Hepatic angiosarcoma arising in an adult mesenchymal hamartoma

The histogenesis of the hepatic sarcoma and its association with hamartoma is not well understood. We hereby present a Chinese patient with hepatic angiosarcoma arising from an adult mesenchymal hamartoma of liver. A 33-yr-old woman was diagnosed hepatic hamartoma eight years ago and presented with epigastric distention recently. Now she was admitted to our hospital with some unusual features: (a) this patient was diagnosed in mid-twenties, (b) the tumor occupied the whole liver and most importantly (c) the hepatic angiosarcoma appeared 8 years after the diagnosis of hamartoma. Based on this case and some reports, hepatic hamartoma may develop to hepatic angiosarcoma

Satisfactory short-term outcomes of totally laparoscopic ileostomy reversal compared to open surgery in colorectal cancer patients

BackgroundRecently, totally laparoscopic (TLAP) surgery has suggested its potential on ileostomy reversal. This study aimed to compare the short-term outcomes between TLAP and traditional open ileostomy reversal.Patients and methodsFrom September 2016 to September 2021, 107 eligible patients underwent TLAP (n = 48) or open (n = 59) loop ileostomy reversal were retrospectively enrolled. Surgical parameters, postoperative recovery and complications were identified and compared between TLAP technique vs. open surgery.ResultsThe operation time and estimated blood loss showed no obvious difference between TLAP and open group. However, TLAP reversal significantly decreased the incision length (4.5cm vs. 6cm, P < 0.001). Furthermore, patients underwent TLAP surgery showed quicker first ground activities (1 day vs. 2 days, P < 0.001), faster first flatus passage (2 days vs. 3 days, P = 0.004) and shorter postoperative stay (5 days vs. 7 days, P = 0.007). More importantly, postoperative complications were significantly reduced after TLAP reversal (3 cases vs. 10 cases, P = 0.026). Further logistic regression analyses also indicated the TLAP technique was associated with lower incidence of complications (OR=3.316, CI, 1.118–9.835; P = 0.031).ConclusionsTLAP surgery is competitive in promoting postoperative recovery as well as reducing complications compared to the traditional open ileostomy reversal

Exosomes as a tumor immune escape mechanism: possible therapeutic implications

Advances in cancer therapy have been substantial in terms of molecular understanding of disease mechanisms, however these advances have not translated into increased survival in the majority of cancer types. One unsolved problem in current cancer therapeutics is the substantial immune suppression seen in patients. Conventionally, investigations in this area have focused on antigen-nonspecific immune suppressive molecules such as cytokines and T cell apoptosis inducing molecules such as Fas ligand. More recently, studies have demonstrated nanovesicle particles termed exosomes are involved not only in stimulation but also inhibition of immunity in physiological conditions. Interestingly, exosomes secreted by cancer cells have been demonstrated to express tumor antigens, as well as immune suppressive molecules such as PD-1L and FasL. Concentrations of exosomes from plasma of cancer patients have been associated with spontaneous T cell apoptosis, which is associated in some situations with shortened survival. In this paper we place the "exosome-immune suppression" concept in perspective of other tumor immune evasion mechanisms. We conclude by discussing a novel therapeutic approach to cancer immune suppression by extracorporeal removal of exosomes using hollow fiber filtration technolog

Pushing the Limits of Machine Design: Automated CPU Design with AI

Design activity -- constructing an artifact description satisfying given goals and constraints -- distinguishes humanity from other animals and traditional machines, and endowing machines with design abilities at the human level or beyond has been a long-term pursuit. Though machines have already demonstrated their abilities in designing new materials, proteins, and computer programs with advanced artificial intelligence (AI) techniques, the search space for designing such objects is relatively small, and thus, "Can machines design like humans?" remains an open question. To explore the boundary of machine design, here we present a new AI approach to automatically design a central processing unit (CPU), the brain of a computer, and one of the world's most intricate devices humanity have ever designed. This approach generates the circuit logic, which is represented by a graph structure called Binary Speculation Diagram (BSD), of the CPU design from only external input-output observations instead of formal program code. During the generation of BSD, Monte Carlo-based expansion and the distance of Boolean functions are used to guarantee accuracy and efficiency, respectively. By efficiently exploring a search space of unprecedented size 10^{10^{540}}, which is the largest one of all machine-designed objects to our best knowledge, and thus pushing the limits of machine design, our approach generates an industrial-scale RISC-V CPU within only 5 hours. The taped-out CPU successfully runs the Linux operating system and performs comparably against the human-designed Intel 80486SX CPU. In addition to learning the world's first CPU only from input-output observations, which may reform the semiconductor industry by significantly reducing the design cycle, our approach even autonomously discovers human knowledge of the von Neumann architecture.Comment: 28 page