[Transanal specimen extraction after left-sided laparoscopic colectomy: a systematic review and meta-analysis]. / Transanal'naya ekstraktsiya preparata pri laparoskopicheskikh rezektsiyakh levykh otdelov obodochnoi kishki. Sistematicheskii obzor i metaanaliz randomizirovannykh issledovanii.

OBJECTIVE: To compare the short-term results after left-sided laparoscopic colectomy with transanal and transabdominal specimen extraction. MATERIAL LAND METHODS: We selected 998 appropriate manuscripts and subsequently excluded 995 ones due to exclusion criteria. Thus, the meta-analysis was based on 3 randomized trials in accordance with PRISMA recommendations. RESULTS: A total of 353 patients were enrolled in meta-analysis including 169 resections with transanal specimen extraction and 184 surgeries with transabdominal extraction. Overall risk of postoperative complications (OR=0.60; 95% CI 0.31-1.14; p=0.12) including anastomotic leakage (OR=1.83; 95% CI 0.43-7.89; p=0.42) was similar in both groups. At the same time, severity of pain syndrome (mean difference = -2.35; 95% CI -2.51-2.19), time to the first flatus discharge (mean difference = -0.92; 95% CI -0.99-0.85) and postoperative hospital stay (mean difference = -1.5; 95% CI -2.03-0.98) were significantly lower in the group of transanal extraction (p<0.00001). CONCLUSION: Transanal specimen extraction in left-sided laparoscopic colectomy does not increase overall risk of postoperative complications. In addition, the NOSE technique has some advantages in short-term results compared to procedures with transabdominal specimen extraction.

[The role of neutrophil CD64 index in the diagnosis of infectious complications after colorectal resection]. / Rol' indeksa CD64-neitrofilov v diagnostike infektsionnykh oslozhnenii posle rezektsii tolstoi kishki.

OBJECTIVE: To determine diagnostic value of neutrophil CD64 index (iCD64n) in the diagnosis of postoperative infectious complications after colorectal resections. MATERIAL AND METHODS: Seventy-three patients underwent colorectal surgery for the period from January to December 2018. These patients were included into a single-center study. Peripheral blood samples were taken on 3 and 6 postoperative days (POD) to check iCD64n level. We analyzed incidence of postoperative infectious complications, sensitivity (Se) and specificity (Sp) of postoperative iCD64n level on the 3rd and 6th POD. RESULTS: Postoperative infectious complications developed in 10 (13.7%) patients. Median iCD64n was significantly higher (p=0.0017 for POD 3; p=0.018 for POD 6) in patients with infectious complications (1.6 on POD 3; 1.3 on POD 6) compared to those without complications (1.1 on POD 3; 0.9 on POD 6). Area under curve (AUC) on the 3rd POD was 0.8 with the cut-off value of 1.4, Se - 70%, Sp - 93.7% (p=0.002). On the 6th POD, AUC was 0.91 with cut-off value of 1.23, Se - 80%, Sp - 93.7% (p<0.001). CONCLUSION: Neutrophil CD64 index is a valuable predictor for the diagnosis of postoperative infectious complications after colorectal resections. It is a useful tool to ensure a safe early discharge.The study is registered on the website «clinictrials.gov¼ (registration number NCT03559335).

[Effectiveness of intraperitoneal chemotherapy for t4 colon cancer]. / Effektivnost' vnutribryushnoi khimioterapii pri rake obodochnoi kishki T4.

OBJECTIVE: To determine the effect of intraperitoneal chemotherapy (IPC) with mitomycin C on expression of intraperitoneal cancer cells markers in patients with T4 colon cancer. MATERIAL AND METHODS: For the period from January 2019 to April 2020, 65 patients with T4 colon cancer were included in prospective comparative study. There were 46 patients in the main group and 19 patients in the control group. In the main group, surgical procedure was followed by IPC with mitomycin C. No IPC was performed in the control group. An effectiveness of IPC was evaluated using CD133, CD24, CD26, CD44, CD184 markers expression in peritoneal lavages. RESULTS: Significant between-group differences were observed for CD133 (p=0.0168), CD24 (p=0.0455) and CD44 (p=0.0012). There was a tendency to decrease in the level of CD184 expression in both groups in the second lavage (p=0.0605). CONCLUSION: IPC in patients with T4 colon cancer can reduce the expression and proliferative potential of free cancer cells.

Scaling, rotation, and channeling behavior of helical and skyrmion spin textures in thin films of Te-doped Cu2OSeO3.

Topologically nontrivial spin textures such as vortices, skyrmions, and monopoles are promising candidates as information carriers for future quantum information science. Their controlled manipulation including creation and annihilation remains an important challenge toward practical applications and further exploration of their emergent phenomena. Here, we report controlled evolution of the helical and skyrmion phases in thin films of multiferroic Te-doped Cu2OSeO3 as a function of material thickness, dopant, temperature, and magnetic field using in situ Lorentz phase microscopy. We report two previously unknown phenomena in chiral spin textures in multiferroic Cu2OSeO3: anisotropic scaling and channeling with a fixed-Q state. The skyrmion channeling effectively suppresses the recently reported second skyrmion phase formation at low temperature. Our study provides a viable way toward controlled manipulation of skyrmion lattices, envisaging chirality-controlled skyrmion flow circuits and enabling precise measurement of emergent electromagnetic induction and topological Hall effects in skyrmion lattices.

Short-term outcomes of a multicentre randomized clinical trial comparing D2 versus D3 lymph node dissection for colonic cancer (COLD trial).

BACKGROUND: It remains unclear whether extended lymphadenectomy provides oncological advantages in colorectal cancer. This multicentre RCT aimed to address this issue. METHODS: Patients with resectable primary colonic cancer were enrolled in four hospitals registered in the COLD trial, and randomized to D2 or D3 dissection in a 1 : 1 ratio. Data were analysed to assess the safety of D3 dissection. RESULTS: The study included the first 100 patients randomized in this ongoing trial. Ninety-nine patients were included in the intention-to-treat (ITT) analysis (43 D2, 56 D3). Ninety-two patients received the allocated treatment and were included in the per-protocol (PP) analysis: 39 of 43 in the D2 group and 53 of 56 in the D3 group. There were no deaths. The 30-day postoperative morbidity rate was 47 per cent in the D2 group and 48 per cent in the D3 group, with a risk ratio of 1·04 (95 per cent c.i. 0·68 to 1·58) (P = 0·867). There were two anastomotic leaks (5 per cent) in the D2 group and none in the D3 group. Postoperative recovery, complication and readmission rates did not differ between the groups in ITT and PP analyses. Mean lymph node yield was 26·6 and 27·8 in D2 and D3 procedures respectively. Good quality of complete mesocolic excision was more frequently noted in the D3 group (P = 0·048). Three patients in the D3 group (5 per cent) had metastases in D3 lymph nodes. D3 was never the only affected level of lymph nodes. N-positive status was more common in the D3 group (46 per cent versus 26 per cent in D2), with a risk ratio of 1·81 (95 per cent c.i. 1·01 to 3·24) (P = 0·044). CONCLUSION: D3 lymph node dissection is feasible and may be associated with better N staging. Registration number: NCT03009227 ( http://www.clinicaltrials.gov).

ANTECEDENTES: El beneficio oncológico de la linfadenectomía extendida en el cáncer colorrectal es controvertido. Este ensayo clínico aleatorizado multicéntrico tuvo como objetivo abordar esta discrepancia. MÉTODOS: Se analizaron los datos de los primeros 100 pacientes aleatorizados en un ensayo en curso para evaluar la seguridad de la disección D3. Los pacientes con cáncer de colon primario resecable incluidos en 4 hospitales participantes en el ensayo COLD, se aleatorizaron para la disección D2 y D3 en una proporción 1: 1. RESULTADOS: Se incluyeron 99 pacientes en el análisis por intención de tratamiento (intention-to-treat, ITT) (43 en D2, 56 en D3). Un total de 92 pacientes recibieron el tratamiento asignado y se incluyeron en el análisis por protocolo (per-protocol, PP): 90,7% (39 de 43) en D2, 94,6% (53 de 56) en D3. No hubo mortalidad. La morbilidad postoperatoria a los 30 días fue del 46,5% en el grupo D2 y del 48,2% en el grupo D3 con un riesgo relativo (RR) de 1,04 (i.c. del 95%: 0,68 a 1,58), P = 0,86. Hubo dos casos de fuga anastomótica (4,7%) en el grupo D2 y ninguna en D3. La recuperación postoperatoria, las complicaciones y las tasas de reingreso no difirieron entre los análisis ITT y PP. El recuento medio de ganglios linfáticos fue 26,6 y 27,8 en D2 y D3, respectivamente. Se observó una resección completa del mesorrecto de buena calidad con mayor frecuencia en el grupo D3 (P = 0,048). En el grupo D3, 3 pacientes (5,4%) tenían metástasis en los ganglios linfáticos D3. D3 nunca fue el único nivel afectado de ganglios linfáticos. El estadio pN positivo fue más frecuente en el grupo D3: 46,4% versus 25,6% en D2, con un RR para revelar enfermedad N positiva de 1,81 (i.c. del 95% 1,01 a 3,2), P = 0,04. CONCLUSIÓN: La disección de ganglios linfáticos D3 es factible y puede estar asociada con una mejor estadificación N.

[Prevention of carcinomatosis in colon cancer]. / Profilaktika kartsinomatoza pri rake obodochnoi kishki.

Colorectal cancer (CRC) is one of the leading forms of cancer. In 2017, over 72,000 of Russian citizens have been diagnosed with CRC. Cancer stage IV was diagnosed in 18 149 of them. Peritoneal carcinomatosis (PC) is one of the forms of metastatic dissemination throughout the peritoneum. There no any unified and standardized approaches to the treatment or prevention of PC associated with CRC. Therefore, it is advisable to identify PC predictors in patients with colon cancer and prevention measures.

[Factors affecting the survival of patients with peritoneal carcinomatosis of colorectal origin]. / Faktory prognoza vyzhivaemosti bol'nykh, operirovannykh po povodu peritoneal'nogo kartsinomatoza pri rake tolstoi kishki.

One of the main problems in the treatment of peritoneal carcinomatosis (PC) in colorectal cancer (CRC) is the adequate selection of patients for cytoreductive surgery (CS) and hyperthermic intraperitoneal chemotherapy (HIPEC). AIM: To determine the predictive factors of overall (OS) and disease-free survival (DFS) in CRC patients with PC after CS with HIPEC. MATERIAL AND METHODS: From 2010 to 2018 years 102 patients with CRC and PC were included in the study. The cytoreduction was complete (CC0, according to Sugabaker scale) in 96 (94.2%) cases. The age median of patients was 65 years. There were 63 (62%) women. In 81 (79%) patients, the PC was synchronous. The median level of CEA was 8.5 ng/ml. The median peritoneal carcinomatous index (PCI) was 3 (1-23). RESULTS: The median of follow-up was 18 (11; 33) months. The median of DFS and OS were 13 (9;31) and 32 (17; n/d) months, respectively. Multifactorial Cox-regression analysis showed the localization of the primary tumor in the right colon (OR=1.66; 95% CI 1.1-2.5; p=0.013) and the level of the PCI (OR = 1.08; 95% CI 1.024-1.15; p=0.008) were independent negative factors of OS. CONCLUSION: The CS and HIPEC in patients with CRC with PC allowes to achieve five-year survival in a part of patients, especially with low PCI. Identifying adverse prognostic factors preoperatively can help in selecting patients for CS in the future.

[Local recurrences of colon cancer (in Russian only)]. / Mestnyi retsidiv raka obodochnoi kishki: rezul'taty lecheniia.

AIM: To evaluate the outcomes in patients with local recurrences (LR) of colon cancer. MATERIAL AND METHODS: Prospective study included 52 patients with local recurrences of colon cancer MR and no distant metastases or disseminated carcinomatosis. Patients have been treated at Ryzhikh State Research Center for Coloproctology for the period 2009-2017. Median of local recurrence was 17.6 months. By the moment of diagnosis, CEA was increased in 24 (46.2%), CA 19-9 - in 4 (7.7%) patients. Forty-eight (92%) patients underwent surgery for local recurrences of colon cancer. In 26 (54%) cases, low ligation of supplying vessel was made during primary tumor excision that was confirmed by significant fragment of intact mesentery of the colon. RESULTS: Radical surgery for LR was possible in 34 (70.8%) patients, resection of more than one organ was required in 60% of cases. R1-resection was obtained in 12 (25.0%) cases, palliative resections - in 2 (4.2%) patients. Various complications occurred in 34 (70.8%) patients. Additional intraperitoneal chemotherapy was need in 12 (23.1%) cases. Lethal outcomes were absent. Forty-six out of 48 (95.8%) patients were followed-up. Mean follow-up was 19.5 (8.6-34.7) months. Twelve (26.1%) patients were free from recurrent cancer. Only distant metastases developed in 16 (34.8%) patients. Redo LR occurred in 18 (39.1%) patients including 12 of them with distant metastases. Overall 5-year survival was 38%, disease-free survival - 17.5%, median overall survival - 42.8 months, median disease-free survival - 15.2 months. Intraperitoneal chemotherapy did not significantly affect overall survival. Multivariate analysis confirmed high level of CEA and CA 19-9, positive resection margin as negative predictors. Moreover, impaired survival (p=0.03) was noted in case of LR after non-radical surgery for primary tumor with high ligation of the vessel. CONCLUSION: R0-resection is essential to improve survival and reduce incidence of recurrences. Intraoperative intra-abdominal chemotherapy does not affect the outcomes in patients with LR of colon cancer. Adherence to surgical principles for cancer can reduce the incidence of LR.

Electrical Control of the Zeeman Spin Splitting in Two-Dimensional Hole Systems.

Semiconductor holes with strong spin-orbit coupling allow all-electrical spin control, with broad applications ranging from spintronics to quantum computation. Using a two-dimensional hole system in a gallium arsenide quantum well, we demonstrate a new mechanism of electrically controlling the Zeeman splitting, which is achieved through altering the hole wave vector k. We find a threefold enhancement of the in-plane g-factor g_{∥}(k). We introduce a new method for quantifying the Zeeman splitting from magnetoresistance measurements, since the conventional tilted field approach fails for two-dimensional systems with strong spin-orbit coupling. Finally, we show that the Rashba spin-orbit interaction suppresses the in-plane Zeeman interaction at low magnetic fields. The ability to control the Zeeman splitting with electric fields opens up new possibilities for future quantum spin-based devices, manipulating non-Abelian geometric phases, and realizing Majorana systems in p-type superconductor systems.

[Enhanced recovery program for colorectal surgery in cinical practice. Survey of surgeons of the Russian Federation]. / Vnedrenie programmy uskorennogo vyzdorovleniia koloproktologicheskikh patsientov v klinicheskuiu praktiku. Opros khirurgov Rossiiskoi Federatsii.

AIM: To analyze RF surgeons' attitude to accelerated recovery program (ERP) and to determine how often it is used in daily work. MATERIAL AND METHODS: 223 physicians from 42 Russian regions were interviewed in 2017. RESULTS: ERP is unknown among 11.7% of specialists; 8.9% heard about ERP but did not think that it is used in the Russian Federation; 16.6% know but do not apply the program; 55.6% use some elements of ERP; complete application of ERP was found in 7.2% of surgeons. This technique is more often used by more active surgeons (p = 0.001) and less often - by female surgeons (p = 0.0066). The most controversial and difficult elements of ERP are administration of carbohydrate mixtures prior to surgery, optimal body temperature maintenance, restrictive protocol of infusion therapy, refusal mechanical intestinal depuration and routine abdominal drainage, and administrative control over the protocol. CONCLUSION: The majority of surgeons are ready to apply ERP. Some elements are difficult to apply for use in real healthcare. More educational activities are needed for wider and complete use of the protocol. New scientific available data should be used to improve this approach.

[Is implantation metastasis of colorectal cancer to the kidney possible?]

Kidney metastasis in colorectal cancer are rare. A number of publications dedicated to this topic is quite limited. In this article a rare observation of metastasis of colorectal cancer to the kidney is described.

Bound States of Skyrmions and Merons near the Lifshitz Point.

We study topological defects in anisotropic ferromagnets with competing interactions near the Lifshitz point. We show that Skyrmions and bimerons are stable in a large part of the phase diagram. We calculate Skyrmion-Skyrmion and meron-meron interactions and show that Skyrmions attract each other and form ring-shaped bound states in a zero magnetic field. At the Lifshitz point merons carrying a fractional topological charge become deconfined. These results imply that unusual topological excitations may exist in weakly frustrated magnets with conventional crystal lattices.

Mechanisms for Strong Anisotropy of In-Plane g-Factors in Hole Based Quantum Point Contacts.

In-plane hole g factors measured in quantum point contacts based on p-type heterostructures strongly depend on the orientation of the magnetic field with respect to the electric current. This effect, first reported a decade ago and confirmed in a number of publications, has remained an open problem. In this work, we present systematic experimental studies to disentangle different mechanisms contributing to the effect and develop the theory which describes it successfully. We show that there is a new mechanism for the anisotropy related to the existence of an additional B_{+}k_{-}^{4}σ_{+} effective Zeeman interaction for holes, which is kinematically different from the standard single Zeeman term B_{-}k_{-}^{2}σ_{+} considered until now.

Detection and Control of Spin-Orbit Interactions in a GaAs Hole Quantum Point Contact.

We investigate the relationship between the Zeeman interaction and the inversion-asymmetry-induced spin-orbit interactions (Rashba and Dresselhaus SOIs) in GaAs hole quantum point contacts. The presence of a strong SOI results in the crossing and anticrossing of adjacent spin-split hole subbands in a magnetic field. We demonstrate theoretically and experimentally that the anticrossing energy gap depends on the interplay between the SOI terms and the highly anisotropic hole g tensor and that this interplay can be tuned by selecting the crystal axis along which the current and magnetic field are aligned. Our results constitute the independent detection and control of the Dresselhaus and Rashba SOIs in hole systems, which could be of importance for spintronics and quantum information applications.

The amplitudes and the structure of the charge density wave in YBCO.

We find unknown s- and d-wave amplitudes of the recently discovered charge density wave (CDW) in underdoped cuprates. To do so we perform a combined analysis of experimental data for ortho-II YBa2Cu3Oy. The analysis includes data on nuclear magnetic resonance, resonant inelastic X-ray scattering, and hard X-ray diffraction. The amplitude of doping modulation found in our analysis is 3.5 · 10-3 in a low magnetic field and T = 60 K, the amplitude is 6.5 · 10-3 in a magnetic field of 30T and T = 1.3 K. The values are in units of elementary charge per unit cell of a CuO2 plane. We show that the data rule out a checkerboard pattern, and we also show that the data might rule out mechanisms of the CDW which do not include phonons.

The analysis of microRNAs miR-200C and miR-145 expression in colorectal cancer of different molecular subtypes.

The expression levels of microRNAs miR-200c and miR-145 in two groups of colorectal cancer differing by the presence/absence of epithelial-mesenchymal transition (EMF) were studied. In the EMF-positive cancer, the level of miR-145 is increased, whereas the level of miR-200c is reduced. The reverse situation is observed in the EMI-negative cancer. MiR-145 can serve as a marker of the mesenchymal subtype of cancer. Gene expression profiles and microRNAs allow prognostically unfavorable tumors of the mesenchymal subtype to be distinguished.

Violation of the spin-statistics theorem and the bose-einstein condensation of particles with half-integer spin.

We consider the Bose condensation of bosonic particles with spin 1/2. The condensation is driven by an external magnetic field. Our work is motivated by ideas of quantum critical deconfinement and bosonic spinons in spin liquid states. We show that both the nature of the novel Bose condensate and the excitation spectrum are fundamentally different from that in the usual integer spin case. We predict two massive ("Higgs") excitations and two massless Goldstone excitations. One of the Goldstone excitations has a linear excitation spectrum and another has a quadratic spectrum. This implies that the Bose condensate does not support superfluidity, the Landau criterion is essentially violated. We formulate a "smoking gun" criterion for searches of the novel Bose condensation.

Epithelial-mesenchymal transition and somatic alteration in colorectal cancer with and without peritoneal carcinomatosis.

Colorectal cancer is highly metastatic even when the tumors are small. To disseminate, cells use a complex and multistage process known as the epithelial-mesenchymal transition, in which epithelial phenotype is transformed into mesenchymal phenotype. The objective of this study is to describe the epithelial-mesenchymal transition in terms of gene expression profile and somatic alterations in samples of colorectal cancer with or without peritoneal carcinomatosis. We analyzed samples taken from 38 patients with colorectal cancer (stages II-IV) and samples from 20 patients with colorectal cancer complicated by peritoneal carcinomatosis. The expression of ZEB1, ZEB2, CDH1, VIM, and SNAI1 was analyzed by real-time PCR. KRAS/BRAF mutations were mapped using sequencing. Microsatellite instability was evaluated by fragment analysis. Epithelial-mesenchymal transition was detected in 6 out of 38 samples of colorectal cancer (stages II-IV), 7 out of 20 tumors from patients with peritoneal carcinomatosis, and 19 out of 20 samples taken from carcinomatous nodules. Tumors of the mesenchymal subtype displayed high frequency of somatic mutations, microsatellite stability, and low degree of differentiation. The identification of epithelial-mesenchymal transition may be used as a marker of high metastatic potential, which is particularly relevant at early stages of tumor growth.

Topological insulating states in laterally patterned ordinary semiconductors.

We propose that ordinary semiconductors with large spin-orbit coupling, such as GaAs, can host stable, robust, and tunable topological states in the presence of quantum confinement and superimposed potentials with hexagonal symmetry. We show that the electronic gaps which support chiral spin edge states can be as large as the electronic bandwidth in the heterostructure miniband. The existing lithographic technology can produce a topological insulator operating at a temperature of 10-100 K. Improvement of lithographic techniques will open the way to a tunable room temperature topological insulator.

[The manually assisted laparoscopic surgery of colon cancer].

The experience of 193 manually assisted laparoscopic operations on the reason of colon cancer was analyzed. The mean age of the patients was 63.6±11.3 years. Men were 85 (44%), women - 108 (56%). The majority of patients had tumor of 2nd or 3rd stage. The mean body mass index was 27.6±4.6 kg/m2. The conversion was needed in 8 (4.1%) cases. There were no intraoperative complications. The duration of the manually assisted laparoscopic colon resection was 168±45min. 11 (5.7%) patients had postoperative complications. The thorough analysis of the results allow to recommend the method for the treatment of patients with colon cancer.