Risk factors for anastomotic fistula development after radical colon cancer surgery and their impact on prognosis.

BACKGROUND: Colon cancer is a common malignant tumor in the gastrointestinal tract that is typically treated surgically. However, postradical surgery is prone to complications such as anastomotic fistulas. AIM: To investigate the risk factors for postoperative anastomotic fistulas and their impact on the prognosis of patients with colon cancer. METHODS: We conducted a retrospective analysis of 488 patients with colon cancer who underwent radical surgery. This study was performed between April 2016 and April 2019 at a tertiary hospital in Wuxi, Jiangsu Province, China. A t-test was used to compare laboratory indicators between patients with and those without postoperative anastomotic fistulas. Multiple logistic regression analysis was performed to identify independent risk factors for postoperative anastomotic fistulas. The Functional Assessment of Cancer Therapy-Colorectal Cancer was also used to assess postoperative recovery. RESULTS: Binary logistic regression analysis revealed that age [odds ratio (OR) = 1.043, P = 0.015], tumor, node, metastasis stage (OR = 2.337, P = 0.041), and surgical procedure were independent risk factors for postoperative anastomotic fistulas. Multiple linear regression analysis showed that the development of postoperative anastomotic fistula (P = 0.000), advanced age (P = 0.003), and the presence of diabetes mellitus (P = 0.015), among other factors, independently affected prognosis. CONCLUSION: Postoperative anastomotic fistulas significantly affect prognosis and survival rates. Therefore, focusing on the clinical characteristics and risk factors and immediately implementing individualized preventive measures are important to minimize their occurrence.

A Systematic Review and Meta-analysis of the Therapeutic Effect of Acupuncture on Migraine.

Background: Migraine is an intractable headache disorder, manifesting as periodic attacks. It is highly burdensome for patients and society. Acupuncture treatment can be beneficial as a supplementary and preventive therapy for migraine. Objectives: This systematic review and meta-analysis aimed to investigate the efficacy and safety of acupuncture for migraine, and to examine transcranial doppler changes after acupuncture. Methods: Reports, conference, and academic papers published before March 15, 2019 in databases including PubMed, Cochrane library, Embase, China National Knowledge Infrastructure, WANFANG Database, Chinese journal of Science and Technology, and China Biomedical were searched. Randomized controlled trials (RCTs) involving acupuncture, sham acupuncture, and medication in migraine were included. The Cochrane Collaboration software, RevMan 5.3, was used for data processing and migration risk analysis. Results: Twenty-eight RCTs were included. 15 RCTs included medication only, 10 RCTs included sham acupuncture only, and 3 RCTs included both. The study included 2874 patients, split into 3 groups: acupuncture treatment group (n = 1396), medication control group (n = 865), and sham acupuncture control group (n = 613). The results showed that treatment was more effective in the acupuncture group than in the sham acupuncture group (MD = 1.88, 95% CI [1.61, 2.20], P < 0.00001) and medication group (MD = 1.16, 95% CI [1.12, 1.21], P < 0.00001). Improvement in visual analog scale (VAS) score was greater in the acupuncture group than in the sham acupuncture group (MD = -1.00, 95% CI [-1.27,-0.46], P < 0.00001; MD = -0.59, 95% CI [-0.81,-0.38], P < 0.00001), and their adverse reaction rate was lower than that of the medication group (RR = 0.16, 95% CI [0.05, 0.52], P = 0.002). The improvement of intracranial blood flow velocity by acupuncture is better than that by medication, but the heterogeneity makes the result unreliable. Conclusions: Acupuncture reduced the frequency of migraine attacks, lowered VAS scores, and increased therapeutic efficiency compared with sham acupuncture. Compared with medication, acupuncture showed higher effectiveness with less adverse reactions and improved intracranial blood circulation. However, owing to inter-study heterogeneity, a prospective, multicenter RCT with a large sample is required to verify these results.

Broad dual-band asymmetric transmission of circular polarized waves in near-infrared communication band.

In this paper, a three-layered chiral metamaterial is proposed to achieve broad dual-band and high magnitude asymmetric transmission (AT) in near-infrared communication band for circularly polarized waves. The asymmetric parameter reaches to 0.9/0.86 at 174/235 THz, over 0.6 in broad dual bands from 160 to 183 THz and from 220 to 245 THz. Remarkably, the AT effect of circularly and linearly polarized waves can be modulated to appear or vanish with variants of the G shapes that has not been found in previous reports. The proposed structure shows great potential applications in high performance multi-band circular and linear polarizers.

HER-2, ER, PR status concordance in primary breast cancer and corresponding metastatic lesion in lymph node in Chinese women.

AIMS AND BACKGROUND: To compare the expression of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER-2) in the primary site and the metastatic lesion of lymph nodes in invasive breast cancer for investigating whether the expression of these biomarkers in the primary site could act as a surrogate to the lymphatic metastatic lesion in the same patient. METHODS: In lymphatic metastatic lesion and corresponding primary lesion of 107 cases of invasive breast cancer, ER and PR statuses were assessed by immunohistochemistry (IHC). HER-2 expression level was evaluated by IHC and/or fluorescence in situ hybridization (FISH). RESULTS: In the primary lesions, 43.9% were ER positive; 46.7% were PR positive; 34.6% were HER-2 positive. In corresponding lymphatic metastatic lesions, the HER-2 status was concordant in 90 patients; 9 patients were diagnosed positive in metastatic lesion while negative in primary lesion; 8 patients were negative in metastatic lesion while positive in primary site (agreement, 84.1%; κ=0.647). A change in ER status was observed in 24 cases: 17 cases positive in metastatic site while negative in primary site; 7 cases negative in metastatic site while positive in primary site (agreement, 77.6%; κ=0.534). PR status discordance between the primary lesion and the metastatic regional lymph nodes was reported in 19 cases (agreement, 82.2%; κ=0.640). CONCLUSIONS: This study revealed that there was only a moderate concordance of ER, PR and HER-2 status between primary tumors and metastatic lymph nodes. These results indicate that it was inappropriate to predict the status of ER, PR and HER-2 in metastatic lymph nodes based on the results of evaluation of that in primary lesions.

Enhanced asymmetric transmission due to Fabry-Perot-like cavity.

In this paper, a three layered metamaterial composed of a ring-chain structure sandwiched between two layers of twisted sub-wavelength cut-wire arrays is proposed and investigated. The designed structure is optimized such that asymmetric transmission with an extremely broad bandwidth, sharp rejection stop-band and high transmittance is achieved. The physical mechanism is accounted for that the metallic layers form the Fabry-Perot-like resonance cavity, enhancing the polarization conversion efficiency between two orthogonal linearly polarized waves. To some extent, this approach offers a way to strengthen asymmetric transmission effect.

[Enhancing the attendance rate of psychiatric day care patients].

BACKGROUND & PROBLEMS: Attending rehabilitation programs at psychiatric daycare wards has been shown to stabilize psychiatric patients' daily routines, reduce patient symptoms, and help them regain social functions. Non-attendance increases risks of patient decompensation and return to the inpatient unit, which reduces quality of care and increases medical costs. The attendance rate for psychiatric daycare patients at our hospital was 73%. To maximize rehabilitation and treatment success, we developed a special project to raise patient program-attendance motivation. PURPOSE: This study aimed to enhance the attendance rate of our psychiatric day care patients to improve patient independence and their capacity to return to the community. RESOLUTION: Methods used included rehabilitation game cards, holding medication educational workshops, utilizing reward systems, making attendance passports, and designing activity booklets. RESULTS: The attendance rate of psychiatric day care patients rose from 73% to 89%, a 16% increase. CONCLUSION: This program not only increased the attendance rate of psychiatric day care patients but also improved communications between professional care staff and patient family members. In addition, this program strengthened daycare ward staff teamwork, which further enhanced treatment quality. We suggest considering rehabilitation program attendance as an important ward quality control criterion to assess and improve treatment and nursing care quality.

Performance evaluation of knowledge management among hospital employees.

PURPOSE: The purpose of this study is to investigate the cognition of knowledge management (KM) among hospital employees and the relationship between KM and the KM enabler activities (financial, customer, internal business processes, learning and growth) in a regional hospital in Taiwan. DESIGN/METHODOLOGY/APPROACH: Both qualitative and quantitative research were used in this study. The instrument was conducted using in-depth interviews of three policy-makers as participants. The quantitative data were collected from a regional hospital in the Northern part of Taiwan with a 77 percent effective response rate (n=154). FINDINGS: The findings in this paper indicate that the cognition and demand for KM in subordinates is close to the expectations of policy-makers. The policy-makers expect subordinates working in the hospital to be brave in taking on new responsibilities and complying with hospital operation norms. KM is emphasized as a powerful and positive asset. Moreover, understanding KM predicts good performance in an organization. RESEARCH LIMITATIONS/IMPLICATIONS: The findings in this paper can be generalized to other regional hospitals. The findings may be applied to a wider population. PRACTICAL IMPLICATIONS: This study can provide insights into the perceptions and cognitions of workers in a hospital about KM and the activities of KM enablers. The responses and perceptions observed in the interviews in this study, as well as the quantitative research results could be useful to other hospitals and individuals who engage KM as a new management trend. ORIGINALITY/VALUE: This study suggested KM guidelines for policy-makers who are experienced managers.

Down-regulated miRNA-214 induces a cell cycle G1 arrest in gastric cancer cells by up-regulating the PTEN protein.

To detect the expression of miRNA-214 in human gastric cancer cell lines of BGC823, MKN45 and SGC7901, and to identify the effect of miRNA-214 on cell cycle and apoptosis of these cells. Expression of miRNA-214 in human normal gastric mucosal cell line GES-1 and human gastric cancer cell lines was detected by real-time reverse-transcription polymerase chain reaction. Antisense-miRNA-214 oligonucleotides were transfected transiently into gastric cancer cell lines to down-regulate the expression of miRNA-214. The cell cycle and apoptosis were studied by flow cytometry assay. PTEN, one of the target genes of miRNA-214 was detected by using of immunocytochemistry and Western blotting. MiRNA-214 was overexpressed in gastric cancer cell lines of BGC823, MKN45 and SGC7901 compared with normal gastric mucosal cell line GES-1. Antisense-miRNA-214 oligonucleotides significantly down-regulated the expression of miRNA-214, and increased the portion of G1-phase and decreased the portion of S-phase in BGC823 and MKN45 cells. The immunocytochemistry test and Western blotting analysis showed that the down-regulation of miRNA-214 could significantly up-regulate the expression of PTEN in BGC823 and MKN45 cells. MiRNA-214 is overexpressed in human gastric cancer cell lines of BGC823, MKN45 and SGC7901. The down-regulation of miRNA-214 could induce a G1 cell cycle arrest in them, the up-regulation of PTEN maybe one of the mechanism.

Optimization of immobilization for selective oxidation of benzyl alcohol by Gluconobacter oxydans using response surface methodology.

This study used the Box-Behnken design and response surface methodology to optimize immobilization of Gluconobacter oxydans in Ca-alginate gel for the production of benzaldehyde in a biphasic system. Immobilization parameters, such as Na-alginate concentration, cell load, and bead diameter, were optimized. The mathematical model developed was validated and proven to be statistically adequate and accurate in predicting the response. For both activity and stability responses, the best results were achieved at alginate concentration of 2.55% (w/v), cell load of 49.26 mg/ml, and 2.2 mm bead diameter. Under these conditions, retention activity of 87.6% could be attained for the immobilized cell. In addition, the oxidative activity of immobilized cells was retained at 53.2% compared with that of free cells after 10 repeated batch reactions, while only 15.7% of activity remained in free cells.