Survival prognostic analysis of laparoscopic D2 radical resection for locally advanced gastric cancer: A multicenter cohort study

BACKGROUND With the development of minimally invasive surgical techniques,the use of laparoscopic D2 radical surgery for the treatment of locally advanced gastric cancer(GC)has gradually increased.However,the effect of this procedure on survival and prognosis remains controversial.This study evaluated the survival and prognosis of patients receiving laparoscopic D2 radical resection for the treatment of locally advanced GC to provide more reliable clinical evidence,guide clinical decision-making,optimize treatment strategies,and improve the survival rate and quality of life of patients.METHODS A retrospective cohort study was performed.Clinicopathological data from 652 patients with locally advanced GC in our hospitals from December 2013 to December 2023 were collected.There were 442 males and 210 females.The mean age was 57±12 years.All patients underwent a laparoscopic D2 radical operation for distal GC.The patients were followed up in the outpatient department and by telephone to determine their tumor recurrence,metastasis,and survival.The follow-up period ended in December 2023.Normally distributed data are expressed as the mean±SD,and normally distributed data are expressed as M(Q1,Q3)or M(range).Statistical data are expressed as absolute numbers or percentages;theχ2 test was used for comparisons between groups,and the Mann-Whitney U nonparametric test was used for comparisons of rank data.The life table method was used to calculate the survival rate,the Kaplan-Meier method was used to construct survival curves,the log rank test was used for survival analysis,and the Cox risk regression model was used for univariate and multifactor analysis.RESULTS The median overall survival(OS)time for the 652 patients was 81 months,with a 10-year OS rate of 46.1%.Patients with TNM stages II and III had 10-year OS rates of 59.6%and 37.5%,respectively,which were significantly different(P<0.05).Univariate analysis indicated that factors such as age,maximum tumor diameter,tumor diffe-rentiation grade(low to undifferentiated),pathological TNM stage,pathological T stage,pathological N stage(N2,N3),and postoperative chemotherapy significantly influenced the 10-year OS rate for patients with locally advanced GC following laparoscopic D2 radical resection for distal stomach cancer[hazard ratio(HR):1.45,1.64,1.45,1.64,1.37,2.05,1.30,1.68,3.08,and 0.56 with confidence intervals(CIs)of 1.15-1.84,1.32-2.03,1.05-1.77,1.62-2.59,1.05-1.61,1.17-2.42,2.15-4.41,and 0.44-0.70,respectively;P<0.05].Multifactor analysis revealed that a tumor diameter greater than 4 cm,low tumor differentiation,and pathological TNM stage III were independent risk factors for the 10-year OS rate in these patients(HR:1.48,1.44,1.81 with a 95%CI:1.19-1.84).Additionally,postoperative chemotherapy emerged as an independent protective factor for the 10-year OS rate(HR:0.57,95%CI:0.45-0.73;P<0.05).CONCLUSION A maximum tumor diameter exceeding 4 cm,low tumor differentiation,and pathological TNM stage III were identified as independent risk factors for the 10-year OS rate in patients with locally advanced GC following laparoscopic D2 radical resection for distal GC.Conversely,postoperative chemotherapy was found to be an independent protective factor for the 10-year OS rate in these patients.

基于GROUP STUDY的《资产评估》多元教学法研究

近年来,很多高校在传统资产评估课程的教学中引入了案例,但大多案例是事先组织和规划好的,使得资产评估的案例教学变成了单纯的计算和解答,忽略了对学生实践能力的培养。本文在分析传统教学方法不足的基础上,提出了基于GROUP STUDY的《资产评估》多元教学法,详细分析了基于GROUP STUDY的《资产评估》多元教学法的构成。得出采用该方法后,学生的缺课率明显降低、课堂热情和参与度明显提高、成绩的区分度明显改善、综合能力大大提高等结论。该研究为应用性专业课程的教学提供了新的思路。

STUDY GROUP在中国

<正>一、什么是STUDY GROUP STUDY GROUP是牛津大学的A.B.Tayler博士和当时他的学生J.Ockendon等人在1968年创立的,它的原名是Oxford Study Group with Industry。这种活动历时一周,是由数学工作者和工业界人士参加的旨在解决实际问题的研讨会。在研讨会的第一天,由工业界代表陈述要解决的问题和目的要求,通常会有5~6个问题。后续2~3天按问题分组讨论,试图建立问题的数学模型和求解方法来解决问题。

Autonomous Unbiased Study Group Formation Algorithm for Rapid Knowledge Propagation

Knowledge propagation is a necessity,both in academics and in the industry.The focus of this work is on how to achieve rapid knowledge propaga-tion using collaborative study groups.The practice of knowledge sharing in study groupsfinds relevance in conferences,workshops,and class rooms.Unfortu-nately,there appears to be only few researches on empirical best practices and techniques on study groups formation,especially for achieving rapid knowledge propagation.This work bridges this gap by presenting a workflow driven compu-tational algorithm for autonomous and unbiased formation of study groups.The system workflow consists of a chronology of stages,each made of distinct steps.Two of the most important steps,subsumed within the algorithmic stage,are the algorithms that resolve the decisional problem of number of study groups to be formed,as well as the most effective permutation of the study group participants to form collaborative pairs.This work contributes a number of new algorithmic concepts,such as autonomous and unbiased matching,exhaustive multiplication technique,twisted round-robin transversal,equilibrium summation,among others.The concept of autonomous and unbiased matching is centered on the constitution of study groups and pairs purely based on the participants’performances in an examination,rather than through any external process.As part of practical demon-stration of this work,study group formation as well as unbiased pairing were fully demonstrated for a collaborative learning size of forty(40)participants,and partially for study groups of 50,60 and 80 participants.The quantitative proof of this work was done through the technique called equilibrium summation,as well as the calculation of inter-study group Pearson Correlation Coefficients,which resulted in values higher than 0.9 in all cases.Real life experimentation was carried out while teaching Object-Oriented Programming to forty(40)under-graduates between February and May 2021.Empirical result showed that the per-formance of the learners was improved appreciably.This work will therefore be of immense benefit to the industry,academics and research community involved in collaborative learning.

ZTE Joins Global IT Leaders on Cloud Computing Standards Study Group

ZTE Corporation announced on 1 March that it will join global information technology leaders in a cloud computing standards study group.

The Roadmap for Lenovo to Go Global——A Case study of Lenovo Group Strategies

I.Lenovo: refocus on PC operation On December 8th, 2004, Lenovo consummated a deal with IBM whereby Lenovo was to acquire IBM’s desktop and laptop PC unit and its R&D and procurement operations worldwide for the sum of US$1.25 billion. On May 1st 2005, Lenovo completed its acquisition of IBM’s PC Unit. "Using an analogy, our enterprise is well likened to a tortoise but our foreign competitor is more like a rabbit. Instead of racing against the rabbit heads-on, we would rather ride on its back and let it carry us forward," said former Lenovo Chairman Liu Chuanzhi.

Study on fishery biology features of spawning group of Pseudopleuronectes yokamae(Gunther) in the Sheath Bay

Pseudopleuronectes yokamae (Günther) is one of the most important economic fish species in the genus living specially in the northwest Pacific, and is distributed in the southern area of the far east sea of Russia, Japan, Korea, the Huanghai Sea, the Bohai Sea and the northern area of the East China Sea. Usually they live in nearshore waters of these areas as geographic subpopulations. P. yokamae in the Sheath Bay belongs to a local group of the Huanghai-Bohai Sea subpopulation and is distributed in the mouth and adjacent waters of the bay all the year round, and the catch of its spawning group has

An Investigation of Samoan Student Experiences in Two Homework Study Groups in Melbourne

This research examines Samoan student experiences in two Homework Study Groups （HSGs） in Melbourne using a researcher-practitioner approach. It highlights that school teachers need to acknowledge students＇ preferred learning methods, especially those of minority backgrounds like the Samoan participants in this investigation. A detailed exploration of the experiences of students in two HSGs finds that while students and their families place a high priority on learning, their cultural practices are not compatible with standard Western learning approaches. The HSGs provided a social space in which students could ask the teacher questions without fear of appearing foolish, in which they could apply themselves to study. It provided a physical study space away from the demands some Samoan families place on their young people, and it provided a cultural space in which the students could learn according to fa＇aSamoa （traditional values and beliefs）. This research makes a contribution to an understanding of the motivations of Melbourne-based Samoan students to learn, of what concerns them, and of impediments to their educational success. It also offers insight into the benefits that set up a specific space for students offers, when its specific intent is influencing the merging of Samoan and Western ideas to further learning.

如何举办一次成功的Study Group——以2012工业与应用数学国际研讨会为例

作为数学工作者和产业界专业人士共同探讨实际问题的数学建模及其解决方案的一种国际合作形式,诞生40多年的Study Group with Industry(工业与应用数学国际研讨会)活动遍及世界各大洲,为数学工作者参与高技术领域的创新、产业部门发现和培养高素质人才提供了有效的平台。在中国科学院院士李大潜、英国皇家学会会员(Fellow)J.Ockendon的大力推动下,这项活动在中国的影响力正在逐步扩大[1]。

Lymphocyte-to-white blood cell ratio is associated with outcome in patients with hepatitis B virus-related acute-on-chronic liver failure

BACKGROUND The lymphocyte-to-white blood cell ratio(LWR)is a blood marker of the systemic inflammatory response.The prognostic value of LWR in patients with hepatitis B virus-associated acute-on-chronic liver failure(HBV-ACLF)remains unclear.AIM To explore whether LWR could stratify the risk of poor outcomes in HBV-ACLF patients.METHODS This study was conducted by recruiting 330 patients with HBV-ACLF at the Department of Gastroenterology in a large tertiary hospital.Patients were divided into survivor and non-survivor groups according to their 28-d prognosis.The independent risk factors for 28-d mortality were calculated by univariate and multivariate Cox regression analyses.Patients were divided into low-and high-LWR groups according to the cutoff values.Kaplan-Meier analysis was performed according to the level of LWR.RESULTS During the 28-d follow-up time,135 patients died,and the mortality rate was 40.90%.The LWR level in non-surviving patients was significantly decreased compared to that in surviving patients.A lower LWR level was an independent risk factor for poor 28-d outcomes(hazard ratio=0.052,95%confidence interval:0.005-0.535).The LWR level was significantly negatively correlated with the Child-Turcotte-Pugh,model for end-stage liver disease,and Chinese Group on the Study of Severe Hepatitis B-ACLF II scores.In addition,the 28-d mortality was higher for patients with LWR<0.11 than for those with LWR≥0.11.CONCLUSION LWR may serve as a simple and useful tool for stratifying the risk of poor 28-d outcomes in HBVACLF patients.

STUDIES ON THE INITIATION MECHANISM OF CERIC ION AND ACETYLACETONE REDOX SYSTEM IN VINYL POLYMERIZATION

The initiation mechanism of acrylamide (AAM)polymerization using ceric ion/acetylacetone system as an initiator has been studied. The redox polymerization was revealed by the low value of overall activation energy of AAm polymerization. The structure of free radicals formed from above-mentioned initiation sytem were detected by radical trapping and ESR spectra techniques and the end groups of polymers obtained were determined by FT-IR spectra analysis method. Based on these results the initiation mechanism is proposed.

Experimental study on distribution of serotypes and antimicrobial patterns of Group B streptococcus strains

Objective To obtain information on the distribution of serotypes and antimicrobial agent susceptibilities to group B streptococcus (GBS) strains isolated in Beijing area from 1991 to 1996. Methods Bacterial isolates of GBS were obtained from vaginal and cervical tract of pregnant and nonpregnant women in Beijing Tian Tan Hospital by culture. A total of 76 GBS strains were identified finally by coagglutination. Serotyping was determined by Standard Lancefield method. Susceptibility to test agents was assessed by determining the minimal inhibitory concentrations (MICs) with agar dilution method that was established by the National Committee for Clinical Laboratory Standards (NCCLS). Results Seven serotypes were identified among 76 GBS strains isolates. Types Ⅱ (33%), Ⅲ (23%) and Ⅰa (16%) were the predominant serotypes in pregnant and nonpregnant women. MICs of penicillin G and ampicillin were ≤0.06 μg/ml. MICs of cephazolin, cefuroxime and cefoperozone were 0.003 μg/ml 0.06 μg/ml. MICs of erythromycin were 0.003 μg/ml 0.03 μg/ml. MICs of gentamycin were 1 μg/ml 32 μg/ml. MICs of amikacin were 4 μg/ml ≥64 μg/ml, nearly 12.8% and 40.4% of the strains were resistant to gentamycin and amikacin, respectively. Conclusions Our study provides useful epidemiologic data for preparation of GBS type specific vaccines which can prevent GBS infections and antimicrobial agents susceptibility patterns in China. Routine reports on GBS susceptibilities by clinical laboratories and continuous surveillance for changes in the susceptibility are of considerable clinical importance.

A qualitative exploration of GPs’perspectives on managing chronic nonspecific musculoskeletal pain in Australian general practice-a focus group study

Objective:Chronic nonspecific musculoskeletal pain(CNMP)is a complex idiopathic condi-tion that causes significant disruption to patients’lives,their relationships,and functionality.The cause of CNMP is not fully understood,which makes diagnosis and management challenging.As general practitioners(GPs)are central to the management of chronic pain,their perspectives on managing CNMP are important.Purpose:To explore the clinical reasoning GPs use when diagnosing and managing CNMP.Methods:A qualitative study design using focus group discussion was conducted with Australian GPs.Five focus group discussion were conducted across Adelaide.All focus group discussions were audio-recorded,and transcripts were coded and analyzed thematically with the program NVivo.Results:The main themes remained consistent across the five focus group discussion’s:the ambiguous cause of CNMP;sex differences;developing the“right strategy”;patient-centered care;and verifying vitamin D levels.Conclusion:The findings show that GPs use a patient-centered approach tailored to indi-vidual patients’medical history,physical examination findings,and psychosocial health.There was general concern about low levels of vitamin D in patients with CNMP,and vitamin D supplements were recommended if indicated by a patient’s history.

The Study of Rationalization of the Economic Functions in Shanghai——the Study Group of the “Same topic”

From the PersPective of the systemsaPProaeh,the urban eeonomie functions re-fer to the role Played by the eeonomy of theeity in its surrounding areas.Beeause of different geograPhieal loeations,historiealeonditions,the various roles and funetionsof the eities in the national economy,theeeonomie funetions of a eity may be of

Progress on clinical prognosis assessment in liver failure

Liver failure is a group of clinical syndromes with a mortality rate of>50%.The accurate evaluation of severity in patients with liver failure has been a meaningful and hot topic in clinical research and an important guide for liver transplantation.Numerous prognosis studies have emerged in recent years with high accuracy and adequate validity.Nonetheless,different models utilize distinct parameters and have unequal efficiencies,leading to a specific value and unique application situations for each model.This review focused on the progress in recent prognostic studies including the model for end-stage liver disease,sequential organ failure assessment and its derivative models,the Chinese Group on the Study of Severe Hepatitis B Acute-on-Chronic Liver Failure,the Tongji prognostic predictor model,and other emerging prognostic models and predictors.This review aims to assist clinicians understand the framework of recent models and choose the appropriate model and treatment.

Decomposition and Reformulation of Banxia Baizhu Tianma Decoction:A Vasodilatory Approach

Objective To decompose and reformulate Banxia Baizhu Tianma Decoction（BBT） in order to optimize its ratio for vasodilatory effect.The fingerprints of these six component herbs were also studied via Tri-step FTIR analysis.Methods The herbal components of BBT were extracted separately with different solvents,such as 95%ethanol,50%ethanol,and distilled water.The vasodilatory effect of the extracts was studied using the in vitro pre-contracted aortic ring model.Among these extracts,the water extracts of Pinellia ternata[PT（W）]and Citri reticulatae[CR（W）],50%ethanol extracts of Castrodia elata[GE（50）]and Clycyrrhiza uralensis[GU（50）],and 95%ethanol extracts of Atractylodes macrocephala[AM（E）],and Poria cocos[PC（E）]were selected for the orthogonal stimulus-response compatibility group study due to their high effectiveness in vasodilation.Results The best combination ratio（G2） was GE（50）,GU（50）,AM（E）,PC（E）,CR（W）,and PT（W） at EC0,EC5,EC5,EC5,EC5,and EC5,with EC50 of（0.06 ± 0.01） mg/mL.Comparison between the vasodilatory effects of extracts derived from G2 and BBT were also studied.From the results,the 50%ethanol extract following G2 ratio was found to be most potent extract with the highest vasodilatory effect compared with other extracts derived from G2 or BBT,with EC50 of（0.05 ±0.005） mg/mL.Conclusion The optimum ratio and appropriate extraction method for the new BBT formulae are obtained.G2 is determined as the best formulae with the highest potency in producing the vasodilatory effect on isolated rat aortic rings.The results obtained suggest that 50%ethanol is found to be the best solvent to extract the vasoactive compounds of G2 in order to exhibit the highest efficacy of vasodilatory effect.

The incidence and severity of post-hepatectomy bile leaks is affected by surgical indications,preoperative chemotherapy,and surgical procedures

Background:Bile leaks are one of the most common complications after liver resection.The International Study Group of Liver Surgery(ISGLS)established a uniform bile leak definition including a severity grading.However,a risk factor assessment according to ISGLS grading as well as the clinical implications has not been studied sufficiently so far.Methods:The incidence and grading of bile leaks according to ISGLS were prospectively documented in 501 consecutive liver resections between July 2012 and December 2016.A multivariate regression analysis was performed for risk factor assessment.Association with other surgical complications,90-day mortality as well as length of hospital stay(LOS)was studied.Results:The total rate of bile leaks in this cohort was 14.0%:2.8%grade A,8.0%grade B,and 3.2%grade C bile leaks were observed.Preoperative chemotherapy or biliary intervention,diagnosis of hilar cholangiocarcinoma,colorectal metastasis,central minor liver resection,major hepatectomy,extended hepatectomy or two-stage hepatectomy,were some of the risk factors leading to bile leaks.The multivariate regression analysis revealed that preoperative chemotherapy,major hepatectomy and biliodigestive reconstruction remained significant independent risk factors for bile leaks.Grade C bile leaks were associated not only with surgical site infection,but also with an increased 90-day mortality and prolonged LOS.Conclusions:The preoperative treatment as well as the surgical procedure had significant influence on the incidence and the severity of bile leaks.Grade C bile leaks were clinically most relevant,and led to significant increased LOS,rate of infection,and mortality.

Studies on the effect of opposite terminal groups in phenylpolyenic conjugative systems

Seven homologous series p-A=B-C_6H_4(CH=CH)_nX=Y (A=B: NO_2, X=Y: CHO, COMe, CN, NO_2; A=B: CN, X=Y: CHO, CN; A=B: H, X=Y: NO_2) were synthesized, the effect of opposite terminal groups in phenylpolyenic conjugative systems has been studied by means of UV, XPS, ^(13) C NMR and quantum chemical calculation. The results show that: 1. There exists the effect of opposite terminal groups exists in phenylpolyenic and other aromatic conjugative systems. 2. When A=B and X=Y are the same, the group (-X=Y) connected at polyenic chain is a terminal group, while the other is an opposite terminal group. When the two groups are different, the one with weaker conjugative power plays the role of the opposite terminal group. 3. The effect of opposite terminal groups increases successively in the order of CN, COMe, CHO, NO_2 and can be quantita- tively described with substitute equivalent △N_s. Theλ_(max) of compound containing an opposite terminal group can be calculated by the homologous equation 10^(-4) =a+b/(1/2)^(2/N＇^(-S)_a), most of the calculated values are in agreement with experiment results.