A nomogram for predicting overall survival in patients with type II endometrial carcinoma: a retrospective analysis and multicenter validation study

OBJECTIVE

Type II endometrial cancer (EC) is associated with high risk of metastasis and poor prognosis. We aimed to develop a nomogram for predicting survival probability in patients with type II EC.

PATIENTS AND METHODS

Data from a total of 4,117 patients with confirmed type II EC were pulled from the Surveillance, Epidemiology, and End Results (SEER) database, and were randomly divided into a training set and an internal verification set. A nomogram was constructed based on the training set. The concordance index (C-index), area under the ROC curve, and calibration plots were used to evaluate the identification and calibration of the nomogram. The SEER internal validation set and the Chinese multicenter data set (74 patients) were used to verify discriminations and corrections of the model.

RESULTS

Multivariate analysis indicated that age, marital status, tumor size, T stage, N stage, M stage, surgery, radiotherapy, and chemotherapy were independent factors affecting the prognosis of type II EC patients (p<0.001). The corresponding nomogram has showed excellent calibration and discrimination (C-index [95% CI], 0.752 [0.738-0.766]). The model was verified in the internal verification set (0.760 [0.739-0.781]) and the Chinese multicenter set (0.784 [0.607-0.961]). In addition, the AUC further confirmed the accuracy of the nomogram in predicting survival. The calibration curve of OS within 5 years confirmed good calibration of the nomogram.

CONCLUSIONS

This model and the corresponding risk classification system may provide useful tools for clinicians to evaluate the long-term prognosis of patients and carry out personalized clinical evaluation.

Fractionation of levofloxacin and ofloxacin during their transport in NOM-goethite: Batch and column studies

Adsorption and transport of levofloxacin (LEV) and ofloxacin (OFL) enantiomers in a matrix containing goethite and natural organic matter (NOM) were investigated using batch and column experiments. In batch studies, competition and enantioselectivity were observed in the adsorption of LEV and OFL. Enantioselectivity upon adsorption was investigated by comparing changes in the enantiomer fraction (EF) (the ratio of LEV to the sum of LEV and OFL remaining in the solution) after and before adsorption. At pH < 7, there was hardly any selectivity in adsorption of OFL and LEV to goethite. At pH > 7, OFL showed a stronger adsorption than LEV to goethite, and this preference remained when NOM samples of Leonardite humic acid (LHA) and Elliott Soil fulvic acid (ESFA) were added. However, when Suwannee River NOM (SRNOM) was added, the preference was reversed, and LEV was adsorbed more strongly. In single systems, the presence of different types of NOM increased adsorption of LEV and OFL, especially LEV. In column studies, preloaded NOM decreased the transport of LEV and OFL through goethite-coated sand. The EF values in the effluent increased with retention time and reached the largest values (0.59-0.72) at around 1.5 pore volume (PV), and then decreased again, reaching a stable value at 5.0-30.0 PV. Both batch and column experiments showed that, fractionation of LEV and OFL occurred during adsorption and transport in the presence of NOM-goethite complexes, which would eventually affect their environmental fate.

Hydrogeochemical evolution induced by long-term mining activities in a multi-aquifer system in the mining area

The hydrogeochemical evolution of groundwater is related to and affected by long-term mining activities, which may deteriorate the quality of groundwater. The Fengfeng mine in Handan, North China has a 30-y history of coal mining with long-term mining activities and complex geological conditions, resulting in a complex hydrogeochemical environment in the mining region. In this study, the hydrogeochemical evolution mechanism of groundwater in a multi-aquifer system in the Fengfeng Mining Area was investigated using machine learning (self-organizing maps combined with K-means clustering) and sulfur and oxygen isotopes (δ34SSO4 and δ18OSO4). The hydrogeochemical characteristics of different aquifers in the mining area changed to different degrees after mining compared with the characteristics before mining. The spatiotemporal variations in groundwater components were found to be controlled by pyrite oxidation, gypsum dissolution, and carbonate dissolution, which are affected by mining activities. Pyrite oxidation primarily occurred in the Carboniferous thin-layer limestone aquifer (CLA) and Permian sandstone aquifer (PSA). The hydrogeochemical evolution in the Ordovician limestone aquifer (OLA), the main aquifer in the study area, was affected by leakage recharge from CLA and PSA caused by mining activities. The results showed that owing to the effects of long-term mining, the altered groundwater flow system affected the evolution of groundwater components in each aquifer, particularly the sulfate concentration. This study reveals a distinct hydrogeochemical evolution induced by mining activities, which can provide a basis for groundwater resource management in mining areas.

Collision-System and Beam-Energy Dependence of Anisotropic Flow Fluctuations

Elliptic flow measurements from two-, four-, and six-particle correlations are used to investigate flow fluctuations in collisions of U+U at sqrt[s_{NN}]=193  GeV, Cu+Au at sqrt[s_{NN}]=200  GeV and Au+Au spanning the range sqrt[s_{NN}]=11.5-200  GeV. The measurements show a strong dependence of the flow fluctuations on collision centrality, a modest dependence on system size, and very little if any, dependence on particle species and beam energy. The results, when compared to similar LHC measurements, viscous hydrodynamic calculations, and trento model eccentricities, indicate that initial-state-driven fluctuations predominate the flow fluctuations generated in the collisions studied.

Female mouse model of diabetes mellitus induced by streptozotocin and high-carbohydrate high-fat diet

With the improvement of people's living standards and rapid economic development, the incidence of diabetes mellitus (DM) is increasing in most parts of the world. DM presents an important potential threat to human health. In the present study, a model of diabetes in female mice was established, and fasting blood glucose was detected at week 4, after which the biochemical profiles were evaluated by histopathological analysis. The success rate of modeling in the normal control (NC) group and the low/ middle/high-dose streptozotocin (STZ) group were 0, 0, 25% and 60%, respectively. In the middle-dose and high-dose STZ groups, the liver index was increased significantly compared with the NC group (p⟨0.05). The blood biochemical indicators of total cholesterol and low density lipoprotein cholesterol in three STZ injection groups were as follows: alanine aminotransferase and aspartate transaminase in middle- and high-dose STZ groups, high-density lipoprotein cholesterol and serum creatinine in the high-dose STZ group, and blood urea nitrogen in the middle-dose STZ group were significantly increased (p⟨0.05). The level of total triglycerides was lower, obviously, in the high-dose STZ group than in the NC group (p⟨0.05). The mice showed marked steatosis, green-dyed fiber tissue coloring in varying degrees, and the contour of the hepatic lobules basically disappeared in STZ injection groups. The results suggest that to establish a diabetes model for female ICR mice, the optimum dose of STZ is 100 mg/kg.

[A case of ocular albinism with an abnormal visual evoked potential]

A 16-year-old male patient had poor binocular vision, alternating exotropia, horizontal nystagmus, and no obvious pigmentation loss in the eyes and other parts of the body. Optical coherence tomographic examination showed no normal central macular depression. The three-channel flash visual evoked potential method was used to examine each eye. The left and right channel reactions were found to be significantly asymmetric, and the clinical diagnosis was ocular albinism.

Analysis method for calculating radial correlation length of electron temperature turbulence from correlation electron cyclotron emission radiometer

The radial correlation length (L_r) is one of the essential quantities to measure in order to more fully characterize and understand turbulence and anomalous transport in magnetic fusion plasmas. The analysis method for calculating L_r of electron temperature (T_e) turbulence from correlation electron cyclotron emission (correlation ECE or CECE) radiometer measurements has not been fully developed partly due to the fact that the turbulent electron temperature fluctuations are generally imbedded in much larger amplitude thermal noise, which leads to a greatly reduced cross correlation coefficient (ϱ) between two spatially separated ECE signals. This work finds that this ϱ reduction factor due to thermal noise is a function of the local relative temperature fluctuation power and CECE system bandwidths of intermediate and video frequencies, independent of radial separations. This indicates that under the approximation of constant relative temperature fluctuation power for a small radial range of local CECE measurements, the original shape of ϱ as a function of radial separation without thermal noise is preserved in the CECE data with thermal noise present. For T_e turbulence with a Gaussian radial wavenumber spectrum, a fit function using the product of Gaussian and sinusoidal functions is derived for calculating L_r. This analysis method has been numerically tested using simulated ECE radiometer data over a range of parameters. Using this method, the experimental temperature turbulence correlation length L_r in a DIII-D L-mode plasma is found to be ∼10 times the local ion gyroradius.

[Clinical effects of lateral supramalleolar perforator island flaps with low rotation points in repairing foot skin and soft tissue defect wounds]

Objective: To investigate the clinical effects of lateral supramalleolar perforator island flaps with low rotation points in repairing foot skin and soft tissue defect wounds. Methods: The retrospective observational study was conducted. From October 2017 to August 2020, 14 patients (6 males and 8 females, aged 14-77 years) with foot skin and soft tissue defect wounds were admitted to Lanzhou University Second Hospital, including 4 cases of plantar skin tumor, 4 cases of chronic plantar ulcer, 4 cases of foot traffic injury, and 2 cases of residual wounds after deep foot burns. The wound size was 2.0 cm×2.0 cm to 7.0 cm×5.0 cm after tumor resection or debridement, which was repaired with island flap pedicled with the descending branch of the lateral supramalleolar perforator and the rotation point located at the lower front edge of the lateral ankle. The size of the flap ranged from 3.0 cm×2.0 cm to 8.0 cm×6.0 cm, and the length of vascular pedicle ranged from 8.0 to 14.0 cm. The flap was transferred by subcutaneous tunnel to repair the wound. The donor site wound of the flap was repaired with medium thickness skin graft from the lateral thigh. The survival of flaps, wound healing of the donor and recipient sites, and the occurrence of complications after operation were observed. The appearances of flaps and donor sites, and foot function were observed during follow-up. Results: The flaps of 14 patients survived successfully after operation, and the wounds in the donor and recipient sites healed well, without vascular crisis, venous congestion, or other complications. Follow-up for 2 to 24 months showed that the flaps had good appearance without bloating and were wear-resistant, the functions of wearing shoes and walking were not affected, and there was no obvious scar hyperplasia or hyperpigmentation at the donor site. Conclusions: With the descending branch of the lateral supramalleolar perforator as the pedicle and the rotation point located at the lower front edge of the lateral ankle, the island flap has a good effect in repairing the skin and soft tissue defect wound of the foot because of its reliable blood supply, simple design and operation, no need for vascular anastomosis, low rotation point, long vascular pedicle, and large radius of rotation.

[The role of continuous 48 h oropharyngeal pH monitoring in the diagnosis of laryngopharyngeal reflux disease]

Objective: To investigate the daily variation of LPR and the significance of 48-hour oropharyngeal pH monitoring in the diagnosis of LPRD. Methods: 72 subjects with suspected LPRD who were treated in our department from June 2018 to June 2021 were included. All patients were hospitalized to complete continuous 48-hour oropharyngeal Dx-pH monitoring. The consistency of Ryan index and W index and the correlation of various reflux parameters between the first and second 24-hour were compared. SPSS 24.0 was used for statistical analysis. Results: All 72 subjects successfully completed 48-hour oropharyngeal Dx-pH monitoring. Ryan index was positive in 11 cases (15.2%) in the first 24-hour, in 17 cases (23.6%) in the second 24-hour, in 5 cases (6.9%) both first and second, and in 23 cases (31.9%) in either 24-hour, Kappa=0.211 (P=0.064), 18 cases (25%) had inconsistent results of the first 24-hour and the second 24-hour, and there was no significant difference in the positive rate between the first and second (P=0.234). The number of positive cases in 48-hour monitoring increased by 109.1% compared with 24-hour monitoring.For W index, 49 cases (68.1%) were positive in the first 24-hourf 53 cases (73.6%) were positive in the second 24-hour, 42 cases (58.3%) were positive both first and second, and 58 cases (80.6%) were positive in either 24-hour, Kappa=0.477 (P<0.001), 16 cases (22.2%) had inconsistent results of the first and second, and there was no significant difference in the positive rate between the first and second (P=0.804). The number of positive cases in 48-hour monitoring increased by 18.4% compared with 24-hour monitoring. There was no significant difference in all the reflux parameters of first and second (P>0.05). The correlation comparison showed that the correlation of various reflux parameters in the upright position was lower than that in the supine position. Conclusion: Laryngeal reflux has daily variability. Extending the monitoring time of Dx-pH to 48-hour can help reduce the missed diagnosis caused by daily variability; the use of W index can reduce the influence of daily variability on the diagnostic results of LPRD.

Seroprevalence of antibodies to classical swine fever virus and porcine reproductive and respiratory syndrome virus in healthy pigs in Hunan Province, China

Classical swine fever (CSF) and porcine reproductive and respiratory syndrome (PRRS) are responsible for major economic losses and represent a threat to the swine industry worldwide. Routine surveillance serology for CSF and PRRS viruses is critical to maintaining the health status of sow farms in Hunan Province, which is one of the top pig production provinces in China. The aim of our study was to investigate the serological statistics of CSF virus (CSFV) and PRRS virus (PRRSV) in Hunan Province. The cohort serum samples were collected from vaccinated and unvaccinated pigs. Our findings showed that the average rates of CSFV and PRRSV antibody seropositivity were 82.2% (95% CI: 80.1-84.3) and 84.8% (95% CI: 82.5-87.1), respectively, in the immunized group and that these rates were higher than those in the unvaccinated group (58.6% for CSFV and 47.8% for PRRSV). Additionally, the level of CSFV antibody in piglet serum declined gradually with age, whereas PRRSV-specific antibody level increased initially (1 to 2 weeks old) and then declined with age (2 to 4 weeks old). In summary, we investigated the difference in CSFV/PRRSV antibody levels among piglets at various weeks old (1 to 4 weeks) to further establish the duration of maternal immunity in piglets. In addition, routine monitoring of CSFV/PRRSV antibodies in immunized pigs was carried out to evaluate the efficacy of vaccination.

[Effect analysis of treating intracranial wide-neck bifurcation aneurysms through Woven EndoBridge]

Objective: To explore the clinical effect of Woven EndoBridge (WEB) in the treatment of wide-neck bifurcation aneurysms. Methods: The clinical and imaging data of 11 patients with intracranial wide-neck bifurcation aneurysms treated by WEB alone at Department of Neurosurgery of the Northern Theater General Hospital from September 2017 to May 2018, were retrospectively analyzed. The patients were 7 males and 4 females, aged (54±11) years (ranged from 31 to 66 years). The aneurysms of 5 patients were located in the anterior communicating artery, 3 in the top of the basilar artery, and 3 in the bifurcation of the middle cerebral artery. The intraoperative and postoperative conditions of the patients were recorded, and the degree of aneurysm embolization was evaluated by WEB embolization aneurysm occlusion scale (WOS). Results: The intraoperative WEB release of all the 11 patients was good, with 3 cases of WOS grade A, 1 of grade B and 7 of grade C, with no intraoperative acute complications occurring. The imaging follow-up was not carried out in 1 patient due to economic reason, and the clinical follow-up was good until 3 years after the operation; 10 patients were followed up by imaging for 6 months to 3 years, and no postoperative complications occurred in the target treatment area. Among the 2 patients with WOS grade A and 1 patient with grade B during operation, according to the postoperative follow-up, all were WOS grade A; among the 7 patients with WOS grade C during operation, 4 were still of grade C and 3 were of grade D according to the follow-up. Among the 3 patients with WOS grade D, 1 patient received secondary embolization due to poor recurrence morphology, unstable hemodynamics and high possibility of rupture of aneurysm, stent assisted coil embolization was adopted, with good immediate effect; the other 2 cases had recurrent aneurysms, but the aneurysms had good morphology and stable hemodynamics, therefore, clinical follow-up was continued and no secondary surgery was performed. No complications occurred in all these 11 patients. Conclusions: The operation of treating unruptured intracranial wide-neck bifurcation aneurysms with WEB device alone is simple, and there is no need for anticoagulation and antiplatelet treatment before and after the operation, the clinical effect is being good. WEB device provides a new treatment option for intracranial wide-neck bifurcation aneurysms.

Evidence for Nonlinear Gluon Effects in QCD and Their Mass Number Dependence at STAR

The STAR Collaboration reports measurements of back-to-back azimuthal correlations of di-π^{0}s produced at forward pseudorapidities (2.6<η<4.0) in p+p, p+Al, and p+Au collisions at a center-of-mass energy of 200 GeV. We observe a clear suppression of the correlated yields of back-to-back π^{0} pairs in p+Al and p+Au collisions compared to the p+p data. The observed suppression of back-to-back pairs as a function of transverse momentum suggests nonlinear gluon dynamics arising at high parton densities. The larger suppression found in p+Au relative to p+Al collisions exhibits a dependence of the saturation scale Q_{s}^{2} on the mass number A. A linear scaling of the suppression with A^{1/3} is observed with a slope of -0.09±0.01.

Hydrochemical assessments and driving forces of groundwater quality and potential health risks of sulfate in a coalfield, northern Ordos Basin, China

Groundwater is the primary water source in coalfields under arid and semiarid climates. However, the problem of excessive concentrations of sulfate, which is a constant component in coalfields, and its potential health risks are often neglected in Northwest, China. To determine the groundwater quality, health threats, and driving forces of sulfate in coal mine groundwater, this study performed hydrochemical and isotopic analyses of 61 groundwater samples from a typical coalfield in northwestern China. We found that phreatic groundwater had lower total dissolved solid (TDS) and freshwater hydrochemical types (mainly Ca-HCO₃ and Ca-Na + K-HCO₃ types). In contrast, confined groundwater showed saline affinity (Na + K-SO₄ type) and high TDS values, and the quality was unacceptable for drinking, with EWQI values larger than 100, which could be attributed to its high SO₄^2- concentration. In addition, confined groundwater was also unsuitable for irrigation with high values of electric conductivity (EC), sodium absorption ratio (SAR), and Na%. Combining with isotopic analysis (δD, δ¹⁸O_water, δ³⁴S and δ¹⁸O_sulfate), the sulfate of confined and phreatic groundwater was controlled by gypsum dissolution and irrigation activities. As for public human health, SO₄^2- poses potential non-carcinogenic risks to various populations, especially children. Therefore, the impact of geogenic and anthropogenic factors should be paid attention to, including the reduction of the use of sulfur-containing fertilizers and discharge of sulfur-containing sewage; and the water treatment should be carried out. Importantly, there is a need to adopt a strategy of water supply from multiple sources to ensure human health.