GR Group Research Articles

Predictors of good outcomes in patients with hepatocellular carcinoma (HCC) treated with transarterial radioembolization (TARE).

e16219 Background: No reliable biomarkers or risk factors guide treatment selection in HCC patients. Management is typically institution-specific, and compliance with the available guidelines is low. Our retrospective review aims to identify HCC patients suitable for TARE. Methods: HCC patients treated with TARE between 1/1/2015 and 8/30/22 at Ohio State University were included in this study. Patient-related information was extracted from chart review. Various risk factors (related to HCC and TARE) were compared between good (GR) and poor (PR) responders (progression-free survival (PFS) ≤ vs. > median (m)), and good (GSv) and poor (PSv) survivors (overall survival (OS) ≤ vs. > m). Chi-square test and logistic regression were performed using JMP Pro 17 (SAS Institute Inc., Cary, NC). Results: Our cohort included 141 patients. The median age was 65 years (range 49-88), 80% were males and 80% were White (16% were African American and 4% were other). The median OS and PFS were 9 months (m) (95% confidence interval [CI], 5-22.5) and 4m (95% CI, 2-9), respectively. Compared to PSv (OS ≤ 9m, N = 71), the GSv group (OS > 9m, N = 70) had a high alcohol history (hx) (64% vs. 44%, p = 0.01); less baseline (BL) encephalopathy (Enc) (21% vs. 37%, p = 0.04) and post-TARE ascites (As) (31% vs. 63%, p = 0.001); were able to receive immune-checkpoint inhibitor (ICI) (44% vs. 6%, p < 0.001) before (6% vs. 1%) or after (39% vs. 10%) TARE. Other key BL features with a trend to significance (p = 0.06-0.08) were less BL cirrhosis (69% vs. 87%) and As (19% vs. 34%), hx of HCC treatment (systemic or local, 43% vs, 28%), and ability to get second TARE (19% vs. 8%). In worse survivors (PFS ≤ 5m, N = 40), post-TARE As (65% vs. 41%, p = 0.008) was significantly higher. Only 2/40 patients were able to get ICI (95% vs. 37%, p = 0.0002) in this group. Compared to PR, the GR group (PFS > 5m, N = 64) had a higher rate of diabetes mellitus (DM) (45% vs. 26%, p = 0.02) and less post-TARE As (34% vs. 58%, p = 0.004). BL and HCC-related factors prominently NOT featured in these comparisons were hepatitis (B or C) or smoking hx and macrovascular invasion. Conclusions: TARE suits patients with hx of alcohol use or DM, no BL Enc, As, or cirrhosis, and failed prior lines. Post-TARE As is poor prognostic markers. ICI use will improve the outcomes.

#695 Modulation of probiotics on intestinal flora and related short-chain fatty acids in patients with peritoneal dialysis

Abstract Background and Aims Probiotics may play a role in inflammation, nutritional status, kidney function and quality of life. However, few studies were performed to study the effects of probiotics on metabolites of intestinal flora in patients. Method We investigated the effects of Lactobacillus paracasei N1115 on intestinal flora and related short-chain fatty acids in end stage kidney disease patients on peritoneal dialysis (PD) in a single-center, prospective, randomized, double-blind, placebo-controlled study (ChiCTR-TRC2016254). Fifty one patients on peritoneal dialysis underwent an intervention with the probiotic supplement (n = 36, PR group) or placebo (n = 15, PL group) for twelve weeks. In addition to collecting fecal samples for 16S rRNA gene high-throughput sequencing and short-chain fatty acids (SCFAs) analysis, gastrointestinal symptom was also assessed at baseline and after the intervention. Moreover, PR group was divided into gastrointestinal symptom remission group (n = 30, GR group) and gastrointestinal symptom non-remission group (n = 5, GNR group). Results Probiotic administration caused significant changes in the composition of gut microbiota, as indicated by increased abundance of beneficial bacteria (Firmicutes), decreased Bacteroidetes, and opportunistic pathogens (Fusobacterium, Bilophila) (p < 0.05). However, there was no significant difference in intestinal microbial diversity, SCFAs levels increased in PR group although the change was not statistically significant between the two groups (P > 0.05). In addition, probiotic administration could effectively reduce gastrointestinal symptoms, particularly in dyspepsia and constipation (p < 0.05). The contents of SCFAs was increased in GNR group (p < 0.05), and there was a significant correlation between these SCFAs and the differential bacterial genera with significant changes between the GR and GNR groups (p < 0.05). Conclusion Together, the results suggest that probiotic can promote the beneficial changes of intestinal flora in PD patients. Probiotic supplementation can improve the gastrointestinal symptoms of PD patients, possibly by affecting the composition of intestinal bacteria and their metabolites.

Effects of task repetition with grammatizing on oral task performance and knowledge development

Abstract This study compared the effects of task repetition only (TR), task repetition with grammatizing (TR+GR), and grammatization with no task repetition (GR) on 94 EFL learners’ oral task performances. Participants’ productions were measured both in terms of complexity, accuracy, and fluency as well as receptive knowledge (measured by an error correction test) and productive knowledge (measured by a sentence-level oral production test) development. Immediately after performing a narrative task, the TR+GR and GR learners were required to restore the target structure, namely the English regular past tense, which had been deleted in a grammatized text. Learners in the TR group received no grammatization, and only the TR+GR and TR groups repeated the same task twice. Results revealed that although both TR conditions led to enhanced receptive knowledge, the TR+GR performed better than the TR in fostering learners’ receptive knowledge and improving accuracy and productive knowledge at a delayed posttest. The GR group improved their receptive knowledge in the immediate posttest, but this improvement tailed off in the delayed posttest. Lastly, the TR+GR group could also improve the complexity and accuracy of their narrative task performances–albeit at the expense of fluency.

The Clinical and Imaging Outcome of the Tandem Growing Rod Technique in Early-Onset Scoliosis With the Proximal Upper Thoracic Curve Progression: A Modified Technique of Growing Rod.

Retrospective cohort study. The orthopaedic ability of traditional GR for severe EOS is limited. The proximal upper thoracic curve may progress during the lengthening procedure, which may lead to coronal imbalance and inhibit the longitudinal growth of the spine. In this retrospective cohort study, we investigated the clinical outcome of tandem GR. We modified the traditional technique by using two groups of GR devices to control the major and the proximal upper thoracic curve, connected the two groups of GR in series, and named it tandem GR. The clinical and imaging outcomes of the new technique were evaluated and compared with traditional technique. Twenty one patients were enrolled in the tandem GR group, and 30 patients were treated with traditional GR as the control. The baseline parameters were consistent between the two groups. In the tandem GR group, the secondary curve progressed from 24.9 ± 3.9° to 31.4 ± 3.2° (P = .006) in the procedure with the traditional GR and improved to 18.4 ± 4.5° (P = .001) after the switch. Meanwhile, the clavicular angle aggravated from 1.6 ± 1.0° to 2.6 ± .7° (P = .041), and improved to 1.7 ± .8° after changed to the tandem GR (P = .033). At the final of the follow-up, the secondary curve was higher in the control group (27.1 ± 8.3° vs 18.4 ± 4.5°, P = .034), the clavicle angle was 2.4 ± 1.1° in control and 1.7 ± .8° in the tandem GR group (P = .028), the T1-S1 height was 28.2 ± 4.8cm in the control and 33.3 ± 3.0cm in the tandem GR group (P = .027). The average growth rate was 1.0 ± .3cm/year in the control and 1.2 ± .4cm/year in the tandem GR group (P = .046). Tandem GR can effectively improve the proximal upper thoracic curve progression during the treatment of EOS. Compared with the traditional GR, tandem GR can achieve better curve correction, better shoulder balance, and retains more capacity for longitudinal spine growth.

Effects of prenatal dichromatic light exposure on hatching results and post-hatch performance of Japanese quail.

Present study evaluated the effect of lighted incubation on pre- and post-hatch performance of Japanese quail. In a completely randomized design, 1200 eggs were evenly divided into 4 treatments groups having six replicates (each tray was considered as replicate), 50 eggs each. Different dichromatic lights (Green + Red; GR, Green + Blue; GB, and Blue + Red; BR) of 250 lux were provided during incubation for 12 h daily and effects of these lights very evaluated on hatching results and post-hatch growth. After hatch, 600 quail chicks were divided into 4 treatments, 6 replicates, and 25 birds each. Regarding hatching traits, better hatchability was found in the GR group compared to GB, BR, and dark group; while early embryonic mortality was lower in BR, GB, and dark group than GR; mid embryonic mortality was lower in dark group and late embryonic mortality was noted in the GR group than those of other treatment groups. In addition, moisture loss during incubation was minimum in BR and dark groups; however, chick spread was better in the GR group. In terms of growth performance, weight gain was better in the GR group; feed intake in dark, feed conversion ratio in BR, and livability were better in BR and GR group. In morphometrics, keel and shank length were higher in all the colored groups (GB, BR, and GR) whereas body length, wing spread, shank circumference, drumstick length, and circumference were higher in the GR group. Regarding serum chemistry, glucose, albumin, and globulin levels were higher in the GR group. It was concluded that under the experimental conditions, GR light at the prenatal stage to Japanese quail eggs positively influenced hatching performance and post-hatch growth.

A Prospective Study of the Effect of Gastroduodenal Artery Reconstruction on Duodenal Oxygenation and Enzyme Content After Pancreas Transplantation

BackgroundWhole pancreas transplantation provides durable glycemic control and can improve survival rate; however, it can carry an increased risk of surgical complications. One devastating complication is a duodenal leak at the site of enteroenteric anastomosis. The gastroduodenal artery (GDA) supplies blood to the donor duodenum and pancreas but is commonly ligated during procurement. Since we have not had expressive changes in pancreatic back table surgical techniques in the recent decades, we hypothesized whether back table GDA reconstruction, improving perfusion of the donor duodenum and head of the pancreas, could lead to fewer surgical complications in simultaneous pancreas-kidney (SPK) transplants.Material and MethodsBetween 2017 and 2021, we evaluated demographic information, postoperative complications, intraoperative donor duodenum, recipient bowel O2 tissue saturation, and patient morbidity through the Comprehensive Complication Index (CCI®).ResultsA total of 26 patients were included: 13 underwent GDA reconstruction (GDA-R), and 13 had GDA ligation (GDA-L). There were no pancreatic leaks in the GR group compared to 38% (5/13) in the GDA-L group (p = 0.03913). Intraoperative tissue oxygen saturation was higher in the GDA-R group than in the GDA-L (95.18 vs.76.88%, p < 0,001). We observed an increase in transfusion rate in GDA-R (p < 0.05), which did not result in a higher rate of exploration (p = 0.38). CCI® patient morbidity was also significantly lower in the GDA-R group (s < 0.05).ConclusionsThis study identified improved intraoperative duodenal tissue oxygen saturation in the GDA-R group with an associated reduction in pancreatic leaks and CCI® morbidity risk. A larger prospective multicenter study comparing the two methods is warranted.

Influence of probiotic supplementation on the growth performance, plasma variables, and ruminal bacterial community of growth-retarded lamb.

Growth-retarded lambs would reduce the economic incomes of sheep farming. Nutritional interventions are supposed to promote gastrointestinal health and the compensatory growth of growth-retarded lambs. This study evaluated the effects of probiotic supplementation on the growth performance, plasma characteristics and ruminal bacterial community of growth-retarded lambs. Twenty-four 50-days old male Hu lambs, including 8 healthy lambs (13.2 ± 1.17 kg) and 16 growth-retarded lambs (9.46 ± 0.81 kg), were used in this study. The 8 healthy lambs were fed the basal diet and considered the positive control (GN), and the other 16 growth-retarded lambs were randomly assigned into 2 groups (basal diet without probiotic [negative control, GR] and basal diet supplementation with 1 g/kg concentrate feed probiotic [GRP]), with each group having 4 replicate pens. The feeding trial lasted for 60 days with 7 days for adaptation. The results showed that dietary supplementation with probiotic increased (p < 0.05) the average daily gain and dry matter intake of growth-retarded lambs. For growth-retarded lambs, supplementation with probiotic increased (p < 0.05) the activities of superoxide dismutase and glutathione peroxidase, as well as the concentrations of growth hormone and immunoglobulin G. Furthermore, the highest (p < 0.05) concentrations of interleukin-6, interferon-gamma and tumor necrosis factor alpha were observed in the GR group. The concentrations of total volatile fatty acids and acetate in growth-retarded lambs were increased by probiotic supplementation (p < 0.05). The relative abundances of Ruminococcus, Succiniclasticum and Acidaminococcus were lower (p < 0.05) in growth-retarded lambs. However, probiotic supplementation increased (p < 0.05) the relative abundances of these three genera. These results indicate that dietary supplementation with probiotic are promising strategies for improving the growth performance of growth-retarded lambs by enhancing immunity and altering the ruminal microbiota.

Distinct adaptations of endocrine and cognitive functions may contribute to high variability in long-term weight loss outcome after bariatric surgery

Background: Bariatric surgery has been widely recognized as the most efficient long-term treatment method in severe obesity, yet therapy success shows considerable interindividual variability. Postoperative metabolic adaptations, including improved gut hormone secretion (GLP-1, PYY and ghrelin), and restored executive function may play an explanatory role in weight loss, yet causes for poor success in individual patients remain unknown. This study investigates gut-hormonal and cognitive characteristics in extreme weight loss responders to bariatric surgery. Methods: Patients (n = 47) with high or low excessive weight loss (EWL) at least 2 years after Roux-en-Y-gastric bypass or sleeve gastrectomy were allocated into good responders (GR, EWL 82.4 ± 11.6%) and poor responders (PR, EWL 24.0 ± SD 12.8%) to study differences in postprandial secretion of GLP-1, PYY, ghrelin and in working memory (WM). Results: Mean BMI was 47.1 ± 6.2 kg/m² in PR (n = 21) and 28.9 ± 3.1 kg/m² in GR (n = 26, p < 0.001). Fasted GLP-1 and PYY were comparable for GR and PR (p > 0.2) and increased strongly after a standardized test meal (300 kcal liquid meal) with a peak at 15 to 30 min. The increase was stronger in GR compared to PR (GLP-1, PYY: Time x Group p < 0.05). Plasma ghrelin levels already differed between groups at fasted state, showing significantly higher levels for GR (p < 0.05). Postprandially, ghrelin secretion was suppressed in both groups, but suppression was higher in GR (Time x Group p < 0.05). GR showed significantly higher WM scores than PR (p < 0.05). Postprandial ghrelin (iAUC), but not GLP-1 or PYY plasma levels, significantly mediated the relationship between EWL and a WM subscore (IS score, CI = 0.07 - 1.68), but not WM main score (MIS score, CI = -0.07 - 1.54), in mediation analyses. Conclusion: Excess weight loss success after bariatric surgical procedures is associated with distinct profiles of gut-hormones at fasted and postprandial state, and differences in working memory. Better working memory performance in GR might be mediated by higher postprandial reduction in ghrelin plasma levels. Future studies need to integrate longitudinal data, larger samples and more sensitive cognitive tests.

Excessively increased thalamocortical connectivity and poor initial antiseizure medication response in epilepsy patients.

The network mechanism underlying the initial response to antiseizure medication in epilepsy has not been revealed yet. Given the central role of the thalamus in the brain network, we conducted a case-control study to investigate the association between thalamic connectivity and medication response. We recruited 39 patients with newly diagnosed and medication-naïve epilepsy of genetic or unknown etiology, including 26 with a good response (GR group) and 13 with a poor response (PR group), and 26 matched healthy participants (control group). We measured the gray matter density (GMD) and the amplitude of low-frequency fluctuation (ALFF) of bilateral thalami. We then set each thalamus as the seed region of interest (ROI) to calculate voxel-wise functional connectivity (FC) and assessed ROI-wise effective connectivity (EC) between the thalamus and targeted regions. We found no significant difference between groups in the GMD or ALFF of bilateral thalami. However, we observed that the FC values of several circuits connecting the left thalamus and the cortical areas, including the bilateral Rolandic operculum, the left insula, the left postcentral gyrus, the left supramarginal gyrus, and the left superior temporal gyrus, differed among groups (False Discovery Rate correction, P < 0.05), with a higher value in the PR group than in the GR group and/or the control group (Bonferroni correction, P < 0.05). Similarly, both the outflow and the inflow EC in each thalamocortical circuit were higher in the PR group than in the GR group and the control group, although these differences did not remain statistically significant after applying the Bonferroni correction (P < 0.05). The FC showed a positive correlation with the corresponding outflow and inflow ECs for each circuit. Our finding suggested that patients with stronger thalamocortical connectivity, potentially driven by both thalamic outflowing and inflowing information, may be more likely to respond poorly to initial antiseizure medication.

Depression mediated the relationships between precentral-subcortical causal links and motor recovery in spinal cord injury patients.

Depression after brain damage may impede the motivation and consequently influence the motor recovery after spinal cord injury (SCI); however, the neural mechanism underlying the psychological effects remains unclear. This study aimed to examine the casual connectivity changes of the emotion-motivation-motor circuit and the potential mediating effects of depression on motor recovery after SCI. Using the resting-state functional magnetic resonance imaging data of 35 SCI patients (24 good recoverers, GR and 11 poor recoverers, PR) and 32 healthy controls (HC), the results from the conditional Granger causality (GC) analysis demonstrated that the GR group exhibited sparser emotion-motivation-motor GC network compared with the HC and PR groups, though the in-/out-degrees of the emotion subnetwork and the motor subnetwork were relatively balanced in the HC and GR group. The PR group showed significantly inhibitory causal links from amygdala to supplementary motor area and from precentral gyrus to nucleus accumbens compared with GR group. Further mediation analysis revealed the indirect effect of the 2 causal connections on motor function recovery via depression severity. Our findings provide further evidence of abnormal causal connectivity in emotion-motivation-motor circuit in SCI patients and highlight the importance of emotion intervention for motor function recovery after SCI.

Sleep deprivation induces structural changes in the adult rat testis: The protective effects of olive oil.

Sleep deprivation (SD) is a common problem in today's stressful lifestyle and have physiological consequences, including reproductive dysfunction and infertility. As an antioxidant, olive oil may be effective in reducing testicular and spermatological damage by decreasing the production of free radicals. This study investigated the effects of olive oil on sperm quality and testicular structure using stereological methods to assess rats with SD. When comparing SD group to grid floor+distilled water (GR) group, we found that the sperm count and motility, as well as the percentage of slow progressive sperm was significantly lower in SD group (p<0.05), but the percentage of immotile sperm was higher (p<0.01). However, no improvement was observed in sperm count or motility after concomitant treatment of SD group with olive oil. Stereological examinations revealed no significant change in the total volumes of the seminiferous tubules, interstitial tissue, and germinal epithelium in the study groups. Conversely, the total number of testicular cell types was significantly lower in SD group than in GR group. Although the total number of Sertoli and Leydig cells was significantly higher in the SD+olive oil group than in the untreated SD group, no significant difference in the total number of other testicular cell types was observed between the two groups. SD potentially induced structural changes in testis that affected sperm count and motility. However, olive oil only improved the total number of Sertoli and Leydig cells in the animals with SD and did not improve sperm count and motility.

Th2 cells infiltrating high-grade serous ovarian cancer: a feature that may account for the poor prognosis.

We aimed to investigate the differences of transcriptome profile between 2 groups of high-grade serous ovarian cancer (HGSOC) patients with distinct outcomes and identify potential biomarkers for recurrence. RNA sequencing was performed in 2 groups of HGSOC patients with similar demographic characteristics but exhibiting distinct progression-free survival (PFS). Transcriptome data of poor response (PR; PFS ≤6 months) and good response (GR; PFS ≥12 months) group were compared. We employed xCell to evaluate the abundance of 63 cells in tumor microenvironment. The predictive value of recurrence-related tumor infiltration cells was validated in cohort data from Gene Expression Omnibus (GEO) and The Cancer Genome Atlas (TCGA) dataset. The weighted correlation network analysis was performed to identify the genes related to cell infiltration. PR patients exhibited a distinct tumor infiltration immune cells-related transcriptional profile compared to GR patients, such as lower signatures of leukocyte differentiation, activation and chemotaxis. The fraction of T-helper 2 (Th2) cells infiltration was significantly higher in PR group than in GR group. High infiltration of Th2 was significantly associated with unfavorable prognosis in the GEO cohort (area under the curve=0.84 at 6 months recurrence) and TCGA cohort (p=0.008). Genes enriched to extracellular matrix organization and integrin binding were relevant to Th2 infiltration. Patients with HGSOC having shorter PFS exhibited a distinct gene signature that related to tumor-infiltrating immune cells. The level of Th2 infiltration could facilitate patient recurrence risk stratification and may be a promising biomarker for prognosis prediction and immune-related treatment.

Safety and Efficacy of Simultaneous Resection of Gastric Carcinoma and Synchronous Liver Metastasis-A Western Center Experience.

Background and objectives: Gastric cancer (GC) is often diagnosed in the metastatic stage. Palliative systemic therapy is still considered the gold standard, even for patients with resectable oligometastatic disease. The aim of the current study is to assess the potential benefit of up-front gastric and liver resection in patients with synchronous resectable liver-only metastases from GC (LMGC) in a Western population. Materials and Methods: All patients with GC and synchronous LMGC who underwent gastric resection with or without simultaneous resection of LMs between January 1997 and December 2016 were selected from the institutional records. Those with T4b primary tumors or with unresectable or more than three LMs were excluded from the analysis. All patients who underwent emergency surgery for hemorrhagic shock or gastric perforation were also excluded. Results: Out of 28 patients fulfilling the inclusion criteria, 16 underwent simultaneous gastric and liver resection (SR group), while 12 underwent palliative gastric resection (GR group). The median overall survival (OS) of the entire cohort was of 18.81 months, with 1-, 3- and 5-year OS rates of 71.4%, 17.9% and 14.3%, respectively. The 1-, 3- and 5-year OS rates in SR group (75%, 31.3% and 25%, respectively) were significantly higher than those achieved in GR group (66.7%, 0% and 0%, respectively; p = 0.004). Multivariate analysis of the entire cohort revealed that the only independent prognostic factor associated with better OS was liver resection (HR = 3.954, 95% CI: 1.542-10.139; p = 0.004). Conclusions: In a Western cohort, simultaneous resection of GC and LMGC significantly improved OS compared to patients who underwent palliative gastric resection.

Grazing cotton crop residue to reduce winter supplementation cost in late-gestation beef cows and assessment of the negative effects of gossypol on fermentation of mixed ruminal microorganisms

This research aimed to evaluate the use of standing cotton crop residue as a winter supplementation source for gestating beef cows and the effects of gossypol, a naturally occurring pigment with potential anti-quality characteristics, on in vitro mixed ruminal microorganism fermentations. Experiment 1 used a 3-yr completely randomized study with 108 Angus cross cows (BW 559 ± 7.9 kg) enrolled in a 30-d grazing trial. Cows were weighed, stratified by weight, and randomly assigned to 1 of 2 treatments: dormant bermudagrass ( Cynodon dactylon ) pasture + bermudagrass hay (GR) or cotton ( Gossypium ) crop residue + bermudagrass hay (CT). Experiment 2 used a completely randomized in vitro mixed ruminal microorganism fermentation with 3 × 5 factorial arrangements of treatments. This included 3 substrates: corn ( Zea mays ; CC), average relative forage quality (RFQ 100) coastal bermudagrass (ABG), and high relative forage quality (RFQ 120) coastal bermudagrass (HBG), along with 5 concentrations of gossypol: 0, 0.0615, 0.123, 0.1845, or 0.246 mg of gossypol/mL. Total hay offered and hay per head per day were greater ( P ≤ 0.02) in the GR group compared with the CT group. Economic analysis indicated that total hay cost, cost per head per day, and cost of gain were all significantly decreased for cows in the CT treatment compared with cows in the GR treatment ( P < 0.002). In vitro DM digestibility and total VFA production were lower ( P < 0.002) as gossypol concentration reached the highest concentration. Results suggest that grazing cotton crop residue is a partial replacement for hay supplementation during the winter months. Increased levels of gossypol have negative effects on DM disappearance and VFA production. The gossypol amount found in crop residue is approximately the same as the lowest concentration evaluated in the in vitro experiment. These results indicate that grazing cotton crop residue should not influence ruminal fermentation.

Favorable outcome of high-dose chemotherapy and autologous hematopoietic stem cell transplantation in patients with nonmetastatic osteosarcoma and low-degree necrosis.

BackgroundA low-degree tumor necrosis after neoadjuvant chemotherapy is a poor prognostic factor for osteosarcoma (OSA). However, the role of high-dose chemotherapy (HDC) and autologous hematopoietic stem cell transplantation in OSA remains controversial. We analyzed the treatment outcomes and prognostic factors of nonmetastatic OSA and compared the HDC and conventional chemotherapy (CC) outcomes of patients with <90% necrosis after neoadjuvant chemotherapy.MethodsWe retrospectively evaluated patients with OSA treated at the Seoul National University Children’s Hospital from 2000 to 2020. Totally, 113 patients with non-metastatic OSA at diagnosis were included. The majority were treated with cisplatin, doxorubicin, and methotrexate as neoadjuvant chemotherapy. This was continued when the postoperative necrosis rate was >90% (good response [GR]), whereas most cases with <90% (poor response [PR]) were changed to chemotherapy. The HDC regimen was composed of melphalan, etoposide, and carboplatin.ResultsThe median age at diagnosis was 12.6 years (range, 5.0–20.3), and 61.9% of patients were men. The 5-year event-free survival (EFS) and overall survival (OS) rates were 75.8% and 91.5%, respectively. Among these, 59 and 44 patients were included in the GR and PR groups, respectively. The GR group had a better 5-year EFS rate than the PR group (82.4% vs. 67.3%, p=0.071). Age at diagnosis, sex, tumor site, type of neoadjuvant chemotherapy, and degree of tumor necrosis were not different between the PR-HDC (n=24) and PR-CC (n=20) groups. The 5-year EFS and OS rates in the PR-HDC (n=24) and PR-CC (n=20) groups were 78.6% and 53.6% (p=0.065) and 100% and 76.9% (p=0.024), respectively. In the Cox regression analysis, the PR-CC group (hazard ratio, 4.95; p=0.004) and age ≥12 years (hazard ratio, 2.68; p=0.024) were significant risk factors for 5-year EFS.ConclusionsHDC showed favorable outcomes in patients with non-metastatic OSA and <90% necrosis after neoadjuvant chemotherapy.

Immune Profile of BRAF-Mutated Metastatic Colorectal Tumors with Good Prognosis after Palliative Chemotherapy.

Simple SummaryThe present study demonstrated that the distinct subgroup of BRAF-MT CRC showed a good response after palliative chemotherapy. Based on the immune profile analysis, higher PD-L1 expression and CD8-positive cell infiltration were shown in this study population. Furthermore, the assessment of the immune profile of BRAF-MT tumors can be helpful to better understand tumor biology and the different clinical outcomes of BRAF-MT CRC. Background: BRAF-mutated colorectal cancers (BRAF-MT CRCs) are known to have poor prognoses. BRAF-MT CRC was reported to be possibly related to the immune-activated phenotype. Objectives: This study aimed to investigate the association between the immune microenvironment and prognosis of BRAF-MT CRC. Methods: We evaluated clinical outcomes and investigated the immune profile of the BRAF-MT CRC tumors using the multiplex immunohistochemistry of immune-related markers: cytokeratin, programmed death ligand-1 (PD-L1), programmed cell death protein-1 (PD-1), and a cluster of differentiation 8 (CD8). Results: Out of 2313 tumors, 123 were BRAF-MT tumors. Among them, 86 tumors with available tissue were included. Out of 86 patients, 75 patients were non-good responders (GR), whereas 11 patients were GR. Median progression-free survival after first-line chemotherapy (4.6 vs. 12.4 months, p = 0.008) and overall survival (11.8 vs. 45.0 months) were longer in the GR group (p < 0.001). Median CD8+ T cell (254.29 vs. 656.0, p = 0.092), PD-L1+ tumor cell (0.95 vs.15.56, p = 0.050), PD-L1+ stromal cell (3.17 vs. 72.38, p = 0.025), PD-L1+ tumor and stromal cell (5.08 vs. 74.92, p = 0.032), and PD-1+ stromal cell (45.08 vs. 325.40, p = 0.046) counts were greater in the GR group. Conclusion: The clinical outcomes of unselected patients with BRAF-MT CRC were generally similar to those in previous studies. Based on the immune profile analysis, higher PD-L1 expression and CD8-positive cell infiltration were observed in BRAF-MT tumors with a good prognosis.

Enhanced recovery after lumbar fusion surgery: Benefits of using Game Ready©

IntroductionThe primary aim of this study was to evaluate how the Game Ready© cryotherapy system impacts postoperative analgesia following lumbar fusion. The secondary aim was to study the effect of cryotherapy on blood loss, transfusion rate and recovery after surgery. Materials and methodsThis was a retrospective study of 60 patients divided into two consecutive sets. The first set of 30 patients underwent the current anesthesia protocol at our facility (control group) while the second set of 30 underwent the same protocol but the patient wore the Game Ready© cryotherapy belt immediately postoperative (GR group). ResultsVAS for pain at H6 did not differ between groups [5.2±1.7 vs. 5.2±1.8 (p=0.94)]; however, there was a significant decrease in pain at H24 and H48 in the GR group relative to the control group (p=0.04; p=0.01; p=0.01). Consumption of morphine over the first 24 and 48hours was 50% less in the GR group than in the control group (p=0.01 and p<0.0001). Discharge occurred significantly earlier in the GR group (3.9±1.0 days) than the control group (5.1±0.9 days) (p<0.001). The estimated blood loss was greater in the control group than the GR group (574.7ml±339.2 vs. 305.9ml±229.6; p=0.0003). ConclusionUse of a cryotherapy device in the context of spine surgery is effective at controlling postoperative pain. It also decreases the consumption of analgesics, limits blood loss, reduces the need for transfusions, and contributes to enhanced recovery after surgery. Level of evidenceIV.

Interaction effect of green tea consumption and resistance training on office and ambulatory cardiovascular parameters in women with high-normal/stage 1 hypertension.

This study aimed to investigate the chronic effects of green tea (GT) extract and resistance training (RT) on ambulatory and office blood pressure (BP), heart rate (HR), and rate‐pressure product (RPP) in a sample of Iranian women with high‐normal/stage 1 hypertension. Forty‐four middle‐aged sedentary women participated in this randomized, double‐blind, placebo‐controlled study. They were randomly assigned to one of four groups: GT and RT (GR, n = 11), RT (n = 10), GT (n = 10), or control (n = 13). Three weeks of GT consumption were followed by six weeks of the interaction with RT. GR and RT groups performed two circuits of RT at %50 of 1RM two days per week. RT and control groups also received placebo (maltodextrin) with the same timing. The changes of each variable from baseline to post‐intervention were compared between the groups using the ANOVA test, and effect size (ES) statistic was also calculated. In comparison with the control group, significant reductions were found for office systolic BP (SBP, 8%, ES = 1.22), and 24 h‐SBP (5%, ES = 1.2) in the RT group. However, GR group showed significant decreases in office SBP (10.5%, ES = 1.45), mean BP (8%, ES = 1.11), RPP (13%, ES = 1.47), 24 h‐SBP (5%, ES = 1.21), and 24 h‐RPP (10%, ES = 1.15). The interaction of regular RT and GT consumption seems to induce more beneficial effects on some important parameters including MBP and RPP when compared to RT or GT alone.

Risk factors for thoracolumbar pain following percutaneous vertebroplasty for osteoporotic vertebral compression fractures.

ObjectiveTo explore possible risk factors for poor outcomes following percutaneous vertebroplasty (PV) for painful osteoporotic compression fractures of thoracolumbar vertebra.MethodsThis was a retrospective review of data from patients who underwent PV at our institution over a ten-year period to evaluate the association between possible risk factors and thoracolumbar pain (T11-L2). According to the difference between pre- and post-operative visual analogue scale (VAS) scores for pain, patients were separated into poor relief (PR; <4) and good relief (GR; ≥4) of pain.ResultsOf the 750 patients identified, 630 (PR group, n =310; GR group, n = 320) fulfilled the eligibility criteria. Multivariate binary logistic analysis showed that bone mineral density (BMD), >2 fractured vertebral bodies, maldistribution of bone cement, <5 ml bone cement injected into a single vertebral body and thoracolumbar fascia injury prior to surgery were independent risk factors associated with thoracolumbar pain following PV.ConclusionAlthough prospective controlled studies are required to confirm our results, this review suggests that the above factors should be taken into account when selecting patients for PV.

Protective action of the ginsenoside Rh3 in a rat myocardial ischemia-reperfusion injury model by inhibition of apoptosis induced via p38 mitogen-activated protein kinase/caspase-3 signaling.

ObjectiveTo investigate the protective effects of the ginsenoside Rh3 on rats subjected to myocardial ischemia-reperfusion (MIR) via its impact on caspase-3 and the p38 mitogen-activated protein kinase (MAPK) pathway.MethodsFifteen male Sprague-Dawley rats were randomly categorized into the MIR group (MY group, n = 5), sham surgery group (SS group, n = 5), and ginsenoside Rh3 group (GR group, n = 5).ResultsThe MY group exhibited the largest myocardial infarctions compared with the GR and SS groups. The GR group exhibited significantly higher cell viability of cardiomyocytes and significantly decreased apoptosis compared with the MY group. Fibrils of infarcted tissue in the GR group were disordered but less swollen, with a more organized fibril orientation than those in the MY group. The GR group showed reduced p-p38 MAPK protein and caspase-3 mRNA expression levels compared with the MY and SS groups.ConclusionsRh3 significantly improved myocardial necrosis and caspase-3 levels in myocardial tissues by suppressing the p38 MAPK pathway, thereby inhibiting caspase-3 involvement in apoptosis. Thus, Rh3 was effective in inhibiting the escalated apoptotic pathway in myocardial infarction and can potentially serve as a useful therapeutic agent to rescue myocardial infarction.