Stomach-partitioning versus conventional gastrojejunostomy for unresectable gastric cancer with gastric outlet obstruction: A propensity score matched cohort study.

BACKGROUND: Stomach partitioning gastrojejunostomy (SPGJ) was introduced to deal with delayed gastric emptying (DGE). This study aimed to compare the short- and long-term outcomes of SPGJ versus conventional gastrojejunostomy (CGJ). METHOD: This cohort study analyzed 108 patients who underwent gastrojejunostomy for unresectable gastric cancer: 70 patients underwent SPGJ, and 38 patients underwent CGJ between 2018 and 2022. Propensity score-matched (PSM) analysis was used to balance the baseline characteristics. RESULTS: After PSM, there were 26 patients in each group. SPGJ group had significantly lower incidence of DGE (3.8% vs. 34.6%), vomiting (3.8% vs. 42.3%), and prokinetics requirement (11.5% vs. 46.2%). SPGJ group had significantly shorter time to solid diet tolerance (4.1 days vs. 5.7 days) and postoperative hospital stay (7.7 days vs. 9.3 days). There was no significant difference in relapse reinterventions, gastric outlet obstruction (GOO) recurrence, conversion surgery, and survival outcomes. CONCLUSIONS: SGPJ was associated with lower rate of DGE, prokinetics requirement, and shorter time of solid diet tolerance compared to CGJ in the treatment of unresectable gastric cancer patients with GOO.

Levofloxacin+Tetracycline Quadruple Regimen for Eradication of Helicobacter pylori: A Multicenter Multinational Randomized Controlled Trial.

Background: The ideal combination regimen for Helicobacter pylori (HP) eradication has not yet been determined and the success rate of HP eradication has been extensively reduced worldwide due to increasing antibiotic resistance. So this multinational multi-center randomized controlled trial was designed to evaluate the efficacy of tetracycline +levofloxacin for HP eradication. Methods: During a 6-month period, all of the cases with HP infection in eight referral tertiary centers of three countries were included and randomly allocated to receive either tetracycline + levofloxacin or clarithromycin plus amoxicillin quadruple regimen for two weeks. For all of the participants, pantoprazole was continued for 4 more weeks and after one to two weeks of off-therapy, they underwent urea breath test C13 to prove eradication. Results: Overall 788 patients were included (358 male (45.4%), average age 44.2 years). They were diagnosed as having non-ulcer dyspepsia (516 cases, 65.5%), peptic ulcer disease (PUD) (234 cases, 29.69%), and intestinal metaplasia (38 cases, 4.8%). Racially 63.1% were Caucasian, 14.5% Arab, 15.6% African, and 6.1% Asian. The participants were randomly allocated to groups A and B to receive either tetracycline + levofloxacin or clarithromycin. Among groups A and B in intention to treat (ITT) and per protocol (PP) analysis, 75.2% & 82.1% (285 cases) and 67.5% & 70.1% (276 cases) of participants achieved eradication, respectively (P = 0.0001). The complete compliance rate in groups A and B were 84.4% and 83.6%, respectively. During the study, 33.5% of the participants in group A (127 cases) reported side effects while the complication rate among group B was 27.9% (114 cases, P = 0.041). The most common complaints among groups A and B were nausea and vomiting (12.6% & 9.3%) and abdominal pain (4.48% & 2.68%), respectively. The rate of severe complications that caused discontinuation of medication in groups A and B were 2.1% and 1.46%, respectively (P = 679). In subgroup analysis, the eradication rates of tetracycline+levofloxacin among patients with non-ulcer dyspepsia, PUD, and intestinal metaplasia were 79.4%, 88.1%, and 73.9%, respectively. These figures in group B (clarithromycin base) were 71.3%, 67.6%, and 61.5% respectively (P = 0.0001, 0.0001, and 0.043). Conclusion: Overall, the combination of tetracycline+levofloxacin is more efficient for HP eradication in comparison with clarithromycin+amoxicillin despite more complication rate. In areas with a high rate of resistance to clarithromycin, this therapeutic regimen could be an ideal choice for HP eradication, especially among those who were diagnosed with PUD.

Effect of Time to Minimally Invasive Esophagectomy After Neoadjuvant Chemotherapy for Esophageal Squamous Cell Carcinoma.

BACKGROUND: Neoadjuvant chemotherapy (NAC) with docetaxel, cisplatin, and 5-fluorouracil/capecitabine (DCF/DCX) followed by esophagectomy has been the recommended treatment for esophageal squamous cell carcinoma (ESCC). However, the optimal interval from NAC to surgery has not yet been established. This study evaluated the impact of time to surgery (TTS) in the treatment of ESCC. METHODS: Between August 2018 and September 2021, 97 patients who underwent radical esophagectomy following 3-6 cycles of NAC with DCF/DCX for ESCC at a single hospital were analyzed. TTS was categorized into three groups: 16-41 days (group 1; 33 patients), 42-55 days (group 2; 29 patients), and 56-135 days (group 3; 35 patients). Survival outcomes included overall survival (OS) and progression-free survival (PFS). RESULTS: Mean age was 59.6 ± 6.8 years, and 95 patients were male. One patient had grade-III anemia, 12 had grade-II anemia, and four had grade-II neutropenia; all other NAC-related toxicities were as grade I. Regarding pathologic tumor response, 18.6% achieved complete response, 71.1% achieved partial response, and 10.3% had stable disease. Forty-eight patients (49.5%) had a postoperative complication, but only six (6.2%) with grade IIIa and two (2.1%) with grade IVa according to the Clavien-Dindo classification. Median follow-up time was 24 months. Groups 1 and 3 had worse OS (HR [95% CI]: 3.36 [1.16-11.7] and 1.83 [0.55-6.10]) and worse PFS (HR [95% CI]: 3.27 [1.25-8.53] and 1.61 [0.58-4.45]) compared to group 2. CONCLUSION: We suggest the optimal TTS after NAC is 6-8 weeks. However, this finding must be confirmed by prospective trials.

Rhenium(I)-tricarbonyl complexes with methimazole and its selenium analogue: Syntheses, characterization and cell toxicity.

This study explores the effect of a thione/selone ligand on the cell toxicity (in vitro) and light activity of diimine Re(CO)3+ complexes. Six rhenium(I) complexes with general formula fac-[Re(CO)3(N,N')X]+ were prepared, where X = 2-mercapto-1-methylimidazole (methimazole; MMI), and 1-methylimidazole-2-selone (MSeI); N,N' = 2,2'-bipyridine (bpy), 1,10-phenanthroline (phen) and 2,9-dimethyl-1,10-phenanthroline (dmphen). Their triflate salts were characterized using single-crystal X-ray diffraction, 1H, 13C and 2D NMR, UV-vis and vibrational spectroscopy. Their cytotoxic properties were tested, showing significant cytotoxicity (IC50 = 8.0-55 µM) towards the human breast cancer cell line MDA-MB-231. The half-inhibitory concentration (IC50) for fac-[Re(CO)3(dmphen)(MMI)]+, the most toxic complex in this series (8.0 ± 0.2 µM), was comparable to that of the corresponding aqua complex fac-[Re(CO)3(dmphen)(H2O)]+ with IC50 = 6.0 ± 0.1 µM. The fac-[Re(CO)3(bpy)(MMI/MSeI)]+ complexes were somewhat less toxic towards the human embryonic kidney cell line HEK-293 T after 48 h of exposure. The stability of the complexes upon irradiation was monitored using UV-vis spectroscopy, with no CO released when exposed to UV-A light (λ = 365 nm).

Reverse shoulder megaprosthesis replacement for aggressive aneurysm bone cyst of proximal humerus: Case report and literature review.

INTRODUCTION: and importance: Wide resection in the surgical treatment of aneurysms bone cysts is often performed in cases where the tumor is large, recurrent, growing, and intensely invasive. Reshaping the defect after tumor removal is a necessary issue to restore shape and maintain function for the patient. CASE PRESENTATION: A 26-year-old male patient, diagnosed with an aneurysm bone cyst in the proximal humerus, underwent surgery for curettage and bone grafting twice. After surgery, there was still pain in the shoulder area, the tumor progressed aggressively with limited shoulder movement. Based on the imaging re-evaluation, it was shown that the tumor increased rapidly in size, invaded the soft tissue, and completely changed the normal structure of the shoulder joint, and the proximal humerus. We used a reverse shoulder joint with an additional module to restore the bone defect of the tumor and the function of the shoulder joint. Follows-up showed that patient no longer pain in shoulder area, shoulder joint function recovery is progressing well, Musculoskeletal Tumor Society (MSTS) score is 25 & 28, shoulder joint function score according to ASES scale: 80 & 93.33 respectively at 3 months and 6 months after surgery. CLINICAL DISCUSSION: Aggresive aneurysm bone cyst of proximal humerus is not common and still a challenge to the treatment. Due to the bone and joint destruction, the indication of tumor resection and reconstruct the joint and bone loss is required. Among several solution, reverse shoulder megaprosthesis is a newest one can favor the purpose of our treatment. Up to now, this solution is mainly used to preserving for malignant bone tumor. CONCLUSIONS: Tumor wide resection with modular reverse shoulder replacement with the modular segment is a reasonable intervention option in cases of large aneurysm bone cysts, with rapid recurrence, aggressive progression, and soft tissue invasion.

The comparison of analgesic efficacy between ultrasound-guided continuous thoracic paravertebral block and continuous thoracic epidural block using bupivacaine - fentanyl in patients undergoing lung surgery: A prospective, randomized, controlled trial.

OBJECTIVES: This study aimed to compare the efficacy and the safety of ultrasound-guided continuous thoracic paravertebral block (CTPB) to the continuous thoracic epidural block (CTEB) for pain relief in patients undergoing lung surgery. MATERIAL AND METHODS: Our study included 102 patients after lung surgery at the 74 Central Hospital from 9/2013 to 12/2017. Patients were divided into 2 groups: CTPB group (n= 51) and CTEB group (n= 51). The primary outcomes were the Visual Analogue Scale (VAS) scores when patients were at rest (VR) and movement (VM), the total used dosage of bupivacaine - fentanyl after surgery, plasma glucose, and cortisol levels, additional doses of morphine. Adverse reactions were recorded during the study. The study was approved by the Ethics Committee of the 74 Central Hospital. All participants provided their informed consent. RESULTS: There were no significant differences between CTPB and CTEB groups in terms of the VR and the VM, total used doses of bupivacaine - fentanyl after 72-hours of surgery (p> 0.05), the increased plasma glucose, and plasma cortisol (p> 0.05), and the additional doses of morphine. The percent of patients in the CTPB group undergoing adverse reactions in the circular system and the respiratory system was lower than in the CTEB group. Adverse reactions included vascular puncture, urinary retention, and itch. CONCLUSION: Ultrasound-guided CTPB is an effective intervention of pain relief after lung surgery. Its analgesic efficacy is comparable to CTEB. Also, this method had fewer adverse reactions in circulation and respiration compared to the CTEB.

Tobacco and Alcohol Use Among Ethnic Minorities in Vietnam.

This study investigates the prevalence of tobacco and alcohol uses and associated factors among 12 ethnic minorities in Vietnam in 2019. A cross-sectional survey was conducted among 5172 people aged ≥15 years. The prevalence of smoking and drinking was 19.7% and 29.9%, respectively, and significantly higher among men than women. These numbers were heterogeneous across ethnic minorities. Smoking prevalence was high among Ba Na (25.9%), Cham An Giang (22.3%), Khmer (23.5%), La Hu (26.3%), Ta Oi (30.7%), and Bru Van Kieu (29.6%) ethnicities whereas that of Gie Trieng and Mnong ethnicities was low (3.7% and 9.5%, respectively). Drinking prevalence ranged from 1.4% in Cham An Giang ethnicity to 68.6% in Ba Na ethnicity. A wide ethnic disparity on tobacco and alcohol use could be explained by the ethnic variation of lifestyles, social norms, and cultural features. Our findings suggest the need to develop ethnic-specific interventions to mitigate the smoking and drinking prevalence.

Value of CIM, CLO Test and Multiplex PCR for the Diagnosis of Helicobacter Pylori Infection Status in Patients with Gastritis and Gastric Ulcer.

OBJECTIVE: To assess the value of Current Infection Marker (CIM) test, Campylobacter-Like Organism (CLO) test, and the multiplex polymerase chain reaction test (PCR) for the diagnosis of Helicobacter pylori (H. pylori) infection in a Vietnamese population. METHODS: Targeted suitable patients were recruited. CIM test, CLO test and multiplex PCR were used to diagnose for H. pylori infection. Patients were considered positive for H. pylori when at least two of the three tests were positive. The performance of each of the three tests was compared to the H. pylori positive populations as defined. RESULT: Amongst 201 patients with a mean age of 40.5 (range, 18-74) years, there were 115 females and 86 males. Of the 201 patients, 107 (53.2%) were diagnosed as H. pylori positive according to the defined criteria. The positive patients obtained with CLO test, CIM test and multiplex PCR were 38.3%, 59.2% and 72.1%, correspondingly. The full performance of the three tests as highlighted in order as above were 85.07%, 83.08% and 81.09%, respectively. The positive rate of CLO test was the lowest, with 38.3% positive, but this method was the most accurate, with the accuracy of 85.07%. This suggested that CLO test has the highest specificity among the three. The sensitivity, specificity, positive, negative predictive values and accuracy of the CLO / CIM / multiplex PCR tests were 71.96% / 89.72% / 100%, 100% / 75.53% / 59.57%, 100% / 80.67% / 73.79%, 75.81% / 86.59% / 100%, and 85.07% / 83.08% / 81.09%, respectively. CONCLUSION: All the three methods have high accuracy for the diagnosis of H. pylori infection in the Vietnamese population with gastritis and gastric ulcers. These tests can be employed in the clinical settings for the Vietnamese population. CLO test should be used in combination with the other tests to reduce false-negative results.

Co-Translational Insertion of Aquaporins into Liposome for Functional Analysis via an E. coli Based Cell-Free Protein Synthesis System.

Aquaporins are important and well-studied water channel membrane proteins. However, being membrane proteins, sample preparation for functional analysis is tedious and time-consuming. In this paper, we report a new approach for the co-translational insertion of two aquaporins from Escherichia coli and Nicotiana tabacum using the CFPS system. This was done in the presence of liposomes with a modified procedure to form homogenous proteo-liposomes suitable for functional analysis of water permeability using stopped-flow spectrophotometry. Two model aquaporins, AqpZ and NtPIP2;1, were successfully incorporated into the liposome in their active forms. Shifted green fluorescent protein was fused to the C-terminal part of AqpZ to monitor its insertion and status in the lipid environment. This new fast approach offers a fast and straightforward method for the functional analysis of aquaporins in both prokaryotic and eukaryotic organisms.

A label-free and highly sensitive DNA biosensor based on the core-shell structured CeO2-NR@Ppy nanocomposite for Salmonella detection.

A core-shell cerium oxide nanorod@polypyrrole (CeO2-NR@Ppy) nanocomposite-based electrochemical DNA biosensor was studied for Salmonella detection. The core-shell CeO2-NR@Ppy nanocomposite was prepared by in situ chemical oxidative polymerization of pyrrole monomer on CeO2-NRs, which provided a suitable platform for electrochemical DNA biosensor fabrication. The immobilization of ss-DNA sequences onto nanocomposite-coated microelectrode was performed via covalent attachment method. DNA biosensor electrochemical responses were studied by cyclic voltammetry and electrochemical impedance spectroscopy with [Fe (CN)6]3-/4- as redox probe. Under optimal conditions, DNA biosensor response showed good linearity in the range of 0.01-0.4 nM with sensitivity of 593.7â€¯Ω·nM-1·cm-2. The low limit of detection and limit of quantification for the DNA biosensor were 0.084 and 0.28 nM, respectively. The proposed DNA biosensor also showed good results when used in detecting actual Salmonella samples.

Iron-doped ZnO as a support for Pt-based catalysts to improve activity and stability: enhancement of metal-support interaction by the doping effect.

In heterogeneous catalysis, the role of the interface between a metal and a metal oxide in deciding catalytic performance has remained a long-standing question. Out of many molecular-scale factors that affect the properties of metal-oxide interfaces, doping or impurities in the oxides can result in excess charge carriers or oxygen vacancies on the oxides, which lead to a change in catalytic activity. For a model system with a tunable dopant, we employed Pt nanoparticles with Fe doping. We synthesized a series of Fe-doped ZnO with different Fe loadings (i.e., 0, 1, and 4%) using the co-precipitation method, and then deposited Pt nanoparticles onto these supports. The Pt-based catalysts were employed to investigate the effect of the dopant to promote the catalytic performance for the CO oxidation reaction. The 4% Fe loading sample showed the highest catalytic activity among the catalysts, with a turnover frequency of 5.37 s-1 at 126 °C. The dopant was found to enhance the interaction between the Pt nanoparticles and the catalyst support, including the prevention of metal sintering, which resulted in an improvement of catalytic activity.