Efficacy and Perioperative Safety of Robot-Assisted Minimally Invasive Esophagectomy for Esophageal Cancer.

Background: Esophageal cancer (EC) remains a significant global health concern. Minimally invasive surgical techniques, including robot-assisted approaches, have emerged as promising options for improving outcomes and patient recovery in EC management. Objective: This study aims to evaluate the clinical utility of robot-assisted minimally invasive esophagectomy (RAMIE) in the treatment of EC. Methods: A total of 160 EC patients undergoing treatment at our hospital were included in this study. Patients were randomly assigned to either the research group, receiving RAMIE, or the control group, undergoing thoracoscopic minimally invasive esophagectomy (MIE). Surgical outcomes, postoperative recovery, complication rates, and changes in inflammatory factors (IFs) such as malondialdehyde (MDA), superoxide dismutase (SOD), and glutathione peroxidase (GSH-Px) levels were compared between the two groups. Additionally, prognostic survival and EC recurrence rates were assessed at a 1-year follow-up. Results: The research group demonstrated longer operative times, a higher number of dissected lymph nodes, reduced intraoperative bleeding, and quicker postoperative recovery compared to the control group, with significantly fewer complications (P < .05). Furthermore, the research group exhibited lower levels of postoperative IFs and MDA, along with higher levels of SOD and GSH-Px, compared to the control group (P < .05). There was no significant difference between the two groups in terms of prognostic survival and EC recurrence rates (P > .05). Conclusion: RAMIE demonstrates superior efficacy in enhancing therapeutic outcomes and accelerating postoperative recovery in patients with EC, thus establishing its value in EC treatment protocols. RAMIE is suggested as a valuable therapeutic option and warrants clinical adoption for EC management.

Lensless computationally defined confocal incoherent imaging with a Fresnel zone plane as coded aperture.

We present a Fresnel zone plate (FZP) mask-based system for single-shot lensless confocal imaging. The system uses an FZP as coded aperture, which allows each point source to cast a unique pattern onto the sensor, representing their horizontal and axial positions. This results in a 2D sensor measurement comprising a series of FZP patterns, which records the spatial intensity distribution of the incoherent illuminant. The reconstruction process is facilitated by an algorithm based on compress sensing (CS) theory and the use of the nuclear norm of gradient scanning and hologram segmentation technology for autofocusing. The simulative and experimental results of this study align well with the expectation that every layered scene can be accurately recovered at the corresponding depth, without undesirable signals from other layers. Additionally, we analyze the deviation of the reconstruction results in the experiment, which emphasizes the need to consider the thickness of the FZP for a precise forward propagation model.

Analogical Assessment of Train-Induced Vibration and Radiated Noise in a Proposed Theater.

This study presents the analogical assessment of the train-induced vibration and radiated noise in a proposed theater. The theater is to be constructed in a region with crowded metro lines, and the assessment is implemented in an analogical building with comparable structural type and metro condition. Prior to the assessment, the comparability of the analogical building with the theater is validated using the train-induced ground vibration. With the same horizontal distance from the metro line, the train-induced vibration level in the analogical building is 9 dB higher than that in the construction site of the theater. Such results indicate that the lack of soil layers may lead to a dramatic increase in train-induced vibration in the building. In the staircase of the analogical building, the train-induced radiated noise reached 55 dB (A), which is 10 dB (A) higher than the daytime allowable level. As the most important indicator, the noise rating number in the cinema of the analogical building is NR-43, which put forward an enormous challenge on the construction of the theater with a denoise demand of 23 dB. The analogical method applied in this study provides an effective and practical way for the assessment of train-induced vibration and radiated noise in proposed vibration-sensitive buildings. The assessment results that provide necessary reference and support for the anti-vibration design will help guarantee the stage effect of the theater.

Long noncoding RNA HOTAIR facilitates pulmonary vascular endothelial cell apoptosis via DNMT1 mediated hypermethylation of Bcl-2 promoter in COPD.

BACKGROUND: To study the regulatory effect of Long non-coding RNA (LncRNA) HOX transcript antisense RNA (HOTAIR) on pulmonary vascular endothelial cell (HPVEC) apoptosis and determine whether the HOTAIR facilitate HPVEC apoptosis via DNMT1 mediated hypermethylation of Bcl-2 promoter in chronic obstructive pulmonary disease (COPD). METHODS: LncRNA array was used to measure the differentially expressed lncRNAs in COPD and non-COPD lung tissues. Expression of HOTAIR in COPD patient lungs and cigarette smoke extract (CSE)-induced HPVEC was assessed by qRT-PCR. The location of HOTAIR was determined in COPD patient lungs and HPVEC by RNA in situ hybridization (RNA-ISH). The emphysema mouse model and HOTAIR knockdown mice were each established by inhaling cigarette smoke or intratracheal lentiviral vectors instillation. The dysregulation of DNA methyltransferase enzyme 1 (DNMT1), B-cell lymphoma-2 (Bcl-2), Bcl-2-associated X protein (Bax) and Cleaved-caspase 3 protein expression were detected by Western blotting. HOTAIR, DNMT1, Bcl-2 and Bax mRNA expression were measured by quantitative real-time polymerase chain reaction. TUNEL (terminal deoxynucleotidyl transferase dUTP nick end labeling) assays were used to assess apoptotic ratio in mice and CSE-induced HPVEC. Methylation-specific PCR (MSP) assay was conducted to observe the alterations in the methylation of the Bcl-2 promoter in specimens. RNA pull-down assay was used for analysis of the correlation between HOTAIR and DNMT1. RESULTS: The expression levels of the HOTAIR were up-regulated in COPD patient lungs and CSE-induced HPVEC. HPVEC apoptosis with down-regulated Bcl-2 expression, increased promoter methylation, DNMT1, Bax and Cleaved-caspase 3 expression was found in emphysema mouse model and CSE-induced HPVEC. Knockdown HOTAIR can attenuate cell apoptosis and emphysema via DNMT1 mediated hypermethylation of Bcl-2 promoter in mice. In vitro, HOTAIR can aggravate the apoptosis of CSE-exposed HPVEC. DNMT1 was a target of HOTAIR and had a positive correlation with HOTAIR. CONCLUSION: HOTAIR facilitates HPVEC apoptosis via DNMT1 mediated hypermethylation of Bcl-2 promoter in COPD, and attenuating the expression of HOTAIR may be a new therapy to prevent COPD.

First Indirect Drive Experiment Using a Six-Cylinder-Port Hohlraum.

The new hohlraum experimental platform and the quasi-3D simulation model are developed to enable the study of the indirect drive experiment using the six-cylinder-port hohlraum for the first time. It is also the first implosion experiment for the six laser-entrance-hole hohlraum to effectively use all the laser beams of the laser facility that is primarily designed for the cylindrical hohlraum. The experiments performed at the 100 kJ Laser Facility produce a peak hohlraum radiation temperature of ∼222 eV for ∼80 kJ and 2 ns square laser pulse. The inferred x-ray conversion efficiency η∼87% is similar to the cylindrical hohlraum and higher than the octahedral spherical hohlraum at the same laser facility, while the low laser backscatter is similar to the outer cone of the cylindrical hohlraum. The hohlraum radiation temperature and M-band (>1.6 keV) flux can be well reproduced by the quasi-3D simulation. The variations of the yield-over-clean and the hot spot shape can also be semiquantitatively explained by the calculated major radiation asymmetry of the quasi-3D simulation. Our work demonstrates the capability for the study of the indirect drive with the six-cylinder-port hohlraum at the cylindrically configured laser facility, which is essential for numerically assessing the laser energy required by the ignition-scale six-cylinder-port hohlraum.

The role of cigarette smoke-induced pulmonary vascular endothelial cell apoptosis in COPD.

Chronic obstructive pulmonary disease (COPD) is one of the most common chronic respiratory diseases with high morbidity and mortality. It has become the fifth most burdened and the third most deadly disease in the global economy and increases year by year. The prevention and treatment of COPD are urgent. Smoking is the main and most common risk factor for COPD. Cigarette smoke (CS) contains a large number of toxic substances, can cause a series of changes in the trachea, lung tissue, pulmonary blood vessels, and promotes the occurrence and development of COPD. In recent years, the development of epigenetics and molecular biology have provided new guidance for revealing the pathogenesis, diagnosis, and treatment of diseases. The latest research indicates that pulmonary vascular endothelial cell apoptosis initiates and participates in the pathogenesis of COPD. In this review, we summarize the current research on the epigenetic mechanisms and molecular biology of CS-induced pulmonary vascular endothelial cell apoptosis in COPD, providing a new research direction for pathogenesis of COPD and a new target for the diagnosis, treatment, and prevention of COPD.

Resveratrol attenuates cigarette smoke induced endothelial apoptosis by activating Notch1 signaling mediated autophagy.

BACKGROUND: Increasing evidence shows that endothelial apoptosis contributes to cigarette smoke (CS)-induced disease progression, such as chronic obstructive pulmonary disease (COPD). Our previous studies have validated Notch1 as an anti-apoptotic signaling in CS-induced endothelial apoptosis. Resveratrol (RESV) is a naturally occurring polyphenol that exhibits an anti-apoptotic activity in endothelial cells that exposed to many kinds of destructive stimulus. However, the effects of resveratrol on Notch1 signaling in CS-induced endothelial apoptosis have not yet been fully elucidated. Therefore, the aim of this study was to examine whether RESV can protect endothelial cells from CS-induced apoptosis via regulating Notch1 signaling. METHODS: Human umbilical vein endothelial cells (HUVECs) were pretreated with RESV for 2 h, followed by cotreatment with 2.5%CSE for 24 h to explore the role of RESV in CSE induced endothelial apoptosis. 3-methyladenine (3-MA) or rapamycin was used to alter autophagic levels. Lentivirus Notch1 intracellular domain (LV-N1ICD), γ-secretase inhibitor (DAPT) and Notch1 siRNA were used to change Notch1 expression. The expression of Notch1, autophagic and apoptotic markers were examined by Western blot and the apoptosis rate was detected by Flow cytometry analysis. RESULTS: Our results showed that activating autophagy reduced CSE-induced endothelial apoptosis, while blocking autophagy promoted cell apoptosis in HUVECs. RESV pretreatment attenuated the CSE-induced endothelial apoptosis and activated Notch1 signaling. RESV pretreatment also increased LC3b-II and Beclin1 production, decreased p62 and mTOR expression. 3-MA treatment inhibited autophagy and aggravated CSE induced apoptosis, while rapamycin promoted autophagy, led to a decrease in cell apoptosis. LV-N1ICD transfection upregulated autophagy and reduced apoptosis. However, this protective effect was abolished by 3-MA treatment. In cells treated with DAPT or Notch1 siRNA, autophagy was decreased, while apoptosis was increased. RESV partly rescued the DAPT or Notch1 siRNA induced apoptosis by activating Notch1 signaling. CONCLUSION: In HUVECs, RESV attenuates CSE induced endothelial apoptosis by inducing autophagy in a Notch1-dependent manner.

First Inertial Confinement Fusion Implosion Experiment in Octahedral Spherical Hohlraum.

In inertial confinement approaches to fusion, the asymmetry of target implosion is a major obstacle to achieving high gain in the laboratory. A recently proposed octahedral spherical hohlraum makes it possible to naturally create spherical target irradiation without supplementary symmetry control. Before any decision is made to pursue an ignition-scale laser system based on the octahedral hohlraum, one needs to test the concept with the existing facilities. Here, we report a proof-of-concept experiment for the novel octahedral hohlraum geometry on the cylindrically configured SGIII laser facility without a symmetry control. All polar and equatorial self-emission images of the compressed target show a near round shape of convergence ratio 15 under both square and shaped laser pulses. The observed implosion performances agree well with the ideal spherical implosion simulation. It also shows limitations with using the existing facilities and adds further weight to the need to move to a spherical port geometry for future ignition laser facilities.

C-Reactive Protein to Serum Albumin Ratio as a Novel Biomarker to Predict Prognosis in Patients with Chronic Obstructive Pulmonary Disease.

BACKGROUND: This study aimed to evaluate the C-reactive protein to serum albumin ratio (CAR) to predict prognosis in COPD patients with acute exacerbations (AECOPD). METHODS: A retrospective cohort study of AECOPD patients, admitted to a large tertiary hospital between January 2017 and June 2018, was conducted. Univariate and multivariate logistic regression models were built to assess the relationship between variables and different clinical outcomes in one-year follow up. In addition, Kaplan-Meier method was used to estimate the relationship between CAR and the time to first rehospitalization due to acute exacerbation of COPD. RESULTS: A total of 167 AECOPD patients were included in this study, with an overall age of 68.5 ± 9.4 years. Both univariate and multivariate logistic regression analysis demonstrated that CAR at admission was significantly associated with rehospitalization and frequent exacerbations in COPD patients (p < 0.05). Kaplan-Meier curve showed that the rehospitalization event-free rate was significantly higher in the low CAR group than the high CAR group (p < 0.01). CONCLUSIONS: As an easily available parameter, CAR at admission can be an independent predictor for rehospitalization and frequent exacerbations in COPD patients with acute exacerbations.

Modulation on tetrodotoxin-resistant sodium current of loureirin B in rat dorsal root ganglion neurons via cyclic AMP-dependent protein kinase A.

To search the modulation mechanism of loureirin B, a flavonoid is extracted from Dracaena cochinchinensis, on tetrodotoxin-resistant (TTX-R) sodium channel in dorsal root ganglion (DRG) neurons of rats. Experiments were carried out based on patch-clamp technique and molecular biological methods. We observed the time-dependent inhibition of loureirin B on TTX-R sodium currents in DRG neurons and found that neither occupancy theory nor rate theory could well explain the time-dependent inhibitory effect of loureirin B on TTX-R sodium currents. It suggested that a second messenger-mediated signaling pathway may be involved in the modulation mechanism. So the cyclin AMP (cAMP) level of the DRG neurons before and after incubation with loureirin B was tested by ELISA Kit. Results showed that loureirin B could increase the cAMP level and the increased cAMP was caused by the enhancement of adenylate cyclase (AC) induced by loureirin B. Immunolabelling experiments further confirmed that loureirin B can promote the production of PKA in DRG neurons. In the presence of the PKA inhibitor H-89, the inhibitory effect of loureirin B on TTX-R sodium currents was reversed. Forskolin, a tool in biochemistry to raise the levels of cAMP, also could reduce TTX-R sodium currents similar to that of loureirin B. These studies demonstrated that loureirin B can modulate the TTX-R sodium channel in DRG neurons via an AC/cAMP/PKA pathway involving the activation of AC and PKA, which also can be used to explain the other pharmacological effects of loureirin B.

The relationship between inflammation and neurocognitive dysfunction in obstructive sleep apnea syndrome.

Obstructive sleep apnea syndrome (OSAS), a state of sleep disorder, is characterized by repetitive apnea, chronic hypoxia, oxygen desaturation, and hypercapnia. Previous studies have revealed that intermittent hypoxia (IH) conditions in OSAS patients elicited neuron injury (especially in the hippocampus and cortex), leading to cognitive dysfunction, a significant and extraordinary complication of OSAS patients. The repeated courses of airway collapse and obstruction in OSAS patients resulted in apnea and arousal during sleep, leading to IH and excessive daytime sleepiness (EDS) and subsequently contributing to the development of inflammation. IH-mediated inflammation could further trigger various types of cognitive dysfunction. Many researchers have found that, besides continuous positive airway pressure (CPAP) treatment and surgery, anti-inflammatory substances might alleviate IH-induced neurocognitive dysfunction. Clarifying the role of inflammation in IH-mediated cognitive impairment is crucial for potentially valuable therapies and future research in the related domain. The objective of this article was to critically review the relationship between inflammation and cognitive deficits in OSAS.

MBS Vehicle-Crossing Model for Crossing Structural Health Monitoring.

This paper presents the development of a multi-body system (MBS) vehicle-crossing model and its application in the structural health monitoring (SHM) of railway crossings. The vehicle and track configurations in the model were adjusted to best match the real-life situation. By using the measurement results obtained from an instrumented crossing and the simulation results from a finite element (FE) model, the MBS model was validated and verified. The results showed that the main outputs of the MBS model correlated reasonably well with those from both the measurements and the FE model. The MBS and FE models formed the basis of an integrated analysis tool, which can be applied to thoroughly study the performance of railway crossings. As part of the SHM system for railway crossings developed at Delft University of Technology, the MBS model was applied to identify the condition stage of a monitored railway crossing. The numerical results confirmed the highly degraded crossing condition. By using the measured degradation as the input in the MBS model, the primary damage sources were further verified. Through identifying the crossing condition stage and verifying the damage source, necessary and timely maintenance can be planned. These actions will help to avoid crossing failure and unexpected traffic interruptions, which will ultimately lead to sustainable railway infrastructure.

Train Hunting Related Fast Degradation of a Railway Crossing-Condition Monitoring and Numerical Verification.

This paper presents the investigation of the root causes of the fast degradation of a railway crossing. The dynamic performance of the crossing was assessed using the sensor-based crossing instrumentation, and the measurement results were verified using the multi-body system (MBS) vehicle-crossing model. Together with the field inspections, the measurement and simulation results indicate that the fast crossing degradation was caused by the high wheel-rail impact forces related to the hunting motion of the passing trains. Additionally, it was shown that the train hunting was activated by the track geometry misalignment in front of the crossing. The obtained results have not only explained the extreme values in the measured responses, but also shown that crossing degradation is not always caused by the problems in the crossing itself, but can also be caused by problems in the adjacent track structures. The findings of this study were implemented in the condition monitoring system for railway crossings, using which timely and correctly aimed maintenance actions can be performed.

Treatment outcomes of tuberculous meningitis in adults: a systematic review and meta-analysis.

BACKGROUND: Tuberculous meningitis is the most devastating presentation of disease with Mycobacterium tuberculosis. We sought to evaluate treatment outcomes for adult patients with this disease. METHODS: The Ovid MEDLINE, EMBASE, Cochrane Library and Web of Science databases were searched to identify all relevant studies. We pooled appropriate data to estimate treatment outcomes at the end of treatment and follow-up. RESULTS: Among the articles identified, 22 met our inclusion criteria, with 2437 patients. In a pooled analysis, the risk of death was 24.7% (95%CI: 18.7-31.9). The risk of neurological sequelae among survivors was 50.9% (95%CI: 40.2-61.5). Patients diagnosed in stage III or human immunodeficiency virus (HIV) positive were significantly more likely to die (64.8, 53.4% respectively) during treatment. The frequency of cerebrospinal fluid (CSF) acid-fast-bacilli smear positivity was 10.0% (95% CI 5.5-17.6), 23.8% (15.2-35.3) for CSF culture positivity, and 22.3% (17.8-27.5) for CSF polymerase chain reaction positivity. We found that the headache, fever, vomiting, and abnormal chest radiograph were the most common symptoms and diagnostic findings among tuberculous meningitis patients. CONCLUSIONS: Despite anti-tuberculosis treatment, adult tuberculous meningitis has very poor outcomes. The mortality rate of patients diagnosed in stage III or HIV co-infection increased significantly during treatment.

Inhibition on acid-sensing ion channels and analgesic activities of flavonoids isolated from dragon's blood resin.

Acid-sensing ion channel (ASIC) serves important roles in the transmission of nociceptive information. To confirm the analgesic mechanism of dragon's blood resin, patch-clamp technique, in vivo animal experiments, and immunohistochemical staining were used to observe the effects of the three flavonoids (loureirin B, cochinchinemin A, and cochinchinemin B) isolated from dragon's blood resin on ASIC. Results showed that the three flavonoids exerted various inhibitory effects on ASIC currents in rat dorsal root ganglion (DRG) neurons. The combination of the three flavonoids with total concentration of 6.5 µM could decrease (53.8 ± 4.3%) of the peak amplitude and (45.8 ± 4.5%) of the sustained portion of ASIC currents. The combination of the three flavonoids was fully efficacious on complete Freud's adjuvant (CFA)-induced inflammatory thermal hyperalgesia at a dose of 6.5 mM similar with amiloride at 10 mM. The analgesic effects of the combination could be weakened by an ASIC activator 2-guanidine-4-methylquinazoline. CFA-induced hyperalgesia was accompanied by c-Fos up-regulation in DRG neurons, and the combination rescued thermal hyperalgesia through down-regulation of c-Fos and ASIC3 expression in CFA-induced inflammation. These collective results suggested that the flavonoids isolated from dragon's blood resin could be considered as the chemical compounds that exert analgesic effects on inflammatory thermal pain due to action on ASIC.

Optical control of spectral diffusion with single InAs quantum dots in a silver-embedded nanocone.

We study the spectral diffusion in a single epitaxial InAs quantum dot placed in a silver-embedded nanocone structure. Making use of a series of stroboscopic detection of optical transitions, we demonstrate the temporal fluctuations in peak energy of photoluminescence. In particular, the photoluminescence fluctuations can be effectively suppressed by strong illumination. By analyzing the photon statistics, we find that the dot emission exhibits stable non-classical nature with the strong anti-bunching behavior after this stabilization.

Merging Photoredox with Brønsted Acid Catalysis: The Cross-Dehydrogenative C-O Coupling for sp3 C-H Bond Peroxidation.

A photoredox and Brønsted acid synergistically catalyzed cross-dehydrogenative C-O coupling reaction is developed in which isochroman peroxyacetals are formed through sp3 C-H bond peroxidation. The reported method is characterized by its extremely mild reaction conditions, excellent yields, and broad substrate scope. An oxocarbenium ion p-chlorobenzenesulfonate was speculated to be the reactive intermediate. The role of hemiacetals and oxygenated dimers on the effective stabilization of the oxocarbenium ion was investigated; the presence of acid appeared to establish equilibrium between hemiacetals and oxygenated dimers with the oxocarbenium ion pairs. The broad applicability of the method highlights the potential of the protocol for molecule synthesis.

Subclinical highly pathogenic avian influenza virus infection among vaccinated chickens, China.

Subclinical infection of vaccinated chickens with a highly pathogenic avian influenza A(H5N2) virus was identified through routine surveillance in China. Investigation suggested that the virus has evolved into multiple genotypes. To better control transmission of the virus, we recommend a strengthened program of education, biosecurity, rapid diagnostics, surveillance, and elimination of infected poultry.

[Retracted] AdipoR1­mediated miR­3908 inhibits glioblastoma tumorigenicity through downregulation of STAT2 associated with the AMPK/SIRT1 pathway.

Following the publication of this paper, it was drawn to the Editor's attention by a concerned reader that certain of the western blotting data shown in Figs. 3B and 9, and the migration assay data shown in Fig. 6C, were strikingly similar to data that had already appeared in other publications written by different authors at different research institutes. Owing to the fact that the contentious data in the above article had already been published prior to its submission to Oncology Reports, the Editor has decided that this paper should be retracted from the Journal. The authors were asked for an explanation to account for these concerns, but the Editorial Office did not receive a reply. The Editor apologizes to the readership for any inconvenience caused. [Oncology Reports 37: 3387­3396, 2017; DOI: 10.3892/or.2017.5589].

A Sensitivity-Enhanced Vertical-Resonant MEMS Electric Field Sensor Based on TGV Technology.

In order to enhance the sensitivity of wafer-level vacuum-packaged electric field sensors, this paper proposed a vertical-resonant MEMS electric field sensor based on TGV (Through Glass Via) technology. The microsensor is composed of the electric field sensing cover, the drive cover, and the SOI-based microstructures between them. TGV technology is innovatively used to fabricate the electric field sensing cover and the vertically-driven cover. The external electric field is concentrated and transmitted to the area below the silicon plate in the center of the electric field sensing cover through a metal plate and a metal pillar, reducing the coupling capacitance between the silicon plate and the packaging structure, thereby achieving the enhanced transmission of the electric field. The sensitivity-enhanced mechanism of the sensor is analyzed, and the key parameters of the sensor are optimized through finite element simulation. The fabrication process is designed and realized. A prototype is tested to characterize its performance. The experimental results indicate that the sensitivity of the sensor is 0.82 mV/(kV/m) within the electrostatic electric field ranging from 0-50 kV/m. The linearity of the sensor is 0.65%.