BackgroundOsteosarcoma is the most common primary sarcoma of the bone. Lung osteosarcoma metastases at diagnosis have a significantly poor prognosis, even when surgery plus chemotherapy are performed. Our goal was to analyze clinical and sarcoma characteristics that could help identify factors related to an increased rate of lung metastasis and to identify different modes of treatment and its correlation with survival.Materials and MethodsThe Surveillance, Epidemiology, and End Results (SEER) database was used to identify all osteosarcoma patients diagnosed from 2010 to 2015. Patient characteristics such as age, sex, ethnicity, marital status, tumor location, histologic grade, surgery, chemotherapy, radiation therapy, SEER cause-specific death classification, survival, and lung metastasis were collected. These factors were analyzed using Univariate and multivariate regression models in survival analyses.ResultsA total of 1057 osteosarcoma patients diagnosed from 2010 to 2015 were included, of which 176 were patients with lung metastasis. Substantial disparities in the rate of lung metastasis existed when osteosarcoma patients were stratified according to tumor location (P = 0.0002) and tumor size (P < .001). Using a Multivariate Cox regression model, being older than 30 years (vs. younger than 30, HR = 2.171, 95% CI = 1.623–2.905, P < .0001), having a tumor >5–10 cm (vs. <5 cm, HR = 2.046, 95% CI = 1.153–3.632, P = 0.0014) and >10 cm (vs. <5 cm, HR = 3.610, 95% CI = 2.066–6.310, P < .0001) were related to an increased HR for all-cause death. The HR decreased in patients with surgery (vs. no surgery, HR = 0.189, 95% CI = 0.138–0.260, P < 0.0001) and osteosarcoma. As for osteosarcoma patients with lung metastases, Multivariate Cox regressions revealed that an increased HR was associated with being older than 30 years (vs. younger than 30 years, HR = 2.142, 95% CI = 1.273–3.605, P = .0041) and married (vs. no marriage, HR = 2.418, 95% CI = 1.400–4.176, P= .0015), while a decreased HR was related to having had surgery (vs. no surgery, HR = 0.282, 95% CI = 0.171–0.464, P < .0001) and chemotherapy (vs. no chemotherapy, HR = 0.107, 95% CI = 0.050–0.229, P < .0001).ConclusionsAdvanced age (older than 30 years) and large tumors were related to a higher risk of lung metastases in osteosarcoma patients. Therefore, patients who were diagnosed at advanced age or had large tumors should receive comprehensive chest CT scans. Surgery and chemotherapy can significantly improve the survival of metastatic patients, while radiotherapy did not improve survival in these patients.

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The development of an effective one‐photon excitation pathway to improve the charge‐carrier separation and mobility of semiconductors, which have been proven to be favorable for heterogeneous catalysis, is highly desirable but remains a great challenge. Herein, a high‐throughput one‐photon excitation pathway is reported by constructing 0D carbon dots/3D porous carbon nitride nanovesicles (denoted as CDs/PCN NVs) heterostructures for photocatalytic hydrogen evolution. In particular, the optimum CDs/PCN NVs heterostructures exhibit an impressive performance of 14.022 mmol h−1 g−1, which is 56.54 times higher than that of pristine CN. Detailed characterization reveals that the improved performance is primarily attributed to the high‐throughput and one‐photon excitation pathway. The former could be attributed to a great deal of CDs with high charge‐carrier mobility coupled to PCN NVs, which enable more electrons to be photoexcited via the broad absorption response, and the multiple reflection of incident light owing to the porous nanovesicle structure with shortened route of carriers migrating toward the surface; the latter would lead to the photoinduced holes and electrons accumulated at the valence band of PCN NVs and surface of CDs, respectively, achieving an effective spatial separation. The high‐throughput one‐photon excitation pathway demonstrated here may provide insights into the development of nanocomposites for various related applications.

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Light harvesting is ak ey step in photosynthesis but creation of synthetic light-harvesting systems (LHSs) with high efficiencies has been challenging.W hen donor and acceptor dyes with aggregation-induced emission were trapped within the interior of cross-linked reverse vesicles,L HSs were obtained readily through spontaneous hydrophobically driven aggregation of the dyes in water.A ggregation in the confined nanospace was critical to the energy transfer and the light-harvesting efficiency.T he efficiency of the excitation energy transfer (EET) reached 95 %atadonor/acceptor ratio of 100:1 and the energy transfer was clearly visible even at ad onor/acceptor ratio of 10 000:1. Multicolor emission was achieved simply by tuning the donor/acceptor feed ratio in the preparation and the quantum yield of white light emission from the system was 0.38, the highest reported for organic materials in water to date.

Dysregulation of microRNA expression is involved in several pathological activities associated with gastric cancer progression and chemo-resistance. However, the role and molecular mechanisms of miR-363 in the progression and chemoresistance of gastric cancer remain enigmatic. In this study, we validated that miR-363 expression was higher in gastric cancer tissues than in adjacent normal tissues. Multivariate analysis identifies high levels of miR-363 expression as an independent predictor for postoperative recurrence and lower overall survival. Increased miR-363 expression promotes gastric cancer cell proliferation and chemo-resistance through directly targeting the tumor suppressor F-box and WD repeat domain-containing 7 (FBW7). Clinically, our data reveal that overexpression of miR-363 correlates with the poor survival outcomes in patients with gastric cancer, and docetaxel + cisplatin + 5-FU (DCF) regimen response is impaired in patients with miR-363 overexpression. These data suggest that miR-363 may be a potential therapeutic target for gastric cancer and serve as a biomarker for predicting response to DCF regimen treatment.

BackgroundThe literature comparing private not-for-profit, for-profit, and government providers mostly relies on empirical evidence from high-income and established market economies. Studies from developing and transitional economies remain scarce, especially regarding patient case-mix and quality of care in public and private hospitals, even though countries such as China have expanded a mixed-ownership approach to service delivery. The purpose of this study is to compare the operations and performance of public and private hospitals in Guangdong Province, China, focusing on differences in patient case-mix and quality of care.MethodsWe analyze survey data collected from 362 government-owned and private hospitals in Guangdong Province in 2005, combining mandatorily reported administrative data with a survey instrument designed for this study. We use univariate and multi-variate regression analyses to compare hospital characteristics and to identify factors associated with simple measures of structural quality and patient outcomes.ResultsCompared to private hospitals, government hospitals have a higher average value of total assets, more pieces of expensive medical equipment, more employees, and more physicians (controlling for hospital beds, urban location, insurance network, and university affiliation). Government and for-profit private hospitals do not statistically differ in total staffing, although for-profits have proportionally more support staff and fewer medical professionals. Mortality rates for non-government non-profit and for-profit hospitals do not statistically differ from those of government hospitals of similar size, accreditation level, and patient mix.ConclusionsIn combination with other evidence on health service delivery in China, our results suggest that changes in ownership type alone are unlikely to dramatically improve or harm overall quality. System incentives need to be designed to reward desired hospital performance and protect vulnerable patients, regardless of hospital ownership type.