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1.
Ann Surg ; 279(6): 923-931, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38375670

RESUMO

OBJECTIVE: To assess the effectiveness of indocyanine green (ICG)-guided lymph node (LN) dissection during laparoscopic radical gastrectomy after neoadjuvant chemotherapy (NAC) in patients with locally advanced gastric cancer (LAGC). BACKGROUND: Studies on ICG imaging use in patients with LAGC on NAC are rare. METHODS: Patients with gastric adenocarcinoma (clinical T2-4NanyM0) who received NAC were randomly assigned to receive ICG-guided laparoscopic radical gastrectomy or laparoscopic radical gastrectomy alone. Here, we reported the secondary endpoints including the quality of lymphadenectomy (total retrieved LNs and LN noncompliance) and surgical outcomes. RESULTS: Overall, 240 patients were randomized. Of whom, 236 patients were included in the primary analysis (118 in the ICG group and 118 in the non-ICG group). In the ICG group, the mean number of LNs retrieved was significantly higher than in the non-ICG group within the D2 dissection (48.2 vs 38.3, P < 0.001). The ICG fluorescence guidance significantly decreased the LN noncompliance rates (33.9% vs 55.1%, P = 0.001). In 165 patients without baseline measurable LNs, ICG significantly increased the number of retrieved LNs and decreased the LN noncompliance rate ( P < 0.05). For 71 patients with baseline measurable LNs, the quality of lymphadenectomy significantly improved in those who had a complete response ( P < 0.05) but not in those who did not ( P > 0.05). Surgical outcomes were comparable between the groups ( P > 0.05). CONCLUSIONS: ICG can effectively improve the quality of lymphadenectomy in patients with LAGC who underwent laparoscopic radical gastrectomy after NAC.


Assuntos
Adenocarcinoma , Gastrectomia , Verde de Indocianina , Laparoscopia , Excisão de Linfonodo , Terapia Neoadjuvante , Neoplasias Gástricas , Humanos , Verde de Indocianina/administração & dosagem , Neoplasias Gástricas/cirurgia , Neoplasias Gástricas/patologia , Neoplasias Gástricas/tratamento farmacológico , Excisão de Linfonodo/métodos , Masculino , Laparoscopia/métodos , Feminino , Pessoa de Meia-Idade , Gastrectomia/métodos , Idoso , Adenocarcinoma/cirurgia , Adenocarcinoma/tratamento farmacológico , Adenocarcinoma/patologia , Corantes/administração & dosagem , Adulto , Resultado do Tratamento , Estadiamento de Neoplasias , Quimioterapia Adjuvante
2.
Opt Lett ; 49(10): 2585-2588, 2024 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-38748111

RESUMO

Einstein-Podolsky-Rosen (EPR) steering, an important resource in quantum information, describes the ability of one party to influence the state of another party through local measurements. It differs from Bell nonlocality and entanglement due to its asymmetric property. EPR steering swapping allows two spatially independent parties to present EPR steering without direct interaction. Here, we theoretically propose an all-optical EPR steering swapping (AOSS) scheme based on low-noise high-broadband optical parametric amplifiers (OPAs). A low-noise high-broadband OPA is utilized to implement the function of Bell-state measurement without detection, avoiding the optic-electro and electro-optic conversions. After AOSS, one-way and two-way EPR steering between two independent optical modes can be obtained. Our scheme provides a guidance for the construction of a measurement-free, all-optical broadband quantum network utilizing EPR steering swapping.

3.
Phys Rev Lett ; 132(4): 040601, 2024 Jan 26.
Artigo em Inglês | MEDLINE | ID: mdl-38335349

RESUMO

Quantum erasure-correcting code, which corrects the erasure in the transmission of quantum information, is an important protocol in quantum information. In the continuous variable regime, the feed-forward technique is needed for realizing quantum erasure-correcting code. This feed-forward technique involves optic-electro and electro-optic conversions, limiting the bandwidth of quantum erasure-correcting code. Moreover, in the previous continuous variable quantum erasure-correcting code, only two modes are protected against erasure, limiting the applications of quantum erasure-correcting code in high-capacity quantum information processing. In this Letter, by utilizing the orbital angular momentum (OAM) multiplexed entanglement in the encoding part and replacing the feed-forward technique with OAM mode-matched phase-sensitive amplifier in the decoding part, we experimentally demonstrate a scheme of OAM multiplexed deterministic all-optical quantum erasure-correcting code. We experimentally demonstrate that four orthogonal modes can be simultaneously protected against one arbitrary erasure. Our results provide an all-optical platform to implement quantum erasure-correcting code and may have potential applications in implementing all-optical fault-tolerant quantum information processing.

4.
Phys Rev Lett ; 132(16): 160803, 2024 Apr 19.
Artigo em Inglês | MEDLINE | ID: mdl-38701483

RESUMO

Quantum telecloning, a pivotal multiuser quantum communication protocol in the realm of quantum information science, facilitates the copy of a quantum state across M distinct locations through teleportation technique. In the continuous-variable regime, the implementation of quantum telecloning necessitates the distribution of multipartite entanglement among the sender and M receiver parties. Following this, the sender carries out optic-electro conversion and transmits information via classical channel to M spatially separated receivers simultaneously. To successfully reconstruct the input state, electro-optic conversion needs to be employed by each receiver. However, due to these conversions, the bandwidth of the optical mode in this process is largely constrained. In this Letter, we present an all-optical version of the 1→2 continuous-variable quantum telecloning scheme, wherein both optic-electro and electro-optic conversions are replaced by optical components. Our scheme allows the two receivers to achieve input state reconstruction solely by utilizing beam splitters, significantly simplifying its complexity. We experimentally demonstrate all-optical 1→2 quantum telecloning of coherent state and achieve the fidelities of 58.6%±1.0% and 58.6%±1.1% for two clones, exceeding the corresponding classical limits (51.9%±0.5% and 51.9%±0.6%). Our results establish a platform for constructing a flexible all-optical multiuser quantum network and promote the field of all-optical quantum information processing.

5.
Phys Rev Lett ; 132(10): 100801, 2024 Mar 08.
Artigo em Inglês | MEDLINE | ID: mdl-38518346

RESUMO

Quantum teleportation, disembodied transfer of the unknown quantum state between two locations, has been experimentally demonstrated for both discrete and continuous variable states in one degree of freedom (DOF). Generally, multiple DOFs are needed to fully characterize a quantum state. Therefore, to implement intact quantum teleportation, multiple DOFs of quantum state should be teleported simultaneously. Recently, teleporting a single photon encoded in two DOFs has been experimentally demonstrated in discrete variable regime. However, the teleportation of more than two DOFs remains unexplored. Here, by utilizing continuous variable hyperentanglement in four DOFs (azimuthal and radial indexes of Laguerre-Gaussian mode, frequency, and polarization), we experimentally demonstrate deterministic all-optical quantum teleportation of four DOFs. Moreover, we experimentally construct 24 parallel teleportation channels. Our results pave the way for deterministically implementing multiple-DOF quantum communication protocols.

6.
Diabetes Obes Metab ; 2024 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-38738333

RESUMO

AIMS: To examine the differential associations between cardiometabolic risk factors and cardiovascular disease (CVD), and to evaluate the population-attributable fractions (PAFs) for CVD among community-dwelling adults with varied blood pressure (BP) statuses. METHODS: This prospective cohort study included participants without prevalent CVD from a subcohort of the China Patient-Centred Evaluative Assessment of Cardiac Events Million Persons Project. Participants were divided into four BP groups according to the American College of Cardiology/American Heart Association guidelines. The study exposure comprised the selected cardiometabolic risk factors, including waist circumference (WC), body mass index, (BMI) heart rate, fasting blood glucose (FBG), low-density lipoprotein cholesterol, and remnant cholesterol. The outcome was hospitalizations for CVD. Cox proportional hazard models were conducted, and the PAFs were calculated in the analysis. RESULTS: Among the 94 183 participants (39.0% were men, mean age: 54.2 years), 26.6% had Stage 1 hypertension and 30.8% had Stage 2 hypertension. A total of 6065 hospitalizations for CVD were captured after a median follow-up of 3.5 years. BP (per 1-standard deviation [SD]: hazard ratio [HR] 1.34, 95% confidence interval [CI] 1.29, 1.40), FBG (per 1-SD: HR 1.16, 95% CI 1.14, 1.19) and WC (per 1-SD: HR 1.41, 95% CI 1.36, 1.47) were three major contributors to CVD events. BP status significantly modified the associations of abdominal obesity, suboptimal BMI, suboptimal heart rate and abnormal FBG with CVD, with stronger associations with CVD observed in optimal BP groups compared to hypertensive groups (p for risk factor-by-BP group interaction <0.05). Participants with all cardiometabolic risk factors were at the highest risk for CVD, accounting for 35.6% (95% CI 30.0, 40.8) of the PAF for CVD. Among the risk factors, BP control explained the highest PAF for CVD (15.1%, 95% CI 8.2, 21.4) The overall PAFs of cardiometabolic risk factors for CVD were higher among the normotensive participants compared to the hypertensive participants. CONCLUSIONS: The awareness and control rates of hypertension were extremely low among Southern Chinese adults. BP status significantly modified the associations between cardiometabolic risk factors and CVD, and the overall PAFs for CVD were higher among people with normal BP. Dedicated efforts are needed to improve the management of cardiometabolic factors.

7.
Prev Med ; 178: 107797, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38065339

RESUMO

OBJECTIVE: The American Heart Association has introduced the Life's Essential 8 metrics to evaluate and promote cardiovascular health (CVH) and we aimed to evaluate the association of CVH and incident heart failure (HF). METHODS: The China PEACE Million Persons Project is a population-based cardiovascular disease (CVD) screening study. This was a sub-cohort of the project that included individuals free of CVD at baseline. Components and classifications of CVH, including diet, physical activity, smoking status, sleep status, body mass index (BMI), non-high density lipoprotein (non-HDL), blood glucose and blood pressure, were determined based on the Life's Essential 8. CVH status was categorized as poor, intermediate and ideal status. HF cases were identified by linking hospital records. RESULTS: Among the cohort (n = 38,571, median age 54 years and women 60.5%), proportion of individuals with poor, intermediate and ideal CVH was 30.7%, 56.9% and 12.4%. After a median follow-up of 3.56 years, the incidence of HF in individuals with poor, intermediate and ideal CVH was 2.5%, 1.1% and 0.5% respectively. Compared to poor CVH, intermediate (adjusted HR: 0.52 [95% CI: 0.43-0.61]) and ideal CVH (adjusted HR: 0.38 [95% CI: 0.26-0.57]) were associated with a lower HF risk. A gradient of association between CVH and HF risk was observed (P-trend<0.001). Ideal physical activity, ideal smoking status, and intermediate and ideal status of BMI, blood glucose and blood pressure were associated with a lower HF risk. CONCLUSION: Poor CVH was associated with an increased risk of HF, and promotion of CVH may help prevent HF development.


Assuntos
Doenças Cardiovasculares , Insuficiência Cardíaca , Estados Unidos , Humanos , Feminino , Pessoa de Meia-Idade , Doenças Cardiovasculares/epidemiologia , Fatores de Risco , Glicemia , Insuficiência Cardíaca/epidemiologia , Dieta , Pressão Sanguínea/fisiologia
8.
Gastric Cancer ; 27(3): 598-610, 2024 05.
Artigo em Inglês | MEDLINE | ID: mdl-38379100

RESUMO

BACKGROUND: Laparoscopy-assisted gastrectomy (LG) is rapidly gaining popularity owing to its minimal invasiveness. Previous studies have found that compared with two-dimensional (2D)-LG, three-dimensional (3D)-LG showed better short-term outcomes. However, the long-term oncological outcomes in patients with locally resectable gastric cancer (GC) remain controversial. METHODS: In this noninferiority, open-label, randomized clinical trial, a total of 438 eligible GC participants were randomly assigned in a 1:1 ratio to either 3D-LG or 2D-LG from January 2015 to April 2016. The primary endpoint was operating time, while the secondary endpoints included 5-year overall survival (OS), disease-free survival (DFS), and recurrence pattern. RESULTS: Data from 401 participants were included in the per-protocol analysis, with 204 patients in the 3D group and 197 patients in the 2D group. The 5-year OS and DFS rates were comparable between the 3D and 2D groups (5-year OS: 70.6% vs. 71.1%, Log-rank P = 0.743; 5-year DFS: 68.1% vs. 69.0%, log-rank P = 0.712). No significant differences were observed between the 3D and 2D groups in the 5-year recurrence rate (28.9% vs. 28.9%, P = 0.958) or recurrence time (mean time, 22.6 vs. 20.5 months, P = 0.412). Further stratified analysis based on the type of gastrectomy, postoperative pathological staging, and preoperative BMI showed that the 5-year OS, DFS, and recurrence rates of the 3D group in each subgroup were similar to those of the 2D group (all P > 0.05). CONCLUSIONS: For patients with locally resectable GC, 3D-LG performed by experienced surgeons in high-volume professional institutions can achieve long-term oncological outcomes comparable to those of 2D-LG. REGISTRATION NUMBER: NCT02327481 ( http://clinicaltrials.gov ).


Assuntos
Laparoscopia , Neoplasias Gástricas , Humanos , Neoplasias Gástricas/patologia , Intervalo Livre de Doença , Intervalo Livre de Progressão , Gastrectomia/métodos , Laparoscopia/métodos , Resultado do Tratamento , Estudos Retrospectivos
9.
Surg Endosc ; 38(3): 1151-1162, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38082017

RESUMO

OBJECTIVE: To assess the effect of preoperative sarcopenia on the short-term and long-term outcomes in older patients with locally advanced gastric cancer (LAGC). METHODS: Clinicopathological data of older patients with LAGC who underwent radical surgery were retrospectively analyzed. Sarcopenia was defined as a skeletal muscle index of less than 36.4 cm2/m2 for men and less than 28.4 cm2/m2 for women. Comparing the postoperative complications and survival between sarcopenia and non-sarcopenia groups using multicenter data. RESULTS: A total of 406 older patients with LAGC were included in the analysis, including 145 (35.7%) with sarcopenia and 261 (64.3%) with non-sarcopenia. Multivariate logistic regression analysis showed that sarcopenia was an independent risk factor for postoperative complications with CD grade ≥ II (OR 1.616; P < 0.05). Kaplan-Meier survival curve analysis showed that the 5-year overall survival (OS) and 5-year recurrence-free survival (RFS) in the sarcopenia group were lower than those in the non-sarcopenia group (P both < 0.05). Multivariate Cox regression analyses showed that sarcopenia was an independent prognostic factor for 5-year OS and RFS (P both < 0.05). The 5-year recurrence rate in the sarcopenia group was 57.2%, which was significantly higher than that in the non-sarcopenia group (46.4%; P = 0.036). Recurrence pattern analysis showed that the incidence of distant metastases in patients with sarcopenia (42.8%) was significantly higher than non-sarcopenia (31.4%; P = 0.022). CONCLUSION: Sarcopenia serves as a valuable predictor of both short-term and long-term outcomes in older patients with LAGC. Therefore, the significance of assessing preoperative nutritional status and implementing thorough postoperative follow-up for older LAGC patients with sarcopenia should be emphasized.


Assuntos
Sarcopenia , Neoplasias Gástricas , Masculino , Humanos , Feminino , Idoso , Sarcopenia/complicações , Neoplasias Gástricas/complicações , Neoplasias Gástricas/cirurgia , Estudos Retrospectivos , Prognóstico , Complicações Pós-Operatórias/etiologia
10.
Surg Endosc ; 38(5): 2666-2676, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38512349

RESUMO

BACKGROUND: Textbook outcome (TO) has been widely employed as a comprehensive indicator to assess the short-term prognosis of patients with cancer. Preoperative malnutrition is a potential risk factor for adverse surgical outcomes in patients with gastric cancer (GC). This study aimed to compare the TO between robotic-assisted gastrectomy (RAG) and laparoscopic-assisted gastrectomy (LAG) in malnourished patients with GC. METHODS: According to the diagnostic consensus of malnutrition proposed by Global Leadership Initiative on Malnutrition (GLIM) and Nutrition Risk Index (NRI), 895 malnourished patients with GC who underwent RAG (n = 115) or LAG (n = 780) at a tertiary referral hospital between January 2016 and May 2021 were included in the propensity score matching (PSM, 1:2) analysis. RESULTS: After PSM, no significant differences in clinicopathological characteristics were observed between the RAG (n = 97) and LAG (n = 194) groups. The RAG group had significantly higher operative time and lymph nodes harvested, as well as significantly lower blood loss and hospital stay time compared to the LAG group. More patients in the RAG achieved TO. Logistic regression analysis revealed that RAG was an independent protective factor for achieving TO. There were more adjuvant chemotherapy (AC) cycles in the RAG group than in the LAG group. After one year of surgery, a higher percentage of patients (36.7% vs. 22.8%; P < 0.05) in the RAG group recovered from malnutrition compared to the LAG group. CONCLUSIONS: For malnourished patients with GC, RAG performed by experienced surgeons can achieved a higher rate of TO than those of LAG, which directly contributed to better AC compliance and a faster restoration of nutritional status.


Assuntos
Gastrectomia , Laparoscopia , Desnutrição , Procedimentos Cirúrgicos Robóticos , Neoplasias Gástricas , Humanos , Neoplasias Gástricas/cirurgia , Neoplasias Gástricas/complicações , Gastrectomia/métodos , Masculino , Feminino , Laparoscopia/métodos , Desnutrição/etiologia , Procedimentos Cirúrgicos Robóticos/métodos , Pessoa de Meia-Idade , Idoso , Estudos Retrospectivos , Resultado do Tratamento , Tempo de Internação/estatística & dados numéricos , Duração da Cirurgia , Pontuação de Propensão
11.
Ann Nutr Metab ; 80(2): 74-86, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38128489

RESUMO

INTRODUCTION: Malnutrition during a critical window of development in a fetus or infant can result in abnormal cardiac remodeling and function. It is uncertain whether the contribution of these effects continues to impact the cardiac remodeling and function of adults over the course of several decades of growth. Our study examined the impact of early Chinese famine exposure on cardiac remodeling, left ventricular (LV) diastolic function, and LV systolic function in adults. METHODS: Participants at high risk of cardiovascular disease from the China Patient-Centered Evaluative Assessment of Cardiac Events Million Persons Project (PEACE MPP) were enrolled. The famine in China lasted from 1959 to 1962. A total of three groups were formed based on the participants' birth dates: pre-famine group, famine exposure group, and post-famine group. Logistic regression and linear mixed models were used to explore the association between famine exposure and cardiac remodeling, LV diastolic function and LV systolic function in adults. RESULTS: The study included 2,758 participants, the mean age was 57.05 years, 62.8% were female, 26.4% had LV hypertrophy (LVH), 59.6% had LV diastolic dysfunction (LVDD), and 10.5% had reduced global longitudinal strain (GLS). Compared to post-famine exposure, participants had independently increased risk of LVH in the famine exposure group (OR: 2.02, 95% CI: 1.60-2.56) and pre-famine exposure (OR: 1.36, 95% CI: 1.06-1.76). Compared to post-famine exposure, the risk of LVDD remarkably increased in the famine exposure group (OR: 3.04, 95% CI: 2.49-3.71) and pre-famine exposure group (OR: 1.87, 95% CI: 1.52-2.31). Famine exposure had no significant impact on GLS but was associated with a significant increase in LV ejection fraction (LVEF) and LV end-diastolic diameter (LVEDD). Significant interactions were observed between the effects of famine exposure and other clinical/sociodemographic variables (gender, systolic blood pressure [SBP] ≥140 mm Hg or not, high school or above or not, and annual income <50,000 RMB or not) on these outcomes. CONCLUSION: Exposure to famine, particularly during fetal and infant stages, increases the risk of LVH and LVDD in adults. However, the LV systolic function remains preserved. These impacts are more pronounced in females, individuals with SBP ≥140 mm Hg, those with low income, or those with high educational status.


Assuntos
Disfunção Ventricular Esquerda , Remodelação Ventricular , Adulto , Humanos , Feminino , Pessoa de Meia-Idade , Masculino , Fome Epidêmica , Função Ventricular Esquerda , Sístole , Disfunção Ventricular Esquerda/etiologia , Disfunção Ventricular Esquerda/complicações
12.
BMC Public Health ; 24(1): 1763, 2024 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-38956557

RESUMO

OBJECTIVE: To study the historical global incidence and mortality trends of gastric cancer and predicted mortality of gastric cancer by 2035. METHODS: Incidence data were retrieved from the Cancer Incidence in Five Continents (CI5) volumes I-XI, and mortality data were obtained from the latest update of the World Health Organization (WHO) mortality database. We used join-point regression analysis to examine historical incidence and mortality trends and used the package NORDPRED in R to predict the number of deaths and mortality rates by 2035 by country and sex. RESULTS: More than 1,089,000 new cases of gastric cancer and 769,000 related deaths were reported in 2020. The average annual percent change (AAPC) in the incidence of gastric cancer from 2003 to 2012 among the male population, South Korea, Japan, Malta, Canada, Cyprus, and Switzerland showed an increasing trend (P > 0.05); among the female population, Canada [AAPC, 1.2; (95%Cl, 0.5-2), P < 0.05] showed an increasing trend; and South Korea, Ecuador, Thailand, and Cyprus showed an increasing trend (P > 0.05). AAPC in the mortality of gastric cancer from 2006 to 2015 among the male population, Thailand [3.5 (95%cl, 1.6-5.4), P < 0.05] showed an increasing trend; Malta Island, New Zealand, Turkey, Switzerland, and Cyprus had an increasing trend (P > 0.05); among the male population aged 20-44, Thailand [AAPC, 3.4; (95%cl, 1.3-5.4), P < 0.05] showed an increasing trend; Norway, New Zealand, The Netherlands, Slovakia, France, Colombia, Lithuania, and the USA showed an increasing trend (P > 0.05). It is predicted that the mortality rate in Slovenia and France's female population will show an increasing trend by 2035. It is predicted that the absolute number of deaths in the Israeli male population and in Chile, France, and Canada female population will increase by 2035. CONCLUSION: In the past decade, the incidence and mortality of gastric cancer have shown a decreasing trend; however, there are still some countries showing an increasing trend, especially among populations younger than 45 years. Although mortality in most countries is predicted to decline by 2035, the absolute number of deaths due to gastric cancer may further increase due to population growth.


Assuntos
Saúde Global , Neoplasias Gástricas , Humanos , Neoplasias Gástricas/mortalidade , Neoplasias Gástricas/epidemiologia , Masculino , Feminino , Incidência , Saúde Global/estatística & dados numéricos , Mortalidade/tendências , Previsões , Distribuição por Sexo
13.
Bioprocess Biosyst Eng ; 47(6): 851-862, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38676738

RESUMO

In this paper, a magnetic sequencing batch reactor (SBR) was constructed, and the influence rule of magnetic particle dosing performance of denitrification was investigated. The diversity, structure, and potential functions of the microbial community were comprehensively explored. The results showed that the particle size and the dosage of Fe3O4 magnetic particles were the main parameters affecting the sedimentation performance of activated sludge. The start-up phase of the SBR reactor with Fe3O4 magnetic particles was 5 days less than the control. Moreover, total nitrogen removal efficiency during the start-up phase was improved, with the maximum value reaching 91.93%, surpassing the control by 9.7% with the Fe3O4 dosage of 1.2 g L-1. In addition, the activated sludge concentration and dehydrogenase activity were improved, compared to the control. High-throughput sequencing showed that the denitrifying bacterium Saccharimonadales dominated the reactor and was enriched by magnetic particles. According to predicted functions, the abundance of genes for denitrification increased with the addition of magnetic particles, suggesting the capacity of nitrogen removal was enhanced in the microbial community. Overall, the Fe3O4 magnetic particles provide great potential for enhanced wastewater nitrogen removal.


Assuntos
Reatores Biológicos , Desnitrificação , Nitrogênio , Nitrogênio/química , Nitrogênio/metabolismo , Esgotos/microbiologia , Bactérias/metabolismo , Bactérias/genética , Águas Residuárias/microbiologia , Águas Residuárias/química , Nanopartículas de Magnetita/química
14.
Ann Surg ; 278(2): 222-229, 2023 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-36250322

RESUMO

OBJECTIVE: To verify an intraoperative adverse event (iAE) classification (ClassIntra grade) to evaluate quality control and to predict the prognostic performance of laparoscopic radical surgery for gastric cancer. BACKGROUND: Surgical quality control is a key factor in the evaluation of surgical treatment for tumors. And, there is no recognized iAE classification for gastric cancer. METHODS: We performed a retrospective post hoc analysis of previously collected data from the FUGES-001 study (NCT02327481) and a subset of the CLASS-01 study (NCT01609309). Patients were classified into the iAE and non-iAE groups. And iAE was further classified into 5 subgrades according to the ClassIntra grade (with I-V severity categories). Technical performance was evaluated using the Objective Structured Assessment of Technical Skills tool and the Generic Error Rating Tool. RESULTS: Overall, 528 gastric cancer patients were included in this study, with 105 patients (19.9%) in the iAE group and 423 (80.1%) in the non-iAE group. The survival curve showed that the overall, disease-specific, and recurrence-free survival of the non-iAE group were significantly better than those of the iAE group ( P =0.001). The prognosis of patients with ClassIntra grade ≥II was significantly worse than that of patients with ClassIntra grade ≤I. A higher ClassIntra grade, lower Objective Structured Assessment of Technical Skills score, and total gastrectomy were independent risk factors for severe postoperative complications. There was a significant increase in bleeding (grade IV) and injury with splenic hilar lymph node dissection during total gastrectomy. CONCLUSIONS: The ClassIntra grade is an effective prognostic and surgical quality control index for laparoscopic radical surgery for gastric cancer; therefore, it could be included in routine hospital care and surgical quality control.


Assuntos
Laparoscopia , Neoplasias Gástricas , Humanos , Estudos Retrospectivos , Neoplasias Gástricas/cirurgia , Neoplasias Gástricas/patologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Complicações Pós-Operatórias/etiologia , Laparoscopia/efeitos adversos , Gastrectomia/efeitos adversos , Resultado do Tratamento , Excisão de Linfonodo/efeitos adversos
15.
Ann Surg Oncol ; 30(3): 1759-1769, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36414907

RESUMO

OBJECTIVE: Totally laparoscopic total gastrectomy (TLTG) and laparoscopic-assisted total gastrectomy (LATG) are two types of minimally invasive radical gastrectomy procedures to treat gastric cancer (GC). This study compared the long-term prognosis and postoperative health-related quality of life (HRQoL) between TLTG and LATG. METHODS: A total of 106 patients who underwent TLTG and 1,076 patients who underwent LATG at the Union Hospital of Fujian Medical University (Fuzhou, China) between January 2014 and April 2018 were included in the propensity score matching (PSM, 1:2). Patient-reported outcomes at 3, 6, and 12 months after gastrectomy were analyzed. The questionnaire referred to the European Organization for Research and Treatment of Cancer (EORTC) 30-item core QoL (QLQ-C30)and the GC module (QLQ-STO22) questionnaire. RESULTS: After PSM, there were no significant differences in clinicopathological characteristics between the TLTG (n = 104) and the LATG groups (n = 208). Operative time and volume of blood loss were significantly lower in the TLTG group than in the LATG group. Kaplan-Meier survival analysis revealed similar 3-year survival rates between the TLTG and LATG groups (83.7 vs. 80.3%, respectively; P = 0.462). Tolerance to nonliquid diet, decrease in body weight, and albumin levels were also significantly lower in the TLTG group than in the LATG group (all P < 0.05). The HRQoL scale demonstrated that the overall score in the TLTG group was better than that in the LATG group at 3, 6, and 12 months after gastrectomy (all P < 0.05). CONCLUSIONS: Patients with GC undergoing TLTG reported better HRQoL and experienced faster recovery of social function than those undergoing LATG, although the two groups demonstrated similar short-term outcomes and long-term prognosis.


Assuntos
Laparoscopia , Neoplasias Gástricas , Humanos , Qualidade de Vida , Neoplasias Gástricas/cirurgia , Neoplasias Gástricas/patologia , Pontuação de Propensão , Laparoscopia/métodos , Gastrectomia/métodos , Estudos Retrospectivos , Medidas de Resultados Relatados pelo Paciente , Resultado do Tratamento , Complicações Pós-Operatórias/cirurgia
16.
Opt Express ; 31(17): 27332-27344, 2023 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-37710812

RESUMO

Biology, medicine, and chemistry all rely heavily on highly sensitive optical fiber temperature sensors. To the best of our knowledge, this research introduces a unique design framework for high-performance fiber temperature sensors that helps eliminate the all-fiber interferometers' sensitivity bottleneck. A section of photopolymerized waveguide is embedded in a typical Mach-Zehnder interferomenter framework with multimode fiber-single mode fiber-multimode fiber (MSM) structure. The thermal-optical coefficient (TOC) of the photopolymerized waveguide core, which is created via the fiber-end lithography technique, differs dramatically from that of the resin cladding. Due to the considerable TOC difference, the phase difference between the interfering beams significantly increases as the temperature changes. The fundamental variables affecting temperature sensitivity are conceptually explored and experimentally verified. The suggested device achieves a typical temperature sensitivity of 1.15 nm/ ∘C in the range of 30-100 ∘C, which is about 10 times as high as that of the all-fiber MSM sensors. The suggested designing framework offers a fresh thought for creating high-performing fiber optic temperature sensors.

17.
Opt Lett ; 48(20): 5261-5264, 2023 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-37831842

RESUMO

The lab-on-fiber design philosophy is the foundation for creating high-performance integrated fiber sensors. Hence, this Letter proposes an ultra-compact Fabry-Perot interferometer (FPI) based on a laser-induced micro-cavity (LIMC-FPI) on a fiber end for measuring relative humidity. To our knowledge, this novel approach, named the fiber-end photopolymerization (FEP) technique, is applied to create a micro-cavity. Specifically, a pair of humidity-sensitive polymer pillars and a resin end cap obtained by FEP are integrated to generate the cavity. As the ambient humidity changes, the pillars lengthen or shorten, resulting in the spectral evolution of the LIMC-FPI. A typical humidity sensitivity of 0.18 nm/%RH is obtained experimentally. For monitoring the human breathing process, the LIMC-FPI is responsive in the breathing frequency range of 0.2 to 0.5 Hz, allowing a response and recovery time of less than 0.388 s and 1.171 s, respectively. This work introduces a fresh and cost-effective approach for developing lab-on-fiber concept-based sensors.

18.
Opt Lett ; 48(5): 1272-1275, 2023 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-36857266

RESUMO

This paper proposes a new, to the best of our knowledge, design framework of long-period fiber grating (LPFG) sensors resistant to multi-parameter cross talk. A section of hollow quartz capillary (HQC), which acts as an exoskeleton, is periodically merged with a single-mode fiber (SMF) by the arc-discharge method. The mechanical stress in the SMF is released while the thermal stress is enhanced after a high-temperature fusion process. Under the influence of the elastic-optical effect, the refractive index of the core is periodically modulated along the axial direction to form an exoskeleton long-period fiber grating (Es-LPFG). The unique exoskeleton structure not only induces mode coupling but also enables the proposed device to resist cross talk among the strain, ambient refractive index, and vector bending. The temperature is able to be measured independently with a sensitivity of 74 pm/ ∘C. The novel Es-LPFG is promising in single-parameter sensing, mode-locked lasers, and frequency-locked gain flattening.

19.
Cancer Cell Int ; 23(1): 286, 2023 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-37990321

RESUMO

BACKGROUND: Chemoresistance is a major clinical challenge that leads to tumor metastasis and poor clinical outcome. The mechanisms underlying gastric cancer resistance to chemotherapy are still unclear. METHODS: We conducted bioinformatics analyses of publicly available patient datasets to establish an apoptotic phenotype and determine the key pathways and clinical significance. In vitro cell models, in vivo mouse models, and numerous molecular assays, including western blotting, qRT-PCR, immunohistochemical staining, and coimmunoprecipitation assays were used to clarify the role of factors related to apoptosis in gastric cancer in this study. Differences between datasets were analyzed using the Student's t-test and two-way ANOVA; survival rates were estimated based on Kaplan-Meier analysis; and univariate and multivariate Cox proportional hazards models were used to evaluate prognostic factors. RESULTS: Bulk transcriptomic analysis of gastric cancer samples established an apoptotic phenotype. Proapoptotic tumors were enriched for DNA repair and immune inflammatory signaling and associated with improved prognosis and chemotherapeutic benefits. Functionally, cyclin-dependent kinase 5 (CDK5) promoted apoptosis of gastric cancer cells and sensitized cells and mice to oxaliplatin. Mechanistically, we demonstrate that CDK5 stabilizes DP1 through direct binding to DP1 and subsequent activation of E2F1 signaling. Clinicopathological analysis indicated that CDK5 depletion correlated with poor prognosis and chemoresistance in human gastric tumors. CONCLUSION: Our findings reveal that CDK5 promotes cell apoptosis by stabilizing DP1 and activating E2F1 signaling, suggesting its potential role in the prognosis and therapeutic decisions for patients with gastric cancer.

20.
BMC Cancer ; 23(1): 964, 2023 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-37821825

RESUMO

BACKGROUND: The long-term dynamic recurrence hazard of locally advanced gastric cancer (LAGC) in the clinical setting of adjuvant chemotherapy (ACT) remains unclear. PURPOSE: This study aimed to investigate the dynamic recurrence risk of LAGC in patients who received ACT or not. METHODS: The study assessed data from patients with LAGC who underwent radical gastrectomy between January, 2010 and October, 2015. Inverse probability of treatment weighting (IPTW) was performed to reduce selection bias between the ACT and observational (OBS) groups. Conditional recurrence-free survival (cRFS) and restricted mean survival time (RMST) were used to assess the survival differences. RESULTS: In total, 1,661 LAGC patients were included (ACT group, n = 1,236 and OBS group, n = 425). The recurrence hazard gradually declined; in contrast, cRFS increased with RFS already accrued. Following IPTW adjustment, the cRFS rates were higher in the ACT group than those in the OBS group for patients at baseline or with accrued RFS of 1 and 2 years (p˂0.05). However, the cRFS rates of the ACT group were comparable with those of the OBS group for patients with accrued RFS of 3 or more years (p > 0.05). Likewise, the 5-year △RMST between the ACT and OBS groups demonstrated a similar trend. Moreover, the hematological metastasis rate of the ACT group was significantly lower than that of the OBS group for patients at baseline or with accrued RFS of 1 and 2 years, respectively (p˂0.05). CONCLUSIONS: Although ACT could provide substantial benefits for patients with LAGC, the differences in recurrence hazard between the ACT and OBS groups may attenuate over time, which could help guide surveillance and alleviate patients' anxiety. Further prospective large-scale studies are warranted.


Assuntos
Neoplasias Gástricas , Humanos , Neoplasias Gástricas/tratamento farmacológico , Neoplasias Gástricas/cirurgia , Neoplasias Gástricas/patologia , Quimioterapia Adjuvante , Gastrectomia , Terapia Neoadjuvante , Probabilidade , Estudos Retrospectivos
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