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Background: The prognostic value of nutritional status in anaplastic thyroid carcinoma (ATC) remains unclear. The Prognostic Nutritional Index (PNI) is a reliable indicator of overall nutritional and immune status, and it has emerged as a significant prognostic factor in various malignancies. This study aimed to explore the utility of PNI in ATC. Methods: We systematically reviewed ATC patients in our institute from January 2000 to June 2023 and categorized them into high and low PNI groups based on the median PNI value. Kaplan–Meier analysis and Cox regression were employed to assess the impact of PNI on overall survival, while ROC curve analysis evaluated the predictive value of PNI. Mimics software was used for three-dimensional reconstruction of pre- and post-immunotherapy tumor volumes, enabling the assessment of treatment response. Results: A total of 77 ATC patients were included in this study. Low baseline PNI was associated with significantly shorter overall survival (1-year survival rate: 5.26% vs 30.77%; median survival time: 5.30 months vs 8.87 months). The 1-year, 2-year, and 3-year AUC values for PNI were 0.82, 0.79, and 0.77, respectively. In the multivariate analysis, both PNI and tumor size emerged as independent prognostic factors for patient overall survival. Among ATC patients receiving 2–3 cycles of immunotherapy, an increase in post-treatment PNI levels was positively correlated with a reduction in tumor volume. Conclusion: PNI is an independent predictor of overall survival and holds the potential to serve as a valuable indicator for assessing and predicting immunotherapy efficacy in ATC patients.

Introduction: Bacterial infection is one of the most frequent complications in hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF), which leads to high mortality. However, a predictive model for bacterial infection in HBV-ACLF has not been well established. This study aimed to establish and validate a predictive model for bacterial infection in two independent patient cohorts. Methods: Admission data from a prospective cohort of patients with HBV-ACLF without bacterial infection on admission was used for derivation. Bacterial infection development from day 3 to 7 of admission was captured. Independent predictors of bacterial infection development on multivariate logistic regression were used to develop the predictive model. External validation was performed on a separate retrospective cohort. Results: A total of 377 patients were enrolled into the derivation cohort, including 88 patients (23.3%) who developed bacterial infection from day 3 to 7 of admission. On multivariate regression analysis, admission serum globulin (OR 0.862, 95% CI 0.822–0.904; P< 0.001), interleukin-6 (OR 1.023, 95% CI 1.006–1.040; P= 0.009), and C-reactive protein (OR 1.123, 95% CI 1.081–1.166; P< 0.001) levels were independent predictors for the bacterial infection development, which were adopted as parameters of the predictive model (GIC). In the derivation cohort, the area under the curve (AUC) of GIC was 0.861 (95% CI 0.821–0.902). A total of 230 patients were enrolled into the validation cohort, including 57 patients (24.8%) who developed bacterial infection from day 3 to 7 of admission, and the AUC of GIC was 0.836 (95% CI 0.782–0.881). The Hosmer–Lemeshow test showed a good calibration performance of the predictive model in the two cohorts (P= 0.199, P= 0.746). Decision curve analysis confirmed the clinical utility of the predictive model. Conclusion: GIC was established and validated for the prediction of bacterial infection development in HBV-ACLF, which may provide a potential auxiliary solution for the primary complication of HBV-ACLF.

According to the complex adaptive systems theory, tourist destinations may be regarded as complex adaptive systems formed by multiple adaptive agent interactions and composed of an agent system, tourist attraction subsystem, tourist service facility subsystem, and external environment system. This paper explores the spatial evolutionary progress of the Southern Anhui tourist area. The period 1979 to 1990 comprised the formation stage of spatial agglomerates, during which tourist attractions centering on Huangshan Scenic Area and Jiuhuashan Scenic Area were gradually exploited and formed scale agglomeration; tourism spatial structure began to show the characteristics of agglomeration development, and Gini indexes of the number of tourists and tourism revenue increased significantly from 0.26 to 0.29, and from 0.33 to 0.35, respectively. From 1991 to 2008, the system experienced a growth stage in which Huangshan Scenic Area and Jiuhuashan Scenic Area were further developed with improved tourist service facilities. Rapid development of Xidi-Hongcun Scenic Area and establishment of Fantawild Tourist Area promoted the formation of more spatial agglomerates with larger scales; Gini indexes of the number of tourists and tourism revenue presented fluctuating changes, reaching low points of 0.15 and 0.25 in 2000 and 0.12 and 0.22 in 2007, respectively. From 2009 to the present day, the system has remained in a blowout-development stage, during which non-linear interactions among agents are strengthened; various emerging development factors generate cultural tourism, vacation tourism, rural tourism and other new tourism products jointly with traditional development factors. New tourism products form a large number of new spatial agglomerates that are interconnected, accelerating the spatial flow of tourists and tourism revenue and reducing the differences in tourism development levels within the region; Gini indexes of the number of tourists and tourism revenue declined steadily from 0.17 and 0.23 in 2009 to 0.12 and 0.15 in 2016.

ABSTRACTHead and neck squamous cell carcinoma (HNSCC) is a lethal disease with suboptimal survival outcomes. In this study, we aimed to find an independent prognostic factor of head and neck squamous cell carcinoma and investigate its effect on tumor cell proliferation, apoptosis, migration progress and cell cycle phase. Weighted gene co-expression network analysis (WGCNA) is an analysis method for mining module information in chip data through soft threshold. In this article, it was used to divide differential genes into different modules and determined the ten hub genes. Overall survival (OS) and disease-free survival (DFS) analyses as well as univariate and multivariate regression analyses were used to figure out HMGA2 as the independent prognostic factor. RT-qPCR and western blot results revealed the HMGA2 expression levels. Via colony formation, flow cytometry and wound healing assays, we tested the involvement of HMGA2 knockdown in corresponding cancer cell biological behaviors. HMGA2 level was up-regulated in HNSCC tissues and cell lines (SCC-25 and FaDu) in comparison with their normal counterparts. HMGA2 knockdown decreased cancer cell proliferation, promoted cell apoptosis, blocked cell cycle at G0/G1 phase, and inhibited cell migration. We regarded HMGA2 as a potential diagnostic and therapeutic target of HNSCC.

Objectives: Nasopharyngeal adenocarcinomas (NPACs) are rare malignant tumors. The treatment of NPACs is usually surgery with resection of normal nasal passage tissues.We introduced an innovative double endoscopic surgery for NPACs patients and evaluated the clinical efficacy of this approach.Methods: The clinical data of 4 NPACs patients who underwent radical endoscopic nasopharyngectomy using a combined transnasal and transoral approach were analyzed to determine the efficacy of this surgery. The endpoints were en bloc resection and relief of clinical symptoms.Results: All surgeries were successfully performed without any severe postoperative complications or death. Postoperative MRI revealed that en bloc resection was achieved for all patients with NPACs, and they had high quality of life without postoperative complications.Conclusions: The transnasal-transoral approach to endoscopic nasopharyngectomy for nasopharyngeal adenocarcinoma is safe and effective.