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First-principles calculations were employed to study the molecular and dissociative adsorption of CO2, H2O, O2 and N2 on a LaB6(100) surface. The adsorption energy calculation results indicate that these gas molecules can form thermodynamically stable adsorption structures. Dissociative adsorption is always accompanied by more electron transfer compared to molecular adsorption, which is one of the necessary conditions for dissociation to occur. Bader charge analysis indicates that the adsorption of gas molecules on the LaB6(100) surface is always accompanied by electron transfer from the surface to the adsorbed molecules. This electron transfer forms a dipole moment from the adsorbed molecule towards the surface, leading to an increase in the work function of LaB6(100). This mechanism is a crucial aspect of the LaB6(100) poisoning effect. Additionally, LaB6(100) sometimes exhibits a certain degree of resistance to poisoning. In such cases, after the adsorption of gas molecules, local regions of the LaB6(100) surface become negatively charged, which counteracts the poisoning effect to some extent. Using electronic density of states and electron localization function analyses, we examined the nature of the chemical bonds. It was found that La tends to form non-covalent bonds with the adsorbates, whereas B tends to form covalent bonds with them. The 2p orbitals of B play a significant role in the formation of these covalent bonds in most cases.
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A 28-year-old woman was found to have coagulation factor â § activity (Fâ §â¶C) <1% and von Willebrand factor antigen (VWFâ¶Ag) <1% during routine prenatal examinations. No pathogenic variation was found in the exon region of the VWF gene using next-generation sequencing. The clinical presentation of this patient does not match the clinical characteristics of type â ¢ hemophilia [von Willebrand disease (VWD) ]; therefore, third-generation sequencing technology was used to perform whole-genome sequencing on the patient and her family members. Multiple members of the patient's paternal family carried a heterozygous variant of VPS33B, c.869G>C. The family members carrying this variant all had varying degrees of reduced VWF levels (39% -56% ). Moreover, the proband was detected with the heterozygous variant c.1474dupA in GP1BA. The ACMG and Clinvar databases determined that this variation was associated with platelet-type pseudo VWD. The decrease in VWF levels caused by heterozygous variations in VPS33B in families is the first international report, and no previous studies have reported cases of severe decrease in plasma VWF levels caused by double heterozygous variations in VPS33B and GP1BA.
Subject(s)
Mutation , Vesicular Transport Proteins , von Willebrand Factor , Humans , Female , Adult , von Willebrand Factor/genetics , Vesicular Transport Proteins/genetics , Heterozygote , Pedigree , von Willebrand Diseases/genetics , von Willebrand Diseases/diagnosis , Platelet Glycoprotein GPIb-IX Complex/geneticsABSTRACT
OBJECTIVE: To identify the biomarkers for early rheumatoid arthritis (RA) diagnosis and explore the possible immune regulatory mechanisms. METHODS: The differentially expressed genesin RA were screened and functionally annotated using the limma, RRA, batch correction, and clusterProfiler. The protein-protein interaction network was retrieved from the STRING database, and Cytoscape 3.8.0 and GeneMANIA were used to select the key genes and predicting their interaction mechanisms. ROC curves was used to validate the accuracy of diagnostic models based on the key genes. The disease-specific immune cells were selected via machine learning, and their correlation with the key genes were analyzed using Corrplot package. Biological functions of the key genes were explored using GSEA method. The expression of STAT1 was investigated in the synovial tissue of rats with collagen-induced arthritis (CIA). RESULTS: We identified 9 core key genes in RA (CD3G, CD8A, SYK, LCK, IL2RG, STAT1, CCR5, ITGB2, and ITGAL), which regulate synovial inflammation primarily through cytokines-related pathways. ROC curve analysis showed a high predictive accuracy of the 9 core genes, among which STAT1 had the highest AUC (0.909). Correlation analysis revealed strong correlations of CD3G, ITGAL, LCK, CD8A, and STAT1 with disease-specific immune cells, and STAT1 showed the strongest correlation with M1-type macrophages (R=0.68, P=2.9e-08). The synovial tissues of the ankle joints of CIA rats showed high expressions of STAT1 and p-STAT1 with significant differential expression of STAT1 between the nucleus and the cytoplasm of the synovial fibroblasts. The protein expressions of p-STAT1 and STAT1 in the cell nuclei were significantly reduced after treatment. CONCLUSION: CD3G, CD8A, SYK, LCK, IL2RG, STAT1, CCR5, ITGB2, and ITGAL may serve as biomarkers for early diagnosis of RA. Gene-immune cell pathways such as CD3G/CD8A/LCK-γδ T cells, ITGAL-Tfh cells, and STAT1-M1-type macrophages may be closely related with the development of RA.
Subject(s)
Arthritis, Rheumatoid , Biomarkers , Protein Interaction Maps , STAT1 Transcription Factor , Synovial Membrane , Arthritis, Rheumatoid/immunology , Arthritis, Rheumatoid/metabolism , Animals , Rats , STAT1 Transcription Factor/metabolism , Biomarkers/metabolism , Synovial Membrane/metabolism , Arthritis, Experimental/immunology , Arthritis, Experimental/metabolism , Lymphocyte Specific Protein Tyrosine Kinase p56(lck)/metabolism , Lymphocyte Specific Protein Tyrosine Kinase p56(lck)/genetics , Gene Expression Profiling , Databases, Genetic , Humans , CD8 Antigens/metabolism , Receptors, CCR5/metabolism , Receptors, CCR5/genetics , Syk Kinase/metabolism , Syk Kinase/genetics , ROC CurveABSTRACT
INTRODUCTION: The Shape Trail Test (STT) was developed based upon the Trail Making Test, as a culture-neutral test for measuring processing speed and mental flexibility. This study aims to evaluate the accuracy and validity of this five-minute test for differentiating individuals with normal cognition (NC), subjective memory impairment (SMI), and mild cognitive impairment (MCI). METHOD: The study included 210 participants aged 50-80 years, with 70 participants in each group matched for age, education, and gender. RESULTS: No significant difference in STT measures was found between the NC and SMI groups. In contrast, both the NC and SMI groups exhibited significantly better performance (shorter completion time in STT-A and STT-B and fewer STT-B errors) than the MCI group. No significant group differences were found in STT-A errors. Stepwise regression analysis identified three significant predictors for classifying the MCI group from the NC and/or SMI groups, including the STT-B completion time, the STT-A errors, and the interaction between STT-B completion time and STT-B errors. The composite score of these three predictors demonstrated good discriminatory power for classifying the MCI group from the other groups, with area under the curves (AUCs) of 0.76 - 0.79 (p < 0.001), sensitivities of 78.6% - 80%, and specificities of 60% - 61.4%. However, none of the STT measures or their interactions were significant predictors for differentiating the SMI group from the NC group. Besides, the STT measures were significantly correlated with age, education, and executive function measures. DISCUSSION: The STT could be a culture- and language-free, reliable test for assessing executive function and a sensitive test for predicting MCI.
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Cognitive Dysfunction , Trail Making Test , Humans , Cognitive Dysfunction/diagnosis , Aged , Female , Male , Middle Aged , Aged, 80 and over , Memory Disorders/diagnosis , Sensitivity and Specificity , Executive Function/physiology , Reproducibility of Results , Neuropsychological Tests/standards , Neuropsychological Tests/statistics & numerical dataABSTRACT
INTRODUCTION: Surgical site infections (SSIs) are significant postoperative risks; antibiotic prophylaxis is crucial due to the presence of anaerobic bacteria. This study investigated the efficacy and safety of a novel nitroimidazole, morinidazole, in SSI reduction in class III wounds, as there is currently a lack of evidence in the existing literature. METHODS: A multi-centre randomized clinical trial was conducted from December 2020 to October 2022 in the general surgery departments of 12 tertiary hospitals in China, including 459 patients in two treatment groups using morinidazole plus ceftriaxone or ceftriaxone alone. Efficacy and safety were evaluated including SSI incidence, adverse events, and compliance. Statistical analysis employed SAS 9.4 software. Data analysis was performed from February to May 2023. RESULTS: A total of 440 participants (median (interquartile range, IQR) age, 63.0 (54.0, 70.0) years; 282 males (64.09%); 437 patients were of Han race (99.32%) and were randomized. The experimental group exhibited a significantly lower SSI rate compared with the control group (31 (14.49%) vs 52 (23.01%); risk difference, 1.76%, 95% confidence interval (CI) 1.08-2.88%; P=0.0224). The superficial incisional site infections revealed a marked reduction in the experimental group (12 (5.61%) vs 31 (13.37%); risk difference, 2.68%; 95% CI 1.34-5.36%; P=0.0042). Non-surgical site infections, severe postoperative complications, and total adverse events showed no statistically significant differences between the groups (P>0.05). CONCLUSION: The significant decrease in SSI rates and superficial incisional infections demonstrates morinidazole to be a valuable prophylactic antibiotic. Our findings provide valuable insights for clinical practice, where this new-generation nitroimidazole can play a crucial role in SSI prevention.
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Structural symmetry breaking plays a pivotal role in fine-tuning the properties of nano-layered materials. Here, based on the first-principles approaches we propose a Janus monolayer of metallic CoSb by breaking the out-of-plane structural symmetry. Specifically, within the CoSb monolayer by replacing the top-layer 'Sb' with 'As' atoms entirely, the Janus Co2AsSb monolayer can be formed, whose structure is confirmed via structural optimization and ab initio molecular dynamics simulations. Notably, the Janus Co2AsSb monolayer demonstrates stability at an elevated temperature of 1200 K, surpassing the stability of the CoSb monolayer, which remains stable only up to 900 K. We propose that both the CoSb and Janus Co2AsSb monolayers could serve as capable anode materials for power-driven metal-ion batteries, owing to their substantial theoretical capacity and robust binding strength. The theoretical specific capacities for Li/Na reach up to 1038.28/1186.60 mA h g-1 for CoSb, while Janus Co2AsSb demonstrates a marked improvement in electrochemical storage capacity of 3578.69/2215.38 mA h g-1 for Li/Na, representing a significant leap forward in this domain. The symmetry-breaking effect upgrades the CoSb monolayer, as a more viable contender for power-driven metal-ion batteries. Furthermore, electronic structure calculations indicate a notable charge transfer that augments the metallic nature, which would boost electrical conductivity. These simulations demonstrate that the CoSb and Janus Co2AsSb monolayers have immense potential for application in the design of metal-ion battery technologies.
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OBJECTIVE: To investigate the dosimetric difference between manual and inverse optimization in 3-dimensional (3D) brachytherapy for gynecologic tumors. METHODS: This retrospective study was conducted among a total of 110 patients with gynecologic tumors undergoing intracavitary combined with interstitial brachytherapy or interstitial brachytherapy. Based on the original images, the brachytherapy plans were optimized for each patient using Gro, IPSA1, IPSA2 (with increased volumetric dose limits on the basis of IPSA1) and HIPO algorithms. The dose-volume histogram (DVH) parameters of the clinical target volume (CTV) including V200, V150, V100, D90, D98 and CI, and the dosimetric parameters D2cc, D1cc, and D0.1cc for the bladder, rectum, and sigmoid colon were compared among the 4 plans. RESULTS: Among the 4 plans, Gro optimization took the longest time, followed by HIPO, IPSA2 and IPSA1 optimization. The mean D90, D98, and V100 of HIPO plans were significantly higher than those of Gro and IPSA plans, and D90 and V100 of IPSA1, IPSA2 and HIPO plans were higher than those of Gro plans (P < 0.05), but the CI of the 4 plans were similar (P > 0.05). For the organs at risk (OARs), the HIPO plan had the lowest D2cc of the bladder and rectum; the bladder absorbed dose of Gro plans were significantly greater than those of IPSA1 and HIPO (P < 0.05). The D2cc and D1cc of the rectum in IPSA1, IPSA2 and HIPO plans were better than Gro (P < 0.05). The D2cc and D1cc of the sigmoid colon did not differ significantly among the 4 plans. CONCLUSION: Among the 4 algorithms, the HIPO algorithm can better improve dose coverage of the target and lower the radiation dose of the OARs, and is thus recommended for the initial plan optimization. Clinically, the combination of manual optimization can achieve more individualized dose distribution of the plan.
Subject(s)
Algorithms , Brachytherapy , Genital Neoplasms, Female , Radiometry , Radiotherapy Dosage , Radiotherapy Planning, Computer-Assisted , Humans , Brachytherapy/methods , Female , Retrospective Studies , Genital Neoplasms, Female/radiotherapy , Radiotherapy Planning, Computer-Assisted/methods , Radiometry/methodsABSTRACT
Summary: Background. Epistaxis is frequently observed in allergic rhinitis (AR) patients. However, few studies focus on the outcome of epistaxis with treatment of AR patients. This study aimed to retrospectively analyze the efficacy and safety of AR patients with epistaxis treated with sublingual immunotherapy (SLIT). Methods. A total of 74 patients aged 4-60 years with house dust mite (HDM)-induced AR accompanied by epistaxis and who completed 1 year of SLIT treatment with standard Dermatophagoides farinae (D. farinae) drops were enrolled in this study. The symptom scores, total medication scores (TMS), combined symptom and medication score (CSMS), visual analog scales (VAS), and bleeding score (BS) were assessed, as well as the nasal endoscopic examinations were performed to observe nasal signs. Results. The levels of symptom scores, TMS, CSMS, VAS, and BS at 0.5 year and 1 year of SLIT treatment were significantly lower than those at the baseline (all p less than 0.01). Also, statistical differences were seen in CSMS (p less than 0.05) and VAS (p less than 0.01) between 0.5 year and 1 year. As expected, BS was positively correlated with CSMS (r = 0.617, 95% CI 0.517-0.699) and VAS (r = 0.777, 95% CI 0.719-0.822) at all three time points. Conclusions. SLIT with D. farinae drops was effective and safe for AR patients with epistaxis, resulting in improving the symptoms of rhinitis while relieving the symptoms of epistaxis.
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Interesting behaviors may emerge in the magnetic frustrated materials with significant site-mixing disorder. We present the results of the structural, magnetic susceptibility, and specific heat measurements of Dy3Sb3Zn2O14with â¼20%Dy/Zn site-mixing disorder, which results in either a diluted 2D triangular lattice, or an intermediate structure between the kagome and pyrochlore lattice. In addition to the sharp anomaly of the temperature dependence of specific heat atTâ¼0.35 K, which was attributed to the emergent charge order state for the sample with less disorder, a broad peak atTâ¼1.5 K, and a small hump belowTâ¼0.1 K are observed. The measured temperature dependence of specific heat and the Monte Carlo simulation suggest that the magnetic frustration persists despite of a strong site-mixing disorder.
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Computational fluid dynamics (CFD) is an emerging technology applied in the field of cardiovascular medicine, which can obtain hemodynamic data by simulating the blood flow in the patient's heart for cardiac function assessment and disease diagnosis. Left ventricular function plays a key role in the occurrence and development of cardiomyopathies and coronary disease. CFD can reconstruct the left ventricular anatomic structures of patients to clarify pathophysiologic mechanisms and analyze hemodynamic parameters to evaluate left ventricular function, verify surgical efficacy, and guide surgical strategy, which has a positive effect on achieving early diagnosis and reducing mortality from cardiomyopathies and coronary disease. At present, there are still technical limitations in the large-scale clinical application of CFD, and various solutions are being developed and tested, and further improvement and refinement are needed.
Subject(s)
Cardiomyopathies , Hydrodynamics , Ventricular Function, Left , Humans , Cardiomyopathies/physiopathology , Ventricular Function, Left/physiology , Coronary Disease/physiopathology , Computer Simulation , Hemodynamics , Models, CardiovascularABSTRACT
Objective: To summarize and analyze the clinical features, treatment, and prognosis of pulmonary artery stenosis post-lung transplantation. Methods: A 62-year-old male patient was admitted to the hospital with a cough and chest tightness of over a year's duration, which had worsened in the last two months, leading to the diagnosis of idiopathic pulmonary fibrosis. The clinical data were observed and reviewed post-left allograft single lung transplantation. Literature searches were conducted using the keywords "lung transplantation" "stenosis, pulmonary artery" and "postoperative complications" in CNKI, Wanfang Medical Network, and PubMed databases up to December 2022. Results: On January 26, 2022, a left allograft single lung transplantation was performed under general anesthesia. Postoperatively, extracorporeal membrane oxygenation and mechanical ventilation were successfully weaned off at 22 hours and 2 days, respectively, with transfer from the intensive care unit 12 days after surgery. PaO2 and PaCO2 were 50 mmHg and 40 mmHg after deoxygenation. Both pulmonary CT angiography and ventilatory-perfusion imaging indicated stenosis of the left pulmonary anastomosis. Balloon dilation and pulmonary artery stenting were performed, with PaO2 and PaCO2 improving to 87 mmHg and 42 mmHg, respectively. The patient was discharged 102 days post-surgery, and was followed up for 1 year, with a good prognosis. Additionally, 36 related articles were retrieved, encompassing 69 cases with a median age of 53 years (38.5-59.0 years). Of these, 27.54% (19/69) were diagnosed with idiopathic pulmonary fibrosis, 46.38% (32/69) underwent single lung transplantation, with the primary clinical symptom being hypoxemia in 71.01% (49/69) cases. Left pulmonary artery anastomotic stenosis was observed in 43.48% (30/69), with 65.22% (45/69) being diagnosed in the late postoperative period. Interventional therapy was performed to 44.93% (31/69), with a mortality rate of 21.74% (15/69). Conclusions: The primary clinical manifestation of post-lung transplantation pulmonary artery stenosis is hypoxemia and can be diagnosed by pulmonary artery CT angiography, transesophageal echocardiography, and pulmonary angiography. Early diagnosis can significantly reduce mortality, and interventional therapy is an effective treatment for severe pulmonary artery stenosis post-lung transplantation.
Subject(s)
Idiopathic Pulmonary Fibrosis , Lung Transplantation , Stenosis, Pulmonary Artery , Male , Humans , Middle Aged , Stenosis, Pulmonary Artery/surgery , Constriction, Pathologic , HypoxiaABSTRACT
OBJECTIVE: During menopause, women are more likely to develop coronary heart disease (CHD) due to the significant changes in body metabolism brought on by the loss of estrogen. The purpose of this study was to investigate the independent association between platelet parameters and blood urea nitrogen (BUN) in postmenopausal patients with coronary artery disease in order to clarify the function performed by platelet parameters and BUN in thrombosis. PATIENTS AND METHODS: We took information from the NHANES between 2003 and 2016. Platelet count (PC), mean platelet volume (MPV), and PC/MPV were the independent variables, BUN was the dependent variable, and age, race, marital status, body mass index (BMI), inflammation indicators, alanine aminotransferase (ALT), and aspartate aminotransferase (AST) were the covariates. RESULTS: BUN decreased with increasing PC in postmenopausal heart disease patients after controlling for other factors. When PC/MPV was less than 30.5, there was a strong negative correlation with BUN. In addition, there was a strong positive correlation with BUN when MPV was less than 9.3 fL. CONCLUSIONS: The findings of this study will contribute to a better understanding of the mechanisms underlying thrombosis in postmenopausal women with CHD and offer fresh perspectives on how to create novel antithrombotic medications for an aging population.
Subject(s)
Coronary Artery Disease , Thrombosis , Humans , Female , Aged , Blood Urea Nitrogen , Postmenopause , Nutrition Surveys , Blood Platelets , Mean Platelet VolumeABSTRACT
Black phosphorene (BP) is a glowing two-dimensional semiconducting layer material for cutting-edge microelectronics, with high carrier mobility and thickness-dependent band gap. Here, based on van der Waals (vdW)-corrected first-principles approaches, we investigated stacked BP/tin selenide (BP/SnSe) vdW heterostructure as an anode material for metal ion batteries, which exhibits a significant theoretical capacity, along with relatively durable binding strength compared to the constituent BP and SnSe monolayers. Our calculations demonstrated that the Li/Na adatom favors insertion into the interlayer region of BP/SnSe vdW heterostructure owing to synergistic interfacial effect, resulting in comparable diffusivity to the BP and SnSe monolayers. Subsequently, the theoretical specific capacities for Li/Na are found to be as high as 956.30 mAhg-1and 828.79 mAhg-1, respectively, which could be attributed to the much higher storage capacity of Li/Na adatoms in the BP/SnSe vdW heterostructure. Moreover, the electronic structure calculations reveal that a large amount of charge transfer assists in semiconductor-to-metallic transition upon lithiation/sodiation, ensuring good electrical conductivity. These simulations verify that the BP/SnSe vdW heterostructure has immense potential for application in the design of metal-ion battery technologies.
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Objective: To evaluate the safety of double and a half layered esophagojejunal anastomosis in radical gastrectomy. Methods: This prospective, multi-center, single-arm study was initiated by the Affiliated Cancer Hospital of Zhengzhou University in June 2021 (CRAFT Study, NCT05282563). Participating institutions included Nanyang Central Hospital, Zhumadian Central Hospital, Luoyang Central Hospital, First Affiliated Hospital of Henan Polytechnic University, First Affiliated Hospital of Henan University, Luohe Central Hospital, the People's Hospital of Hebi, First People's Hospital of Shangqiu, Anyang Tumor Hospital, First People's Hospital of Pingdingshan, and Zhengzhou Central Hospital Affiliated to Zhengzhou University. Inclusion criteria were as follows: (1) gastric adenocarcinoma confirmed by preoperative gastroscopy;(2) preoperative imaging assessment indicated that R0 resection was feasible; (3) preoperative assessment showed no contraindications to surgery;(4) esophagojejunostomy planned during the procedure; (5) patients volunteered to participate in this study and gave their written informed consent; (6) ECOG score 0-1; and (7) ASA score I-III. Exclusion criteria were as follows: (1) history of upper abdominal surgery (except laparoscopic cholecystectomy);(2) history of gastric surgery (except endoscopic submucosal dissection and endoscopic mucosal resection); (3) pregnancy or lactation;(4) emergency surgery for gastric cancer-related complications (perforation, hemorrhage, obstruction); (5) other malignant tumors within 5 years or coexisting malignant tumors;(6) arterial embolism within 6 months, such as angina pectoris, myocardial infarction, and cerebrovascular accident; and (7) comorbidities or mental health abnormalities that could affect patients' participation in the study. Patients were eliminated from the study if: (1) radical gastrectomy could not be completed; (2) end-to-side esophagojejunal anastomosis was not performed during the procedure; or (3) esophagojejunal anastomosis reinforcement was not possible. Double and a half layered esophagojejunal anastomosis was performed as follows: (1) Open surgery: the full thickness of the anastomosis is continuously sutured, followed by embedding the seromuscular layer with barbed or 3-0 absorbable sutures. The anastomosis is sutured with an average of six to eight stitches. (2) Laparoscopic surgery: the anastomosis is strengthened by counterclockwise full-layer sutures. Once the anastomosis has been sutured to the right posterior aspect of the anastomosis, the jejunum stump is pulled to the right and the anastomosis turned over to continue to complete reinforcement of the posterior wall. The suture interval is approximately 5 mm. After completing the full-thickness suture, the anastomosis is embedded in the seromuscular layer. Relevant data of patients who had undergone radical gastrectomy in the above 12 centers from June 2021 were collected and analyzed. The primary outcome was safety (e.g., postoperative complications, and treatment). Other studied variables included details of surgery (e.g., surgery time, intraoperative bleeding), postoperative recovery (postoperative time to passing flatus and oral intake, length of hospital stay), and follow-up conditions (quality of life as assessed by Visick scores). Result: [1] From June 2021 to September 2022,457 patients were enrolled, including 355 men and 102 women of median age 60.8±10.1 years and BMI 23.7±3.2 kg/m2. The tumors were located in the upper stomach in 294 patients, mid stomach in 139; and lower stomach in 24. The surgical procedures comprised 48 proximal gastrectomies and 409 total gastrectomies. Neoadjuvant chemotherapy was administered to 85 patients. Other organs were resected in 85 patients. The maximum tumor diameter was 4.3±2.2 cm, number of excised lymph nodes 28.3±15.2, and number of positive lymph nodes five (range one to four. As to pathological stage,83 patients had Stage I disease, 128 Stage II, 237 Stage III, and nine Stage IV. [2] The studied surgery-related variables were as follows: The operation was successfully completed in all patients, 352 via a transabdominal approach, 25 via a transhiatus approach, and 80 via a transthoracoabdominal approach. The whole procedure was performed laparoscopically in 53 patients (11.6%), 189 (41.4%) underwent laparoscopic-assisted surgery, and 215 (47.0%) underwent open surgery. The median intraoperative blood loss was 200 (range, 10-1 350) mL, and the operating time 215.6±66.7 minutes. The anastomotic reinforcement time was 2 (7.3±3.9) minutes for laparoscopic-assisted surgery, 17.6±1.7 minutes for total laparoscopy, and 6.0±1.2 minutes for open surgery. [3] The studied postoperative variables were as follows: The median time to postoperative passage of flatus was 3.1±1.1 days and the postoperative gastrointestinal angiography time 6 (range, 4-13) days. The median time to postoperative oral intake was 7 (range, 2-14) days, and the postoperative hospitalization time 15.8±6.7 days. [4] The safety-related variables were as follows: In total, there were 184 (40.3%) postoperative complications. These comprised esophagojejunal anastomosis complications in 10 patients (2.2%), four (0.9%) being anastomotic leakage (including two cases of subclinical leakage and two of clinical leakage; all resolved with conservative treatment); and six patients (1.3%) with anastomotic stenosis (two who underwent endoscopic balloon dilation 21 and 46 days after surgery, the others improved after a change in diet). There was no anastomotic bleeding. Non-anastomotic complications occurred in 174 patients (38.1%). All patients attended for follow-up at least once, the median follow-up time being 10 (3-18) months. Visick grades were as follows: Class I, 89.1% (407/457); Class II, 7.9% (36/457); Class III, 2.6% (12/457); and Class IV 0.4% (2/457). Conclusion: Double and a half layered esophagojejunal anastomosis in radical gastrectomy is safe and feasible.
Subject(s)
Adenocarcinoma , Laparoscopy , Stomach Neoplasms , Aged , Female , Humans , Male , Middle Aged , Adenocarcinoma/surgery , Anastomosis, Surgical/methods , Flatulence/complications , Flatulence/surgery , Gastrectomy/methods , Laparoscopy/adverse effects , Postoperative Complications/etiology , Prospective Studies , Quality of Life , Retrospective Studies , Stomach Neoplasms/pathologyABSTRACT
Tetradymite compounds, such as Bi2Te3, crystallizing in rhombohedral structures have triggered tremendous research interest from the scientific community because of their intriguing properties. Herein, using the state-of-the-art first-principles calculations, we identify that La2X2Y (X = I, Br, Cl; Y = Ge, Te) nanosheets exhibit a ternary tetradymite-type structure with extraordinary electrical and electrochemical properties. It is first demonstrated that the layered La2X2Y compounds exhibit weak interlayer coupling with cleavage energies in the range of â¼0.28-0.38 J m-2, allowing the ready separation of monolayers that can be synthesized by mechanical exfoliation from their bulk counterparts. Next, we predict that La2X2Ge nanosheets exhibit a semiconducting nature, and upon physical realistic strain, a Dirac cone can be realized. These findings can be exploited in the transport properties. Furthermore, we comprehensively investigated the electrochemical properties of the predicted systems to evaluate their potential use in metal-ion (Li/Na) batteries. Our detailed analyses reveal that the Li (Na) adatoms are sufficiently mobile on the surface of the studied systems. For instance, the binding energy for the Li (Na) adatom on La2I2Ge is -2.24(-1.79) eV with a diffusion barrier of as small as â¼0.31(0.20) eV. Subsequently, the maximum theoretical specific capacity for Li (Na) reaches as high as 887(1064) mA h g-1, which can be attributed to a much higher storage capacity compared to previously identified 2D anode materials. These findings substantiate that the predicted nanosheets could be synthesized to explore their potential applications in future metal-ion batteries.
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The energy loss functions (ELFs) of Fe and Ni have been derived from measured reflection electron energy loss spectroscopy (REELS) spectra by a reverse Monte Carlo analysis in our previous work. In this work, we present further improvements of ELFs for these metals. For Fe, we have updated ELFs at primary electron energies of 2 keV and 3 keV in a wider photon energy region (0-180 eV) with a better accuracy, which is verified by sum rules. Regarding to Ni, we supplement the ELF at primary energy of 5 keV and we also improve the data accuracy at 3 keV. Applying these new and more accurate ELFs we present the optical constants and dielectric functions for the two metals. The improvements were highlighted by comparing our present results with the previous data.
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Objective: To evaluate the long-term efficacy of laparoscopic-assisted natural orifice specimen extraction surgery (NOSES) colectomy using Cai tube for treating left-sided colorectal cancer. Methods: This was a randomized controlled trial. Inclusion criteria were as follows: preoperative pathological diagnosis of left-sided colorectal adenocarcinoma (rectal, sigmoid colon, descending colon, or left transverse colon cancer with the caudad margin ≥8 cm from the anal margin); preoperative abdominal and pelvic computed tomography (or magnetic resonance imaging) showing maximum tumor diameter <4.5 cm; and BMI <30 kg/m2. Patients with synchronous multiple primary cancers or recurrent cancers, a history of neoadjuvant chemoradiotherapy, preoperative evidence of significant local infiltration, distant metastasis, or complications such as intestinal obstruction and intestinal perforation, or who were not otherwise considered suitable for laparoscopic surgery were excluded. A random number table was used to randomize sequential patients to NOSES surgery using Cai tube (non-assisted incision anal sleeve: patent number ZL201410168748.2) (NOSES group) or traditional laparoscopic-assisted surgery (CLS group). Relevant clinical data of the two groups of patients were analyzed, the main outcomes being disease-free survival, overall survival, overall recurrence rate, and local recurrence rate 5 years after surgery. Results: Patients in both study groups completed the surgery successfully with no requirement for additional surgery. After mean 70 (7-83) months postoperative follow-up, the 5-year overall postoperative survival in the NOSES and CLS groups was 90.0% and 83.3%, respectively (P=0.455); disease free survival was 90.0% and 83.3%, respectively (P=0.455); overall recurrence rate 6.6% and 10.0%, respectively (P=0.625); and local recurrence rate both were 3.3% (P=0.990), respectively. None of these differences was statistically significant. Conclusions: NOSES and CLS have similar long-term efficacy, and NOSES deserves to be used in clinical practice.
Subject(s)
Colorectal Neoplasms , Laparoscopy , Rectal Neoplasms , Humans , Rectal Neoplasms/surgery , Follow-Up Studies , Retrospective Studies , Neoplasm Recurrence, Local/surgery , Colorectal Neoplasms/surgery , Laparoscopy/methods , Treatment OutcomeABSTRACT
Core-shell nanoparticles (NPs) are active research areas for their unique properties and wide applications. By changing the elemental composition in the core and shell, a series of core-shell NPs with specific functions can be obtained, where the sizes of the core and shell also influence the properties. X-ray photoelectron spectroscopy (XPS) is useful in this context as a means of quantitatively analyzing such NPs. The empirical formula proposed by Shard [J. Phys. Chem. C, 2012, 116(31), 16806-16813] for calculating the shell thickness of the spherical core-shell NPs has been verified by Powell et al. [J. Phys. Chem. C, 2016, 120(39), 22730-22738] through a simulation of XPS with Simulation of Electron Spectra for Surface Analysis (SESSA) software. However, real core-shell NPs are not necessarily ideal spheres; such NPs can have rich shapes and uneven thicknesses. This work aims to extend the Shard formula to non-ideal core-shell NPs. We have used a Monte Carlo simulation method to study the XPS signal variation with the shell thickness for several modeled non-spherical shapes of core-shell NPs including some complex geometric structures which are numerically constructed with finite-element triangular meshes. Five types of non-spherical shapes, i.e. egg, ellipsoid, rod, rough-surface, and star shapes, are considered, while the size parameters are varied over a wide range. The equivalent radius and equivalent thickness are defined to characterize the average size of the nanoparticles for the use of the Shard formula. We have thus derived an extended Shard formula for the specific core-shell NPs, with which the relative error between the predicted shell thickness and the real thickness can be reduced to less than 10%.
ABSTRACT
Knowledge of absolute secondary electron yield (δ) is important for various applications of electron emission materials. Besides, it is also crucial to know the dependence of δ on primary electron energy Ep and material properties like atomic number Z. The available experimental database of δ reveals a large discrepancy among the measurement data, while the oversimplified semi-empirical theories of secondary electron emission can only present the general shape of the yield curve but not the absolute yield value. This limits not only the validation of a Monte Carlo model for theoretical simulations but also presents large uncertainties in the applications of different materials for various purposes. In applications, it is highly desirable to have the knowledge of the absolute yield of a material. Therefore, it is highly desirable to establish the relationship of the absolute yield with material and electron energy based on the available experimental data. Recently, machine learning (ML) methods have been increasingly used for the prediction of material properties mainly based on the atomistic calculations with the first-principles theory. We propose here the application of ML models to a material property study, starting with experimental observations and unfolding the relationship of δ with basic material properties and primary electron energy. Our ML models are able to predict δ(Ep)-curve covering a wide energy range of 10 eV-30 keV for unknown elements within the uncertainty range of the experimental data and can suggest more reliable data among the scattered experimental data.
ABSTRACT
OBJECTIVE: To explore the biomarkers of tinnitus in vestibular schwannoma patients using electroencephalographic (EEG) microstate technology. METHODS: The EEG and clinical data of 41 patients with vestibular schwannoma were collected. All the patients were evaluated by SAS, SDS, THI and VAS scales. The EEG acquisition time was 10-15 min, and the EEG data were preprocessed and analyzed using MATLAB and EEGLAB software package. RESULTS: Of the 41 patients with vestibular schwannoma, 29 patients had tinnitus and 12 did not have tinnitus, and their clinical parameters were comparable. The average global explanation variances of the non-tinnitus and tinnitus groups were 78.8% and 80.1%, respectively. The results of EEG microstate analysis showed that compared with those without tinnitus, the patients with tinnitus had an increased frequency (P=0.033) and contribution (P=0.028) of microstate C. Correlation analysis showed that THI scale scores of the patients were negatively correlated with the duration of microstate A (R=-0.435, P=0.018) and positively with the frequencies of microstate B (R=0.456, P=0.013) and microstate C (R=0.412, P=0.026). Syntax analysis showed that the probability of transition from microstate C to microstate B increased significantly in vestibular schwannoma patients with tinnitus (P=0.031). CONCLUSION: EEG microstate features differ significantly between vestibular schwannoma patients with and without tinnitus. This abnormality in patients with tinnitus may reflect the potential abnormality in the allocation of neural resources and the transition of brain functional activity.