This paper studies a dual-hop Simultaneous Wireless Information and Power Transfer(SWIPT)-based multi-relay network with a direct link.To achieve high throughput in the network,a novel protocol is first developed,in w...This paper studies a dual-hop Simultaneous Wireless Information and Power Transfer(SWIPT)-based multi-relay network with a direct link.To achieve high throughput in the network,a novel protocol is first developed,in which the network can switch between a direct transmission mode and a Single-Relay-Selection-based Cooperative Transmission(SRS-CT)mode that employs dynamic decode-and-forward relaying accomplished with Rateless Codes(RCs).Then,under this protocol,an optimization problem is formulated to jointly optimize the network operation mode and the resource allocation in the SRS-CT mode.The formulated problem is difficult to solve because not only does the noncausal Channel State Information(CSI)cause the problem to be stochastic,but also the energy state evolution at each relay is complicated by network operation mode decision and resource allocation.Assuming that noncausal CSI is available,the stochastic optimization issue is first to be addressed by solving an involved deterministic optimization problem via dynamic programming,where the complicated energy state evolution issue is addressed by a layered optimization method.Then,based on a finite-state Markov channel model and assuming that CSI statistical properties are known,the stochastic optimization problem is solved by extending the result derived for the noncausal CSI case to the causal CSI case.Finally,a myopic strategy is proposed to achieve a tradeoff between complexity and performance without the knowledge of CSI statistical properties.The simulation results verify that our proposed SRS-and-RC-based design can achieve a maximum of approximately 40%throughput gain over a simple SRS-and-RC-based baseline scheme in SWIPT-based multi-relay networks.展开更多
AIM: To investigate the potential impact of complications in gastric cancer patients who survive the initial postoperative period. METHODS: Between January 1, 2005 and December 31, 2006, 432 patients who received cura...AIM: To investigate the potential impact of complications in gastric cancer patients who survive the initial postoperative period. METHODS: Between January 1, 2005 and December 31, 2006, 432 patients who received curative gastrectomy with D2 lymph node dissection for gastric cancer at our department were studied. Associations between clinicopathological factors [age, sex, American Society of Anesthesiologists grade, body mass index, tumornode-metastases (TNM) stage and tumor grade], including postoperative complications (defined as any deviation from an uneventful postoperative course within 30 d of the operation and survival rates) and treatment-specific factors (blood transfusion, neoadjuvant therapy and duration of surgery). Patients were divided into 2 groups: with (n = 54) or without (n = 378) complications. Survival curves were compared between the groups, and univariate and multivariate models were conducted to identify independent prognostic factors. RESULTS: Among the 432 patients evaluated, 61 com-plications occurred affecting 54 patients (12.50%).Complications included anastomotic leakages, gastric motility disorders, anastomotic block, wound infections, intra-abdominal abscesses, infectious diarrhea, bleeding, bowel obstructions, arrhythmias, angina pectoris, pneumonia, atelectasis, thrombosis, unexplained fever, delirium, ocular fungal infection and multiple organ failure. American Society of Anesthesiologists grade, body mass index, combined organ resection and median duration of operation were associated with higher post-operative complications. The 1-, 3- and 5-year survival rates were 83.3%, 53.2% and 37.5%, respectively. In the univariate analysis, the size of lesions, TNM stage, blood transfusion, lymphovascular invasion, perineural invasion, neoadjuvant chemotherapy, and postoperative complications were significant predictors of overall survival. In the multivariate analysis, only TNM stage and the presence of complications remained significant predictors of reduced survival. CONCLUSION: The occurrence of in-hospital postoperative complications was an independent predictor of worse 5-year overall survival rate after radical resection of gastric cancer.展开更多
AIM:To evaluate the fast-track rehabilitation protocol and laparoscopic surgery(LFT)vs conventional care strategies and laparoscopic surgery(LCC).METHODS:Studies and relevant literature comparing the effects of LFT an...AIM:To evaluate the fast-track rehabilitation protocol and laparoscopic surgery(LFT)vs conventional care strategies and laparoscopic surgery(LCC).METHODS:Studies and relevant literature comparing the effects of LFT and LCC for colorectal malignancy were identified in MEDLINE,the Cochrane Central Register of Controlled Trials and EMBASE.The complications and re-admission after approximately 1 mo were assessed.RESULTS:Six recent randomized controlled trials(RCTs)were included in this meta-analysis,which related to 655 enrolled patients.These studies demonstrated that compared with LCC,LFT has fewer complications and a similar incidence of re-admission after approximately 1 mo.LFT had a pooled RR of 0.60(95%CI:0.46-0.79,P<0.001)compared with a pooled RR of 0.69(95%CI:0.34-1.40,P>0.5)for LCC.CONCLUSION:LFT for colorectal malignancy is safe and efficacious.Larger prospective RCTs should be conducted to further compare the efficacy and safety of this approach.展开更多
AIM: To detect the expression of CD44 correlated with the ability of micro-metastasis in peripheral blood and bone marrow of patients with gastric cancer and to deduce its clinical significance. METHODS: Preoperativ...AIM: To detect the expression of CD44 correlated with the ability of micro-metastasis in peripheral blood and bone marrow of patients with gastric cancer and to deduce its clinical significance. METHODS: Preoperative peripheral blood and bone marrow specimens from 46 patients with gastric cancer and 6 controls were studied by semi-quantitative RTPCR amplification of CD44v6mRNA. Preoperative and postoperative peripheral blood specimens from 40 patients with gastric cancer and 14 controls were studied by quantitative RT-PCR amplification of CD44v6mRNA in the corresponding period. RESULTS: Semi-quantitative RT-PCR amplification showed that CD44v6mRNA expression of peripheral blood and bone marrow was positive in 39 (84.8%) and 40 (86.9%) of 46 patients with gastric cancer, respectively. In peripheral blood, CD44v6mRNA expression was positive for diffuse type in 30 (93.8%) of 32 patients and for intestinal type in 9 (64.3%) of 14 patients. On the other hand, in bone marrow, CD44v6mRNA expression was positive for diffuse type in 31 (96.9%) of 32 patients and for intestinal type in 10 (71.4%) of 14 patients. There was a significant difference between the diffuse type and intestinal type. Quantitative RTopCR amplification demonstrated that CD44v6mRNA was not expressed in the peripheral blood of controls and CD44v6mRNA expression was positive for preoperative peripheral blood in 40 patients with gastric cancer, the expression levels being from 4.9 × 10^2 to 3.2× 10^5 copies/g RNA. The average expression level of CD44v6mRNA in peripheral blood was 3.9 × 10^10 copies/g RNA. The expression levels of CD44v6mRNA in peripheral blood in gastric cancer patients after curative operation increased from 5.5 × 100 to 7.6 × 10 copies/g RNA (P = 0.00496). After curative operation, the expression level decreased markedly. CONCLUSION: Semi-quantitative and quantitative RTPCR amplification for CD44v6mRNA is a sensitive and specific method for the detection of micro-metastasis in peripheral blood and bone marrow, which might be used as an indicator of tumor burden and therapeutic effect.展开更多
AIM: To assess the efficacy and safety of combination therapy based on S-1, a novel oral fluoropyrimidine, vs S-1 monotherapy in advanced gastric cancer (AGC).
BACKGROUND Abdominal pregnancy is a rare type of ectopic pregnancy.We describe here a case of ectopic pregnancy implanted under the surface of the diaphragm,presenting the particular features of imaging findings from ...BACKGROUND Abdominal pregnancy is a rare type of ectopic pregnancy.We describe here a case of ectopic pregnancy implanted under the surface of the diaphragm,presenting the particular features of imaging findings from ultrasound,computed tomography(CT)and magnetic resonance imaging(MRI).CASE SUMMARY A 30-year-old woman presented with complaint of intermittent abdominal pain,that had begun 5 d earlier.She had no current or abnormal vaginal bleeding,and her serum human chorionic gonadotropin level(13372.08 IU/L)indicated pregnancy.Vaginal ultrasound showed a mixed echogenic mass in the right ovary.CT(plain)scan showed a curved high density mass beneath the subhepatic space.MRI scan showed a curved mixed signal,with restricted diffusion beneath the subhepatic space.Abdominal ultrasound demonstrated a mixed echogenic mass in the right lobe of the liver near the apex of the diaphragm,with a visible yolk sac and germ cell region with a bud.Subsequent laparoscopy visualized a dark red mass under the right diaphragm,which was resected completely.Histopathological examination of the resected mass confirmed an ectopic pregnancy.The recovery was swift and uneventful,and the patient was discharged to home.CONCLUSION Ectopic pregnancy should be in the differential diagnostic workup(via multiple imaging modalities)of childbearing woman with unexplained abdominal pain.展开更多
BACKGROUND Papillary thyroid carcinoma(PTC)is the most common endocrine malignancy.Papillary thyroid microcarcinoma(PTMC)accounts for the majority of PTC cases.However,concurrent pulmonary and hepatic metastases of PT...BACKGROUND Papillary thyroid carcinoma(PTC)is the most common endocrine malignancy.Papillary thyroid microcarcinoma(PTMC)accounts for the majority of PTC cases.However,concurrent pulmonary and hepatic metastases of PTMC are rarely seen.Here,we present a patient with coexisting liver and lung metastases from PTMC.CASE SUMMARY We describe a 26-year-old woman with PTMC with multiple concurrent metastases.After 3 d of unexplained fever,she was admitted to our hospital.Her thyroid functional tests were abnormal.Her positron emission tomography(PET)/magnetic resonance imaging(MRI)examination showed increased fluorodeoxyglucose(FDG)metabolism and space-occupying lesions in the left lobe of the thyroid.Additionally,PET/MRI images revealed multiple nodules in the lung and liver with increased FDG metabolism.Chest computer tomography(CT)showed multiple pulmonary metastases.Abdominal ultrasound and liver MRI showed multiple space-occupying lesions in the liver.The patient underwent total thyroidectomy and central lymph node dissection.Postoperative pathological analysis showed a papillary microcarcinoma multiplex in the left lobe of the thyroid.A diagnosis of hepatopulmonary metastases from papillary thyroid microcarcinoma was made.The patient was given iodine-131 treatment one year after the surgery.She recovered well after the operation,and the incision healed well.After discharge,she was treated with oral levothyroxine sodium tablets,and symptomatic and supportive treatments were also given to promote radioactive excretion and prevent bone marrow suppression by iodine-131 treatment.CONCLUSION Since patients with thyroid cancer concurrent with hepatopulmonary metastases have rarely been reported,our case will highlight the clinical and pathological profiles of these patients.展开更多
Black tea is a healthy and popular tea beverage.However,its main bioactive compounds(theaflavins and thearubigins)are not easily absorbed.The aim of this study was to investigate the modulation of intestinal microbiot...Black tea is a healthy and popular tea beverage.However,its main bioactive compounds(theaflavins and thearubigins)are not easily absorbed.The aim of this study was to investigate the modulation of intestinal microbiota by the nonabsorptive components of Keemun black tea(KBT)and Dianhong black tea(DBT),and fructooligosaccharide(FOS)was selected for use in the control group.KBT,DBT,and FOS significantly increased total short-chain acid production.Specifically,FOS treatment predominantly increased the production of acetic acids and black tea treatments increased the production of acetic,propionic,and butyric acids at similar rates.Moreover,FOS exerted a strong bifidogenic effect after 24 h of fermentation;KBT and DBT increased the abundance of the beneficial genus Bacteroides and Roseburia.In summary,the nonabsorptive components of KBT and DBT could serve as novel prebiotics,the underlying mechanisms of which are quite different from those of FOS.展开更多
Gastric cancer is closely related to the stomach microbiota,especially Helicobacter pylori.Numerous reports and clinical studies have shown that microbial behavior in the stomach may lead to pathological changes in th...Gastric cancer is closely related to the stomach microbiota,especially Helicobacter pylori.Numerous reports and clinical studies have shown that microbial behavior in the stomach may lead to pathological changes in the gastrointestinal tract of the host,which ultimately leads to the production and development of gastric cancer.This review outlines the major pathogenic processes of Helicobacter pylori in the stomach,specifically focusing on Cag A,Vac A,inflammatory pathways and oxidative stress.In addition,we describe the effects of some non-Helicobacter pylori factors,such as other microbiota,alcohol,and tobacco,on the carcinogenesis induced by Helicobacter pylori.The effects of family history are also taken into account.We hope that understanding the stomach microbiota will make it possible to more easily prevent,detect and treat gastric cancer.展开更多
BACKGROUND Oncogenic osteomalacia caused by phosphaturic mesenchymal tumors is very difficult to detect.We report a case of tumor-induced osteomalacia caused by a phosphaturic mesenchymal tumor of the left femur in a ...BACKGROUND Oncogenic osteomalacia caused by phosphaturic mesenchymal tumors is very difficult to detect.We report a case of tumor-induced osteomalacia caused by a phosphaturic mesenchymal tumor of the left femur in a middle-aged woman after medical imaging and biopsy.CASE SUMMARY A 57-year-old woman presented with progressive bone pain for five years.She was diagnosed with hypophosphatemic osteomalacia,as her laboratory data showed low serum phosphorus and low serum calcium.Her knee joint radiography revealed an osteolytic lesion of the left femur.A computed tomography scan showed mixed density shadows in the left femur.Magnetic resonance imaging of the left femur showed the presence of an oval area with a hypointense signal in T1-weighted magnetic resonance imaging(MRI)and highlow mixed signal in T2-weighted MRI.Biopsy samples revealed the presence of short spindle cells,vascularization,and characteristics of phosphaturic mesenchymal tumors.Tumor resection was performed,and the clinical presentations and laboratory abnormalities were reversed.CONCLUSION Diagnosis of oncogenic osteomalacia is difficult due to the varieties and localization of source tumors and absence of pathognomonic biomedical signs.Our case highlights the importance of a combination of medical imaging and biopsy in the diagnosis of oncogenic osteomalacia caused by a phosphaturic mesenchymal tumor.展开更多
We theoretically investigate high-order harmonic generation(HHG)in crystals induced by linearly polarized laser fields.We obtain the HHG spectra by solving the semiconductor Bloch equations and analyze the radiation p...We theoretically investigate high-order harmonic generation(HHG)in crystals induced by linearly polarized laser fields.We obtain the HHG spectra by solving the semiconductor Bloch equations and analyze the radiation process by different models.Here we propose a multiple collision model,in which the electrons and holes are produced at different times and places.It is found that the multiple collision trajectories can help us comprehensively and better explain the results of the quantum calculation.Moreover,we find that the harmonic suppression occurs due to the overlap of multiple collision trajectories.展开更多
Diabetes are a group of metabolic disorders characterized by persistent hyperglycemia that is a major public health problem.Middle-aged and elderly people are at the highest risk of type 2 diabetes,but younger cases a...Diabetes are a group of metabolic disorders characterized by persistent hyperglycemia that is a major public health problem.Middle-aged and elderly people are at the highest risk of type 2 diabetes,but younger cases are now being diagnosed with greater frequency.Numerous clinical studies have reported that the behavior of the intestinal microbiota may affect the development of metabolic disorders in humans,including obesity and diabetes.This review describes the relationship between the gut microbiota and diabetes,and discusses the possible mechanisms underlying their involvement in the development of type 1 diabetes,obesity,and type 2 diabetes.By better understanding the intestinal microbiota,it may become possible to treat diabetes and obesity by manipulating the gut microbes through probiotics and dietary changes,fecal microbiota transplantation,or surgical approaches.展开更多
The clearance of lesions during surgery for colorectal cancer encompasses the removal of both the primary tumour and its concomitant lymphatic drainage.Huge strides have been made in identifying the precise location o...The clearance of lesions during surgery for colorectal cancer encompasses the removal of both the primary tumour and its concomitant lymphatic drainage.Huge strides have been made in identifying the precise location of not only the primary tumour,but also the lymph nodes(LNs),owing to the use of intraoperative navigation techniques.Among these techniques,indocyanine green-enhanced fluorescence imaging(ICG-FI)has revolutionized colorectal oncologic surgery by providing clear visualization during lymphangiography.ICG-FI has emerged as a powerful tool for sentinel lymph node procedures that allows for local excision instead of radical D3 lymphadenectomy.It also makes it possible to identify potential metastatic lateral pelvic lymph nodes,which enables simultaneous lymphadenectomy of the pelvic side-wall during the resection of middle-lower rectal cancer.This review provides an update on the current use of and research on ICG-FI-guided LNs mapping for colorectal malignancies,and also discusses its drawbacks and future prospects.展开更多
Objectives To explore the value of performing a modified colonic transit test in the diagnosis of chronic constipation.Methods we retrospectively analyzed the results in 101 patients admitted to the MDT Outpatient Cli...Objectives To explore the value of performing a modified colonic transit test in the diagnosis of chronic constipation.Methods we retrospectively analyzed the results in 101 patients admitted to the MDT Outpatient Clinic of Subei People’s Hospital,Jiangsu Province,China,from July 1,2019,to July 31,2021.Patients were prohibited from using drugs and stimulant foods that could affect bowel motility for three days before and during the examination.We performed two abdominal X-rays at 6 and 72 hours after oral ingestion of the barium suspension to observe the residual condition of barium in the patient's colon.We then gave specific treatments based on the different types of constipation detected in the patients.Results Compared with patients with normal transit,patients with slow transit(P<0.001)and patients with rectal evacuation disorders had a significantly reduced stool frequency(P<0.05).The kappa coefficient of the modified colonic transit test compared to anorectal manometry in the diagnosis of functional defecation disorders(FDDs)was 0.649,indicating substantial consistency between the two methods.Conclusion The modified colonic transit test not only assesses colonic transit function and provides an initial determination of the type of constipation,but also shows the colon morphology,providing a reference for possible subsequent treatments.展开更多
Objective In this meta-analysis,we analyzed the risk factors for gallstone formation after gastric cancer surgery.Methods Relevant studies published from 1990 to 2017 were retrieved from the PubMed,Embase,Medline,Web ...Objective In this meta-analysis,we analyzed the risk factors for gallstone formation after gastric cancer surgery.Methods Relevant studies published from 1990 to 2017 were retrieved from the PubMed,Embase,Medline,Web of Science,Cochrane Library,Springer Link,Chinese Biomedical Literature,and Wanfang databases.We performed a meta-analysis to determine the odds ratio and 95%confidence interval(95%CI).Results Nineteen studies were included in the meta-analysis:four randomized controlled trials(RCTs),10 case-control studies,and five cohort studies.The 19 studies included 32 to 16,045 patients.The pooled OR(95%CI)and P-values of the OR(95%CI)were 1.89(1.25,2.86)(P=0.003)for gastric resection,0.22(0.12,0.40)(P<0.00001)for vagus nerve retention,1.73(1.45,2.06)(P<0.00001)for digestive tract reconstruction,0.80(0.54,1.17)(P=0.25)for pylorus-preserving gastrectomy,0.59(0.33,1.04)(P=0.07)for the degree of lymph node dissection,1.98(0.50,7.86)(P=0.33)for D12 lymph node dissection,and 1.33(1.15,1.54)(P<0.0001)for diabetes.Conclusions Our findings indicate that partial gastrectomy,vagus nerve preservation,and physiological digestive tract reconstruction can reduce the incidence of gallstones after gastrectomy.Diabetes is a contributory factor to gallstone formation.There was no significant difference in the incidence of gallstones based on pylorus preservation/non-preservation,the degree of lymph node dissection,or D12 lymph node dissection.This is the first meta-analysis to comprehensively analyze the risk factors for gallstone formation after gastric cancer surgery.We investigated the risk associated with gastric resection,vagus nerve retention,digestive tract reconstruction,PPG,the degree of lymph node dissection,D12 lymph node dissection,and diabetes.展开更多
It has been proposed that the intestinal microbiota and gastrointestinal tumors are interdependent.Changes in the microbiota can cause dysfunction of the gastrointestinal tract,thereby promoting carcinogenic changes,l...It has been proposed that the intestinal microbiota and gastrointestinal tumors are interdependent.Changes in the microbiota can cause dysfunction of the gastrointestinal tract,thereby promoting carcinogenic changes,leading to the occurrence of gastrointestinal tumors.Recent studies on intestinal microbiota have opened up a new area in intestinal micro-ecological immunotherapy.The intestinal microbiota is a double-edged sword.Gut microbes participate in carcinogenesis,but can also be used for immunotherapy.The intestinal microbiota is also regulated by the daily diet.Intestinal micro-ecological immunotherapy combines intestinal immune nutrition and intestinal ecological nutrition to make full use of the intestinal microbiota to strengthen nutritional support.Micro-ecological immunotherapy enhances the body’s immune function by providing energy,improving the functional state of tissues and organs,protecting the intestinal mucosal barrier and maintaining normal intestinal microbiota balance.This involves,to some extent,PD-1 and PD-L1.The microbiota is beneficial to improve the clinical efficacy of conventional anti-cancer therapy and to reduce the incidence of complications.At the same time,micro-ecological immunotherapy is itself active and effective in the perioperative treatment of tumors,which is of great significance for the prognosis of the patient.Gastrointestinal tumors are increasingly linked to intestinal microbiota,and various microbiota-related technologies and drugs have been developed.In the future,the intestinal microbiota may represent a screening marker for gastrointestinal tumors.In addition,clinicians may be able to prevent and treat cancers by changing the gene expression levels of certain microbiota,or by regulating the types of microbes present.展开更多
Background Galectin-1 is aβ-galactoside-binding protein overexpressed in the pancreatic stellate cells(PSCs)of pancreatic ductal adenocarcinoma(PDAC),while its expression is typically low in pancreatic cancer cells(P...Background Galectin-1 is aβ-galactoside-binding protein overexpressed in the pancreatic stellate cells(PSCs)of pancreatic ductal adenocarcinoma(PDAC),while its expression is typically low in pancreatic cancer cells(PCCs).The point at which galectin-1 expression in PCCs increases,and its association with PDAC progression,have been unclear.Methods Galectin-1 expression in PDAC and metastatic lymph nodes was investigated using an immunohistochemical assay.PANC-1 PCC cells were co-cultured with PSCs expressing different levels of galectin-1.Subsequently,galectin-1 was overexpressed in PANC-1 cells using recombinant lentiviruses,and their proliferation,invasion,anchorage-independent growth,and in vivo tumorigenicity were evaluated.Results There was intermediate galectin-1 expression in PCCs,and it was positively associated with galectin-1 expression in PSCs in the PDAC tissues.Galectin-1 was strongly expressed in the metastatic lymph nodes.In the co-culture,high galectin-1 expression in the PSCs increased the galectin-1 expression in the PANC-1 cells.The galectin-1 overexpression in the PANC-1 cells enhanced their clone formation ability,proliferation,and invasion,increased the expression of proliferating cell nuclear antigen(PCNA)and BCL-2,and decreased Bax expression,promoting the establishment and growth of tumors.Conclusion High galectin-1 expression in PSCs induces galectin-1 expression in PCCs and subsequently promotes the malignant biological behavior of PDAC.展开更多
Background:Observational studies have shown that inflammatory bowel disease(IBD),such as ulcerative colitis(UC)and Crohn disease(CD),is associated with gingivitis and periodontal disease(GP).This study aims to investi...Background:Observational studies have shown that inflammatory bowel disease(IBD),such as ulcerative colitis(UC)and Crohn disease(CD),is associated with gingivitis and periodontal disease(GP).This study aims to investigate whether there is a causal relationship between IBD and GP.Methods:This study assessed the causal relationship between IBD and GP through a two-sample Mendelian randomization(MR)study.The required data were obtained through the IEU OpenGWAS project.Instrumental variable screening and the MR and sensitivity analyses were performed using the“TwoSampleMR”R package.Results:IBD,UC,and CD may have a causal effect on GP(IBD,inverse variance weighting[IVW]OR=1.05,95%CI=1.00–1.10,P=0.03;UC,IVWOR=1.05,95%CI=1.00–1.11,P=0.03;CD,weighted median OR=1.06,95%CI=1.00–1.13,P=0.04;simple mode OR=1.15,95%CI=1.02–1.31,P=0.03).Scatterplots,forest plots,and funnel plots showed a significant relationship between IBD and GP and confirmed the robustness of the model.In sensitivity testing,no horizontal pleiotropy or heterogeneity was found in this study.Conclusions:This study found a possible causal relationship between IBD(UC and CD)and GP,which deserves to be considered in clinical practice.展开更多
基金supported in part by the National Natural Science Foundation of China under Grant 61872098 and Grant 61902084the Natural Science Foundation of Guangdong Province under Grant 2017A030313363.
文摘This paper studies a dual-hop Simultaneous Wireless Information and Power Transfer(SWIPT)-based multi-relay network with a direct link.To achieve high throughput in the network,a novel protocol is first developed,in which the network can switch between a direct transmission mode and a Single-Relay-Selection-based Cooperative Transmission(SRS-CT)mode that employs dynamic decode-and-forward relaying accomplished with Rateless Codes(RCs).Then,under this protocol,an optimization problem is formulated to jointly optimize the network operation mode and the resource allocation in the SRS-CT mode.The formulated problem is difficult to solve because not only does the noncausal Channel State Information(CSI)cause the problem to be stochastic,but also the energy state evolution at each relay is complicated by network operation mode decision and resource allocation.Assuming that noncausal CSI is available,the stochastic optimization issue is first to be addressed by solving an involved deterministic optimization problem via dynamic programming,where the complicated energy state evolution issue is addressed by a layered optimization method.Then,based on a finite-state Markov channel model and assuming that CSI statistical properties are known,the stochastic optimization problem is solved by extending the result derived for the noncausal CSI case to the causal CSI case.Finally,a myopic strategy is proposed to achieve a tradeoff between complexity and performance without the knowledge of CSI statistical properties.The simulation results verify that our proposed SRS-and-RC-based design can achieve a maximum of approximately 40%throughput gain over a simple SRS-and-RC-based baseline scheme in SWIPT-based multi-relay networks.
文摘AIM: To investigate the potential impact of complications in gastric cancer patients who survive the initial postoperative period. METHODS: Between January 1, 2005 and December 31, 2006, 432 patients who received curative gastrectomy with D2 lymph node dissection for gastric cancer at our department were studied. Associations between clinicopathological factors [age, sex, American Society of Anesthesiologists grade, body mass index, tumornode-metastases (TNM) stage and tumor grade], including postoperative complications (defined as any deviation from an uneventful postoperative course within 30 d of the operation and survival rates) and treatment-specific factors (blood transfusion, neoadjuvant therapy and duration of surgery). Patients were divided into 2 groups: with (n = 54) or without (n = 378) complications. Survival curves were compared between the groups, and univariate and multivariate models were conducted to identify independent prognostic factors. RESULTS: Among the 432 patients evaluated, 61 com-plications occurred affecting 54 patients (12.50%).Complications included anastomotic leakages, gastric motility disorders, anastomotic block, wound infections, intra-abdominal abscesses, infectious diarrhea, bleeding, bowel obstructions, arrhythmias, angina pectoris, pneumonia, atelectasis, thrombosis, unexplained fever, delirium, ocular fungal infection and multiple organ failure. American Society of Anesthesiologists grade, body mass index, combined organ resection and median duration of operation were associated with higher post-operative complications. The 1-, 3- and 5-year survival rates were 83.3%, 53.2% and 37.5%, respectively. In the univariate analysis, the size of lesions, TNM stage, blood transfusion, lymphovascular invasion, perineural invasion, neoadjuvant chemotherapy, and postoperative complications were significant predictors of overall survival. In the multivariate analysis, only TNM stage and the presence of complications remained significant predictors of reduced survival. CONCLUSION: The occurrence of in-hospital postoperative complications was an independent predictor of worse 5-year overall survival rate after radical resection of gastric cancer.
基金Supported by The National Natural Science Foundation of China,No.81201885 and No.81172279
文摘AIM:To evaluate the fast-track rehabilitation protocol and laparoscopic surgery(LFT)vs conventional care strategies and laparoscopic surgery(LCC).METHODS:Studies and relevant literature comparing the effects of LFT and LCC for colorectal malignancy were identified in MEDLINE,the Cochrane Central Register of Controlled Trials and EMBASE.The complications and re-admission after approximately 1 mo were assessed.RESULTS:Six recent randomized controlled trials(RCTs)were included in this meta-analysis,which related to 655 enrolled patients.These studies demonstrated that compared with LCC,LFT has fewer complications and a similar incidence of re-admission after approximately 1 mo.LFT had a pooled RR of 0.60(95%CI:0.46-0.79,P<0.001)compared with a pooled RR of 0.69(95%CI:0.34-1.40,P>0.5)for LCC.CONCLUSION:LFT for colorectal malignancy is safe and efficacious.Larger prospective RCTs should be conducted to further compare the efficacy and safety of this approach.
基金Supported by the grant from Science and Technology Committee of Jiangsu Province,No.457-99064
文摘AIM: To detect the expression of CD44 correlated with the ability of micro-metastasis in peripheral blood and bone marrow of patients with gastric cancer and to deduce its clinical significance. METHODS: Preoperative peripheral blood and bone marrow specimens from 46 patients with gastric cancer and 6 controls were studied by semi-quantitative RTPCR amplification of CD44v6mRNA. Preoperative and postoperative peripheral blood specimens from 40 patients with gastric cancer and 14 controls were studied by quantitative RT-PCR amplification of CD44v6mRNA in the corresponding period. RESULTS: Semi-quantitative RT-PCR amplification showed that CD44v6mRNA expression of peripheral blood and bone marrow was positive in 39 (84.8%) and 40 (86.9%) of 46 patients with gastric cancer, respectively. In peripheral blood, CD44v6mRNA expression was positive for diffuse type in 30 (93.8%) of 32 patients and for intestinal type in 9 (64.3%) of 14 patients. On the other hand, in bone marrow, CD44v6mRNA expression was positive for diffuse type in 31 (96.9%) of 32 patients and for intestinal type in 10 (71.4%) of 14 patients. There was a significant difference between the diffuse type and intestinal type. Quantitative RTopCR amplification demonstrated that CD44v6mRNA was not expressed in the peripheral blood of controls and CD44v6mRNA expression was positive for preoperative peripheral blood in 40 patients with gastric cancer, the expression levels being from 4.9 × 10^2 to 3.2× 10^5 copies/g RNA. The average expression level of CD44v6mRNA in peripheral blood was 3.9 × 10^10 copies/g RNA. The expression levels of CD44v6mRNA in peripheral blood in gastric cancer patients after curative operation increased from 5.5 × 100 to 7.6 × 10 copies/g RNA (P = 0.00496). After curative operation, the expression level decreased markedly. CONCLUSION: Semi-quantitative and quantitative RTPCR amplification for CD44v6mRNA is a sensitive and specific method for the detection of micro-metastasis in peripheral blood and bone marrow, which might be used as an indicator of tumor burden and therapeutic effect.
文摘AIM: To assess the efficacy and safety of combination therapy based on S-1, a novel oral fluoropyrimidine, vs S-1 monotherapy in advanced gastric cancer (AGC).
文摘BACKGROUND Abdominal pregnancy is a rare type of ectopic pregnancy.We describe here a case of ectopic pregnancy implanted under the surface of the diaphragm,presenting the particular features of imaging findings from ultrasound,computed tomography(CT)and magnetic resonance imaging(MRI).CASE SUMMARY A 30-year-old woman presented with complaint of intermittent abdominal pain,that had begun 5 d earlier.She had no current or abnormal vaginal bleeding,and her serum human chorionic gonadotropin level(13372.08 IU/L)indicated pregnancy.Vaginal ultrasound showed a mixed echogenic mass in the right ovary.CT(plain)scan showed a curved high density mass beneath the subhepatic space.MRI scan showed a curved mixed signal,with restricted diffusion beneath the subhepatic space.Abdominal ultrasound demonstrated a mixed echogenic mass in the right lobe of the liver near the apex of the diaphragm,with a visible yolk sac and germ cell region with a bud.Subsequent laparoscopy visualized a dark red mass under the right diaphragm,which was resected completely.Histopathological examination of the resected mass confirmed an ectopic pregnancy.The recovery was swift and uneventful,and the patient was discharged to home.CONCLUSION Ectopic pregnancy should be in the differential diagnostic workup(via multiple imaging modalities)of childbearing woman with unexplained abdominal pain.
基金Supported by the Joint Funds of the Zhejiang Provincial Natural Science Foundation of China,No.LBY21H030001the Science and Technology Planning Project of Zhejiang Province,No.2020KY708.
文摘BACKGROUND Papillary thyroid carcinoma(PTC)is the most common endocrine malignancy.Papillary thyroid microcarcinoma(PTMC)accounts for the majority of PTC cases.However,concurrent pulmonary and hepatic metastases of PTMC are rarely seen.Here,we present a patient with coexisting liver and lung metastases from PTMC.CASE SUMMARY We describe a 26-year-old woman with PTMC with multiple concurrent metastases.After 3 d of unexplained fever,she was admitted to our hospital.Her thyroid functional tests were abnormal.Her positron emission tomography(PET)/magnetic resonance imaging(MRI)examination showed increased fluorodeoxyglucose(FDG)metabolism and space-occupying lesions in the left lobe of the thyroid.Additionally,PET/MRI images revealed multiple nodules in the lung and liver with increased FDG metabolism.Chest computer tomography(CT)showed multiple pulmonary metastases.Abdominal ultrasound and liver MRI showed multiple space-occupying lesions in the liver.The patient underwent total thyroidectomy and central lymph node dissection.Postoperative pathological analysis showed a papillary microcarcinoma multiplex in the left lobe of the thyroid.A diagnosis of hepatopulmonary metastases from papillary thyroid microcarcinoma was made.The patient was given iodine-131 treatment one year after the surgery.She recovered well after the operation,and the incision healed well.After discharge,she was treated with oral levothyroxine sodium tablets,and symptomatic and supportive treatments were also given to promote radioactive excretion and prevent bone marrow suppression by iodine-131 treatment.CONCLUSION Since patients with thyroid cancer concurrent with hepatopulmonary metastases have rarely been reported,our case will highlight the clinical and pathological profiles of these patients.
基金supported by the Key Research and Development Program of Anhui Province(201904b11020038,1804b06020367)a Key Joint Grant for Regional Innovation and Development from National Sciences Foundation of China(U19A2034)+1 种基金the National Natural Science Foundation(31972459)an Earmarked fund for China Agriculture Research System(CARS-19)。
文摘Black tea is a healthy and popular tea beverage.However,its main bioactive compounds(theaflavins and thearubigins)are not easily absorbed.The aim of this study was to investigate the modulation of intestinal microbiota by the nonabsorptive components of Keemun black tea(KBT)and Dianhong black tea(DBT),and fructooligosaccharide(FOS)was selected for use in the control group.KBT,DBT,and FOS significantly increased total short-chain acid production.Specifically,FOS treatment predominantly increased the production of acetic acids and black tea treatments increased the production of acetic,propionic,and butyric acids at similar rates.Moreover,FOS exerted a strong bifidogenic effect after 24 h of fermentation;KBT and DBT increased the abundance of the beneficial genus Bacteroides and Roseburia.In summary,the nonabsorptive components of KBT and DBT could serve as novel prebiotics,the underlying mechanisms of which are quite different from those of FOS.
基金the Yangzhou Science and Technology Bureau Social Development Project of Jiangsu Province[No.YZ2018087]the training project of Key Talents of Youth Medicine in Jiangsu Province,China[QNRC2016330]+1 种基金the Key Disease Standardization Diagnosis and Treatment Project in Jiangsu Province[BE2015664]the Academic Science and Technology Innovation Fund for College Students[x20180714].
文摘Gastric cancer is closely related to the stomach microbiota,especially Helicobacter pylori.Numerous reports and clinical studies have shown that microbial behavior in the stomach may lead to pathological changes in the gastrointestinal tract of the host,which ultimately leads to the production and development of gastric cancer.This review outlines the major pathogenic processes of Helicobacter pylori in the stomach,specifically focusing on Cag A,Vac A,inflammatory pathways and oxidative stress.In addition,we describe the effects of some non-Helicobacter pylori factors,such as other microbiota,alcohol,and tobacco,on the carcinogenesis induced by Helicobacter pylori.The effects of family history are also taken into account.We hope that understanding the stomach microbiota will make it possible to more easily prevent,detect and treat gastric cancer.
基金Supported by Research Fund of Hangzhou Normal University Affiliated Hospital
文摘BACKGROUND Oncogenic osteomalacia caused by phosphaturic mesenchymal tumors is very difficult to detect.We report a case of tumor-induced osteomalacia caused by a phosphaturic mesenchymal tumor of the left femur in a middle-aged woman after medical imaging and biopsy.CASE SUMMARY A 57-year-old woman presented with progressive bone pain for five years.She was diagnosed with hypophosphatemic osteomalacia,as her laboratory data showed low serum phosphorus and low serum calcium.Her knee joint radiography revealed an osteolytic lesion of the left femur.A computed tomography scan showed mixed density shadows in the left femur.Magnetic resonance imaging of the left femur showed the presence of an oval area with a hypointense signal in T1-weighted magnetic resonance imaging(MRI)and highlow mixed signal in T2-weighted MRI.Biopsy samples revealed the presence of short spindle cells,vascularization,and characteristics of phosphaturic mesenchymal tumors.Tumor resection was performed,and the clinical presentations and laboratory abnormalities were reversed.CONCLUSION Diagnosis of oncogenic osteomalacia is difficult due to the varieties and localization of source tumors and absence of pathognomonic biomedical signs.Our case highlights the importance of a combination of medical imaging and biopsy in the diagnosis of oncogenic osteomalacia caused by a phosphaturic mesenchymal tumor.
基金Project supported by the National Natural Science Foundation of China(Grant No.91850121)the K.C.Wong Education Foundation(Grant No.GJTD-2019-15)
文摘We theoretically investigate high-order harmonic generation(HHG)in crystals induced by linearly polarized laser fields.We obtain the HHG spectra by solving the semiconductor Bloch equations and analyze the radiation process by different models.Here we propose a multiple collision model,in which the electrons and holes are produced at different times and places.It is found that the multiple collision trajectories can help us comprehensively and better explain the results of the quantum calculation.Moreover,we find that the harmonic suppression occurs due to the overlap of multiple collision trajectories.
基金the National Natural Science Funding of China(81572344)the Training Project of Key Talents of Youth Medicine in Jiangsu Province,China(QNRC2016330)+3 种基金the Key Disease Standardization Diagnosis and Treatment Project in Jiangsu Province(BE2015664)the Academic Science and Technology Innovation Fund for College Students(x20180714)the Social Development-Health Care Project of Yangzhou,Jiangsu Province,(YZ2018087)the High-level Talent“Six One Projects”Top Talent Scientific Research Project of Jiangsu Province(LGY2019034).
文摘Diabetes are a group of metabolic disorders characterized by persistent hyperglycemia that is a major public health problem.Middle-aged and elderly people are at the highest risk of type 2 diabetes,but younger cases are now being diagnosed with greater frequency.Numerous clinical studies have reported that the behavior of the intestinal microbiota may affect the development of metabolic disorders in humans,including obesity and diabetes.This review describes the relationship between the gut microbiota and diabetes,and discusses the possible mechanisms underlying their involvement in the development of type 1 diabetes,obesity,and type 2 diabetes.By better understanding the intestinal microbiota,it may become possible to treat diabetes and obesity by manipulating the gut microbes through probiotics and dietary changes,fecal microbiota transplantation,or surgical approaches.
基金supported by the Graduate Research-Innovation Project in Jiangsu Province(No.SJCX21_1644)the Academic Science and Technology Innovation Fund for College Students(No.202011117056Y)+3 种基金the Social Development-Health Care Project of Yangzhou,Jiangsu Province(No.YZ2021075)the High-level Talent“Six One Projects”Top Talent Scientific Research Project of Jiangsu Province(No.LGY2019034)the Graduate Research-Innovation Project in Jiangsu Province(SJCX22_1816)the Social Development Project of the Key R&D Plan of Jiangsu Provincial Department of Science and Technology(BE2022773).
文摘The clearance of lesions during surgery for colorectal cancer encompasses the removal of both the primary tumour and its concomitant lymphatic drainage.Huge strides have been made in identifying the precise location of not only the primary tumour,but also the lymph nodes(LNs),owing to the use of intraoperative navigation techniques.Among these techniques,indocyanine green-enhanced fluorescence imaging(ICG-FI)has revolutionized colorectal oncologic surgery by providing clear visualization during lymphangiography.ICG-FI has emerged as a powerful tool for sentinel lymph node procedures that allows for local excision instead of radical D3 lymphadenectomy.It also makes it possible to identify potential metastatic lateral pelvic lymph nodes,which enables simultaneous lymphadenectomy of the pelvic side-wall during the resection of middle-lower rectal cancer.This review provides an update on the current use of and research on ICG-FI-guided LNs mapping for colorectal malignancies,and also discusses its drawbacks and future prospects.
基金supported by the Graduate ResearchInnovation Project in Jiangsu Province [Nos.SJCX21_1644and SJCX22_1816]the Academic Science and Technology Innovation Fund for College Students [No.202011117056Y]+2 种基金the Social Development-Health Care Project of YangzhouJiangsu Province [No.YZ2021075]the High-level Talent"Six One Projects"Top Talent Scientific Research Project of Jiangsu Province [No.LGY2019034]
文摘Objectives To explore the value of performing a modified colonic transit test in the diagnosis of chronic constipation.Methods we retrospectively analyzed the results in 101 patients admitted to the MDT Outpatient Clinic of Subei People’s Hospital,Jiangsu Province,China,from July 1,2019,to July 31,2021.Patients were prohibited from using drugs and stimulant foods that could affect bowel motility for three days before and during the examination.We performed two abdominal X-rays at 6 and 72 hours after oral ingestion of the barium suspension to observe the residual condition of barium in the patient's colon.We then gave specific treatments based on the different types of constipation detected in the patients.Results Compared with patients with normal transit,patients with slow transit(P<0.001)and patients with rectal evacuation disorders had a significantly reduced stool frequency(P<0.05).The kappa coefficient of the modified colonic transit test compared to anorectal manometry in the diagnosis of functional defecation disorders(FDDs)was 0.649,indicating substantial consistency between the two methods.Conclusion The modified colonic transit test not only assesses colonic transit function and provides an initial determination of the type of constipation,but also shows the colon morphology,providing a reference for possible subsequent treatments.
基金the Social Development-Health Care Project of Yangzhou,Jiangshu Province,(No.TZ2018087).
文摘Objective In this meta-analysis,we analyzed the risk factors for gallstone formation after gastric cancer surgery.Methods Relevant studies published from 1990 to 2017 were retrieved from the PubMed,Embase,Medline,Web of Science,Cochrane Library,Springer Link,Chinese Biomedical Literature,and Wanfang databases.We performed a meta-analysis to determine the odds ratio and 95%confidence interval(95%CI).Results Nineteen studies were included in the meta-analysis:four randomized controlled trials(RCTs),10 case-control studies,and five cohort studies.The 19 studies included 32 to 16,045 patients.The pooled OR(95%CI)and P-values of the OR(95%CI)were 1.89(1.25,2.86)(P=0.003)for gastric resection,0.22(0.12,0.40)(P<0.00001)for vagus nerve retention,1.73(1.45,2.06)(P<0.00001)for digestive tract reconstruction,0.80(0.54,1.17)(P=0.25)for pylorus-preserving gastrectomy,0.59(0.33,1.04)(P=0.07)for the degree of lymph node dissection,1.98(0.50,7.86)(P=0.33)for D12 lymph node dissection,and 1.33(1.15,1.54)(P<0.0001)for diabetes.Conclusions Our findings indicate that partial gastrectomy,vagus nerve preservation,and physiological digestive tract reconstruction can reduce the incidence of gallstones after gastrectomy.Diabetes is a contributory factor to gallstone formation.There was no significant difference in the incidence of gallstones based on pylorus preservation/non-preservation,the degree of lymph node dissection,or D12 lymph node dissection.This is the first meta-analysis to comprehensively analyze the risk factors for gallstone formation after gastric cancer surgery.We investigated the risk associated with gastric resection,vagus nerve retention,digestive tract reconstruction,PPG,the degree of lymph node dissection,D12 lymph node dissection,and diabetes.
文摘It has been proposed that the intestinal microbiota and gastrointestinal tumors are interdependent.Changes in the microbiota can cause dysfunction of the gastrointestinal tract,thereby promoting carcinogenic changes,leading to the occurrence of gastrointestinal tumors.Recent studies on intestinal microbiota have opened up a new area in intestinal micro-ecological immunotherapy.The intestinal microbiota is a double-edged sword.Gut microbes participate in carcinogenesis,but can also be used for immunotherapy.The intestinal microbiota is also regulated by the daily diet.Intestinal micro-ecological immunotherapy combines intestinal immune nutrition and intestinal ecological nutrition to make full use of the intestinal microbiota to strengthen nutritional support.Micro-ecological immunotherapy enhances the body’s immune function by providing energy,improving the functional state of tissues and organs,protecting the intestinal mucosal barrier and maintaining normal intestinal microbiota balance.This involves,to some extent,PD-1 and PD-L1.The microbiota is beneficial to improve the clinical efficacy of conventional anti-cancer therapy and to reduce the incidence of complications.At the same time,micro-ecological immunotherapy is itself active and effective in the perioperative treatment of tumors,which is of great significance for the prognosis of the patient.Gastrointestinal tumors are increasingly linked to intestinal microbiota,and various microbiota-related technologies and drugs have been developed.In the future,the intestinal microbiota may represent a screening marker for gastrointestinal tumors.In addition,clinicians may be able to prevent and treat cancers by changing the gene expression levels of certain microbiota,or by regulating the types of microbes present.
文摘Background Galectin-1 is aβ-galactoside-binding protein overexpressed in the pancreatic stellate cells(PSCs)of pancreatic ductal adenocarcinoma(PDAC),while its expression is typically low in pancreatic cancer cells(PCCs).The point at which galectin-1 expression in PCCs increases,and its association with PDAC progression,have been unclear.Methods Galectin-1 expression in PDAC and metastatic lymph nodes was investigated using an immunohistochemical assay.PANC-1 PCC cells were co-cultured with PSCs expressing different levels of galectin-1.Subsequently,galectin-1 was overexpressed in PANC-1 cells using recombinant lentiviruses,and their proliferation,invasion,anchorage-independent growth,and in vivo tumorigenicity were evaluated.Results There was intermediate galectin-1 expression in PCCs,and it was positively associated with galectin-1 expression in PSCs in the PDAC tissues.Galectin-1 was strongly expressed in the metastatic lymph nodes.In the co-culture,high galectin-1 expression in the PSCs increased the galectin-1 expression in the PANC-1 cells.The galectin-1 overexpression in the PANC-1 cells enhanced their clone formation ability,proliferation,and invasion,increased the expression of proliferating cell nuclear antigen(PCNA)and BCL-2,and decreased Bax expression,promoting the establishment and growth of tumors.Conclusion High galectin-1 expression in PSCs induces galectin-1 expression in PCCs and subsequently promotes the malignant biological behavior of PDAC.
基金the Training Project of Key Talents of Youth Medicine in Jiangsu Province of China(No.QNRC2016330)the Graduate Research-Innovation Project in Jiangsu Province(No.SJCX21_1644)+5 种基金the Academic Science and Technology Innovation Fund for College Students(No.202011117056Y)the Social Development-Health Care Project of Yangzhou,Jiangsu Province(No.YZ2018087)the Social Development-Health Care Project of Yangzhou,Jiangsu Province(No.YZ2021075)the High-Level Talent“Six One Projects”Top Talent Scientific Research Project of Jiangsu Province(No.LGY2019034)the Graduate Research-Innovation Project in Jiangsu Province(No.SJCX22_1816)the Social development project of the key R&D plan of Jiangsu Provincial Department of Science and Technology(No.BE2022773).
文摘Background:Observational studies have shown that inflammatory bowel disease(IBD),such as ulcerative colitis(UC)and Crohn disease(CD),is associated with gingivitis and periodontal disease(GP).This study aims to investigate whether there is a causal relationship between IBD and GP.Methods:This study assessed the causal relationship between IBD and GP through a two-sample Mendelian randomization(MR)study.The required data were obtained through the IEU OpenGWAS project.Instrumental variable screening and the MR and sensitivity analyses were performed using the“TwoSampleMR”R package.Results:IBD,UC,and CD may have a causal effect on GP(IBD,inverse variance weighting[IVW]OR=1.05,95%CI=1.00–1.10,P=0.03;UC,IVWOR=1.05,95%CI=1.00–1.11,P=0.03;CD,weighted median OR=1.06,95%CI=1.00–1.13,P=0.04;simple mode OR=1.15,95%CI=1.02–1.31,P=0.03).Scatterplots,forest plots,and funnel plots showed a significant relationship between IBD and GP and confirmed the robustness of the model.In sensitivity testing,no horizontal pleiotropy or heterogeneity was found in this study.Conclusions:This study found a possible causal relationship between IBD(UC and CD)and GP,which deserves to be considered in clinical practice.