腔镜下经口腔前庭与全乳晕入路甲状腺手术的倾向得分匹配分析

目的比较经口腔前庭入路与全乳晕入路腔镜甲状腺手术的短期临床结局,初步探讨经口腔前庭入路甲状腺手术的安全性。方法收集2018年3月-2020年3月于南方医科大学附属中山市博爱医院接受经口腔前庭(n=50)和全乳晕入路(n=101)腔镜甲状腺手术患者的临床资料,经1∶1倾向评分匹配后,得到50对匹配的配对,比较两组患者临床结局。结果经口腔前庭组建腔时长[(39.9±10.0)和(32.7±7.2)min,P<0.01]和手术时间[(194.3±32.4)和(159.3±33.7)min,P<0.01]明显较经全乳晕入路组长,首日引流量明显较经全乳晕入路组少[(50.8±22.7)和(64.8±34.8)mL,P=0.019],总费用较经乳晕入路组高[(23626.5±5217.6)和(17879.7±3534.7)元,P<0.05]。两组患者术中出血量、总引流量、引流管留置时长、术后住院时长和术后并发症发生情况比较,差异均无统计学意义(P>0.05)。结论尽管经口腔前庭入路的甲状腺手术时间较经全乳晕入路长,且费用更高,但在手术并发症及住院时长方面并无明显差异。对美容有特殊要求的患者来说,经口腔前庭入路甲状腺手术是一种安全的选择。

pH-responsive mesoporous silica nanoparticles employed in controlled drug delivery systems for cancer treatment

In the fight against cancer, controlled drug delivery systems have emerged to enhance the therapeutic efficacy and safety of anti-cancer drugs. Among these systems, mesoporous silica nanoparticles(MSNs) with a functional surface possess obvious advantages and were thus rapidly developed for cancer treatment. Many stimuli-responsive materials, such as nanoparticles, polymers, and inorganic materials, have been applied as caps and gatekeepers to control drug release from MSNs. This review presents an overview of the recent progress in the production of pH-responsive MSNs based on the pH gradient between normal tissues and the tumor microenvironment. Four main categories of gatekeepers can respond to acidic conditions. These categories will be described in detail.

Basic transcription factor 3 is involved in gastric cancer development and progression

AIM: To further analyse cancer involvement of basic transcription factor 3 (BTF3) after detection of its upregulation in gastric tumor samples. METHODS: BTF3 transcription rates in human gastric tumor tissue samples (n = 20) and adjacent normal tissue (n = 18) specimens as well as in the gastric cancer cell lines AGS, SGC-7901, MKN-28, MKN-45 and MGC803 were analyzed via quantitative real-time polymerase chain reaction. The effect of stable BTF3 silencing via infection with a small interfering RNA (siRNA)-BTF3 expressing lentivirus on SGC-7901 cells was measured via Western blotting analysis, proliferation assays, cell cycle and apoptosis profiling by flow cytometry as well as colony forming assays with a Cellomic Assay System. RESULTS: A significant higher expression of BTF3 mRNA was detected in tumors compared to normal gastric tissues (P < 0.01), especially in section tissues from female patients compared to male patients, and all tested gastric cancer cell lines expressed high levels of BTF3. From days 1 to 5, the relative proliferation rates of stable BTF3-siRNA transfected SGC7901 cells were 82%, 70%, 57%, 49% and 44% compared to the control, while the percentage of cells arrested in the G 1 phase was significantly decreased (P = 0.000) and the percentages of cells in the S (P = 0.031) and G 2 /M (P = 0.027) phases were significantly increased. In addition, the colony forming tendency was significantly decreased (P = 0.014) and the apoptosis rate increased from 5.73% to 8.59% (P = 0.014) after BTF3 was silenced in SGC7901 cells. CONCLUSION: BTF3 expression is associated with enhanced cell proliferation, reduced cell cycle regulation and apoptosis and its silencing decreased colony forming and proliferation of gastric cancer cells.

Correlation between crowdedness in emergency departments and anxiety in Chinese patients

BACKGROUND Emergency department(ED)overcrowding is a severe health care concern,while anxiety and depression rates among ED patients have been reported to be substantially higher compared to the general population.We hypothesized that anxiety due to over crowdedness may lead to adverse events in EDs.AIM To investigate correlations between crowdedness in EDs and anxiety of patients and nurses,and to identify factors affecting their anxiety.METHODS In this prospective observational study,a total 43 nurses and 389 emergency patients from two tier III hospitals located in Beijing were included from January 2016 to August 2017.Patients were grouped into inpatients when they were hospitalized after diagnoses,or into outpatients when they were discharged after treatments.The State Trait Anxiety Inventory(STAI Form Y)questionnaire was used to investigate patient and nurse anxieties,while crowdedness of EDs was evaluated with the National Emergency Department Over Crowding Score.RESULTS The present results revealed that state anxiety scores(49.50±6.00 vs 50.80±2.80,P=0.005)and trait anxiety scores(45.40±5.70 vs 46.80±2.70,P=0.002)between inpatients(n=173)and outpatients(n=216)were significantly different,while the state anxiety of nurses(44.70±5.80)was different from those of both patient groups.Generalized linear regression analysis demonstrated that multiple factors,including crowdedness in the ED,were associated with state and trait anxieties for both inpatients and outpatients.In addition,there was an interaction between state anxiety and trait anxieties.However,multivariable regression analysis showed that while overcrowding in the ED did not directly correlate with patients’and nurses’anxiety levels,the factors that did correlate with state and trait anxieties of inpatients were related to crowdedness.These factors included waiting time in the ED,the number of patients treated,and the number of nurses in the ED,whereas for nurses,only state and trait anxieties correlated significantly with each other.CONCLUSION Waiting time,the number of patients treated,and the number of nurses present in the ED correlate with patient anxiety in EDs,but crowdedness has no effect on nurse or patient anxiety.

Gliding arc plasma adjusting pre-combustion cracking products

In view of the difficulty of kerosene-air detonation faced by the application of rotating detonation to aviation engines,in order to improve the kerosene detonation activity,the atmospheric pressure gliding arc plasma is used to conduct secondary adjustment of the pre-combustion cracking products.The results show that the components with larger molecular weight in the pre-combustion cracking products,such as ethylene and methane,can be cracked into highly active species of hydrogen and acetylene by gliding arc plasma.With the increase of the fuel ratio of pre-combustion cracking,the plasma has a more significant effect on the adjustment of high active components.However,as the flow rate of the cracking gas treated by plasma increases,the adjustment effect is obviously reduced.

Spherical Confinement Generates Entropic Force to Accelerate Polymer Chain Detachment

To understand the dynamic process of polymer detachment, it is necessary to determine the mean detachment time of a single breakable link, which is modeled as a spring. Normally, this time can be viewed as the escape of a Brownian particle from the potential well of the spring. However, as the free dangling length of the polymer chain increases, the conformational entropy of the chain is affected by geometric confinement. It means that the wall exerts a repulsive force on the chain, resulting in accelerated link detachment from a macroscopic perspective. In this work, we investigate the effect of entropy on the detachment rate in the case where the substrate is spherical. We demonstrate that spherical confinement accelerates chain detachment both inside and outside the sphere. An analytical expression for the mean detachment time of breakable links is given, which includes an additional pre-factor that is related to the partition function. Additionally, we analyze the expressions for entropic forces inside the sphere, outside the sphere, and on a flat wall, comparing their magnitudes to explain the difference in mean detachment time.

Multi-surrogate framework with an adaptive selection mechanism for production optimization

Data-driven surrogate models that assist with efficient evolutionary algorithms to find the optimal development scheme have been widely used to solve reservoir production optimization problems.However,existing research suggests that the effectiveness of a surrogate model can vary depending on the complexity of the design problem.A surrogate model that has demonstrated success in one scenario may not perform as well in others.In the absence of prior knowledge,finding a promising surrogate model that performs well for an unknown reservoir is challenging.Moreover,the optimization process often relies on a single evolutionary algorithm,which can yield varying results across different cases.To address these limitations,this paper introduces a novel approach called the multi-surrogate framework with an adaptive selection mechanism(MSFASM)to tackle production optimization problems.MSFASM consists of two stages.In the first stage,a reduced-dimensional broad learning system(BLS)is used to adaptively select the evolutionary algorithm with the best performance during the current optimization period.In the second stage,the multi-objective algorithm,non-dominated sorting genetic algorithm II(NSGA-II),is used as an optimizer to find a set of Pareto solutions with good performance on multiple surrogate models.A novel optimal point criterion is utilized in this stage to select the Pareto solutions,thereby obtaining the desired development schemes without increasing the computational load of the numerical simulator.The two stages are combined using sequential transfer learning.From the two most important perspectives of an evolutionary algorithm and a surrogate model,the proposed method improves adaptability to optimization problems of various reservoir types.To verify the effectiveness of the proposed method,four 100-dimensional benchmark functions and two reservoir models are tested,and the results are compared with those obtained by six other surrogate-model-based methods.The results demonstrate that our approach can obtain the maximum net present value(NPV)of the target production optimization problems.

Impact of edaravone on serum CXC chemokine ligand-13 levels and perioperative neurocognitive disorders in elderly patients with hip replacement

Background:Perioperative neurocognitive disorders(PND)are a series of severe complications in the perioperative and anesthetic periods with a decline in memory,execution ability,and information processing speed as the primary clinical manifestation.This study aimed to evaluate the impact of edaravone(EDA)on PND and peripheral blood C-X-C motif chemokine ligand 13(CXCL13)levels in elderly patients with hip replacement.Methods:A total of 160 elderly patients undergoing hip arthroplasty in Affiliated Dongguan People’s Hospital of Southern Medical University(from March 2016 to March 2018)were randomly and double-blindly categorized into an EDA group and a control group(CON).Group EDA was administered intravenously EDA 30 min before surgery,and group CON was administered intravenously saline.The cognitive function of the two groups was evaluated 1-day before the operation and at 1 and 12 months after surgery,and the incidence of post-operative delirium was tested on days 1,3,and 7 after surgery using the Chinese version of the confusion assessment method.Serum CXCL13 and interleukin(IL)-6 concentrations were measured before anesthesia,during surgery(30 min after skin incision),and on days 1,3,and 7 after surgery.The continuous variables in accordance with normal distribution were tested using the Student’s t test,the continuous variables without normal distribution using the Mann-Whitney U test,and categorical variables by the x 2 test or Fisher exact test.Results:The incidence of post-operative delirium within 7 days after surgery was significantly higher in group CON than that in group EDA(31.3%vs.15.0%,t=-5.6,P<0.001).The modifiedtelephone interview for cognitive status andactivities of daily life scores were significantly higher in the group EDA than those in the group CON at 1 month(39.63±4.35 vs.33.63±5.81,t=-2.13,P<0.05and 74.3±12.6 vs.61.2±13.1,t=-1.69,P<0.05)and 12 months(40.13±5.93 vs.34.13±5.36,t=-3.37,P<0.05 and 79.6±11.7 vs.65.6±16.6,t=-2.08,P<0.05)after surgery;and the incidence of neurocognitive dysfunction was significantly lower in the group EDA than that in the group CON(P<0.05).Serum CXCL13 and IL-6 concentrations were significantly lower in the group EDA than those in the group CON during and after surgery(P<0.05).Conclusion:EDA can significantly reduce the serum concentrations of CXCL13 and IL-6 and improve the PND of patients.

Discrimination of Repetitive Sequences Polymorphism in Secale cereale by Genomic In Situ Hybridization-Banding

Genomic in situ hybridization banding (GISH-banding), a technique slightly modified from conventional GISH, was used to probe the Chinese native rye (Secale cereale L.) DNA, and enabled us to visualize the individual rye chromosomes and create a universal reference karyotype of the S. cereale chromosome 1R to 7R. The GISH-banding approach used in the present study was able to discriminate S. cereale chromosomes or segments in the wheat (Triticum aestivum L.) background, including the Triticale, wheat-rye addition and translocation lines. Moreover, the GISH-banding pattern of S. cereale subsp. Afghanicum chromosomes was consistent with that of Chinese native rye cv. Jingzhou rye; whereas the GISH-banding pattern of Secale vavilovii was different from that of S. cereale, indicating that GISH-banding can be used to study evolutionary polymorphism in species or subspecies of Secale. In addition, the production and application of GISH-banding to the study of adenine-thymine-riched heterochromatin is discussed.

Chinese guideline for the application of rectal cancer staging recognition systems based on artificial intelligence platforms (2021 edition)

Development and Application of Artificial Intelligence Recognition Systems in Rectal Cancer Staging Whether for surgical treatment or for neoadjuvant chemoradiotherapy,imaging evaluation has become an important basis to perform the treatment plans.[1]The reading of imaging results requires a large number of experienced radiologists to complete,but shortages and uneven distributions of personnel cause delays and biases in imaging results.Therefore,independent research and development of automatic recognition systems of rectal cancer staging based on artificial intelligence(AI)platforms aim to partially replace practitioners’work and achieve rapid and accurate identification of rectal cancer staging.

Multidisciplinary treatment in pulmonary metastasis of a mesorectal angiosarcoma achieving complete remission

To the Editor:Angiosarcoma(AS)is a rare and highly malignant mesenchymal tumor that accounts for 2%of adult soft tissue sarcomas.The prognosis of AS is poor due to the high rate of metastasis and reoccurrence.According to a retrospective study by Lahat et al and Fayette et al,[1,2]31 of 121(19%)patients had metastases upon initial diagnosis,and 90(74%)had relapse and progression.The median survival of AS was 3.4 years,declining to 10 months in patients with metastasis.To attempt to improve AS treatment outcomes,a multimodality approach is advocated,including surgical resection combined with radiation,chemotherapy,immunotherapy,and/or anti-angiogenetic therapy.Herein,we present a man who previously underwent resection of a mesorectal-derived intermediate hemangioendothelioma(HAE)and developed pulmonary metastasis of AS within a year.The history is remarkable because of(1)the rare primary location:only 2 cases were mesenteric-related;(2)the uncharacteristic clinical course:the primary diagnosis of intermediate hemangioendothelioma later progressed to pulmonary metastatic AS;and(3)a successful series of multidisciplinary therapeutic procedures,especially selective arterial infusion(SAI)chemotherapy before metastases resection.

Improved ferroelectric and piezoelectric properties of(Na_(0.5)K_(0.5))NbO_(3)ceramics via sintering in low oxygen partial pressure atmosphere and adding LiF

Dense(Na_(0.5)K_(0.5))NbO_(3)lead-free ceramics with the simple composition were prepared via sintering in low oxygen partial pressure(pO_(2),~10^(−12) atm)atmosphere and adding LiF.All the ceramics have pure orthorhombic structure.Compared to the LiF-added(Na_(0.5)K_(0.5))NbO_(3)ceramics sintered in air and the low pO_(2)-sintered pure(Na_(0.5)K_(0.5))NbO_(3)ceramics without LiF addition,the present ceramics exhibit improved piezoelectric and ferroelectric properties.The piezoelectric constant d33 is 125 pC/N,and the converse piezoelectric constant d_(33)^(*)is 186 pm/V.The dielectric constant and dielectric loss of the ceramics at room temperature and 1 kHz are 451 and 0.03,respectively.Under the measured electric field of 70 kV/cm,the remanent polarization is 25.9μC/cm^(2)and the coercive field is 13.9 kV/cm.Furthermore,if the base metals such as Cu and Ni powders were mixed into the green pellets and sintered in the low pO_(2)atmosphere,the base metals cannot be oxidized,suggesting possibility of using base metals as electrodes.