Objective To develop and validate a fusion model that integrates a multi-parametric magnetic resonance imaging deep learning algorithm with clinicopathological factors to improve the accuracy of preoperative prediction for lymph node metastasis (LNM) in rectal cancer. Methods A total of 191 rectal cancer patients who received treatment at Zhongshan Hospital (Xiamen), Fudan University from January 2022 to December 2024 (modeling group, n＝141) and at Zhongshan Hospital, Fudan University from January to June 2021 (external validation group, n＝50) were retrospectively included. Magnetic resonance imaging and clinical data of all patients were collected to compare the diagnostic performance of the previously developed algorithm with that of two radiologists. Logistic regression was further employed to identify independent risk factors for LNM, and an integrated model combining ‘‘algorithm + clinicopathological features’’ was constructed. The clinical value of this model was evaluated using the area under the receiver operating characteristic curve (AUC) and decision curve analysis (DCA). Results In the modeling group, the algorithm’s predictive performance for LNM (AUC＝0.763) was higher than those of two physicians (AUC＝0.675, 0.655). Multivariate analysis results indicated that carcinoembryonic antigen ＞5 μg/L and low differentiation were independent risk factors for LNM (P＜0.01). The fusion model improved predictive performance, with an AUC of 0.872 in the modeling group and 0.830 in the external validation group. DCA analysis showed that the fusion model provided higher net benefits across the clinically common threshold range. Conclusions The fusion model based on multi-parametric magnetic resonance image deep learning algorithm and clinical features shows good predictive performance for LNM of rectal cancer, which is superior to simple algorithms and manual interpretation. It is expected to become an auxiliary tool for preoperative risk stratification and treatment strategy selection of rectal cancer.

Radiotherapy,as one of the important means of treating cancer,is more prone to medical errors than other treatment methods due to its involvement of a wide variety of equipment,high demands for personnel collaboration,and relatively complex treatment processes.Therefore,the establishment of an effective reporting and learning system for adverse events of radiotherapy is of great significance for ensuring patients'safety and improving healthcare quality.The International Atomic Energy Agency(IAEA)has established the Safety Reporting And Learning System For Radiotherapy(SAFRON),which constructed comprehensive database and formulated standard procedures of reporting event and analytical methods through collected and analyzed the worldwide cases of adverse event of radiotherapy.At the same time,the SAFRON system emphasizes the cultivation for safety culture,and encourages healthcare professionals to actively report adverse events,and creates a non-punitive learning environment to learn from mistakes and prevent the recurrence of similar incidents.This review introduced the structure and usage method of reporting and learning system of adverse event of SAFRON radiotherapy,so as to understand the using processes,system architecture and security culture of that,which can provide references for the establishment and use of reporting and learning system of adverse event of department,and promote continuous improvement of healthcare quality.

Objective To evaluate the safety and efficacy of simultaneous resection for initially resectable rectal cancer with synchronous liver metastases. Methods A retrospective analysis was conducted on 305 patients with initially resectable rectal cancer with synchronous liver metastases. These patients were diagnosed at Zhongshan Hospital, Fudan University from January 2016 to June 2020. Among them, 191 underwent simultaneous rectum and liver resection and 114 underwent staged resection. Propensity score matching (PSM) was performed at a 1∶1 ratio. Clinical data were compared and Kaplan-Meier survival curves were plotted. Results After PSM, 85 patients were included in each group. General data showed no significant differences. Except for liver metastasis resection method, no statistical differences were found in primary tumor surgery approach, intraoperative blood loss, intraoperative complications, time to first flatus and defecation, 30-day mortality, and postoperative hospital stay between the simultaneous resection group and the staged resection group. The overall complication rate was higher in the simultaneous resection group (48.2% vs 29.4%, P＝0.04). Specifically, the grade Ⅱ complications were significantly higher (29.4% vs 14.1%, P＝0.016), but there’s no differences in severe complications (grade Ⅲ-Ⅴ). No statistically differences were observed in median progression-free survival (HR＝0.70, 95%CI 0.50-0.97, P＝0.103) and 5-year overall survival (HR＝0.95, 95%CI 0.63-1.44, P＝0.259). Conclusions Simultaneous resection demonstrates comparable safety and efficacy to staged resection for initially resectable rectal cancer with synchronous liver metastases.

Radiotherapy,as one of the important means of treating cancer,is more prone to medical errors than other treatment methods due to its involvement of a wide variety of equipment,high demands for personnel collaboration,and relatively complex treatment processes.Therefore,the establishment of an effective reporting and learning system for adverse events of radiotherapy is of great significance for ensuring patients'safety and improving healthcare quality.The International Atomic Energy Agency(IAEA)has established the Safety Reporting And Learning System For Radiotherapy(SAFRON),which constructed comprehensive database and formulated standard procedures of reporting event and analytical methods through collected and analyzed the worldwide cases of adverse event of radiotherapy.At the same time,the SAFRON system emphasizes the cultivation for safety culture,and encourages healthcare professionals to actively report adverse events,and creates a non-punitive learning environment to learn from mistakes and prevent the recurrence of similar incidents.This review introduced the structure and usage method of reporting and learning system of adverse event of SAFRON radiotherapy,so as to understand the using processes,system architecture and security culture of that,which can provide references for the establishment and use of reporting and learning system of adverse event of department,and promote continuous improvement of healthcare quality.

Syncope is a relatively common symptom in clinical practice, and its underlying etiology is complex. This article reports a case of nasopharyngeal carcinoma that presented with recurrent syncope as the initial symptom. After radiotherapy, the patient did not experience any further episodes of syncope. The aim of this case report is to increase the awareness of this rare type of syncope by stating the clinical facts, radiological, pathological of the case and the relevant literature.
Humans ; Syncope/etiology* ; Nasopharyngeal Neoplasms/radiotherapy* ; Nasopharyngeal Carcinoma/complications* ; Carcinoma/complications* ; Male ; Middle Aged

Objective The study aimed to explore the main forms of double minute chromosomes(DMs)in the cell cycle of colorectal cancer at different phases,and to clarify the replication and separation phases of DMs.Methods After using serum-free starvation to block the progression of cell cycle in colorectal cancer COLO 320DM cells,Calyculin-A was used to induce interphase cells to prepare karyotype samples through advanced chromatin condensation.COLO 320DM cells were treated with colchicine to ob-tain mitosis(M)phase cells for karyotype analysis.The karyotypes of cells at the early stage of DNA synthesis(G1 phase),the late stage of DNA synthesis(G2 phase),metaphase(M-mid),anaphase(M-late),and telophase(M-ter)of mitosis were observed and photographed under a regular optical microscope,and counted the number of DMs.Results DMs mainly existed in monotypic form at the G1 phase,M-late phase and M-ter phase of cells.In the G2 and M-mid phases of cells,DMs mainly existed in a diploid form.Conclusion Monomeric DMs undergo replication in the S phase and transform from monomers to diploids,while diploid DMs in the M-late phase complete separation and transition from diploids to monomers.

Objective:To investigate the safety of early antiplatelet therapy for non-cardioembolic mild stroke patients with thrombocytopenia.Methods:Data of acute ischemic stroke patients with baseline National Institutes of Health Stroke Scale(NIHSS)score≤3 and a platelet count<100×109/L were obtained from a multicenter register.Those who required anticoagulation or had other contraindications to antiplatelet therapy were excluded.Short-term safety outcomes were in-hospital bleeding events,while the long-term safety outcome was a 1-year all-cause death.The short-term neurological outcomes were evaluated by modified Rankin scale(mRS)score at discharge.Results:A total of 1868 non-cardioembolic mild stroke patients with thrombocytopenia were enrolled.Multivariate regression analyses showed that mono-antiplatelet therapy significantly increased the proportion of mRS score of 0-1 at discharge(OR=1.657,95%CI:1.253-2.192,P<0.01)and did not increase the risk of intracranial hemorrhage(OR=2.359,95%CI:0.301-18.503,P>0.05),compared with those without antiplatelet therapy.However,dual-antiplatelet therapy did not bring more neurological benefits(OR=0.923,95%CI:0.690-1.234,P>0.05),but increased the risk of gastrointestinal bleeding(OR= 2.837,95%CI:1.311-6.136,P<0.01)compared with those with mono-antiplatelet therapy.For patients with platelet counts≤75×109/L and>90×109/L,antiplatelet therapy significantly improved neurological functional outcomes(both P<0.05).For those with platelet counts(>75-90)×109/L,antiplatelet therapy resulted in a significant improvement of 1-year survival(P<0.05).For patients even with concurrent coagulation abnormalities,mono-antiplatelet therapy did not increase the risk of various types of bleeding(all P>0.05)but improved neurological functional outcomes(all P<0.01).There was no significant difference in the occurrence of bleeding events,1-year all-cause mortality risk,and neurological functional outcomes between aspirin and clopidogrel(all P>0.05).Conclusions:For non-cardioembolic mild stroke patients with thrombocytopenia,antiplatelet therapy remains a reasonable choice.Mono-antiplatelet therapy has the same efficiency as dual-antiplatelet therapy in neurological outcome improvement with lower risk of gastrointestinal bleeding.

Purpose: Patients with triple-negative breast cancer (TNBC) have an increased risk of distant metastasis compared to those with other subtypes. In this study, we aimed to identify the genes associated with distant metastasis in TNBC and their underlying mechanisms. Methods: We established patient-derived xenograft (PDX) models using surgically resected breast cancer tissues from 31 patients with TNBC. Among these, 15 patients subsequently developed distant metastases. Candidate metastasis-associated genes were identified using RNA sequencing. In vitro wound healing, proliferation, migration, and invasion assays and in vivo tumor xenograft and metastasis assays were performed to determine the functional importance of aldo-keto reductase family 1 member C2 (AKR1C2). Additionally, we used the METABRIC dataset to investigate the potential role of AKR1C2 in regulating TNBC subtypes and their downstream signaling activities. Results: RNA sequencing of primary and PDX tumors showed that genes involved in steroid hormone biosynthesis, including AKR1C2, were significantly upregulated in patients who subsequently developed metastasis. In vitro and in vivo assays showed that silencing of AKR1C2 resulted in reduced cell proliferation, migration, invasion, tumor growth, and incidence of lung metastasis. AKR1C2 was upregulated in the luminal androgen receptor (LAR) subtype of TNBC in the METABRIC dataset, and AKR1C2 silencing resulted in the downregulation of LAR classifier genes in TNBC cell lines. The androgen receptor (AR) gene was a downstream mediator of AKR1C2-associated phenotypes in TNBC cells. AKR1C2 expression was associated with gene expression pathways that regulate AR expression, including JAK-STAT signaling or interleukin 6 (IL-6). The levels of phospho-signal transducer and activator of transcription and IL-6, along with secreted IL-6, were significantly downregulated in AKR1C2-silenced TNBC cells. Conclusion Our data indicate that AKR1C2 is an important regulator of cancer growth and metastasis in TNBC and may be a critical determinant of LAR subtype features.

Genetic background can lead to differences in drug effects among different populations when they use the same drug. To delineate the pharmacogenomics and population genetic differences may help to clarify the role of polymorphisms of drug metabolism-related genes in drug effect heterogeneity among different populations. This article has summarized the latest progress on the polymorphisms of drug metabolism-related genes among different populations in China.
China ; Humans ; Pharmaceutical Preparations ; Pharmacogenetics ; Polymorphism, Genetic

Genetic factors play a key role in human athletic ability, and endurance quality and explosive power quality are the important components of athletic ability. In this review, we aimed to reveal the biological genetic mechanism of human athletic ability at the molecular level through summarizing the relationship between genetic variants and human athletic ability, including endurance quality related genetic markers angiotensin converting enzyme (ACE) gene, creatine kinase MM (CKMM) gene and explosive power quality related genetic markers alpha actinin 3 (ACTN3) gene, angiotensinogen (AGT) gene and interleukin6 (IL6) gene. Meanwhile, we also summarized the distribution of allele frequencies among various populations.
Actinin/genetics* ; Athletic Performance ; Gene Frequency ; Genetic Markers ; Genotype ; Humans ; Polymorphism, Genetic