480†nm InGaN-based cyan laser diode grown on Si by interface engineering of active region.

InGaN-based long wavelength laser diodes (LDs) grown on Si are highly desirable for expanding the applications in laser display and lighting. Proper interface engineering of high In-content InGaN multi-quantum wells (MQWs) is urgently required for the epitaxial growth of InGaN-based long wavelength LD on Si, because the deteriorated interfaces and crystalline quality of InGaN MQWs can severely increase the photon scattering and further exacerbate the internal absorption loss of LDs, which prevents the lasing wavelength of InGaN-based LDs from extending. In this work, a significantly improved morphology and sharp interface of the InGaN active region are obtained by using a graded-compositional InGaN lower waveguide (LWG) capped with a 10-nm-thick Al0.1Ga0.9N layer. The V-pits density of the InGaN LWG was one order of magnitude reduction from 4.8 × 108 to 3.6 × 107 cm-2 along with the root-mean-square surface roughness decreasing from 0.3 to 0.1 nm. Therefore, a room-temperature electrically injected 480 nm InGaN-based cyan LD grown on Si under pulsed current operation was successfully achieved with a threshold current density of 18.3 kA/cm2.

The difficulty grade of laparoscopic hepatectomy for hepatocellular carcinoma correlates with long-term outcomes.

The tremendous development of laparoscopic hepatectomy helps to relieve the difficulties encountered during open hepatectomy. Therefore, a difficulty scoring system was produced to assess the difficulty grade of laparoscopic hepatectomy. The aim of this study was to explore whether the IWATE-DSS is comparable to the long-term outcomes of LH for hepatocellular carcinoma. Clinical data from all consecutive patients who underwent laparoscopic hepatectomy for hepatocellular carcinoma at the Sir Run Run Shaw Hospital, Hangzhou, were prospectively collected and reviewed. The difficulty level of the operations was graded using the IWATE-DSS. The perioperative and postoperative outcomes of laparoscopic hepatectomy were compared at each difficulty level. A total of 300 patients underwent laparoscopic hepatectomy for HCC during the study period. The perioperative and postoperative outcomes were significantly different between the groups according to the IWATE-DSS. There were significant differences in both the intraoperative (bleeding control p = 0.000; surgical time p = 0.000; estimated blood loss p = 0.033) and postoperative variables (postoperative hospital stay p = 0.005) among these four groups. The 5-year disease-free survival decreased significantly along with the LH difficulty score (p = 0.000). The 5-year overall survival also decreased significantly along with the LH difficulty score (p = 0.000). IWATE-DSS was significantly correlated with short- and long-term outcomes in patients who underwent laparoscopic hepatectomy for HCC.

Laparoscopic hepatectomy for hepatocellular carcinoma: short- and long-term outcomes with blood loss.

BACKGROUND: Laparoscopic hepatectomy (LH) for treating hepatocellular carcinoma (HCC) is a complex procedure. Compared to open hepatectomy (OH), LH offers certain advantages such as faster recovery, smaller incisions, and shorter hospital stay, but bleeding during LH remains a significant concern. Currently, the impacts of blood loss on the short- and long-term outcomes of patients undergoing LH are poorly understood. This retrospective study analyzes the impacts of blood loss on the prognosis of LH in HCC patients. METHODS: Between 2001 and 2019, 192 patients underwent LH for HCC at a single high-volume center. These patients were divided into two groups according to intraoperative blood loss (IBL) (Group A: ≤250 mL; Group B: >250 mL). The patient characteristics assessed included age, gender, cirrhosis, hepatitis B virus (HBV) infection, Child-Pugh class, number of tumors, tumor size, vascular invasion, and diabetes mellitus. The perioperative and postoperative factors compared included operative time, blood loss, type of resection, blood transfusion, general complications, surgical complications, hospital mortality, and postoperative hospital stay. RESULTS: Factors associated with IBL in our multivariate analysis included the type of resection (P<0.01) and operative time (P<0.01). IBL, tumor size and number of tumors were independent predictors of a patient's overall survival (OS) and recurrence-free survival (RFS). Through our subgroup multivariate analysis, we found that IBL was the only significant factor associated with RFS (P<0.02). There was also a noted IBL "dose effect", as patients with IBL >1,000 mL had a worse median OS (24 months) and median RFS (6 months), while patients with IBL 250-1,000 mL had a median OS of 36 months and RFS of 12 months, and patients with IBL ≤250 mL had a median OS of 36 months and RFS of 24 months. CONCLUSIONS: We found that the extent of IBL during LH was related to tumor size, operative time, and surgery type. Increased IBL during LH was also an independent prognostic factor for tumor recurrence. Furthermore, a dose-response relationship between increased IBL and decreased RFS and OS was evident.