Present situation of minimally invasive surgical treatment for early gastric cancer

Minimally invasive surgery is a kind of surgical operation,which is performed by using professional surgical instruments and equipment to inactivate,resect,repair or reconstruct the pathological changes,deformities and wounds in human body through micro-trauma or micro-approach,in order to achieve the goal of treatment,its surgical effect is equivalent to the traditional open surgery,while avoiding the morbidity of conventional surgical wounds.In addition,it also has the advantages of less trauma,less blood loss during operation,less psychological burden and quick recovery on patients,and these minimally invasive techniques provide unique value for the examination and treatment of gastric cancer patients.Surgical minimally invasive surgical techniques have developed rapidly and offer numerous options for the treatment of early gastric cancer(EGC):endoscopic mucosal resection(EMR),underwater EMR(UEMR),endoscopic submucosal dissection(ESD),endoscopic full-thickness resection(EFTR),endoscopic submu-cosal excavation(ESE),submucosal tunnel endoscopic resection,laparoscopic and endoscopic cooperative surgery(LECS);Among them,EMR,EFTR and LECS technologies have a wide range of applications and different modific-ations have been derived from their respective surgical operations,such as band-assisted EMR(BA-EMR),conven-tional EMR(CEMR),over-the-scope clip-assisted EFTR,no-touch EFTR,the inverted LECS,closed LECS,and so on.These new and improved minimally invasive surgeries are more precise,specific and effective in treating different types of EGC.

Reproducibility study of intravoxel incoherent motion and apparent diffusion coefficient parameters in normal pancreas

BACKGROUND The consistency of pancreatic apparent diffusion coefficient(ADC)values and intravoxel incoherent motion(IVIM)parameter values across different magnetic resonance imaging(MRI)devices significantly impacts the patient’s diagnosis and treatment.AIM To explore consistency in image quality,ADC values,and IVIM parameter values among different MRI devices in pancreatic examinations.METHODS This retrospective study was approved by the local ethics committee,and informed consent was obtained from all participants.In total,22 healthy volunteers(10 males and 12 females)aged 24-61 years(mean,28.9±2.3 years)underwent pancreatic diffusion-weighted imaging using 3.0T MRI equipment from three vendors.Two independent observers subjectively scored image quality and measured the pancreas’s overall ADC values and signal-to-noise ratios(SNRs).Subsequently,regions of interest(ROIs)were delineated for the IVIM parameters(true diffusion coefficient,pseudo-diffusion coefficient,and perfusion fraction)using post-processing software.These ROIs were on the head,body,and tail of the pancrease.The subjective image ratings were assessed using the kappa consistency test.Intraclass correlation coefficients(ICCs)and mixed linear models were used to evaluate each device’s quantitative parameter values.Finally,a pairwise analysis of IVIM parameter values across each device was performed using Bland-Altman plots.RESULTS The Kappa value for the subjective ratings of the different observers was 0.776(P<0.05).The ICC values for interobserver and intra-observer agreements for the quantitative parameters were 0.803[95% confidence interval(CI):0.684-0.880]and 0.883(95%CI:0.760-0.945),respectively(P<0.05).The ICCs for the SNR between different devices was comparable(P>0.05),and the ICCs for the ADC values from different devices were 0.870,0.707,and 0.808,respectively(P<0.05).Notably,only a few statistically significant inter-device agreements were observed for different IVIM parameters,and among those,the ICC values were generally low.The mixed linear model results indicated differences(P<0.05)in the f-value for the pancreas head,D-value for the pancreas body,and D-value for the pancreas tail obtained using different MRI machines.The Bland-Altman plots showed significant variability at some data points.CONCLUSION ADC values are consistent among different devices,but the IVIM parameters’repeatability is moderate.Therefore,the variability in the IVIM parameter values may be associated with using different MRI machines.Thus,caution should be exercised when using IVIM parameter values to assess the pancreas.

Vacuum diffusion bonding of Ti_(2)AlNb alloy and TC4 alloy

The Ti_(2)AlNb alloy was joined with TC4 alloy by vacuum diffusion bonding.The relationship between bonding parameters,and joint microstructure and shear strength was investigated.The results indicated that the diffusion of Al,Ti,Nb and V elements across bonding interface led to the formation of three reaction layers:B2/βlayer andα2 layer on the TC4 side,andα2+B2/βlayer on the Ti_(2)AlNb side.The bonding temperature determined the atomic activity,thus controlling the growth of reaction layers and influencing the shear strength of the joint.When the Ti_(2)AlNb alloy and TC4 alloy were bonded at 950℃for 30 min under 10 MPa,the shear strength of the joint reached the maximum of 467 MPa.The analysis on the fracture morphology showed that the fracture occurred within the B2/βlayer and the fracture model was ductile rupture.Meanwhile,the formation mechanism of the Ti_(2)AlNb/TC4 joint was discussed in depth.

Attenuation coefficients of gamma and X-rays passing through six materials

The aim of this study was to determine the attenuation of gamma and X-rays with different energies caused by passage through different materials.To this end,different materials with a range of atomic numbers were chosen to measure gamma and X-ray attenuation coefficients and to explore the mechanisms of interaction of gamma and X-rays with matter of various kinds.It is shown that the attenuation coefficients first decrease and then increase with increase in the radiation(photon)energy.The attenuation of gamma and X-rays passing through materials with high atomic number is greater than that in materials with low atomic number.The attenuation minimum is related to the atomic number of the irradiated materials.The larger the atomic number is,the lower the energy corresponding to attenuation minimum is.Photoelectric and Compton effects are the main processes when gamma rays pass through individual materials with high and low atomic numbers,respectively.Therefore,for radiotherapy and radiation protection,different methods should be considered and selected for the use of gamma and X-rays of different energies for use in different materials.

Emerging roles of non-coding RNAs in colorectal cancer oxaliplatin resistance and liquid biopsy potential

Colorectal cancer(CRC)is one of the most common malignancies of the digestive tract,with the annual incidence and mortality increasing consistently.Oxaliplatinbased chemotherapy is a preferred therapeutic regimen for patients with advanced CRC.However,most patients will inevitably develop resistance to oxaliplatin.Many studies have reported that non-coding RNAs(ncRNAs),such as microRNAs,long non-coding RNAs,and circular RNAs,are extensively involved in cancer progression.Moreover,emerging evidence has revealed that ncRNAs mediate chemoresistance to oxaliplatin by transcriptional and post-transcriptional regulation,and by epigenetic modification.In this review,we summarize the mechanisms by which ncRNAs regulate the initiation and development of CRC chemoresistance to oxaliplatin.Furthermore,we investigate the clinical application of ncRNAs as promising biomarkers for liquid CRC biopsy.This review provides new insights into overcoming oxaliplatin resistance in CRC by targeting ncRNAs.

An optimized numerical method to pre-researching the performance of solid-phase oxygen control in a non-isothermal lead–bismuth eutectic loop

In the present work,a new transient calculation method for parameters that can be used to evaluate the ability of oxygen control in a non-isothermal lead-bismuth eutectic(LBE)loop with solid-phase oxygen control was proposed.It incorporates the dissolution process of PbO particles and the oxygen mass transfer process,and an optimized method was used for finding out the optimized oxygen mass transfer coefficient.In numerical terms,three mass transfer models were simultaneously applied,and comparisons of calculated and experimental results from the CRAFT loop indicated that the optimized calculation method and these new oxygen mass transfer models were correct and applicable to other LBE loops.Through this calculation method,we aimed to optimize prediction of the distribution of oxygen and iron concentrations,time taken to establish the steady state of oxygen,and maximum dissolution/precipitation rates of corrosion products and corrosion depth across the entire LBE loop.We hope that this work will provide a potential reference for designing a more intelligent oxygen control system in the future.

Correlation between circulating endothelial cell level and acute respiratory distress syndrome in postoperative patients

BACKGROUND Acute respiratory distress syndrome(ARDS)is injury of alveolar epithelial cells and capillary endothelial cells caused by various factors,including endogenous and exogenous lung factors,leading to diffuse pulmonary interstitial and alveolar edema,and acute respiratory failure.ARDS involves alveolar epithelial cells and pulmonary interstitial capillary endothelial cells.Circulating endothelial cells(CECs)are the only marker that directly reflects vascular endothelial injury in vivo.There have been few studies on the correlation between peripheral blood CECs and ARDS at home and abroad.The lungs are the organs with the highest capillary density and the most endothelial cells,thus,it is speculated that when ARDS occurs,CECs are stimulated and damaged,and released into the circulatory system.AIM To explore the correlation between CEC level and severity of ARDS in patients postoperatively.METHODS Blood samples were collected from all patients on day 2(d2)and day 5(d5)after surgery.The control group comprised 32 healthy volunteers.Number of CECs was measured by flow cytometry,and operation time was recorded.Changes in various indexes of patients were monitored,and diagnosis of ARDS was determined based on ARDS Berlin definition.We comprised d2 CECs in different groups,correlation between operation time and d2 CECs,ARDS of different severity by d2 CECs,and predictive value of d2 CECs for ARDS in postoperative patients.RESULTS The number of d2 CECs in the ARDS group was significantly higher than that in the healthy control group(P<0.001).The number of d2 CECs in the ARDS group was significantly higher than that in the non-ARDS group(P<0.001).The number of d2 CECs in the non-ARDS group was significantly higher than that in the healthy control group(P<0.001).Operation time was positively correlated with number of CECs on d2(rs=0.302,P=0.001).The number of d2 CECs in the deceased group was significantly higher than that in the improved group(P<0.001).There was no significant difference in number of d2 CECs between patients with mild and moderate ARDS.The number of d2 CECs in patients with severe ARDS was significantly higher than that in patients with mild and moderate ARDS(P=0.041,P=0.037).There was no significant difference in number of d5 and d2 CECs in the non-ARDS group after admission to intensive care.The number of d5 CECs was higher than the number of d2 CECs in the ARDS improved group(P<0.001).The number of d5 CECs was higher than the number of d2 CECs in the ARDS deceased group(P=0.002).If the number of CECs was>1351/mL,sensitivity and specificity of predicting ARDS were 80.8%and 78.1%,respectively.CONCLUSION Changes in number of CECs might predict occurrence and adverse outcome of ARDS after surgery,and higher numbers of CECs indicate worse prognosis of ARDS.

Influence of gonadotropin-releasing hormone agonist on the effect of chemotherapy upon ovarian cancer and the prevention of chemotherapy-induced ovarian damage:an experimental study with nu/nu athymic mice

Background and objective:Gonadotropin-releasing hormone (GnRH) plays an important role in the regulation of ovarian function and ovarian cancer cell growth. In this study, we determined whether administration of the GnRH agonist (GnRHa), triporelin, prior to cisplatin treatment affects cisplatin and/or prevents cisplatin-induced ovarian damage. Methods:nu/nu mice were injected with ovarian cancer OVCAR-3 cells intraperitoneally. After two weeks, the mice were treated with saline (control), cisplatin, GnRHa, or cisplatin plus GnRHa for four weeks. At the end of the experimental protocol, blood, tumor, ovary, and uterine tissues were resected for hematoxylin and eosin (H&E) staining, immunohistochemical analyses of Ki67, nuclear factor-κB (NF-κB), and caspase-3, transmission electron microscopy of apoptosis, or enzyme-linked immunosorbent assay (ELISA) analyses of anti-Mullerian hormone (AMH). Results:Cisplatin treatment effectively inhibited tumor growth in mice treated with human ovarian cancer cells; however the treatment also induced considerable toxicity. Immunohistochemical analyses showed that Ki67 expression was reduced in cisplatin-treated mice compared to control (P<0.05), but there was no statistically significant differences between cisplatin-treated mice and cisplatin plus GnRHa-treated mice (P>0.05), while expressions of NF-κB and caspase-3 were reduced and induced, respectively, in cisplatin-treated mice and cisplatin plus GnRHa-treated mice. Apoptosis occurred in the GnRHa, cisplatin, and cisplatin plus GnRHa-treated mice, but not in control mice. Ovaries exposed to GnRHa in both GnRHa mice and cisplatin-treated mice (combination group) had significantly more primordial and growth follicles and serum levels of AMH than those in the control mice and cisplatin-treated mice (P<0.05). Conclusions:Administration of GnRHa to mice significantly decreased the extent of ovarian damage induced by cisplatin, but did not affect the anti-tumor activity of cisplatin.

Biallelic mutations in spermatogenesis and centriole-associated 1 like(SPATC1L)cause acephalic spermatozoa syndrome and male infertility

Acephalic spermatozoa syndrome is a rare type of teratozoospermia that severely impairs the reproductive ability of male patients,and genetic defects have been recognized as the main cause of acephalic spermatozoa syndrome.Spermatogenesis and centrioleassociated 1 like(SPATC1L)is indispensable for maintaining the integrity of sperm head-to-tail connections in mice,but its roles in human sperm and early embryonic development remain largely unknown.Herein,we conducted whole-exome sequencing(WES)of 22 infertile men with acephalic spermatozoa syndrome.An in silico analysis of the candidate variants was conducted,and WES data analysis was performed using another cohort consisting of 34 patients with acephalic spermatozoa syndrome and 25 control subjects with proven fertility.We identified biallelic mutations in SPATC1L(c.910C>T:p.Arg304Cys and c.994G>T:p.Glu332X)from a patient whose sperm displayed complete acephalia.Both SPATC1L variants are rare and deleterious.SPATC1L is mainly expressed at the head–tail junction of elongating spermatids.Plasmids containing pathogenic variants decreased the level of SPATC1L in vitro.Moreover,none of the patient’s four attempts at intracytoplasmic sperm injection(ICSI)resulted in a transplantable embryo,which suggests that SPATC1L defects might affect early embryonic development.In conclusion,this study provides the first identification of SPATC1L as a novel gene for human acephalic spermatozoa syndrome.Furthermore,WES might be applied for patients with acephalic spermatozoa syndrome who exhibit reiterative ICSI failures.

High thermoelectric and mechanical performance in the n-type polycrystalline SnSe incorporated with multi-walled carbon nanotubes

In this study,we introduce multi-walled carbon nanotubes(MWCNTs)in Pb/I co-doped n-type polycrys-tal SnSe to simultaneously improve its thermoelectric and mechanical properties for the first time.The introduced MWCNTs act as the“bridges”to accelerate the electron carrier transport between SnSe grains,leading to significantly increased electrical conductivity from 32.6 to 45.7 S cm^(−1) at 773 K,which con-tributes to an enhanced power factor of∼5.0μW cm^(−1) K^(−2) at this temperature.Although MWCNTs possess high intrinsic thermal conductivities,these MWCNTs,acting as nanoinclusions in the SnSe matrix to form the dense interfaces between SnSe and MWCNTs,provide extra heat-carrying phonon scattering centers,leading to a slightly reduced lattice thermal conductivity of only 0.34 W m^(−1) K^(−2) at 773 K and in turn,a high ZT of∼1.0 at this temperature.Furthermore,the introduced MWCNTs can simultane-ously act as the“binders”to bond adjacent grains,significantly improving the mechanical properties of SnSe by boosting its Vickers hardness from 39.5 to 50.5.This work indicates that our facile approach can achieve high thermoelectric and mechanical properties in n-type SnSe polycrystals with a considerable potential for applying to thermoelectric devices as n-type elements.

C–F bond functionalizations of trifluoromethyl groups via radical intermediates

Selective functionalization of C-F bonds in trifluoromethyl groups has recently received a growing interest, as it offers atom- and step-economic pathways to access highly valuable mono- and difluoroalkyl-substituted organic molecules using simple and inexpensive trifluoromethyl sources as the starting materials. In this regard, impressive progress has been made on the defluorinative functionalization reactions that proceed via radical intermediates. Nevertheless, it is still a great challenge to precisely control the defluorination process, due to the continuous decrease of the C-F bond strength after the replacement of one or two fluorine atoms with various functionalities. This review article is aimed to provide a brief overview of recently reported methods used to functionalize C-F bonds of CF_(3) groups via radical intermediates. An emphasis is placed on the discussion of mechanistic aspects and synthetic applications.

4-Dimethylaminopyridine-Boryl Radical Promoted Monodefluorinative Alkylation of 3,3-Difluorooxindoles

A selective monodefluorinative alkylation of 3,3-difluorooxindoles is achieved.The reaction starts by the attack of a 4-dimethylaminopyrine-boryl radical to the carbonyl oxygen atom of 3,3-difluorooxindoles,followed by a spin-center shift to generate radical intermediates with the elimination of a fluoride anion.The subsequent radical addition to alkenes affords a range of 3-alkyl-fluorooxindoles products.The strategy offers access to C-3 functionalized oxindoles with wide substrate scope and tolerates a wide range of functional groups.

NHC-Boryl Radical Catalysis for Cycloisomerization With C–C Triple Bond Reorganization

Our present study unveils a new and efficient N-heterocyclic carbene(NHC)-boryl radical-catalyzed cycloisomerization of N-(2-ethynylaryl)arylamides.This catalytic process is triggered by the addition of an NHC-boryl radical to the alkynyl moiety,followed by a radical cascade comprising of an intramolecular cyclization,successive 1,5-and 1,2-aryl migrations,and the reorganization of a C–C triple bond.

The Yin and Yang of the protein corona on the delivery journey of nanoparticles

Nanoparticles-based drug delivery systems have attracted significant attention in biomedical fields because they can deliver loaded cargoes to the target site in a controlled manner.However,tremendous challenges must still be overcome to reach the expected targeting and therapeutic efficacy in vivo.These challenges mainly arise because the interaction between nanoparticles and biological systems is complex and dynamic and is influenced by the physicochemical properties of the nanoparticles and the heterogeneity of biological systems.Importantly,once the nanoparticles are injected into the blood,a protein corona will inevitably form on the surface.The protein corona creates a new biological identity which plays a vital role in mediating the bio–nano interaction and determining the ultimate results.Thus,it is essential to understand how the protein corona affects the delivery journey of nanoparticles in vivo and what we can do to exploit the protein corona for better delivery efficiency.In this review,we first summarize the fundamental impact of the protein corona on the delivery journey of nanoparticles.Next,we emphasize the strategies that have been developed for tailoring and exploiting the protein corona to improve the transportation behavior of nanoparticles in vivo.Finally,we highlight what we need to do as a next step towards better understanding and exploitation of the protein corona.We hope these insights into the“Yin and Yang”effect of the protein corona will have profound implications for understanding the role of the protein corona in a wide range of nanoparticles.