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Introduction To date, the role of deficient mismatch repair (dMMR) remains to be proven in gastric cancer, and it is difficult to judge its value in clinical application. Our study aimed to investigate how MMR status affected the prognosis in patients with gastrectomy, as well as the efficacy of neoadjuvant chemotherapy and adjuvant chemotherapy in patients with dMMR with gastric cancer. Materials and Methods Patients with gastric cancer with certain pathologic diagnosis of dMMR or proficient MMR (pMMR) using immunohistochemistry from 4 high-volume hospitals in China were included. Propensity score matching was used to match patients with dMMR or pMMR in 1:2 ratios. Overall survival (OS) and progression-free survival (PFS) curves were plotted using the Kaplan-Meier method and compared statistically using the log-rank test. Univariate and multivariate Cox proportional hazards models based on hazard ratios (HRs) and 95% confidence intervals (CIs) were used to determine the risk factors for survival. Results In total, data from 6176 patients with gastric cancer were ultimately analyzed, and loss of expression of one or more MMR proteins was observed in 293 patients (293/6176, 4.74%). Compared to patients with pMMR, patients with dMMR are more likely to be older (≥66, 45.70% vs. 27.94%, P  < .001), distal location (83.51% vs. 64.19%, P  < .001), intestinal type (42.21% vs. 34.46%, P  < .001), and in the earlier pTNM stage (pTNM I, 32.79% vs. 29.09%, P  = .009). Patients with gastric cancer with dMMR showed better OS than those with pMMR before PSM (P  = .002); however, this survival advantage was not observed for patients with dMMR after PSM (P  = .467). As for perioperative chemotherapy, results of multivariable Cox regression analysis showed that perioperative chemotherapy was not an independent prognostic factor for PFS and OS in patients with dMMR with gastric cancer (HR = 0.558, 95% CI, 0.270-1.152, P  = .186 and HR = 0.912, 95% CI, 0.464-1.793, P  = .822, respectively). Conclusion In conclusion, perioperative chemotherapy could not prolong the OS and PFS of patients with dMMR with gastric cancer. [ABSTRACT FROM AUTHOR]

The present study is conducted with a dual-aim; firstly, examine the effect of several single shot peening conditions on the subsurface layer properties and fatigue performance of the case-hardened 18CrNiMo7-6 steel. By carrying out the subsurface integrity analysis and fatigue testing, the underlying relationships among the peening process, subsurface layer property and fatigue performance are investigated, the way peening conditions affect the fatigue life and its associated scatter for the casehardened 18CrNiMo7-6 steel is quantitatively assessed.

Late Mesozoic lithospheric extension in NE China resulted in the development of a large extensional province and widespread formation of volcanic-sedimentary basins. The Songliao Basin is the largest one and contains voluminous volcanic rocks composing the majority of the basin fill. This study focuses on two adjacent eruption cycles, the Huoshiling Formation (K1h) and the first member of the Yingcheng Formation (K1yc1), in the Changling fault depression of the Songliao basin, constrains their time ranges and compares the origins of volcanic rocks. Zircon populations from K1h yield U-Pb ages of 124–118 Ma; those from K1yc1 yield younger ones (115–106 Ma). Different volcanic rocks are identified in K1h (alkaline basic rocks, calc-alkaline intermediate-acid rocks) and K1yc1 (alkaline basic rocks, A-type rhyolites), and their geochemistry and isotope characteristics confirm their different origins. The alkaline basic rocks from K1h have the similar magma source as those from K1yc1; both formed under within-plate conditions from an ocean island basalt (OIB)-type mantle source, assumed to be the heterogeneous shallow asthenosphere. The calc-alkaline intermediate-acid volcanic rocks from K1h formed by fractional crystallization of magma, related to the enriched lithospheric mantle, whereas the A-type rhyolites from K1yc1 directly originated from the partial melting of crust newly formed from the depleted mantle. The development of alkaline basic rocks and A-type acid rocks, a typical bimodal volcanic assemblage in K1yc1, requires a relatively thin lithosphere and thus implies that lithospheric thinning reached its maximum during this time (115–106 Ma). However, the rare expression of alkaline basic rocks and the formation of acid rocks mainly by fractional crystallization in K1h indicate that the lithosphere was relatively thick; during this time (124–118 Ma), the lithosphere below the Songliao Basin had just begun thinning. These different stages of lithospheric extension may be due to the intermittent rollback of the Palaeo-Pacific Plate. [ABSTRACT FROM AUTHOR]

Background: There was no consistent evidence of whether perioperative blood transfusion (PBT) affects the long-term survival of gastric cancer (GC) patients after undergoing gastrectomy. This study aimed to investigate the effects of PBT on the long-term survival of GC patients, as well as to determine the threshold of PBT and provide evidence for future surgical practice., Methods: We performed this real-world study of GC patients undergoing gastrectomy at China National Cancer Center from January 1, 2000 to December 30, 2019. Overall survival (OS) curves were plotted using the Kaplan-Meier method and compared statistically using the log-rank test. Univariate and multivariate Cox proportional hazard models were used to determine the risk factors for OS., Results: In total, 13 470 GC patients undergoing gastrectomy from 2000 to 2019 were included, of whom 3465 (34.6%) GC patients received PBT. PBT ratios declined from 29.1% (114/392) in 2000 to 11.2% in 2019 (149/1178), with the highest blood transfusion ratio in 2005 at 43.7% (220/504). For patients transfused with red blood cells, the median value of hemoglobin (Hb) before transfusion in the PBT group decreased from 110 g/l in 2000 to 87 g/l in 2019. Compared with patients who not receiving PBT, PBT group are more likely to be older (≥65, 39.1% vs. 30.1%, P <0.001), open operation (89.7% vs. 78.1%, P <0.001), higher American Society of Anesthesiologists score (>2, 25.3% vs. 14.9%, P <0.001) and in the later pTNM stage (pTNM stage III, 68.5% vs. 51.5%, P <0.001). Results of multivariable Cox regression analysis showed that PBT was an independent prognostic factor for worse OS in GC patients undergoing gastrectomy [HR=1.106, 95% confidence interval (CI): 1.01-1.211, P =0.03). After stratified according to tumor stage, we found that PBT group had a worse prognosis only in pTNM stage III (HR=1.197, 95% CI: 1.119-1.281, P <0.001). OS was obviously poor in the PBT group when Hb levels were higher than 90 g/l (90 g/l120 g/l: HR=1.207, 95% CI: 1.098-1.327, P <0.001), while there was no difference between the two groups when Hb levels were lower than or equal to 90 g/l (Hb≤90 g/l: HR=1.162, 95% CI: 0.985-1.370, P =0.075)., Conclusion: In conclusion, PBT was an independent prognostic factor for worse OS. Blood transfusion might not be recommended for GC patients with perioperative minimum Hb values higher than 90 g/l., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

Background: Human epidermal growth factor receptor 2 (HER2) is a well-developed therapeutic target in breast and gastric cancer (GC). However, the impact of HER2 on survival and benefit from fluorouracil-based adjuvant chemotherapy remains unclear in patients with GC., Materials and Methods: This multicenter cohort study involved 5622 consecutive stage II/III GC patients. HER2 expression was assessed prospectively via immunohistochemistry (IHC). The staining intensity was graded on a scale of 0 to 3+. An IHC score of 2+or 3+was defined as high expression, and a score of 3+was defined as overexpression., Results: HER2 overexpression was independently associated with a lower 5-year overall survival (OS) in stage II [hazard ratio (HR), 2.10; 95% CI: 1.41-3.11], but not in stage III GC (HR, 1.00; 95% CI, 0.82-1.20). Further analysis revealed that stage II patients with high HER2 expression showed a poorer response to chemotherapy than stage II patients with low HER2 expression ( Pinteraction =0.024). The HRs for 5-year OS were 0.51 (95% CI, 0.38-0.70) for stage II patients with low HER2 expression, 0.58 (95% CI, 0.51-0.66) for stage III patients with low HER2 expression, 1.13 (95% CI, 0.61-2.09) for stage II patients with high HER2 expression, and 0.47 (95% CI, 0.36-0.61) for stage III patients with high HER2 expression., Conclusions: Fluorouracil-based adjuvant chemotherapy is insufficient for stage II GC patients with high HER2 expression, indicating that prospective trials are required to validate alternative HER2-targeted adjuvant therapies in the individuals above., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)