chow 1* cancer-related mortality of solid tumors remains the major cause of death worldwide. circulating tumor DNA (ctDNA) released from cancer cells harbors specific somatic mutations. Sequencing ctDNA opens opportunities to non-invasive population screening and lays foundations for personalized therapy. in this study, two commercially available platforms, Roche's Avenio ctDNA Expanded panel and QIAgen's QIAseq Human Comprehensive Cancer panel were compared for (1) panel coverage of clinically relevant variants; (2) target enrichment specificity and sequencing performance; (3) the sensitivity; (4) concordance and (5) sequencing coverage using the same human blood sample with ultra-deep next-generation sequencing. Our finding suggests that Avenio detected somatic mutations in common cancers in over 70% of patients while QIAseq covered nearly 90% with a higher average number of variants per patient (Avenio: 3; QIAseq: 8 variants per patient). Both panels demonstrated similar ontarget rate and percentage of reads mapped. However, Avenio had more uniform sequencing coverage across regions with different GC content. Avenio had a higher sensitivity and concordance compared with QIAseq at the same sequencing depth. This study identifies a unique niche for the application of each of the panel and allows the scientific community to make an informed decision on the technologies to meet research or application needs. Cancer is the second leading cause of death worldwide. Cancer-related mortality of most solid tumors remains steady despite intense research on carcinogenesis and significant advancement in effective treatments. It is estimated that 1 in every 6 deaths is related to cancer and late-stage presentation is still very common 1. For cervical and colorectal cancers, population-wide screenings have contributed to the decreasing mortality 2. However, there is still an urgent need for accurate, effective and non-invasive paradigms to reduce cancer-related mortality for other common and deadly cancer types via early diagnosis, personalized therapeutic strategies and disease monitoring. Circulating cell-free DNA (cfDNA) is released into the peripheral blood due to apoptosis, necrosis or active release 3-5. Higher cfDNA level is found in the plasma of cancer patients comparing to healthy controls 6,7. Circulating tumor DNA (ctDNA) from cancer cells harboring a unique set of genetic and epigenetic alterations creates a biological signature. This mutation signature is not only specific to cancer in general when compared to normal tissues but is also highly individual specific 3,8,9. The level of ctDNA, somatic mutations burden, the mutation signature and epigenetic marks are highly correlated with cancer pathophysiology and treatment response 3,10. Unlike traditional biopsy, profiling of somatic mutations via ctDNA is not only minimally invasive but also provides a less localized and biased sampling. Profiling of ctDNA, released from various cells in the tumor, allows a snapshot of somatic mutation burden to provide a more ...

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Background: Colonic self-expandable metal stents (SEMSs) are usually placed through an endoscope under fluoroscopic guidance. In this retrospective study, we measured the safety and efficacy of through-the-scope colonic stent placement without fluoroscopic guidance. Materials and Methods: We included consecutive patients with malignant colonic obstruction who underwent SEMS placement through the endoscope without fluoroscopic guidance (NF group) from 2016 to June 2019 in a single tertiary medical center. Technical and clinical success rates and complication rates were compared with those of a historical control group consisting of consecutive patients who underwent stent placement through the endoscope under fluoroscopic guidance (F group) from 2012 to 2015. Results: Of 136 patients analyzed, 67 were in the NF group and 69 were in the F group. For the NF and F groups, technical success rates were 97.0% and 95.7%, respectively (P=0.763); clinical success rates were 92.5% and 89.9%, respectively (P=0.581). Major complications included perforation (NF group, 1.5%; F group, 1.4%), stent migration (NF group, 0; F group, 1.4%), and stent occlusion (NF group, 1.5%; F group, 2.9%) (P=0.425). The median procedure time was significantly lower in the NF group (25.90±18.68 min) than in the F group (44.23±20.40 min) (P<0.001). Conclusions: Colonic SEMS placement without fluoroscopy is as safe and effective as the conventional fluoroscopically guided approach. This new method significantly reduced the procedure time.

Compared with hormone therapy, TCM had the advantages of overall adjustment and less side effects in the treatment of menopausal syndrome. But due to the complex pharmacodynamic composition of Guizhi decoction (GZD), the mechanism of TCM treating diseases was not clear. Network pharmacology could analyze drug action pathways through multi-pathway and multi-target, which provide a new direction for TCM mechanism research. The common targets of GZD and menopausal syndrome (MPS) were obtained by TCMSP and DisGeNET databases. And for the common targets, protein-protein interaction networks were established using the STRING database and analyzed by Gene Ontology and the Kyoto Encyclopedia of Genes and Genomes. (Our research does not require ethical approval). One hundred forty-six active ingredients with 283 targets were obtained from GZD by network pharmacological analysis. Besides, 230 target genes were found to have interactions with MPS, 52 of which were common targets between MPS and GZD and were predicted to be potential targets for MPS treatment of GZD. GO enrichment analysis revealed that GZD could affect 51 biological processes, 15 cellular components, and 13 molecular functions. Kyoto Encyclopedia of Genes and Genomes enrichment analysis yielded a total of 223. The pathways that are closely related to the pathogenesis of MPS are MAPK, PI3K-Akt. In this study, the relevant targets and mechanisms of GZD in the treatment of MPS were discussed from the perspective of network pharmacological analysis, reflecting the characteristics of multi-component, multi-target and multiple pathways, and it provides a good theoretical basis for the clinical application of GZD.