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Background It remains unclear whether intensification of the chemotherapy backbone in tandem with an anti-EGFR can confer superior clinical outcomes in a cohort of RAS/BRAF wild-type colorectal cancer (CRC) patients with initially unresectable colorectal liver metastases (CRLM). To that end, we sought to comparatively evaluate the efficacy and safety of cetuximab plus FOLFOXIRI (triplet arm) versus cetuximab plus FOLFOX (doublet arm) as a conversion regimen (i.e., unresectable to resectable) in CRC patients with unresectable CRLM. Methods and findings This open-label, randomized clinical trial was conducted from April 2018 to December 2022 in 7 medical centers across China, enrolling 146 RAS/BRAF wild-type CRC patients with initially unresectable CRLM. A stratified blocked randomization method was utilized to assign patients (1:1) to either the cetuximab plus FOLFOXIRI (n = 72) or cetuximab plus FOLFOX (n = 74) treatment arms. Stratification factors were tumor location (left versus right) and resectability (technically unresectable versus [greater than or equal to]5 metastases). The primary outcome was the objective response rate (ORR). Secondary outcomes included the median depth of tumor response (DpR), early tumor shrinkage (ETS), R0 resection rate, progression-free survival (PFS), overall survival (not mature at the time of analysis), and safety profile. Radiological tumor evaluations were conducted by radiologists blinded to the group allocation. Primary efficacy analyses were conducted based on the intention-to-treat population, while safety analyses were performed on patients who received at least 1 line of chemotherapy. A total of 14 patients (9.6%) were lost to follow-up (9 in the doublet arm and 5 in the triplet arm). The ORR was comparable following adjustment for stratification factors, with 84.7% versus 79.7% in the triplet and doublet arms, respectively (odds ratio [OR] 0.70; 95% confidence intervals [CI] [0.30, 1.67], Chi-square p = 0.42). Moreover, the ETS rate showed no significant difference between the triplet and doublet arms (80.6% (58/72) versus 77.0% (57/74), OR 0.82, 95% CI [0.37, 1.83], Chi-square p = 0.63). Although median DpR was higher in the triplet therapy group (59.6%, interquartile range [IQR], [50.0, 69.7] versus 55.0%, IQR [42.8, 63.8], Mann-Whitney p = 0.039), the R0/R1 resection rate with or without radiofrequency ablation/stereotactic body radiation therapy was comparable with 54.2% (39/72) of patients in the triplet arm versus 52.7% (39/74) in the doublet arm. At a median follow-up of 26.2 months (IQR [12.8, 40.5]), the median PFS was 11.8 months in the triplet arm versus 13.4 months in the doublet arm (hazard ratio [HR] 0.74, 95% CI [0.50, 1.11], Log-rank p = 0.14). Grade [greater than or equal to] 3 events were reported in 47.2% (35/74) of patients in the doublet arm and 55.9% (38/68) of patients in the triplet arm. The triplet arm was associated with a higher incidence of grade [greater than or equal to] 3 neutropenia (44.1% versus 27.0%, p = 0.03) and diarrhea (5.9% versus 0%, p = 0.03). The primary limitations of the study encompass the inherent bias in subjective surgical decisions regarding resection feasibility, as well as the lack of a centralized assessment for ORR and resection. Conclusions The combination of cetuximab with FOLFOXIRI did not significantly improve ORR compared to cetuximab plus FOLFOX. Despite achieving an enhanced DpR, this improvement did not translate into improved R0 resection rates or PFS. Moreover, the triplet arm was associated with an increase in treatment-related toxicity. Trial Registration ClinicalTrials.gov Identifier: NCT03493048., Author(s): De-Shen Wang 1, Chao Ren 1, Shan-Shan Li 2, William Pat Fong 1, Xiao-Jun Wu 3, Jian Xiao 2,4, Bin-Kui Li 5, Yun Zheng 5, Pei-Rong Ding 3, Gong [...]

Objective: To realize the rapid traceability detection of Astragalus membranaceus from different origins. Methods: This study proposed a rapid detection method for the origin of Astragalus membranaceus based on the improved MobileNetv3 network based on the combination of electronic tongue and electronic eye. The electronic tongue and electronic eye were used to collect the one-dimensional fingerprint and two-dimensional appearance image information of different samples of Astragalus membranaceus. The Gramian Angular Field (GAF) was used to convert the one-dimensional electronic tongue signal into two-dimensional image information, retain the time series related features in the electronic tongue signal, and then fused them with the image information collected by the electronic eye. Finally, the MobileNetv3 model improved based on Pyramid Split Attention (PSA) was adopted to realize the classification and recognition of Astragalus samples from different habitats. Results: The experimental results showed that the method in this paper had higher recognition accuracy than using electronic tongue or electronic eye alone. The accuracy, precision, rrecall and F1-score of the test set were 98.8%, 98.8%, 98.8% and 0.99, respectively. The classification accuracy of the improved MobileNetv3 network was 8% higher than that of the original model, and the parameter quantity was only about 1/5 of the original parameter quantity. Conclusion: The improved MobileNetv3 network can effectively reduce the calculation of parameters and improve the recognition accuracy of Astragalus membranaceus from different origins.

The aim of this study was to investigate the clinicopathological features and differential diagnosis of gastric pleomorphic giant cell carcinoma. Histopathology, immunohistochemistry, and human epidermal growth factor receptor 2 (HER2) gene testing were conducted for seven cases of gastric pleomorphic giant cell carcinoma. In histomorphological terms, all seven cases involved pleomorphic giant cell carcinoma, accounting for more than 10% of the entire tumor, with pleomorphic spindle cells and giant cells mixed with various histomorphological structures of adenocarcinoma with high, intermediate, and low differentiation. There was large heterogeneity in the HER2 protein expression and HER2 gene amplification in the gastric pleomorphic giant cell carcinoma, and both levels of HER2 were focal in three cases, accounting for 42.9% (3/7). The mismatch repair gene proteins MLH1, MSH2, PMS2, and MSH6 were positive. Routine immunohistochemical markers, i.e., pan-cytokeratin, epithelial membrane antigen, villin, caudal-type homeobox 2, E-cadherin, and p53, were positive in the gastric pleomorphic giant cell carcinoma, while vimentin, calponin, smooth muscle actin, nestin, S-100, cluster of differentiation (CD) 99, desmin, and CD34 were focally expressed in both the spindle and the giant cells, with Ki-67-positive cells accounting for 70–80%. Gastric pleomorphic giant cell carcinoma presents multiple histomorphological features and is easily confused with various tumors. Clarifying the histopathological features of this type of tumor is important for differential diagnosis and precise treatment.

Objective: In order to solve the problem that temperature change during drying can detect the moisture content of Camellia oleifera seeds by visible/near infrared spectroscopy, a temperature modified Camellia oleifera seed moisture content detection model was proposed. Methods: Drying experiments were carried out at different temperatures （50，60，70 ℃） to collect spectral data. By acquiring the spectral data collected at different temperatures, the reasons why the temperature affected the spectrum were analyzed. Then, by comparing the three spectral preprocessing methods, using the Competitive Adaptive Reweighting （CARS） and Partial Least Squares Regression （PLSR） were used to establish the benchmark PLSR model at 60 ℃. Finally, the slope/bias method was used to correct the predicted values of external samples at 50 ℃ and 70 ℃, which greatly improved the precision and accuracy. Results: The coefficients of determination before and after correction at the two temperatures were 0.729 and 0.848, 0.763 and 0.862, respectively. The relative analytical error RPD values were 1.921 and 2.565, 2.054 and 2.692, respectively. Conclusion: The modified model could effectively improve the prediction accuracy, achieve good prediction effect, overcome the influence of temperature, and provide a new method to eliminate the influence of temperature when detecting the oil Camellia oleifera seed moisture content by visible/near infrared spectroscopy in the drying field.

The harsh marine corrosive environment has gradually become the key factor causing serious corrosion problems of offshore platform equipment and impeding the development and utilization of oil and gas resources. For comprehensively studying the corrosion factors and laws of offshore platform facilities and proposing a scientific and effective corrosion control method, accelerated laboratory simulation experiments were carried out, and weight loss and electrochemical methods were used to study the corrosion laws and mechanisms of offshore facilities. On this basis, a coating system for the protection of offshore facilities was designed and evaluated. The research results could provide reference for the corrosion analysis and the anti - corrosion coating system design and performance evaluation for marine environment.