Unravelling the mechanism of columnar-to-equiaxed transition and grain refinement in ultrasonic vibration assisted laser welding of Ti6Al4V titanium alloy.

In this study, the microstructural evolution and mechanical properties of Ti6Al4V titanium alloy welded joints subjected to ultrasonic assisted laser welding were scrutinized, while numerical simulations were employed to explicate the grain refinement mechanism. The simulations indicate that the ultrasonic vibration significantly improves the overall fluidity and temperature of the molten pool. Under the identical condition of laser power and welding speed (1500 W, 1.3 m/min), the presence of 0.2A ultrasonic current yields a more uniform refinement of columnar grains, along with a denser arrangement of acicular martensite. The refinement mechanism can be attributed to the small temperature gradient, cavitation effects, and stress induced by ultrasonic vibration. Notably, the welded joint attains a peak tensile strength of 945.2 MPa under the aforementioned 0.2A condition, distinctly demonstrating the characteristics of ductile fracture. This research further reveals the underlying mechanism of grain refinement in Ti6Al4V alloy laser-welded joints induced by ultrasonic vibration, providing valuable references for optimizing process parameters and improving the quality of such welded joints.

Efficacy and Long-Term Effect of Transabdominal Preperitoneal Prosthesis for Unilateral Inguinal Hernia.

Objective: To investigate the efficacy and long-term results of transabdominal preperitoneal prosthesis (TAPP) in the treatment of patients with unilateral inguinal hernia (UIH). Methods: Ninety-two patients with UIH admitted to our hospital from January 2017 to August 2021 were selected to be the study subjects of this trial. They were divided into two groups with 46 patients in each, based on whether they were treated with a transabdominal preperitoneal prosthesis (TAPP group) or an open Bassini repair (OBR group). The clinical data of both groups were compared in terms of surgery (time and bleeding), postoperative (length of stay and costs), postoperative (near and far) complications, visual analog (VAS) score within 6 months after surgery, and postoperative SF-36 health survey scale. Results: The mean operative time and intraoperative bleeding were lower in the TAPP group than in the OBR group (P < .05), the postoperative hospital stay was shorter in the TAPP group than in the OBR group (P < .05), and the hospital costs were markedly higher in the TAPP group than in the OBR group (P < .05). There was no remarkable difference in the occurrence of postoperative complications between the two groups. The mean VAS score and SF-36 score profiles were better in the TAPP group than in the OBR group at 3 and 14 days after surgery (P < .05), and there were no marked differences in VAS score and SF-36 score profiles between both groups at 2-month and 6-month postoperative follow-up (P > .05). Conclusion: TAPP is effective in treating patients with UIH, improving their pain and quality of life, and safeguarding their health.

GREB1L overexpression is associated with good clinical outcomes in breast cancer.

BACKGROUND: Breast cancer is the most common malignant tumor among women worldwide. GREB1L is a protein-coding gene. Previous studies have shown that GREB1L plays a vital role in lung and gastric adenocarcinoma. Currently, there is no relevant report about its role in breast cancer. METHODS: The Cancer Genome Atlas database was used to compare the expression level of GREB1L between tumor and normal tissues. The TISIDB website was used for prognosis analysis. The LinkedOmics database was used to predict the potential biological mechanism of GREB1L in breast cancer. Immunohistochemistry was used to detect the GREB1L expression level in breast tissue. Western blotting was used to detect the GREB1L expression level in cell lines. Transwell assays, CCK-8 cell proliferation assays, and colony formation assays were used to detect the migration, invasion, proliferation, and colony formation abilities of cells. Subcutaneous xenograft models were used to detect the in vivo tumor formation abilities of cells. RESULTS: GREB1L is highly expressed in breast cancer tissues and breast cancer cells. KEGG enrichment analysis suggested that GREB1L participates in the regulation of the Hedgehog signaling pathway; changes in GREB1L expression affected the migration and invasion abilities of MCF7 and MDA-MB-231 cells. Although changes in GREB1L expression did not affect their proliferation and colony formation abilities in vitro and in vivo, they affected the expression of tumor metastasis-related genes in vivo. The overexpression of GREB1L in breast cancer predicted a favorable prognosis. CONCLUSION: These results showed that GREB1L is involved in the development of breast cancer, and it may be a potential molecular marker for predicting the prognosis of breast cancer.

Diffuse Large B-cell Lymphoma (Leg Type) Originating in the Skin of the Right Cheek Region: A Case Report and Literature Review.

Primary diffuse cutaneous large B-cell lymphoma, leg type (PCDLBCL-LT), usually affecting one or both lower legs, with a 5-year disease-free survival rate of less than 60%. Solitary facial lesions are extremely rare. Our report is about a 93-year-old woman whose clinical examination revealed a 4 cm × 5 cm × 3 cm mass with a soft texture and smooth margins on the right side of her cheek. Immunohistochemical analyses were consistent with a diagnosis of PCDLBCL-LT. The surgical method for this patient was: extensive resection of the tumor and repair of the defect with an adjacent flap. Neither local recurrence nor systemic invasion was observed during postoperative follow-up (8 months). The clinician must be very careful when making a correct diagnosis based on the clinical and immunohistochemical findings of PCDLBCL-LT. For this type of PCDLBCL-LT isolated in 1 site without invasion of the rest of the body, extensive surgical resection may result in a favorable prognosis.

Interlaminar Microstructure and Mechanical Properties of Narrow Gap Laser Welding of 40-mm-Thick Ti-6Al-4V Alloy.

Narrow gap laser welding (NGLW) is a common solution for the welding of thick structures. NGLW was carried out on narrow-gap butt joints of 40 mm-thick Ti-6Al-4V alloy plates with a U-shaped groove. The distribution characteristics of the interlaminar microstructure in different height ranges of the joint were investigated, and the evolution behavior and formation mechanism of the interlaminar microstructure of the joint were also revealed. This showed that a large amount of short needle martensite nucleated and grew up near the fusion line and the upper boundary of the remelting zone. The "softening" phenomenon occurred in all welds except the cover layer weld. The microstructure evolution and defect migration, induced by multiple welding thermal cycles in the upper weld forming process, were the main reasons for the "softening" of the lower weld. The tensile strength of each sample changed in the range of 920~990 MPa; the fracture mode of the sample belongs to a transgranular ductile fracture. In addition, compared with the upper part of the joint, the plasticity and toughness of the weld area in the lower part of the joint was improved.

Iron and copper micronutrients influences cadmium accumulation in rice grains by altering its transport and allocation.

Cadmium (Cd) contamination in rice paddy fields constitutes a serious health issue in some parts of China. Here we study the potential for remediation of Cd contaminated alkaline paddy soil with low iron (Fe) and high copper (Cu) background by altering the concentrations of Fe and Cu in the growing media, which has been only seldom considered. We assessed how these two micronutrients (Cu and Fe) affect the absorption and transport of Cd in rice. Adding Cu significantly increased rice biomass and grain yield by reducing root Cd influx and Cd upward transport which, consequently, lowered Cd concentrations in roots, culms and leaves. However, excessive Cu also promoted a relatively higher Cd allocation in grains, especially under Fe deficiency, likely because Cu significantly increased the proportion of bioavailable Cd in leaves. Contrastingly, Fe did not alleviate the toxic effects of Cd on rice growth and yield, but it significantly reduced Cd transfer towards grains, which might be attributed to a sharp decrease in the proportion of bioavailable Cd in leaves. Our results demonstrated that Cd remediation may be achieved through altering Fe and Cu inputs, such that Cd accumulation in rice grains is reduced.

Comparison of cardiac rehabilitation (exercise + education), exercise only, and usual care for patients with coronary artery disease: A non-randomized retrospective analysis.

Cardiac rehabilitation program is well-established but the Rehabilitation After Myocardial Infarction Trial (RAMIT) is reported that it does not affect mortality and morbidity of patients after myocardial infarction during follow-up period. The objectives of the study were to compare functional walking capacity, risk factor control, and morbidities in follow-up for cardiac rehabilitation (exercise + education), exercise only, and usual care among patients with coronary artery disease. A total of 492 male and female patients (age range: 45-73 years) with coronary artery disease after myocardial infarction or underwent percutaneous coronary intervention or coronary artery bypass grafting surgeries referred to cardiac rehabilitation were included in the study. Patients were participating in a cardiac rehabilitation program (exercise + education, CRP cohort, n = 125), exercise only (USC cohort, n = 182), or usual care (NCR cohort, n = 185). Data regarding incremental shuttle walk test, lipid profile, the Patient Health Questionnaire 9, and morbidities in follow-up of patients were retrospectively collected and analyzed. After completion of 1 year, cardiac rehabilitation program (p < 0.0001, q = 20.939) and exercise (p < 0.0001, q = 6.059) were successfully increased incremental shuttle walk test. After completion of 1 year, cardiac rehabilitation program reduced low-density lipoprotein (p = 0.007, q = 3.349) and depressive symptoms (p < 0.0001, q = 5.649). Morbidities were reported fewer in the patients of CRP cohort than those of USC (p = 0.003, q = 3.427) and NCR (p = 0.003, q = 4.822) cohorts after completion of 1 year of program. Cardiac rehabilitation program (exercise +education) improved functional walking capacity, controlled risk factors, and reduced morbidities of patients with coronary artery disease than exercise only and usual care (Level of evidence: III).

Computed tomography, magnetic resonance imaging, and F-deoxyglucose positron emission computed tomography/computed tomography findings of alveolar soft part sarcoma with calcification in the thigh: A case report.

BACKGROUND: Alveolar soft part sarcoma (ASPS) is an extremely rare malignant sarcoma, accounting for less than 1% of all soft-tissue sarcomas. However, limited information is available on multimodal imaging [computed tomography (CT), magnetic resonance imaging (MRI), and positron emission computed tomography/computed tomography (PET/CT)] of ASPS. CASE SUMMARY: This study reports a case of a 35-year-old female patient with ASPS of the left thigh with lung metastasis. The patient presented with a 1-year history of a palpable mass in the lower extremity, which exhibited rapid growth for 3 wk. CT, MRI, and F-deoxyglucose PET/CT examinations were performed. CT showed a slightly hypodense or isodense mass with patchy calcifications. On MRI examination, the mass manifested hyperintensity on T1-weighted, T2-weighted, and diffusion-weighted images with some signal voids. PET/CT images demonstrated an intensely hypermetabolic mass in the left thigh and hypermetabolic nodules in lungs. CONCLUSION: ASPS should be considered as a possible diagnosis when a slow-growing mass is detected in the soft tissue of the extremities, with hyperintensity and numerous signal voids on T1-weighted, T2-weighted, and diffusion-weighted images and intense F-deoxyglucose uptake on PET/CT. ASPS can have calcifications on CT.

Elevated soluble E-cadherin during the epithelial-mesenchymal transition process and as a diagnostic marker in colorectal cancer.

Epithelial-mesenchymal transition (EMT) plays a crucial role in colorectal cancer (CRC) metastasis. Soluble E-cadherin (sE-cadherin) is a peptide degradation product of the E-cadherin, a key epithelial molecule of EMT. However, it is not known if elevated levels of sE-cadherin also occur during EMT. And the study of sE-cadherin in colorectal cancer is rare. The purpose of the study was to evaluate the relationship between sE-cadherin and EMT in CRC and to evaluate the diagnostic value of sE-cadherin as a serum marker for CRC. Transforming growth factor-ß1 (TGF-ß1) was used to induce EMT in HT29 and SW480 cells. The cells treated with TGF-ß1 showed morphological and biological behavior changes consistent with EMT. Western blot and ELISA showed the levels of sE-cadherin were increased during EMT in CRC cells. In addition, we intravenously injected luciferase-labeled SW480 cells into nude mice to construct CRC metastasis model. Following the elongation of time, the fluorescence intensity of the experimental group was gradually increased. Correspondingly, the serum concentration of sE-cadherin also increased during CRC metastasis in mice. Furthermore, compared to healthy subjects, significantly higher levels of serum sE-cadherin were also observed in CRC patients and correlated with clinicopathological features. For discriminating CRC from healthy controls, the area under the receiver operating characteristic (ROC) curve (AUC) of sE-cadherin was 0.853, while the optimal cut-off point was set at 5928.16 ng/ml, the diagnostic sensitivity was 73.9% and the specificity was 80%. Compared with current commercial biomarkers (CEA, CA19-9 and CA125), the diagnostic performance of sE-cadherin was highest. Combined sE-cadherin and CEA raised the sensitivity to 82.4%. Serum sE-cadherin level can be used as a potential diagnostic biomarker of CRC.

Efficacy of dexmedetomidine for treatment of patients with sepsis: A meta-analysis of randomized controlled trials.

BACKGROUND: This meta-analysis aimed to evaluate the effect of dexmedetomidine on prognosis in patients with sepsis. METHODS: Computer-related electronic databases were searched, including PubMed, Embase, Web of Science, the Cochrane Library, and the China National Knowledge Infrastructure, from the date of database construction to January 2019. Stata 12.0 was used to perform a meta-analysis of short-term mortality [intensive care unit (ICU) mortality or 28-day mortality], ICU length of stay, and mechanical ventilation. Mortality was expressed using risk ratio (RR) and 95% confidence interval (CI). ICU length of stay and mechanical ventilation were expressed as weighted mean difference (WMD) and 95% CIs. RESULTS: We finally included 8 randomized controlled trials in this meta-analysis. Compared with the control group, the dexmedetomidine group had a lower occurrence of 28-day mortality (RR, 0.49; 95% CI, 0.35 to 0.69; P = .000) and ICU mortality (RR, 0.44; 95% CI, 0.23 to 0.84; P = .013). However, there was no statistically significant difference for the length of hospital stay (WMD, -0.05; 95% CI, -0.59 to 0.48; P = .840) and mechanical ventilation time (WMD, 1.05; 95% CI, -0.27 to 2.37; P = .392) between dexmedetomidine group and control group. CONCLUSIONS: In patients with sepsis, dexmedetomidine can reduce the short-term mortality of patients, but could not shorten the ICU length of stay and mechanical ventilation time. More clinical randomized controlled trials are needed to verify the efficacy and safety of dexmedetomidine on the length of hospital stay and mechanical ventilation time.

MicroRNA16 regulates glioma cell proliferation, apoptosis and invasion by targeting Wip1-ATM-p53 feedback loop.

The present study aimed to investigate the role and underlying mechanisms of microRNA16 (miR-16) on proliferation, apoptosis and invasion of glioma cells. The cell models of miR-16 upregulation and Negative control group (NC group) were built. The cell functions of different groups were detected by colony formation assay, transwell chamber assay, proliferation, apoptosis and cycle experiments. The intracranial orthotopic transplantation animal models were built to different groups: miR-16 agomir group, miR-16 antagomir group and their NC group. The expressions of miR-16, Wip1, ATM and p53 were measured by qRT-PCR, western blot and immunohistochemistry. As a result, miR-16 overexpressed groups had lower cloning formation rate and proliferation rate, less invasive cells, higher early apoptosis rate than the control groups. G1 phase was significantly smaller compared miR-16 overexpressed groups with the control groups, and S phase significantly lesser. Cell growth was retardated. Differences were statistically significant (P <0.05). Compared with miR-16 overexpressed groups and NC groups, the Wip1 gene and protein expression were downregulated, while ATM and p53 genes, p-ATM and p-p53 proteins were upregulated. The differences were statistically significant (P <0.05). Taken together, our findings demonstrated that miR-16 suppressed glioma cell proliferation and invasion, promoted apoptosis and inhibited cell cycle by targeting Wip1-ATM-p53 signaling pathway.

Cumulative score based on preoperative plasma fibrinogen and serum C-reactive protein could predict long-term survival for esophageal squamous cell carcinoma.

The present study was to establish a prognostic indicator based on preoperative fibrinogen and C-reactive protein (CRP) (FC score) in esophageal squamous cell carcinoma (ESCC). Clinicopathologic characteristics, preoperative plasma fibrinogen and serum CRP levels were reviewed in patients who underwent transthoracic esophagectomy. The optimal cut-off value for fibrinogen and CRP was defined as 4.0 g/dL and 10.0 mg/L according to previous reports. Patients with elevated fibrinogen and CRP levels were assigned a score of 2, those with only one of these two abnormalities were allocated a score of 1, and those with neither of the two abnormalities were assigned a score of 0. Preoperative FC score was significantly correlated with degree of differentiation, depth of invasion, tumor-node-metastasis (TNM) stage and modified Glasgow Prognostic Score (mGPS). No significant differences in age, gender, tumor length, tumor location, lymph node status or smoking were identified between groups. Univariate survival analysis demonstrated that high preoperative FC score (1/2) was significantly associated with impaired disease free survival (DFS) [hazard ratio (HR), 1.650; 95% confidence interval (CI), 1.181-2.303; P=0.003] and overall survival (OS) (HR, 1.879; 95% CI, 1.333-2.648; P<0.001), and it remained an independent predictor for both DFS (HR, 1.468; 95% CI, 1.043-2.067; P=0.028) and OS (HR, 2.070; 95% CI, 1.266-3.385; P=0.004) in multivariate Cox regression analysis. Preoperative FC score might represent a new potential marker of worst prognosis that warrants further evaluation in prospective and large cohort studies among ESCC patients who underwent transthoracic esophagectomy.

The preoperative sensitive-modified Glasgow prognostic score is superior to the modified Glasgow prognostic score in predicting long-term survival for esophageal squamous cell carcinoma.

The present study was designed to investigate the prognostic significance of the preoperative sensitive-modified Glasgow prognostic score (S-mGPS) and its superiority in esophageal squamous cell carcinoma (ESCC). Clinicopathologic characteristics, preoperative albumin and C-reactive protein (CRP) levels were retrospectively collected in 442 patients who underwent transthoracic esophagectomy. The S-mGPS was calculated before surgery based on optimal cutoff values of 45.6 g/L for albumin and 10.0 mg/L for CRP. 360, 74 and 8 cases were assigned an mGPS of 0, 1 and 2, respectively. In contrast, the S-mGPS was 0 in 114, 1 in 258 and 2 in 70 patients. Of the 360 patients with an mGPS of 0, 246 migrated to the S-mGPS-1 group. Both mGPS and S-mGPS were significantly correlated with tumor length, depth of invasion, pathological tumor-node-metastasis (pTNM) stage and adjuvant treatment. In addition, they were significantly associated with disease free survival (DFS) and overall survival (OS) in univariate analysis. Furthermore, multivariate Cox regression analysis identified S-mGPS as an independent prognostic indicator for both DFS [hazard ratio (HR), 1.577; 95% confidence interval (CI), 1.149-2.163; P = 0.005] and OS (HR, 1.762; 95% CI, 1.250-2.484; P = 0.001), but not mGPS (HR, 0.957; 95% CI, 0.692-1.323; P = 0.790 for DFS and HR, 1.089; 95% CI, 0.781-1.517; P = 0.615 for OS, respectively). Moreover, subgroup analysis revealed that the prognostic impact of the S-mGPS was especially striking in pTNM stage II patients. The preoperative S-mGPS is superior to the mGPS as a prognostic predictor in patients with resectable ESCC.

[Effect of VATS wedge resection and mediastinal lymph node sampling in elderly patients with early peripheral lung cancer].

BACKGROUND AND OBJECTIVE: The treatment for early-stage non-small cell lung cancer is primarily surgical. However, the optimal extent of mediastinal lymph node resection remains to be determined. The aim of the current study is to investigate the effect of a pulmonary wedge resection on aged patients with lung cancer. METHODS: A total of 15 lung cancer patients aged over 70 years were treated via video-assisted thoracoscopic surgery (VATS) wedge resection and mediastinal lymph node sampling from June 2004 to February 2008. Mediastinal lymph node sampling included stations 2R, 4R, 8 and 9 for the right-sided cancers and stations 5, 6, 8 and 9 for the left-sided cancers. RESULTS: VATS wedge resection and mediastinal lymph node sampling for aged patients with peripheral lung cancer are minimally invasive treatments with a short operative time and low postoperative morbidity. The 1-year and 3-year survival rates were 100% and 86.6%, respectively. CONCLUSION: VATS wedge resection and mediastinal lymph node sampling can be an alternative treatment for aged patients with early peripheral lung cancer.