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PDS manifests as an exophytic, asymmetric tumor that is fast growing and often ulcerated and hemorrhagic

Author contributions (I) Conception and design: FZ (II) Administrative support: FZ, FQ, JY (III) Provision of study materials or patients: FZ (IV) Collection and assembly of data: FZ, JY (V) Data analysis and interpretation: FZ, FQ, JY (VI) Manuscript writing: FZ, FQ, JY (VII) Final approval of manuscript: FZ, FQ, JY

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ech-6 encodes an enoyl-CoA hydratase and is proposed to act in branched-chain amino acid catabolism 31 , for example, by catalyzing methacrylyl-CoA to 3-hydroxyisobutyryl-CoA in the valine catabolic pathways 32

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Since in most cases only one treatment is needed, this further reduces the overall cost