Comparison of virtual and true non-contrast images from dual-layer spectral detector computed tomography (CT) in patients with colorectal cancer.

Background: Colorectal cancer (CRC) is commonly assessed by computed tomography (CT), but the associated radiation exposure is a major concern. This study aimed to quantitatively and qualitatively compare the image quality of virtual non-contrast (VNC) images reconstructed from arterial and portal venous phases with that of true non-contrast (TNC) images in patients with CRC to assess the potential of TNC images to replace VNC images, thereby reducing the radiation dose. Methods: A total of 69 patients with postoperative pathologically confirmed CRC at the West China Hospital of Sichuan University between May 2022 and April 2023 were enrolled in this cross-sectional study. The CT protocol included the acquisition of TNC images, arterial and portal venous phase images; the VNC images were reconstructed from the two postcontrast phase images. Several parameters, including the CT attenuation value, absolute attenuation error, imaging noise [standard deviation (SD)], signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR), were measured in multiple abdominal structures for both the TNC and VNC images. Two blinded readers assessed the subjective image quality using a five-point scale. Interobserver agreement was evaluated using interclass correlation coefficients (ICCs). The paired t-test and Wilcoxon signed-rank test were used to compare the objective and subjective results between the TNC and VNC images. Individual measurements of radiation doses for the TNC scan and contrast scan protocols were recorded. Results: A total of 2,070 regions of interest (ROIs) of the 69 patients were analyzed. Overall, the VNC images exhibited significantly lower attenuation values and SD values than the TNC images in all tissues, except for the abdominal aorta, portal vein, and spleen. The mean absolute attenuation errors between the VNC and TNC images were all less than 10 Hounsfield units (HU). The percentages of absolute attenuation errors less than 5 and 10 HU in the VNC images from the arterial phase (VNCa) were 78.99% and 97.97%, respectively, while those from the portal venous phase (VNCp) were 81.59% and 96.96%, respectively. The absolute attenuation errors between the TNC and VNCa images were smaller than those between the TNC and VNCp images for tumors [VNCaerror: 2.77, interquartile range (IQR) 1.77-4.22; VNCperror: 3.27, IQR 2.68-4.30; P=0.002]. The SNR values and CNR values in the VNC images were significantly higher than those in the TNC images for all tissues, except for the portal vein and spleen. The image quality was rated as excellent (represented by a score of 5) in the majority of the TNC and VNC images; however, the VNC images scored lower than the TNC images. Eliminating the TNC phase resulted in a reduction of approximately 37.99% in the effective dose (ED). Conclusions: The VNC images provided accurate CT attenuation, good image quality, and lower radiation doses than the TNC images in CRC, and the VNCa images showed minimal differences in the CT attenuation of the tumors.

A giant solitary fibrous tumor of the abdominal pelvic cavity: A case report and literature review.

RATIONALE: Solitary fibrous tumor (SFT) is a rare mesenchymal tumor, especially the giant one from the abdominal pelvic cavity. We report on a rare case of a giant SFT of the abdominal pelvic cavity to review the existing literature in detail to improve the diagnosis and treatment of SFT. PATIENT CONCERNS: The patient is a 52-year-old female who presented with 2 weeks of abdominal distension. Abdominal magnetic resonance imaging showed a giant mass (>20 cm) in the abdominal pelvic cavity, considered a mesenchymal tumor. She denies a history of tumor disease. DIAGNOSES: A whole abdomen bulge and a mass of about 18 cm × 10 cm on the right side and middle side were found in the physical examination after admission. Abdominal enhanced computed tomography revealed a giant cystic-solid mass located on the middle and right side of the abdominal pelvic cavity, measuring approximately 20.4 cm × 11.7 cm, with multiple cystic changes and necrosis and compression of adjacent organs and tissues, and marked inhomogeneous enhancement. INTERVENTIONS: The patient underwent an open abdominal pelvic cavity giant tumor operation to achieve a radical resection, and did not undergo chemotherapy or radiotherapy. OUTCOMES: The patient underwent open complete resection of a giant abdominal pelvic tumor with no complications and was diagnosed as SFT according to the pathology, immunohistochemistry showed that the tumor tested positive for CD34(+), STAT-6(+), and Ki-67 (10%). Abdominal computed tomography scans were performed 6 months after resection, and no signs of recurrence or metastasis were found. LESSONS: The clinical symptoms and imaging features of giant abdominal pelvic cavity SFT are not typical. Preoperative diagnosis is difficult and has the potential for malignancy. Based on the results of the current study, there is no standard treatment strategy around the world and the therapeutic effect of radiation therapy and chemotherapy is relatively limited. Thus, complete surgical resection and close clinical follow-up are advocated.

Purse-string versus linear closure of the skin wound following stoma reversal: A meta-analysis with RCT and systematic review.

BACKGROUND: Linear closure (LC) following stoma reversal is associated with a high risk of surgical site infection (SSI). Purse-string closure and LC were both positive for the closure of the skin wound following stoma reversal, and it was not yet possible to distinguish which one was more beneficial to the patient's prognosis. METHODS: We conducted a search in Embase, PubMed, Web of Science, and Cochrane Library and conducted a randomized controlled experiment from the inception of each database to July 2024. Among them, the SSI within 30 days, operation time, hospitalization time, incisional hernia, and wound healing time were all outcome indicators. RESULTS: Eleven studies were included in this meta-analysis (506 patients in the purse-string closure group and 489 patients in the LC group). The pooled data showed that the SSI rate was significantly lower in the purse-string closure group than in the LC group (odds ratio, 0.15; 95% confidence interval, 0.09-0.24; P < .00001; I2 = 0%). The differences in operative time, hospitalization time, incision hernia, and wound healing time were not statistically significant. CONCLUSION: Overall, purse-string closure had a significantly lower SSI rate following stoma reversal than LC.

Understanding the impact of soil components on the environmental existence of Nonylphenol:From the perspective of soil aggregates.

Nonylphenol (4-NP) has significant adverse effects on the male reproductive system. 4-NP is commonly used in agriculture as a plasticizer and pesticide emulsifier. In the current study, two soil samples with different textures were collected to evaluate the impact of soil components on the environmental existence of 4-NP among soil aggregates. It was found that the presence of soil POM resulted in 4-NP exhibiting a significantly polarized distribution in soil aggregates, instead of the expected increase in content with decreasing particle size. High levels of organic matter and metal oxides result in a high carrying capacity of small aggregates for 4-NP in both soil textures, while POM results in a higher carrying capacity of large aggregates for 4-NP in clay soil. Another important finding is that the existence of 4-NP in soil was regulated by the percentage of aggregates. The results of contribution shown that although small aggregates in sand presented stronger 4-NP carrying capacity, whereas 4-NP was mainly distributed in large aggregates in sand. For clay soil, 4-NP was predominantly located in small aggregates with the 4-NP contributions of small aggregates amounting to 63.17%, despite the highest carrying capacity of 4-NP was observed in large aggregates. These results provide a theoretical basis to investigate the transport and transformation of 4-NP in the soil environment.

A lightweight intelligent laryngeal cancer detection system for rural areas.

OBJECTIVE: Early diagnosis of laryngeal cancer (LC) is crucial, particularly in rural areas. Despite existing studies on deep learning models for LC identification, challenges remain in selecting suitable models for rural areas with shortages of laryngologists and limited computer resources. We present the intelligent laryngeal cancer detection system (ILCDS), a deep learning-based solution tailored for effective LC screening in resource-constrained rural areas. METHODS: We compiled a dataset comprised of 2023 laryngoscopic images and applied data augmentation techniques for dataset expansion. Subsequently, we utilized eight deep learning models-AlexNet, VGG, ResNet, DenseNet, MobileNet, ShuffleNet, Vision Transformer, and Swin Transformer-for LC identification. A comprehensive evaluation of their performances and efficiencies was conducted, and the most suitable model was selected to assemble the ILCDS. RESULTS: Regarding performance, all models attained an average accuracy exceeding 90 % on the test set. Particularly noteworthy are VGG, DenseNet, and MobileNet, which exceeded an accuracy of 95 %, with scores of 95.32 %, 95.75 %, and 95.99 %, respectively. Regarding efficiency, MobileNet excels owing to its compact size and fast inference speed, making it an ideal model for integration into ILCDS. CONCLUSION: The ILCDS demonstrated promising accuracy in LC detection while maintaining modest computational resource requirements, indicating its potential to enhance LC screening accuracy and alleviate the workload on otolaryngologists in rural areas.

Physiological Mechanisms by Which the Functional Ingredients in Beer Impact Human Health.

Nutritional therapy, for example through beer, is the best solution to human chronic diseases. In this article, we demonstrate the physiological mechanisms of the functional ingredients in beer with health-promoting effects, based on the PubMed, Google, CNKI, and ISI Web of Science databases, published from 1997 to 2024. Beer, a complex of barley malt and hops, is rich in functional ingredients. The health effects of beer against 26 chronic diseases are highly similar to those of barley due to the physiological mechanisms of polyphenols (phenolic acids, flavonoids), melatonin, minerals, bitter acids, vitamins, and peptides. Functional beer with low purine and high active ingredients made from pure barley malt, as well as an additional functional food, represents an important development direction, specifically, ginger beer, ginseng beer, and coix-lily beer, as consumed by our ancestors ca. 9000 years ago. Low-purine beer can be produced via enzymatic and biological degradation and adsorption of purines, as well as dandelion addition. Therefore, this review paper not only reveals the physiological mechanisms of beer in overcoming chronic human diseases, but also provides a scientific basis for the development of functional beer with health-promoting effects.

Grinding siderite with ferric sulfate to generate an active ferrous source for Cr(VI) reduction.

Activated siderite, endowed with excellent properties, was simply prepared by co-grinding with Fe sulfate to enhance its high reducing ability for Cr(VI). Batch experiments were conducted to investigate the main affecting parameters, such as material ratio, pH, temperature, etc. The removal of Cr(VI) by activated siderite was completed within 4 h of the reaction. The activated siderite maintained a high removal effect of Cr(VI) within a wide pH range (3-9). Various analytical methods, including XRD, SEM/EDS, XPS, etc., were employed to characterize the samples and discover variations before and after the reaction. The Fe (Ⅱ) in activated siderite becomes highly active, and it can even be released from the solid phase in the mildly acidic liquid phase to efficiently reduce Cr(VI) and mitigate its toxicity. These findings introduce an innovative approach for activating various minerals widely distributed in nature to promote the recovery of the ecological system.

Parallel Driving with Big Models and Foundation Intelligence in Cyber-Physical-Social Spaces.

Recent years have witnessed numerous technical breakthroughs in connected and autonomous vehicles (CAVs). On the one hand, these breakthroughs have significantly advanced the development of intelligent transportation systems (ITSs); on the other hand, these new traffic participants introduce more complex and uncertain elements to ITSs from the social space. Digital twins (DTs) provide real-time, data-driven, precise modeling for constructing the digital mapping of physical-world ITSs. Meanwhile, the metaverse integrates emerging technologies such as virtual reality/mixed reality, artificial intelligence, and DTs to model and explore how to realize improved sustainability, increased efficiency, and enhanced safety. More recently, as a leading effort toward general artificial intelligence, the concept of foundation model was proposed and has achieved significant success, showing great potential to lay the cornerstone for diverse artificial intelligence applications across different domains. In this article, we explore the big models embodied foundation intelligence for parallel driving in cyber-physical-social spaces, which integrate metaverse and DTs to construct a parallel training space for CAVs, and present a comprehensive elucidation of the crucial characteristics and operational mechanisms. Beyond providing the infrastructure and foundation intelligence of big models for parallel driving, this article also discusses future trends and potential research directions, and the "6S" goals of parallel driving.

Laparoscopic assisted colectomy versus laparoscopic complete colectomy: a cost analysis.

To compare the short-term outcomes and explore the potential economic benefits of laparoscopic-assisted colectomy with extracorporeal anastomosis (LAC/EA) vs. laparoscopic complete colectomy with intracorporeal anastomosis (LCC/IA) for patients with non-metastatic resectable colon cancer. Data of patients who underwent laparoscopic hemicolectomy from January 2017 to March 2023 were collected and analyzed. Propensity score matching (PSM) analyses was carried out to minimize the selection bias. Before PSM, a total of 113 patients met the inclusion criteria (39 in the LCC/IA vs. 74 in the LAC/EA). Clinicopathologic characteristics were comparable except for the median number of removed lymph nodes (P = 0.023). LCC/IA was associated with longer operative time, less intraoperative blood loss, and shorter incision length. The rate of 30-day postoperative complications was similar, but the time to first flatus and soft diet was shorter in the LCC/IA. No deaths were reported in either group within 30 days after surgery. Costs of surgical instruments (25,945.8 ± 1,918.0 vs. 23,551.9 ± 2,665.5 RMB; P < 0.01) were higher for the LCC/IA but overall costs were similar (LCC/IA, 43,220.0 ± 4,954.0 vs. LAC/EA, 41,269.2 ± 6,685.9 RMB; P = 0.112). After PSM, 38 patients in the LCC/IA and 63 patients in the LAC/EA were compared. LCC/IA was superior in terms of intraoperative blood loss, incision length, and postoperative functional recovery. There was an extra charge of 2385.0 RMB regarding surgical instruments in the LCC/IA but the overall cost did not reach statistical significance. LCC/IA is a feasible, safe, and cost-effective surgical treatment for patients with non-metastatic resectable colon cancer.

Unveiling the hidden: identification and management of overlooked blood vessels in laparoscopic left hemicolectomy for splenic flexure cancer.

BACKGROUND: During laparoscopic left hemicolectomy procedures, a previously overlooked consistently thick blood vessel within the gastrocolic ligament near the splenic hilum may contribute to post-operative bleeding complications. The purpose of this study was to investigate the identification and management of the previously overlooked blood vessel. METHODS: This is a retrospective descriptive study of patients undergoing laparoscopic left colectomy for splenic fexure cancer conducted at a national gastrointestinal surgery centre in China. Consecutive patients with splenic fexure cancer who underwent laparoscopic left colectomy using our"five-step process"(n = 34) between January 2021 and July 2023 were included. RESULTS: The vessels can be effectively exposed using the aforementioned "five-step process." It was observed that the overlooked vessels consistently present in all patients were identified as the omental branch of the left gastroepiploic artery and vein. CONCLUSION: We have identified the origin of previously overlooked blood vessels and recommended a safe method for their management. This may offer advantages to colorectal surgeons performing laparoscopic left colectomy for splenic flexure cancer.

Health-promoting compounds in Amomum villosum Lour and Amomum tsao-ko: Fruit essential oil exhibiting great potential for human health.

The Zingiberaceae family serves as a diverse repository of bioactive phytochemicals, comprising approximately 52 genera and 1300 species of aromatic perennial herbs distinguished by their distinct creeping horizontal or tuberous rhizomes. Amomum villosum Lour. and Amomum tsao-ko Crevost & Lemaire., are the important plants of family Zingiberaceae that have been widely used in traditional medicine for the treatment of many ailments. The Amomum species are employed for their aromatic qualities and are valued as spices and flavorings. In the essential oils (EOs) of Amomum species, notable constituents include, camphor, methyl chavicol, bornyl acetate, trans-p-(1-butenyl) anisole, α-pinene, and ß-pinene. OBJECTIVE: The aim of this review is to present an overview of pharmacological studies pertaining to the extracts and secondary metabolites isolated from both species. The foremost objective of review is not only to increase the popularity of Amomum as a healthy food choice but also to enhance its status as a staple ingredient for the foreseeable future. RESULT: We endeavored to gather the latest information on antioxidant, antidiabetic, anticancer, antiobesity, antimicrobial, and anti-inflammatory properties of plants as well as their role in neuroprotective diseases. Research conducted through in-vitro studies, animal model, and compounds analysis have revealed that both plants exhibit a diverse array health promoting properties. CONCLUSION: the comprehensive review paper provides valuable insights into the diverse range of bioactive phytochemicals found in A. villosum and A. tsao-ko, showcasing their potential in preventing diseases and promoting overall human well-being. The compilation of information on their various health-enhancing properties contributes to the broader understanding of these plants and their potential applications in traditional medicine and beyond.

A novel U-tied semi-manual anastomosis in totally laparoscopic colectomy.

TECHNIQUE: We describe improvements to the previously proposed "U-tied anastomosis" with the aim of broadening its indications, especially in left hemicolectomy. After bowel mobilization and vascular ligation, the proximal and distal colon were aligned in a U-shape using a ligature. An anastomosis was constructed using a linear stapler through the common enterotomies. Following resection of the bowel using laparoscopic coagulation shears, the common opening was closed using 3-0 barbed sutures. RESULTS: Eight consecutive patients underwent colectomy using the U-tied semi-manual technique between May and July 2023. In all cases, the U-tied procedures were completed using one cartridge and two sutures. No complications or mortality were observed after one month of follow-up. CONCLUSIONS: The U-tied semi-manual anastomosis is a straightforward and effective method for intracorporeal anastomosis. The simplified reconstruction technique of U-tied series, together with the minimization of technique variability, results in consistent outcomes when performed by surgeons with different levels of experience. The streamlined process enhances the homogeneity of the intracorporeal anastomosis while reducing cartridge use.

Optimizing the algae-bacteria biofilm reactor for imidacloprid wastewater treatment: An evaluation of hydraulic retention times for enhanced efficiency and energy savings.

Recent observations have highlighted the rapidly growing prevalence of emerging contaminants such as Imidacloprid (IMI) within our environment. These insecticidal pollutants, coexisting with more traditional contaminants, have become predominant in aquatic systems, posing risks to both human and ecological well-being. Among the various wastewater treatment approaches tested, biofilm reactors are currently gaining prominence. In this study, we employed an Algae-Bacteria Biofilm Reactor (ABBR) to concurrently address both conventional and emergent contaminants, specifically IMI, over an extended timeframe. Following a 60-day assessment, the ABBR consistently demonstrated removal efficiencies exceeding 85% for total dissolved nitrogen, ammonia nitrogen, and total dissolved phosphorus, and also achieved removal efficacy for the soluble chemical oxygen demand (sCOD). Despite the removal efficiency of IMI (with initial concentration is 1.0 mg/L) in ABBR showed a gradual decline over the extended period, it remained consistently effective over 50% due to the microalgae-mediated free radical reactions, indicating the ABBR's sustained efficiency in long-duration operations. Additionally, applying some non-conventional modifications, like aeration removal and reducing light exposure, demonstrated minimal impact on the reactor's pollutant removal efficiencies, achieving comparable results to the control group (which utilized aeration with a 14:10 light/dark ratio), 0.92 kW h/L/d of electricity can be saved economically, which accentuated the potential for energy conservation. An in-depth analysis of the treated effluents from the ABBRs, using ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) technique, uncovered four potential transformation pathways for IMI. Overall, our findings suggest that these optimized processes did not influence the transformation products of IMI, thereby reaffirming the viability of our proposed optimization.

Multi-MSIProcessor: Data Visualizing and Analysis Software for Spatial Metabolomics Research.

Mass spectrometry imaging (MSI) has emerged as a revolutionary analytical strategy in biomedical research for molecular visualization. By linking the characterization of functional metabolites with tissue architecture, it is now possible to reveal unknown biological functions of tissues. However, due to the complexity and high dimensionality of MSI data, mining bioinformatics-related peaks from batch MSI data sets and achieving complete spatially resolved metabolomics analysis remain a great challenge. Here, we propose novel MSI data processing software, Multi-MSIProcessor (MMP), which integrates the data read-in, MSI visualization, processed data preservation, and biomarker discovery functions. The MMP focuses on the AFADESI-MSI data platform but also supports mzXML and imzmL data input formats for compatibility with data generated by other MSI platforms such as MALDI/SIMS-MSI. MMP enables deep mining of batch MSI data and has flexible adaptability with the source code opened that welcomes new functions and personalized analysis strategies. Using multiple clinical biosamples with complex heterogeneity, we demonstrated that MMP can rapidly establish complete MSI analysis workflows, assess batch sample data quality, screen and annotate differential MS peaks, and obtain abnormal metabolic pathways. MMP provides a novel platform for spatial metabolomics analysis of multiple samples that could meet the diverse analysis requirements of scholars.

Effects of topping and non-topping on growth-regulating hormones of flue-cured tobacco (Nicotiana tabacum L.)-a proteomic analysis.

Introduction: Until now, the mechanism underlying the impact of topping on hormone regulation in tobacco plants remains unclear, and most studies investigating the hormone signaling pathways in plants rely on genes or transcriptional pathways. Methods: This study examines the regulatory mechanisms of hormones in the roots and leaves of tobacco plants with and without topping at the protein level. Results: The results demonstrate that, compared with non-topped plants, topping leads to a decrease in the levels of IAA (auxin), ABA (abscisic acid), and GA (gibberellin) hormones in the leaves, whereas the content of the JA (jasmonic acid) hormone increases. Furthermore, in the roots, topping results in an increase in the levels of IAA, ABA, and JA hormones, along with a decrease in GA content. In the leaves, a total of 258 significantly different proteins were identified before and after topping, with 128 proteins upregulated and 130 proteins downregulated. In the roots, there were 439 proteins with significantly different quantities before and after topping, consisting of 211 upregulated proteins and 228 downregulated proteins. Notably, these proteins were closely associated with the metabolic and biosynthetic pathways of secondary metabolites, as indicated by functional categorization. Conclusions: When integrating the hormone changes and the proteomics results, it is evident that topping leads to increased metabolic activity and enhanced hormone synthesis in the root system. This research provides a theoretical foundation for further investigations into the regulation and signaling mechanisms of hormones at the protein level before and after topping in plants.

Unveiling the mechanisms of peracetic acid activation by iron-rich sludge biochar for sulfamethoxazole degradation with wide adaptability.

Advanced oxidation processes (AOPs) based on peracetic acid (PAA) has been extensively concerned for the degradation of organic pollutants. In this study, metallic iron-modified sludge biochar (Fe-SBC) was employed to activate PAA for the removal of sulfamethoxazole (SMX). The characterization results indicated that FeO and Fe2O3 were successfully loaded on the surface of the sludge biochar (SBC). Fe-SBC/PAA system achieved 92% SMX removal after 30 min. The pseudo-first-order kinetic reaction constant of the Fe-SBC/PAA system was 7.34 × 10-2 min-1, which was 2.4 times higher than the SBC/PAA system. The degradation of SMX was enhanced with increasing the Fe-SBC dosage and PAA concentration. Apart from Cl-, NO3- and SO42- had a negligible influence on the degradation of SMX. Quenching experiments and electron paramagnetic resonance (EPR) techniques identified the existence of reactive species, of which CH3C(O)OO•, 1O2, and O2•- were dominant reactive species in Fe-SBC/PAA system. The effect of different water matrices on the removal of SMX was investigated. The removal of SMX in tap water and lake water were 79% and 69%, respectively. Four possible pathways for the decay of SMX were presented according to the identification of oxidation products. In addition, following the ecological structure-activity relationship model (ECOSAR) procedure and the germination experiments with lettuce seeds to predict the toxicity of the intermediates. The acute and chronic ecotoxicity of SMX solution was dramatically diminished by processing with Fe-SBC/PAA system. In general, this study offered a prospective strategy for the degradation of organic pollutants.

Antibiotics and antibiotic resistance gene dynamics in the composting of antibiotic fermentation waste - A review.

Fate of antibiotics and antibiotic resistance genes (ARGs) during composting of antibiotic fermentation waste (AFW) is a major concern. This review article focuses on recent literature published on this subject. The key findings are that antibiotics can be removed effectively during AFW composting, with higher temperatures, appropriate bulking agents, and suitable pretreatments improving their degradation. ARGs dynamics during composting are related to bacteria and mobile genetic elements (MGEs). Higher temperatures, suitable bulking agents and an appropriate C/N ratio (30:1) lead to more efficient removal of ARGs/MGEs by shaping the bacterial composition. Keeping materials dry (moisture less than 30%) and maintaining pH stable around 7.5 after composting could inhibit the rebound of ARGs. Overall, safer utilization of AFW can be realized by optimizing composting conditions. However, further removal of antibiotics and ARGs at low levels, degradation mechanism of antibiotics, and spread mechanism of ARGs during AFW composting require further investigation.

Genetically predicted thyroid function and risk of colorectal cancer: a bidirectional Mendelian randomization study.

BACKGROUND: Observational studies have reported an association between thyroid function and colorectal cancer (CRC), with conflicting results. Elucidating the causal relationship between thyroid function and CRC facilitates the development of new preventive strategies to reduce CRC incidence. METHOD: We applied a two-sample Mendelian randomization (MR) method to evaluate the causal relationship between five thyroid-related indexes, including hyperthyroidism, hypothyroidism, thyroid stimulating hormone (TSH), free thyroxine (FT4) and basal metabolic rate (BMR), and CRC. Genome-wide association study statistics for thyroid-related phenotypes were obtained from the ThyroidOmics consortium, and summary statistics for genetic associations with CRC were obtained from the FinnGen consortium. We set a series of criteria to screen single nucleotide polymorphisms (SNPs) as instrumental variables and then performed bidirectional MR analysis, stratified analysis and extensive sensitivity analysis. Multiplicative random-effects inverse variance weighted was the primary analysis method, supplemented by weighted median and MR-Egger. RESULT: We identified 12 SNPs for hyperthyroidism, 10 SNPs for hypothyroidism, 41 SNPs for TSH, 18 SNPs for FT4, and 556 SNPs for BMR. Genetically predicted hyperthyroidism, hypothyroidism, TSH, and FT4 were not associated with CRC risk (all P > 0.05). Sensitivity analysis revealed no heterogeneity or pleiotropy. Genetically predicted BMR was significantly associated with increased CRC risk after removing outlier (OR = 1.30, P = 0.0029). Stratified analysis showed that BMR was significantly associated with colon cancer (OR = 1.33, P = 0.0074) but not rectal cancer. In the reverse analysis, there was no evidence of an effect of CRC on thyroid function (all P > 0.05). CONCLUSION: Our bidirectional MR analysis provides new insights into the relationship between thyroid function and CRC. CRC prevention may benefit from enhanced screening of high BMR populations.

Laparoscopic versus ultrasound-guided transversus abdominis plane block for postoperative pain management in minimally invasive colorectal surgery: a meta-analysis protocol.

Introduction: Transversus abdominis plane block (TAPB) is now commonly administered for postoperative pain control and reduced opioid consumption in patients undergoing major colorectal surgeries, such as colorectal cancer, diverticular disease, and inflammatory bowel disease resection. However, there remain several controversies about the effectiveness and safety of laparoscopic TAPB compared to ultrasound-guided TAPB. Therefore, the aim of this study is to integrate both direct and indirect comparisons to identify a more effective and safer TAPB approach. Materials and methods: Systematic electronic literature surveillance will be performed in the PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and ClinicalTrials.gov databases for eligible studies through July 31, 2023. The Cochrane Risk of Bias version 2 (RoB 2) and Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tools will be applied to scrutinize the methodological quality of the selected studies. The primary outcomes will include (1) opioid consumption at 24 hours postoperatively and (2) pain scores at 24 hours postoperatively both at rest and at coughing and movement according to the numerical rating scale (NRS). Additionally, the probability of TAPB-related adverse events, overall postoperative 30-day complications, postoperative 30-day ileus, postoperative 30-day surgical site infection, postoperative 7-day nausea and vomiting, and length of stay will be analyzed as secondary outcome measures. The findings will be assessed for robustness through subgroup analyses and sensitivity analyses. Data analyses will be performed using RevMan 5.4.1 and Stata 17.0. P value of less than 0.05 will be defined as statistically significant. The certainty of evidence will be examined via the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) working group approach. Ethics and dissemination: Owing to the nature of the secondary analysis of existing data, no ethical approval will be required. Our meta-analysis will summarize all the available evidence for the effectiveness and safety of TAPB approaches for minimally invasive colorectal surgery. High-quality peer-reviewed publications and presentations at international conferences will facilitate disseminating the results of this study, which are expected to inform future clinical trials and help anesthesiologists and surgeons determine the optimal tailored clinical practice for perioperative pain management. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=281720, identifier (CRD42021281720).