Laparoscopic vs open radical resection in management of gallbladder carcinoma:A systematic review and meta-analysis

BACKGROUND Radical resection offers the only hope for the long-term survival of patients with gallbladder carcinoma(GBC)above the T1b stage.However,whether it should be performed under laparoscopy for GBC is still controversial.AIM To compare laparoscopic radical resection(LRR)with traditional open radical resection(ORR)in managing GBC.METHODS A comprehensive search of online databases,including Medline(PubMed),Cochrane Library,and Web of Science,was conducted to identify comparative studies involving LRR and ORR in GBCs till March 2023.A meta-analysis was subsequently performed.RESULTS A total of 18 retrospective studies were identified.In the long-term prognosis,the LRR group was comparable with the ORR group in terms of overall survival and tumor-free survival(TFS).LRR showed superiority in terms of TFS in the T2/tumor-node-metastasis(TNM)Ⅱstage subgroup vs the ORR group(P=0.04).In the short-term prognosis,the LRR group had superiority over the ORR group in the postoperative length of stay(POLS)(P<0.001).The sensitivity analysis showed that all pooled results were robust.CONCLUSION The meta-analysis results show that LRR is not inferior to ORR in all measured outcomes and is even superior in the TFS of patients with stage T2/TNMⅡdisease and POLS.Surgeons with sufficient laparoscopic experience can perform LRR as an alternative surgical strategy to ORR.

Multi-slice three-dimensional spiral CT cholangiography: a new technique for diagnosis of biliary diseases

Objective: To validate multi-slice three-dimensional spiral CT cholangiography (3-D CTC) in clinical di- agnosis of biliary diseases. Methods: This study included 146 patients with bili- ary diseases, involving 73 cases of biliary tumor, 87 cases of radioparent calculus, 12 cases of post cholan- gio-jejunostomy and one case of congenital choledo- chocyst. The data of thin-slice volumetric CT scan were sent to the workstation (GE Advantage Win- dows 3. 1). Rational 3-D CTC including maximum intensity projection, minimum intensity projection, surface shaded display, CT virtual endoscopy and ray sumption was performed. The diagnostic accura- cy of 3-D CTC was compared with that of conven- tional CT, ultrasonography and endoscopic retro- grade cholangiopancreaticography (ERCP). Results: Different biliary diseases showed distinct ima- ging manifestations on 3-D CTC, As a new technique for assessing the status of post cholangio-jejunosto- my, 3-D CTC was superior to conventional CT, ul- trasonography and ERCP in diagnosis of negative bil- iary calculus, extrahepatic cholangiocarcinoma, cancer embolus of the biliary duct, carcinoma of the pancreas head and periampullar carcinoma. It was also superior to conventional CT, ultrasonography or equal to ERCP in diagnosis of hilar cholangiocarcino- ma, but inferior to conventional CT and ultrasonog- raphy in diagnosis of gallbladder cancer. Conclusion: 3-D CTC as a non-invasive and sensitive technique for the diagnosis of biliary diseases with high diagnostic accuracy will greatly increase the de- tection rate of biliary diseases.

Purification and characterization of cholecystokinin from the skin of salamander Tylototriton verrucosus

As a group of intestinal hormones and neurotransmitters, cholecystokinins（CCKs） regulate and affect pancreatic enzyme secretion, gastrointestinal motility, pain hypersensitivity, digestion and satiety, and generally contain a DYMGWMDFG sequence at the C-terminus. Many CCKs have been reported in mammals. However, only a few have been reported in amphibians, such as Hyla nigrovittata, Xenopus laevis, and Rana catesbeiana, with none reported in urodele amphibians like newts and salamanders. Here, a CCK called CCK-TV was identified and characterized from the skin of the salamander Tylototriton verrucosus. This CCK contained an amino acid sequence of DYMGWMDF-NH2 as seen in other CCKs. A c DNA encoding the CCK precursor containing 129 amino acid residues was cloned from the c DNA library of T. verrucosus skin. The CCK-TV had the potential to induce the contraction of smooth muscle strips isolated from porcine gallbladder, eliciting contraction at a concentration of 5.0x10-11 mol/L and inducing maximal contraction at a concentration of 2.0x10-6 mol/L. The EC50 was 13.6 nmol/L. To the best of our knowledge, this is the first report to identify the presence of a CCK in an urodele amphibian.

Factors associated with the nurses’intent to stay in China,Japan,and Korea:an integrative review

Objective:Nurse’s dimission and attrition are globally considered as a public health issue.However,few studies have focused on the nurse shortage from the perspective of intent to stay,as previous studies have focused only on why they left.The purpose of this study was to conduct an integrative review of the factors connected with why nurses in China,Japan,and Korea stay in their current workplace.Methods:The review was done using three databases namely CNKI,Wanfang,and Web of science.The relevant studies published by Chinese,Japanese,and Koreans from 2010 were also included in this review.Literature screening and data extraction were performed by the two researchers,and the qualitative research methods were used for analysis.Results:A total of 17 studies were analyzed in this review and of these two were qualitative and 15 were quantitative.Three themes and six sub-themes emerged from the synthesization of the data of 17 studies,which will help us to find the factors for nurses’intent to stay.The three aspects such as professional characteristics,nurses’individual characteristics,and organizational factors are the main contributing factors of nurses’intent to stay.Conclusions:This integrated review has thrown some important factors about nurses’intent to stay.It is increasingly clear that when(1)nurses have a good professional status,(2)nurses could enjoy a good working relationship,(3)the workplace could meet the needs of personal development,and(4)nurses have good organizational support and excellent leaders,they are inclined to stay in their current jobs.Managers need to adopt targeted measures to improve nurses’intent to stay and to provide a practical reference for health care institutions and managers in different countries and areas to increase the retention rate of nurses and to alleviate the current situation of nurse shortage.

P45 technology reveals bow-and-arrow sign in human ankle

To the Editor:Recent studies have shown that the morphology of bone in vivo,including the shape,diameter,length,curve,and alignment of the bone,adapt to longterm loads both before and after skeletal maturity.The deformation and rate are different according to the magnitude of strain,the mode of action,position and the quality of bone of the strain,which is named by law of dynamic deformation of bone.[1]Here,we found that the existence of circular bone trabecula in the calcaneus by P45 plastination technology.It might be caused by the force conduction to the flexor digitorum brevis during the contraction of the triceps surae according to this law.

FDGLib: A Communication Library for Efficient Large-Scale Graph Processing in FPGA-Accelerated Data Centers

With the rapid growth of real-world graphs,the size of which can easily exceed the on-chip(board)storage capacity of an accelerator,processing large-scale graphs on a single Field Programmable Gate Array(FPGA)becomes difficult.The multi-FPGA acceleration is of great necessity and importance.Many cloud providers(e.g.,Amazon,Microsoft,and Baidu)now expose FPGAs to users in their data centers,providing opportunities to accelerate large-scale graph processing.In this paper,we present a communication library,called FDGLib,which can easily scale out any existing single FPGA-based graph accelerator to a distributed version in a data center,with minimal hardware engineering efforts.FDGLib provides six APIs that can be easily used and integrated into any FPGA-based graph accelerator with only a few lines of code modifications.Considering the torus-based FPGA interconnection in data centers,FDGLib also improves communication efficiency using simple yet effective torus-friendly graph partition and placement schemes.We interface FDGLib into AccuGraph,a state-of-the-art graph accelerator.Our results on a 32-node Microsoft Catapult-like data center show that the distributed AccuGraph can be 2.32x and 4.77x faster than a state-of-the-art distributed FPGA-based graph accelerator ForeGraph and a distributed CPU-based graph system Gemini,with better scalability.