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Is ypTNM staging a comparable predictor as pTNM staging for survival in non-metastatic rectal cancer after preoperative chemoradiation therapy?

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Oncology Research 2024年第11期32卷 1723-1732页

作者： JEN-PIN CHUANG hsiang-lin tsai WEI-CHIH SU PO-JUNG CHEN CHING-WEN HUANG TSUNG-KUN CHANG YEN-CHENG CHEN CHING-CHUN LI YUNG-SUNG YEH TZU-CHIEH YIN JAW-YUAN WANG Ministry of Health and Welfare Chiayi HospitalChiayi60096Taiwan Department of Surgery Faculty of MedicineCollege of MedicineNational Cheng Kung UniversityTainan70101Taiwan Department of Surgery National Cheng Kung University HospitalTainan70101Taiwan Division of Colorectal Surgery Department of SurgeryKaohsiung Medical University HospitalKaohsiung Medical UniversityKaohsiung80708Taiwan Department of Surgery Faculty of MedicineCollege of MedicineKaohsiung Medical UniversityKaohsiung80708Taiwan Graduate Institute of Clinical Medicine College of MedicineKaohsiung Medical UniversityKaohsiung80708Taiwan Department of Surgery Faculty of Post-Baccalaureate MedicineCollege of MedicineKaohsiung Medical UniversityKaohsiung80708Taiwan Division of Colorectal Surgery Department of SurgeryKaohsiung Municipal Hsiaokang HospitalKaohsiung80708Taiwan Division of Trauma and Surgical Critical Care Department of SurgeryKaohsiung Medical University HospitalKaohsiung Medical UniversityKaohsiung80708Taiwan Department of Emergency Medicine Faculty of Post-Baccalaureate MedicineCollege of MedicineKaohsiung Medical UniversityKaohsiung80708Taiwan Department of Surgery Kaohsiung Municipal Tatung HospitalKaohsiung80145Taiwan Graduate Institute of Medicine College of MedicineKaohsiung Medical UniversityKaohsiung80708Taiwan Center for Cancer Research Kaohsiung Medical UniversityKaohsiung80708Taiwan

Abstract:Background:The pTNM staging system is widely recognized as the most effective prognostic indicator for *** latest update of this staging system introduced a new pathological staging system(ypTNM)for patients receiving neoadjuvant chemoradiotherapy(NACRT).However,whether the prognostic value of the ypTNM staging system for rectal cancer is similar to that of the pTNM staging system remains *** study was conducted to compare the ypTNM and pTNM staging systems in terms of their prognostic value for patients with nonmetastatic rectal cancer undergoing *** and Methods:This study was conducted at a large teaching *** January 2014 and December 2022,542 patients with rectal cancer were analyzed(median follow-up period,60 months;range,6–105 months).Of them,258 and 284 were included in the pTNM and ypTNM groups,*** probability of treatment weighting(IPTW)was performed to account for the effects of *** proportional-hazards regression was performed for the between-group comparison of overall survival(OS).Results:The crude model revealed that OS was similar between the two groups(p=0.607).After performing IPTW,we found that patients with the same ypTNM-and pTNM-classified stages had similar overall survival(hazard ratio=1.15;95%CI=0.76–1.73;p=0.5074).Conclusions:For patients with rectal cancer who have received preoperative NACRT,the prognostic value of ypTNM staging appears to be similar to that of pTNM staging,mostly because of the downstaging effect of neoadjuvant chemoradiotherapy。

关键词： pTNM ypTNM Rectal cancer Inverse probability treatment weighting Survival

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Outcomes of neoadjuvant chemoradiotherapy followed by radical resection for T4 colorectal cancer

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World Journal of Gastrointestinal Oncology 2020年第12期12卷 1428-1442页

作者： Chun-Ming Huang Ching-Wen Huang Cheng-Jen Ma hsiang-lin tsai Wei-Chih Su Tsung-Kun Chang Ming-Yii Huang Jaw Yuan Wang Department of Radiation Oncology Kaohsiung Medical University HospitalKaohsiung 80145Taiwan Department of Surgery Kaohsiung Medical University HospitalKaohsiung Medical UniversityKaohsiung 80145Taiwan Division of Colorectal Surgery Department of SurgeryKaohsiung Medical University HospitalKaohsiung 80145Taiwan Department of Surgery and Cancer Center Kaohsiung Medical University HospitalKaohsiung Medical UniversityKaohsiung 80708Taiwan

BACKGROUND Patients with clinical T4 colorectal cancer(CRC)have a poor prognosis because of compromised surgical *** therapy may be effective in downstaging tumors,thereby rendering possible radical resection with clear *** To evaluate tumor downsizing and resection with clear margins in T4 CRC patients undergoing neoadjuvant concurrent chemoradiotherapy followed by *** This study retrospectively included 86 eligible patients with clinical T4 CRC who underwent neoadjuvant concurrent chemoradiotherapy followed by radical *** therapy consisted of radiation therapy at a dose of 45-50.4 Gy and chemotherapy agents,either FOLFOX or capecitabine.A circumferential resection margin(CRM)of<1 mm was considered to be a positive *** defined pathological complete response(p CR)as the absence of any malignant cells in a specimen,including the primary tumor and lymph nodes.A multivariate logistic regression model was used to identify independent predictive factors for p *** For 86 patients who underwent neoadjuvant chemoradiotherapy and surgery,the rate of p CR was 14%,and the R0 resection rate was 91.9%.Of the 61 patients with rectal cancer,7(11.5%)achieved p CR and 5(8.2%)had positive *** the 25 patients with colon cancer,5(20%)achieved p CR and 2(8%)had positive *** observed that the FOLFOX regimen was an independent predictor of p CR(P=0.046).After a median follow-up of 47 mo,the estimated 5-year overall survival(OS)and disease-free survival(DFS)rates were 70.8%and 61.4%,*** analysis revealed that a tumor with a negative resection margin was associated with improved DFS(P=0.014)and OS(P=0.001).Patients who achieved p CR exhibited longer DFS(P=0.042)and OS(P=0.003)than those who did *** Neoadjuvant concurrent chemoradiotherapy engenders favorable p CR and R0 resection rates among patients with T4 *** R0 resection rate and p CR are independent prognostic factors for pat

关键词： T4 Chemoradiotherapy Pathological complete response R0 resection Colorectal cancer Survival

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Effects of the number of neoadjuvant therapy cycles on clinical outcomes, safety, and survival in patients with metastatic colorectal cancer undergoing metastasectomy

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Oncology Research 2022年第2期30卷 65-76页

作者： YUNG-SUNG YEH hsiang-lin tsai YEN-CHENG CHEN WEI-CHIH SU PO-JUNG CHEN TSUNG-KUN CHANG CHING-CHUN LI CHING-WEN HUANG JAW-YUAN WANG Division of Trauma and Surgical Critical Care Department of SurgeryKaohsiungMedical University HospitalKaohsiung Medical UniversityKaohsiungTaiwanChina Department of Emergency Medicine Faculty of Post-Baccalaureate MedicineCollege of MedicineKaohsiung Medical UniversityKaohsiungTaiwanChina Graduate Institute of Injury Prevention and Control College of Public HealthTaipei Medical UniversityTaipeiTaiwanChina Division of Colorectal Surgery Department of SurgeryKaohsiung Medical University HospitalKaohsiung Medical UniversityKaohsiungTaiwanChina Department of Surgery Faculty of MedicineCollege of MedicineKaohsiung Medical UniversityKaohsiungTaiwanChina Graduate Institute of Clinical Medicine College of MedicineKaohsiung Medical UniversityKaohsiungTaiwanChina Department of Surgery Faculty of Post-Baccalaureate MedicineCollege of MedicineKaohsiung Medical UniversityKaohsiungTaiwanChina Graduate Institute of Medicine College of MedicineKaohsiung Medical UniversityKaohsiungTaiwanChina Center for Cancer Research Kaohsiung Medical UniversityKaohsiungTaiwanChina Pingtung Hospital Ministry of Health and WelfarePingtungTaiwanChina

The controversial outcomes in patients with metastatic colorectal cancer(mCRC)highlight the need for developing effective systemic neoadjuvant treatment strategies to improve clinical *** optimal treatment cycles in patients with mCRC for metastasectomy remain undeﬁ*** retrospective study compared the efﬁcacy,safety,and survival of cycles of neoadjuvant chemotherapy/targeted therapy for such ***-four patients with mCRC who received neoadjuvant chemotherapy/targeted therapy following metastasectomy were enrolled between January 2018 and April ***-eight patients received 6 cycles of chemotherapy/targeted therapy,whereas 36 patients received≥7 cycles(median,13;range,7–20).Clinical outcomes,including response,progression-free survival(PFS),overall survival(OS),and adverse events,were compared between these two *** the 64 patients,47(73.4%)were included in the response group,and 17(26.6%)were included in the nonresponse *** analysis revealed chemotherapy/targeted therapy cycle and pretreatment serum carcinoembryonic antigen(CEA)level as independent predictors of the response as well as overall survival and chemotherapy/targeted therapy cycle as an independent predictor of progression(all p0.05).The median OS and PFS were 48 months(95%CI,40.855–55.145)and 28 months(95%CI,18.952–37.48)in the≥7-cycle group and 24 months(95%CI,22.038–25.962)and 13 months(95%CI,11.674–14.326)in the 6-cycle group,respectively(both p<0.001).The oncological outcomes in the≥7-cycle group were signiﬁcantly better than those in the 6-cycle group,without signiﬁcant increases in adverse ***,prospective randomized trials are mand

关键词： Metastatic colorectal cancer Neoadjuvant chemotherapy/targeted therapy Treatment cycles Metastasectomy

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Mobile Detecting Robot Controlled by Smartphone Based on iOS

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Engineering（科研） 2014年第12期6卷 750-757页

作者： Hou-Tsan Lee hsiang-lin tsai Zhong-Quan Chen Yu-Ting Jiang Department of Information Technology Takming University of Science and Technology Taipei Taiwan

The proposed scheme is composed of a smartphone, a vehicle equipped with Wi-Fi module and an IPCam working as a detecting robot to explore the unknown environment. Besides, another vehicle equipped with Wi-Fi module is also developed as a trunk robot to extend the detecting range. On the other hand, these vehicles are designed to be driven by the smartphone based on iOS (an iPod Touch in the experiments) via Wi-Fi module along with some proper designs of control circuit mounted on the vehicles. By the audio-visual feedback signals from IPCam, the real-time scenario from the detecting area not only can be shown on the screen of the smartphone but also provides the information of the detected environment in order to guide the robot. Two control approaches were provided in the proposed control scheme, the touch-panel control and the smartphone-status control, to drive the vehicles with the help of visual feedback on the screen of the smartphone. Moreover, the trajectories of the robots were also recorded for further applications. Some experimental results are given to validate the satisfactory performance of the proposed control scheme.

关键词： Mobile Robot Smartphone Controlled iOS Wi-Fi

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Inelastic Scattering of Dark Matter with Heavy Cosmic Rays

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Research in Astronomy and Astrophysics 2024年第6期24卷 68-80页

作者： Keyu Lu Yue-lin Sming tsai Qiang Yuan Le Zhang School of Physics and Astronomy Sun Yat-sen UniversityZhuhai 519082China Key Laboratory of Dark Matter and Space Astronomy Purple Mountain ObservatoryChinese Academy of SciencesNanjing 210023China School of Astronomy and Space Science University of Science and Technology of ChinaHefei 230026China CSST Science Center for the Guangdong-Hong Kong-Macao Greater Bay Area SYSUZhuhai 519082China Peng Cheng Laboratory Shenzhen 518000China

We investigate the impact of inelastic collisions between dark matter(DM)and heavy cosmic ray(CR)nuclei on CR *** approximate the fragmentation cross-sections for DM-CR collisions using collider-measured proton-nuclei scattering cross-sections,allowing us to assess how these collisions affect the spectra of CR boron and *** derive new CR spectra from DM-CR collisions by incorporating their cross-sections into the source terms and solving the diffusion equation for the complete network of reactions involved in generating secondary *** a specific example with a coupling strength of b_(χ)=0.1 and a DM mass of m_(χ)=0.1 GeV,considering a simplified scenario where DM interacts exclusively with oxygen,a notable modification in the boron-to-carbon spectrum due to the DM-CR interaction is ***,the peak within the spectrum,spanning from 0.1 to 10 GeV,experiences an enhancement of approximately 1.5 ***,in a more realistic scenario where DM particles interact with all CRs,this peak can be amplified to twice its original *** the latest data from AMS-02 and DAMPE on the boron-to-carbon ratio,we estimate a 95%upper limit for the effective inelastic cross-section of DM-proton as a function of DM *** findings reveal that at m_(χ)?2 MeV,the effective inelastic cross-section between DM and protons must be less than O(10^(-32))cm^(2).

关键词： elementary particles nuclear reactions nucleosynthesis abundances scattering astroparticle physics (cosmology:)dark matter

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Mechanically driven assembly of biomimetic 2D-material microtextures with bioinspired multifunctionality

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Nano Research 2024年第2期17卷 663-678页

作者： Yang Li lin Jing Joshua M.Little Haochen Yang tsai-Chun Chung Po-Yen Chen Department of Chemical and Biomolecular Engineering University of MarylandCollege ParkMD 20740USA Maryland Robotics Center University of MarylandCollege ParkMD 20742USA School of Materials Science and Engineering Nanyang Technological University50 Nanyang AvenueSingapore 639798Singapore

Nature provides a wealth of bio-inspiration for advanced material *** various nanomaterials into biomimetic microtextures with bioinspired functionalities has spurred increasing research interests and facilitated technological advances in various *** recent years,two-dimensional materials(2DMs)have emerged as important building block units in the biomimicry field due to their distinct chemical,physical,electrical,electrochemical,and catalytic *** this review article,various mechanically driven assembly approaches are summarized to fabricate various genealogies of biomimetic 2DM microtextures with bio-inspired ***,sequential deformation strategies are discussed to programmably construct higher dimensional 2DM microtextures,ranging from wrinkles/crumples(one-time deformation)to multiscale hierarchies(multiple deformations).Next,the current progress using higher dimensional 2DM microtextures to imitate different biological structures and/or induce bio-inspired multifunctionality is systematically *** showcases of bio-inspiration and biomimicry using different 2DM nanosheets are highlighted:(1)wrinkle patterns of an earthworm that spur the design of strain sensors with programmable working ranges and sensitivities,(2)wrinkle appearance of a Shar-Pei dog that motivates the fabrication of stretchable energy storage devices,(3)hierarchical scale textures of a desert lizard that inspire cation-induced gelation platforms for 2DM aerogels,and(4)wrinkle skin of an elephant that influences the development of 2DM protective skin for soft ***,challenges and future opportunities of adopting 2DM nanosheets to assemble biomimetic microstructures with synergistic functionalities are discussed.

关键词： two-dimensional(2D)materials mechanically driven assembly biomimetic microtextures functional nanocomposite bio-inspired multifunctionality

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Time Parameter Based Low-Energy Data Encryption Method for Mobile Applications

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Computer Modeling in Engineering & Sciences 2024年第9期140卷 2779-2794页

作者： Li-Woei Chen Kun-lin tsai Fang-Yie Leu Wen-Cheng Jiang Shih-Ting Tseng Department of Computer and Information Sciences Chinese Military AcademyKaohsiung830TaiwanChina Department of Electrical Engineering Tunghai UniversityTaichung407TaiwanChina Department of Computer Science Tunghai UniversityTaichung407TaiwanChina

Various mobile devices and applications are now used in daily *** devices require high-speed data processing,low energy consumption,low communication latency,and secure data transmission,especially in 5G and 6G mobile ***-security cryptography guarantees that essential data can be transmitted securely;however,it increases energy consumption and reduces data processing ***,this study proposes a low-energy data encryption(LEDE)algorithm based on the Advanced Encryption Standard(AES)for improving data transmission security and reducing the energy consumption of encryption in Internet-of-Things(IoT)*** the proposed LEDE algorithm,the system time parameter is employed to create a dynamic S-Box to replace the static S-Box of *** indicated that six-round LEDE encryption achieves the same security level as 10-round conventional AES *** reduction in encryption time results in the LEDE algorithm having a 67.4%lower energy consumption and 43.9%shorter encryption time than conventional AES;thus,the proposed LEDE algorithm can improve the performance and the energy consumption of IoT edge devices.

关键词： Mobile application security AES data encryption time parameter mobile device

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Assessment and Visualization of Ki67 Heterogeneity in Breast Cancers through Digital Image Analysis

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Advances in Breast Cancer Research 2024年第2期13卷 11-26页

作者： Chien-Hui Wu Min-hsiang Chang Hsin-Hsiu tsai Yi-Ting Peng Department of Anatomical Pathology Far Eastern Memorial Hospital New Taipei AI Lab Quanta Computer Inc. Taoyuan

The Ki67 index (KI) is a standard clinical marker for tumor proliferation;however, its application is hindered by intratumoral heterogeneity. In this study, we used digital image analysis to comprehensively analyze Ki67 heterogeneity and distribution patterns in breast carcinoma. Using Smart Pathology software, we digitized and analyzed 42 excised breast carcinoma Ki67 slides. Boxplots, histograms, and heat maps were generated to illustrate the KI distribution. We found that 30% of cases (13/42) exhibited discrepancies between global and hotspot KI when using a 14% KI threshold for classification. Patients with higher global or hotspot KI values displayed greater heterogenicity. Ki67 distribution patterns were categorized as randomly distributed (52%, 22/42), peripheral (43%, 18/42), and centered (5%, 2/42). Our sampling simulator indicated analyzing more than 10 high-power fields was typically required to accurately estimate global KI, with sampling size being correlated with heterogeneity. In conclusion, using digital image analysis in whole-slide images allows for comprehensive Ki67 profile assessment, shedding light on heterogeneity and distribution patterns. This spatial information can facilitate KI surveys of breast cancer and other malignancies.

关键词： Ki67 Heterogeneity Breast Cancer Digital Image Analysis

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Characteristics and prognosis of small bowel tumors:A retrospective study

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World Journal of Clinical Cases 2024年第34期12卷 6696-6704页

作者： Fang-Chen Liu Ching-hsiang Wang Peng-Jen Chen Yu-Lueng Shih Hsuan-Hwai lin Jung-Chun lin Wei-Kuo Chang tsai-Yuan Hsieh Gen-Min lin Tien-Yu Huang Division of Gastroenterology Department of Internal MedicineTri-Service General HospitalNational Defense Medical CenterTaipei 11490Taiwan Department of Internal Medicine Taoyuan Armed Forces General HospitalTaoyuan 325208Taiwan Department of Medicine Tri-Service General Hospital and National Defense Medical CenterTaipei 114Taiwan Department of Medicine Hualien Armed Forces General HospitalHualien 970Taiwan Taiwan Association for the Study of Small Intestinal Diseases Taoyuan 33305Taiwan

BACKGROUND Small bowel tumors(SBTs)are a heterogeneous group of difficult-to-diagnose tumors that account for 2%-5%of all gastrointestinal ***-balloon enteroscopy greatly enhances the diagnosis and treatment of ***,few epidemiological studies have been conducted in Taiwan to determine the clinical profile of *** To investigate the clinical characteristics,managements and prognosis of SBTs in a medical center in *** The study enrolled 51 patients aged 58.9±8.8 years(range,22-93)diagnosed with SBTs from November 2009 to July *** retrospectively recorded clinical characteristics,indications,endoscopic findings,pathological results,management,and outcomes for further *** A male preponderance was observed(56.8%).The most common indications were suspected small intestinal tumors(52.9%)and obscure gastrointestinal bleeding(39.2%).The most common tumor location was the ileum(41.2%).The performance of imaging studies(P=0.004)and the types of findings(P=0.005)differed significantly between malignant and benign *** most frequent imaging finding was a small intestinal mass(43.1%).The top three malignant tumor types were gastrointestinal stromal tumors(GISTs),adenocarcinomas,and ***,the proportions of benign and malignant tumors were 27.5%and 72.5%,*** survival rates of patients with malignant tumors in the GIST and non-GIST groups differed significantly(P=0.015).Kaplan–Meier survival analysis showed a significant difference in survival between patients in the malignant and benign groups(P=0.04).All patients with lymphoma underwent chemotherapy(n=7/8,87.5%),whereas most patients with GISTs underwent surgery(n=13/14,92.8%).CONCLUSION Patients with GISTs have a significantly higher survival rate than those with other malignant ***,a large-scale nationwide study is warranted to evaluate the population-based epidemiology of SBTs.

关键词： Gastrointestinal bleeding Intestinal neoplasms Single-balloon enteroscopy,survival rate

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Adult sigmoid intussusception resembling rectal prolapse:A case report

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World Journal of Clinical Cases 2024年第6期12卷 1163-1168页

作者： Tsung-Jung tsai Yu Shih Liu Department of Surgery Changhua Christian HospitalChanghua 500209Taiwan Department of Colorectal Surgery Changhua Christian HospitalChanghua 500209Taiwan

BACKGROUND Rectal prolapse arises from benign *** symptoms of internal intussusception mirror those of rectal prolapse,a misdiagnosis is possible,especially under limited clinical *** is crucial to recognize and differentiate rectal prolapse from internal intussusception because the two diagnoses have different ***,we describe a case of adult sigmoid intussusception presenting as rectal *** SUMMARY A 64-year-old woman with no known medical history visited a gastrointestinal outpatient department due to hard bloody stool defecation for 1 wk followed by constipation for 3 *** revealed a huge polypoid ulcerated tumor at the sigmoid colon with lumen *** patient was admitted due to postprocedural dull abdominal *** to failed colonoscopy reduction and stent insertion,the patient underwent sigmoid colon resection with primary end-to-end anastomosis,with the transverse colostomy pathological report showing adenocarcinoma,*** recovered well from the operation and was discharged with regular outpatient clinic *** Presentation and manifestation of sigmoid intussusception may resemble that of rectal prolapse,necessitating careful observation due to distinct prognostic implications.

关键词： Sigmoid intussusception Rectal prolapse Endoscopic reduction Adenocarcinoma Case report

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