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To determine strategy, the following must be discussed in each individual case the probability of procedural success, the expectation of long-term patency, and an assessment of the balance between procedure-related complications and overall benefits. In essence, we believe the following facts to be the current sincere appraisal of CTO-PCI (1) improvements of symptoms and QOL are established, but the others remain inconclusive, and; (2) their margins for improvement are narrowing and numbers of candidates are shrinking. Precision medicine or individualization may be the right directions to take, to enhance the potential of this treatment. This course of action demands discrimination of those candidates who will truly receive benefits from invasive treatment, and that still requires further clinical studies or actions.Propofol and dexmedetomidine are popular used for sedation in ICU, however, inadequate attention has been paid to their effect on gastrointestinal tract (GIT) motility. Present study aimed to compare the effect of propofol and dexmedetomidine on GIT motility at parallel level of sedation and explore the possible mechanism. Male C57BL/6 mice (8-10 weeks) were randomly divided into control, propofol and dexmedetomidine group. After intraperitoneal injection of propofol or dexmedetomidine, comparable sedative level was confirmed by sedative score, physiological parameters and electroencephalogram (EEG). Different segments of GIT motility in vivo (gastric emptying, small intestine transit, distal colon bead expulsion, stool weight and number of fecal pellets, gastrointestinal transit and whole gut transit time) and colonic migrating motor complexes (CMMCs) pattern in vitro were evaluated. The Ca2+ response of primary enteric glia was examined under the treatment of propofol or dexmedetomidine. There is little difference in physiological parameters and composite permutation entropy index (CPEI) between administration of 50 mg/kg propofol and 40 μg/kg dexmedetomidine, indicated that parallel level of sedation was reached. Data showed that propofol and dexmedetomidine had significantly inhibitory effect on GIT motility while dexmedetomidine was stronger. Also, the amplitude (ΔF/F0) of Ca2+ response in primary enteric glia was attenuated after treated with the sedatives while the effect of dexmedetomidine was greater than propofol. These findings demonstrated that dexmedetomidine caused stronger inhibitory effects on GIT motility in sedative mice, which may involve impaired Ca2+ response in enteric glia. Hence, dexmedetomidine should be carefully applied especially for potential GIT dysmotility patient.

In survival analysis, some patients may be at risk of more than one event, for example cancer-related death and cancer-unrelated death. MK-8776 concentration In this case, if the aim of study becomes to assess the impact of risk factors on different causes of death, the competing risk model should be used rather than classical survival model. The aim of the present study is to determine the risk factors for related and unrelated mortality in patients with colorectal cancer using competing risk regression models.

The present retrospective cohort study was carried out on 310 CRC patients. Death due to cancer progression was considered as the interest event, and death due to unrelated cancer was considered as a competing event. Two most popular methods, cause-specific and subdistribution hazard regression model, were used to determine the effect of covariates on incidence and cause-specific hazard. Data analysis was performed using R3.6.2 software and cmprsk and survival packages.

The mean (SD) of patients’ age was 55.84 ± 13.2years and 53.9% of them were male. BMI, T and N stage had a significant effect on both incidence and cause specific hazard of cancer-related death.

The results of this study showed that cancer-related death is strongly correlated with under-weight (BMI < 18.5) and advanced clinical stage of the disease in patients with colorectal cancer. So, in the presence of competing events, both types of regression hazard models should be applied to permit a full understanding of the impact of covariates on the incidence and the rate of occurrence of each outcome.

The results of this study showed that cancer-related death is strongly correlated with under-weight (BMI  less then  18.5) and advanced clinical stage of the disease in patients with colorectal cancer. So, in the presence of competing events, both types of regression hazard models should be applied to permit a full understanding of the impact of covariates on the incidence and the rate of occurrence of each outcome.

Plexin C1 is a transmembrane receptor and plexin C1 overexpression might have role in carcinogenesis. Hepatocellular carcinoma (HCC) has poor prognosis because of its aggressive behavior and limited treatment options, especially in advanced stage. We recently documented that Plexin C1 was overexpressed in HCC. We aimed to evaluate the prognostic significance of Plexin C1 overexpression in HCC in the present study.

Plexin C1 overexpression was evaluated immunohistochemically on paraffin-embedded blocks of the HCC patients. Plexin C1 immunohistochemical staining was scored. Plexin C1 overexpression staining intensity and prevalence were used for plexin scale staining evaluation and plexin scores were estimated according this staining scale. Plexin C1 score and its association with survival and clinicopathological features was assessed.

Sixty-seven HCC patients with adequate tissue for pathological evaluation were included. Median age was 63 years with male predominance (male to female ratio was 4.75 (n 57/12). Well-differentiated HCC (53.7%) patients had higher plexin C1 overexpression (p < 0.05). Median OS was 22.1 months. Patients with lower plexin C1 score (< 12) had shorter OS (17.5 vs 30.1 months, p = 0.036). Neutrophil count, GGT, and PNR (platelet/neutrophil ratio) had prognostic significance (p = 0.047, p = 0.018, and p = 0.045).

Plexin C1 overexpression is inversely correlated with grade in HCC. The patients with lower rate of Plexin C1 overexpression have worse survival outcome. It might be a prognostic factor in HCC.

Plexin C1 overexpression is inversely correlated with grade in HCC. The patients with lower rate of Plexin C1 overexpression have worse survival outcome. It might be a prognostic factor in HCC.