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Photonic computing enables faster and more energy-efficient processing of vision data1-5. However, experimental superiority of deployable systems remains a challenge because of complicated optical nonlinearities, considerable power consumption of analog-to-digital converters (ADCs) for downstream digital processing and vulnerability to noises and system errors1,6-8. Here we propose an all-analog chip combining electronic and light computing (ACCEL). It has a systemic energy efficiency of 74.8 peta-operations per second per watt and a computing speed of 4.6 peta-operations per second (more than 99% implemented by optics), corresponding to more than three and one order of magnitude higher than state-of-the-art computing processors, respectively. After applying diffractive optical computing as an optical encoder for feature extraction, the light-induced photocurrents are directly used for further calculation in an integrated analog computing chip without the requirement of analog-to-digital converters, leading to a low computing latency of 72 ns for each frame. With joint optimizations of optoelectronic computing and adaptive training, ACCEL achieves competitive classification accuracies of 85.5%, 82.0% and 92.6%, respectively, for Fashion-MNIST, 3-class ImageNet classification and time-lapse video recognition task experimentally, while showing superior system robustness in low-light conditions (0.14 fJ µm-2 each frame). ACCEL can be used across a broad range of applications such as wearable devices, autonomous driving and industrial inspections.
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Cephalotaxines harbor great medical potential, but their natural source, the endemic conifer Cephalotaxus is highly endangered, creating a conflict between biotechnological valorization and preservation of biodiversity. Here, we construct the whole biosynthetic pathway to the 1-phenethylisoquinoline scaffold, as first committed compound for phenylethylisoquinoline alkaloids (PIAs), combining metabolic modeling, and transcriptome mining of Cephalotaxus hainanensis to infer the biosynthesis for PIA precursor. We identify a novel protein, ChPSS, driving the Pictet-Spengler condensation and show that this enzyme represents the branching point where PIA biosynthesis diverges from the concurrent benzylisoquinoline-alkaloids pathway. We also pinpoint ChDBR as crucial step to form 4-hydroxydihydrocinnamaldehyde diverging from lignin biosynthesis. The elucidation of the early PIA pathway represents an important step toward microbe-based production of these pharmaceutically important alkaloids resolving the conflict between biotechnology and preservation of biodiversity.
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Alcaloides , Benzilisoquinolinas , Cephalotaxus , Cephalotaxus/genética , BiotecnologiaRESUMO
Adiabatic demagnetization refrigeration (ADR) is a promising cooling technology with high efficiency and exceptional stability in achieving ultralow temperatures, playing an indispensable role at the forefront of fundamental and applied science. However, a significant challenge for ADR is that existing magnetic refrigerants struggle to concurrently achieve low magnetic ordering temperatures (T0) and substantial magnetic entropy changes (-ΔSm) at ultralow temperatures. In this work, we propose the combination of Gd3+ and Yb3+ to effectively regulate both -ΔSm and T0 in ultralow temperatures. Notably, the -ΔSm values for Gd0.1Yb0.9F3 (1) and Gd0.3Yb0.7F3 (2) in the 0.4-1.0 K range exceed those of all previously reported magnetic refrigerants within this temperature interval, positioning them as the most efficient magnetic refrigerants for the third stage to date. Although the -ΔSm values for Gd0.5Yb0.5F3 (3) in 1-4 K are less than those of the leading magnetic refrigerant Gd(OH)F2, the -ΔSm values for Gd0.7Yb0.3F3 (4) in 1-4 K at 2 T surpass those of all magnetic refrigerants previously documented within the same temperature range, making it the superior magnetic refrigerant for the fourth stage identified thus far.
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Open hollow dodecahedral cage clusters have long been a coveted target in synthetic chemistry, yet their creation poses immense challenges. Here we report two open hollow dodecahedral lanthanide-aluminum (Ln-Al) heterometallic cage clusters, namely, [Ln210Al140(µ2-OH)210(µ3-OH)540(OAc)180(H2O)156](ClO4)120·(MeCN)x·(H2O)y, (Ln = Dy and x = 27, y = 300 for 1; Ln = Y and x = 28, y = 420 for 2). Remarkably, the 350 metal atoms in 1 and 2 display a Keplerate-type four-shell structure of truncated icosidodecahedron@dodecahedron@dodecahedron@icosidodecahedron. The diameter of the cationic cluster in 1 is approximately 5.0 nm, with an inner cavity diameter of about 2.8 nm and a window diameter of roughly 0.66 nm. The cluster in 1 boasts an accessible inner void volume of up to 15,000 Å3. Notably, these cage clusters maintain stability in water, and the truncated icosidodecahedrons in 1 and 2 are the first of their kind synthesized to date. Given that the open hollow dodecahedral Ln-Al cage cluster has never been reported before, this work represents a member in the family of hollow open dodecahedral cages.
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Keggin-Fe13 clusters are considered foundational building blocks or prenucleation precursors of ferrihydrite. Understanding the factors that influence the rotational configuration of these clusters, and their transformations in water, is vital for comprehending the formation mechanism of ferrihydrite. Here, we report syntheses and crystal structures of four lanthanide-iron-oxo clusters, namely, [Dy6Fe13(Gly)12(µ2-OH)6(µ3-OH)18(µ4-O)4(H2O)17]·13ClO4·19H2O (1), [Dy6Fe13(Gly)12(µ3-OH)24(µ4-O)4(H2O)18]·13ClO4·14H2O (2), [Pr8Fe34(Gly)24(µ3-OH)28(µ3-O)30(µ4-O)4(H2O)30]·6ClO4·20H2O (3), and [Pr6Fe13(Gly)12(µ3-OH)24(µ4-O)4(H2O)18]·13ClO4·22H2O (4, Gly = glycine). Single-crystal analyses reveal that 1 has a ß-Keggin-Fe13 cluster, marking the first documented instance of such a cluster to date. Conversely, both 2 and 4 contain an α-Keggin-Fe13 cluster, while 3 is characterized by four hexavacant ε-Keggin-Fe13 clusters. Magnetic property investigations of 1 and 2 show that 2 exhibits ferromagnetic interactions, while 1 exhibits antiferromagnetic interactions. An exploration of the synthetic conditions for 1 and 2 indicates that a higher pH promotes the formation of α-Keggin-Fe13 clusters, while a lower pH favors ß-Keggin-Fe13 clusters. A detailed analysis of the transition from 3 to 4 emphasizes that lacunary Keggin-Fe13 clusters can morph into Keggin-Fe13 clusters with a decrease in pH, accompanied by a significant change in their rotational configuration.
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Organic contaminated sites have gained significant attention as a prominent contributor to shallow groundwater contamination. However, limited knowledge exists regarding the impact of hydrodynamic effects on microbially mediated contaminant degradation at such sites. In this study, we investigated the distribution characteristics and community structure of prokaryotic microorganisms at the selected site during both wet and dry seasons, with a particular focus on their environmental adaptations. The results revealed significant seasonal variations (P < 0.05) in the α-diversity of prokaryotes within groundwater. The dry season showed more exclusive OTUs than the wet season. The response of prokaryotic metabolism to organic pollution pressure in different seasons was explored by PICRUSt2, and enzymes associated with the degradation of organic pollutants were identified based on the predicted functions. The results showed that hormesis was considered as an adaptive response of microbial communities under pollution stress. In addition, structural equation models demonstrated that groundwater level fluctuations can, directly and indirectly, affect the abundance and diversity of prokaryotes through other factors such as oxidation reduction potential (ORP), dissolved oxygen (DO), and naphthalene (Nap). Overall, our findings imply that the taxonomic composition and functional properties of prokaryotes in groundwater in organic contaminated sites is influenced by the interaction between seasonal variations and characteristics of organic pollution. The results provide new insights into microbiological processes in groundwater systems in organic contaminated sites.
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Água Subterrânea , Microbiota , Água Subterrânea/química , Poluição Ambiental/análiseRESUMO
Ratiometric luminescent thermometers with excellent performance often require the luminescent materials to possess high thermal stability and relative sensitivity (Sr). However, such luminescent materials are very rare, especially in physiological (298-323 K) and high-temperature (>373 K) regions. Here we report the synthesis and luminescent property of [Tb0.995Eu0.005(pfbz)2(phen)Cl] (3), which not only exhibits high Sr in physiological temperature but also has a Sr up to 7.47% K-1 at 440 K, the largest Sr at 440 K in known lanthanide-based coordination compound luminescent materials.
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Change of hydrodynamic conditions is a key factor inducing sedimentation, water eutrophication and algal blooms in the Three Gorges Reservoir (TGR). How to mitigate sedimentation and phosphorus (P) retention by improving hydrodynamic conditions in the Three Gorges Reservoir area (TGRA) is an urgent issue in the study of sediment and water environment. In this study, a Hydrodynamic-Sediment-Water quality model for the whole TGRA is proposed considering sediment and P inputs from numerous tributaries, and a new reservoir operation method namely the tide-type operation method (TTOM) is used to investigate the large-scale sediment and P transport in the TGR based on the model. Results indicate that the TTOM can reduce sedimentation and total phosphorus (TP) retention in the TGR. Compared with the actual operation method (AOM), sediment outflow and sediment export ratio (Eratio) of the TGR increased about 17.13% and 1%-3% in 2015-2017, and sedimentation decreased about 3% under the TTOM. TP retention flux and retention rate (RE) decreased about 13.77% and 2%-4%. The flow velocity (V) and sediment carrying capacity (S*) increased about 40% in the local reach. Larger daily water level fluctuation at dam site is more conducive to reducing sedimentation and TP retention in the TGR. Sediment inputs from the Yangtze River, Jialing River, Wu River and other tributaries account for 59.27%, 11.21%, 3.81% and 25.70% of the total sediment inflow during 2015-2017, and TP inputs were 65.96%, 10.01%, 17.40% and 6.63%. In the paper, an innovative method is proposed to reduce sedimentation and P retention in the TGR under the given hydrodynamic conditions and related quantitative contribution driven by the proposed method is analyzed. The work is favorable for expanding the understanding of the hydrodynamic and nutrition flux changes in the TGR, and provides a new perspective for water environment protection and reasonable operation of large reservoirs.
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Fósforo , Poluentes Químicos da Água , Fósforo/análise , Poluentes Químicos da Água/análise , Monitoramento Ambiental/métodos , Eutrofização , Qualidade da Água , Rios , ChinaRESUMO
A new method relying on machine learning and resistivity to predict concentrations of petroleum hydrocarbon pollution in soil was proposed as a means of investigation and monitoring. Currently, determining pollutant concentrations in soil is primarily achieved through costly sampling and testing of numerous borehole samples, which carries the risk of further contamination by penetrating the aquifer. Additionally, conventional petroleum hydrocarbon geophysical surveys struggle to establish a correlation between survey results and pollutant concentration. To overcome these limitations, three machine learning models (KNN, RF, and XGBOOST) were combined with the geoelectrical method to predict petroleum hydrocarbon concentrations in the source area. The results demonstrate that the resistivity-based prediction method utilizing machine learning is effective, as validated by R-squared values of 0.91 and 0.94 for the test and validation sets, respectively, and a root mean squared error of 0.19. Furthermore, this study confirmed the feasibility of the approach using actual site data, along with a discussion of its advantages and limitations, establishing it as an inexpensive option to investigate and monitor changes in petroleum hydrocarbon concentration in soil.
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Poluentes Ambientais , Poluição por Petróleo , Petróleo , Poluentes do Solo , Solo , Hidrocarbonetos , Poluição por Petróleo/análise , Poluentes do Solo/análiseRESUMO
A glycosyl transferase, isolated from Angelica decursiva a medical herb rich in coumarin, shows C-glycosyl transferase activity by in vitro activity assay using 5,7-dihydroxycoumarin as substrate, producing a C-glycosylated product at position C'8 along with the main product at C'6 position. Catalytic promiscuity assay shows that AdCGT also displays O- or C-glycosylation activity to other coumarins and flavonoids. When phloretin and 2,4,6-trihydroxyacetophenone were fed as substrates, AdCGT catalyzed the formation of di-C-glycosides. Therefore, AdCGT is a multifunctional glycosyltransferase with a broad substrate acceptability. This work highlights the potential of AdCGT as a catalyst for glycosylation of coumarin and reveals a new regio-selective C-glycosyltransferase, providing a basis for exploring the mechanism of coumarin glycosylation.
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Angelica , Angelica/química , Angelica/metabolismo , Biocatálise , Cumarínicos/química , Glicosídeos , Glicosiltransferases/metabolismoRESUMO
MAIN CONCLUSION: An alkenal double-bond reductase enzyme (CaDBR1) was cloned from Colchicum autumnale L. The encoded enzyme catalysed 4-coumaraldehyde to 4-hydroxydihydrocinnamaldehyde (4-HDCA). Its functional characterization increased the understanding of colchicine biosynthesis. As a traditional medical plant, Colchicum autumnale L. is famous for producing colchicine, a widely used drug for alleviating gout attacks. The biosynthetic pathway of colchicine was revealed most recently, and 4-hydroxydihydrocinnamaldehyde (4-HDCA) has been verified as a crucial intermediate derived from L-phenylalanine. However, the functional gene that catalyses the formation of 4-HDCA remains controversial. In this study, the alkenal double-bond reductase (DBR) gene member CaDBR1 was cloned and characterized from C. autumnale. Bioinformatics analysis predicted and characterized the basic physicochemical properties of CaDBR1. Recombinant CaDBR1 protein was heterologously expressed in Escherichia coli and purified by a Ni-NTA column. In vitro enzyme assays indicated that CaDBR1 could catalyse 4-coumaraldehyde to form 4-HDCA but could not generate 4-HDCA by taking cinnamaldehyde as a substrate. Stable transformation into tobacco BY-2 cells revealed that CaDBR1 localized in the cytoplasm, and tissue-specific expression results showed that CaDBR1 had the highest expression in bulbs. All these results verify and confirm the participation and contribution of CaDBR1 in the biosynthesis pathway of 4-HDCA and colchicine alkaloids in C. autumnale.
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Alcaloides , Colchicum , Colchicina , Colchicum/química , Colchicum/genética , Colchicum/metabolismo , Oxirredutases , FenilalaninaRESUMO
Bionic camouflage covert underwater acoustic communication has recently attracted great attention. However, we have not found relevant methods or literature to recognize these bionic camouflage communication signals (BCCSs) in the area of anti-reconnaissance. Focused on recognizing the BCCSs, this article proposes a recognition method based on the statistics of inter-click intervals to recognize the camouflaged click communication train (CCCT), which is modulated by time delay difference (TDD). We first analyze the characteristics of TDD distributions of CCCT and real click train (RCT). According to the coding principle, the TDDs of CCCTs present a ladder-like distribution with a fixed time step, and the TDDs are equal to the integral multiple of the fixed time step. On the contrary, the TDDs of RCTs are approximately random distribution within a certain time range. Therefore, based on the different TDD distributions, this article classifies CCCTs and RCTs by utilizing the statistical property of TDD distributions. To measure the TDDs of diverse cetacean clicks accurately, a new click location scheme based on the dynamic window energy ratio is proposed. Next, based on the statistics of TDD distribution, the influences of the TDDs that are caused by multipath interferences are eliminated by iteration. Simulations demonstrate the accuracy of the recognition method under different conditions.
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Acústica , Biônica , Estimulação Acústica/métodos , Atenção , ComunicaçãoRESUMO
Mass spectrometry imaging is a novel molecular imaging technique that has been developing rapidly in recent years. Air flow-assisted ionization mass spectrometry imaging (AFAI-MSI) has received wide attention in the biomedical field because of its features such as not needing a pretreatment sample, having high sensitivity, and wide coverage of metabolite detection. In this study, we set up a mass spectrometry imaging method for analyzing low molecular metabolites in mango fruits by the AFAI-MSI method. Compounds such as organic acids, vitamin C, and phenols were detected from mango tissue by mass spectrometry under the negative ion scanning mode, and their spatial distribution was analyzed. As a result, all the target compounds showed different distributions. Citric acid was mainly distributed in the pulp. Malic acid, quinic acid, and vitamin C universally existed in the pulp and peel. However, galloylglucose isomer and 5-galloylquinic acid were predominantly found in the peel. These results show that AFAI-MSI can be used for the analysis of mango fruit endogenous metabolites conveniently and directly, which will facilitate the rapid identification and in situ characterization of plant endogenous substances.
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Mangifera , Ácido Ascórbico/análise , Ácido Cítrico/metabolismo , Frutas/química , Mangifera/química , Espectrometria de Massas/métodos , Peso Molecular , Fenóis/química , Ácido Quínico/metabolismo , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz/métodosRESUMO
PURPOSE: The main objective of the study was to translate, validate, and compare the Chinese ORTO scales (ORTO-15 and ORTO-R). The secondary objective was to assess factors that may be related with risk of orthorexia nervosa (ON). METHODS: Two cross-sectional surveys were conducted on March-to-June 2021 for ORTO-15 and April 2022 for ORTO-R. ORTO questionnaires were translated into Chinese using the forward-backward-forward method. Exploratory factor analysis (EFA), discriminant validity and confirmatory factor analysis (CFA) were used to examine the construct validity of the questionnaires. The internal consistency was assessed using the Cronbach alpha coefficient and the test-retest reliability. Multivariate linear regression analysis was used to explore potential factors related with ON scores. RESULTS: Totally, 1289 and 1084 eligible participants were included for assessment of ORTO-15 and ORTO-R, with the mean age of 20.9 ± 2.0 years and 21.0 ± 2.3 years. The internal consistency of Chinese ORTO-15 scale and ORTO-R scale were both satisfactory (α = 0.79, ICC = 0.79; α = 0.77, ICC = 0.82). However, all ORTO-15 models showed a poor fit using CFA whereas the ORTO-R was characterized by acceptable goodness-of-fit. Multivariate linear regression indicated that physical activities and mental disorders were positively associated with ON risk assessed by both ORTO-R and ORTO-15. CONCLUSION: The Chinese ORTO-R scale was a more reliable tool to screen for ON tendencies than the Chinese version of ORTO-15. Mental disorders and physical activities might be associated with the increased ON risk. LEVEL OF EVIDENCE: Level V (descriptive cross-sectional study).
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Transtornos da Alimentação e da Ingestão de Alimentos , Comportamentos Relacionados com a Saúde , Humanos , Adolescente , Adulto Jovem , Adulto , Ortorexia Nervosa , Estudos Transversais , Reprodutibilidade dos Testes , Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico , Estudantes , Inquéritos e Questionários , Psicometria/métodosRESUMO
A 3D coordination polymer, [Gd(HCOO)(C2O4)]n was prepared. Its magnetocaloric effect (MCE) (32.7 J K-1 kg-1 at 2 K and 2 T) is significantly larger than that of commercial Gd3Ga5O12 (GGG) (14.6 J kg-1 K-1 at 2 K and 2 T), while its thermal conductivity (9.9 W m-1 K-1 at 3 K) is comparable to that of the commercial GGG (about 10 W m-1 K-1 at 3 K).
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BACKGROUND: Management of severely angulated Rockwood and Wilkins' type C (RW-C) thumb metacarpal base fractures in children is challenging. We report experiences of percutaneous leverage reduction and dual antegrade crossing Kirschner (DACK) wire fixation in these fractures, aiming to assess the results using our reduction technique. METHODS: From October 2011 to September 2015, A total of 17 patients with severely angulated RW-C thumb metacarpal base fractures were treated at our hospital. The injured arm, including the entire first ray, was immobilized with a thumb-spica cast for 4-6 weeks and evaluated radiologically and clinically. Percutaneous leverage reduction and DACK wire fixation were successfully performed for 17 patients. No patients were treated with open reduction. 16 patients were followed up for a mean of 32 months (range 24-41 months). The results were assessed using the modified Mayo score. The level of significance was set to be p < 0.05. RESULTS: The patients included 9 girls (56.2%) and 7 boys (43.8%), with an average age of 10.8 years (range 7.5 to 14.0 years). Percutaneous leverage reduction and DACK wire fixation were successfully performed within an average total surgery time of 20 min (range 12-32 min). Bone union was achieved in all patients within a mean time of 4.2 weeks (range 4-6 weeks). The average angulation (preoperation: 50.5° (range 40.8°-67.0°) vs postoperation: 5.0° (range 0.0°-7.0°)) significantly changed from pre to post-surgery (P < 0.05). The clinical outcomes were evaluated by the modified Mayo score: 15 patients had an excellent outcome, and one patient had a good outcome. Cosmetic results were described as good and satisfactory by all patients. There were no refractures and no incidences of nonunion, growth arrest in the proximal epiphysis. Only one patient suffered from a superficial infection, which was resolved after the removal of the k-wires and the administration of oral antibiotics. CONCLUSION: Our percutaneous leverage technique with DACK wire fixation can be successfully used to treat these fractures. This technique is simple to learn and minimally invasive, and the results are satisfactory. It may be an appropriate choice for the treatment of irreducible RW-C fractures.
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Fraturas Ósseas , Ossos Metacarpais , Adolescente , Fios Ortopédicos , Criança , Epífises , Feminino , Fixação Interna de Fraturas , Fraturas Ósseas/diagnóstico por imagem , Fraturas Ósseas/cirurgia , Humanos , Masculino , Ossos Metacarpais/diagnóstico por imagem , Ossos Metacarpais/cirurgia , Polegar/diagnóstico por imagem , Polegar/cirurgia , Resultado do TratamentoRESUMO
BACKGROUND: Gasless trans-axillary endoscopic thyroidectomy (GTAET) has satisfactory cosmetic effects for the patients who have benign goiter and small thyroid carcinoma, however the complications of this surgical procedure have not been fully documented. Ipsilateral hypoglossal nerve palsy (IHNP) associated with GTAET has never been reported before. CASE PRESENTATION: A 33-year old male patient presented with a 4 × 5 mm solid thyroid nodule in the right lobe. Papillary thyroid carcinoma was confirmed by the fine needle aspiration. He had strong cosmetic demand, therefore GTAET for right lobectomy and central cervical lymphadenectomy was performed in a supine position with cervical extension. Six hours after the operation, he developed tongue deviation to the right side, speech and swallowing difficulties, indicating IHNP. Head and cervical MRI showed no abnormality. The intravenous steroid was used for three days, and oral vitamin B1 and mecobalamin was prescribed for 1 month. Nine days after surgery, he was discharged. Three months after the operation, all the symptoms were completely resolved. CONCLUSIONS: To the best of the authors' knowledge, this is the first case of IHNP after GTAET, which will be valuable to add our knowledge to diagnose and treat rare complications of GTAET.
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Endoscopia , Doenças do Nervo Hipoglosso , Neoplasias da Glândula Tireoide , Tireoidectomia , Adulto , Endoscopia/efeitos adversos , Endoscopia/métodos , Humanos , Doenças do Nervo Hipoglosso/diagnóstico , Doenças do Nervo Hipoglosso/etiologia , Masculino , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia/efeitos adversos , Tireoidectomia/métodosRESUMO
A luminescent lanthanide-titanium oxo cluster of Eu2Ti4(µ2-O)2(µ3-O)4(phen)2(tbza)10·4CH3CN (1, Eu2Ti4-phen-tbza, phen = 1,10-phenanthroline, Htbza = 4-tert-butylbenzoic acid) was prepared through the reaction of phen, Htbza, Eu(Ac)3·xH2O, and Ti(OiPr)4 in acetonitrile. Its overall absolute quantum yield is 65.4% in solid state and 30.2% in CH2Cl2, and the detection limit of 1 for the nitrobenzene (NB) is 10.5 ppb. When the concentration of NB is 40 ppm, the luminescence quenching of 1 can be observed with the naked eye. Time-resolved excited-state decay measurements indicate that the static quenching process is dominated across the NB concentration of 0-9 ppm. The distinguishable shifts in 1H NMR spectra of NB together with 1 confirm the presence of π···π stacking interactions between the organic ligands in 1 and the NB, which plays a key contribution for the quenching of luminescence.
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BACKGROUND: The safety of total laparoscopic pancreaticoduodenectomy still remains controversial. Laparoscopic assisted pancreaticoduodenectomy (LAPD) may be an alternative selection. The purpose of the present study is to compare a consecutive cohort of LAPD and open pancreaticoduodenectomy (OPD) from a single surgeon. METHODS: A comparison was conducted between LAPD and OPD from January 2013 to December 2018. Perioperative outcomes and short-term oncological results were compared. Univariate and multivariable analyses were performed to determine associations among variables. RESULTS: 133 patients were enrolled, 36 patients (27.1%) underwent LAPD and 97 (72.9%) underwent OPD. No 30-day and 90-day mortality occurred. LAPD was associated with decreased intraoperative estimated blood loss (300 versus 500 ml; P = 0.002), longer operative time (372 versus 305 min; P < 0.001) compared with OPD. LAPD had a conversion rate of 16.7%, and wasn't associated with an increased grade B/C pancreatic fistula rate, major surgical complications, intraoperative blood transfusion, reoperation rate or length of hospital stay after surgery. In the subset of 58 pancreatic ductal adenocarcinomas, R0 resection rate, median total harvested lymph node or lymph nodes ≥12 did not differ between the two groups. CONCLUSION: LAPD could be performed with non-inferior short-term perioperative and oncologic outcomes achieved by OPD in selected patients.
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Carcinoma Ductal Pancreático/cirurgia , Laparoscopia/métodos , Neoplasias Pancreáticas/cirurgia , Pancreaticoduodenectomia/métodos , Adolescente , Adulto , Idoso , Perda Sanguínea Cirúrgica , Transfusão de Sangue , Estudos de Coortes , Feminino , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Fístula Pancreática/epidemiologia , Complicações Pós-Operatórias/epidemiologia , Estudos Retrospectivos , Adulto JovemRESUMO
BACKGROUND: The clinical outcomes of patients who received distal pancreatectomy with splenectomy (DPS) and spleen-preserving distal pancreatectomy (SPDP) have been generally investigated. However, postoperative hematological changes after distal pancreatectomy with or without splenectomy are poorly understood. METHODS: Information from patients undergoing distal pancreatectomy (DP) between January 2014 and June 2019 at a single institution was reviewed. A linear mixed-effects model was used to compare dynamic hematological changes between different groups. RESULTS: A total of 302 patients who underwent DP were enrolled. In the long term, most postoperative hematological parameters remained significantly higher than preoperative levels in the DPS group, while postoperative lymphocyte, monocyte, basophil, and platelet levels returned to preoperative levels in the SPDP group. All postoperative hematological parameters except for red blood cell count and serum hemoglobulin level were significantly higher in the DPS group than in the SPDP group. There were no significant differences in hematological changes between the splenic vessel preservation (SVP) and Warshaw technique (WT) groups. CONCLUSIONS: Postoperative hematological changes were significantly different between the DPS and SPDP groups. Compared to DPS, SPDP reduced abnormal hematological changes caused by splenectomy. SVP and WT were comparable in terms of postoperative hematological changes.