High-Performance Monolithic 3D Integrated Complementary Inverters Based on Monolayer n-MoS2 and p-WSe2.

Herein, the structure of integrated M3D inverters are successfully demonstrated where a chemical vapor deposition (CVD) synthesized monolayer WSe2 p-type nanosheet FET is vertically integrated on top of CVD synthesized monolayer MoS2 n-type film FET arrays (2.5 × 2.5 cm) by semiconductor industry techniques, such as transfer, e-beam evaporation (EBV), and plasma etching processes. A low temperature (below 250 °C) is employed to protect the WSe2 and MoS2 channel materials from thermal decomposition during the whole fabrication process. The MoS2 NMOS and WSe2 PMOS device fabricated show an on/off current ratio exceeding 106 and the integrated M3D inverters indicate an average voltage gain of ≈9 at VDD = 2 V. In addition, the integrated M3D inverter demonstrates an ultra-low power consumption of 0.112 nW at a VDD of 1 V. Statistical analysis of the fabricated inverters devices shows their high reliability, rendering them suitable for large-area applications. The successful demonstration of M3D inverters based on large-scale 2D monolayer TMDs indicate their high potential for advancing the application of 2D TMDs in future integrated circuits.

Experience of a modified chest tube suture-fixation technique in uniportal thoracoscopic pulmonary resection.

OBJECTIVE: This study aimed to explore the feasibility and advantages of a modified chest tube suture-fixation technique in uniportal video-assisted thoracic surgery for pulmonary resection. METHODS: A retrospective analysis was conducted on 116 patients who underwent uniportal video-assisted thoracic surgery (U-VATS) for lung diseases in Zhengzhou People's Hospital between October 2019 and October 2021. Patients were stratified into two groups based on the applied suture-fixation methods, i.e., 72 patients in the active group and 44 patients in the control group. The two groups were subsequently compared in the terms of gender, age, operation method, indwelling time of chest tube, postoperative pain score, chest tube removal time, wound healing grade, length of hospital stay, incision healing grade, and patient satisfaction. RESULTS: There was no significant difference between the two groups in terms of gender, age, operation method, indwelling time of chest tube, postoperative pain score, and length of hospital stay (P = 0.167, 0.185, 0.085, 0.051, 0.927, and 0.362, respectively). However, the chest tube removal time, incision healing grade, and incision scar satisfaction in the active group were significantly better compared with those of the control group (P = < 0.001, 0.033, and < 0.001, respectively). CONCLUSION: In summary, the new suture-fixation approach can minimize the number of stitches, and time necessary for chest tube removal process, and avoid the pain experienced when removing the drainage tube. This method is more feasible, has better incision conditions, and provides a convenient tube removal, making it more suitable to patients.

Operando photoelectron spectroscopy analysis of graphene field-effect transistors.

In this study, operando photoelectron spectroscopy was used to characterize the performance of graphene field-effect transistors under working conditions. By sweeping the back-gate voltages, the carrier concentration of the graphene channel on the 150 nm Si3N4/Si substrate was tuned. From the C1s core level spectra acquired under the application of different gate voltages, the binding energy shifts caused by electric-field effects were obtained and analyzed. Together with the C1s peak shape information and the photoluminescence spectrum of the Si3N4/Si substrate, the presence of local potential across the x-ray beam spot associated with defects and gate leakage current in amorphous Si3N4was identified. The presence of defects in Si3N4/Si substrate could not only screen the partial electric field generated by the back gate but also serve as long-range scattering centers to the carriers, thus affecting charge transport in the graphene channel. Our findings will help further investigate the dielectric/graphene interface properties and accelerate the utilization of graphene in real device applications.

Application of bilateral simultaneous sequential single-incision video-assisted thoracic surgery in multiple nodules both lungs: a single-center experience of 10 cases.

OBJECTIVE: To discuss the application of bilateral simultaneous sequential single-incision video-assisted thoracic surgery in multiple nodules in both lungs. METHODS: A retrospective analysis of 10 patients in Zhengzhou People's Hospital who underwent single-incision thoracoscopic surgery to treat multiple nodules in both lungs at the same time from September 2019 to January 2021, and analyze the perioperative indicators (general condition, smoking history, family history, follow-up time of pulmonary nodules, size, location, height and weight, pulmonary function, intraoperative blood loss, operation time, color and volume of drainage fluid, catheterization time, perioperative complications, length of stay, pathology, patient satisfaction, etc.). RESULTS: All 10 patients used single-incision thoracoscopy to complete bilateral simultaneous sequential operations, aged 32 to 70 years, 8 female patients, 2 male patients, preoperative follow-up time ranging from 1 day to 2 years, a total of 23 lung nodules were removed except for the benign lesions in one nodule in the 2 patients, the other nodules were tumorous lesions (91.3%). The average total hospital stay was 10.5 days (8-14 days), and the average operation time was 194.5 min (145-292 min). The blood loss ranged from 10 to 280 ml, all patients had no serious complications during the perioperative period, and they recovered well and were discharged smoothly, and the satisfaction reached 100%. CONCLUSION: Single-incision bilateral simultaneous sequential thoracoscopy have certain advantages in the treatment of patients with multiple nodules in both lungs, conforms to the concept of rapid recovery, and is a feasible choice in the shared decision making of doctors and patients.

Paraganglioma of the anterior superior mediastinum: Presentation of a case of mistaken diagnosis so long and review of the literature.

INTRODUCTION AND IMPORTANCE: Mediastinal paraganglioma is a rare tumor with neuroendocrine activity, highly susceptible to misdiagnosis. Herein, we present a case misdiagnosed as Castleman disease for nearly a decade, significantly enlarged, lost the opportunity of thoracoscopic surgery, and was removed by median thoracotomy. CASE PRESENTATION: A 59-year-old woman complained of having a mediastinal mass, was diagnosed with Castleman disease for nearly a decade and was admitted to the hospital due to neck tightness. The tumor size was significantly enlarged. We proceeded to interventional angiography with gelatin sponge angioembolization, and the tumor was resected through a median sternotomy on the second day. The operation was smooth, and the tumor was gray and slightly brittle. Postoperative pathology confirmed paraganglioma; lymph node metastasis was not detected (0/3). CLINICAL DISCUSSION: Mediastinal paraganglioma is a rare tumor and can be either functional or nonfunctional. It can be differentiated from many diseases. The SSTR-PET-CT labeled with 68Ga-somatostatin analog, plasma metanephrine, and normetanephrine are essential for the diagnosis. Surgical resection is the most effective form of treatment. Pre-operative embolization of the feeding artery is considered to have a low rate of intraoperative bleeding. We recommend making comprehensive preparations to ensure perioperative safety and long-term survival. CONCLUSION: When a vascularized mass is discovered in the mediastinum, surgeons should consider the possibility of a paraganglioma. Multidisciplinary consultation should be involved in the formulation of treatment plans. Lifelong surveillance for residual tumor growth and recurrence is required.

Invasiveness assessment by artificial intelligence against intraoperative frozen section for pulmonary nodules ≤ 3 cm.

PURPOSE: To investigate the performance of an artificial intelligence (AI) algorithm for assessing the malignancy and invasiveness of pulmonary nodules in a multicenter cohort. METHODS: A previously developed deep learning system based on a 3D convolutional neural network was used to predict tumor malignancy and invasiveness. Dataset of pulmonary nodules no more than 3 cm was integrated with CT images and pathologic information. Receiver operating characteristic curve analysis was used to evaluate the performance of the system. RESULTS: A total of 466 resected pulmonary nodules were included in this study. The areas under the curves (AUCs) of the deep learning system in the prediction of malignancy as compared with pathological reports were 0.80, 0.80, and 0.75 for all, subcentimeter, and solid nodules, respectively. Additionally, the AUC in the AI-assisted prediction of invasive adenocarcinoma (IA) among subsolid lesions (n = 184) was 0.88. Most malignancies that were misdiagnosed by the AI system as benign diseases with a diameter measuring greater than 1 cm (26/250, 10.4%) presented as solid nodules (19/26, 73.1%) on CT. In an exploratory analysis involving nodules underwent intraoperative pathologic examination, the concordance rate in identifying IA between the AI model and frozen section examination was 0.69, with a sensitivity of 0.50 and specificity of 0.97. CONCLUSION: The deep learning system can discriminate malignant diseases for pulmonary nodules measuring no more than 3 cm. The AI model has a high positive predictive value for invasive adenocarcinoma with respect to intraoperative frozen section examination, which might help determine the individualized surgical strategy.

Meta analysis of XRCC3 Thr241Met polymorphism and lung cancer susceptibility of populations in East Asia.

OBJECTIVE: To assess the relation between XRCC3 Thr241Met polymorphism and lung cancer susceptibility of populations in East Asia. METHODS: Related studies of XRCC3 Thr241Met polymorphism and lung cancer susceptibility of populations in East Asia were collected through searching the Pubmed, Embase Library, SPRINGER, CNKI and CSSCI. RESULTS: According to the entry criteria, there were 8 case-control studies in the assessing system and there were 6 321 study cases, including 3 215 patients with lung cancer and 3 106 cases without cancers. Meta analysis results showed the combined OR value of the ratio of genotype Thr/Met+Met/Met and Thr/Thr was 1.03 (95%CI: 0.89-1.20) (P>0.05). CONCLUSIONS: XRCC3 Thr241Met polymorphism may not related to lung cancer susceptibility of populations in East Asia. Allele 241Met did not increase the risk of lung cancer.

[Treatment of superior lobe central lung cancer with lung replantation].

BACKGROUND: Patients suffering from lung cancer often have poor quality of life after pneumonectomy. It has clinical significances to preserve maximum lobes of the "healthy" lung. The aim of this study is to report the applications of lung replantation in treatment of superior lobe central lung cancer. METHODS: Three lung cancer cases were included and analysed. The bronchus and margin of lower lung lobe were encroached by cancer. Pulmonary artery was invaded and surrounded by metastatic lymph node. Complete pneumonectomy, antegrade perfusion and retroperfusion with low-potassium dextran (LPD) solution in vitro were performed. The retainable lower pulmonary lobe was selected from the isolated lung and superior pulmonary vein was replaced with inferior pulmonary veins. The bronchus and pulmonary artery were inosculated by turns. RESULTS: The operative cumulative time ranged from 220 min to 250 min. The isolated time of lobus inferior pulmonary ranged from 120 min to 150 min. The chest tube was pulled out after chest X-ray confirmed the reimplant lung full re-expansion. The patients were followed up for 4 months to 8 months and accomplished adjuvant chemotherapy for 3 or 4 periodicities. The patients had a sound quality of life. CONCLUSIONS: Lung replantation removing the extensive tumor tissue and retaining the maximum pulmonary normal tissue is an useful method for treatment of lung cancer.