Efficacy and safety of 13 surgical techniques for the treatment of complex anal fistula, non-Crohn CAF: a systematic review and network meta-analysis.

BACKGROUND: Considering the difficulty of treating complex anal fistula (CAF), various surgical techniques exist in clinical work. However, none are ideal. Evidence on the efficacy and safety of different surgical treatments is scarce. The authors aimed to compare the outcomes of the 13 surgical techniques and tried to find the best surgical method for treating CAF. MATERIALS AND METHODS: The authors searched worldwide databases, including Pubmed, Embase, Cochrane Library, Web of Science, CNKI, WanFang, VIP, and SinoMed, from inception to March 2023. All randomized controlled trials comparing the outcomes of 13 surgical techniques were included according to the PICO principles. The indicators of the cure rate, the recurrence rate, the complication rate, the operating time, the postoperative pain on day 1 (VAS), and the postoperative incontinence in month 1 (Wexner) were extracted and analyzed using STATA software 15.1, Review Manager 5.4, and GeMTC14.3. RESULTS: Twenty-eight randomized controlled trials with a total of 2274 patients were included in the network meta-analysis. There was no statistically significant difference in the comparison among any surgical interventions in terms of the cure rate ( P >0.05 Table 2) and recurrence rate ( P >0.05 Table 3). However, in terms of complication rate, fistulectomy was lower than FPS (Median: 0.14; 95% CI: 0.02-0.70) or fistulotomy (Median: 0.09; 95% CI: 0.01-0.55), and fistulotomy was lower than EAFR (Median: 0.24; 95% CI: 0.05-0.84), LIFT (Median: 0.17; 95% CI: 0.02-0.66) or LIFT-EAFR (Median: 0.11; 95% CI: 0.01-0.69) ( P >0.05 Table 4). The surface estimated the advantages and disadvantages under the cumulative ranking (SUCRA). The ranking results indicated that fistulectomy might have the lowest complication rate (SUCRA=7.9%). Because the network results of the operating time, the postoperative pain, and the postoperative incontinence contained no closed loops, the results of their probability ranking could only be referenced, demonstrating that fistulectomy might have the shortest operating time (SUCRA=23.4%), video-assisted modified ligation of the intersphincteric fistula tract (VAMLIFT) might have the lowest postoperative pain on day 1 (VAS) (SUCRA=0.4%) and LIFT might have the lowest postoperative incontinence in month 1(Wexner) (SUCRA=16.2%). CONCLUSION: Fistulectomy might have the lowest complication rate, which might be the relatively superior surgical technique for treating CAF.

Achieving highly reversible zinc metal anode via surface termination chemistry.

An oxidation layer on a Zn surface is considered to play a negative role in hindering the practical applications of aqueous zinc ion batteries (AZBs). Herein, we demonstrate the importance of Zn-surface termination on the overall electrochemical behavior of AZBs by revisiting the well-known bottleneck issues. Experimental characterizations in conjugation with theoretical calculations reveal that the formation of a dense Zn4(OH)6SO4·xH2O (ZSH) layer from the well-designed surface-oxide termination layer improves the interface stability of the Zn anode and reduces the dehydration energy of Zn(H2O)62+, thereby accelerating the interface transport kinetics of Zn2+. Moreover, instead of directly diffusing over the ZSH layer, a new "edge dehydration-along edge transfer" mechanism of Zn2+ is discovered. Owing to the presence of a Zn anode with a ZnO-derived ZSH layer, an ultrahigh stability of over 1200 h with a high cumulative-plated capacity of 6.24mAh cm-2 is achieved with a symmetrical cell. Furthermore, high cycling stability (over 1000 cycles) and Coulombic efficiency (99.07%) are obtained in the entire AZBs with a MnO2 cathode. An understanding of the oxygen surface termination mechanism is beneficial to Zn-anode protection and is a timely forward step toward the long-pursued practical application of AZBs.

Comparison of clinical outcomes of anal fistula plug and endoanal advancement flap repair treating the complex anal fistula: a systematic review and meta-analysis.

Anal fistula (AF) is a common disease with high prevalence and surgical operations are effective treatments in clinical work. There exist many well-known surgical techniques treating complex anal fistula (CAF), however, none is ideal. To compare the superiority of Anal fistula plug (AFP) and Endoanal advancement flap repair (EAFR) for complex anal fistula. We searched worldwide databases including Pubmed, Embase, Cochrane Library, Web of Science, CNKI, WanFang, VIP, and SinoMed from their inception to March 2023. Studies comparing the outcomes of AFP and EAFR were included according to the PICO principles. The indicators of the healing rate, recurrence rate, wound infection rate, and complication rate, et al. were extracted and compared between different surgical methods. 5 RCTS and 7 non-RCTs were included in the meta-analysis with a total of 847 patients (341 patients conducted with AFP and 506 patients with EAFR). By combining the total effect of the 12 articles, we found that there was a statistical difference reporting the healing rate of AFP 48.3% and EAFR 64.4% treating the CAF (OR 0.68, 95% CI 0.30,1.55, P = 0.03), and EAFR has a better healing rate. However, there was no significant difference in terms of the recurrence rate (OR 1.68, 95% CI 0.80,3.54, P = 0.17), the wound infection rate (OR 1.82, 95% CI 0.95,3.52, P = 0.07), and the complication rate (OR 1.06, 95% CI 0.70,1.61, P = 0.77) either in the 12 articles or in the subgroup. The meta-analysis indicated that the EAFR was superior to AFP in terms of the healing rate treating the CAF, however, there were no significant differences between the two groups when it came to the recurrence rate, the wound infection rate, and the complication rate. EAFR might be one initial treatment for the complex cryptoglandular anal fistulas compared with AFP.

Interfacial Chemistry Modulation via Amphoteric Glycine for a Highly Reversible Zinc Anode.

Zn metal is thermodynamically unstable in aqueous electrolytes, which induces dendrite growth and ongoing parasitic reactions at the interface during the plating process and even during shelf time, resulting in rapid battery failure and hindering the practical application of aqueous Zn ion batteries. In this work, glycine, a common multifunctional additive, is utilized to modulate the solvation shell structure and enhance the interfacial stability to guard the reversibility and stability of the Zn anode. Apart from partially replacing the original SO42- in the contact ion pair of Zn2+[H2O]5·OSO32- complexes to suppress the formation of Zn4(OH)6SO4·xH2O byproducts at the interface, glycine molecules can also form a water-poor electrical double layer on the zinc metal surface during resting and be further reduced to build in situ a ZnS-rich solid electrolyte interphase (SEI) layer during cycling, which further suppresses side reactions and the random growth of Zn dendrites in the whole process. As expected, the cycle life of the symmetrical cells reaches over 3200 h in glycine-containing electrolytes. In addition, the Zn//NVO full cell shows exceptional cycling stability for 3000 cycles at 5 A g-1. Given the low-cost superiority of glycine, the proposed strategy for interfacial chemistry modulation shows considerable potential in promoting the commercialization progress of aqueous batteries.

Anchoring ultra-small Mo2C nanocrystals on honeycomb-structured N-doped carbon spheres for efficient hydrogen evolution.

Molybdenum carbide (Mo2C) has attracted considerable research interest as one of the most efficient non-noble electrocatalysts for the hydrogen evolution reaction (HER). Supporting nanosized Mo2C on a conductive carbon matrix with high porosity and large surface area represents an efficient strategy to enhance its HER performance. Herein, we constructed a Mo2C based HER catalyst consisting of ultra-small Mo2C nanocrystals anchored on honeycomb-structured N-doped carbon spheres (Mo2C-HNCS). The as-prepared Mo2C-HNCS manifests a high HER catalytic activity in alkaline media with an overpotential of 128 mV at 10 mA cm-2, a Tafel slope of 60 mV decade-1, and good stability.

Beyond the Phase Segregation: Probing the Irreversible Phase Reconstruction of Mixed-Halide Perovskites.

Mixed-halide perovskites can undergo a photoinduced phase segregation. Even though many reports have claimed that such a phase segregation process is reversible, what happens after phase segregation and its impact on the performance of perovskite-based devices are still open questions. Here, the phase transformation of MAPb(I1- x Brx )3 after phase segregation and probe an irreversible phase reconstruction of MAPbBr3 is investigated. The photoluminescence imaging microscopy technique is introduced to in situ record the whole process. It is proposed that the type-I band alignment of segregated I-rich and Br-rich domains can enhance the emission of the I-rich domains by suppressing the nonradiative recombination channels. At the same time, the charge injection from Br-rich to I-rich domains drives the expulsion of iodide from the lattice, and thus triggers the reconstruction of MAPbBr3 . The work highlights the significance of ion movements in mixed-halide perovskites and provides new perspectives to understand the property evolution.

Overexpression of lncRNA NLIPMT Inhibits Colorectal Cancer Cell Migration and Invasion by Downregulating TGF-ß1.

BACKGROUND: NLIPMT, as a tumor suppressive lncRNA, has only been investigated in breast cancer, while its roles in other types of cancer remain unknown. This study aimed to explore the role of NLIPMT in colorectal cancer (CRC). METHODS: Expression levels of NLIPMT and TGF-ß1 in two types of CRC tissue (Non-tumor tissues and tumor tissues) were measured and compared by qRT-PCR and paired t-test, respectively. Correlations between the expression of NLIPMT and TGF-ß1 were analyzed by performing linear regression. The effects of transfections on cell invasion and migration were evaluated by Transwell assays. RESULTS: We found that NLIPMT was downregulated, while TGF-ß1 was upregulated in CRC. In CRC tumor, a negative correlation was found between the expression of NLIPMT and TGF-ß1. In CRC cells, overexpression of NLIPMT resulted in downregulation, while silencing of NLIPMT resulted in upregulation of TGF-ß1. Analysis of cell invasion and migration showed that overexpression of NLIPMT suppressed the tumor cell invasion and migration. In contrast, overexpression of TGF-ß1 could promote CRC cell invasion and migration and also reduce the role of NLIPMT. Through the overall survival evaluation, NLIPMT-high groups of CRC represented better survival rate compared to that of the NLIPMT-low group patients. CONCLUSION: The expression of lncRNA NLIPMT was negatively correlated with TGF-ß1 in CRC. Overexpression of NLIPMT inhibited the colorectal cancer cell migration and invasion by downregulating TGF-ß1. Furthermore, the expression of NLIPMT in CRC patients predicted better prognosis, which suggested that NLIPMT could be considered as a novel diagnosis biomarker.

Asymmetric Wide-Bandgap Polymers Simultaneously Improve the Open-Circuit Voltage and Short-Circuit Current for Organic Photovoltaics.

A trade-off between open-circuit voltage (V OC ) and high short-circuit (J SC ) becomes one of the most vital problems limiting further improvement in polymer solar cells' (PSCs) efficiency. In this work, two asymmetric polymer donors PBDT-F-2TC and PBDT-SF-2TC are designed and synthesized. When blended with a state-of-the-art acceptor IT-4F with low lowest-unoccupied molecular orbital level, simultaneously high V OC (up to 0.94 V) and J SC (up to 20.73 mA cm-2 ) are obtained for both copolymers. Note that the V OC value of 0.94 V is the highest value of PSCs based on IT-4F reported so far. The simultaneously improved V OC and J SC in resulting devices are discovered from the deep highest-occupied molecular orbital levels (-5.5 to -5.7 eV) and the hyperchromic effect of the polymers, the small driving force, and the small energy loss during the charge transfer, due to the synergistic effect of asymmetric carboxylate unit and fluorine/sulfur atoms. More importantly, thanks to the asymmetric 2TC, both PBDT-F-2TC- and PBDT-SF-2TC-based PSCs can be successfully processed by non-halogenated solvent 1,2,4-trimethylbenzene (TMB) to yield device efficiencies of 10.29% and 10.39%, respectively, which are the maximum values for non-fullerene PSCs fabricated using the eco-friendly solvent TMB.

Post-Treatment-Free Main Chain Donor and Side Chain Acceptor (D-s-A) Copolymer for Efficient Nonfullerene Solar Cells with a Small Voltage Loss.

Main chain donor and side chain acceptor (D-s-A) copolymers are an important branch of the D-A copolymer family. However, the development of D-s-A copolymers significantly falls behind the alternative D-A copolymers, especially for organic solar cells, because a breakthrough in device performance is not yet obtained with a reported power conversion efficiency (PCE) of 2%-4%. Herein, a newly developed D-s-A copolymer PDRCNBDT, bearing 2-(1, 1-dicyanomethylene) rhodanine pendant group as the donor material, delivers a high PCE of 5.3% for nonfullerene solar cells. To the best of our knowledge, this is the best value reported for D-s-A copolymers to date. The improved PCE is observed to be associated with a very small energy loss (Eloss ) of 0.57 eV, accompanied by a high open-circuit voltage (Voc ) of 1.015 eV. It is important to note that this efficient D-s-A copolymer is employed in organic solar cells (OSCs), free of additive and annealing treatments.

Novel Copolymers Based Tetrafluorobenzene and Difluorobenzothiadiazole for Organic Solar Cells with Prominent Open Circuit Voltage and Stability.

Two novel copolymers based on benzothiadiazole (BT) or difluorobenzothiadizole (ffBT) with 2,2'-(perfluoro-1,4-phenylene)dithiophene (2TPF4), namely PBT-2TPF4 and PffBT-2TPF4, are synthesized for applications in polymer solar cells (PSCs). A noticeably high open-circuit voltage (Voc ) of 1.017 and 0.87 V are achieved for PffBT-2TPF4 and PBT-2TPF4-based devices, respectively. Although only a moderate efficiency (5.7%) of PBT-2TPF4-based devices is obtained, it is first demonstrated that 2TPF4 is a promising acceptor block for construction of the donor copolymers which possess high Voc , prominent crystallinity, and long-term stability, simultaneously. Besides, two thienyl flanking the tetrafluorophenylene can decrease torsion angle between conjugated units, resulting in a high coplanar structure of copolymers to enhance their charge carrier mobility. The findings may open a promising and practical way to accelerate the commercialization of PSCs by developing a series of new donor copolymers for efficient and long-term stable thickness bulk heterojunction PSCs.

Influence of Tanshinone IIA on the Apoptosis of Human Esophageal Ec-109 Cells.

The induced-apoptosis effect and mechanism of human esophageal cancer Ec-109 cells via tanshinone IIA was investigated. The Ec-109 cells were cultured in vitro with different concentrations of tanshinone IIA (2 µg/mL, 4 µg/mL, or 8 µg/mL) for 12, 24, 36, and 48 hours. MTT assay was used to evaluate the proliferative inhibition rate of tanshinone IIA on esophageal Ec-109 cells. After 24 hours of culturing in vitro, a control group was assigned. The apoptosis rate was detected by the AO/EB and annexin V-FITC/propidium iodide assay, and the protein levels of Caspase-4 and CHOP were determined by the Western blot technique. MTT data showed that tanshinone IIA could significantly inhibit the proliferation of Ec-109 cells with a dose- and time-dependent mode. Compared with the control group, tanshinone IIA could apparently induce apoptosis of Ec-109 cells, and the level of Caspase-4 and CHOP (p < 0.01) obviously increased. Tanshinone IIA can significantly induce the apoptosis of Ec-109 cells, which may take effect by the stress pathway of the endoplasmic reticulum.