Trephination-based autonomous robotic surgery for dental implant placement: A proof of concept.

OBJECTIVES: To present a novel drilling protocol of trephine osteotomy technique for autologous bone grafting with simultaneous implant placement using an autonomous robotic system. METHODS: The novel protocol consists of 1) preoperative procedures: marker fabrication and fixation, data acquisition, and preoperative planning; 2) intraoperative procedures: registration and calibration, and osteotomy and implant placement performed by an autonomous dental implant robot; 3) postoperative procedures: CBCT acquisition and accuracy assessment. RESULT: The protocol was an effective method for implant osteotomy, with no reported intraoperative complications. The implant surgery was successfully completed, and autogenous bone was obtained. Meanwhile, the accuracy of implant placement was clinically acceptable, with minor deviations. CONCLUSIONS: Trephination-based robotic surgery can be successfully implemented in implant osteotomy, which might replace freehand implant surgery and conventional drilling protocol. However, further clinical studies are necessary. CLINICAL SIGNIFICANCE: The main finding of this case is a potential alternative for preserving autogenous bone during implant surgery.

Efficacy of reinforcing sutures for prevention of anastomotic leakage after low anterior resection for rectal cancer: A systematic review and meta-analysis.

BACKGROUND AND OBJECTIVES: Anastomotic leakage is a serious complication following surgery for cancer of the rectum. It is not clear whether reinforcing sutures could prevent anastomotic leakage. Therefore, this study aims at evaluating the efficacy of reinforcing sutures on anastomotic leakage. METHODS: We searched PubMed, Embase, and the Cochrane Library databases from inception to January 31, 2023. We included studies comparing anastomosis with reinforcing sutures to anastomosis without reinforcing sutures after low anterior resection. Risk of bias was assessed by the Cochrane tool for RCTs and the Risk of Bias in Non-Randomized Studies (ROBINS)-I tool for observational studies. The overall quality of evidence for primary outcome was assessed using Grading of Recommendations Assessment, Development, and Evaluations methodology. RESULTS: Two RCTs (345 patients) and four observational studies (783 patients) were included. Anastomotic leakage occurred in 4.4% (24 of 548) of patients with reinforcing sutures and 11.9% (69 of 580) of patients without reinforcing sutures. Meta-analysis showed a lower incidence of anastomotic leakage (RR, 0.41; 95% CI 0.25 to 0.66, low certainty) in patients with reinforcing sutures. Operative time (WMD, -3.66; 95% CI -18.58 to 11.25) and reoperation for anastomotic leakage (RR, 0.69; 95% CI 0.23 to 2.08) were similar between patients with reinforcing sutures and those without reinforcing sutures. CONCLUSIONS: While observational data suggest that, there is a clear benefit in terms of reducing the risk of anastomotic leakage with the use of reinforcing sutures, RCT data are less clear. Further large, prospective studies are warranted to determine whether a true clinically important benefit exists with this technique.

Molecular epidemiological characteristics and genetic evolutionary relationships of methicillin-resistant Staphylococcus aureus of different avian origins in Qingdao, China, using whole-genome sequencing.

Introduction: To understand the prevalence of avian methicillin-resistant Staphylococcus aureus (MRSA) and the current status of drug resistance in Qingdao, a comprehensive molecular epidemiological investigation and analysis of evolutionary relationships of MRSA isolates from broiler and layer chickens and waterfowl was conducted. Material and Methods: One hundred and two avian MRSA strains were identified by multi-locus sequence typing, staphylococcal protein A (spa) and staphylococcal cassette chromosome mec (SCCmec) typing, and whole-genome sequencing. Results: The sequence type (ST) 9-t899-SCCmec IVb type represented the highest proportion of avian-derived MRSA strains (71.57%), with ST398 type strains occasionally observed in broilers and waterfowl. The poultry-derived MRSA strains were all resistant to eight or more antimicrobials. Avian-derived MRSA strains carried 20 resistance genes, 109 virulence genes and 10 plasmids. Strains carrying the cfr oxazolidinone resistance gene were occasionally seen in broiler- and layer-derived MRSA. Single nucleotide polymorphism (SNP) core genome evolution and locus difference analysis showed that the closest strains were all of ST9-t899 type (to which also affiliated the highest number of strains) and this type occurred on all three kinds of poultry farm, but the SNP difference loci between strains of the same type ranged from 0 to 1472. Conclusion: The dominant type of MRSA from different poultry sources in Qingdao is ST9-t899-SCCmec IVb, which is commonly resistant to a variety of antimicrobial drugs and carries a variety of resistance genes and a large number of virulence genes. Sequence type 9-t899 type is widely spread among the three kinds of poultry investigated, but there are differences in affiliations.

Immunomodulatory Effect of Irreversible Electroporation Alone and Its Cooperating With Immunotherapy in Pancreatic Cancer.

Emerging studies have showed irreversible electroporation (IRE) focused on pancreatic cancer (PC). However, the effects of IRE treatment on the immune response of PC remain unknown. Moreover, there are few studies on the therapeutic effect of IRE combining with immunotherapy on PC. Thus, we review recent advances in our understanding of IRE alone and its working with immunotherapy towards the immune response of PC, discussing potential opportunities for exploring future treatment strategies.

Development and external validation of a nomogram predicting overall survival after curative resection of colon cancer.

OBJECTIVE: To develop and externally validate a prognostic nomogram to predict overall survival (OS) in patients with resectable colon cancer. METHODS: Data for 50,996 patients diagnosed with non-metastatic colon cancer were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database. Patients were assigned randomly to the training set (n = 34,168) or validation set (n = 16,828). Independent prognostic factors were identified by multivariate Cox proportional hazards regression analysis and used to construct the nomogram. Harrell's C-index and calibration plots were calculated using the SEER validation set. Additional external validation was performed using a Chinese dataset (n = 342). RESULTS: Harrell's C-index of the nomogram for OS in the SEER validation set was 0.71, which was superior to that using the 7th edition of the American Joint Committee on Cancer TNM staging (0.59). Calibration plots showed consistency between actual observations and predicted 1-, 3-, and 5-year survival. Harrell's C-index (0.72) and calibration plot showed excellent predictive accuracy in the external validation set. CONCLUSIONS: We developed a nomogram to predict OS after curative resection for colon cancer. Validation using the SEER and external datasets revealed good discrimination and calibration. This nomogram may help predict individual survival in patients with colon cancer.

Encapsulation of Antarctic krill oil in yeast cell microcarriers: Evaluation of oxidative stability and in vitro release.

Antarctic krill oil (KO) was encapsulated into yeast cells (YCs), and the physicochemical, morphological, and conformational characterizations of KO-loaded YCs (KYCs) were investigated. Moreover, the oxidation stability and in vitro release behavior of KYCs were evaluated. Results showed that KYCs provided significantly higher oxidative stability than native KO. The fatty acid profile remained obviously unchanged after encapsulation. Most interestingly, the phospholipid proportion increased from 49.76% ± 1.42% to 59.92% ± 1.39% after encapsulation. Furthermore, there was a slow and prolonged release of KYCs, along with higher bioaccessibility of docosahexaenoic acid and eicosapentaenoic acid than the KO-in-water emulsion (69.62% ± 7.67% and 66.67% ± 4.55% vs 47.44% ± 4.4% and 39.74% ± 3.89%). KO encapsulation in YCs can be considered as an efficient approach for extending the oxidative and in vitro stability of this nutritious oil and facilitating its application in food products.

Better survival of right-sided than left-sided stage II colon cancer: a propensity scores matching analysis based on SEER database.

BACKGROUND/AIMS: Most studies have found that right-sided colon cancer (RCC) has worse prognosis than left-sided colon cancer (LCC), especially in stage III, but the reported prognosis of stage II colon cancer is variable. This study aimed to evaluate the impact of tumor location on survival outcomes in stage II colon cancer. MATERIALS AND METHODS: Patients with stage II colon cancer were identified in the Surveillance, Epidemiology, and End Results database from 2004 to 2009. The effect of tumor location on overall survival and cancer-specific survival was analyzed using Cox proportional hazards regression models and propensity score matching. RESULTS: Of 16,519 patients, 69.6% had RCC and30.4% had LCC. In unadjusted analyses, RCC had a 13% increased overall mortality risk (hazards ratio [HR], 1.13; 95% confidence interval [CI], 1.07-1.19; p<0.001) but an18% reduction in cancer-specific mortality risk compared with LCC (HR, 0.82; 95% CI, 0.76-0.89; p<0.001). After propensity scores matching analyses, RCC had a 21% reduced overall mortality risk (HR, 0.79; 95% CI, 0.72-0.87; p<0.001) and a 49% reduction in cancer-specific mortality risk compared with LCC (HR, 0.51; 95% CI, 0.44-0.60; p<0.001). CONCLUSION: When adjusted for multiple clinicopathological features, stage II RCC showed better prognosis than stage II LCC.

Solitary fibrous tumor in the subcutaneous soft tissues of the left abdominal wall: A case report.

Solitary fibrous tumor (SFT) derived from the abdominal wall is rare. We report a case of SFT in the abdominal wall. When abdominal computed tomography reveals soft-tissue mass and analysis of preoperative needle biopsy reveals spindle cell tumor, the possibility of SFT should be considered.