Abstract Background Neoadjuvant chemotherapy (NAC) has been widely applied in operable breast cancer patients. This study aim to identify the predictive factors of overall survival(OS) and recurrence free survival (RFS) in breast cancer patients who received NAC from a single Chinese institution. Patients and Methods There were 646 patients recruited in this study. All the patients were treated at department of Surgical Oncology, Sir Run Run Shaw Hospital between February 25, 1999 and August 22, 2018. The relevant clinicopathological and follow-up data were collected retrospectively. RFS and OS were assessed using the Kaplan-Meier method. Multivariate Cox proportional hazards model was also employed. Multi-variate logistic regression model was simulated to predict pathologic complete response (pCR). Results In total, 118 patients (18.2%) achieved pCR during NAC. The 5-year OS was 94.6% versus 78.1% in patients with and without pCR, respectively (P < 0.001). The 5-year RFS was 95.3% and 72.7%, respectively (P < 0.001). No difference was detected among molecular subtypes of 5-year RFS in patients obtained pCR. Factors independently predicting RFS were HER2-positive subtype (hazard ratio(HR), 1.906; P = 0.004), triple-negative breast cancer (TNBC) (HR,2.079; P = 0.003), lymph node positive after NAC(HR,2.939; P < 0.001), pCR (HR, 0.396;P = 0.010), and clinical stage III (HR,2.950; P = 0.016). Multi-variate logistic regression model was simulated to predict the pCR rate after NAC, according to clinical stage, molecular subtype, ki-67, LVSI, treatment period and histology. In the ROC curve analysis, the AUC of the nomogram was 0.734 (95%CI,0.867–12.867). Conclusions Following NAC, we found that pCR positively correlated with prognosis and the molecular subtype was a prognostic factor.
Ferroptosis was reported to have tremendous promise in the treatment and prognosis of hepatocellular carcinoma (HCC). Here, we identified a novel ferroptosis-related prognostic signature incorporating epigenetic and transcriptional biomarkers could help predicting survival of patients with HCC.We employed multi-omics and clinical data from The Cancer Genome Atlas (TCGA) database to identify the ferroptosis-associated methylation CpG sites associated with HCC survival using sure independence screening (SIS). Then we utilized Kaplan-Meier curves to evaluate the prognostic significance of gene expression and DNA methylation. Receiver operating characteristic (ROC) curve was used predicting the 3- and 5-year survival. Mediation analysis of ferroptosis-related methylation and transcriptional score was performed.We firstly identified 114 significant CpG sites under the criteria of false discovery rate (FDR) <0.05 in training set. Then we screened out 5 candidate CpG sites in validation set for multivariate screening and stepwise regression. We found that the high-risk group had significantly shorter survival time than the low-risk group in the prognostic signature combined with epigenetic and transcriptional scores (HR =2.72 95% CI: 2.01-3.68, P=8.75E-11). And the predictive model involving clinical information, gene expression, and methylation data performed best for 3-year survival prediction (AUC =0.672) and 5-year survival prediction (AUC =0.742).Our results suggested a signature combining clinical information, ferroptosis-related gene expression, and methylation presented a superior ability for prognostic prediction in HCC, which may bring us novel tool and targets in the treatment of HCC.
Abstract Background Organized chronic subdural hematoma (CSDH) is a special type of CSDH. However, the optimal surgical procedure has not been established. We present our experience here to discuss the surgical procedure in treatment of organized CSDH. Methods Thirty-three patients with organized CSDH were admitted between January 1, 2008 and January 1, 2018. Age, gender, clinical symptoms, imaging data, type of surgical procedure, Barthel index (BI), and postoperative complications were collected and retrospectively analyzed. The BI was assessed both pre and postoperatively (1 week and 1 month after surgery). Results Overall, 14 patients underwent large craniotomy and 19 patients underwent small craniotomy. No significant differences in gender, age, initial clinical symptoms, and preoperative BI were found between the groups (p > 0.05). Among the 14 patients who underwent large craniotomy, 2 patients developed epilepsy after the operation, while 1 patient had postoperative aphasia. None of the patients had recurrence in 6 months postoperatively. Among the 19 patients who underwent small craniotomy, 1 patient developed an acute subdural hematoma and 1 patient developed aphasia. No obvious complications were found in the remaining 18 patients and none of the 19 patients had recurrence in 6 months postoperatively. BI scores of the small craniotomy group were significantly better than those of the large craniotomy group at 1 week postoperatively (p < 0.05). However, there was no significant difference in the 1-month results (p > 0.05). Conclusion According to our single-center experience, a small craniotomy for treating organized CSDH can be considered as an alternative to a larger craniotomy.
With the further development of economic globalization, transnational supply chain is faced with three bottom line principles. Enterprises need to take social benefits into account while pursuing economic benefits. Cause-related marketing is an effective way for enterprises to improve corporate image, undertake social responsibility and obtain economics benefits at the same time. In this paper, we consider a two-echelon transnational supply chain structure composed of an overseas manufacturer and a domestic retailer, and both the manufacturer and the retailer can perform cause-related marketing. By comparing the size of equilibrium solution under the two scenarios, we analyze the impact of tariff and consumer public welfare preference on the results. The results show that the retailer's CRM level in RCRM scenario is higher than that in the MCRM scenario. The tariff will reduce the channel profit, and the consumer's preference for public welfare will improve the channel profit, the retailer's implementation of CRM will bring more profit to the supply chain. Keywords- Cause-related marketing, Supply chain management, Public welfare preference, Game theory
Abstract Background Lymphopenia was often observed during follow-up for cancer patients, this study aimed to evaluate the prognostic value of prolonged lymphopenia for breast cancer patients. Methods This was a retrospective cohort analysis of 296 patients with clinical stage I-III operable breast cancer, who had received chemotherapy and/or radiotherapy. Absolute lymphocyte count lower than 1.1×10^3/ul was defined as lymphopenia. Lymphopenia around the 6th month after chemo-radiotherapy was defined as cohort L, while normal Absolute lymphocyte count was defined as cohort N. Predictors of lymphopenia were assessed using univariate and multivariate logistic regression analyses. Kaplan–Meier and Cox regression analyses were used to evaluate the relationship between the two cohorts. Results The baseline characteristics analysis: comparing to cohort N, cohort L had more Stage III(47.4% vs. 25.5%) and less Stage I cancer(12.3% vs. 20.1%)(p = 0.005), more patients experienced combined chemotherapy regimen(86.0% vs. 69.5%, p = 0.012), more patients experienced radiotherapy(78.9% vs. 64.9%, p = 0.041), and less patients experienced endocrine therapy(54.4% vs. 68.2%, p = 0.049). Multivariate logistic regression analysis revealed two negative independent factors associated with DFS: pTNM staging (stage II vs. I: HR = 5.346, 95% CI: 2.286–12.504, p < 0.001; stage III vs. II: HR = 3.089, 95% CI:1.739–5.487, p < 0.001), and ALC status 6 months after chemo- and/or radiotherapy (HR = 2.445, 95% CI: 1.577–3.788, p < 0.001). Cohort L had significantly shorter DFS (log rank: p < 0.001), as well as significantly shorter OS (log rank: p < 0.001). Conclusion Persistent lymphopenia after chemotherapy and/or radiotherapy was an independent predictor for breast cancer relapse and unfavorable survival.
Abstract Background Neoadjuvant chemotherapy has been widely applied in operable breast cancer patients. This study aim to identify the predictive factors of overall survival(OS) and recurrence free survival (RFS) in breast cancer patients who received NAC from a single Chinese institution . Patients and Methods There were 646 patients recruited in this study. All the patients were treated at department of Surgical Oncology, Sir Run Run Shaw Hospital between February 25, 1999 and August 22, 2018. The relevant clinicopathological and follow-up data were collected retrospectively. RFS and OS were assessed using the Kaplan-Meier method. Multivariate Cox proportional hazards model was also employed.Multi-variate logistic regression model was simulated to predict pathologic complete response (pCR) . Results In total, 126 patients (19.5%) achieved pCR during NAC. The 5-year OS was 92.6% and 75.3% in patients with and without pCR, respectively (P<0.001). The 5-year RFS was 93.4% and 71.2%, respectively (P<0.001). No difference was detected among molecular subtypes of 5-year RFS in patients obtained pCR. Factors independently predicting RFS were HER2-positive subtype (hazard ratio(HR), 1.793; P=0.006), triple-negative breast cancer (TNBC) (HR,1.895; P=0.002), Ki-67>25 (HR, 2.363; P=0.044), lymph node involvement after NAC(HR,3.639; P<0.001), pCR (HR, 0.375;P=0.004), and clinical stage III (HR,2.918; P=0.014). Multi-variate logistic regression model was simulated to predict the pCR rate after NAC, according to clinical stage, molecular subtype, ki-67, LVSI, treatment period and histology. In the ROC curve analysis, the AUC of the nomogram was 0.734(95%CI,0.867–12.867). Conclusions Following NAC, we found that pCR positively correlated with prognosis and the molecular subtype was a prognostic factor.
Abstract Background: Lymphopenia was often observed during follow-up for cancer patients, this study aimed to evaluate the prognostic value of prolonged lymphopenia for breast cancer patients. Methods: This was a retrospective cohort analysis of 296 patients with clinical stage I-III operable breast cancer, who had received chemotherapy and/or radiotherapy. Absolute lymphocyte count lower than 1.1×10^3/ul was defined as lymphopenia. Lymphopenia around the 6 th month after chemo-radiotherapy was defined as cohort L, while normal Absolute lymphocyte count was defined as cohort N. Predictors of lymphopenia were assessed using univariate and multivariate logistic regression analyses. Kaplan–Meier and Cox regression analyses were used to evaluate the relationship between the two cohorts. Results: The baseline characteristics analysis: comparing to cohort N, cohort L had more Stage III(47.4% vs. 25.5%) and less Stage I cancer(12.3% vs. 20.1%)(p=0.005), more patients experienced combined chemotherapy regimen(86.0% vs. 69.5%, p=0.012), more patients experienced radiotherapy(78.9% vs. 64.9%, p=0.041), and less patients experienced endocrine therapy(54.4% vs. 68.2%, p=0.049). Multivariate logistic regression analysis revealed two negative independent factors associated with DFS: pTNM staging (stage II vs. I: HR=5.346, 95% CI: 2.286-12.504, p<0.001; stage III vs. II: HR=3.089, 95% CI:1.739-5.487, p<0.001), and ALC status 6 months after chemo- and/or radiotherapy (HR=2.445, 95% CI: 1.577-3.788, p<0.001). Cohort L had significantly shorter DFS (log rank: p< 0.001), as well as significantly shorter OS (log rank: p< 0.001). Conclusion: Persistent lymphopenia after chemotherapy and/or radiotherapy was an independent predictor for breast cancer relapse and unfavorable survival.
Abstract It becomes more difficult and expensive to design and test new combustors for large jet engines which require increasing mass flow rates and temperature and pressure levels. Therefore, it is important to study the scaling laws of combustor performance and to provide the modeling rules for practical use for the development and application of engines. This paper deals with the modeling theory of combustion chambers. Based on similarity principles and some typical combustion mechanisms, different rules for combustor modeling, are systematically suggested, particularly for the modeling of gas turbine combustors. These rules may be applied to the design and testing of combustion systems. Moreover as the theory has extensively correlated with the operating parameters of the combustor, it may also be used to predict the combustor performance.
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