Impact of Neoadjuvant Treatment and Minimally Invasive Surgery on Perioperative Outcomes of Pancreatoduodenectomy: an ACS NSQIP Analysis.

BACKGROUND: There is an increasing use of neoadjuvant treatment (NAT) for pancreatic cancer (PC) followed by minimally invasive pancreatoduodenectomy (MIPD). We evaluate the impact of the surgical approach on 30-day outcomes in PC patients who underwent NAT. METHODS: Patients with PC who had NAT followed by MIPD or open pancreatoduodenectomy (OPD) were identified from a pancreatectomy-targeted dataset (2014-2020) of the National Surgical Quality Improvement Program. Comparisons were made between MIPD and OPD within NAT groups. RESULTS: A total of 5588 patients were analyzed. Of those, 4907 underwent OPD and 476 underwent MIPD. In addition, 3559 patients received neoadjuvant chemotherapy alone and 1830 received neoadjuvant chemoradiation. In the chemotherapy-alone group, the MIPD subgroup had lower rates of any complication (38.2% vs. 45.8%, P = 0.005), but there were no differences in mortality (2.1% for MIPD vs 1.9% for OPD, P=0.8) or serious complication (11.8% for MIPD vs 15% for OPD, P=0.1). On multivariable analysis, MIPD was independently predictive of lower rates of any complication (OR: 0.74, 95% CI 0.6-0.93, P = 0.0009), CR-POPF (OR: 0.58, 95% CI 0.35-0.96, P = 0.04), and shorter LOS (estimate: -1.03, 95% CI -1.73 to -0.32, P = 0.004). In the chemoradiation group, patients undergoing MIPD had higher rates of preoperative diabetes (P < 0.05), but there were no significant differences in any outcomes between the two approaches in this group. CONCLUSION: MIPD is safe and feasible after NAT. Patients having neoadjuvant chemotherapy alone followed by MIPD had lower rates of complications, shorter LOS, and fewer CR-POPFs compared to OPD.

Effects of Alkali on Water Soluble Hexavalent Chromium in Ordinary Portland Cement.

Due to the toxicity and mobility of chromium, the disposal of chromium-containing waste is a pressing issue. Co-processing of chromium-containing waste in a cement kiln is currently one of the most effective methods. However, the presence of water-soluble hexavalent chromium (Cr(VI)) in cement limits the use of this method. In this study, Na2CO3 was used to simulate alkali in industrial raw materials to investigate the pattern of influence of alkali content on water-soluble hexavalent chromium. The mechanisms associated with the oxidation and dissolution of chromium were investigated using X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS), and inductively coupled plasma emission spectrometry (ICP-OES). The proportion of Cr(VI) in the clinker detected by XPS increased rapidly with increasing alkali content. In the cement slurry system, alkali promotes more hexavalent chromium leaching by influencing pH and other ion concentrations (Ca2+, SO42-). Therefore, the addition of alkali to either the raw meal or to the cement slurry system will favour an increase in the water-soluble Cr(VI) content. This study may provide theoretical guidance for the preparation and use of clinkers containing chromium.

MicroRNA-1294 inhibited oral squamous cell carcinoma growth by targeting c-Myc.

Oral squamous cell carcinoma (OSCC) is the predominant histological type of oral cancer. The 5-year survival rate of OSCC is only ~50%. c-Myc is a known oncogene and target gene in various cancer types, including OSCC. The presnet study revealed that c-Myc is one of the target genes of miR-1294. Results indicated lower levels of miR-1294 in OSCC tissues samples collected from 24 patients with OSCC. Notably, overexpression of miR-1294 inhibited proliferation and migration in OSCC cell lines and inhibition of miR-1294 promoted cell growth and migration in OSCC cell lines. Moreover, miR-1294 can target the 3'UTR of c-Myc, as we identified a negative correlation between c-Myc mRNA expression and miR-1294 expression in 24 OSCC tissues. In conclusion, the data demonstrate the tumor suppressive role of miR-1294 in OSCC.