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Abstract Background To elucidate the relationship between the triglyceride-glycemic index (TyG) and clinical characteristics of pancreatic ductal adenocarcinoma (PDAC). Methods A total of 1,594 individuals diagnosed with pancreatic and periampullary neoplasms were categorized into four groups: PDAC-early (n = 403), locally advanced PDAC (LAPC, n = 315), PDAC-late with distant metastasis (n = 371), and other tumor types (n = 505). TyG-high was defined as a TyG index greater than 8.81 in males and 8.73 in females. Results The prevalence of TyG-high status was highest in PDAC-early (68.48%), followed by LAPC (53.33%), and lowest in PDAC-late (44.47%). TyG-high status significantly predicted worse PDAC prognosis (P = 0.0166), particularly in PDAC-late (P = 0.0420). Despite similar blood glucose levels across PDAC groups (P = 0.897), PDAC-early patients showed significantly higher rates of glycemic disturbances (56.33% vs. 32.28%) and TyG-high status (68.48% vs. 47.13%) compared to those with other tumors. Progressive increases in glycemic disturbances and TyG-high status were observed from benign to pre-malignant lesions and PDAC-early. PDAC-early patients at the pancreatic head exhibited higher rates of glycemic disturbances (58.12% vs. 33.33%, P

Abstract Background Good food safety practices are essential to minimizing foodborne diseases. The present study explored the food safety-related practices of residents during the COVID-19 pandemic in Southwest China and identified the impacting factors. Methods Residents aged 18–75 years from Guizhou, Yunnan, Sichuan, and Chongqing, China, were included in our study. The convenience sampling method was used to select participants, and face-to-face surveys were conducted in households and communities to collect data. Descriptive statistics including sociodemographic characteristics of respondents and weighted percentages were obtained and the log-binomial regression was used to evaluate the influencing factors associated with food safety-related practices. Results Overall, 7,848 respondents were involved, with 97.5% efficacy. Disparities in food safety-related practices were observed between males and females, with the former performing poorer practices than the latter (70.5% vs. 68.0%, respectively). Notably, paying attention to nutrition labels when shopping for prepackaged foods was the worst practice. Age, ethnicity, region, occupation, education level, and income were identified as significant determinants of food safety-related practices. Moreover, in comparison to males, females were more likely to acquire pertinent knowledge from diverse sources, including social media, family members/ friends, books/ newspapers/ magazines, experts, and food sales staff (p

Abstract Objective The global epidemic of overweight/obesity in children and adolescents poses a significant public health threat. This longitudinal study aims to investigate the relationship between adolescents’ and their parents’ dietary knowledge and overweight/obesity among adolescents in China. Methods Data were collected from the China Health and Nutrition Survey (CHNS) in 2004, 2006, 2009, 2011 and 2015. Overweight/obesity was defined according to the International Obesity Task Force (IOTF) cut-off for body mass index (BMI). A set of questions were used to assess the dietary knowledge scores of both adolescents and their parents during face-to-face interviews. Mixed effect models were used to analyze the data. Results A total of 2035 adolescents aged 12–17 years were included in the data analysis. The mean BMI increased from 19.2 in 2004 to 20.5 in 2015, with a significant increase in the prevalence of overweight and obesity from 6.8% and 0.5% in 2004 to 15.1% and 7.8% in 2015, respectively. Adolescents with medium-score dietary knowledge were less likely to be overweight/obese compared to those with low-score dietary knowledge (OR (95% CI): 0.20 (0.05–0.80), P 0.05). Additionally, a significant interaction between adolescents’ dietary knowledge score and education in relation to adolescents’ BMI (P for interaction

Abstract Background Ampullary adenocarcinoma (AAC) arises from the ampulla of Vater where the pancreatic duct and bile duct join and empty into the duodenum. It can be classified into intestinal and pancreatobiliary types based on histopathology or immunohistochemistry. However, there are no biomarkers for further classification of pancreatobiliary-type AAC which has important implications for its treatment. We aimed to identify the tumor origin of pancreatobiliary-type AAC by systematically analyzing whole-slide images (WSIs), survival data, and genome sequencing data collected from multiple centers. Methods This study involved three experiments. First, we extracted quantitative and highly interpretable features from the tumor region in WSIs and constructed a histologic classifier to differentiate between pancreatic adenocarcinoma (PAC) and cholangiocarcinoma. The histologic classifier was then applied to patients with pancreatobiliary-type AAC to infer the tumor origin. Secondly, we compared the overall survival of patients with pancreatobiliary-type AAC stratified by the adjuvant chemotherapy regimens designed for PAC or cholangiocarcinoma. Finally, we compared the mutation landscape of pancreatobiliary-type AAC with those of PAC and cholangiocarcinoma. Results The histologic classifier accurately classified PAC and cholangiocarcinoma in both the internal and external validation sets (AUC > 0.99). All pancreatobiliary-type AACs (n = 45) were classified as PAC. The patients with pancreatobiliary-type AAC receiving regimens designed for PAC showed more favorable overall survival than those receiving regimens designed for cholangiocarcinoma in a multivariable Cox regression (hazard ratio = 7.24, 95% confidence interval: 1.28–40.78, P = 0.025). The results of mutation analysis showed that the mutation landscape of AAC was very similar to that of PAC but distinct from that of cholangiocarcinoma. Conclusions This multi-center study provides compelling evidence that pancreatobiliary-type AAC resembles PAC instead of cholangiocarcinoma in different aspects, which can guide the treatment selection and clinical trials planning for pancreatobiliary-type AAC.

Abstract Background Growing evidence indicates that the systemic inflammatory response plays an important role in cancer development and progression. Several inflammatory markers have been reported to be associated with clinical outcomes in patients with various types of cancer. This study was designed to evaluate the prognostic value of inflammatory indexes in patients with ampullary cancer (AC) who underwent pancreaticoduodenectomy (PD). Methods We retrospectively reviewed the data of 358 patients with AC who underwent PD between 2009 and 2018. R software was used to compare the area under the time-dependent receiver operating characteristic (ROC) curves (AUROCs) of the inflammation-based indexes, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), modified Glasgow Prognostic Score (mGPS), prognostic nutritional index (PNI) and prognostic index (PI), in terms of their predictive value for survival. The survival differences of these indexes were compared by the Kaplan-Meier method and univariate and multivariate analyses were performed to determine the prognostic factors of disease-free survival (DFS) and overall survival (OS). Results The estimated 1-, 2-, and 3-year OS and DFS rates were 83.9, 65.8, and 55.2% and 58.0, 42.8, and 37.8%, respectively, for the entire cohort. The survival differences were significant in terms of OS and DFS when patients were stratified by these inflammation-based indexes. The comparisons of the AUROCs of these inflammation-based indexes illustrated that NLR and PI displayed the highest prognostic value, compared to the other indexes. When NLR and PI were combined, NLR-PI showed even higher AUROC values and was identified as a significant prognostic factor for OS and DFS. Conclusion Specific inflammatory indexes, such as NLR, PLR and dNLR, were found to be able to predict the OS or DFS of patients. As a novel inflammatory index, the level of NLR-PI, which can be regarded as a more useful prognostic index, exhibited strong predictive power for predicting the prognosis of patients with AC after the PD procedure.

An amendment to this paper has been published and can be accessed via the original article.

This article has been retracted. Please see the Retraction Notice for more detail: https://doi.org/10.1186/s13046-018-0681-y.

Abstract Background The prognostic benefits and safety of extended lymphadenectomy for hilar cholangiocarcinoma remain uncertain. The available evidence is still insufficient concerning its retrospective aspect. The aim of this study is to explore the clinical effect and safety of extended lymphadenectomy compared to regional lymphadenectomy in patients with hilar cholangiocarcinoma. Methods The Relay-HC trial is a prospective, multicenter, and randomized controlled trial. Seven hundred and thirty-four eligible patients with resectable perihilar cholangiocarcinoma across 15 tertiary hospitals in China will be randomly assigned (1:1) to receive either regional lymphadenectomy or extended lymphadenectomy. The primary objective is to determine the overall survival after the two approaches. Secondary objectives of the study include the evaluation of perioperative mortality, postoperative complication, and disease-free survival. This study has been approved by the ethics committee of each participating hospital. Discussion The Relay-HC trial is designed to investigate the prognostic benefits and safety of expanded lymphadenectomy for hilar cholangiocarcinoma. Currently, it has never been investigated in a prospective randomized controlled clinical trial. Trial registration Chinese Clinical Trial Registry (ChiCTR), ChiCTR1800015688. Registered on 15 April 2018.

Abstract Background Locally advanced pancreatic cancer (LAPC) represents more than one third of pancreatic cancers and owns poor survival after the standard chemotherapy. Irreversible electroporation (IRE) is a novel method and has been recently used in LAPC. The aim of this study was to compare the efficacy of IRE and radiotherapy after induction chemotherapy for patients with LAPC. Methods From August 2015 to August 2017, a total of 76 patients with biopsy proven LAPC and who had received IRE or radiotherapy after chemotherapy were included. Thirty-two pairs of patients were selected through propensity score matching (PSM) analysis and the efficacy of two treatments was compared. Results Before PSM analysis, after induction chemotherapy, patients with LAPC benefited more in terms of overall survival (OS) and progression free survival (PFS) from IRE, compared with radiotherapy (2-year OS rates, 53.5% vs 26.9%, p = 0.039; 2-year PFS rates, 28.4% vs 13.3%, p = 0.045). After PSM analysis, the survival benefits of OS and PFS of patients after induction chemotherapy followed by IRE were more obvious than those of patients treated with radiotherapy (2-year OS rates, 53.5% vs 20.7%, p = 0.011; 2-year PFS rates, 28.4% vs 5.6%, p = 0.004). Multivariate Cox regression analysis indicated that IRE after induction chemotherapy was identified as a significant favourable factor for both OS and PFS in both the whole and matched cohort. Conclusions Induction chemotherapy followed by IRE is superior to induction chemotherapy followed by radiotherapy for treating LAPC. A randomized clinical trial comparing the efficacy of IRE and radiotherapy after the induction chemotherapy is therefore considerable.

Abstract Background The prognosis of patients with periampullary adenocarcinoma after pancreatoduodenectomy is diverse and not yet clearly illustrated. The aim of this study was to develop a nomogram to predict individual risk of overall survival (OS) and progression-free survival (PFS) in patients with periampullary adenocarcinoma after pancreatoduodenectomy. Methods A total of 205 patients with periampullary adenocarcinoma after pancreatoduodenectomy were retrospectively included. OS and PFS were evaluated by the Kaplan-Meier method. Two nomograms for predicting OS and PFS were established, and the predictive accuracy was measured by the concordance index (Cindex) and calibration plots. Results Lymph node ratio (LNR), carbohydrate antigen 19–9 (CA19–9) and anatomical location were incorporated into the nomogram for OS prediction and LNR, CA19–9; anatomical location and tumor differentiation were incorporated into the nomogram for PFS prediction. All calibration plots for the probability of OS and PFS fit well. The Cindexes of the nomograms for OS and PFS prediction were 0.678 and 0.68, respectively. The OS and PFS survival times were stratified significantly using the nomogram-predicted survival probabilities. Conclusions The present nomograms for OS and PFS prediction can provide valuable information for tailored decision-making for patients with periampullary adenocarcinoma after pancreatoduodenectomy.

Abstract Background Hepatitis B virus (HBV) plays a critical role in the tumorigenic behavior of human hepatocellular carcinoma (HCC). MicroRNAs (miRNAs) have been reported to participate in HCC development via the regulation of their target genes. However, HBV-modulated miRNAs involved in tumorigenesis remain to be identified. Here, we found that a novel highly expressed miRNA, TLRC-m0008_3p (miR-3928v), may be an important factor that promotes the malignancy of HBV-related HCC. Methods Solexa sequencing was applied to profile miRNAs, and RT-qPCR was used to identify and quantitate miRNAs. We studied miR-3928v function in HCC cell lines by MTT, colony formation, migration/invasion, and vascular mimicry (VM) assays in vitro and by a xenograft tumor model in vivo. Finally, we predicted and verified the target gene of miR-3928v by a reporter assay, studied the function of this target gene, and cloned the promoter of miR-3928v and the transcription factor for use in dual-luciferase reporter assays and EMSAs. Results A variant of miR-3928 (miR-3928v) was identified and found to be highly expressed in HBV (+) HCC tissues. Voltage-dependent anion channel 3 (VDAC3) was validated as a target of miR-3928v and found to mediate the effects of miR-3928v in promoting HCC growth and migration/invasion. Furthermore, HBx protein increased early growth response 1 (EGR1) expression and facilitated its translocation into the nucleus to enhance miR-3928v promoter activity in an NF-κB signaling-dependent manner. Conclusions miR-3928v is induced by HBx through the NF-κB/EGR1 signaling pathway and down-regulates the tumor suppressor gene VDAC3 to accelerate the progression of HCC.

Abstract Background A lot of medical mentions can be extracted from a huge amount of medical texts. In order to make use of these medical mentions, a prerequisite step is to link those medical mentions to a medical domain knowledge base (KB). This linkage of mention to a well-defined, unambiguous KB is a necessary part of the downstream application such as disease diagnosis and prescription of drugs. Such demand becomes more urgent in colloquial and informal situations like online medical consultation, where the medical language is more casual and vaguer. In this article, we propose an unsupervised method to link the Chinese medical symptom mentions to the ICD10 classification in a colloquial background. Methods We propose an unsupervised entity linking model using multi-instance learning (MIL). Our approach builds on a basic unsupervised entity linking method (named BEL), which is an embedding similarity-based EL model in this paper, and uses MIL training paradigm to boost the performance of BEL. First, we construct a dataset from an unlabeled large-scale Chinese medical consultation corpus with the help of BEL. Subsequently, we use a variety of encoders to obtain the representations of mention-context and the ICD10 entities. Then the representations are fed into a ranking network to score candidate entities. Results We evaluate the proposed model on the test dataset annotated by professional doctors. The evaluation results show that our method achieves 60.34% accuracy, exceeding the fundamental BEL by 1.72%. Conclusions We propose an unsupervised entity linking method to the entity linking in the medical domain, using MIL training manner. We annotate a test set for evaluation. The experimental results show that our model behaves better than the fundamental model BEL, and provides an insight for future research.

Abstract Background Knowledge graphs (KGs), especially medical knowledge graphs, are often significantly incomplete, so it necessitating a demand for medical knowledge graph completion (MedKGC). MedKGC can find new facts based on the existed knowledge in the KGs. The path-based knowledge reasoning algorithm is one of the most important approaches to this task. This type of method has received great attention in recent years because of its high performance and interpretability. In fact, traditional methods such as path ranking algorithm take the paths between an entity pair as atomic features. However, the medical KGs are very sparse, which makes it difficult to model effective semantic representation for extremely sparse path features. The sparsity in the medical KGs is mainly reflected in the long-tailed distribution of entities and paths. Previous methods merely consider the context structure in the paths of knowledge graph and ignore the textual semantics of the symbols in the path. Therefore, their performance cannot be further improved due to the two aspects of entity sparseness and path sparseness. Methods To address the above issues, this paper proposes two novel path-based reasoning methods to solve the sparsity issues of entity and path respectively, which adopts the textual semantic information of entities and paths for MedKGC. By using the pre-trained model BERT, combining the textual semantic representations of the entities and the relationships, we model the task of symbolic reasoning in the medical KG as a numerical computing issue in textual semantic representation. Results Experiments results on the publicly authoritative Chinese symptom knowledge graph demonstrated that the proposed method is significantly better than the state-of-the-art path-based knowledge graph reasoning methods, and the average performance is improved by 5.83% for all relations. Conclusions In this paper, we propose two new knowledge graph reasoning algorithms, which adopt textual semantic information of entities and paths and can effectively alleviate the sparsity problem of entities and paths in the MedKGC. As far as we know, it is the first method to use pre-trained language models and text path representations for medical knowledge reasoning. Our method can complete the impaired symptom knowledge graph in an interpretable way, and it outperforms the state-of-the-art path-based reasoning methods.

Abstract Background The number grain per panicle of rice is an important phenotypic trait and a significant index for variety screening and cultivation management. The methods that are currently used to count the number of grains per panicle are manually conducted, making them labor intensive and time consuming. Existing image-based grain counting methods had difficulty in separating overlapped grains. Results In this study, we aimed to develop an image analysis-based method to quickly quantify the number of rice grains per panicle. We compared the counting accuracy of several methods among different image acquisition devices and multiple panicle shapes on both Indica and Japonica subspecies of rice. The linear regression model developed in this study had a grain counting accuracy greater than 96% and 97% for Japonica and Indica rice, respectively. Moreover, while the deep learning model that we used was more time consuming than the linear regression model, the average counting accuracy was greater than 99%. Conclusions We developed a rice grain counting method that accurately counts the number of grains on a detached panicle, and believe this method can be a huge asset for guiding the development of high throughput methods for counting the grain number per panicle in other crops.