Synchronous quintuple primary gastrointestinal tract malignancies: Case report

Multiple primary malignancy is defined as two or more malignancies detected in an individual person. In particular, synchronous quintuple primary malignancy is extremely rare. A 52-year-old male with anal pain and intermittent blood-tinged stool was diagnosed with malignancies in the stomach, jejunum, ascending colon, transverse colon and rectum. He underwent a subtotal gastrectomy, segmental resection of the jejunum and total protocolectomy with end ileostomy. The postoperative pathologic findings were moderate differentiated gastric adenocarcinoma (pT1bN0M0, pStageIA), combined adenocarcinoma and neuroendocrine carcinoma of the jejunum (pT3N0M0, pStageIIA), three mucinous adenocarcinoma of the ascending colon (pT3N0M0, pStageIIA), transverse colon (pT1N0M0, pStageI) and rectum (pT3N1aM0, pStageIIIB). The tumors did not lack MLH-1 and MSH-2 expression, as the markers (bat26, D5S346, bat25, D2S123) suggest MSI-H presence. Adjuvant chemoradiotherapy was started according to regimen, FOLFOX 4 for advanced rectal cancer. Six years post-operation, the patient is currently attending regular follow-ups without recurrence or metastasis.

Modification of the Hybridization Gap by Twisted Stacking of Quintuple Layers in a Three-Dimensional Topological Insulator Thin Film

Twisting the stacking of layered materials leads to rich new physics. A three-dimensional topological insulator film hosts two-dimensional gapless Dirac electrons on top and bottom surfaces, which, when the film is below some critical thickness, will hybridize and open a gap in the surface state structure. The hybridization gap can be tuned by various parameters such as film thickness and inversion symmetry, according to the literature. The three-dimensional strong topological insulator Bi(Sb)Se(Te) family has layered structures composed of quintuple layers(QLs) stacked together by van der Waals interaction. Here we successfully grow twistedly stacked Sb_2Te_3 QLs and investigate the effect of twist angels on the hybridization gaps below the thickness limit. It is found that the hybridization gap can be tuned for films of three QLs, which may lead to quantum spin Hall states.Signatures of gap-closing are found in 3-QL films. The successful in situ application of this approach opens a new route to search for exotic physics in topological insulators.

Enantioselective Construction of Polycyclic Chromanes through Organocatalytic Sequential Quintuple Reaction via One-Pot Step-Wise Procedure

An efficient and highly stereoselective synthetic method to access polycyclic chromanes has been achieved through organocatalyzed one-pot step-wise reactions involving 2-hydroxycinnamaldehydes,2-aminochalcones,and malononitrile as substrates.The reactions underwent a quintuple process by aza-Michael/Michael/Knoevenagel/oxa-Michael/aldol-type reaction in sequence to give products bearing 3 new generated rings and 5 chiral centers in moderate to quantitative yields with excellent stereoselectivities.

Unraveling the amplified chiroptical responses of rylene-bladed quintuple[6]helicenes

Unraveling the key structural features to maximize the chiroptical properties is of significance for developing high-performance chiral materials.Here we present our first attempt to elucidate and understand the molecular design of excellent chiroptical properties via the combination of multiplicity and the alignment of subhelicenes.Two stereoisomeric PDI-bladed quintuple[6]helicenes,namely D_(5)-CRP and C_(2)-CRP,were revealed to show distinct spatial arrangements of subhelicenes.Circular dichroism(CD)spectra showed that the Cotton effects(Δε)are reaching 1,412 mol-1L cm-1for D_(5)-CRP and 669 mol^(-1)L cm^(-1)for C_(2)-CRP in the visible spectrum.The greatly amplifiedΔεrelative to the smaller analogue NPDH arises from the circular annulation of helicenes and high molecular symmetry that could significantly regulate the transition dipole moments and thereby make them tend to be(anti)parallel,as supported by TDDFT calculations for the rotatory strength(R).Consequently,the maximal dissymmetry factors(|g_(abs)|and|g_(lum)|)of this kind of chiral molecular carbon imides were estimated to be up to 0.021 and 0.012,respectively.This study provides a deep insight into the chiroptical properties of complicated chiral systems.

Multiple primary malignancies including colon, stomach, lung, breast, and liver cancer： a case report and literature review

Multiple primary malignancies in a single patient are relatively rare but have increase in frequency in recent decades. This may be a result of medical advancements in diagnostic and therapeutic strategies, a possible effect of new carcinogens in the industrial environment, and longer life span allowing another primary cancer to develop. Among those with multiple primary malignancies, double cancer is commonly seen, while triple cancers occur in 0.5% of patients, and quadruple or quintuple cancers occur in only less than 0.1% of the population.

The Products of Three Theta Functions and the General Cubic Theta Functions

In this paper we establish two theta function identities with four parameters by the theory of theta functions. Using these identities we introduce common generalizations of Hirschhorn-Garvan-Borwein cubic theta functions, and also re-derive the quintuple product identity, one of Ramanujan＇s identities, Winquist＇s identity and many other interesting identities.

Eco-innovative development of industrial ecosystems based on the quintuple helix

This article explores how eco-innovation practices are integrated into different industrial ecosystems in different national and regional contexts,and the role of the quintuple helix model in this integration.The research examines the collaborative interaction of academia,industry,government,civil society,and the natural environment in fostering an integrated eco-innovation ecosystem.The findings underscore the central role of the Quintuple Helix framework in effectively managing eco-innovation,suggesting a comprehensive approach that integrates environmental and societal concerns into a dynamic system for sustainable progress.The study shows that an ecosystem-based approach,underpinned by the quintuple helix,facilitates the rapid exchange of knowledge and resources essential to overcoming eco-innovation challenges,such as high R&D expenditures and the complex integration of sustainable technologies.The quintuple helix model emerges as a strategic imperative for concerted action to achieve eco-efficiency and eco-effectiveness.The study employs an innovative methodological framework based on Quintuple Helix projections using the Eco-Innovation Index(Eco-IS)and highlights significant trends in the roles of academia,industry,government,civil society,and the natural environment in ecoinnovation,with a particular focus on their contributions to eco-innovation leaders,average performers,and catching-up groups.The article describes the different roles and interdependencies of the actors within the ecosystem and urges a coherent,networked strategy for managing eco-innovation,which is crucial for sustainable and responsible growth.Acknowledging the issue of externalities that complicate eco-innovation management,the article posits that the quintuple helix framework can better address these challenges by enabling shared R&D investments and broad diffusion of innovations.This research contributes to the discourse on sustainable industrial development by proposing the quintuple helix as a transformative model for improving eco-innovation performance and fostering a culture of sustainability.