ASO Visual Abstract: Association of Obesity with Worse Operative and Oncologic Outcomes Among Patients Undergoing Gastric Cancer Resection

Annals of Surgical Oncology -     

Clinicopathological characteristics,prognosis, and chemosensitivity in patients with metastatic upper tract urothelial carcinoma

PurposeTo investigate the clinical characteristics, chemosensitivity, and outcome of metastatic upper tract urothelial carcinoma (UTUC).Patients and MethodsRecords of patients with metastatic UTUC since January 2005 were retrieved from a database that included clinical and survival data. Statistical analyses including survival and multivariate analyses of factors were respectively performed by the Kaplan-Meier method and Cox proportional hazard model.ResultsA total of 250 consecutive UTUC cases were evaluated. There were 56 patients (22.4%) with initially diagnosed stage IV disease. The most common metastatic sites were lung (39.6%), distant lymph nodes (39.2%), bone (19.6%), liver (18.0%), and adrenal gland (7.2%), respectively, and the local recurrence rate was 10.4%. Two hundred thirteen patients received first-line chemotherapy. The overall response rate was only 28.7% and the median progression-free survival time was only 5.0 months. The overall survival time of the cohort was 18.0 months. Multivariate analyses showed that initially diagnosed stage IV disease, number of metastatic organs ≥3, no response to chemotherapy and cycles of chemotherapy ≤2 were adverse prognosticators for overall survival.ConclusionUTUC presented to be more prone to metastasize than locally recur and thought to have low chemosensitivity. Stage IV disease at initial diagnosis, number of metastatic organs, response and cycles of chemotherapy were independent prognosticators for metastatic UTUC.     

Surgical Treatment and Proposed Modified Classification for Harrington Class III Periacetabular Metastases

ObjectivesThis study aims to: (i) evaluate the outcome of patients with Harrington class III lesions who were treated according to Harrington classification; (ii) propose a modified surgical classification for Harrington class III lesions; and (iii) assess the efficiency of the proposed modified classification.MethodsThis study composes two phases. During phase 1 (2006 to 2011), the clinical data of 16 patients with Harrington class III lesions who were treated by intralesional excision followed by reconstruction of antegrade/retrograde Steinmann pins/screws with cemented total hip arthroplasty (Harrington/modified Harrington procedure) were retrospectively reviewed and further analyzed synthetically to design a modified surgical classification system. In phase 2 (2013 to 2019), 62 patients with Harrington class III lesions were classified and surgically treated according to our modified classification. Functional outcome was assessed using the Musculoskeletal Tumor Society (MSTS) 93 scoring system. The outcome of local control was described using 2‐year recurrence‐free survival (RFS). Owing to the limited sample size, we considered P < 0.1 as significant.ResultsIn phase 1, the mean surgical time was 273.1 (180 to 390) min and the mean intraoperative hemorrhage was 2425.0 (400.0 to 8000.0) mL, respectively. The mean follow‐up time was 18.5 (2 to 54) months. Recurrence was found in 4 patients and the 2‐year RFS rate was 62.4% (95% confidence interval [CI] 31.6% to 93.2%). The mean postoperative MSTS93 score was 56.5% (20% to 90%). Based on the periacetabular bone destruction, we categorized the lesions into two subgroups: with the bone destruction distal to or around the inferior border of the sacroiliac joint (IIIa) and the bone destruction extended proximal to inferior border of the sacroiliac joint (IIIb). Six patients with IIIb lesions had significant prolonged surgical time (313.3 vs 249.0 min, P = 0.022), massive intraoperative hemorrhage (3533.3 vs 1760.0 mL, P = 0.093), poor functional outcome (46.7% vs 62.3%, P = 0.093), and unfavorable local control (31.3% vs 80.0%, P = 0.037) compared to the 10 patients with IIIa lesions. We then modified the surgical strategy for two subgroup of class III lesions: Harrington/modified Harrington procedure for IIIa lesions and en bloc resection followed by modular hemipelvic endoprosthesis replacement for IIIb lesions. Using the proposed modified surgical classification, 62 patients in the phase 2 study demonstrated improved surgical time (245.3 min, P = 0.086), intraoperative hemorrhage (1466.0 mL, P = 0.092), postoperative MSTS 93 scores (65.3%, P = 0.067), and 2‐year RFS rate (91.3%, P = 0.002) during a mean follow‐up time of 19.9 (1 to 60) months compared to those in the phase 1 study.ConclusionThe Harrington surgical classification is insufficient for class III lesions. We proposed modification of the classification for Harrington class III lesions by adding two subgroups and corresponding surgical strategies according to the involvement of bone destruction. Our proposed modified classification showed significant improvement in functional outcome and local control, along with acceptable surgical complexity in surgical management for Harrington class III lesions.     

X-ray scatter correction algorithm for cone beam CT imaging

Developing and optimizing an x-ray scatter control and reduction technique is one of the major challenges for cone beam computed tomography (CBCT) because CBCT will be much less immune to scatter than fan-beam CT. X-ray scatter reduces image contrast, increases image noise and introduces reconstruction error into CBCT. To reduce scatter interference, a practical algorithm that is based upon the beam stop array technique and image sequence processing has been developed on a flat panel detector-based CBCT prototype scanner. This paper presents a beam stop array-based scatter correction algorithm and the evaluation results through phantom studies. The results indicate that the beam stop array-based scatter correction algorithm is practical and effective to reduce and correct x-ray scatter for a CBCT imaging task.     

人工神经网络预滤波的自适应运动心电信号增强器

运动心电图是一种将人体对象置于非平静状态下检测到的心电信号，其特点是运动导致基线严重漂移，肌电干扰显著增加，信噪比低。介绍了一种用人工神经网络预滤波的自适应运动心电信号增强器。运用人工神经网络的非线性和自适应处理的跟踪特性有机地结合设计而成。能降低噪声，提高信噪比，有效地提取运动心电信号。     

Primary study of iontophoresis of zinc ion in treatment of retinitis pigmentosa

We report here the preliminary effects of zinc iontophoresis in treatment of 26 Rp patients who had decreased zinc serum level or abnormal ratio of serum copper to zinc. Through more than 20 to 30 times of therapy, the vision of 15.38% eyes increased more than "3 lines", 4% eyes increased more than 5 degrees in the visual field, 13.46% eyes improved in dark adaptation threshold (greater than 1.0), the visual functions of the rest eyes were slightly improved or unimproved. The fundus didn't change before & after treatment. There were no changes of ERG in 8 eyes of 4 cases. In addition, the advantages and disadvantages between Zn iontophoresis and Zn compound taken orally, the improvement of vision by direct electric current therapy, the relationship between the metabolism of Zn element and Vit A and influence of Zn over the mechanism of dark adaptation were also briefly discussed.