Comparison of manual sutures and laparoscopic stapler for pancreatic stump closure techniques in robotic distal pancreatectomy: a single-center experience.

BACKGROUND: Postoperative pancreatic fistulas (POPFs) are prevalent and major postoperative complications of distal pancreatectomy (DP). There are numerous ways to manage the pancreatic stump. However, no single approach has been shown to be consistently superior. Moreover, the potential role of robotic systems in reducing POPFs has received little attention. METHODS: The clinical data of 119 patients who had consecutively received robotic distal pancreatectomy between January 2019 and December 2022 were retrospectively analyzed. Patients were divided into two groups according to the method of handling the pancreatic stump. The attributes of the patients and the variables during the perioperative period were compared. RESULTS: The analysis included 72 manual sutures and 47 stapler procedures. The manual suture group had a shorter operative time (removing installation time) than the stapler group (125.25 ± 63.04 min vs 153.30 ± 62.03 min, p = 0.019). Additionally, the manual suture group had lower estimated blood loss (50 mL vs 100 mL, p = 0.009) and a shorter postoperative hospital stay. There were no significant differences in the incidence of clinically relevant POPFs between the two groups (18.1% vs 23.4%, P > 0.05). No perioperative death occurred in either group. CONCLUSION: The manual suturing technique was shown to have an incidence of POPFs similar to the stapler technique in robotic distal pancreatectomy and to be safe and feasible.

Synthesis of Two-Dimensional MoO2 Nanoplates with Large Linear Magnetoresistance and Nonlinear Hall Effect.

Two-dimensional (2D) materials with large linear magnetoresistance (LMR) are very interesting owing to their potential application in magnetic storage or sensor devices. Here, we report the synthesis of 2D MoO2 nanoplates grown by a chemical vapor deposition (CVD) method and observe large LMR and nonlinear Hall behavior in MoO2 nanoplates. As-obtained MoO2 nanoplates exhibit rhombic shapes and high crystallinity. Electrical studies indicate that MoO2 nanoplates feature a metallic nature with an excellent conductivity of up to 3.7 × 107 S m-1 at 2.5 K. MoO2 nanoplates display a large LMR of up to 455% at 3 K and -9 T. A thickness-dependent LMR analysis suggests that LMR values increase upon increasing the thickness of nanoplates. Besides, nonlinearity has been found in the magnetic-field-dependent Hall resistance, which decreases with increasing temperatures. Our studies highlight that MoO2 nanoplates are promising materials for fundamental studies and potential applications in magnetic storage devices.

Sensitive Electrochemical Detection of Carcinoembryonic Antigen Based on Biofunctionalized Nanochannel Modified Carbonaceous Electrode.

The convenient construction of carbon-based electrochemical immunosensors with high performance is highly desirable for the efficient detection of tumor biomarkers. In this work, an electrochemical immunosensor was fabricated by integrating a biofunctionalized mesoporous silica nanochannel film with a carbon-based electrode, which can enable the sensitive determination of carcinoembryonic antigen (CEA) in serum. The commonly used carbonaceous electrode, glassy carbon electrode (GCE), was employed as the supporting electrode and was pre-treated through electrochemical polarization to achieve the stable binding of a vertically ordered mesoporous silica film with amino groups (NH2-VMSF) without the use of any adhesive layer. To fabricate the immunorecognition interface, antibodies were covalently immobilized after the amino groups on the outer surface of NH2-VMSF was derivatized to aldehyde groups. The presence of amino sites within the high-density nanochannels of NH2-VMSF can facilitate the migration of negatively charged redox probes (Fe(CN)63-/4-) to the supporting electrode through electrostatic adsorption, leading to the generation of electrochemical signals. In the presence of CEA, the formation of immunocomplexes on the recognitive interface can reduce the electrochemical signal of Fe(CN)63-/4- on the supporting electrode. Based on this principle, the sensitive electrochemical detection of CEA was achieved. CEA can be determined to range from 0.01 ng mL-1 to 100 ng mL-1 with a limit of detection of 6.3 pg mL-1. The fabricated immunosensor exhibited high selectivity, and the detection of CEA in fetal bovine serum was achieved.

Fe3 C/nanocarbon-Enabled Lithium Dendrite Mitigation in Lithium-Sulfur batteries.

Lithium dendrite-induced short circuits and material loss are two major obstacles to the commercialization of lithium-sulfur (Li-S) batteries. Here, a nanocarbon composite consisting of cotton-derived Fe3 C-encapsulated multiwalled carbon nanotubes (Fe3 C-MWCNTs) and graphene effectively traps polysulfides to suppress lithium dendrite growth is reported. Machine learning combined with molecular dynamics (MD) simulations unveils a new polysulfide-induced lithium dendrite formation mechanism: the migration of polysulfides away from the anode drags out lithium protrusions through localized lattice distortion of the lithium anode and traps lithium ions in the surrounding electrolyte, leading to lithium dendrite formation. The Li-S battery, constructed using the composite of cotton-derived Fe3 C-MWCNTs and graphene that serves as both the sulfur host and the anode interlayer, exhibits exceptional cycling stability, impressive capacity retention, and effective mitigation of lithium dendrite formation. The findings offer valuable strategies to prevent lithium dendrite formation and enhance understanding of lithium dendrite growth in Li-S batteries.

NIR-Triggered On-Demand Nitric Oxide Release for Enhanced Synergistic Phototherapy of Hypoxic Tumor.

Hypoxia of tumor microenvironments is a major factor restricting tumor treatment, which causes progression and metastasis of tumor. The hypoxic tumor microenvironment not only makes the traditional treatment method, such as chemotherapy, ineffective but also hinders the O2-dependent treatments, such as photodynamic therapy (PDT). Recently, stimuli-responsive nitric oxide (NO) donors have attracted extensive research interest in hypoxic tumor treatment because the NO release process is O2-independent. Besides, NO can distribute more uniformly than drug molecules and more widely than the PDT-generated active species due to its strong diffusion ability (200 µm in cells) and long lifetime (2 s in cells). Encouraged by these advantages, a near infrared light-triggered NO release polymeric nanoplatform (P1-CapNO NPs) was constructed by a thermally sensitive NO release unit, a photothermal unit, and a hydrophilic polyethylene glycol unit. P1-CapNO NPs possess strong absorption in the NIR region (the wavelength of maximal absorption peak was 790 nm with a molar absorption coefficient of 2.4 × 105 M-1 cm-1), great photothermal conversion efficiency (23.8%), and NO release ability (the released NO concentration can reach 1.3 µM) under 808 nm laser irradiation. Owing to these advantages, the great synergistic antitumor effect can be achieved in vitro and in vivo even under the hypoxic environment. The synergistic therapeutic strategy in this work could bypass the obstacles caused by hypoxia in tumor treatment and provide a reference for building a NO-involved therapeutic platform.

Molecular insight into the transformation of dissolved organic matter during sewage sludge composting: An investigation of a full-scale composting plant.

The aim of the study was to explore the molecular dynamics and transformation pathways of dissolved organic matter (DOM) in sewage sludge (SS) during composting, and the DOM of raw material, material experiencing thermophilic phase and material collected from humification phase were characterized using electrospray ionization coupled with Fourier transform ion cyclotron resonance mass spectrometry. The results indicated that there were approximately 85% of aliphatic/proteins and 75% of carbohydrate preferentially decomposed in the thermophilic phase. Moreover, lignins/carboxylic-rich alicyclic molecules (CRAM) were the main N-containing substances evolved in the decomposition, which leading to a reduction of N/C ratio from 0.073 to 0.041. Whereas aliphatic acids and tryptophan in lignins/CRAM with high oxidizing capacities are preferentially decomposed in the thermophilic phase. As for maturity phase, the carbon of the newly generated compounds (belonging to lignins/CRAM and tannins), possessed an oxidation state that similar to sulfonates and sulfonamides, and these DOM are beneficial for the humic substances formation. Moreover, it was found that the newly formed N2Ox and N3Ox compounds had a more significant contribution to the double bond equivalent (DBE) of the compost, corresponding to 1.0 and 1.7 DBE, respectively. The results would help explore the understanding of DOM transformation and humification during SS composting in the microscopic molecular level.

Factors predicting recurrence after left­sided pancreatectomy for pancreatic ductal adenocarcinoma.

BACKGROUND: Recurrence after resection is the main factor for poor survival. The relationship between clinicopathological factors and recurrence after curative distal pancreatectomy for PDAC has rarely been reported separately. METHODS: Patients with PDAC after left­sided pancreatectomy between May 2015 and August 2021 were retrospectively identified. RESULTS: One hundred forty-one patients were included. Recurrence was observed in 97 patients (68.8%), while 44 (31.2%) patients had no recurrence. The median RFS was 8.8 months. The median OS was 24.9 months. Local recurrence was the predominant first detected recurrence site (n = 36, 37.1%), closely followed by liver recurrence (n = 35, 36.1%). Multiple recurrences occurred in 16 (16.5%) patients, peritoneal recurrence in 6 (6.2%) patients, and lung recurrence in 4 (4.1%) patients. High CA19-9 value after surgery, poor differentiation grade, and positive lymph nodes were found to be independently associated with recurrence. The patients receiving adjuvant chemotherapy had a decreased likelihood of recurrence. In the high CA19-9 value cohort, the median PFS and OS of the patients with or without chemotherapy were 8.0 VS. 5.7 months and 15.6 VS. 13.8 months, respectively. In the normal CA19-9 value cohort, there was no significant difference in PFS with or without chemotherapy (11.7 VS. 10.0 months, P = 0.147). However, OS was significantly longer in the patients with chemotherapy (26.4 VS. 13.8 months, P = 0.019). CONCLUSIONS: Tumor biologic characteristics, such as T stage, tumor differentiation and positive lymph nodes, affecting CA19-9 value after surgery are associated with patterns and timing of recurrence. Adjuvant chemotherapy significantly reduced recurrence and improved survival. Chemotherapy is strongly recommended in patients with high CA199 after surgery.

Cotton-Derived Fe/Fe3C-Encapsulated Carbon Nanotubes for High-Performance Lithium-Sulfur Batteries.

Fabrication processes of fossil fuel-derived carbon nanomaterials are of high carbon emissions. Deriving carbon materials from low-cost and sustainable biomass is eco-friendly. Cotton, one of the most abundant biomass materials, naturally holds a hierarchically porous structure, making the activated cotton textile (ACT) an ideal scaffold for loading active materials. Here, we report a low-cost approach to massively producing multiwalled carbon nanotubes (MWCNTs) via a combination process of vapor-liquid-solid (VLS) and solid-liquid-solid (SLS) where cotton decomposed into carbon-containing gases and amorphous carbons that then dissolved into Fe nanoparticles, forming Fe/Fe3C-encapsulated MWCNTs. The lithium-sulfur (Li-S) battery constructed by the Fe/Fe3C-MWCNT@ACT/S composite (as the cathode) and the Fe/Fe3C-MWCNT@ACT (as the interlayer) exhibited a superlative cycling stability (over 1000 cycles at 1.0 C), an ultralow capacity decay rate (0.0496% per cycle) and a remarkable specific capacity (1273 mAh g-1 at 0.1 C). The Fe/Fe3C-MWCNTs enhanced electrode stability and suppressed polysulfide dissolution during cycling.

Lithium extraction from typical lithium silicate ores by two bacteria with different metabolic characteristics: Experiments, mechanism and significance.

Microorganisms obtain inorganic nutrients or energy from specific minerals to selectively weather minerals, but few studies on the differences in metabolic components of different functional bacteria lead to different weathering effects. This study evaluated the leaching effects of two bacteria with distinct metabolic characteristics on lithium silicate minerals with different structures. We aimed to understand the microscopic mechanism of crystal destruction of lithium silicate minerals with different structures under the action of microorganisms. The results showed that the metabolites produced by an acid producing silicate strain Raoultella sp. Z107 (strain Z107) had a high content of organic acids, among which lactic acid was up to about 11 g/L. Bacillus mucilaginosus 21,699 (strain BM) secreted capsular polysaccharide with a high content of 14.84 mg/L. The metabolic activities of the two strains were significantly different. Through the analysis of the leaching residue, it was found that the lithium silicate minerals were acid etched, interlayer domains expanded, crystallinity decreased, and metal bonds were broken under the action of bacteria. The dissolution of lithium silicate minerals by bacteria is a combination of bacterial adsorption, organic acid corrosion, and complexation of small molecular organic acids and macromolecular polymers with metal ions. The acid erosion and complexation effects of organic acids are greater than the single complexation of capsular polysaccharides, and the layered lepidolite is more likely to be decomposed by the weathering of bacterial metabolites than the chain structure spodumene. These results indicate that the diversity of metabolic activity of bacteria from different sources and the sequence and decomposition mechanism of metal ions released from minerals after lattice destruction are also different. Microorganisms decompose minerals for energy and nutrients, and eventually become the main players in the transformation of elements in biogeology.

Echocardiographic Study of Left Ventricular Pressure-Strain Loop in Evaluating Changes in Left Ventricular Myocardial Work in Breast Cancer Patients After Chemotherapy.

This study aimed to evaluate the changes in the left ventricular (LV) myocardial work (MW) in breast cancer patients following chemotherapy by left ventricular pressure-strain loop (LVPSL).A total of 50 patients with newly breast cancer undergoing postoperative adjuvant chemotherapy containing anthracycline were selected. Echocardiography was performed before the treatment (T0), the second (T2) and fourth (T4) cycles of chemotherapy, and 3 (P3 m) and 6 (P6 m) months after the end of chemotherapy. The standard dynamic images of the required sections were collected. After off-line analysis, the routine, global myocardial strain, and global MW parameters were obtained, and the average regional MW index (RMWI) and regional MW efficiency (RMWE) at three levels of LV were calculated.Compared with those at T0 and T2, the global work index (GWI), global constructive work (GCW), global work efficiency (GWE), and global longitudinal strain (GLS) gradually decreased and global wasted work (GWW) gradually increased at T4, P0, and P6 m. The mean RMWI and RMWE of the three levels of LV exhibited a gradually decreasing trend at T4, P0, and P6 m compared with those at T0 and T2. The GWI, GCW, GWE, mean RMWI, and RMWE (basal, medial, and apical) were negatively correlated with the GLS (r = -0.76, -0.66, -0.67, -0.76, -0.77, -0.66, -0.67, -0.59, and -0.61, respectively), whereas the GWW was positively correlated with the GLS (r = 0.55).The mean RMWI and RMWE are effective parameters to reflect the cardiotoxicity of LV, and LVPSL has certain value in the evaluation of the left ventricular myocardial work (LVMW) during anthracycline treatment and follow-up in breast cancer patients.

3D Single-Layer-Dominated Graphene Foam for High-Resolution Strain Sensing and Self-Monitoring Shape Memory Composite.

Flexible intelligent materials are desired to effectively regulate their own deformation and accurately sense their immediate morphology at the same time. Graphene foam is an attractive material for strain sensing and electrical/thermal performance control due to its outstanding mechanical, electrical, and thermal properties. However, graphene-foam-based materials with both strain sensing and deformation control capabilities are rarely reported. Here, a multiscale design of graphene foam with a single-layer-graphene-dominated microstructure and resilient 3D network architecture, which leads to exceptional strain sensing performance as well as modulation ability of the electrical and thermal conductivity for shape memory polymers, is reported. The graphene foams exhibit a strain detection limit of 0.033%, a rapid response of 53 ms, long-term stability over 10 000 cycles, significant thermoacoustic effect, and great heat-generation and heat-diffusion ability. By combining these advantages, an electro-activated shape-memory composite that is capable of monitoring its own shape state during its morphing process, is demonstrated.

Label compliance for ingredient verification: regulations, approaches, and trends for testing botanical products marketed for "immune health" in the United States.

During the COVID-19 pandemic, the botanical product market saw a consumer interest increase in immune health supplements. While data are currently insufficient to support public health guidance for using foods and dietary supplements to prevent or treat COVID-19 and other immune disorders, consumer surveys indicate that immune support is the second-most cited reason for supplement use in the United States. Meanwhile, consumers showed increased attention to dietary supplement ingredient labels, especially concerning authenticity and ingredient claims. Top-selling botanical ingredients such as elderberry, turmeric, and functional mushrooms have been increasingly marketed toward consumers to promote immune health, but these popular products succumb to adulteration with inaccurate labeling due to the intentional or unintentional addition of lower grade ingredients, non-target plants, and synthetic compounds, partially due to pandemic-related supply chain issues. This review highlights the regulatory requirements and recommendations for analytical approaches, including chromatography, spectroscopy, and DNA approaches for ingredient claim verification. Demonstrating elderberry, turmeric, and functional mushrooms as examples, this review aims to provide industrial professionals and scientists an overview of current United States regulations, testing approaches, and trends for label compliance verification to ensure the safety of botanical products marketed for "immune health."

Laparoscopic duodenum-preserving pancreatic head resection with real-time indocyanine green guidance of different dosage and timing: enhanced safety with visualized biliary duct and its long-term metabolic morbidity.

PURPOSE: Laparoscopic duodenum-preserving pancreatic head resection (L-DPPHR) is technically demanding with extreme difficulty in biliary preservation. Only a few reports of L-DPPHR are available with alarming bile leakage, and none of them revealed the long-term metabolic outcomes. For the first time, our study explored the different dosage and timing of indocyanine green (ICG) for guiding L-DPPHR and described the long-term metabolic results. METHODS: Between October 2015 and January 2021, different dosage and timing of ICG were administrated preoperatively and evaluated intra-operatively using Image J software to calculate the relative fluorescence intensity ratio of signal-to-noise contrast between bile duct and pancreas. Short-term complications and long-term metabolic disorder were collected in a prospectively maintained database and analyzed retrospectively. RESULTS: Twenty-five patients were enrolled without conversion to laparotomy or pancreaticoduodenectomy. Administrating a dosage of 0.5 mg/kg 24 h before the operation had the highest relative fluorescence intensity ratio of 19.3, and it proved to guide the biliary tract the best. Fifty-six percent of patients suffered from postoperative complications with 48% experiencing pancreatic fistula and 4% having bile leakage. No one suffered from the duodenal necrosis, and there was no mortality. When compared with the non-ICG group, the ICG group had a comparable diameter of tumor and similar safety distance from lesions to common bile duct; however, it decreased the incidence of bile leakage from 10% to none. The median length of hospital stay was 16 days. After a median follow-up of 26.6 months, no one had tumor recurrence or refractory cholangitis. No postoperative new onset of diabetes mellitus (pNODM) was observed, while pancreatic exocrine insufficiency (pPEI) and non-alcoholic fatty liver disease (NAFLD) were seen in 4% of patients 12 months after the L-DPPHR. CONCLUSION: L-DPPHR is feasible and safe in selected patients, and real-time ICG imaging with proper dosage and timing may greatly facilitate the identification and the prevention of biliary injury. And it seemed to be oncological equivalent to PD with preservation of metabolic function without refractory cholangitis.

A Particleboard Surface Defect Detection Method Research Based on the Deep Learning Algorithm.

Particleboard surface defects have a significant impact on product quality. A surface defect detection method is essential to enhancing the quality of particleboard because the conventional defect detection method has low accuracy and efficiency. This paper proposes a YOLO v5-Seg-Lab-4 (You Only Look Once v5 Segmentation-Lab-4) model based on deep learning. The model integrates object detection and semantic segmentation, which ensures real-time performance and improves the detection accuracy of the model. Firstly, YOLO v5s is used as the object detection network, and it is added into the SELayer module to improve the adaptability of the model to receptive field. Then, the Seg-Lab v3+ model is designed on the basis of DeepLab v3+. In this model, the object detection network is utilized as the backbone network of feature extraction, and the expansion rate of atrus convolution is reduced to the computational complexity of the model. The channel attention mechanism is added onto the feature fusion module, for the purpose of enhancing the feature characterization capabilities of the network algorithm as well as realizing the rapid and accurate detection of lightweight networks and small objects. Experimental results indicate that the proposed YOLO v5-Seg-Lab-4 model has mAP (Mean Average Precision) and mIoU (Mean Intersection over Union) of 93.20% and 76.63%, with a recognition efficiency of 56.02 fps. Finally, a case study of the Huizhou particleboard factory inspection is carried out to demonstrate the tiny detection accuracy and real-time performance of this proposed method, and the missed detection rate of surface defects of particleboard is less than 1.8%.

Overcoming Tumor Hypoxia through Multiple Pathways Using an All-in-One Polymeric Therapeutic Agent to Enhance Synergistic Cancer Photo/Chemotherapy Effects.

Hypoxia is a significant characteristic of tumors, which causes aggressive tumor growth and strong therapy resistance. Inspired by the improved therapeutic efficacy of synergistic treatment, herein, an all-in-one polymeric therapeutic agent was developed, which could overcome tumor hypoxia through multiple pathways. Multiple therapeutic agents were incorporated into the polymer, including the singlet oxygen (1O2) carrier unit to store cytotoxic reactive oxygen species, the photosensitized and photothermal unit to trigger the capture and release of 1O2, and the hypoxia-responsive prodrug unit to maintain a long-term tumor inhibition. In addition, the hydrophilic polyethylene glycol unit was also introduced to improve water-solubility and biocompatibility. Importantly, this study achieved the capture and controllable release of 1O2 just by regulating the power of an 808 nm laser for the first time, which is more convenient and flexible than previous works. As expected, the as-prepared copolymer displayed reduced oxygen dependence, accompanied with promising synergistic anti-tumor and anti-recurrence efficacies under hypoxic in vitro and in vivo environments. Consequently, this synergistic anti-hypoxia strategy may open up new avenues in the design of all-in-one therapeutic platforms for promoting the development of accurate, efficient, and long-acting treatment in clinical studies.

Comparison of clinical outcomes and quality of life between laparoscopic distal pancreatectomy with or without spleen preservation.

BACKGROUND: The studies comparing laparoscopic spleen-preserving distal pancreatectomy (LSPDP) and laparoscopic distal pancreatosplenectomy (LDPS) are limited. This study aimed to compare clinical outcomes and quality of life of patients undergoing LSPDP and LDPS. METHODS: Between March 2004 and December 2014, patients who underwent laparoscopic distal pancreatectomy were reviewed. Patients were divided into 2 groups as LSPDP and LDPS. Data considered for comparison analysis were patient demographics, intraoperative variables, morbidity, postoperative hospital stay, mortality, pathologic findings, and quality of life (SF-36 questionnaire). RESULTS: A total of 110 patients (50 LSPDP and 60 LDPS) were included in the final analysis. Baseline characteristics were similar in the 2 groups. The LSPDP group had a significantly shorter operative time(153.3 ± 46.2 vs. 179.9 ± 54.1 min, p = 0.015) than the LDPS group. Also in analysis of propensity-matched population(LSPDP:LDPS = 35:35, 1:1 matching), LSPDP group still had a significantly shorter operative time (159.3 ± 36.2 vs. 172.9 ± 44.1 min, p = 0.045) than the LDPS group.There were no significant differences with respect to estimated blood loss, first flatus time, diet start time, and postoperative hospital stay. Postoperative outcomes, including morbidity, pancreatic fistula rates, and mortality, were similar in the LSPDP and LDPS group. On the follow-up survey, the total quality of life score (635.8 ± 50.7 vs. 596.1 ± 92.1)was higher in the LSPDP group compared with the LDPS group. However, the differences were not statistically significant(p > 0.05). The score in vitality (82.5 ± 14.4 vs. 68.9 ± 11.4, p = 0.046) was significantly higher in LSPDP group and not statistically significant in other areas (p > 0.05).Similar results of quality of life assessment were found in analysis of propensity-matched population. CONCLUSIONS: Compared to LDPS, LSPDP had shorter operating time and better quality of life with similar morbidity and recovery period.

Brucella melitensis UGPase inhibits the activation of NF-κB by modulating the ubiquitination of NEMO.

BACKGROUND: UTP-glucose-1-phosphoryl transferase (UGPase) catalyzes the synthesis of UDP-glucose, which is essential for generating the glycogen needed for the synthesis of bacterial lipopolysaccharide (LPS) and capsular polysaccharide, which play important roles in bacterial virulence. However, the molecular function of UGPase in Brucella is still unknown. RESULTS: In this study, the ubiquitination modification of host immune-related protein in cells infected with UGPase-deleted or wild-type Brucella was analyzed using ubiquitination proteomics technology. The ubiquitination modification level and type of NF-κB Essential Modulator (NEMO or Ikbkg), a molecule necessary for NF-κB signal activation, was evaluated using Coimmunoprecipitation, Western blot, and dual-Luciferase Assay. We found 80 ubiquitin proteins were upregulated and 203 ubiquitin proteins were downregulated in cells infected with B. melitensis 16 M compared with those of B. melitensis UGPase-deleted strain (16 M-UGPase-). Moreover, the ubiquitin-modified proteins were mostly enriched in the categories of regulation of kinase/NF-κB signaling and response to a bacterium, suggesting Brucella UGPase inhibits ubiquitin modification of related proteins in the host NF-κB signaling pathway. Further analysis showed that the ubiquitination levels of NEMO K63 (K63-Ub) and Met1 (Met1-Ub) were significantly increased in the 16 M-UGPase--infected cells compared with that of the 16 M-infected cells, further confirming that the ubiquitination levels of NF-κB signaling-related proteins were regulated by the bacterial UGPase. Besides, the expression level of IκBα was decreased, but the level of p-P65 was significantly increased in the 16 M-UGPase--infected cells compared with that of the 16 M- and mock-infected cells, demonstrating that B. melitensis UGPase can significantly inhibit the degradation of IκBα and the phosphorylation of p65, and thus suppressing the NF-κB pathway. CONCLUSIONS: The results of this study showed that Brucella melitensis UGPase inhibits the activation of NF-κB by modulating the ubiquitination of NEMO, which will provide a new scientific basis for the study of immune mechanisms induced by Brucella.

van der Waals force layered multiferroic hybrid perovskite (CH3NH3)2CuCl4 single crystals.

In inorganic-organic perovskites, the three-dimensional arrangement of the organic group results in more subtle balance of charge, spin and space, thereby providing an attractive route toward new multiferroics. Here we report the existing of multiple ferroic orderings in inorganic-organic layered perovskites with relative strong hydrogen bond ordering of the organic chains intra plane. In addition, the inter plane in perovskite is stacking via van der Waals force. However, such magnetoelectric coupling properties for this compound have not been reported since it is difficult to characterize the properties in single crystals since most of the hybrid perovskites are usually deliquescent and unstable when exposed to air. To deal with these problems, we synthesized a (CH3NH3)2CuCl4 single crystal by using a simple evaporation technique, and demonstrated ferroelectric, magnetic and magneto-electric properties of (CH3NH3)2CuCl4. The internal hydrogen bonding of easily tunable organic unit combined with 3d transition-metal layers in such hybrid perovskites make (CH3NH3)2CuCl4 a multiferroic crystal with magnetoelectrical coupling and offer an new way to engineer multifunctional multiferroic.

Laparoscopic pancreaticoduodenectomy versus open pancreaticoduodenectomy for pancreatic ductal adenocarcinoma: oncologic outcomes and long-term survival.

OBJECTIVE: The study aimed to compare the oncologic outcomes and long-term survival of laparoscopic pancreaticoduodenectomy (LPD) and open pancreaticoduodenectomy (OPD) for patients diagnosed with pancreatic ductal adenocarcinoma (PDAC). BACKGROUND: Substantial evidence demonstrated that LPD is technically safe and feasible with perioperative outcomes equivalent to that of OPD. However, for patients with malignancy, especially PDAC, the oncologic outcomes and long-term survival of patients who underwent LPD remains to be elucidated. METHODS: Studies on LPD for the treatment of PDAC published before December 25, 2018 were searched online. The oncologic outcomes (e.g., numbers of lymph nodes retrieved, negative margin (R0) resection), and long-term survival (postoperative survival from 1 to 5 year) of LPD were compared to that of ODP. RESULTS: After screening 1507 studies, six comparative cohort studies, which reported the oncologic outcomes and long-term survival of patients with PDAC were included. No significant difference was found between LPD and OPD regarding lymph nodes harvested (OR 1.96, 95% CI - 1.17 to 5.09, p = 0.22), R0 rate (OR 1.44, 95% CI 1.00 to 2.06, p = 0.05), number of positive lymph nodes (OR - 0.44, 95% CI - 1.06 to 0.17, p = 0.16), rate of adjuvant treatment (OR 1.04, 95% CI 0.68 to 1.59, p = 0.86) and time to adjuvant treatment (OR - 6.21, 95% CI - 16.00 to 3.59, p = 0.21). LPD showed similar 1-year (OR 1.20, 95% CI 0.87 to 1.65, p = 0.28), and 2-year survival (OR 1.25, 95% CI 0.94 to 1.66, p = 0.13) to that of OPD. The 3-year (OR 1.50, 95% CI 1.12 to 2.02, p = 0.007), 4-year (OR 1.73, 95% CI 1.02 to 2.93, p = 0.04), and 5-year survival (OR 2.11, 95% CI 1.35 to 3.31, p = 0.001) were significantly longer in LPD group. CONCLUSION: For the treatment of PDAC, the oncologic outcomes of LPD were equivalent to that of OPD; LPD seemed promising regarding the postoperative long-term survival.

Short- and Long-Term Outcomes of Laparoscopic Organ-Sparing Resection for Pancreatic Neuroendocrine Neoplasms.

BACKGROUND: Pancreatic neuroendocrine neoplasms (PNENs) are rare neoplasms associated with a long life expectancy after resection. In this setting, patients may benefit from laparoscopic organ-sparing resection. Studies of laparoscopic organ-sparing resection for PNENs are limited. The aim of this study was to evaluate the short- and long-term outcomes of laparoscopic organ-sparing resection for PNENs. METHODS: A retrospective study was performed for patients with PNENs who underwent laparoscopic organ-sparing pancreatectomy between March 2005 and May 2018. The patients' demographic data, operative results, pathological reports, hospital courses and morbidity, mortality, and follow-up data (until August 2018) were analysed. RESULTS: Thirty-five patients were included in the final analysis. There were 9 male and 26 female patients, with a median age of 46 years (range 25-75 years). The mean BMI was 24.6 ± 3.3 kg/m2. Nine patients received laparoscopic enucleation (LE), 20 received laparoscopic spleen-preserving distal pancreatectomy (LSPDP), and 6 received laparoscopic central pancreatectomy. The operative time, intraoperative blood loss, transfusion rate, and postoperative hospital stay were 186.4 ± 60.2 min, 165 ± 73.0 ml, 0 days, and 9 days (range 5-23 days), respectively. The morbidity rate, grade ≥ III complication rate, and grade ≥ B pancreatic fistula rate were 34.2%, 11.4%, and 8.7%, respectively, with no mortality. The rate of follow-up was 94.3%, and the median follow-up time was 55 months (range 3-158 months). One patient developed recurrence 36 months after LE and was managed with surgical resection. The other patients survived without metastases or recurrence during the follow-up. One patient had diabetes after LSPDP, and no patients had symptoms of pancreatic exocrine insufficiency. Nineteen patients who underwent LSPDP (16 with the Kimura technique and 3 with the Warshaw technique) were followed. Normal patency of the splenic artery and vein was observed in 14 and 14 patients within 1 month of surgery and in 15 and 14 patients 6 months or more after the operation, respectively. Partial splenic infarction was observed in 3 patients within 1 month of surgery and in no patients 6 months or more after the operation. Three patients eventually developed collateral venous vessels around the gastric fundus and reserved spleen, with one case of variceal bleeding. CONCLUSIONS: Laparoscopic organ-sparing resection for selected cases of PNENs is safe and feasible and has favourable short- and long-term outcomes.