poorer survival than those with endometrial or high-grade serous carcinomas. Although the treatment strategies are controversial, a comprehensive management approach is recommended, which involves complete debulking surgery followed by adjuvant chemotherapy and/or radiotherapy. Molecular-targeted therapies are promising for the management and improvement in the overall survival of patients with carcinosarcomas.
Investigation of quality of life in patients with lung cancer by the EORTC QLQ-C30 (V3.0) Chinese version ⁎
Authors: Li Jun , Xiao Xiaoguang , Wei Yao , Li Yang , Zou Man , Yu Shiying , Chen Yuan , Chu Qian
Published: June 2023

Objective

To explore quality of life (QOL) and its influencing factors in patients with lung cancer.

Methods

A QOL questionnaire (European Organization for Research and Treatment of Cancer [EORTC] Quality of Life Questionnaire-Core 30 [QLQ-C30] Chinese version) was used with 138 patients with lung cancer participating in the study. A statistical description of the general characteristics of the patients with lung cancer was performed. The patients’ QLQ-C30 scores were compared with the reference value for each dimension. To analyze the influence of QOL in different genders, age groups, and cancer stages, t-tests and rank sum tests were used to compare the differences in QOL using a 5% significance level. Results The QLQ-C30 function scores in PF (physical functioning), EF (emotional functioning), SF (social functioning), and GH (global functioning), and symptom scales in NV (nausea and vomiting), DY (dyspnea), SL (insomnia), and FI (financial difficulties) were significantly different (P < 0.05) in comparison to the reference values. Female patients were worse than males (P < 0.05) in EF, NV, and DI (diarrhea). The later the stage of lung cancer, the worse the quality of life became; the functional scales in RF (role functioning), EF, CF, SF, and GH, and symptom scales in PA (pain), AP (appetite), and SL differences were statistically significant (P < 0.05).

Conclusion

This study aids understanding of the status of the quality of life of Chinese patients with cancer and might be useful for clinical work, theory research, and health policymakers.
Lung cancer: Progress, current status, and controversies
Authors: Chen Yuan
Published: June 2023

Yuan Chen,

Professor of Oncology, Doctoral Supervisor; the Deputy Director of the Oncology Department and the Director of the Thoracic Oncology Department in Tongji Hospital, Tongji Medical College of HUST, China. Prof. Chen graduated from Tongji Medical University in 1985 and studied in the MD Anderson Cancer Center as a visiting associate professor from August 2002 to August 2003. He has worked in the clinical, teaching, and research fields of oncology for 29 years. He is an expert in tumor diagnosis and treatment, especially in thoracic oncology, and in palliative care and radiation therapy. He has undertaken in-depth studies and, his achievements are as follows: Member of Council, CHINESE ANTI-CANCER ASSOCIATION (CACA); Vice Chairman, Cancer Rehabilitation and Palliative Care Committee, CACA; Chairman, Cancer Rehabilitation and Palliative Care Committee, HUBEI ANTI-CANCER ASSOCIATION; Vice Chairman, Lung Cancer Committee, HUBEI ANTI-CANCER ASSOCIATION; Vice Chairman, Hubei Targeted Therapy Committee; Vice Chairman, Radiation Oncology Committee, WUHAN MEDICAL ASSOCIATION; Vice Chairman, Hubei Stereotactic Radiotherapy Committee.
Clinical study of docetaxel plus S-1 as neoadjuvant therapy for advanced gastric cancer
Authors: Chai Yuxiao , Han Yu , Wang Bing , Zhang Yi , Qu Xinglong
Published: June 2023

Objective

To evaluate the efficacy, toxicity, and operative complications of docetaxel in combination with S-1 for treating patients with advanced gastric cancer.

Methods

From July 2013 to December 2014, 30 patients with advanced gastric cancer were treated with i.v. docetaxel 75 mg/m2 on day 1 and oral S-1 60 mg/m2 bid on days 1-14 every 3 weeks. The efficacy and toxicity were evaluated after two chemotherapy cycles.

Results

The overall treatment response (complete response [CR] + partial response [PR]) was 76.6% (23/30), CR was 6.7% (2/30), PR was 70.0% (21/30), SD was 23.3% (7/30), and progression disease was 0% (0/30). All patients were treated surgically. Twenty-six patients received radical surgery; of them, 23 received D2 lymph node dissection. The other four patients received exploratory celiotomy. No patients died in the group, and the adverse reactions included neutropenia, diarrhea, nausea, and vomiting.

Conclusion

Docetaxel/S-1 combination is highly active, safe, and well tolerated in patients with advanced gastric cancer. Further investigations in randomized studies are warranted.
Cine magnetic resonance imaging for quantitative assessment of healthy volunteers and patients with organic small bowel disease ⁎
Authors: Wang Zi , Tang Hao , Li Jianjun , Wang Qiuxia , Shen Yaqi , Li Zhen , Yuan Sishu , Hu Daoyu
Published: June 2023

Objective

The aim of the study was to use dynamic magnetic resonance imaging (MRI) to compare quantitative parameters of small bowel motility between healthy volunteers and patients with small bowel diseases in order to investigate the characteristics of normal and impaired bowel peristalsis.

Methods

A total of 44 healthy volunteers (20 men, 24 women; mean age: 36 years; range: 20-61 years) and 42 patients (28 men, 14 women; mean age: 44 years; range: 15-72 years) with organic small bowel disease were recruited in our hospital (Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China) in this prospective study approved by the hospital institutional review board. Imaging was performed using a 3.0-T scanner 45 minutes after standardized oral administration of 1500 mL non-absorbable fluid (2.5% mannitol). A serial coronal scan was performed at selected planes for two minutes without breath-hold. Time-caliber curves were plotted at two well-distended small bowel loops in both healthy and patient groups regardless of location. Luminal diameter (LD), contraction period (CP), frequency of contraction (FC), and amplitude-diameter ratio (ADR) were measured based on the graph.

Results

The characteristics of abnormal peristaltic parameters were assessed in different patients and compared to normal curves from healthy volunteers. A total of 37 segments with abnormal motility were confirmed by two readers in consensus, based on curve patterns and the presence of a stationary phase. Compared to normal peristalsis in healthy volunteers, five different patterns of impaired peristalsis were identified: I, consecutive; II, slow; III, giant type; IV, uncoordinated; and V, akinetic. Dilated LDs were detected in all instances of abnormal peristalsis (P< 0.05). Increased frequency was found in type I [(8.73 ± 1.15) /min], while decreased frequency was detected in type III peristalsis [(0.67 ± 0.29) /min]. There were no significant differences in frequency between type II [(3.19 ± 0.43) /min] and normal peristalsis [(3.45 ± 0.57) /min]. Apart from type I [(8.70 ± 0.75) /min], increased FCs were found in all other abnormal patterns. In type II peristalsis, the average ADR value was 0.82 ± 0.08, comparable to the ADR value in the healthy group (0.83 ± 0.13).

Conclusion

MR cine is an effective method for differentiating normal and abnormal small bowel peristalsis. Plotting time-caliber curves and measuring quantitative MR cine parameters such as LD, CP, FC, and ADR offers more precise information about small bowel motility.
Progress in research on the relationships among tumor blood supply patterns
Authors: Li Jie , Du Xiaobo
Published: June 2023

Tumor cell growth, invasion, and metastasis require a blood supply. The diversity of tumor blood supply patterns and the biological properties of tumor cells play important roles in these processes. The discovery of vascular mimicry (VM) has enhanced the understanding of the plasticity of tumor cells and angiogenesis. VM is only a supplemental form of tumor microcirculation. However, the extensive clinical significance and special formation of VM have generated new ideas regarding anti-vascular tumor therapy. Currently, the exploration of the relationship between VM and other blood supply patterns is in the early stages, and many questions remain unanswered. Further in-depth studies of the relationships among tumor blood supply patterns will identify novel anti-tumor therapeutics.
Analysis of long-term outcomes and application of the tumor regression grading system in the therapeutic assessment of resectable limited-disease small cell lung cancer
Authors: Xu Shuonan , Zhu Jianfei , Dou Yawei , Tian Wei , Dai Yun , Luo Xianghui , Wang Hongtao
Published: June 2023

Objective

The present study attempted to evaluate the value of neoadjuvant chemotherapy in limiteddisease small cell lung cancer (LD-SCLC), and to identify the predictive value of the tumor regression grading (TRG) system in LD-SCLC treatment-response and prognosis.

Methods

The records of patients with LD-SCLC (p-Stage I-IIIa) who underwent definitive radical resection at Shaanxi Provincial People’s Hospital between March 1, 2000 and March 31, 2014 were retrospectively analyzed. We compared the disease-free survival (DFS) and overall survival (OS) rates between Group A patients (patients who underwent surgery combined with pre- and post-operative chemotherapy) and Group B patients (patients who underwent surgery combined with adjuvant chemotherapy only) using the Kaplan-Meier method and the Mantel-Cox test. The specimens of patients who received neoadjuvant chemotherapy were reassessed according to the TRG system.

Results

The median DFS for 27 patients was 16.267 months and the median OS was 81.167 months (1-year OS, 74.07%; 3-year OS, 22.22%; 5-year OS, 14.81%). Thirteen patients received neoadjuvant chemotherapy, and their specimens were reassessed by TRG (pathological complete remission, 3/13, 23.08%). Patients in group A had a longer OS than those in group B (mean, 93.782 months versus 42.322 months,P= 0.025), although there was no significant difference in DFS between the two groups (median 20.100 months versus 14.667 months,P= 0.551). Statistical analysis revealed that TRG Grade (G) 0 (mean, 61.222 months) was associated with better OS than G1-2 (mean, 31.213 months) (P= 0.311).

Conclusion

Our study indicated that neoadjuvant chemotherapy combined with surgical resection may represent a feasible treatment method for patients with LD-SCLC. The TRG system may be a valuable prediction tool to assess neoadjuvant chemotherapeutic efficacy, especially in patients with G0 disease as determined by TRG; these patients may attain an improved survival benefit with neoadjuvant chemotherapy.
Epinephrine use during chemotherapy to treat severe tracheal stenosis secondary to advanced esophageal cancer: A case report and review of the literature
Authors: Yao Qiang , Zhou Yan , Xu Chunni , Min Ke , Jin Jun
Published: June 2023

Dyspnea from tracheal stenosis due to compression by a tumor is an emergency that complicates therapy in oncology. We report a case of advanced esophageal cancer in a 56-year-old male who developed severe dyspnea due to airway compression by mediastinal lymph node enlargement. We used epinephrine by subcutaneous injection and aerosol inhalation to temporarily relieve dyspnea while the patient received bevacizumab and chemotherapy. The dyspnea had subsided considerably after 5 days, and the mediastinal lymph nodes were significantly reduced after 2 cycles of chemotherapy. However, the patient died of massive tracheal hemorrhage 2 months later.
Middle lobe torsion after right upper and lower lobectomy: repositioning of lobar torsion using a 3-cm uniportal video-assisted thoracoscopic surgery
Authors: Zhang Ruijie , Cai Yixin , Fu Shengling , Fu Xiangning , Zhang Ni
Published: June 2023

We aimed to describe a method for repositioning of right middle lobar torsion by using a 3-cm uniportal video-assisted thoracoscopic surgery (VATS) approach. Middle lobe torsion occurred after right upper and lower lobectomy in a 74-year-old man. Immediate re-exploratory thoracotomy using the 3-cm uniportal VATS approach was performed. The torsion was corrected, and the lobe was anchored to the anterior chest wall with Prolene stitches. The patient recovered well postoperatively with daily improvements in chest radiographic findings. Follow-up examination was performed using fiberbronchoscopy, which revealed an unobstructed right middle lobe bronchus and sticky yellow sputum. Follow-up chest computed tomography was performed 3 months after the primary surgery and revealed increased expansion of the right middle lobe. We repositioned the right middle lobe successfully by using the 3-cm uniportal VATS approach, but more cases are needed to confirm the feasibility of the approach. Lobectomy remains the primary treatment option for such cases.
Sex-related changes in tumor consistency in prolactinoma patients after bromocriptine pretreatment ⁎
Authors: Huang Yimin , Hu Feng , Wu Kang , Chen Juan , Li Ran , Xu Hao , Lei Ting
Published: June 2023

Objective

It has long been reported that prolactinomas treated with bromocriptine increase fibrosis and may affect surgical outcomes. We retrospectively studied 238 consecutive patients with histopathologically confirmed prolactinomas undergoing microsurgery in a single neurosurgery department of Tongji Hospital (Wuhan, China) from 2012 to 2015 in order to evaluate tumor consistency changes after bromocriptine pretreatment and surgical outcomes.

Methods

We divided the patients into four groups: males in the dopamine agonist (DA) group, females in the DA group, males in the no DA group, and females in the no DA group, and we compared the surgery process, specimen Masson staining, and clinical outcomes of the four groups. According to a previously published classification, the operative notes from an experienced neurosurgeon were reviewed to classify the consistency of tumors as “fibrous” or “nonfibrous”.

Results

No differences in tumor consistency were found in male patients with or without DA treatment. However, in female patients with DA treatment, tumors were likely to be harder in texture than the tumors of female patients without DA treatment. Despite tumor consistency differences between sexes, the tumor biological remission rate was similar between groups, as was the rate of tumor resection.

Discussion

Our study indicates that preoperative DA therapy impacts tumor consistency in female patients but not male patients. Although the surgical and histopathological outcomes are not influenced, these findings may provide useful information for the choice of operative approach and surgery process for pituitary adenoma.
Milk fat globule epithelial growth factor VIII (MFG-E8) sustains survival of cancer cells by prompting tumor angiogenesis and suppressing host immunities ⁎
Authors: Nie Keke , Liu Shichao , Zhang Ling , Zhang Zhongfa , Zou Xiao , Ji Youxin
Published: June 2023

Milk fat globule epithelial growth factor VIII (MFG-E8) is a novel adhesion protein mainly produced by macrophages and dendritic cells; it is expressed in most of the human tissues and functions to prompt cancer progression and survival. MFG-E8 contains a signal sequence for secretion, two epidermal growth factor (EGF)-like domains at the NH2 terminus and two discoidin domains with blood-clotting factor V/factor VIII (C1 and C2) at the COOH terminus. The second EGF domain contains an arginine-glycine-aspartic (RGD) integrin-binding motif that engages αvβ5integrins to facilitate cell adhesion and induce integrinmediated signal transduction. Integrin αvβ3associates with VEGF receptor 2, engagement of integrins can promote angiogenesis, which plays key roles in growth, proliferation, and survival of cancer cells. VEGF stimulates the expression of αvβ3and αvβ5integrins on angiogenic vasculature, thereby potentiating effects of VEGF receptor engagement. Mice expressing a mutant form of αvβ3integrin are unable to undergo tyrosine phosphorylation, confirming the important role that this integrin plays in pathological angiogenesis and providing important mechanistic insights. The C-terminus discoidin-like domains promote binding to membrane phospholipids, functioning close to VEGF like angiogenesis. MFG-E8 is an opsonin for apoptotic cells, and it acts as a bridging protein between apoptotic cells and phagocytes. It also influences cell immunities by altering CD4+and/or CD8+cells. Antibody or small peptide works with MFG-E8 at different functional sites or interacts with EGF-like domains and/or discoidin-like domains may play an important role in anti-angiogenesis or immune restoration. Altering the structures and/or functions of MFG-E8 and/or its domains is promising for development of novel anti-cancer strategies.

List of abbreviations:

milk fat globule epithelial growth factor VIII (MFG-E8); vascular endothelial growth factors (VEGFs); fibroblast growth factor (FGF); tripeptide Arg-Gly-Asp (RGD); granulocyte/monocyte colony-stimulating factor (GM-CSF); cyclin-dependent kinase inhibitor 1 (P21WAF1/CIP1); B-cell lymphoma 2/Bcl-2 associated X protein (Bcl-2/Bax); platelet-derived growth factor receptor β (PDGFRβ); tumor cells proliferation rate index (Ki-67); toll-like receptor (TLR)
Implications of the mismatch repair-deficient status for the management of colorectal cancers
Authors: Wei Qing , Shen Lin
Published: June 2023

Although the majority of colorectal cancer (CRC) cases develop through the CIN pathway, approximately 15% of cases are caused by the hypermutation known as microsatellite instability (MSI) that is a consequence of deficient (d) DNA mismatch repair (MMR). dMMR CRCs have distinct phenotypic characteristics compared with microsatellite stable (MSS) tumors. MSI CRC is associated with an earlier stage at diagnosis and improved stage-specific prognosis, although this is controversial in stage IV patients. Current evidence supports the use of adjuvant chemotherapy with fluoropyrimidine plus oxaliplatin for stage III dMMR CRC. The distinctive genomic characterization and expression profiling of dMMR CRC paves the way for tailored immunotherapies. This is supported by recent studies that highlighted the efficacy of immunotherapy in dMMR CRC. Here, we describe the molecular aspects of the MMR system and discuss the associations of MMR-deficient/MSI-H status with clinical management, especially for patients with metastatic CRC.
The current status of laparoscopic pancreaticoduodenectomy for pancreatic cancer in China
Authors: Zhang Hang , Qin Renyi
Published: June 2023

Renyi Qin. Surgeon, Second grade professor, Postdoctoral supervisor, Director of the Department of Biliary-pancreatic Surgery, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, China. Prof. Qin graduated from the Zhejiang University School of Medicine in 1995 and obtained his Master’s degree in the Department of General Surgery. From 1995 to 1997, he performed postdoctoral research in the Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology. He then spent 3 years in the research of minimally invasive surgery in the United Christian Hospital of Hong Kong, and was a surgical senior visiting scholar in the University of Freiburg and University of Ulm in Germany. In addition, he taught pancreatic surgery to medical students, foreign medical students, and graduate students. His research has mainly focused on pancreatic cancer and minimally invasive pancreatic surgery. His current credentials include: Fellow of the American College of Surgeons, committee member of the International Hepato-Pancreato-Biliary Association, standing committee member of the Pancreatic Cancer Committee of the Chinese Anti-Cancer Association, assessment expert of The National Natural Science Foundation of China, and assessment expert of The Project Sponsored by The Scientific Research Foundation for Returned Overseas Chinese Scholars, State Education Ministry.
Research progression of PD-1/PD-L1 in non-small cell lung cancer
Authors: Liu Xing , Xie Xiaodong
Published: June 2023

Lung cancer is the leading cause of cancer-related mortality worldwide. Despite great progress in the development of target agents, most people who do not harbor a mutation do not benefit from these agents. Immunotherapy, which stimulates the body’s immune system to improve the anti-tumor immunity effect, is a new therapeutic method for non-small cell lung cancer (NSCLC). Programmed cell death 1 (PD-1) and its ligand (PD-L1) belong to the CD28/B7 immunoglobulin super-family and are co-stimulatory molecules that show negative regulation effects. Combined with its ligand, PD-1 can modulate the tumor microenvironment, enabling tumor cells to escape host immune surveillance and elimination and play a key role in the clinical significance of NSCLC. An increasing number of clinical trials have suggested that immune checkpoint inhibitors, including anti-PD-1 and anti-PD-L1 monoclonal antibodies, are beneficial and safe for NSCLC. Here, we review the brief history of PD-L1 as a biomarker, mechanism of action, and critical role of PD-1/PD-L1 in the treatment of NSCLC as well as the current research status and future directions.
Effect of etoposide plus thalidomide as maintenance therapy on progression-free survival of elderly patients with advanced non-small cell lung cancer
Authors: Ge Yanan , Zheng Zhendong , Liu Zhaozhe , Qiu Jianing , Xie Xiaodong
Published: June 2023

Objective

The aim of the study was to evaluate the efficacy and safety of etoposide plus thalidomide as maintenance therapy for elderly patients with advanced non-small cell lung cancer (NSCLC) without disease progression after first-line chemotherapy.

Methods

After four to six cycles of platinum-based first-line therapy, 64 elderly patients with advanced NSCLC without disease progression who were treated in the General Hospital of Shenyang Military Region (China) from 2014 to 2016 were enrolled in this study. According to the different maintenance treatment methods, patients were divided as having received etoposide plus thalidomide therapy (treatment group, n = 32) and best supportive care (control group, n = 32). Disease control and progression-free survival (PFS) were compared between the two groups.

Results

The recent curative effect objective response rates of the treatment group and the control group were 31.3% and 3.1%, respectively, and the disease control rates were 71.9% and 31.3%, respectively. The Kaplan-Meier survival curves of the two groups were significantly different (χ2 = 26.532, P = 0.001). The median PFS for the treatment group and control group was 6.0 months [95% confidence interval (CI) = 4.3-7.9 months] and 3.2 months (95% CI = 2.6-3.8 months), respectively. The side effects in the treatment group included hematologic abnormalities, gastrointestinal toxicity, and impaired liver function, which were relieved after symptomatic support therapy and drug withdrawal.

Conclusion

Etoposide plus thalidomide as maintenance therapy is associated with a significantly longer PFS with tolerable toxicity for elderly patients with advanced NSCLC.
Efficacy of pemetrexed combined with erlotinib/gefitinib in advanced non-small cell lung cancer patients during tyrosine kinase inhibitor treatment ⁎
Authors: Zhang Guanzhong , Liu Zhaozhe , Han Tao , Xie Xiaodong , Jiao Shunchang
Published: June 2023

Objective

We aimed to evaluate the efficacy and safety of pemetrexed combined with erlotinib/gefitinib in advanced non-small cell lung cancer (NSCLC) patients during tyrosine kinase inhibitor (TKI) treatment.

Methods

Thirty-two patients with advanced NSCLC were divided into two groups. Patients in the control group received continuous daily epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) treatment, and patients in the experimental group received continuous daily EGFR-TKI along with pemetrexed treatment, which was administered on day 1 at 500 mg/m2. Erlotinib (150 mg) or gefitinib (250 mg) was administered daily from day 1 to day 21, with a cycle of every 21 days. Dexamethasone, folic acid, and vitamin B12 were also administered during the treatment. The endpoint of the primary study was the disease control rate.

Results

The objective response rate was 21.9% (95% CI: 7.6% to 36.3%) in the control group, whereas the disease control rate was 84.4% (95% CI: 71.8% to 97.0%) in the experimental group. The median progression-free survival was 6.2 (95% CI: 2.4 to 10.0). Grades 3 or 4 adverse effects of leucopenia (15.6%), neutropenia (12.5%), anemia (3.1%), and nausea or vomiting (3.1%) were found in the experimental group.

Conclusion

The administration of pemetrexed combined with erlotinib or gefitinib showed a higher efficacy in TKI-resistant NSCLC patients. Further, the adverse effects of this drug combination were well tolerated by the patients. Pemetrexed combined with TKI treatment might provide a satisfactory therapeutic strategy for advanced NSCLC patients after TKI treatment.
The role of the HGF/c-Met signaling pathway in crizotinib-induced apoptosis in lung cancer with c-Met amplification ⁎
Authors: Zhou Shaozhang , Dong Zhixin , Lv Jinyi , Zeng Aiping , Wang Huilin , Ning Ruiling , Song Xiangqun
Published: June 2023

Objective

This study aimed to study the role of the HGF/c-Met signaling pathway in crizotinib-induced apoptosis of various lung adenocarcinoma cell lines and xenograft tumor models.

Methods

In vitro, H2228, H1993, and A549 cells were treated with crizotinib. The inhibition of proliferation was quantitated by a 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) assay. Apoptosis was quantified by flow cytometry. Expression of key proteins of the HGF/c-Met signaling pathway was examined by western blotting. In vivo, H1993 and A549 tumor cell xenograft models were established. Immunohistochemical analysis was used to determine protein expression of HGF and c-MET and the amount of phospho-c-MET (p-c-Met). Real-time quantitative polymerase chain reaction (PCR) was applied to examine the messenger RNA (mRNA) expression of c-MET and serine/ threonine protein kinase (AKT). The expression and activation of the key proteins were evaluated by western blotting.

Results

In vitro, the growth of H1993, H2228, and A549 cells was inhibited after crizotinib treatment for 72 h. Apoptotic rates of H1993 and H2228 cells increased with the crizotinib concentration and exposure time. In vivo, the growth-inhibitory rate of crizotinib for H1993 xenografts was 72.3%. Positive expression rates of HGF and c-MET in H1993 xenografts were higher than those in A549 xenografts; the p-c-MET amount was the largest in H1993 xenograft control but the lowest in the H1993 xenograft with crizotinib treatment. The mRNA expression levels of c-MET and AKT in H1993 xenografts were higher than those of A549 xenografts. The protein levels of c-MET, AKT, and extracellular regulated protein kinases (ERK) in H1993 xenografts were higher than those in A549 xenografts; the p-AKT amount was higher in H1993 xenograft control than in A549 xenografts; the largest amount of p-c-MET was detected in H1993 xenograft control; the amount of p-ERK was the lowest in the H1993 xenograft with crizotinib treatment.

Conclusion

The HGF/c-Met signaling pathway may mediate crizotinib-induced apoptosis and inhibition of proliferation of lung adenocarcinoma cells.
Expression of CXCL12-CXCR4 in osteosarcoma and its correlation with angiogenesis
Authors: Han Lu , Shen Yangyang , Zhao Wenhua , Sun Baoyong , Zhang Xin , Cui Kai , Zhou Lei , Li Sheng
Published: June 2023

Objective

The expression of CXCL12 (stromal cell-derived factor-1)-CXCR4 (chemokine receptors-4) in osteosarcoma and its role in angiogenesis were examined.

Methods

The expression of CXCR4 and CXCL12 in 40 cases of osteosarcoma was detected by immunohistochemistry and real-time fluorescence quantitative PCR. The expression of CD34 in osteosarcoma was detected by immunohistochemistry. Morphometric image analysis was performed to measure microvessel density (MVD). Additionally, the relationship between CXCL12 and CXCR4 expression and MVD of osteosarcoma and pulmonary metastasis were analyzed.

Results

The positive rates of CXCL12 and CXCR4 protein expression in osteosarcoma were 40.0% (16/40) and 60.0% (24/40), respectively. Fluorescence quantitative real-time PCR indicated that the expression level of CXCR4 mRNA in pulmonary metastatic osteosarcoma was higher than that in non-pulmonary metastatic osteosarcoma (P < 0.01). The level of MVD in pulmonary metastatic osteosarcoma was higher than that in non-pulmonary metastatic osteosarcoma (P < 0.01).

Conclusion

The expression level of CXCR4 was significantly associated with pulmonary metastasis and angiogenesis of osteosarcoma.
Function and clinical significance of SUMOylation in type I endometrial carcinoma
Authors: Cui Xin , Zhang Caixin , Li Yunhui , Qi Yongyun , Ding Xiaoyan , Hei Shumin , Huang Weiqing
Published: June 2023

Objective

This study elucidated the function and role of SUMOylation in type I endometrial carcinoma.

Methods

Fifty type I endometrial carcinoma cases and para-cancer tissue samples were collected. The expression levels of ubiquitin-conjugating enzyme E2 I (Ube2i, Ubc9) and small ubiquitin-like modifier 1 (SUMO1)/sentrin-specific peptidase 1 (SENP1) proteins were examined using immunohistochemistry and the correlation with clinicopathological parameters was analyzed.

Results

Ubc9 expression in type I endometrial carcinoma tissues was significantly higher than that in the para-cancer tissues; in contrast, the expression of the SENP1 protein was markedly lower than that in the para-cancer tissues. Ubc9 and SENP1 expression levels were negatively correlated and were associated with tumor differentiation, but not age, depth of invasion, tumor stage, and lymph node metastasis.

Conclusion

SUMOylation modification plays a major role in the pathogenesis and development of type I endometrial carcinoma. Thus, it could be a potential target for the treatment of endometrial cancer.
Complete transthoracic resection of giant posterior mediastinal goiter: A case report and review of the surgical approaches
Authors: Lin Gaoyang , Gao Dadeng , Yuan Fang , Lv Yingyi , Liu Zhenbo
Published: June 2023

Intrathoracic goiter (IG) is commonly located in the anterior mediastinum. Here, we report the case of a 54-year-old Chinese woman with successful removal of an intrathoracic goiter and improvement of dyspnea by a right posterolateral thoracotomy approach. Conclusion: Posterior mediastinal thyroid goiter with mediastinal compressive symptoms is an indication for surgery.
Risk factors for anastomotic leakage after low anterior resection without diversional stomas*
Authors: Chen Xiaolong , Feng Libo , Liu Yu , Wu Xiaolong , Xu Jie , Chen Peng , Zuo Zhonglin , Liu Yi , Zou Qingwei , Liu Qing , Xia Dong
Published: June 2023

Objective

The most important complication after low anterior resection (LAR) for mid-low rectal cancer is symptomatic anastomotic leakage (AL). More than one-third of patients with rectal cancer who underwent LAR will have functional stomas during primary operation. The aim of this retrospective study was to evaluate the risk factors associated with clinical AL following LAR without diversional stomas.

Methods

Between 2012 and 2017, information about 578 consecutive patients with rectal tumors less than 12 cm from the anal verge who underwent LAR without diversional stomas by the same surgical team was collected retrospectively. A standardized extraperitonealized anastomosis and pelvic drainage were conducted for all patients during primary operations, and the outcome of interest was clinical AL. The associations between AL and 14 patient-related and surgical variables were examined by both univariate chi-square test and multivariate logistic regression analysis.

Results

The AL rate was 7.27% (42 of 578). Univariate and multivariate analyses showed that male sex (P= 0.018), mid-low rectal cancer (located 10 cm or less above the anal verge) (P= 0.041), presence of diabetes (odds ratio = 2.117), longer duration of operation (odds ratio = 1.890), and intraoperative contamination (odds ratio = 2.163) were risk factors of AL for LAR without diversional stoma and independently predictive of clinical AL. Nearly 83.3% (35 of 42) of leakage could be cured by persistent pelvic irrigation-suction-drainage without surgical intervention. Only 7 patients (16.7%) with severe complications, such as peritonitis, and fistula, required reoperation, and functional stoma was used as a salvage treatment.

Conclusion

From the findings of this retrospective survey, we identified that mid-low rectal cancer and male sex were independent risk factors for developing clinical AL after LAR without diversional stomas, as well as longer duration of operation, presence of diabetes, and contamination of the operative field. Moreover, we deemed that LAR without diversional stomas for mid-low rectal cancers was safe, effective, and feasible. Extraperitonealized anastomosis and pelvic drainage obtained a relatively low rate of AL and avoided unnecessary functional stomas. Pelvic irrigation-suction-drainage was an effective procedure to resolve AL, and functional stoma was potentially used as a salvage modality for serious leakage.
A pulmonary metastatic breast phyllodes tumor and clinicopathology analysis
Authors: Li Jia , Li Gang , Xing Yixiang , Kang Min , Xu Xianjie
Published: June 2023

Objective

Breast phyllodes tumors (PTs) are rare fibroepithelial tumors that are characterized by formation of foliation patterns. Behaviorally, only relatively poor prediction of PTs is possible based on their histological appearance. PTs are frequently misdiagnosed because they are difficult to differentiate from soft tissue tumors. In this report, we describe the pathological features of a rare case of PT and review the relevant literature, summarizing the essentials of the diagnosis and differential diagnosis, while attempting to avoid misdiagnosis or missed diagnosis of the tumor to the best of our abilities.

Methods

We present a case of pulmonary metastatic lobular tumor, analyzing the morphological [hematoxylin-eosin (HE) staining] and immunohistochemical (streptavidin perosidase method, SP) features of the tissue.

Results

Long spindle-shaped tumor cells were observed using microscopy. The cells were arranged in bundles, with a whirlpool pattern, and braided. The proliferation of the spindle cells was markedly atypical and karyokinesis was elevated. Residual ductal epithelium was detected in some areas, and the margins of the tumor tissues showed invasive growth. Immunohistochemical studies of the spindle-shaped tumor cells were positive for actin, PR, CD10, SMA, Bcl-2, and negative for CKP, S-100, CD34, ER. The Ki-67 index was 40%.

Conclusion

The spindle cell tumor identified in the lung should first be considered as a metastatic neosplasm, because most soft-tissue sarcomas commonly metastasize through the bloodstream to the lungs. Although malignant breast PTs are rare, a detailed medical history that includes prior surgical history is required to avoid wrongful or missed diagnosis.
Predictive value of serum levels of transforming growth factor beta 1 for the short-term effects of radiotherapy and chemotherapy in patients with esophageal cancer
Authors: Gao Fei , Jia Lin , Han Jianjun , Wang Jisheng , Wang Yun
Published: June 2023

Objective

To investigate variation in levels of transforming growth factor beta 1 (TGF-β1) before and after radiotherapy in patients with esophageal cancer in order to evaluate the predictive value of TGF-β1 for the effects of radiotherapy

Methods

A total of 140 patients with esophageal squamous carcinoma undergoing radical radiation therapy in the Department of Oncology from March 2015 to December 2017 were enrolled. The patients were divided into the effective (115 cases) and ineffective (25 cases) groups according to World Health Organization (WHO) criteria for the evaluation of solid tumors (2009 RECIST standard). TGF-β1 levels were measured in all patients by using enzyme-linked immunosorbent assay (ELISA). Multiple-factor analysis of the predictive value of the treatment efficacy was performed by Cox regression analysis.

Results

After radiotherapy, 36, 79, and 25 cases experienced complete response (CR), partial response (PR), and no response (NR), respectively, with a total effective rate of 82.14%. The TGF-β1 level was significantly lower in the effective group than that in the ineffective group (P < 0.05) and covariance analysis revealed significantly reduced TGF-β1 level in esophageal cancer patients following radiotherapy. The multi-factor Cox regression model revealed that the predictive value of TGF-β1 for the effect of radiotherapy was largest, with a hazard ratio [HR] of 1.955 (P = 0.002), followed by exposure dose, with (HR = 1.367; P = 0.035).

Conclusion

Serum TGF-β1 level can serve as a predictor for the short-term effects of radiotherapy in patients with esophageal cancer.