Pancreatic cancer (PC) is one of the most common malignancies. Surgical resection is a potential curative approach for PC, but most patients are unsuitable for operations when at the time of diagnosis. Even with surgery, some patients may still experience tumour metastasis during the operation or shortly after surgery, as precise prognosis evaluation is not always possible. If patients miss the opportunity for surgery and resort to chemotherapy, they may face the challenging issue of chemotherapy resistance. In recent years, liquid biopsy has shown promising prospects in disease diagnosis, treatment monitoring, and prognosis assessment. As a noninvasive detection method, liquid biopsy offers advantages over traditional diagnostic procedures, such as tissue biopsy, in terms of both cost-effectiveness and convenience. The information provided by liquid biopsy helps clinical practitioners understand the molecular mechanisms underlying tumour occurrence and development, enabling the formulation of more precise and personalized treatment decisions for each patient. This review introduces molecular biomarkers and detection methods in liquid biopsy for PC, including circulating tumour cells (CTCs), circulating tumour DNA (ctDNA), noncoding RNAs (ncRNAs), and extracellular vesicles (EVs) or exosomes. Additionally, we summarize the applications of liquid biopsy in the early diagnosis, treatment response, resistance assessment, and prognostic evaluation of PC.

BACKGROUND:Knee osteoarthritis (KOA) is one of the leading causes of disability. The effectiveness of auricular point pressing therapy for treating KOA remains controversial. This protocol describes the method of a systematic review and meta-analysis evaluating the effectiveness and safety of auricular point pressing therapy for treating KOA.METHODS:Four English databases (PubMed, Embase, Cochrane Library databases and Web of Science) and 4 Chinese databases (China National Knowledge Infrastructure, Chinese Biomedical Literature Database, VIP Database for Chinese Technical Periodicals, and Wanfang) will be searched. All randomized controlled trials related to auricular point pressing therapy for KOA will be included. Extracted data will include publication details, basic information, demographic data, intervention details and patient outcomes. The primary outcome will be Western Ontario and McMaster Universities Osteoarthritis Index and visual analogue scale. Risk of bias will be assessed using the Cochrane Collaboration tool for assessing risk of bias. Article selection, data extraction and risk of bias assessment will be performed by 2 independent reviewers. If the meta-analysis is precluded, we will conduct a descriptive synthesis using a best-evidence synthesis approach. The strength of recommendations and quality of evidence will be assessed using the Grading of Recommendations Assessment Development.RESULTS:The systematic review will provide evidence to assess the efficacy and safety of auricular point pressing therapy on KOA.CONCLUSION:The systematic review will provide evidence to assess the efficacy and safety of auricular point pressing therapy for KOA patients.ETHICS AND DISSEMINATION:For this review, ethical approval is not required. Patients will not be involved. The findings will be published in a peer-reviewed journal.INPLASY REGISTRATION NUMBER:INPLASY 202220077.

Limonitic nickel laterite always contains abundant high smelting components such as Al2O3 and MgO, which is extremely adverse to sintering. To weaken the negative effect of the abundant high smelting components, in this study, sinter pot tests of limonitic nickel laterite were conducted for better sintering performance by the optimization of (MgO + Al2O3)/SiO2 mass ratio at the same basicity. The relevant mechanism was revealed by the theoretical analysis and the measurement of chemistry and mineralogy of product sinter. At the optimum (MgO + Al2O3)/SiO2 mass ratio of 1.10, better sintering performance of limonitic nickel laterite can be achieved with tumble index and productivity increased by 8.22% and 7.22%, respectively, and solid fuel rate reduced by 7.41% compared with that of base case. Metallurgical performance of product sinter is excellent with reduction index (RI) and reduction degradation index (RDI+3.15 mm) of as high as 83.66% and 95.64%, respectively. In this case, liquid phase volume and fluidity are both significantly improved and nicely suitable for sintering. The optimization of (MgO + Al2O3)/SiO2 mass ratio contributes to the homogenization of liquid phase and the generation of tighter sinter microstructure with the obvious reduction of sinter porosity, the more formation of silico-ferrite of calcium and alumina (SFCA) and the improvement of bonding efficacy of solid phase by liquid phase. In the follow-up study, (MgO + Al2O3)/SiO2 mass ratio is considered to be adjusted by adding another type of nickel laterite with relatively lower MgO and Al2O3 contents for further improving limonitic nickel laterite sintering and eventually achieving its effective utilization.

It is a challenge to segment the location and size of rectal cancer tumours through deep learning. In this paper, in order to improve the ability of extracting suffi-cient feature information in rectal tumour segmentation, attention enlarged ConvNeXt UNet (AACN-UNet), is proposed. The network mainly includes two improvements: 1) the encoder stage of UNet is changed to ConvNeXt structure for encoding operation, which can not only integrate multi-scale semantic information on a large scale, but al-so reduce information loss and extract more feature information from CT images; 2) CBAM attention mechanism is added to improve the connection of each feature in channel and space, which is conducive to extracting the effective feature of the target and improving the segmentation accuracy.The experiment with UNet and its variant network shows that AACN-UNet is 0.9% ,1.1% and 1.4% higher than the current best results in P, F1 and Miou.Compared with the training time, the number of parameters in UNet network is less. This shows that our proposed AACN-UNet has achieved ex-cellent results in CT image segmentation of rectal cancer.

Background Surgical resection and reconstruction for low-grade bone sarcoma in the metaphysis of the distal femur remain challenging. We hypothesized that 3D printing osteotomy guide plate could assist to accurately resect the tumor lesion and save the joint function. Methods From January 2017 to August 2019, five patients diagnosed with low-grade bone sarcoma in the metaphysis of the distal femur were treated with hemicortical resection using 3D printing guide plate. Autologous bone graft was inactivated in a high-temperature water bath and re-implanted in situ fixed with plate and screw. Patients were followed up from 17 to 33 months. The Musculoskeletal Tumor Society Score was used to evaluate the joint function. X-ray was used to evaluate the bone union. Results One patient was paracorticular osteosarcoma, and four cases had highly differentiated chondrosarcoma. All cases were involved in the metaphysis of the distal femur. Patients were followed up from 13 to 33 months, with an average of 23.6 months. There was neither post-operation infection, internal fixation loosening, nor fracture occurrence in any of the patients. The Musculoskeletal Tumor Society Score averaged at 28.1, while the International Society of Limb Salvage imaging score examination averaged 89.8%. Conclusions Here, we demonstrate that the 3D printing osteotomy guide plate-assisted hemicortical bone resection is a beneficial strategy to effectively resect the primary low-grade malignant bone tumors in the metaphysis of the distal femur and retained satisfied joint function.

Objective. This study aimed to present an investigation of the clinical significance of magnetic resonance imaging (MRI) images obtained based on the backpropagation neural network (BPNN) artificial intelligence algorithm for hip arthroplasty under general anesthesia. Methods. In this study, a case-review method was used to collect 100 patients requiring total hip replacement. They were then randomly divided into an observation group and a control group. Based on the neural network algorithm, the images of the two groups of patients were analyzed to judge their accuracy. Then the sensitivity, specificity, and accuracy of MRI images based on neural algorithms were compared with those processed by radiologists. Results. It was found that MRI processed by BP neural network had good accuracy in the diagnosis of hip joint diseases compared with CT. Meanwhile, the images processed by BP neural network had good specificity and accuracy compared with the images processed by radiologists. Conclusion. Imaging images obtained by BPNN artificial intelligence algorithm were more accurate than CT images, which had more guiding value for surgeons in operation.

Background: Surgical resection and reconstruction for low grade bone sarcoma in the metaphysis of the long bone remains challenging. We hypothesize that 3D printing osteotomy guide plate could assist to accurately resect the tumor lesion and save the joint function without higher recurrence rate. Methods : From January 2017 to August 2019, ten patients with low-grade malignant bone tumor in metaphysis of the limbs were treated with hemicortical resection using 3D printing guide plate and biological reconstruction. Results: Four patients were paracorticular osteosarcoma, five cases had highly differentiated chondrosarcoma, and one case was a chondromyxoid fibroma. Two of the cases involved the proximal humerus, while eight cases involved the distal femur. There was neither post-operation infection, internal fixation loosening, nor fracture occurrence in any of the patients. The Musculoskeletal Tumor Society score averaged at 27.1, while the International Society of Limb Salvage imaging score examination averaged 87.8%. Conclusions: Here, we demonstrate that the 3D printing osteotomy guide plate assisted hemicortical bone resection is a beneficial strategy to effectively resect the primary low-grade malignant bone tumors in the metaphysis of long bone and restore excellent joint function.

Melanoma is a human skin malignant tumor with high invasion and poor prognosis. The limited understanding of genomic alterations in melanomas in China impedes the diagnosis and therapeutic strategy selection. We conducted comprehensive genomic profiling of melanomas from 39 primary and metastatic formalin-fixed paraffin-embedded (FFPE) samples from 27 patients in China based on an NGS panel of 223 genes. No significant difference in gene alterations was found between primary and metastasis melanomas. The status of germline mutation, CNV, and somatic mutation in our cohort was quite different from that reported in Western populations. We further delineated the mutation patterns of 4 molecular subgroups (BRAF, RAS, NF1, and Triple-WT) of melanoma in our cohort. BRAF mutations were more frequently identified in melanomas without chromic sun-induced damage (non-CSD), while RAS mutations were more likely observed in acral melanomas. NF1 and Triple-WT subgroups were unbiased between melanomas arising in non-CSD and acral skin. BRAF, RAS, and NF1 mutations were significantly associated with lymph node metastasis or presence of ulceration, implying that these cancer driver genes were independent prognostic factors. In summary, our results suggest that mutational profiles of malignant melanomas in China are significantly different from Western countries, and both gene mutation and amplification play an important role in the development and progression of melanomas.

As a member of transforming growth factor β (TGF-β) family, bone morphogenetic proteins (BMPs) are multi-functional factors and play critical roles in heart, cartilage, neural development and postnatal bone formation. It has been demonstrated that among the family, BMP2/4 have been reported to be especially important for the developmental and maturation of central nervous system (CNS). It has different, even opposite functions, in certain given circumstances, which could be a potential risk for BMPs' clinical use.

BACKGROUND:With the improved survival for patients with bone sarcomas, there is a trend to reconstruct intercalary femur defects using biologic techniques. This study examined whether the results of a frozen femur autograft with vascularised fibula are comparable to other reconstructive options in terms of the functional outcomes and the complications. MATERIALS AND METHODS:Between 2008 and 2012, eight patients with bony sarcoma of the femur were subjected to reconstruction with a recycled frozen autograft combined with a vascularised fibula flap inside. The oncologic and functional results were analysed retrospectively. RESULTS:The mean follow-up was 48.7 months (37-71). The oncologic results were continuously disease free in five patients; there was no evidence of disease in one, one patient was alive with disease and another died of the disease. The average length of defect was 13.6 cm (9-21). Bone union was achieved in all cases. The mean time to bone union was 7.9 months (5-19) and to full weight bearing was 7.8 months (6-11). There was no infection or construct fracture in this series. Two complications were observed. One tumour recurrence in soft tissue was treated with reresection. One tibia fracture was successfully managed with cast immobilisation. The average Musculoskeletal Tumor Society functional score was 95% (27-30). The construct was intact in all patients. CONCLUSIONS:Vascularised fibular flap combined with frozen autografts is a dependable and durable option for the reconstruction of large bony defects after femoral sarcoma resection. It had the merits of reliable bone union and low complications, which compare well with other biological reconstructions. Evidence Rating Scale for Therapeutic Studies Level IV, therapeutic study.