Risk factors of lymph node metastasis in the splenic hilum of gastric cancer patients: a meta-analysis.

BACKGROUND: The issue of whether or not splenic hilum lymph nodes (SHLN) should be excised in radical gastrectomy with D2 lymph node dissection remains controversial. In this study, we identified the clinicopathological features in patients with gastric cancer that could serve as predictive risk factors of SHLN metastasis. METHODS: We searched Medline, Embase, PubMed, and Web of Science databases from inception to May 2020 and consulted the related references. Overall, 15 articles evaluating a total of 4377 patients were included for study. The odds ratios (OR) of each risk factor and corresponding 95% confidence intervals (CI) were determined using the Revman 5.3 software. RESULTS: Our meta-analysis revealed tumor size greater than 5 cm (p < 0.01), tumor localization in the greater curvature (p < 0.01), diffuse type (Lauren's classification) (p < 0.01), Borrmann types 3-4 (p < 0.01), poor differentiation and undifferentiation (p < 0.01), depth of invasion T3-T4 (p < 0.01), number of lymph node metastases N2-N3 (p < 0.01), distant metastasis M1 (p < 0.01), TNM stages 3-4 (p < 0.01), vascular invasion (p = 0.01), and lymphatic invasion (p < 0.01) as potential risk factors of SHLN metastasis. Moreover, positivity of Nos. 1, 2, 3, 4sa, 4sb, 4d, 6, 7, 9, 11, and 16 lymph nodes for metastasis was strongly associated with SHLN metastasis. CONCLUSIONS: Tumor size, tumor location, Lauren's diffuse type, Borrmann type, degree of differentiation, T stage, N stage, M stage, TNM stage, vascular invasion, lymphatic infiltration, and other positive lymph nodes are risk factors for SHLN metastasis.

Effects of Clavien-Dindo Classification on Long-Term Survival of Patients With Advanced Gastric Cancer After Radical Resection: A Propensity Score-matched Study.

BACKGROUND: The impact of postoperative complications (POCs) classified by the Clavien-Dindo (C-D) system on long-term survival after radical resection in patients with advanced gastric cancer (AGC) is not yet clear. METHODS: This study analyzed 531 patients with AGC who underwent radical resection in an institution between January 2015 and December 2017. Patients were divided into 2 groups according to the occurrence of POCs and recorded according to C-D classifications. The long-term survival outcomes of the entire cohort after propensity score matching (PSM) were compared. RESULTS: After PSM, there was no significant difference in baseline data between the complications (C) group (n = 92) and the non-complications (NC) group (n = 92). Survival analysis showed that the 5-year overall survival (OS) and relapse-free survival (RFS) were lower in the C group (48.9% vs 62.0%, P = .040; 38.5% vs 54.9%, P = .005; respectively). Subgroup analysis showed that severe complications (C-D grade > II) were associated with a decrease in 5-year OS and RFS compared with the matched NC group (40.0% vs 62.0%, P = .008; 29.4% vs 54.9%, P = .001; respectively). Multivariate analysis confirmed adjuvant chemotherapy, tumor size, and complications were independent risk factors for poor survival outcomes. Further multivariate analysis showed that older age, combined excision, and comorbidities were independent risk factors for POCs. CONCLUSIONS: Severe complications reduced the survival outcome of patients. More attention should be paid to perioperative management of patients with high risk factors for complications.

Retroperitoneal totally endoscopic prosthetic repair of lumbar hernia.

Lumbar hernia is a rare lateral abdominal wall hernia. Various surgical repair strategies have been recorded, but there is currently no unified standard. A Chinese surgeon recently revealed a novel technique for treating primary lumbar hernia called retroperitoneal totally endoscopic prosthetic repair (R-TEP). We have made a further exploration of this method and successfully used it in the treatment of secondary lumbar hernia. We successfully performed R-TEP on three patients with lumbar hernias. All patients were female with an average age of 64 years (51-71 years). Two patients each had a primary upper lumbar hernia, while one patient had a secondary lumbar hernia. With a mean operative time of 77 min (60-105 min), all operations were performed successfully. The average visual analogue scale (VAS) was 1.3 points (1-2 points) on the second day following surgery. The mean postoperative hospital stay was 2.3 days (2-3 days). No postoperative complications occurred. During a mean follow-up period of 19 months (10-24 months), there was no recurrence of the hernia, chronic pain or mesh infection. Therefore, R-TEP is safe and effective for both primary and secondary lumbar hernia. Anti-adhesive coated meshes are not required, making this a cost-effective procedure that is worthy of recommendation.

Simultaneous determination of sucralose and related compounds by high-performance liquid chromatography with evaporative light scattering detection.

Sucralose is widely used in food and beverages as sweetener. Current synthesis approaches typically provide sucralose products with varying levels of related chlorinated carbohydrates which can affect the taste and flavor-modifying properties of sucralose. Quantification of related compounds in sucralose is often hampered by the lack of commercially available standards. In this work, nine related compounds were purified (purity>97%) and identified by liquid chromatography-mass spectrometry (LC-MS) and nuclear magnetic resonance (NMR), then a rapid and simple HPLC coupled with evaporative light scattering detection (ELSD) method has been developed for the simultaneous determination of sucralose and related compounds. Under optimized conditions, the method showed good linearity in the range of 2-600µgmL(-1) with determination coefficients R(2)⩾0.9990. Moreover, low limits of detection in the range of 0.5-2.0µgmL(-1) and good repeatability (RSD<3%, n=6) were obtained. Recoveries were from 96.8% to 101.2%. Finally, the method has been successfully applied to sucralose quality control and purification process monitoring.

Analysis of sucrose acetates in a crude 6-O-acetyl sucrose product by on-line hydrolysis-high-performance liquid chromatography with pulsed amperometric detection.

A standard-free and sensitive method was developed for analysis of sucrose acetates in a crude 6-O-acetyl sucrose (S-6-a) product by on-line hydrolysis-high-performance liquid chromatography with pulsed amperometric detection (PAD). Sucrose, three regio-isomers of acetyl sucrose and five regio-isomers of diacetyl sucrose were separated on a C18 column using 3% (v/v) acetonitrile in water as eluent within 25min. After purification with LC followed by semi-preparative HPLC, their chemical structures were identified by 1D, 2D NMR and LC-MS. Moreover, quantification of those regio-isomers was achieved by on-line alkaline hydrolysis to liberate sucrose using a post-column delivery system, and then detected by PAD for indirect estimation of the sucrose acetate content. Under optimal conditions, the linear ranges were from 0.03 to 150µmolL(-1) for sucrose corresponding to sucrose acetates with coefficient of determination as 0.9997 and detection limit as 0.01µmolL(-1) (S/N=3). Good repeatability was obtained (RSD<3%, n=6). Furthermore, this method has been successfully applied to the analysis of sucrose and sucrose acetates in a crude S-6-a product during synthesis, purification and structure elucidation studies. The recoveries were from 94.89% to 102.31% for sucrose and sucrose acetates.

Polystyrene-divinylbenzene stationary phases agglomerated with quaternized multi-walled carbon nanotubes for anion exchange chromatography.

This work explores the potential of multi-walled carbon nanotubes as an agglomerated material for ion chromatography stationary phases for the separation of inorganic anions. Polyelectrolytes with quaternary ammonium groups were introduced onto the carbon nanotube surface, based on condensation polymerization of 1,4-butanediol diglycidyl ether (BDDE) and methylamine (MA). Quaternized multi-walled carbon nanotubes (Q-MWCNTs) were electrostatically adsorbed onto the surface of sulfonated polystyrene-divinylbenzene (PS-DVB) beads to generate the anion exchanger, which were confirmed by Fourier transform infrared spectroscopy (FTIR) and scanning electron microscopy (SEM). A 100mm×4.0mm i.d. column was packed with Q-MWCNTs agglomerated PS-DVB particles, with a capacity of 56µequiv./column. Separation of inorganic anions, such as F(-), Cl(-), NO2(-), Br(-), NO3(-), SO4(2-) and PO4(3-) were performed. The stationary phase was rigid, chemically stable and showed good ion-exchange characteristics.

Simultaneous determination of iodide and iodate in povidone iodine solution by ion chromatography with homemade and exchange capacity controllable columns and column-switching technique.

A simple ion chromatographic method for simultaneous detection of iodide and iodate in a single running was proposed, with columns packed with homemade functionalized polystyrene-divinylbenzene (PS-DVB) resins and column-switching technique. Homemade resins were functionalized with controllable amounts of quaternary ammonium groups. The low-capacity anion-exchange column and high-capacity anion-exchange column were prepared, due to the resins having different exchange capacities. With this method, iodide and iodate in povidone iodine solution were detected simultaneously in a short time with iodide being eluted off first. A series of standard solutions consisting of target anions of various concentrations from 0.01 mg/L to 100 mg/L were analyzed. Each anion exhibited satisfactory linearity, with correlation coefficient r ≥ 0.9990. The detection limits (LODs) for iodide and iodate obtained by injecting 100 µL of sample were 5.66 and 14.83 µg/L (S/N=3), respectively. A spiking study was performed with satisfactory recoveries between 101.2% and 100.6% for iodide and iodate.