In this letter, a near-field scattering theory-driven Information Factor (IF) pruning strategy is proposed to enhance the accuracy and speed of microwave breast imaging. Specifically, the IF value of each channel is quantified by the relative scattered field intensity. Subsequently, low-IF channels are identified as novel artifact sources and selectively pruned before confocal microwave imaging (CMI) to improve image quality. Simultaneously, computational overhead is reduced to accelerate imaging speed. Experimental results demonstrate that the IF-enhanced delay-multiply-and-sum (IF-DMAS) achieves a 3.4-dB gain in both signal-to-clutter ratio (SCR) and signal-to mean ratio (SMR) compared to conventional DMAS, significantly suppresses artifacts, and delivers speedups of 28.3× and 16.2× with and without a priori region-of-interest knowledge, respectively. Furthermore, the generalizability of the proposed strategy is validated across four other representative algorithms.

PURPOSE:To analyze on the role of long-chain non coding ribonucleic acid (LncRNA) plasmacytoma variant translocation 1 (PVT1) in the differentiation of dental pulp mesenchymal stem cells (DPMSCs) into dentin by targeting microribonucleic acid 18b-5p(miR-18b-5p). METHODS:Human DPMSCs were isolated and cultured, then identified by staining with oil red O, Alizarin red, and Alisin blue, and detected cell surface marker molecules by flow cytometry. Inoculate cells onto a 24 well plate, 2×104/cm2 density, grouping, including PVT1 upregulation+miR-18b-5p downregulation group (transfected with pcDNA-PVT1 and antomiR-18b-5p), PVT1 downregulation+miR-18b-5p upregulation group (transfected with si-PVT1 and agomiR-18b-5p), empty 1 group (transfected with NC pcDNA), empty 2 group (transfected with ago-NC), PVT1 upregulation + empty 2 group (transfected with pcDNA-PVT1 and empty 2). empty1+miR-18b-5p downregulation group (transfected with empty1 and antomiR-18b-5p) and a blank group. After 7 days, Alizarin red staining was used to observe the calcium mineralization of cells, and alkaline phosphatase (ALP) activity was detected using a reagent kit. Real time fluorescence quantitative polymerase chain reaction(RT-qPCR) was used to detect the expressions of LncRNA PVT1, miR-18b-5p, dentin salivary phosphoprotein(DSPP), osteocalcin(OCN), and Runt related transcription factor 2 (RUNX2) genes in each group. Western blot(WB) was used to detect the expressions of DSPP, OCN, and RUNX2 proteins in each group. Dual luciferase reporter gene detection experiment was used to explore the targeting relationship between LncRNA PVT1 and miR-18b-5p. RESULTS:This study successfully isolated human DPMSCs and identified them by staining with oil red O, Alizarin red, Alishin blue and flow cytometry. The PVT1 upregulation+miR-18b-5p downregulation group had the strongest dentin differentiation activities (P＜0.05), while that of PVT1 downregulation+miR-18b-5p upregulation group was the weakest(P＜0.05). The LncRNA PVT1, DSPP, OCN and RUNX2 expressions were highest in the PVT1 upregulation+miR-18b-5p downregulation group(P＜0.05), while miR-18b-5p expression was lowest (P＜0.05). The PVT1 downregulation+miR-18b-5p upregulation group showed the opposite trend(P＜0.05). There were binding sites between LncRNA PVT1 and miR-18b-5p, and LncRNA PVT1 could negatively feedback and target miR-18b-5p. CONCLUSIONS:Upregulation of LncRNA PVT1 can target the inhibition of miR-18b-5p and promote the differentiation of human DPMSCs into dentin, which may be related to the upregulation of DSPP, OCN and RUNX2 expressions.

BACKGROUND:As the only approved oral medication for premature ejaculation (PE), dapoxetine faces a high discontinuation rate, primarily due to lower than expected efficacy. The impact of serum metabolites on PE treatment remains undetermined; therefore, we aimed to identify metabolites associated with dapoxetine efficacy. METHODS:Clinical data and blood samples were collected from 116 patients with lifelong PE before 8 weeks of dapoxetine treatment. Serum was analyzed by untargeted metabolomics profiling. Efficacy was assessed with the Clinical Global Impression of Change (CGIC) scale: scores ≥ 1 were classified as the effective group and ≤ 0 as the ineffective group. Differential serum metabolites between the two groups were identified using the Mann-Whitney U test. Enrichment analysis determined metabolic pathways significantly associated with efficacy. RESULTS:Compared to the ineffective group, indoleacrylic acid and (-)-riboflavin were significantly upregulated in the effective group, while 15-keto-13,14-dihydroprostaglandin A2, dienestrol, hippuric acid, and PC (16:0/16:0) were downregulated. The six metabolites showed a discriminatory ability of 0.646, 0.667, 0.633, 0.645, 0.651, and 0.635, respectively. Incorporating them significantly improved the accuracy of the model predicting efficacy (0.892 vs. 0.738, p = 0.001), suggesting that modulating these specific metabolites may be a novel strategy for PE treatment. Moreover, differential metabolic ions between the two groups were mostly enriched in the arachidonic acid metabolism pathway, indicating that this pathway may represent an additional route associated with dapoxetine response. CONCLUSIONS:This study revealed serum metabolites correlated with dapoxetine efficacy, paving the way for future research into novel therapeutic targets and personalized treatment strategies.

BACKGROUND:Despite being the only approved oral therapy for premature ejaculation (PE), dapoxetine faces high discontinuation rates because of its suboptimal efficacy. Given that the role of gut microbiota in PE treatment has remained unexplored, we aim to investigate gut microbiota that may reflect the efficacy of dapoxetine. METHODS:Clinical data and fecal samples were collected from patients with lifelong PE before treatment. Gut microbiota was profiled via 16S rDNA sequencing, and differential microbiota between effective and ineffective groups were identified with the LEfSe method. To explore potential links between gut dysbiosis and efficacy, Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway functional predictions were performed with the PICRUSt2 method. Efficacy was assessed using the Clinical Global Impression of Change (CGIC) scale, with scores ≥1 defined as the effective group. RESULTS:In the effective group, Erysipelotrichaceae_UCG_003, Parabacteroides_distasonis, and Prevotella_7_unclassified were significantly more prevalent, while Collinsella aerofaciens was less abundant. Their abundance was significantly correlated with CGIC scores, with correlation coefficients of 0.331, 0.250, 0.288, and ‒0.345, respectively. The discriminatory abilities of the four differential microbiota were 0.654, 0.669, 0.701, and 0.615, respectively. Incorporating them significantly improved the accuracy of the model predicting efficacy (0.796 vs. 0.738), which further suggests that modulating microbiota could be a novel strategy for PE treatment. The predicted gene abundance in the arachidonic acid metabolism pathway was significantly elevated in the effective group, indicating that dapoxetine's mechanism may also involve modulating this pathway. CONCLUSIONS:This study identified gut microbiota associated with the efficacy of dapoxetine for the first time. Targeted modulation of specific gut microbiota may provide a novel strategy for PE treatment.

BACKGROUND:Although a nomogram for predicting the efficacy of dapoxetine (DapE-Nomo) has already been developed, its reliability is limited due to only 4 weeks of follow-up and a lack of external validation. Several patients with premature ejaculation (PE) achieve satisfactory therapeutic effects after longer periods of treatment clinically, we therefore aimed to develop and validate an 8-week DapE-Nomo. METHODS:The training cohort included 243 patients with lifelong PE from Xijing Hospital and Northwest Women's and Children's Hospital (Jan 2019-Jul 2020), while the validation cohort comprised 397 patients from Xijing Hospital and Xi'an Daxing Hospital (Aug 2020-Jan 2022). Efficacy was measured using the Clinical Global Impression of Change (CGIC) scale, with a CGIC score ≥ 1 indicating an improvement (iCGI). LASSO regression was utilized to identify the most valuable predictors (MVPs) of iCGI. The DapE-Nomo was developed utilizing logistic regression coefficients of MVPs and validated across both cohorts. RESULTS:After 8 weeks of medication, 47.7% of patients in the training cohort and 47.6% in the validation cohort achieved iCGI. MVPs of iCGI included intravaginal ejaculation latency time, difficulty delaying ejaculation, and education level. The DapE-Nomo showed discriminatory abilities of 0.722 and 0.709 in internal and external validations, respectively, with satisfactory calibration and clinical utility in both. The optimal cutoff value of the DapE-Nomo was identified as 153.4 in both cohorts. Individuals with scores ≥153.4 exhibited a 3.833-fold and 4.137-fold chance of achieving iCGI, respectively, compared with those with scores < 153.4. CONCLUSION:We constructed and validated the inaugural 8-week DapE-Nomo. In outpatient settings, it will enable andrologists to more accurately evaluate the efficacy and promptly adjust treatment plans for patients with scores below 153.4. Moreover, It will help patients who've taken dapoxetine for 4 weeks with poor results decide whether to stop.

The accumulation of senescent cells has been identified as a key factor in the progression of emphysema. This study aimed to explore the role of neutrophil gelatinase-associated lipocalin (NGAL), a known mediator of COPD, in CSE-induced senescent alveolar macrophages. NGAL and cellular senescence markers expression were quantified in the lungs of COPD patients. Meanwhile, double-immunofluorescence staining was used to detect NGAL levels in alveolar macrophages of COPD lung tissues. Using a cigarette smoke exposure (CSE)-induced cellular senescence model in MH-S cells. Effects of CSE on NGAL secretion in MH-S cells was assessed by ELISA. Western blotting analysis and SA-β-galactosidase staining were employed to measure cellular senescence markers. NGAL siRNA was used to knockdown NGAL expression. In addition, CCK8 was used to evaluate cell viability and proliferation of MH-S cells. The activation status of the PI3K/Akt pathway was determined by Western blotting. NGAL was elevated in alveolar macrophages from COPD patients compared with healthy controls. In vitro, exposure to CSE induced senescence in MH-S cells and concurrently increased NGAL secretion. Notably, NGAL knockdown attenuated CSE-induced senescence in MH-S cells via the PI3K/Akt pathway. Furthermore, NGAL downregulation significantly reversed CSE-suppressed MH-S cells proliferation and reduced MMP2 and MMP9 expression in senescent MH-S cells. These findings indicate that CSE upregulates NGAL in alveolar macrophages, thereby driving cellular senescence and MMP production through PI3K/Akt pathway.

Urinary tumors pose a significant health threat because of their high prevalence and recurrence rates. Despite the availability of various treatment options, many patients poorly respond to traditional therapies, highlighting the urgent need for alternative approaches. Oncolytic viruses are promising therapeutic agents. These viruses exploit the unique characteristics of cancer cells to specifically target and destroy them, thereby triggering potent antitumor immune responses. This review delves into recent advancements and future prospects of oncolytic viruses, focusing on their application in renal, bladder, and prostate cancers. By discussing practical implications and the potential of different viruses, including the cowpox virus, adenovirus, measles virus, coxsackievirus, and reovirus, we pave the way for further exploration and refinement of this exciting field.

Abstract Background There is currently no robust prognostic model for sarcomatous renal cell carcinoma (sRCC), which could help physicians make better decisions. Objectives To build an accurate predictive model for patients who have sRCC by investigating the important characteristics that influence the overall survival of patients. Design and Methods The Surveillance, Epidemiology and Results (SEER) database of the U.S. National Cancer Institute was used for gathering the dataset of sRCC patients. Following data preprocessing, the data was separated into the training set and the test set in an 8:2 ratio. Mann-Whitney U test and Chi-square test were used to verify whether the data set was evenly divided. Univariate Cox proportional hazard model, Kaplan-Meier analysis and machine learning (ML) algorithm were employed to identify the risk features on overall survival (OS). 10 reliable features were selected to construct six ML models. Model performance, predictive accuracy, and clinical benefits were evaluated by the receiver operating characteristic curves (ROC), calibration plots, and decision curve analysis (DCA) respectively. Results After data preprocessing, 692 patients with sRCC from 1975 to 2019 were included in this study. Ten variables including stage group, T stage, M stage, age, surgery, N stage, tumor size, chemotherapy, histological grade, and radiotherapy were selected as reliable features for machine learning model training. All the models show good prediction performance, among which XGBoost has the best prediction accuracy and stability. The DCA showed that all models except Adaboost could be used to support clinical decision-making with the 90-day, 1-, 2-, 3- and 5-year OS model. Conclusions Six machine learning models were developed to predict 90-day, 1-, 2-, 3- and 5-year overall survival in patients with sRCC. Model evaluations showed that the XGBoost model had the best predictive accuracy and clinical net benefit. These models can help make treatment decisions for patients with sRCC.

Patient Health Questionnaire-9 (PHQ-9) is the most widely used tool for screening for major depressive disorder (MDD). Although its reliability and validity have been proven, missed or misjudged cases during MDD screening are often encountered. A nomogram that considers the weights of depressive symptoms was developed using data from premature ejaculation patients to improve screening accuracy. During a 33-month prospective study, a training cohort comprising 605 participants from Xijing Hospital was used to develop and internally validate the nomogram. A validation cohort comprising 461 patients from Xi'an Daxing Hospital was also used to externally test the nomogram. The nomogram was established by integrating the LASSO regression-based optimal predictors of MDD according to their coefficients in a multivariate logistic regression model. The nomogram was well-calibrated during internal and external validations. Moreover, it showed a better discriminatory capacity and yielded more net benefits in both validations than PHQ-9. With better performance, the nomogram may help reduce the number of missed or misjudged cases during MDD screening. This study is the first to weigh the direct indicators of MDD under the DSM-5 criteria, presenting a fresh concept that can be applied to other populations to enhance screening accuracy.

Background:Although erectile dysfunction (ED) often occurs simultaneously with depression, not all patients with ED suffer major depression (MD), with a PHQ-9 score ≥15 indicating MD. Because the PHQ-9 questionnaire includes phrases such as "I think I am a loser" and "I want to commit suicide," the psychological burdens of ED patients are likely to increase inevitably after using the PHQ-9, which, in turn, may affect ED therapeutic effects. Accordingly, we endeavored to develop a nomogram to predict individual risk of PHQ-9 score ≥15 in these patients.Methods:The data of 1,142 patients with ED diagnosed in Xijing Hospital and Northwest Women and Children's Hospital from January 2017 to May 2020 were analyzed. While the Least Absolute Shrinkage and Selection Operator regression was employed to screen PHQ-9 score ≥15 related risk factors, multivariate logistic regression analysis was performed to verify these factors and construct the nomogram. The training cohort and an independent cohort that comprised 877 prospectively enrolled patients were used to demonstrate the efficacy of the nomogram.Results:The IIEF-5 score, PEDT score, physical pain score, frequent urination, and feeling of endless urination were found to be independent factors of PHQ-9 score ≥15 in patients with ED. The nomogram developed by these five factors showed good calibration and discrimination in internal and external validation, with a predictive accuracy of 0.757 and 0.722, respectively. The sensitivity and specificity of the nomogram in the training cohort were 0.86 and 0.52, respectively. Besides, the sensitivity and specificity of the nomogram in the validation cohort were 0.73 and 0.62, respectively. Moreover, based on the nomogram, the sample was divided into low-risk and high-risk groups.Conclusion:This study established a nomogram to predict individual risk of PHQ-9 score ≥15 in patients with ED. It is deemed that the nomogram may be employed initially to avoid those with a low risk of MD completing questionnaires unnecessarily.

Background Pancreatic adenocarcinoma (PAAD) is a highly malignant tumor with a poor prognosis. The identification of effective molecular markers is of great significance for diagnosis and treatment. Aquaporins (AQPs) are a family of water channel proteins that exhibit several properties and play regulatory roles in human carcinogenesis. However, the association between Aquaporin-5 (AQP5) expression and prognosis and tumor-infiltrating lymphocytes in PAAD has not been reported. Methods AQP5 mRNA expression, methylation, and protein expression data in PAAD were analyzed using GEPIA, UALCAN, HAP, METHSURV, and UCSC databases. AQP5 expression in PAAD patients and cell lines from our cohort was examined using immunohistochemistry and Western blotting. The LinkedOmics database was used to study signaling pathways related to AQP5 expression. TIMER and TISIDB were used to analyze correlations among AQP5, tumor-infiltrating immune cells, and immunomodulators. Survival was analyzed using TCGA and Kaplan–Meier Plotter databases. Results In this study, we investigated AQP5 expression in PAAD and determined whether the expression of AQP5 is a strong prognostic biomarker for PAAD. We searched and analyzed public cancer databases (GEO, TCGA, HAP, UALCAN, GEPIA, etc.) to conclude that AQP5 expression levels were upregulated in PAAD. Kaplan–Meier curve analysis showed that high AQP5 expression positively correlated with poor prognosis. Using TIMER and TISIDB, we found that the expression of AQP5 was associated with different tumor-infiltrating immune cells, especially macrophages. We found that hypomethylation of the AQP5 promoter region was responsible for its high expression in PAAD. Conclusions AQP5 can serve as a novel biomarker to predict prognosis and immune infiltration in PAAD.

OBJECTIVE:A PHQ-9 score ≥ 15, represented as PHQ-9+ , indicates major depressive disorder (MDD). On using PHQ-9, the psychological burden of several patients with lifelong premature ejaculation (LPE) gets aggravated, which may lead to LPE development. We aim to construct a nomogram for predicting the individual risk of PHQ-9+ in patients with LPE and discerning those with low risks, who should avoid the PHQ-9.METHODS:The nomogram was constructed by analysing data of 802 patients from Xijing Hospital and Northwest Women's & Children's Hospital. The LASSO and multivariable logistic regressions were used to identify independent predictors of PHQ-9+ , used for developing the nomogram. The discrimination, calibration and clinical usefulness of the nomogram were assessed in the derivation cohort and an independent validation cohort, which was composed of 505 prospectively enrolled patients from Daxing Hospital and Xijing Hospital.RESULTS:The duration of PE, IELT, a history of PE exacerbation, IIEF-5 score, urinary frequency and physical pain score were identified as independent predictors. The nomogram showed excellent calibration, discrimination and clinical usefulness in the derivation and validation cohorts, with a predictive accuracy of 0.781 and 0.763, respectively. Based on this nomogram, patients were divided into not recommended, recommended and strongly recommended PHQ-9 filling groups, with PHQ-9+ rates of 3.5%, 9.3% and 30.7%, respectively.CONCLUSION:A nomogram to discern LPE patients with low risks of PHQ-9+ was established. This tool can increase the positivity of MDD screening and may improve the therapeutic outcomes of those in the low-risk group.

Warburg effect is a pivotal hallmark of cancers and appears prevalently in renal cell carcinoma (RCC). FBP1 plays a negative role in Warburg effect as a rate-limiting enzyme in gluconeogenesis, yet its mechanism in RCC remains to be further characterized. Herein, we revealed that FBP1 was downregulated in RCC tissue samples and was related to the poor survival rate of RCC. Strikingly, miR-24-1 whose DNA locus is overlapped with enhancer region chr9:95084940-95087024 was closely linked with the depletion of FBP1 in RCC. Of note, miRNAs like miR-24-1 whose DNA loci are enriched with H3K27ac and H3K4me1 modifications are belonging to nuclear activating miRNAs (NamiRNAs), which surprisingly upregulate target genes in RCC through enhancer beyond the conventional role of repressing target gene expression. Moreover, miR-24-1 reactivated the expression of FBP1 to suppress Warburg effect in RCC cells, and subsequently inhibited proliferation and metastasis of RCC cells. In mechanism, the activating role of miR-24-1 was dependent on enhancer integrity by dual luciferase reporter assay and CRISPR/Cas9 system. Ultimately, animal assay in vivo validated the suppressive function of FBP1 on 786-O and ACHN cells. Collectively, the current study highlighted that activation of FBP1 by enhancer-overlapped miR-24-1 is capable of contributing to Warburg effect repression through which RCC progression is robustly blocked, providing an alternative mechanism for RCC development and as well implying a potential clue for RCC treatment strategy.

阴茎癌是泌尿生殖系统较为少见的恶性肿瘤,在欧洲和北美洲其发病率低于1/10万,在东南亚、南美洲等地区,阴茎癌占男性恶性肿瘤的1％～2％,发病率可达8.3/10万[1-2].2018年,全球大约有15 000例患者因阴茎癌死亡,并有大约34 500例新发病例被确诊[3].阴茎鳞状细胞癌(squamous cell carcinoma of penile,SCCP)是阴茎癌最常见的组织学类型,约占所有病例的95％左右[4-5].

目的 探讨淋巴结阳性肾盂尿路上皮癌(UCRP)患者疾病特异性生存率(DSS)的独立预测因素,并构建专门的列线图模型以个体化预测其确诊后1、2、3年DSS.方法 回顾性分析2004年1月至2016年12月在SEER数据库中登记的UCRP患者的一般资料,采用Kaplan-Meier法计算患者的总体生存率(OS)和DSS,采用Log-rank检验衡量不同亚组间的生存差异,采用Cox比例风险回归模型分析影响DSS的独立因素,并运用R软件整合所有具有独立预测意义的变量绘制列线图模型.通过计算受试者工作特征(ROC)曲线下面积(AUC)并绘制校准曲线对模型的预测性能进行验证.结果 Cox多因素回归分析显示,确诊时的年龄>75岁、肿瘤最大直径>75 mm、T3～T4期、N3期及M1期是淋巴结阳性UCRP患者DSS的独立危险因素;辅助化疗是独立保护因素.经内部验证,模型预测淋巴结阳性UCRP患者1、2、3年DSS的区分度分别为0.792、0.764、0.750.校准曲线证实模型预测的1、2、3年DSS与实际生存结果均具有良好的符合度.结论 本研究确定了与淋巴结阳性UCRP患者DSS独立相关的因素,并为该类患者构建了国内外首个专门的DSS个体化预测模型.

The roles played by several inflammatory factors in screening for prostate cancer (PCa) among gray area patients, namely those with serum prostate-specific antigen (PSA) levels between 4 and 10 ng/ml, have not been completely identified, and few effective diagnostic nomograms have been developed exclusively for these patients. We aimed to investigate new independent predictors of positive biopsy (PB) results and develop a novel diagnostic nomogram for this group of patients. The independent predictors of PB results were identified, and a nomogram was constructed using multivariate logistic regression analysis based on a cohort comprising 401 Gy area patients diagnosed at Xijing Hospital (Xi’an, China) between January 2016 and December 2019. The predictive accuracy of the nomogram was assessed using the receiver operating characteristic curve, and the nomogram was calibrated by comparing the prediction with the observation. The performance of the nomogram was further validated using an independent cohort. Finally, lymphocyte-to-monocyte ratio (LMR) > 4.11 and red blood cell distribution width (RDW)-standard deviation (SD) > 42.9 fl were identified as independent protective predictors of PB results, whereas PSA density (PSAD) > 0.141 was identified as an independent risk predictor. The nomogram established using PSAD, LMR, and RDW-SD was perfectly calibrated, and its predictive accuracy was superior to that of PSAD in both internal and external validations (0.827 vs 0.769 and 0.765 vs 0.713, respectively). This study is the first to report the importance of LMR and RDW-SD in screening for PCa among gray area patients and to construct an exclusive nomogram to predict the individual risk of positive 13-core biopsy results in this group of patients. With superior performance over PSAD, our nomogram will help increase the accuracy of PCa screening, thereby avoiding unnecessary biopsy.

Aim: To develop a survival nomogram for patients with upper tract recurrence (UTR) after resection for localized bladder urothelial carcinoma (BUC). Methods: The data of 361 patients with UTR after resection for BUC registered in the Surveillance, Epidemiology, and End Results database were retrospectively analyzed. The nomogram was established using the Fine and Gray method and its predictive accuracy was assessed using the concordance index. The nomogram was calibrated by comparing the predicted and actual survival. Results: The concordance index of the nomogram was 0.746 (95% CI: 0.733-0.759). Excellent agreement was observed between the predicted and actual survival in all calibration plots. Conclusion: This study describes the first survival nomogram for patients experienced UTR after resection for BUC.

BACKGROUND:A predictive model for acquired premature ejaculation (APE) in PE patients has not yet been established.OBJECTIVES:This study was aimed at determining which factors were independently associated with the possibility of predicting APE in PE patients, and whether an effective pre-treatment nomogram for predicting their individual chances of being APE in PE patients can be developed.MATERIALS AND METHODS:We analyzed the medical histories of 915 PE patients diagnosed at Xijing Hospital (Xi'an, China) and Northwest Women's and Children's Hospital (Xi'an, China) between May 2019 and May 2020. The diagnostic nomogram was developed using a multivariate logistic regression model by integrating selected significant variables determined through univariate analysis. Receiver operating characteristic curves were used to measure the predictive accuracy of the nomogram and its constituted variables, and calibrations were performed by making a comparison of nomogram-predicted probability with actual rate of APE.RESULTS:The independent predictors for APE that were identified include Age, Intra-vaginal Ejaculation Latency Time (IELT), Frequency of sexual desire (FSD), and Eysenck Personality Questionnaire-Revised Short Scale for Chinese (psychoticism) [EPQ-RSC(P)] scores. The predictive accuracy of the nomogram was 0.782 (95% CI: 0.723-0.841). Also, excellent agreement was demonstrated between the nomogram-predicted probability and the actual rate of APE.DISCUSSION AND CONCLUSION:We identified 4 independent predictors for APE and demonstrated the potential significant differences in psychoticism between LPE and APE patients. This was the first internally validated predictive APE nomogram where good discrimination and calibration were applied, and it offers a promising role in clinical practice. More studies are necessary for verification of its universal applicability.

ABSTRACT:Survival heterogeneity is observed among renal cell carcinoma (RCC) patients with metastases in different organs. Moreover, almost all previous prognostic nomograms based on data from metastatic RCC patients did not take competing events, such as death from cerebrovascular and heart diseases, into account. We aimed to construct novel prognostic nomograms for patients with lung metastatic clear cell RCC (LMCCRCC).Data of 712 non-Hispanic white LMCCRCC patients registered in the Surveillance, Epidemiology, and End Results database were retrospectively analyzed. Nomograms for predicting overall survival (OS) and disease-specific survival (DSS) were established using the Cox approach and Fine and Gray approach, respectively, and their performances were assessed using the concordance index (C-index), calibration plots, and an independent cohort comprising 181 Hispanic patients.Sex, tumor grade, T stage, N stage, presence or absence of bone metastases, and presence or absence of brain metastases were independent predictors for both OS and DSS. Additionally, presence or absence of liver metastases was an independent predictor only for DSS. Meanwhile, age at diagnosis was independently associated with OS. The C-indexes of the nomograms were 0.702 for OS and 0.723 for DSS in internal validation. In external validation, the C-indexes were 0.700 for OS and 0.708 for DSS. Both internal and external calibration plots showed excellent consistency between the prediction and the observation.The current study developed a novel nomogram for predicting individual OS in LMCCRCC patients. Moreover, we constructed an effective competing risk nomogram for predicting their individual DSS for the first time.

Objective:To construct an effective survival nomogram for patients with clear cell renal cell carcinoma (ccRCC) using a large sample sized Chinese dataset, which can be used to predict individual 3- and 5-year overall survival (OS) precisely.Methods:The data of 672 ccRCC patients received operation diagnosed at Xijing Hospital from January 2012 to December 2016 were retrospectively analyzed. There were 467 males and 205 females. Their median age was 56 years old (ranging 23-83 years old). There were 327 patients with tumor on the left kidney and 345 patients with tumor on the right kidney. Clinical stageⅠ, Ⅱ, Ⅲ, Ⅳ were 584, 47, 19 and 22 cases, respectively. At the time of diagnosis, 504 patients were asymptomatic and 168 patients were symptomatic. Preoperative alkaline phosphatase was 80 (41-240) U/L. Preoperative serum albumin was 44.8 (30.5-59.8) g/L. Preoperative neutrophil absolute value/lymphocyte absolute value (NLR) was 2.25 (0.81-9.89). Preoperative platelet count was 205 (82-589)×10 9/L. Preoperative creatinine was 97 (55-230) μmol/L. Radical nephrectomy was performed in 420 (62.5%) patients and partial nephrectomy was performed in 252 patients. Cox multivariate analysis was used to determine the independent predictors of the postoperative OS. Then, the nomogram was constructed using R software, which integrates all independent predictors according to the coefficients in the multivariate analysis. Moreover, the performance of the nomogram was evaluated using the consistency index (C-index) and the calibration plots. Results:Cox multivariate analysis results showed that age at diagnosis ( P<0.001), clinical TNM stage ( P<0.001), preoperative NLR ( P=0.012), preoperative alkaline phosphatase ( P=0.002) and preoperative albumin ( P<0.001) were the independent predictors of postoperative OS in ccRCC patients. The nomogram established by integrating these five factors had a good discriminatory ability (C-index=0.819, 95% CI 0.813-0.825), and the calibration plots showed that excellent agreements between the nomogram prediction and the actual observation were achieved. Conclusions:Based on a large sample sized Chinese dataset, this study established an effective survival model for patients with ccRCC and good performance of the nomogram was demonstrated by internal validation. Our nomogram can help urologists to predict individual 3- and 5-year OS accurately for Chinese ccRCC patients.