Deep muscularis propria tumor invasion without lymph node metastasis as a unique subclassification of stage IB gastric cancer: a retrospective study

BACKGROUND: The prognosis difference based on the depth of tumor muscularis propria invasion in gastric cancer (GC) was still debated, and therapy strategy for stage IB GC patient required further investigation. METHODS: A total of 380 patients with pT2 GC after radical surgery were retrospectively analyzed, including 185 in superficial muscularis propria (sMP) group and 195 in deep muscularis propria (dMP) group. RESULTS: The overall survival (OS) was significantly better for patients in sMP group than for patients in dMP group (P = 0.007). In multivariate analysis, depth of tumor invasion, pN stage, age, primary location, positive expression of p53, elevated maximal LDH, elevated initial CA19-9 and AFP level were independent prognostic factors for OS. The sMP group had a significantly better OS than dMP group (P = 0.014) in pN0 stage. After further stratification, the survival outcomes were not significantly different between deep muscularis propria tumor invasion without lymph node metastasis (dMPN0) group (stage IB) and superficial muscularis propria tumor invasion with stage 1-2 lymph node metastasis (sMPN1-2) group (stage II) (P = 0.100). Patients with adjuvant chemotherapy had a statistically better survival than those without in dMPN0 group (P = 0.045) and dMPN0 patients with adjuvant chemotherapy had better OS than sMPN1-2 patients (P = 0.015). In addition, greater postoperative survival could be observed in sMPN0 patients than dMPN0 patients in p53-positive group (P = 0.002), and similar OS could be seen between dMPN0 patients with p53-positive and T2N1-2 patients (P = 0.872). CONCLUSION: As a unique subclassification of stage IB GC, appropriate adjuvant chemotherapy should be considered for patients with dMPN0 stage. In addition, positive expression of p53, elevated LDH could be potential factors in identifying the different prognoses for stage IB GC patients

A multi-timescale market clearing model considering reserve demand curve

With the advancement of the dual-carbon goal， the integration of a large amount of new energy sources has posed new challenges to power balance of the system. In this context， research on methods for system reserve provision considering both economy and reliability has garnered significant attention. In this regard， a multi-timescale market clearing model considering the reserve demand curve has been constructed， so that the reserve clearing results take account of both economy and reliability. Besides， diverse reserve resources across multiple time scales are considered， allowing for the balance between supply and demand of the reserve under multiple time scales through coordinated interactions among these resources. Finally， it is verified by a case study that the proposed model realizes a rational allocation of reserve， thereby improving the operational economy， safety and reliability of the system

PD‐L1 expression by different scoring methods and different cutoff values and correlation with clinicopathological characteristics in gastric cancer: A retrospective study

Abstract We retrospectively enrolled 325 gastric cancer (GC) patients to investigate the associations of programmed death ligand‐1 (PD‐L1) expression with clinicopathological characteristics by different scoring methods and different cutoff values. PD‐L1 expression was evaluated by the tumor proportion score (TPS) and the combined positive score (CPS). The positive rate of PD‐L1 TPS ≥1%, CPS ≥1, CPS ≥5 and CPS ≥10 in our study were 12.0%, 87.4%, 69.8% and 42.2%, respectively. Multivariate analysis showed that PD‐L1 CPS ≥5 was related to high expression of Ki67 (OR = 2.658, 95% CI: 1.401–5.045, p = .003) and pTNM staging (p = .033). PD‐L1 CPS ≥10 was correlated with larger tumor size (OR = 2.322, 95% CI: 1.052–5.127, p = .037) and lymph node metastasis (OR = 2.495, 95% CI: 1.293–4.814, p = .006). It is expected that these results can provide a reference for screening GC patients with high PD‐L1 expression level

Analysis of Drought Characteristic of Sichuan Province, Southwestern China

Drought is a widespread and destructive natural hazard and is projected to occur more frequently and intensely, with more severe impacts in a changing environment. In this study, we used the standardized precipitation index (SPI) at various time scales (i.e., 3, 6, and 12 months) to provide an overall view of drought conditions across Sichuan Province, southwestern China, from 1961 to 2016. Then, the relationship between the SPI and the soil moisture anomalies was analyzed. Furthermore, the causes of SPI drought from the perspective of large-scale atmospheric circulation were assessed in the study area. The results showed that most stations with decreasing trends were located in the eastern part of Sichuan Province, while most stations with increasing trends were located in the northwestern part, indicating that the eastern region presented a drying trend, while the northwestern part exhibited a wetting trend. The specific analysis focused on extreme drought indicated an increasing occurrence the probability of extreme drought events, which could induce a high potential drought risk in the study area. The SPI values had a strong relationship with the soil moisture anomalies, and the linear correlation coefficients decreased as the time scale increased. This result indicated that SPI3 (3-month SPI) could be regarded as a good predictor of soil moisture drought. The cross wavelet analysis revealed that the Southern Oscillation Index (SOI) had statistically significant correlations with the SPIs in Sichuan Province. The results of this study are useful for assessing the change in local drought events, which will help reduce the losses caused by drought disasters in Sichuan Province