Background Transanal total mesorectal excision(taTME)or intersphincteric resection(ISR)has recently proven to be a valid and safe surgical procedure for low rectal cancer.However,studies focusing on the combination of...Background Transanal total mesorectal excision(taTME)or intersphincteric resection(ISR)has recently proven to be a valid and safe surgical procedure for low rectal cancer.However,studies focusing on the combination of these two technologies are limited.This study aimed to evaluate perioperative results,long-termoncologic outcomes,and anorectal functions of patients with low rectal cancer undergoing taTME combined with ISR,by comparing with those of patients undergoing laparoscopic abdominoperineal resection(laAPR).Methods After 1:1 propensity score matching,200 patients with low rectal cancer who underwent laAPR(n=100)or taTME combined with ISR(n=100)between September 2013 and November 2019 were included.Patient demographics,clinicopathological characteristics,oncological outcomes,and anal functional results were analysed.Results Patients in the taTME-combined-with-ISR group had less intraoperative blood loss(79.6672.6 vs 107.3665.1 mL,P=0.005)and a lower rate of post-operative complications(22.0%vs 44.0%,P<0.001)than those in the laAPR group.The overall local recurrence rates were 7.0%in both groups within 3 years after surgery.The 3-year disease-free survival rates were 86.3%in the taTME-combined-with-ISR group and 75.1%in the laAPR group(P=0.056),while the 3-year overall survival rates were 96.7%and 94.2%,respectively(P=0.319).There were 39 patients(45.3%)in the taTME-combined-with-ISR group who developed major low anterior resection syndrome,whereas 61 patients(70.9%)had good post-operative anal function(Wexner incontinence score≤10).Conclusion We found similar long-term oncological outcomes for patients with low rectal cancer undergoing laAPR and those undergoing taTME combined with ISR.Patients receiving taTME combined with ISR had acceptable post-operative anorectal function.展开更多
The origin of a high mechanical quality in CuO-doped （K, Na）NbO3-based ceramics is addressed by considering the correlations between the lattice positions of Cu ions and the hardening effect in K0.48Na0.52＋xNbO3-0....The origin of a high mechanical quality in CuO-doped （K, Na）NbO3-based ceramics is addressed by considering the correlations between the lattice positions of Cu ions and the hardening effect in K0.48Na0.52＋xNbO3-0.01CuO ceramics. The Cu ions simultaneously occupy K/Na and Nb sites of these ceramics with x = 0 and 0.02, only occupy the K/Na site of the ceramics with x= -0.02, and mostly form a secondary phase of the ceramics with x = -0.05. The Cu ions lead to the hardening of ceramics with an increase of Ec and Qm by only occupying the K/Na site, together with the formation of double hysteresis loops in un-poled compositions. A defect model is proposed to illuminate the origin of a high Qm value, that is, the domain stabilization is dominated by the content of relatively mobile O2- ions in the ceramics, which has a weak bonding with CUK/Na defects.展开更多
基金supported by a grant from the Shenzhen“San Ming Projects”Research[Grant No.lc202002 to L.K.]the Fundamental Research Funds for the Central Universities[Grant No.16ykjc25 to L.K.]+1 种基金Sun Yat-sen University Clinical Research 5010 Program[Grant No.2016005 to L.K.]the National Key Clinical Discipline.
文摘Background Transanal total mesorectal excision(taTME)or intersphincteric resection(ISR)has recently proven to be a valid and safe surgical procedure for low rectal cancer.However,studies focusing on the combination of these two technologies are limited.This study aimed to evaluate perioperative results,long-termoncologic outcomes,and anorectal functions of patients with low rectal cancer undergoing taTME combined with ISR,by comparing with those of patients undergoing laparoscopic abdominoperineal resection(laAPR).Methods After 1:1 propensity score matching,200 patients with low rectal cancer who underwent laAPR(n=100)or taTME combined with ISR(n=100)between September 2013 and November 2019 were included.Patient demographics,clinicopathological characteristics,oncological outcomes,and anal functional results were analysed.Results Patients in the taTME-combined-with-ISR group had less intraoperative blood loss(79.6672.6 vs 107.3665.1 mL,P=0.005)and a lower rate of post-operative complications(22.0%vs 44.0%,P<0.001)than those in the laAPR group.The overall local recurrence rates were 7.0%in both groups within 3 years after surgery.The 3-year disease-free survival rates were 86.3%in the taTME-combined-with-ISR group and 75.1%in the laAPR group(P=0.056),while the 3-year overall survival rates were 96.7%and 94.2%,respectively(P=0.319).There were 39 patients(45.3%)in the taTME-combined-with-ISR group who developed major low anterior resection syndrome,whereas 61 patients(70.9%)had good post-operative anal function(Wexner incontinence score≤10).Conclusion We found similar long-term oncological outcomes for patients with low rectal cancer undergoing laAPR and those undergoing taTME combined with ISR.Patients receiving taTME combined with ISR had acceptable post-operative anorectal function.
基金Acknowledgements This work was supported by the National Natural Science Foundation of China （NSFC Grant Nos. 11305152, 51272164, 50772068 and 50972095） and Foundation of Doctor Training Program in University and College in China （Grant Nos. 20030610035 and 20080610020）.
文摘The origin of a high mechanical quality in CuO-doped （K, Na）NbO3-based ceramics is addressed by considering the correlations between the lattice positions of Cu ions and the hardening effect in K0.48Na0.52＋xNbO3-0.01CuO ceramics. The Cu ions simultaneously occupy K/Na and Nb sites of these ceramics with x = 0 and 0.02, only occupy the K/Na site of the ceramics with x= -0.02, and mostly form a secondary phase of the ceramics with x = -0.05. The Cu ions lead to the hardening of ceramics with an increase of Ec and Qm by only occupying the K/Na site, together with the formation of double hysteresis loops in un-poled compositions. A defect model is proposed to illuminate the origin of a high Qm value, that is, the domain stabilization is dominated by the content of relatively mobile O2- ions in the ceramics, which has a weak bonding with CUK/Na defects.
