Comparison of robotic versus laparoscopic surgery for visceral obesity in mid-low rectal cancer: a propensity-matched analysis.

Obesity is becoming more and more common, and measuring visceral fat area (VFA) is a useful diagnostic technique for visceral obesity (VO). The purpose of this research is to compare the surgical results of robotic versus laparoscopic rectal surgery, with a focus on assessing the benefits of the latter method for treating both VO and mid-low rectal cancer. Patients receiving laparoscopic or robotic anterior rectal excision at Northern Jiangsu People's Hospital's general surgery department were included in the retrospective analysis. 242 people in all took part in the study; 121 cases were assigned to the robotic surgery (RS) group and another 121 cases to the laparoscopic surgery (LS) group. In comparison to LS, our results show that RS led to a shorter period for the recovery of bowel function (p = 0.03), a shorter hospital stay (p < 0.001), a smaller intraoperative blood loss (p < 0.001), and a shorter time until the commencement of oral intake (p = 0.041). However, there were no statistically significant differences between the two groups in terms of the indices of histopathologic specimens, the proportion of temporary loop ileostomy, and the incidence of early postoperative problems (p > 0.05). When patients with VO undergo surgery for rectal cancer, RS has the added benefit of accelerating patient recovery while producing results that are similar to LS in the near run.

Modified Q-type purse-string suture duodenal stump embedding method for laparoscopic gastrectomy for gastric cancer.

OBJECTIVE: This study introduced the modified Q-type purse-string suture duodenal stump embedding method, a convenient way to strengthen the duodenum, and compared it to the conventional one to assess its efficacy and safety. METHODS: This retrospective analysis examined 612 patients who received laparoscopic gastrectomy for gastric Cancer at a single center. The patients were divided into Not Reinforced Group (n = 205) and Reinforced Group (n = 407) according to the surgical approach to the duodenal stump. The reinforced group was further divided into a modified Q-type purse-string suture embedding method group (QM, n = 232) and a conventional suture duodenal stump embedding method group (CM, n = 175) according to the methods of duodenal stump enhancement. Clinicopathological characteristics, operative variables, and short-term complications were documented and analyzed. RESULTS: The incidence of duodenal stump leakage(DSL) in the Not Reinforced Group was higher compared to the Reinforced Group, although the difference was not statistically significant [2.4% (5/205) vs 0.7% (3/407), p = 0.339]. Additionally, the Not Reinforced Group exhibited a higher rate of Reoperation due to DSL compared to the Reinforced Group [2 (1.0%) vs. 0, p = 0.046], with one patient in the Not Reinforced Group experiencing mortality due to DSL [1 (0.5%) vs 0, p = 0.158]. Subgroup analysis within the Reinforced Group revealed that the modified Q-type purse-string suture embedding group (QM) subgroup demonstrated statistically significant advantages over the conventional suture embedding group (CM) subgroup. QM exhibited shorter purse-string closure times (4.11 ± 1.840 vs. 6.05 ± 1.577, p = 0.001), higher purse-string closure success rates (93.1% vs. 77.7%, p = 0.001), and greater satisfaction with purse-string closure [224 (96.6%) vs 157 (89.7%), p = 0.005]. No occurrences of duodenal stump leakage were observed in the QM subgroup, while the CM subgroup experienced two cases [2 (1.1%)], though the difference was not statistically significant. Both groups did not exhibit statistically significant differences in secondary surgery or mortality related to duodenal stump leakage. CONCLUSION: Duodenal Stump Leakage (DSL) is a severe but low-incidence complication. There is no statistically significant relationship between the reinforcement of the duodenal stump and the incidence of DSL. However, laparoscopic reinforcement of the duodenal stump can reduce the severity of fistulas and the probability of Reoperation. The laparoscopic Q-type purse-string suture duodenal stump embedding method is a simple and effective technique that can, to some extent, shorten the operation time and enhance satisfaction with purse-string closure. There is a trend towards reducing the incidence of DSL, thereby improving patient prognosis to a certain extent.

Pathological Complete Response Achieved with XELOX Chemotherapy, HIPEC, and Anti-PD-1 Immunotherapy in Stage IV Gastric Adenocarcinoma with Peritoneal Metastasis: A Case Report and Review of the Literature.

BACKGROUND: The detection rates of early gastric cancer (GC) in China are approximately 20%; upon diagnosis, the majority of patients with GC are identified as having advanced stage disease, and in some cases, even metastatic advanced GC. Currently, the optimal treatment strategy for peritoneal metastasis (PM) in GC remains uncertain, and pathological complete response (pCR) is rare following conversion therapy. CASE PRESENTATION: This case report details the management of a 66-year-old patient diagnosed with advanced stage IVB (T4N2M1c) adenocarcinomas of the gastric cardia with PM who received multimodal therapy comprised of hyperthermic intraperitoneal chemotherapy (HIPEC), XELOX chemotherapy, and anti-programmed cell death-1 (PD-1) therapy followed by radical gastrectomy. Through the multimodal management, the patient attained PCR and experienced long-term survival. CONCLUSION: The conversion therapy protocol combined with HIPEC, XELOX chemotherapy, and anti-PD-1 therapy and our scientific, accurate, full-course management strategy may be propagable for potentially curing patients with advanced GC with PM.

FANCA facilitates G1/S cell cycle advancement, proliferation, migration and invasion in gastric cancer.

The present study explores the function of FANCA gene, a pivotal member of the Fanconi anaemia (FA) pathway crucial for preserving genomic stability and preventing cancer, particularly in the context of gastric cancer (GC). Using immunohistochemistry, quantitative real-time PCR, and western blot analysis, we evaluate FANCA mRNA and protein expressions in GC cell lines. The relationship between FANCA expression and clinicopathological characteristics is also explored. Various assays, including CCK8, colony formation, wound healing, and Transwell assays, are used to assess functional changes in cells associated with FANCA. Flow cytometry is utilized to evaluate alterations in the cell cycle resulted from FANCA knockdown and overexpression. Our findings show elevated FANCA expression in GC cell lines, with levels correlated with pathologic stage and lymphatic metastasis. FANCA knockdown impedes cell proliferation, migration, and invasion and induces G1/S phase cell cycle arrest. Conversely, FANCA overexpression stimulates cell proliferation, migration, and invasion. In vivo xenograft experiments confirm the promotional role of FANCA in GC tumor progression. Moreover, FANCA overexpression is associated with the activation of cell cycle. Collectively, our results suggest that FANCA drives malignant cell behaviors in GC through the cell cycle pathway, highlighting its potential as a therapeutic target for the treatment of GC.

Surgical options and survival prognosis in geriatric patients beyond average lifespan with locally advanced gastric cancer: a propensity score-matched analysis.

BACKGROUND: The appropriateness of laparoscopic gastrectomy (LG) for super-geriatric patients with locally advanced gastric cancer (LAGC) is inconclusive, and the prognostic factors are also yet to be elucidated. Herein, we aimed to investigate the surgical and oncological outcomes of LG versus open gastrectomy (OG) for geriatric patients with LAGC who have outlived the average lifespan of the Chinese population (≥ 78 years). METHODS: This is a monocentric, retrospective, comparative study. A 1:1 propensity score matching (PSM) was performed to minimize selection bias and ensure well-balanced characteristics. The primary endpoint of interest was 3-year overall survival, while secondary endpoints included procedure-related variables, postoperative recovery indices, and complications. Univariate and multivariate Cox proportional hazards regression analyses were performed to identify unfavorable prognostic factors. RESULTS: Of 196 eligible individuals, 107 underwent LG and 89 underwent OG, with a median age (interquartile range [IQR]) of 82 [79, 84] years. PSM yielded 61 matched pairs, with comparable demographic and tumor characteristics. The LG group had a significantly lower overall complication rate than the OG group (31.1% vs. 49.2%, P = 0.042), as well as shorter duration of postoperative hospital stay [12 (11, 13) vs. 13 (12, 15.5) d, P < 0. 001], less intraoperative blood loss [95 (75, 150) vs. 230 (195, 290) mL, P < 0.001], but a longer operative time [228 (210, 255.5) vs. 196 (180, 219.5) min, P < 0.001]. The times to first aerofluxus, defecation, liquid diet, and half-liquid diet were comparable. Kaplan-Meier analyses revealed no significant difference in 3-year overall survival between the groups, either in the entire cohort or in subgroups with different TNM staging. Moreover, Age-adjusted Charlson Comorbidity Index scores of > 6 [hazard ratio (HR) 4.003; P = 0.021] and pathologic TNM stage III (HR 3.816, P = 0.023) were independent unfavorable prognostic factors for long-term survival. CONCLUSIONS: LG performed by experienced surgeons offers the benefits of comparable or better surgical and oncological safety profiles than OG for super-geriatric patients with LAGC.

Sustaining Healthy Habits: The Enduring Impact of Combined School-Family Interventions on Consuming Sugar-Sweetened Beverages among Pilot Chinese Schoolchildren.

This study assesses the enduring impact of combined school- and family-based interventions on reducing the consumption of sugar-sweetened beverages (SSBs) among schoolchildren in China. Two primary schools were assigned at random to either the Intervention Group or the Control Group, in Nanjing, eastern China. All students were in grade three and received an invitation to participate. In the first year, students in the Intervention Group received one-year intervention measures, including monthly monitoring, aiming to decrease the consumption of SSBs. Students in the Control Group only received regular monitoring without interventions. In the second year, both groups received only regular monitoring, without active interventions. A generalized estimating equations model (GEE) was used to assess the intervention effects. After two years, relative to the Control Group, the Intervention Group had a significantly improved knowledge of SSBs and an improved family environment with parents. In the Intervention Group, 477 students (97.3%) had adequate knowledge about SSBs, compared to 302 students (83.2%) in the Control Group (X2 = 52.708, p < 0.001). Two years later, the number of students who stated 'my home always has SSBs' in the Intervention Group (7.8%) was fewer than that in the Control Group (12.4%), which was a statistically significant finding (p < 0.05). One year later, both the frequency and the quantity of SSB consumption in the Intervention Group were less than those in the Control Group; such differences between the groups remained statistically significant for the quantity but not for the frequency of SSB consumption two years later. In the Intervention Group, the frequency of SSB consumption was significantly reduced by 1.0 times per week, compared to a reduction of 0.1 times per week in the Control Group in the first year (p < 0.05). In the second year, the frequency of SSB consumption was reduced by 0.8 times per week in the Intervention Group, compared to 0.5 times per week in the Control Group (p > 0.05). In the first year, the volume of SSB consumption was significantly reduced by 233 mL per week in the Intervention Group, compared to an increase of 107 mL per week in the Control Group (p < 0.05). In the second year, the volume of SSB consumption was reduced by 122 mL per week in the Intervention Group compared to an increase of 31 mL per week in the Control Group (p > 0.05). The combined school-based and family-based interventions had a positive effect on the students' knowledge of SSBs and their family dynamics during the first and second year. Relative to the Control Group, the Intervention Group had a statistically significant reduction in SSB consumption after 1 year, but not after 2 years.

Deep learning radiomics-based prediction model of metachronous distant metastasis following curative resection for retroperitoneal leiomyosarcoma: a bicentric study.

BACKGROUND: Combining conventional radiomics models with deep learning features can result in superior performance in predicting the prognosis of patients with tumors; however, this approach has never been evaluated for the prediction of metachronous distant metastasis (MDM) among patients with retroperitoneal leiomyosarcoma (RLS). Thus, the purpose of this study was to develop and validate a preoperative contrast-enhanced computed tomography (CECT)-based deep learning radiomics model for predicting the occurrence of MDM in patients with RLS undergoing complete surgical resection. METHODS: A total of 179 patients who had undergone surgery for the treatment of histologically confirmed RLS were retrospectively recruited from two tertiary sarcoma centers. Semantic segmentation features derived from a convolutional neural network deep learning model as well as conventional hand-crafted radiomics features were extracted from preoperative three-phase CECT images to quantify the sarcoma phenotypes. A conventional radiomics signature (RS) and a deep learning radiomics signature (DLRS) that incorporated hand-crafted radiomics and deep learning features were developed to predict the risk of MDM. Additionally, a deep learning radiomics nomogram (DLRN) was established to evaluate the incremental prognostic significance of the DLRS in combination with clinico-radiological predictors. RESULTS: The comparison of the area under the curve (AUC) values in the external validation set, as determined by the DeLong test, demonstrated that the integrated DLRN, DLRS, and RS models all exhibited superior predictive performance compared with that of the clinical model (AUC 0.786 [95% confidence interval 0.649-0.923] vs. 0.822 [0.692-0.952] vs. 0.733 [0.573-0.892] vs. 0.511 [0.359-0.662]; both P < 0.05). The decision curve analyses graphically indicated that utilizing the DLRN for risk stratification provided greater net benefits than those achieved using the DLRS, RS and clinical models. Good alignment with the calibration curve indicated that the DLRN also exhibited good performance. CONCLUSIONS: The novel CECT-based DLRN developed in this study demonstrated promising performance in the preoperative prediction of the risk of MDM following curative resection in patients with RLS. The DLRN, which outperformed the other three models, could provide valuable information for predicting surgical efficacy and tailoring individualized treatment plans in this patient population. TRIAL REGISTRATION: Not applicable.

Propensity matched analysis of minimally invasive and open radical resection for rectal cancer: comparison of short-term outcomes in elderly/frail patients.

Although minimally invasive surgery (MIS), such as robotic and laparoscopic procedures, is sometimes a better option than open surgery for patients with rectal cancer, it can present challenges for some elderly or frail patients who have a higher risk of chronic illnesses and poor surgical tolerance. On the basis of several pathophysiological characteristics, the patients were grouped according to their age. The time nodes, which are 65 and 80 years old, can clarify the goal of the study and offer some therapeutic benefit. These subgroups stand to gain a great deal from MIS because of its superior arm of machinery and imagery. The short-term oncological outcomes and postoperative conditions of robotic surgery, laparoscopic surgery, and conventional open surgery were compared in this study using a propensity-matched analysis. In this retrospective study, a total of 2049 consecutive patients who underwent proctectomy between September 2017 and June 2023 were chosen. We then carried out a propensity matching analysis based on inclusion criteria. Patients were split into two age groups: 65-80 and > 80. While the secondary objective was to further investigate the similar characteristics between RS and LS, the major objective was to compare oncological outcomes and postoperative conditions between MIS and OS. K-M survival curves were used to represent oncological outcomes and survival conditions. Complication rate and mFI score were used to assess postoperative conditions. Regarding the functional outcomes, the LARS scale was applied to create questionnaires that calculated the anal function of the patients. 110 cases from the group of patients aged 65-80 were successfully merged after matching 1: 1 by propensity score, whereas 73 instances from patients aged > 80 were incorporated while examining the primary objective between OS and MIS. Regarding the secondary goal, each group contained 45 cases for patients above 80 and 65 cases for patients aged 65-80, respectively. Faster recovery from MIS included quicker first flatus passage, earlier switch to liquid nutrition, and shorter hospital stay. In the meantime, MIS also showed benefits in terms of the proportion of low mFI scores and the rates of wound complications in the two age groups. Less blood loss and shorter operational time are further MIS features. On the other hand, MIS experienced more pulmonary complications than OS. Robotic surgery was statistically no different from laparoscopic surgery in patients aged 65-80, although it was superior in terms of operative time and recovery. Comparable and satisfactory oncological and survival results were obtained with all three treatments. For elderly/frail patients with rectal cancer, MIS could be recognized as an effective procedure with favorable outcomes of recovery that are accompanied by better postoperative conditions. While, robotic surgery is slightly better than laparoscopic surgery in some aspects. However, to further demonstrate the effectiveness of three surgical modalities in treating certain groups, multi-center prospective studies are required.

Advancements in Diagnosis and Multimodal Treatment Strategies for Retroperitoneal Tumors: A Comprehensive Review.

Retroperitoneal tumors (RPTs) encompass both benign and malignant entities, constituting ~0.1% to 0.2% of all malignant tumors, of which 70% to 80% manifest malignancy. Predominantly, retroperitoneal sarcomas (RPS) represent the most prevalent subtype among RPT. With over 70 histologic forms identified, liposarcomas and leiomyosarcomas emerge as the primary constituents of RPS. Accurate diagnosis of RPTs necessitates preoperative core-needle biopsy and comprehensive imaging assessment. The current staging protocol for RPS relies on the eighth edition of the American Joint Committee on Cancer/TNM classification. Surgical excision remains the established gold standard for treating RPS. Therapeutic approaches vary according to the underlying pathophysiology. Although chemotherapy and radiotherapy exhibit efficacy in managing metastatic and recurrent unresectable RPS, their role in primary RPS remains unresolved, necessitating further clinical trials for validation. Concurrently, ongoing research explores the potential of targeted therapies and immunotherapy. This literature review aims to provide a comprehensive overview of existing research, delineating diagnostic pathways and optimal therapeutic strategies for RPT.

Lysine demethylase 3A promotes chondrogenic differentiation of aged human dental pulp stem cells.

Background/purpose: Aging severely impairs the beneficial effects of human dental pulp stem cells (hDPSCs) on cartilage regeneration. Lysine demethylase 3A (KDM3A) is involved in regulating mesenchymal stem cells (MSCs) senescence and bone aging. In this study, we investigated the role of KDM3A in hDPSCs aging and whether KDM3A could rejuvenate aged hDPSCs to enhance their chondrogenic differentiation capacity. Materials and methods: The cellular aging of hDPSCs was evaluated by senescence-associated ß-galactosidase (SA-ß-gal) staining. Protein levels were determined using Western blot analysis. KDM3A was overexpressed in aged hDPSCs by lentivirus infection. Quantitative reverse-transcription polymerase chain reaction (RT-qPCR) were used to determine the mRNA levels of stemness markers. Toluidine blue staining was used to evaluate the effect of KDM3A overexpression on the chondrogenic differentiation of aged hDPSCs. Results: hDPSCs at passage 12 or treated with etoposide exhibited augmented cellular senescence as evidenced by increased SA-ß-gal activity. KDM3A was significantly increased during senescence of hDPSCs. Overexpression of KDM3A did not affect the stemness properties but significantly promoted the chondrogenic differentiation of aged hDPSCs. Conclusion: Our findings indicate that KDM3A plays an important role in the maintenance of the chondrogenic differentiation capacity of aged hDPSCs and suggest that therapies targeting KDM3A may be a novel strategy to rejuvenate aged hDPSCs.

Sphincter-preserving effect of robotic-assisted intersphincteric resection for ultra-low rectal cancer: a propensity score matching analysis.

Intersphincteric resection (ISR) is a viable option for sphincter preservation in early ultra-low rectal cancer, but postoperative anal dysfunction remains a concern. This study evaluates the outcomes of robotic ISR with coloanal anastomosis in early ultra-low rectal cancer, comparing its efficacy and safety with laparoscopic ISR. Retrospective analysis was conducted on data from 74 consecutive patients undergoing robotic intersphincteric resection (R-ISR) for early ultra-low rectal cancer between January 2017 and December 2018 (R-ISR group), matched with 110 patients undergoing laparoscopic intersphincteric resection (L-ISR). After 1:1 propensity score matching, each group comprised 68 patients. Comparative analyses covered surgical outcomes, complications, long-term results, and anal function. The R-ISR group showed longer total operative time than the L-ISR group (211.7 ± 25.3 min vs. 191.2 ± 23.0 min, p = 0.001), but less intraoperative bleeding (55.2 ± 20.7 ml vs. 69.2 ± 22.9 ml, p = 0.01). R-ISR group had fewer conversions to APR surgery (6/8.8% vs. 14/20.6%). Other perioperative indicators were similar. R-ISR exhibited a smaller tumor margin, superior mesorectal integrity, and comparable histopathological outcomes. Postoperative complications, 3-year and 5-year DFS, and OS were similar. At the 1-year follow-up, the Wexner Incontinence Score favored R-ISR (9.24 ± 4.03 vs. 11.06 ± 3.77, p = 0.048). Although R-ISR prolongs the operative time, its surgical safety and oncological outcomes are similar to conventional ISR procedures. Furthermore, it further shortens the margin of anal preservation, reduces the rate of conversion to APR surgery, and improves postoperative anal function.

Comparative analysis of robotic and laparoscopic surgery for mid and low rectal cancer in patients with varied body mass indexes: evaluating of short-term outcomes.

The main aim of this study was to evaluate and contrast the efficacy of robotic and laparoscopic surgical procedures in the treatment of low and mid rectal cancer in different BMI (body mass index) groups. The clinical records of patients who had laparoscopic or robotic proctectomy at a single center between December 2019 and August 2023 were analyzed. Then we utilized a classification framework to categorize individuals based on their BMI into three unique groups: non-obese, overweight, and obese. The short-term efficacy was evaluated. A consecutive sample of 1413 patients was included in this retrospective investigation. 1158 people out of the total sample chose laparoscopic surgery, whereas 255 people chose robotic surgery. In the group of obese people, robotic surgery showed a statistically significant decrease in blood loss compared to laparoscopic surgery (P = 0.026). People who were overweight or obese were in the hospital for a shorter amount of time after robotic surgery than after laparoscopic surgery (P = 0.033 and P = 0.031, respectively). People with different BMIs in the robotic surgery group took less time to have a flatus passage and oral intake those in the laparoscopic surgery group. Oncological outcomes and the frequency of complications were comparable between the two treatments with different BMIs. Surgical resection of patients undergoing low-anterior surgery may benefit from a robotic approach, particularly in overweight and obese patients.

PLCD3 inhibits apoptosis and promotes proliferation, invasion and migration in gastric cancer.

Gastric cancer (GC) is a heterogeneous disease whose development is accompanied by alterations in a variety of pathogenic genes. The phospholipase C Delta 3 enzyme is a member of the phospholipase C family, which controls substance transport between cells in the body. However, its role in gastric cancer has not been discovered. The purpose of this study was to investigate the expression and mechanism of action of PLCD3 in connection to gastric cancer. By Western blot analysis and immunohistochemistry, PLCD3 mRNA and protein expression levels were measured, with high PLCD3 expression suggesting poor prognosis. In N87 and HGC-27 cells, the silencing of PLCD3 using small interfering RNA effectively induced apoptosis and inhibited tumor cell proliferation, invasion, and migration. Conversely, overexpression of PLCD3 using overexpressed plasmids inhibited apoptosis in AGS and BGC-823 cells and promoted proliferation, migration, and invasion. In order to investigate the underlying mechanisms, we conducted further analysis of PLCD3, which indicates that this protein is closely related to the cell cycle and EMT. Additionally, we found that overexpression of PLCD3 inhibits apoptosis and promotes the development of GC cells through JAK2/STAT3 signaling. In conclusion, PLCD3 inhibits apoptosis and promotes proliferation, invasion, and migration, which indicated that PLCD3 might serve as a therapeutic target for gastric cancer.

Laparoscopic versus open distal gastrectomy for advanced gastric cancer in elderly patients: a propensity-score matched analysis.

BACKGROUND: Scarce research has reported the efficacy and safety of laparoscopic distal gastrectomy in elderly patients. This retrospective study aimed to compare the outcomes of laparoscopic and open distal gastrectomy for advanced gastric cancer in elderly patients. METHODS: A total of 303 elderly patients who underwent distal gastrectomy for advanced gastric cancer from June 2017 to June 2021 were enrolled. Variables used to calculate propensity score matching included sex, age, body mass index, American Society of Anesthesiologists, history of diabetes, and history of hypertension. The statistical significance of continuous variables was tested using an independent sample t test. chi-square or Fisher's exact tests were used for categorical variables. Kaplan-Meier curve and log-rank test were used for the evaluation of 3-year overall survival and recurrence-free survival. RESULTS: After performing 1:1 propensity score matching, 248 patients were included for analysis (laparoscopic = 124, open = 124). Compared with the open group, the laparoscopic group showed significant advantages in estimated blood loss (P < 0.001), pain scale on the first postoperative day (P = 0.002), time to first flatus (P = 0.004), time to first liquid diet (P = 0.005), hospital stays (P < 0.001), and total complications (P = 0.011), but devoted much more operation time (P < 0.001). No statistical difference was observed between the two groups in 3-year recurrence-free survival (P = 0.315) or overall survival (P = 0.159). CONCLUSIONS: Our analysis demonstrated that laparoscopic surgery had the advantages of less intraoperative blood loss, fewer postoperative complications, and faster postoperative recovery in distal gastrectomy for advanced gastric, indicating that laparoscopic distal gastrectomy is safe and effective for treating elderly patients with distal gastric cancer.

Impact of visceral fat area on short-term outcomes in robotic surgery for mid and low rectal cancer.

Rectal cancer is one of the most prevalent cancers that arise in the digestive tract. The purpose of this retrospective study was to investigate the impact of visceral fat area (VFA) on postoperative outcomes in mid and low rectal cancer patients undergoing robotic surgery (RS). Data were collected on patients who underwent robotic anterior rectal resection in a single center from December 2019 to October 2023. Clinical pathology information was analyzed. Statistical analysis was done on the computed tomography (CT) imaging data. A total of 277 patients were included in the study, including 121 cases with visceral obesity (VO) and 156 cases without VO. There was no statistically significant disparity in the lymph node dissection count, blood loss, duration of hospitalization, time to first liquid diet, early postoperative complications, histopathologic specimen indices (quality of TME and CRM involvement rate), and or the rate of conversion to open surgery between VO and non-VO group (P > 0.05). Nevertheless, the group of individuals with VO experienced a lengthier duration of surgery (P < 0.001) and a delayed time until the first passage of flatus (P < 0.001) in comparison to the group without VO. The study suggests that VO does not significantly impact early complications or the quality of surgical outcomes in mid and low rectal cancer patients undergoing robotic surgery. The findings support the continued use of RS as an optimal strategy for technically demanding patients.

Radial resection margin distinguishes between superficial versus deep resection in colorectal cancer: a retrospective study.

Randomized studies showed that robotic surgery was short-term useful and safe for cancer patients. We investigated whether robots improve deep resection margins or superficial resection margins for radial resection margins in terms of short-term results. From an institutional database, we selected all superficial groups (≤ 3 mm) and deeper groups (≥ 4 mm) with rectal cancer treated with resection for a year. We evaluated the short-term post-operative 90-day outcomes on a radial resection size-based margin differentiation, including the first bowel movement, length of hospital stay, sepsis, and harvested lymph node. The main results were grades III-IV on the Clavien-Dindo scale and complications. We found 120 patients who had oncologic resection of rectal cancer; 42 patients with a superficial radial resection margin of ≤ 3 mm, all the following outcomes improved: the harvested lymph node, proximal resection margin, TME, flatus time, liquid diet duration, anastomotic leakage, and sepsis. Among these advantages were a reduced risk of metastasis and an overall reduction in local recurrence.

Ubiquitous occurrence of p-Phenylenediamine (PPD) antioxidants and PPD-quinones in fresh atmospheric snow and their amplification effects on associated aqueous contamination.

p-Phenylenediamine (PPD) antioxidants are heavily used for protection of commercial rubber products (e.g., vehicle tire), resulting in their widespread contamination in ecosystem. PPD-quinones (PPDQs), the toxic quinone derivatives of PPDs, are also discovered as novel environmental pollutants. However, the contamination characteristics of PPDs/PPDQs in fresh atmospheric snow (without deposition on the Earth surface) have seldom been studied. This work first reports the broad distributions of PPDs and PPDQs in fresh atmospheric snow collected from seven Chinese urban areas. Individual median values of detected concentrations were in the ranges of 0.4 to 260 pg g-1 (PPDs) and 0.7 to 104 pg g-1 (PPDQs). The concentration deviation by long-term deposition on the ground was eliminated. In most sampling regions, wearing of vehicle rubber tires was possibly responsible for spatial-dependent PPDs' pollution level variations, and high concentrations of PPDs promoted PPDQs' formation in snow from atmosphere. Yet, excessive O3 may further oxidize and reduce PPDQs in atmospheric fresh snow from Zhengzhou, which is different from previous research. Furthermore, snowfall was noticed might amplify concentrations of three PPDs and PPDQs in an inland lake, which possibly worsen corresponding pollution in water system. Current study elucidates the potential impacts of snow-bound PPDs/PPDQs on ecosystems should not be underestimated.

Alveolar bone morphology in patients with palatally-displaced maxillary lateral incisors before and after orthodontic treatment: A cone-beam computed tomography study.

INTRODUCTION: Palatal displacement of maxillary anterior teeth is common in clinical practice. Previous studies have reported that the labial bone around palatally-displaced incisors is thinner than that around normally-placed teeth. Therefore, it is necessary to elucidate alveolar bone changes after alignment to guide orthodontic treatment. In this study, we investigated the alveolar bone changes around palatally-displaced maxillary lateral incisors before and after treatment, and the effects of extraction and age using cone-beam computed tomography. METHODS: In this retrospective study, 55 patients with unilateral palatally-displaced maxillary lateral incisors were included. Three-dimensional alveolar bone changes were measured at three levels (25%, 50% and 75% of the root length) using cone-beam computed tomography. Group comparisons were made between displaced and control teeth, extraction and non-extraction groups, and adult and minor groups. RESULTS: After orthodontic treatment, labiopalatal and palatal alveolar bone widths decreased at all measured levels. Labial alveolar bone width increased significantly at P25, but decreased at P75. Concavity decreased, while tooth-axis angle, tooth length, B-CEJ and P-CEJ increased. Changes in LB and LP at P75, B-CEJ and P-CEJ were statistically significant. After treatment, the tooth-axis angle on the PD side increased by 9.46°. The change in tooth-axis angle on the PD side was significantly smaller, and LB and LP decreased more at P75, in the extraction group. CONCLUSIONS: Compared to the control teeth, alveolar bone thickness and height for the displaced teeth decreased more significantly after treatment. Tooth extraction and age also influenced alveolar bone changes.

Cadmium exposure exacerbates kidney damage by inhibiting autophagy in diabetic rats.

The incidence of diabetes mellitus (DM) is gradually increasing, making it a widespread global health concern. Cadmium (Cd) is a common toxic heavy metal in the environment, and cadmium exposure may be associated with diabetic nephropathy (DN). However, the mechanism of Cd-induced DN remains unclear. In this study, we aimed to determine the effect of cadmium on diabetic kidney injury and the underlying mechanism in diabetic rats and a renal tubular epithelial cell line (NRK-52E cells). Our results could provide novel insights on the nephrotoxic mechanism of cadmium. HE, PAS, and Masson staining were used to observe pathological renal injury. COL-I, COL-IV, CTSB, and CTSD protein levels were detected by immunohistochemistry and western blotting. Immunofluorescence was used to detect the fluorescence intensity of p62 and LC3 proteins in kidney tissue. TEM was used to observe the ultrastructure of mitochondria and number of autophagosomes. After cadmium exposure, DM rats showed a dramatic decrease in body weight compared to the unexposed DM group. Relative kidney weight showed a contrasting trend after cadmium exposure. Urinary microalbumin/creatinine significantly increased in normal and DM rats after cadmium exposure. However, the trend was clearer in the DM groups than in the control groups. Endogenous creatinine clearance exhibited a contrasting trend. After cadmium exposure in DM rats, MDA content significantly increased and GSH, CAT, SOD, and GSH-PX activation reduced compared to normal controls. Pathological damage was more pronounced, and the expression of autophagy related proteins and apoptosis and fibrosis proteins was significantly higher in vivo and vitro in the cadmium-exposed groups than in unexposed controls. Further, lysosomal protein levels were lower, and ROS content and autophagosome count significantly higher in the cadmium exposed groups compared to the unexposed controls. Therefore, Cadmium exposure aggravates diabetic kidney injury via autophagy inhibition.