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The effect of surgical resection on the long-term outcome of GIST patients with initially diagnosed synchronous hepatic metastases in the targeted therapy era is still uncertain. The main aims of this study were to investigate the role of surgery in the treatment of these patients and establish clinical predictive models for assessing prognosis.We identified these patients from the Surveillance, Epidemiology and End Results (SEER) database between 2010 and 2018. The selection bias in comparisons was minimized by performing propensity score matching (PSM). The risk factors associated with long-term survival outcomes were identified by a Cox proportional hazards model and thus used to establish the nomograms. Nomograms were validated by concordance indexes (C-indexes), time-dependent receiver operator characteristic (ROC) curves, calibration plots, and decision curve analyses (DCA).Of these 523 eligible patients, there were 187 (35.8%) and 336 (64.2%) patients in the surgical and nonsurgical groups, respectively. Multivariate analysis revealed that surgical resection was an independent prognostic factor for OS (hazard ratio [HR] 0.62; 95% confidence interval [CI] 0.44-0.88, p = 0.0068) and CSS (HR 0.51; 95% CI 0.33 - 0.77, p = 0.0016). After PSM, it was found that surgical resection still showed significantly improved OS (5-year 54.9% vs 38.8%, p = 0.028) and CSS (5-year 65.8% vs 50.3%, p = 0.077). In addition, the C-indexes of the nomograms for OS and CSS prediction were 0.692 and 0.705, respectively, and the nomograms showed good consistency.This study revealed that surgical resection has a favorable impact on the long-term outcome of patients with synchronous GIST liver metastases, and the nomograms showed remarkable prediction performance for OS and CSS.

Mutation testing is an effective defect-based software testing method, but a large number of mutants lead to expensive testing costs, which hinders the application of variation testing in industrial engineering. To solve this problem and enable mutation testing to be applied in industrial engineering, this paper improves the method of identifying redundant mutants based on data flow analysis and proposes the inclusion relationship between redundant mutants, so that the redundancy rate of mutants is reduced. In turn, the cost of mutation testing can be reduced. The redundant mutants identification method based on definition and reference of variables (ImReMuDF) was validated and evaluated using 8 C programs. The minimum improvement in redundant mutant identification rate was 34.0%, and the maximum improvement was 71.3% in the 8 C programs tested, and the verification results showed that the method is feasible and effective and has been improved in reducing redundant mutants and effectively reducing the execution time of mutation testing.

P38 mitogen-activated protein kinase (MAPK)12 (also known as P38 γ) is critical in the development and progression of various types of tumors. Despite the extensive literature on the subject, further studies are needed to elucidate its role in cancer progression. Here, a comprehensive bioinformatics analysis of a generalized cancer dataset was performed to explore the mechanism of MAPK12 regulation in tumorigenesis. Several tumor datasets and online analytical tools, including HPA, SangerBox, UALCAN, GEPIA2, STRING, ImmuCellAI, and MEXPRESS, were used to analyze the expression information on MAPK12 in several types of cancers. Western blotting and reverse transcription-quantitative PCR were used to verify the protein and mRNA expression levels of MAPK12, respectively, in human normal thyroid cells (HTORI-3) and thyroid carcinoma (THCA) cells. Cytotoxicity and EdU assays were used to verify the promoting effect of MAPK12 on cell proliferation in THCA cells. Analysis of several cancers found that MAPK12 was overexpressed in multiple cancer types. Upregulated MAPK12 mRNA expression levels were correlated with a worse prognosis in patients with several types of cancer. Cytotoxicity and EdU experiments showed that MAPK12 knockdown inhibited THCA cell proliferation. Gene Ontology-Biological Process and Kyoto Encyclopedia of Genes and Genomes analyses showed that the enrichment of MAPK12 genes was related to cell proliferation and the tumor immune microenvironment. These results showed that MAPK12 was closely related to the immune checkpoint, microsatellite instability, and tumor mutational burden and affected the sensitivity of the tumor to immunotherapy. This study showed that MAPK12 may be an immunotherapeutic and promising prognostic biomarker in certain types of tumors.

Aims Molecular profiling of hepatocellular carcinoma (HCC) has helped identify actionable genomic alterations that could guide therapeutic decision-making and clinical trial enrollment. However, in clinical practice, next-generation sequencing (NGS) is not extensively used in routine clinical care to identify patients with HCC who are likely to benefit from genome-directed targeted therapies. Methods Here, we describe the case of a 66-year-old man with advanced HCC. After rapid progression on transarterial chemoembolization, the tissue sample obtained from biopsy was subjected to NGS to verify whether precision therapy was an option. Results Our analysis revealed high MET amplification. The patient received crizotinib (250 mg, bid) and showed a remarkable response. Conclusions Our case report suggests NGS could help identify patients with high MET amplification in HCC who were likely to benefit from MET inhibitors; moreover, this requires further investigation in clinical trials.

Summary Aim Regional lymph node enlargement and alveolar echinococcosis (AE) invasion are two different pathological results. The purpose of this study was to distinguish whether regional lymph node invasion and lymphadenectomy were associated with survival benefits. Methods This study enrolled consecutive patients with AE underwent radical hepatectomy with removal and pathological assessment of the regional lymph nodes between January 2009 and April 2019. Based on the pathological examination, patients with inflammatory lymph node enlargement was included in group A, and patients with AE lymph node invasion were included in group B. The clinical characteristics, survival and recurrence rates of the two groups were compared. Results 421 patients underwent radical hepatectomy, of whom 127 (30.16%) underwent lymphadenectomy. 103 patients were enrolled group A, and 24 were enrolled in group B. Preoperative computed tomography showed that the lymph node positivity rate in group B was 70.8% while that in group A was 43.7% (p = 0.017). The lymph node diameter was 1.8 ± 0.9 cm in group A vs 2.5 ± 1.1 cm in group B (p = 0.004), and the lymph node number (p = 0.035) and lymph node location (p = 0.001) were also different between the two groups. 10 patients (7.9%) had recurrent lesions, and 6 patients (4.7%) died (P > 0.05). Conclusions Preoperative computed tomography has a low sensitivity in diagnosing lymph node invasion of AE. Lymph node diameter, number, and distance from the liver were important characteristics for describing lymph node invasion. There was no difference in the long-term efficacy of lymphadenectomy between patients with lymph node enlargement and those with invasion.

Background The aim of this meta-analysis was to explore associations between polymorphisms in CTLA-4/IL-18 and chronic liver diseases by combing the results of all relevant studies. Methods Eligible studies were searched from Pubmed, Embase, Web of Science and Cochrane library. We used Review Manager to combine the results of eligible studies. Results Sixty-seven studies were included in this meta-analysis. Combined results revealed that CTLA-4 rs231775 (dominant, recessive and allele comparisons), IL-18 rs1946518 (dominant, recessive and allele comparisons) and IL-18 rs187238 (dominant, over-dominant and allele comparisons) polymorphisms were all significantly associated with chronic liver diseases in the overall population. We also obtained similar positive results for rs231775, rs5742909, rs3087243, rs1946518 and rs187238 polymorphisms in subgroup analyses by ethnicity and type of disease. Conclusions This meta-analysis demonstrated that CTLA-4 rs231775, CTLA-4 rs5742909, CTLA-4 rs3087243, IL-18 rs1946518 and IL-18 rs187238 polymorphisms may confer susceptibility to certain types of chronic liver diseases.

Software testing plays an important role in improving the quality of software, but the design of test cases requires a lot of manpower, material resources, and time, and designers tend to be subjective when designing test cases. To solve this problem and make the test cases have objectivity and greater coverage, a branch coverage test case automatic generation method based on genetic algorithm and RBF neural network algorithm (GAR) is proposed. In terms of test case generation, based on the genetic algorithm optimized in this paper, a certain number of test case samples are randomly selected to train the RBF neural network to simulate the fitness function and to calculate the individual fitness value. The experiment uses 7 C language codes to automatically generate test cases and compares the experimental data generated by the branch coverage test case generation method based on adaptive genetic algorithm (PDGA), traditional genetic algorithm (SGA), and random test generation method (random) to evaluate the proposed algorithm. The experimental results show that the method is feasible and effective, the branch coverage is increased in the generation of test cases, and the number of iterations of the population is less.

The molecular mechanism of tumorigenesis of the prevalent cancer hepatocellular carcinoma (HCC) is unclear. In this study, through weighted gene coexpression network analysis, a coexpression network was constructed by selecting the top 25% most variant genes in the dataset GSE62232. The average linkage hierarchical clustering identified 24 modules, and among them, the pink module associated with prognosis of HCC was screened. Five gene candidates (PCNA, RFC4, PTTG1, H2AFZ, and RRM1) with a common network in the module were screened after the protein-protein interaction network complex was combined with the coexpression network. After progression and survival analysis, all candidates were identified as real core genes. According to the Human Protein Atlas and the Oncomine database, these genes were dysregulated in HCC samples. The receiver operating characteristic curve proved that the expression levels of the core genes had high diagnostic efficacy. The results of gene set enrichment analysis and functional enrichment analysis demonstrated the importance of the cell cycle-related pathways in HCC progression and prognosis. In conclusion, the five real core genes and cell cycle-related pathways identified in this study could greatly improve the knowledge about HCC progression and contribute to HCC treatment.

Background: This retrospective study aimed to evaluate the safety and learning curve of ex vivo liver resection and autotransplantation (ELRA).Methods: A total of 102 consecutive end-stage HAE patients who underwent ELRA between 2014 and 2020 in West China Hospital were enrolled. The primary endpoint was major postoperative complications (comprehensive complication index, CCI > 26). The ELRA learning curve was evaluated using risk-adjusted cumulative sum (RA-CUSUM) methods. The learning phases were determined based on RA-CUSUM analysis and tested for their association with intra- and post-operative endpoints.Results: The median surgery time was 738 (659–818) min, with a median blood loss of 2,250 (1,600–3,000) ml. The overall incidence of major morbidity was 38.24% (39/102). Risk-adjusted cumulative sum analysis demonstrated a learning curve of 53 ELRAs for major postoperative complications. The learning phase showed a significant association with the hemodynamic unstable time (HR −30.29, 95% CI −43.32, −17.25, P < 0.0001), reimplantation time (HR −13.92, 95% CI −23.17, −4.67, P = 0.004), total postoperative stay (HR −6.87, 95% CI −11.33, −2.41, P = 0.0033), and postoperative major morbidity (HR 0.25, 95% CI 0.09, 0.68, p = 0.007) when adjusted for age, disease course, liver function, and remote metastasis.Discussion:Ex vivo liver resection and autotransplantation is feasible and safe with a learning curve of 53 cases for major postoperative complications.

Background Ex vivo liver resection and autotransplantation (ELRA) has shown promising outcomes in treating end-stage hepatic alveolar echinococcosis (AE). However, the actual benefits and risks remain unclear. This study aims to analyze the benefits and risks of ELRA. Methods This retrospective cohort analysis included 228 patients with end-stage hepatic AE who underwent ELRA or nonsurgical treatment between 2014 and 2020. Propensity score matching was used. Long-term survival was compared in the matched cohorts using Kaplan-Meier curves generated with the log-rank test. Short-term mortality in entire cohort was predicted based on the nonsurgical group, and the interaction between the predicted mortality risk and observed mortality was tested. Risk factors for postoperative major morbidity in the ELRA group were evaluated using logistic regression analyses. Results The long-term overall survival of the ELRA group was superior to that of the nonsurgical group (82.1% vs 19.1%, 5-year survival). Regarding short-term outcomes, the basic risk of 12-month mortality exerted a significant effect on the benefit of ELRA in entire cohort (per 1%, odds ratio, 1.043; 95% confidence interval [CI]: 1.007–1.082; P = .021). Patients with a predicted 12-month mortality risk >75% would significantly benefit from ELRA. Combined resection (hazard ratio [HR], 3.32; 95% CI: 1.01–10.99; P = .049) and overall surgery time (per hour, HR, 1.41; 95% CI: 1.09–1.82; P = .009) were identified as independent risk factors for postoperative major morbidity. Conclusions ELRA was significantly beneficial in selected patients with end-stage AE compared with nonsurgical treatment. The timing of conducting ELRA remarkably affected the short-term risk of mortality and should be carefully determined.

Yiwen Qiu, Tao Wang, Xianwei Yang, Shu Shen, Yi Yang, Wentao Wang Department of Liver Surgery and Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu, 610041, People’s Republic of ChinaCorrespondence: Wentao WangDepartment of Liver Surgery and Liver Transplantation Center, West China Hospital of Sichuan University, 37 Guoxue Road, Chengdu, 610041, People’s Republic of ChinaTel +86 18980601895Fax +86 28-85422871Email wwtdoctor02@163.comBackground: Spontaneous rupture bleeding is a fatal hepatocellular carcinoma (HCC) complication and a significant determinant of survival outcomes. This study aimed to develop and validate a novel artificial neural network (ANN)-based survival prediction model for patients with spontaneous HCC rupture after transcatheter arterial embolization (TAE).Methods: Patients with spontaneous HCC rupture bleeding who underwent TAE at our hospital between January 2010 and December 2018 were included in our study. The least absolute shrinkage and selection operator (LASSO) Cox regression model was used to screen clinical variables related to prognosis. We incorporated the above clinical variables identified by LASSO Cox regression into the ANNs model. Multilayer perceptron ANNs were used to develop the 1-year overall survival (OS) prediction model for patients with spontaneous HCC ruptured bleeding in the training set. The area under the receiver operating characteristic curve and decision curve analysis were used to compare the predictive capability of the ANNs model with that of existing conventional prediction models.Results: The median survival time for the whole set was 11.8 months, and the 1-year OS rate was 47.5%. LASSO Cox regression revealed that sex, extrahepatic metastasis, macroscopic vascular invasion, tumor number, hepatitis B surface antigen, hepatitis B e antigen, tumor size, alpha-fetoprotein, fibrinogen, direct bilirubin, red blood cell, and γ-glutamyltransferase were risk factors for OS. An ANNs model with 12 input nodes, seven hidden nodes, and two corresponding prognostic outcomes was constructed. In the training set and the validation set, AUCs for the ability of the ANNs model to predict the 1-year OS of patients with spontaneous HCC rupture bleeding were 0.923 (95% CI, 0.890– 0.956) and 0.930 (95% CI, 0.875– 0.985), respectively, which were higher than that of the existing conventional models (all P < 0.0001).Conclusion: The ANNs model that we established has better survival prediction performance.Keywords: hepatocellular carcinoma spontaneous rupture bleeding, HCC spontaneous rupture bleeding, least absolute shrinkage and selection operator regression, LASSO regression, artificial neural networks, ANNs, survival, prognosis

Ting Sun,1 Tao Wang,1 Yiwen Qiu,1 Shu Shen,1 Xianwei Yang,1 Yi Yang,1 Bin Huang,2 Wentao Wang1 1Department of Liver Surgery & Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu, People’s Republic of China; 2Department of Vascular Surgery, West China Hospital of Sichuan University, Chengdu, People’s Republic of ChinaCorrespondence: Wentao Wang Email wwtdoctor02@163.comBackground: Sarcopenia and visceral adiposity have been shown to be associated with postoperative complications in numerous diseases. However, their effects on the postoperative complications of end-stage hepatic alveolar echinococcosis (HAE) patients undergoing ex vivo liver resection and autotransplantation (ELRA) remain unclear.Methods: This retrospective study included 101 end-stage HAE patients who underwent ELRA from January 2014 to August 2020. We measured the skeletal muscle and adipose tissue of all patients at the level of the third lumbar vertebra on plain abdominal computed tomography (CT) images and subsequently derived an equation via least absolute shrinkage and selection operator (LASSO) regression analysis to calculate the sarcopenia score. Univariate and multivariate regression were performed to reveal the relationship between major postoperative complications and perioperative clinical data, and the obtained nomogram was validated with the bootstrapping method.Results: The sarcopenia score was constructed as a personalized indicator to evaluate sarcopenia and visceral adiposity in each patient. Logistic regression analysis finally selected duration from primary diagnosis to obvious symptoms (OR=1.024, 95% CI, 1.007– 1.042), surgical time (OR=1.003, 95% CI, 0.999– 1.007) and sarcopenia score (OR=4.283, 95% CI, 1.739– 10.551) as independent risk factors for predicting major postoperative complications following ELRA for end-stage HAE patients. The area under the receiver operating characteristic curve (AUROC) of 0.807 (95% CI, 0.720– 0.895) and the calibration curve for this prediction model were satisfactory.Conclusion: The sarcopenia score, which systematically evaluates the skeletal muscle and adipose tissue of end-stage HAE patients, was a significant predictive factor for major postoperative complications of ELRA. Relevant interventions should be conducted for those who have a high risk of postoperative complications according to the nomogram.Keywords: hepatic alveolar echinococcosis, liver transplantation, hepatectomy, sarcopenia, postoperative complications

As Charles Darwin anticipated, living fossils provide excellent opportunities to study evolutionary questions related to extinction, competition, and adaptation. Ginkgo (Ginkgo biloba L.) is one of the oldest living plants and a fascinating example of how people have saved a species from extinction and assisted its resurgence. By resequencing 545 genomes of ginkgo trees sampled from 51 populations across the world, we identify three refugia in China and detect multiple cycles of population expansion and reduction along with glacial admixture between relict populations in the southwestern and southern refugia. We demonstrate multiple anthropogenic introductions of ginkgo from eastern China into different continents. Further analyses reveal bioclimatic variables that have affected the geographic distribution of ginkgo and the role of natural selection in ginkgo’s adaptation and resilience. These investigations provide insights into the evolutionary history of ginkgo trees and valuable genomic resources for further addressing various questions involving living fossil species., Ginkgo is one of the living fossils from the plant kingdom. Here, authors conduct population genomics analyses to reveal its refugia and demographic history, and provide evidence of multiple anthropogenic introductions of ginkgo from eastern China into different continents.

Vulvar candidiasis (VVC) is a vaginitis caused by vaginal mucosa infection of Candida, which greatly impairs women's health. Although there are more and more thiazoles on the market, new classes of antifungal drugs are still missing, it is still challenging to treat azole-resistant candidal vaginitis. We found that L-Se-methylselenocysteine (L-SeMC) could effectively inhibit the growth of Candida albicans, reduce the density and length of the mycelia. To extend the retention time of L-SeMC in the vaginal tract and enhance its therapeutic effect for VVC, a mucoadhesive thermogel (NAC-HA thermogel) was successfully synthesized and prepared. The gelation window was around 29-56 °C for L-SeMC loaded mucoadhesive thermogel (L-SeMC@NAC-HA thermogel), which exhibited a sustained release profile in the in vitro release study and an extended retention time in the vaginal tract. Besides, L-SeMC@NAC-HA thermogel exhibited a good safety profile in the in vivo safety study. The in vivo anti-VVC effect was examined in a rat VVC model and L-SeMC@NAC-HA thermogel significantly reduced the number of Candida albicans in the vaginal secreta, mitigated the vaginal damage and reduced the secretion of proinflammatory factors (TNF-α, IL-1α and IL-β). Therefore, it is a promising therapy for the clinical treatment of VVC in the near future.

The High-Resolution Imaging Camera (HiRIC) is one major payload of China’s first Mars exploration mission, and its main objective is to obtain the detailed observation images of the key areas on the Martian surface. In this paper, the leading group of HiRIC shows a full blueprint of the HiRIC. The HiRIC can achieve a high resolution (0.5 m at an altitude of 265 km) with a wide swath width of 9 km. The HiRIC adopts an Off-Axis Three-Mirror Astigmatic (TMA) optical system with a focal length of 4640 mm, an F-number of 12 and a Field of View (FOV) of 2° × 0.693°. In order to reduce the instrument weight, carbon-based material is widely used in the opto-mechanical structure which is in ultra-lightweight design, thus, a light-weight camera with a total mass of 42 kg is obtained. The Time Delay and Integration (TDI) Charge Coupled Devices (CCDs) and Complementary Metal-Oxide-Semiconductor Transistor (CMOS) detectors are all set on the imaging plane to achieve the push-broom imaging and frame imaging, respectively. And the high Signal-to-Noise Ratio (SNR) >100:1 can achieve in multi observation types for various scientific imaging tasks. After 4-year design and fabricate, the HiRIC has been assembly. The testing results show that the instrument is in good condition, and the Modulation Transfer Function (MTF) can achieve 0.18 at Nyquist frequency. The HiRIC can achieve a well image on China first Mars exploration mission.

This protocol is used to clarity the process of stLFR library preparation for Bicolor Angelfish (Centropyge bicolor) genome.

Background Hepatic Alveolar echinococcosis (AE) is also known as worm cancer, parasitic cancer, and it often invades the regional lymph nodes of the liver. The present study was to investigate the clinical value of radical hepatectomy and lymphadenectomy in AE patients. Methods Our study enrolled consecutive AE patients who underwent radical hepatectomy with removal the regional lymph nodes between January 2009 and April 2019. Patients with inflammatory lymph node enlargement was included in group A, and patients with AE lymph node invasion were included in group B. The clinical characteristics, survival and recurrence rates were compared.Results A total of 103 patients were enrolled group A, and 24 in group B. Preoperative computed tomography showed that the lymph node positivity rate in group B was 70.8% while that in group A was 43.7% (p=0.017). The lymph node diameter was 1.8±0.9 cm in group A vs 2.5±1.1 cm in group B (p=0.004), and the lymph node number (p=0.035) and lymph node location (p=0.001). A total of 10 patients (7.9%) had recurrent lesions, and 6 patients (4.7%) died (P>0.05). Conclusions lymph node diameter, number, and distance from the liver were important characteristics for describing lymph node invasion. There was no difference in the long-term efficacy of lymphadenectomy between patients with lymph node enlargement and those with invasion.

ObjectivesTo establish a nomogram based on preoperative laboratory study variables using least absolute shrinkage and selection operator (LASSO) regression for differentiating combined hepatocellular cholangiocarcinoma (cHCC) from intrahepatic cholangiocarcinoma (iCCA).MethodsWe performed a retrospective analysis of iCCA and cHCC patients who underwent liver resection. Blood signatures were established using LASSO regression, and then, the clinical risk factors based on the multivariate logistic regression and blood signatures were combined to establish a nomogram for a differential preoperative diagnosis between iCCA and cHCC. The differential accuracy ability of the nomogram was determined by Harrell’s index (C-index) and decision curve analysis, and the results were validated using a validation set. Furthermore, patients were categorized into two groups according to the optimal cut-off values of the nomogram-based scores, and their survival differences were assessed using Kaplan-Meier curves.ResultsA total of 587 patients who underwent curative liver resection for iCCA or cHCC between January 2008 and December 2017 at West China Hospital were enrolled in this study. The cHCC score was based on the personalized levels of the seven laboratory study variables. On multivariate logistic analysis, the independent factors for distinguishing cHCC were age, sex, biliary duct stones, and portal hypertension, all of which were incorporated into the nomogram combined with the cHCC-score. The nomogram had a good discriminating capability, with a C-index of 0.796 (95% CI, 0.752–0.840). The calibration plot for distinguishing cHCC from iCCA showed optimal agreement between the nomogram prediction and actual observation in the training and validation sets. The decision curves indicated significant clinical usefulness.ConclusionThe nomogram showed good accuracy for the differential diagnosis between iCCA and cHCC preoperatively, and therapeutic decisions would improve if it was applied in clinical practice.

Tao Wang,1,* Jinfu Zhang,1,* Wanxiang Wang,2 Xianwei Yang,1 Junjie Kong,3 Shu Shen,1 Wentao Wang1 1Department of Liver Surgery and Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu, People’s Republic of China; 2Department of Hepatobiliary, Pancreatic, and Splenic Surgery, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, People’s Republic of China; 3Department of Liver Transplantation and Hepatobiliary Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, People’s Republic of China*These authors contributed equally to this workCorrespondence: Wentao WangDepartment of Liver Surgery and Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu, People’s Republic of ChinaTel +86 18980601895Fax +86-28-85422871Email wwtdoctor02@163.comBackground: There are few studies on the prognosis of elderly intrahepatic cholangiocarcinoma (iCCA) patients after liver resection. The aims of this study were to assess the cumulative incidences of cancer-specific mortality in elderly iCCA patients and to construct a corresponding competing risk nomogram for elderly iCCA patients.Methods: We performed a retrospective analysis of elderly patients with iCCA who underwent liver resection between January 2006 and December 2019. Eligible elderly iCCA patients were randomly divided into training and validation sets at a ratio of 7:3. Based on the results of multivariate analysis using the Fine-Gray competing risk model, we developed a competing risk nomogram using data from the training set to predict the cumulative probabilities of iCCA-specific mortality. The performance of the nomogram was measured by the concordance index (C-index) and calibration curves. To evaluate the clinical usefulness of the nomogram, the clinical benefit was measured by using decision curve analysis (DCA). Furthermore, the patients were categorized into two groups according to the dichotomy values of the nomogram-based scores, and their survival differences were assessed using Kaplan–Meier and cumulative incidence function (CIF) curves.Results: The 1-year, 3-year and 5-year cumulative iCCA-specific mortalities were 19.7%, 48.3% and 56.1%, respectively, for elderly iCCA patients. The multivariate Fine-Gray analysis indicated that microvascular invasion, macroscopic vascular invasion and lymph node metastasis were related to a significantly higher likelihood of iCCA specific mortality. The established nomogram was well calibrated and had a good discriminative ability, with a concordance index (C-index) of 0.742 (95% CI, 0.708– 0.748). Furthermore, the DCA indicated that the nomogram had positive net benefits compared with the conventional staging systems. In the training set and validation sets, the high-risk group had the higher probabilities of iCCA cancer-specific mortality than the low-risk group; meanwhile, the patients in the high-risk the group had significantly poorer overall survival (OS) than those in the low-risk group.Conclusion: Elderly iCCA patients had comparable long-term outcomes with non-elderly iCCA patients. In addition, we constructed a prognostic nomogram for predicting survival in elderly iCCA patients based on the competing risk analysis. The competing risk nomogram displayed excellent discrimination and calibration.Keywords: intrahepatic cholangiocarcinoma, iCCA, liver resection, elderly patients, competing risk analysis, nomogram

Background With more than 30,000 species, fish—including bony, jawless, and cartilaginous fish—are the largest vertebrate group, and include some of the earliest vertebrates. Despite their critical roles in many ecosystems and human society, fish genomics lags behind work on birds and mammals. This severely limits our understanding of evolution and hinders progress on the conservation and sustainable utilization of fish. Results Here, we announce the Fish10K project, a portion of the Earth BioGenome Project aiming to sequence 10,000 representative fish genomes in a systematic fashion within 10 years, and we officially welcome collaborators to join this effort. As a step towards this goal, we herein describe a feasible workflow for the procurement and storage of biospecimens, as well as sequencing and assembly strategies. Conclusions To illustrate, we present the genomes of 10 fish species from a cohort of 93 species chosen for technology development.

Targets such as plastic bags can absorb a lot of high-energy lasers which fired from the laser in a long distance. By aligning the laser center with the optical center of the high definition camera, we can determine that the laser emission point is located at the center of video. We can adjust the angle and position of the camera to make the video center coincide with the target, and finally accurately clean up the target from a long distance. In the process of video, this paper uses the target tracking algorithm based on template and the abnormal target detection method based on inter-frame difference. After we lock the target to be cleaned in a frame, the system can automatically calculate the angle and distance if the target swings in the wind, and send the corresponding motion command to the rotating device which can drive the camera to move, finally realize the target tracking and cleaning. Abnormal target detection algorithm is used to monitor the designated area near the target while emitting high-energy laser. When abnormal target such as human is found to enter, protection mechanism is triggered in time to turn off laser which can prevent dangerous accidents.

The successful application of ex vivo liver resection and autotransplantation (ERAT) has gained widespread attention for the treatment of end-stage hepatic alveolar echinococcosis, which is considered to be unresectable by conventional methods due to extensive invasion of the extra- and intrahepatic vasculature. However, data on remnant liver volume (RLV) are limited, and the safe volume limit of remnant liver is still unclear. To determine the effect of liver volume in the technically developed era, we investigated the impact of the remnant liver-to-standard liver volume ratio (RLV/SLV) on the outcomes of ERAT. From February 2014 to May 2018, 56 ERAT procedures were performed. Eleven patients with an RLV/SLV

Background Associations between polymorphisms in cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) / interleukin-18 (IL-18) and susceptibility to liver diseases were already reported by many publications. The aim of this meta-analysis was to clarify associations between polymorphisms in CTLA-4/IL-18 and liver diseases by combing the results of all relevant publications. Methods Eligible publications were searched from Pubmed, Embase, WOS and CNKI. The latest literature searching update was performed on 2nd October, 2019. We used Review Manager to combine the results of individual studies. Results Sixty-seven studies were included in this study. Combined results revealed that CTLA-4 rs231775 (dominant comparison: OR 0.83, 95 % CI 0.79-0.88; recessive comparison: OR 1.33, 95 % CI 1.23-1.43; allele comparison: OR 0.84, 95 % CI 0.78-0.90), IL-18 rs1946518 (dominant comparison: OR 0.85, 95 % CI 0.78-0.92; recessive comparison: OR 1.29, 95 % CI 1.13-1.48; allele comparison: OR 0.79, 95 % CI 0.71-0.88) and IL-18 rs187238 (dominant comparison: OR 1.28, 95 % CI 1.07-1.53; over-dominant comparison: OR 0.81, 95 % CI 0.68-0.97; allele comparison: OR 1.22, 95 % CI 1.07-1.39) polymorphisms were all significantly associated with liver diseases in the general population. We also obtained similar significant associations for CTLA-4 rs231775, CTLA-4 rs5742909, CTLA-4 rs3087243, IL-18 rs1946518 and IL-18 rs187238 polymorphisms in subgroup analyses. Conclusions Collectively, this meta-analysis proved that CTLA-4 rs231775, CTLA-4 rs5742909, CTLA-4 rs3087243, IL-18 rs1946518 and IL-18 rs187238 polymorphisms may confer susceptibility to various types of liver diseases.

Background Hepatic angiomyolipoma (HAML) is a rare and difficult-to-diagnose liver tumour. The aim of this study was to summarize experiences in the management of HAML and to recommend a practical treatment strategy. Methods We retrospectively studied 92 patients who were diagnosed with HAML and analysed the clinical presentation, histopathological features and treatment of the tumours encountered at our institute from May 2009 to June 2016. Results The patients included 67 females and 25 males who underwent at least one radiographic examination. Sixty-eight patients underwent radical hepatectomy, two patients underwent liver biopsy, and 22 patients were treated with radiofrequency ablation after liver biopsy. The tumour cells correspondingly expressed both melanoma cell markers (HMB45, MART-1) and smooth muscle cell markers. Two patients were found to have tumour recurrence (2/92, 2.2%) after radical hepatectomy, and none of the patients died. Conclusion Diagnosis of HAML depends on pathological findings. The treatment strategy for HAML should be selected according to the tumour size, liver biopsy, location and clinical symptoms of HAML. Patients should be followed closely after surgery because of the malignant potential of HAML.

Liver resection surgery is the most commonly used treatment strategy for patients diagnosed with hepatocellular carcinoma (HCC). However, there is still a chance for recurrence in these patients despite the survival benefits of this procedure. This study aimed to explore recurrence-related genes (RRGs) and establish a genomic-clinical nomogram for predicting postoperative recurrence in HCC patients. A total of 123 differently expressed genes and three RRGs (PZP, SPP2, and PRC1) were identified from online databases via Cox regression and LASSO logistic regression analyses and a gene-based risk model containing RRGs was then established. The Harrell’s concordance index (C-index), receiver operating characteristic (ROC) curves and calibration curves showed that the model performed well. Finally, a genomic-clinical nomogram incorporating the gene-based risk model, AJCC staging system, and Eastern Cooperative Oncology Group performance status was constructed to predict the 1-, 2-, and 3-year recurrence-free survival rates (RFS) for HCC patients. The C-index, ROC analysis, and decision curve analysis were good indicators of the nomogram’s performance. In conclusion, we identified three reliable RRGs associated with the recurrence of cancer and constructed a nomogram that performed well in predicting RFS for HCC patients. These findings could enrich our understanding of the mechanisms for HCC recurrence, help surgeons predict patients’ prognosis, and promote HCC treatment.

With more than 30,000 species, fish are the largest and most ancient vertebrate group. Despite their critical roles in many ecosystems and human society, fish genomics lags behind work on birds and mammals. This severely limits our understanding of evolution and hinders progress on the conservation and sustainable utilization of fish. Here, we announce the Fish10K project, an international collaborative project or initiative? aiming to sequence 10,000 representative fish genomes under a systematic context within ten years, and officially welcome collaborators to join this effort. As a step towards this goal, we herein describe a feasible workflow for the procurement and storage of biospecimens, and sequencing and assembly strategies. To illustrate, we present the genomes of ten fish species from a cohort of 93 species chosen for technology development.