PR Group Research Articles

Evaluation of treatment for diffuse large B-cell lymphoma using plasma D-dimer levels

It has been documented that D-dimer levels have potential utility as a measure of tumor activity in diffuse large B-cell lymphoma (DLBCL), however whether it can be used as a predictive marker of treatment outcome has not been established. This study means to retrospectively evaluate the role of D-dimer in prediction of treatment efficacy in patients with DLBCL. 151 patients with newly diagnosed DLBCL were enrolled. Blood samples were taken from those patients during the initial visit to our hospital and again after two cycles of chemotherapy to measure D-dimer levels. The link between plasma D-dimer concentrations and patients’ clinical characteristics was explored before and after treatment. D-dimer levels within the range of 0–1 µg/mL were considered negative, while readings above this range were considered positive. D-dimer difference percentage (Ddp) represents the percentage change in D-dimer levels before and after chemotherapy, calculated as (post-chemotherapy D-dimer minus pre-chemotherapy D-dimer) / pre-chemotherapy D-dimer × 100. Patients showed statistically different plasma D-dimer levels at initial consultation across treatment-response groups: CR (0.63 µg/mL [0.43–1.27]), PR (1.39 µg/mL [0.73–2.46]), SD (0.89 µg/mL [0.59–1.24]), and PD (1.34 µg/mL [0.67–2.62]). After chemotherapy, the PR group exhibited a mean D-dimer level of -0.38 µg/mL (range − 1.64 to -0.11), which was significantly lower than that of the PD group (mean 0.04 µg/mL, range − 0.40 to 0.79; p < 0.05). The CR group revealed significantly lower initial D-dimer levels (median 0.63 µg/mL) and greater reductions after chemotherapy compared to the non-CR group (median 1.17 µg/mL, p < 0.05). Patients with coagulation disorders such as DIC, DVT, or PE were excluded to minimize confounding factors. While this study demonstrates the utility of D-dimer in predicting short-term treatment response, the relationship with long-term outcomes such as PFS and OS requires further investigation. Patients who respond well to chemotherapy typically exhibit lower D-dimer levels at the initial diagnosis. Those in the SD or PD groups usually experience a greater increase in D-dimer levels following chemotherapy. Consequently, variations in plasma D-dimer levels before and after treatment may offer valuable insights for evaluating the efficacy of chemotherapy treatment.

The effect of degenerative scolioisis on segmental thoracolumbar sagittal alignment compared to age- and pelvic incidence-matched reference values.

In asymptomatic subjects, variations of sagittal alignment parameters according to age and pelvic incidence (PI) has been reported. The aim of this observational study was to describe thoraco-lumbar sagittal alignment in patients with degenerative scoliosis and to compare them to asymptomatic individuals, seeking for the specific effect of deformity in similar age and PI groups. Full spine radiographs of 235 asymptomatic subjects and 243 scoliosis patients were analyzed: cervico-thoracic inflexion point (CTIP), thoraco-lumbar inflexion point (TLIP), lumbar lordosis (LL) L1-S1, LL (TLIP-S1), LL superior arch (TLIP-lumbar apex), LL inferior arch (lumbar apex-S1), PI, thoracic kyphosis (TK) T5-T12, TK T1-T12, number of vertebrae CTIP-TLIPandTLIP-S1. The distribution of parameters was analyzed using a Bayesian inference (significant when Pr > 0.975 or Pr < 0.025). Comparisons between reference (R) and pathologic (P) groups were matched according to age (40-60 years; >60 years) and PI (< 45°; 45-60°; >60°). LL L1-S1 was significantly lower in the P-group (Pr = 1.0), decreased with age (Pr > 0.99) and increased with PI (Pr < 0.001). In contrast, there was no significant decrease with age for LL (TLIP-S1) or LL (superior arch) (respectively Pr < 0.92 and Pr > 0.19). LL in the inferior arch was significantly lower in the P-group (Pr = 1.0) and decreased with age (Pr = 0.99). The number of vertebrae TLIP-S1 was significantly lower in the P-group compared to the reference group (Pr < 0.001).Thoracic kyphosis T1-T12 was significantly lower in the P-group (Pr < 0.001), without significant influence of age or PI. The number of vertebrae CTIP-TLIP increased significantly in the P-group (Pr < 0.001) and with PI (Pr < 0.004). This observational study highlights specific thoraco-lumbar sagittal alignment adaptations in degenerative scoliosis, matched on age and PI. Beyond the decrease in LL due to aging, degenerative scoliosis leads to a distal migration of the TLIP, an increase in the number of vertebrae in TK and a decrease in LL. This phenomenon was linked to kyphosis at the thoraco-lumbar junction due to scoliosis and was more important in high PI.

Probiotic treatment induces changes in intestinal microbiota but does not alter SCFA levels in peritoneal dialysis patients—a randomized, placebo-controlled trial

The gut microbiota alterations interact with the pathogenesis and progression of chronic kidney disease (CKD). Probiotics have received wide attention as a potential management in CKD. We investigated the effects of Lactobacillus paracasei N1115 (LP N1115) on intestinal microbiota and related short-chain fatty acids (SCFAs) in end stage kidney disease patients on peritoneal dialysis (PD) in a single-center, prospective, randomized, double-blind, placebo-controlled study. The patients were randomly allocated into two groups. The intervention group (n = 38, PR group) was given the probiotics (two bags) containing fructooligosaccharide (FOS) (additive amount > 80%), maltosaccharin, and LP N1115 (additive amount > 3 × 1010 CFU/bag) every day whereas the control group (n = 19, PL group) received placebo (two bags) containing only pregelatinized starch and lactose, both for 12 weeks. In addition to collecting fecal samples for 16S rRNA gene high-throughput sequencing and SCFAs analysis, gastrointestinal (GI) symptoms were also assessed at baseline and after the intervention. Probiotics 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, probiotics administration could effectively reduce GI symptoms, particularly in dyspepsia and constipation (p < 0.05). Together, the results suggest that probiotics administration caused significant changes in the composition of gut microbiota and also could effectively reduce GI symptoms, particularly in dyspepsia and constipation in PD patients. Trial registration: This study was registered with the Chinese Clinical Trial Registry (Trial registration number: ChiCTR-INR-17011718; Date of the first registration: 21/06/2017).

Comparison of crossed and parallel rod configurations used in posterior occipitocervical and atlantoaxial fixations: a retrospective cohort study

BackgroundThis study is aimed to compare the differences in clinical outcomes between the crossed rod configuration and the parallel rod configuration applied in posterior occipitocervical and atlantoaxial fixations, and to assess the clinical applicability of crossed rods.MethodsFrom January 2015 to December 2021, 21 patients with craniocervical junction disorders were treated surgically with the crossed rod technique (CR group). Meanwhile, 27 corresponding patients treated with the conventional parallel rod technique were included as control (PR group). Clinical data, internal fixation type, neurological status, clinical symptoms relief, image parameter, complications and bone fusion conditions were retrospectively analyzed and evaluated.ResultsNo statistically significant differences were found in baseline characteristics, fixation type and postoperative complications between the two groups. Although the postoperative ADI was significantly reduced in both groups, the ADI was significantly greater in the CR group than that in the PR group after surgery and at the final follow-up (P < 0.05). All patients achieved bone fusion at 1-year postoperative follow-up except for one case in the PR group. However, patients in the CR group had a significantly higher fusion rate than those in the PR group at 3 months postoperatively (P < 0.05).ConclusionsThe application of a crossed rod configuration in posterior occipitocervical and atlantoaxial fixations provides good clinical applicability. Although this technique has a relatively weaker reduction force, it has greater fixation stability and a higher rate of early bone fusion. This technique could be an easy and viable alternative to the current parallel rod configuration for upper cervical surgery.

Effects of probiotic and yeast extract supplement on liver functionality index and metabolic parameters in transition period of dairy cattle

This research sought to evaluate the potential effects of probiotics and yeast cell wall (YCW) supplements on the liver functionality index (LFI) and metabolic parameters of dairy cattle throughout the transitional period. A cohort of forty dry cows was randomly divided into four groups, namely the probiotic group (Pr) receiving a basal diet combined with a blend of Bacillus subtilis, Bacillus lechiniformis, Streptococcus Thermophilis, and Enterococcus faecium; the YCW group receiving a basal diet enriched with Saccharomyces cerevisiae; the probiotic and yeast cell wall extract group (P & Y) receiving a basal diet supplemented with a mixture of probiotic and yeast cell wall extract; and the control group adhering to the basal diet. The intervention was initiated 21 days before calving and persisted until 28 days post-calving, except for the control group. The study entailed the collection of blood samples at four sampling times, encompassing 21 days preceding calving, seven days before calving, seven days post-calving, and four weeks post-calving. Multiple biochemical parameters were assessed, including urea, blood urea nitrogen (BUN), Gamma-glutamyl transferase (GGT), total bilirubin (TB), albumin, total protein (TP), globulin, glucose, triglyceride, cholesterol, and liver functionality index. The results showed that the Pr group exhibited reduced average levels of GGT and glucose compared to the control group (P < 0.05). Similarly, the P & Y group demonstrated lower average BUN, TB, and cholesterol levels than the control (P < 0.05). Notably, the LFI exhibited a discernible trend towards elevation in the Pr group compared to the control group (P = 0.007) and the P & Y group (P = 0.007). In essence, supplementation of YCW and probiotics is associated with advantageous effects on metabolic parameters and liver function.

Effect of Facet Joint Resection on Postoperative Radiographic and Clinical Outcomes After Microendoscopic Laminectomy for Single-Level Lumbar Spinal Stenosis

Facet joint destruction causes postoperative spinal instability, resulting in poor clinical outcomes after lumbar decompression surgery. However, the effect of facet joint destruction on radiographic and clinical outcomes after microendoscopic laminectomy (MEL) is unknown. Therefore, the current study aimed to examine the effect of facet joint resection on radiographic and clinical outcomes after single-level MEL surgery. This study included 116 patients with lumbar spinal canal stenosis (LSCS) who underwent single-level (L4/5) MEL surgery. Eligible patients were divided into the following groups: group P (facet joint preservation rate= 100%) (n= 70); group PR (50%≤the facet joint preservation rate <100%) (n= 27); and group R (the facet joint preservation rate <50%) (n= 19). The demographic characteristics of the patients, surgical data, preoperative and 1-year postoperative radiographic measurements, and clinical outcomes were compared among the 3 groups. Moreover, preoperative and postoperative radiographic and clinical outcomes were compared after adjusting the demographic characteristics of the patients and surgical data by the inverse probability weighting method with propensity scores. The 3 unweighted groups did not significantly differ in terms of demographic characteristics, surgical data, and preoperative and postoperative radiographic and clinical outcomes. Even after adjusting for the demographic characteristics and surgical data, the preoperative and postoperative radiographic and clinical outcomes were comparable among the 3 weighted groups. The extent of facet joint resection might have a minimal impact on radiographic and clinical outcomes at 1 year after single-level MEL surgery.

Early Improvement in Postoperative Clinical Outcomes without Patellar Resurfacing in Patella-Friendly Design of Medial Pivot TKA.

There is continued debate about the efficacy and indications for patellar resurfacing in total knee arthroplasty (TKA), especially with the emergence of patella-friendly designs. This study aimed to compare the postoperative outcomes in patients undergoing TKA with or without patellar resurfacing using the same implant design. This is a retrospective cohort study of patients who underwent TKA including those with patellar resurfacing (PR group) and those without (NPR group). Demographic data included age, gender, side of surgery, operative time, and body mass index (BMI). Outcomes included preoperative, 2-week, 6-week, and 1-year postoperative Knee Injury and Osteoarthritis Outcome Score and Joint Replacement (KOOS, JR) values along with knee range of motion (ROM). Postoperative complications were recorded. The power analysis with a large effect size indicated that a minimum sample size of 54 was required for Student's t-test and 34 for the paired t-test. A total of 90 medial pivot (MP) TKA were included in this study. There were 30 knees in the PR group and 60 in the NPR group. There was no significant difference between the groups for all demographic data, preoperative and postoperative ROM, and KOOS, JR values at all time points (p > 0.05 for all variables). The KOOS, JR significantly improved in the NPR groups at 2 weeks, 6 weeks, and 1 year postoperatively when compared with the preoperative score and at 6 weeks and 1 year postoperatively in the PR group (p < 0.01). No revisions related to the patellofemoral joint were observed in patients initially undergoing patellar resurfacing. One patient in the NPR group required secondary patellar resurfacing. The patella-friendly MP TKA yielded favorable postoperative outcomes, with or without patellar resurfacing. Improvements in KOOS, JR were observed earlier in the NPR group when compared with the PR group, suggesting that patellar resurfacing may not always be necessary for modern TKA designs. LEVEL OF EVIDENCE: Retrospective cohort study, Level III.

754. PATHOLOGICAL RESPONSE PREDICTS EFFICACY OF ADJUVANT FLOT CHEMOTHERAPY IN GASTROESOPHAGEAL CANCER: AN INTERNATIONAL COHORT STUDY

Abstract Background Perioperative FLOT-based chemotherapy is the current standard of care for all patients with locally-advanced gastroesophageal cancer. However, many patients are unable to complete all planned adjuvant FLOT cycles due to treatment related toxicity and diminished performance status after radical surgery. Within this context, it is unclear whether adjuvant FLOT will improve oncological outcomes for patients with cancers that either don’t respond or respond exceptionally well to neoadjuvant FLOT. To facilitate clinical decision-making, we examined whether pathological response to neoadjuvant FLOT can guide its adjuvant use. Methods Prospectively collected data from 43 centres across 12 countries was analysed. Patients with non-metastatic gastroesophageal adenocarcinoma who received neoadjuvant FLOT followed by radical surgery between 2017-2022 were included. Pathological response was assessed using validated tumour regression grading (TRG) systems. All TRG were trichotomized into minimal responders (MR=worse TRG category), complete responders (CR=pathological complete response), and partial responders (PR=all TRG categories between MR and CR). Survival outcomes of patients who did and did not receive adjuvant FLOT within these cohorts were compared using Kaplan Meier and Cox regression analysis. These findings were validated using propensity score matched analysis. Results 1887 patients (MR n=459, CR n=221, PR n=1207) were evaluated. The median follow-up was 25.5 months. In the MR group, there was no DFS (HR=1.03, 95%CI 0.78-1.36) or adjusted-OS (HR=0.96, 95%CI 0.70-1.30) difference between those who did (n=272) and did not (n=187) receive adjuvant FLOT. In the CR group, there was no DFS (HR=0.88, 95%CI 0.41-1.85) or OS (HR=0.69, 95%CI 0.31-1.54) difference between those who did (n=136) and did not (n=85) receive adjuvant FLOT. In the PR group (adjuvant FLOT n=847, no adjuvant FLOT n=360), adjuvant FLOT conferred a significant DFS (HR=0.68, 95%CI 0.55-0.86) and OS (HR=0.55, 95%CI 0.44-0.69) benefit. Conclusions Pathological response to neoadjuvant FLOT predicts therapeutic efficacy to adjuvant FLOT. Only partial responders benefit from adjuvant treatment. Our findings challenge the current doctrine that perioperative FLOT should be applied to all patients regardless of pathological tumour response.

Impact of pulmonary rehabilitation on exercise capacity, health-related quality of life, and cardiopulmonary function in lung surgery patients: a retrospective propensity score-matched analysis.

Pulmonary rehabilitation is considered beneficial for patients undergoing lung surgery, yet its specific impacts on exercise capacity, health-related quality of life (HRQL), and cardiopulmonary function require further elucidation. This study aimed to evaluate the effect of PR on these outcomes in patients undergoing lung surgery using a retrospective propensity score-matched analysis. We retrospectively analyzed 420 patients with non-small cell lung cancer (NSCLC) who underwent lung surgery from January 2022 to May 2024. Among these, 84 patients received PR while 336 did not (control group). Propensity score matching (PSM) at a 1:1 ratio yielded 46 patients in each group. Baseline characteristics, spirometry, cardiopulmonary exercise testing, respiratory muscle strength, HRQL, and muscle measurements were assessed pre-and post-surgery. Before PSM, significant differences existed between groups, with the PR group being older and having different pulmonary function baselines. After PSM, groups were well-balanced. Postoperatively, the PR group showed significant improvements in FEV1/FVC (64.17% vs. 50.87%, p < 0.001), FEV1 (2.31 L/min vs. 1.75 L/min, p < 0.001), and predicted FVC percentage (88.75% vs. 68.30%, p < 0.001). Cardiovascular responses showed a lower CI during exercise in the PR group post-PSM (6.24 L/min/m2 vs. 7.87 L/min/m2, p < 0.001). In terms of exercise capacity, the PR group had higher maximal WR percentage (104.76% vs. 90.00%, p = 0.017) and peak VO2 (1150.70 mL/min vs. 1004.74 mL/min, p = 0.009). PR also resulted in less leg soreness and lower total CAT scores postoperatively. Muscle measurements indicated significantly smaller reductions in ΔHUESMCSA and percentage change in the PR group. Pulmonary rehabilitation significantly enhances exercise capacity, HRQL, and cardiopulmonary function in patients undergoing lung surgery. It also mitigates postoperative muscle loss, underscoring its importance in the postoperative management of lung surgery patients.

Effect of Flow Cytometric MRD Detection at Different Time Points during AML Chemotherapy on Prognosis

To investigate the effect of flow cytometric minimal residual disease (MRD) detection at different time points during AML chemotherapy on prognosis. 130 adult primary AML patients diagnosed and standardized with chemotherapy from March 2018 to March 2022 were retrospectively analyzed, MRD was detected by flow cytometry, Kaplan-Meier curves was used for survival analysis and log-rank test was used for variance analysis, and univariate and multifactor influencing patient survival with COX proportional risk regression model analysis. Cumulative incidence rate (CIR) analysis with competing risk model and variance analysis using Fine-Gray. There were 81 CR1, 26 CR2, 14 PR, and 9 NR patients in 130 patients. OS of the CR1 group was higher than that in the CR2, PR,and NR groups. OS of the CR2 group was higher than that in the PR group, but there was no statistically difference compared to the NR group. There was no statistically difference in OS between the PR and NR groups. 107 patients in CR1 and CR2 were grouped according to MRD detected by flow cytometry, and after the first induction chemotherapy, for patients in the MRD- and MRD+ groups, the 4-year expected RFS rates were 65.3% and 27.9% respectively, the 4-year expected OS rates were 58.7% and 41.4% respectively, and the 4-year expected CIR were 34.7% and 69.7% respectively, with statistically significant differences between 2 groups (χ2=6.639, P =0.010; χ2=6.131, P =0.013 and χ2=6.637， P =0.010). After the second chemotherapy, for patients in the MRD- and MRD+ groups, the 4-year expected RFS rates were 50.8% and 37.9% respectively, the 4-year expected OS rates were 49.2% and 44.5% respectively, and the 4-year expected CIR were 49.2% and 59.5% respectively, with no statistically significant differences between 2 groups (χ2=1.475, P =0.225; χ2=2.432, P =0.119 and χ2=1.416， P =0.234). During consolidation therapy, for patients in the MRD - and MRD+ groups, the 4-year expected RFS rates were 51.9% and 29.6% respectively, the 4-year expected OS rates were 67.5% and 24.6% respectively, and the 4-year expected CIR were 48.1% and 70.4% respectively, with statistically significant differences between 2 groups (χ2=20.982, P < 0.001; χ2=17.794, P < 0.001 and χ2=19.879， P < 0.001). For patients with MRD- at all three time points and positive at either time point, the 4-year expected RFS rates were 69.9% and 33.3% respectively, the 4-year expected OS rates were 59.1% and 44.7% respectively, and the 4-year expected CIR were 30.1% and 65.1% respectively, with statistically significant differences between 2 groups (χ2=7.367, P =0.007; χ2=6.042, P =0.014 and χ2=7.662， P =0.006). Univariate analysis showed that karyotype at high risk of chromosome was an unfavorable factor affecting patients' RFS and OS, while 2 cycles of induction chemotherapy achieved CR, MRD- after the first induction chemotherapy and MRD- after the second induction chemotherapy was a protective factor affecting patients' RFS and OS. MRD- during consolidation therapy and MRD- at all three time points were all protective factors affecting patients' RFS, OS and CIR. Multivariate analysis showed that induction chemotherapy for 2 cycles achieved CR was a protective factor affecting patients' RFS and CIR, and MRD- during consolidation therapy was a protective factor affecting patients' RFS, OS and CIR. Early achievement of CR and MRD- in adult AML patients, especially MRD- during consolidation therapy, is a marker of good prognosis, and flow cytometry is the most commonly used method for MRD detection in AML patients.

Investigating miR-6880-5p in extracellular vesicle from plasma as a prognostic biomarker in endocrine therapy-treated castration-resistant prostate cancer

BackgroundAdvancements in the diagnosis, treatment, and surveillance of castration-resistant prostate cancer (CRPC) have progressed considerably, but a new biomarker that combines existing clinical and pathological data could be useful for a more precise diagnosis and prognosis. Some investigations have found that extracellular vesicle (EV)-derived miRNAs play crucial roles in various types of malignant tumors. The objective of this study was to explore EV miRNA and identify its biologic function as a biomarker for the diagnosis and prognosis of CRPC.MethodsPlasma samples were collected from five healthy donors (Control, CT) and 17 CRPC patients, categorizing into two groups based on their endocrine treatment response: partial response (PR; n = 10) and progressive disease (PD; n = 7). Candidate extracellular vesicle (EV) miRNAs were identified using miRNA microarray and RT-qPCR. The biological functions of the selected miRNAs were evaluated using the MTT assay, wound healing assay, trans-well assay, and RNA sequencing in CRPC cells after transient miRNA expression.ResultsMicroarray analysis revealed a significant downregulation of EV-miR-6880-5p in the PD samples compared to both CT and PR samples (p < 0.01). The expression of EV-miR-6880-5p in CRPC patients was decreased compared with that CT group (p = 0.0336) using RT-qPCR. In the PR group, EV-miR-6880-5p was increased at follow-up compared with the baseline (p = 0.2803), while in the PD group, it decreased at follow-up compared with the baseline samples (p = 0.4356). Furthermore, overexpression of miR-6880-5p hampered cell proliferation, migration, and invasion, downregulated pathways associated with tumor progression, and simultaneously upregulated pathways associated with cell growth and apoptosis in CRPC cells.ConclusionsEV-miR-6880-5p shows promise as a prognostic biomarker in patients with CRPC. Further, prospective validations are necessary to evaluate the potential of these candidate miRNAs.

Gut Microbiome Dysbiosis in Patients with Pemphigus and Correlation with Pathogenic Autoantibodies.

Pemphigus is a group of potentially life-threatening autoimmune bullous diseases induced by pathogenic autoantibodies binding to the surface of epidermal cells. The role of the gut microbiota (GM) has been described in various autoimmune diseases. However, the impact of the GM on pemphigus is less understood. This study aimed to investigate whether there was alterations in the composition and function of the GM in pemphigus patients compared to healthy controls (HCs). Fecal samples were collected from 20 patients with active pemphigus (AP), 11 patients with remission pemphigus (PR), and 47 HCs. To sequence the fecal samples, 16S rRNA was applied, and bioinformatic analyses were performed. We found differences in the abundance of certain bacterial taxa among the three groups. At the family level, the abundance of Prevotellaceae and Coriobacteriaceae positively correlated with pathogenic autoantibodies. At the genus level, the abundance of Klebsiella, Akkermansia, Bifidobacterium, Collinsella, Gemmiger, and Prevotella positively correlated with pathogenic autoantibodies. Meanwhile, the abundance of Veillonella and Clostridium_XlVa negatively correlated with pathogenic autoantibodies. A BugBase analysis revealed that the sum of potentially pathogenic bacteria was elevated in the AP group in comparison to the PR group. Additionally, the proportion of Gram-negative bacteria in the PR group was statistically significantly lower in comparison to the HC group. The differences in GM composition among the three groups, and the correlation between certain bacterial taxa and pathogenic autoantibodies of pemphigus, support a linkage between the GM and pemphigus.

Systemic inflammation enhances metastatic growth in a syngeneic neuroblastoma mouse model.

We previously showed that total tumor resection enhances metastatic growth in a syngeneic metastatic mouse model of neuroblastoma. In this study, we further investigated which surgical factors contributed most to metastatic growth. Tumor cells derived from MYCN transgenic mice were subcutaneously injected into wild-type mice. Mice were randomly assigned to receive partial resection (PR group), subcutaneous implantation of a sponge (Sp group), or observation (Obs group). The lymph node metastasis volume and the frequency of lung metastasis were compared 14days after assignment by measuring C-reactive protein (CRP) and interleukin-6 (IL-6) levels. The lymph node metastasis volume in the Sp group was larger than in the Obs group (148.4 [standard deviation {SD}: 209.5] vs. 10.2 [SD 12.8]mm3). The frequency of lung metastasis was greater in the Sp group than in the PR group (11.9 [SD 12.2] vs. 6.6 [SD 4.0] counts/slide). The CRP level in the Sp group was higher than in the PR group (2.3 [SD 0.5] vs. 1.5 [SD 0.4]μg/mL), and the IL-6 level in the Sp group was higher than in the PR or Obs groups (28.4 [SD 34.5] vs. 12.4 [SD 19.0] vs. 5.4 [SD 8.1]pg/mL). Metastatic growth may be enhanced by systemic inflammation.

Investigation of Natural Helium Circulation Inside Dual Channels Prismatic Modular Reactor

Natural helium circulation inside a dual-channel prismatic modular reactor was numerically investigated to comprehend the passive safety features using the new RHYS/ASYST VER4 package. The natural circulation was studied at Depressurized Cooldown (DC) at heat fluxes of 860–2293 W/m2 with a pressure of 413.7 kPa and Pressurized Cooldown (PC) at pressures of 413.47–689.12 kPa with a flux of 1720 W/m2. A reversal of the heat transfer near the riser exit was seen, combined with a decrease in helium and riser wall temperatures due to the end effect. The pressure has an inverse effect on the heat transfer, where the temperature decreases by 19 % as the pressure increases from 413.47 to 689.12 kPa. The heat transfer was studied under the DC and PC. Both entrance and end effects are introduced with the heat transfer coefficient. Also, the nondimensional groups (Nu, Gr, Pr, and Ra) were discussed.

Long-term survival outcomes in patients with relapsed/refractory large B-cell lymphoma after treatment of relma-cel: 4-year follow-up in RELIANCE study.

e19001 Background: RELIANCE study (NCT04089215) demonstrated the efficacy and safety of relma-cel, a CD19-targeted chimeric antigen receptor T-cell product, in patients with heavily pre-treated relapsed/refractory large B-cell lymphoma (r/r LBCL). We previously reported efficacy of relma-cel, noting objective response rate (ORR) in 77.59% of patients (CRR 53.45%), 2-year progression-free survival (PFS) rate and overall survival (OS) rate were 38.8% and 69.3%, respectively. Herein, we aimed to update the long-term survival results for 4-year follow-up (FU). Methods: Study design was previously published. Eligible patients were adults with histologically confirmed r/r LBCL and had failed at least two prior lines of therapy, including an anti-CD20 monoclonal antibody and an anthracycline-based regimen. Patients were enrolled at 10 clinical sites in China and underwent lymphodepletion prior to receiving relma-cel at a single dose of 100 × 106 (n=27) or 150 × 106 (n=32) CAR+ T cells. The primary endpoint was ORR at 3-month, as assessed by investigators. Secondary endpoints were duration of response (DOR), PFS, OS and safety profiles. For this abstract, we collected the survival status and updated the survival outcomes. Results: From Nov 2017 to Dec 2019, a total of 68 patients were enrolled, and 59 received relma-cel infusion. Among 58 evaluable efficacy patients with 2-year FU, 31 achieved CR (CR group), 14 achieved PR (PR group) and 13 had no response (Non-responder group). As of Dec 18, 2023, with 48.1 months (95% CI, 37.75 to 49.38) of median FU, 25 patients were still alive, 18 were died (5 deaths in CR group, 5 in PR group and 8 in Non-responder group), and 15 patients were censored due to lost to FU including 7 lost within 2 years and 8 after 2 years. The median OS were not reached (NR), and 1-year and 2-year OS rate were reported previously. The update estimated landmark OS rates were 69.3% at 3-year and 66.7% at 4-year. The OS rates of CR group at each year were numerically higher than those of PR group and Non-responder group (87.1% v.s. 59.3% v.s. 30.8% at 3-year and 82.5% v.s. 59.3% v.s. 30.8% at 4-year; Table). Conclusions: Four-year FU results in RELIANCE Study suggested that, although heavily pretreated, the patients who had response, especially who achieved CR, may experience greater survival benefits, from relma-cel therapy. Clinical trial information: NCT04089215 . [Table: see text]

#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 &amp;lt; 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 &amp;gt; 0.05). In addition, probiotic administration could effectively reduce gastrointestinal symptoms, particularly in dyspepsia and constipation (p &amp;lt; 0.05). The contents of SCFAs was increased in GNR group (p &amp;lt; 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 &amp;lt; 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.

Investigation into the application of remimazolamin conjunction with low-dose propofolfor pediatricfiberoptic bronchoscopy.

This study delves into the effectiveness of combining remimazolam with low-dose propofol in pediatric fiberoptic bronchoscopy. Ninety children scheduled for fiberoptic bronchoscopy in our hospital were enrolled as research participants. Based on the intraoperative anesthetic drug regimen, the children were divided into three groups: group R (remimazolam 0.2-0.4mg/kg), group P (propofol 1-3mg/kg), and group RP (remimazolam0.2mg/kg, propofol 0.5mg/kg). Immediately post-anesthesia, group P exhibited lower blood pressure and heart rate (HR) compared to both group R and group RP (P < 0.05). As bronchoscope approached the glottis and epiglottis, group P continued to display lower blood pressure and HR compared to group R and group RP (P < 0.05). During lavage, group P maintained lower blood pressure and HR compared to both the R and RP groups (P < 0.05). Immediately post-anesthesia, group P demonstrated lower SpO2 compared to the R and RP groups (P < 0.05).During lavage, group P maintained lower SpO2 than group R and group RP (P < 0.05). In comparison with group R and group PR, group P showed shortened induction and recovery times (P < 0.05). The one-time entry success rate into the microscope was higher in group R than in group P, with the RP group showing an intermediate decreased (P < 0.05). Moreover, the cough score in R group was higher than in the P and RP groups (P < 0.05). Furthermore, the satisfaction rates of the RP group exceeded those of the R and P groups (P < 0.05). Remimazolam combined with low-dose propofol effectively balances the strengths and weaknesses of remimazolam and propofol, ensuring more stable hemodynamics, a lower incidence of adverse reactions, and optimal surgical conditions in pediatric fiberoptic bronchoscopy.

Effect of converting from propofol to remimazolam with flumazenil reversal on recovery from anesthesia in outpatients with mental disabilities: a randomized controlled trial

BackgroundGeneral anesthesia is often necessary for dental treatment of outpatients with mental disabilities. Rapid recovery and effective management of postoperative nausea and vomiting (PONV) are critical for outpatients. This study aimed to investigate the effect of transitioning from propofol to remimazolam with flumazenil reversal administered toward the end of surgery during propofol-based total intravenous anesthesia (TIVA) on recovery.MethodsAdults with mental disabilities scheduled to undergo dental treatment were randomly assigned to receive either propofol-based TIVA (Group P) or propofol-remimazolam-based TIVA with flumazenil reversal (Group PR). Propofol was replaced with remimazolam 1 h before the end of surgery in Group PR; moreover, 0.5 mg of flumazenil was administered after the neuromuscular blockade reversal agent. The primary outcome was the duration of stay in the post-anesthesia care unit (PACU). The secondary outcomes included time to eye-opening, time to extubation, occurrence of PONV, and quality of recovery.ResultsFifty-four patients were included in this study. The duration of stay in the PACU in Group PR was significantly shorter than that in Group P (mean difference, 8.7 min; confidence interval [95% CI], 3.3–14.2; P = 0.002). Group PR exhibited a shorter time to eye opening (mean difference, 5.4 min; 95% CI, 3.3–8.1; P < 0.001) and time to extubation (mean difference, 5.5 min; 95% CI, 3.6–7.9; P < 0.001) than Group P. Neither group required the administration of rescue analgesics, and the incidence of PONV was not reported.ConclusionsTransitioning from propofol to remimazolam 1 h before the end of surgery followed by flumazenil reversal reduced the duration of stay in the PACU and the time to eye opening and extubation without affecting the incidence of PONV and quality of recovery.Trial registration numberClinical Research Information Service (KCT0007794), Clinical trial first registration date: 12/10/2022.

A randomized comparison of three intubation techniques/tube materials for nasotracheal intubation.

We sought to compare three intubation methods using different intubation techniques/tube materials for tube advancement from the nasal cavity into the oral cavity during nasotracheal intubation. We conducted a randomized clinical trial with adult patients scheduled to undergo elective surgery requiring nasotracheal intubation for general anesthesia. Participants were randomly allocated to a polyvinyl chloride (PVC) tube group (group P), PVC tube attached to a rubber catheter group (group PR), or velvet-soft PVC tube group (group V). Tracheal intubation was then performed based on group allocation. The primary outcome was the first-attempt success rate of tube advancement into the oral cavity; secondary outcomes included the time required for tube advancement into the oral cavity, total intubation time, and the incidence of epistaxis. A total of 149 patients were included in the study. The first-attempt success rate in group V (90%) was significantly higher than that in group P (58%) (odds ratio, 6.5; 95% confidence interval [CI], 2.2 to 19.2), but similar to that in group PR (100%). The mean (standard deviation) time required for tube advancement into the oral cavity was significantly shorter in group V (16 [13] sec) than in group PR [40 (10) sec; 95% CI of mean difference, 17 to 30] and group P (26 [16] sec; 95% CI of mean difference, 3 to 16). Total intubation time was longest in group PR. Epistaxis occurred the least in group V. Among the three intubation techniques/tube materials for nasotracheal intubation, the velvet-soft PVC tube provided the highest first-attempt success rate, most expeditious advancement into the oral cavity, and lowest incidence of epistaxis. ClinicalTrials.gov (NCT04695444); first submitted 30 December 2020.

Scleral buckling with adjuvant pneumatic retinopexy versus scleral buckling alone for rhegmatogenous retinal detachment

To compare the efficacy of scleral buckling with adjuvant pneumatic retinopexy (SB with PR) and scleral buckling (SB) alone for primary rhegmatogenous retinal detachment (RRD). This retrospective and comparative study included patients who underwent SB with PR (n = 88) or SB alone (n = 161) for primary RRD. The primary anatomical success rate for SB with PR was 81.8%, whereas that for SB alone was 80.7% (P = 0.836). Among patients who achieved primary anatomical success, those in the SB with PR group showed postoperative epiretinal membrane (ERM) formation more frequently than those in the SB alone group (11 of 72 [15.3%] vs. 6 of 130 [4.6%]) (P = 0.009). The mean time to subretinal fluid absorption was not significantly different between the SB with PR and SB alone groups (11.2 ± 6.2 vs. 11.4 ± 5.8 months, P = 0.881). In the SB with PR group, retinal detachment involving ≥ three quadrants was a significant risk factor for surgical failure (hazard ratio, 3.04; P = 0.041). Adjuvant pneumatic retinopexy does not provide additional benefit in improving the surgical outcomes of SB for primary RRD repair.