Predictive Model Construction And Prevention Strategies Of Surgical Site Infection In Laparoscopic Appendectomy.

Objective: To construct a nomogram model for predicting the occurrence of the laparoscopic appendectomy surgical site infection (LASSI) and explore prevention strategies. Methods: A total of 995 patients who underwent laparoscopic appendectomy in Shanxi Bethune Hospital from October 2017 to August 2022 were selected. According to whether there was incision infection within 30 days after operation, the patients were divided into the LASSI (97 cases) and non-LASSI (898 cases) group. The following clinicopathological data from these two groups of patients were collected: gender, age, body mass index, ect. The subjects were randomly divided into training group and verification group according to the 7:3 ratio. Univariate and multivariate analysis was used to screen the related influencing factors and construct a nomogram model to predict the occurrence of LASSI. Rreceiver operating characteristic (ROC) curves and the calibration curve were used to evaluate the predictive value of the model. For patients with LASSI, a more effective preventive measure was explored. Results: Multivariate logistic regression analysis showed that operation time >1h (OR: 1.891; 95% CI: 1.07 to 3.36; P = .029), perforated and gangrenous appendix (OR: 4.078; 95% CI: 1.84 to 9.86; P = .001), free intraperitoneal fluid (OR: 2.836; 95% CI: 1.57 to 5.35; P = .001), BMI>30 kg/m2 (OR: 2.828; 95% CI:1.54 to 5.12; P = .001), diabetes mellitus (DM) (OR: 2.795; 95% CI: 1.54 to 5.28; P = .001) were the independent prognostic factors of LASSI. The prediction nomogram model showed satisfactory performance in predicting the occurrence of LASSI, ROC curve area value of the training and verification groups were respectively 0.753 (95 % CI: 0.688 ~ 0.818) and 0.772 (95 % CI: 0.691-0.852). In the event of LASSI, we took out appendix specimens in sections and sterilized surgical site, which effectively prevented it. Conclusion: This study evaluated the risk factors related to the occurrence of LASSI and established a prediction model for LASSI. The prediction model provides a convenient and fast risk assessment tool for clinicians to predict the occurrence of LASSI. Combined with the newly discovered prevention strategy of segmental removal of appendix and incision disinfection, it can effectively avoid the occurrence of LASSI and potentially reduce the hospitalization time and costs.

Highly sensitive electrochemical immunosensor based on electrodeposited platinum nanostructures confined in silica nanochannels for the detection of the carcinoembryonic antigen.

In this study, we report a highly sensitive electrochemical immunosensor for carcinoembryonic antigen (CEA) detection based on the electrodeposited platinum nanoparticles (Pt NPs) confined in the ultrasmall nanochannels of vertically ordered mesoporous silica film (VMSF). VMSF bearing amine groups (NH2-VMSF) can be prepared on the indium tin oxide electrode surface via a one-step co-condensation route using an electrochemically assisted self-assembly method, which renders a strong electrostatic effect for [PtCl6]2- and leads to the spatial confinement of Pt NPs inside the silica nanochannels after electrodeposition. The external surface of NH2-VMSF is functionalized with CEA antibodies using glutaraldehyde as a coupling agent, resulting in an electrochemical immunosensing interface with good specificity for CEA detection. Under optimal experimental conditions, high affinity between the CEA antibody and CEA produces a steric hindrance effect for the accessibility of the electrochemical probe ([Fe(CN)6]3-) in the bulk solution to the underlying indium tin oxide surface, eventually resulting in the attenuated electrochemical signal and enabling the detection of the CEA with a wide linear range of 0.01 pg/mL∼10 ng/mL and a pretty low limit of detection of 0.30 fg/mL. Owing to the signal amplification ability of Pt NPs and the anti-biofouling property of NH2-VMSF, the as-prepared electrochemical immunosensor based on the Pt NPs@NH2-VMSF displays an accurate analysis of the CEA in human serum samples, holding significant promise for health monitoring and clinical diagnosis.

Probe-Integrated Label-Free Electrochemical Immunosensor Based on Binary Nanocarbon Composites for Detection of CA19-9.

Convenient and sensitive detection of tumor biomarkers is crucial for the early diagnosis and treatment of cancer. Herein, we present a probe-integrated and label-free electrochemical immunosensor based on binary nanocarbon composites and surface-immobilized methylene blue (MB) redox probes for detection of carbohydrate antigen 199 (CA19-9), which is closely associated with gastric malignancies. Nanocarbon composites consisting of electrochemically reduced graphene oxides and carbon nanotubes (ErGO-CNT) are electrodeposited onto an indium tin oxide (ITO) electrode surface to form a 3D nanocomposite film, which could provide high surface area to immobilize abundant MB probes, facilitate the electron transfer of MB, and therefore, improve sensitivity. Polydopamine (PDA) served as a bifunctional linker is able to immobilize anti-CA19-9 antibodies and stabilize the inner probe, conferring the sensing interface with specific recognition capacity. Electrochemical detection of CA19-9 is achieved based on the decrease of the redox signal of MB after specific binding of CA19-9 with a wide linear range of 0.1 mU/mL to 100 U/mL and a limit of detection (LOD) of 0.54 nU/mL (S/N = 3). The constructed electrochemical immunosensor has good selectivity, repeatability, reproducibility, and stability. Furthermore, determination of CA19-9 in human serum samples is also realized.

A Prognostic Model for Patients With Gastric Signet Ring Cell Carcinoma.

BACKGROUND: The aim of our study was to develop a nomogram model to predict overall survival (OS) and cancer-specific survival (CSS) in patients with gastric signet ring cell carcinoma (GSRC). METHODS: GSRC patients from 2004 to 2015 were collected from the Surveillance, Epidemiology, and End Results (SEER) database and randomly assigned to the training and validation sets. Multivariate Cox regression analyses screened for OS and CSS independent risk factors and nomograms were constructed. RESULTS: A total of 7,149 eligible GSRC patients were identified, including 4,766 in the training set and 2,383 in the validation set. Multivariate Cox regression analysis showed that gender, marital status, race, AJCC stage, TNM stage, surgery and chemotherapy were independent risk factors for both OS and CSS. Based on the results of the multivariate Cox regression analysis, prognostic nomograms were constructed for OS and CSS. In the training set, the C-index was 0.754 (95% CI = 0.746-0.762) for the OS nomogram and 0.762 (95% CI: 0.753-0.771) for the CSS nomogram. In the internal validation, the C-index for the OS nomogram was 0.758 (95% CI: 0.746-0.770), while the C-index for the CSS nomogram was 0.762 (95% CI: 0.749-0.775). Compared with TNM stage and SEER stage, the nomogram had better predictive ability. In addition, the calibration curves also showed good consistency between the predicted and actual 3-year and 5-year OS and CSS. CONCLUSION: The nomogram can effectively predict OS and CSS in patients with GSRC, which may help clinicians to personalize prognostic assessments and clinical decisions.

The design of Fe, N-doped hierarchically porous carbons as highly active and durable electrocatalysts for a Zn-air battery.

A new type of Fe, N-doped hierarchically porous carbons (N-Fe-HPCs) has been synthesized via a cost-effective synthetic route, derived from nitrogen-enriched polyquaternium networks by combining a simple silicate templated two-step graphitization of the impregnated carbon. The as-prepared N-Fe-HPCs present a high catalytic activity for the oxygen reduction reaction (ORR) with onset and half-wave potentials of 0.99 and 0.86 V in 0.1 M KOH, respectively, which are superior to commercially available Pt/C catalyst (half-wave potential 0.86 V vs. RHE). Surprisingly, the diffusion-limited current density of N-S-HPCs approaches ∼7.5 mA cm(-2), much higher than that of Pt/C (∼5.5 mA cm(-2)). As a cathode electrode material used in Zn-air batteries, the unique configuration of the N-Fe-HPCs delivers a high discharge peak power density reaching up to 540 mW cm(-2) with a current density of 319 mA cm(-2) at 1.0 V of cell voltage and an energy density >800 Wh kg(-1). Additionally, outstanding ORR durability of the N-Fe-HPCs is demonstrated, as evaluated by the transient cell-voltage behavior of the Zn-air battery retaining an open circuit voltage of 1.48 V over 10 hours with a discharge current density of 100 mA cm(-2).