Synergetic conditioning via oxalic acid enhanced Fe2+/CaO2 and skeleton construct to achieve deep dewatering of sewage sludge.

Extracellular polymeric substance (EPS) with highly hydrophilic groups and sludge with high compressibility are determined sludge dewaterability. Herein, Fe2+ catalyzed calcium peroxide (CaO2) assisted by oxalic acid (OA) Fenton-like process combined with coal slime was applied to improve sludge dewaterability. Results demonstrated that the sludge treated by 0.45/1/1.1-OA/Fe2+/CaO2 mM/g DS, the water content (WC), specific resistance to filtration and capillary suction time dropped to 53.01%, 24.3 s and 1.2 × 1012 m/kg, respectively. Under coal slime ratio as 0.6, WC and compressibility were further reduced to 42.72% and 0.66, respectively. The hydroxyl radicals generated by OA/Fe2+/CaO2 under near-neutral pH layer by layer collapsed EPS, resulting in the degradation and migration of inner releasing components and the exposure of inner sludge flocs skeleton. The hydrophilic tryptophan-like protein of TB-EPS were degraded into aromatic protein of S-EPS and exposed inner hydrophobic sites. The protein secondary structures were transformed by destroying hydrophilic functional groups, which were attributed to the reducing α-helix ratio and reconstructing ß-sheet. Moreover, coal slime as the skeleton builder lowered compressibility and formed more macropores to increase the filterability of pre-oxidized sludge for the higher intensity of rigid substances. This study deepened the understanding of OA enhanced Fenton-like system effects on sludge dewaterability and proposed a cost-effective and synergistic waste treatment strategy in sludge dewatering.

Suppressed Phase Segregation with Small A-Site and Large X-Site Incorporation for Photostable Wide-Bandgap Perovskite Solar Cells.

Wide-bandgap (WBG) perovskite solar cells (PSCs) have been widely used as the top cell of tandem solar cells. However, photoinduced phase segregation and high open-circuit voltage loss pose significant obstacles to the development of WBG PSCs. Here, a two-step small-size A-site and large-size X-site incorporation strategy is reported to modulate the lattice distortion and improve the film quality of WBG formamidinium-methylammonium (FAMA) perovskite films for photostable PSCs based on two-step deposition method. First, CsI with content of 0-20% is introduced to tune the lattice distortion and film quality of FAMA perovskite with a bandgap of 1.70 eV. Then, 4% RbI is incorporated to further modulate the perovskite growth and lattice distortion, leading to the suppression of photoinduced phase segregation in the resultant RbCsFAMA quadruple cation perovskites. As a result, the 20%CsI/4%RbI-doped device obtains a promising efficiency of 20.6%, and the corresponding perovskite film shows good photothermal stability. Even without encapsulation, the device can maintain 92% of its initial efficiency after 1000 h of continuous operation under 1 sun equivalent white light-emitting diode illumination.

NIR Light-Fuse Drug-Free Photothermal Armor-Piercing Microcapsule for Femoral Vein Thrombosis Therapy.

Acute thrombosis and its complications are leading global causes of disability and death. Existing thrombolytic drugs, such as alteplase and urokinase (UK), carry a significant bleeding risk during clinical treatments. Thus, the development of a novel thrombolysis strategy is of utmost urgency. Based on the previous work, the hollow structure of microcapsules (MC) is fabricated. Subsequently, armor-piercing MC, known as Fucoidan/S-Nitrosoglutathione/Melanin@MC (FGM@MC) is obtained, using a layer-by-layer (LBL) self-assembly method. Utilizing near-infrared (NIR) light as a trigger, the FGM@MC demonstrated photothermal thrombolysis at the site of thrombus due to its stable and outstanding photothermal properties. Simultaneously, photothermal stimulation leads to the release of a significant amount of nitric oxide from the FGM@MC, resulting in cavitation effects for mechanical thrombolysis. In vivo experiments confirmed the stable release of nitric oxide under NIR light irradiation. Treatment of femoral vein thrombosis in rats revealed that the thrombolytic effectiveness of FGM@MC+NIR (53.71%) is comparable to that of UK (59.70%). Notably, FGM@MC does not interfere with the coagulation function of rats and exhibits a favorable safety profile. In conclusion, this study demonstrates that the drug-free armor-piercing microcapsule has significant potential in the treatment of thrombosis, offering a safe and effective alternative to traditional thrombolytic therapies.

All-in-One Self-Powered Microneedle Device for Accelerating Infected Diabetic Wound Repair.

Diabetic wound healing remains a significant clinical challenge due to the complex microenvironment and attenuated endogenous electric field. Herein, a novel all-in-one self-powered microneedle device (termed TZ@mMN-TENG) is developed by combining the multifunctional microneedle carried tannin@ZnO microparticles (TZ@mMN) with the self-powered triboelectric nanogenerator (TENG). In addition to the delivery of tannin and Zn2+ , TZ@mMN also effectively conducts electrical stimulation (ES) to infected diabetic wounds. As a self-powered device, the TENG can convert biomechanical motion into exogenous ES to accelerate the infected diabetic wound healing. In vitro experiment demonstrated that TZ@mMN shows excellent conductive, high antioxidant ability, and effective antibacterial properties against both Staphylococcus aureus and Escherichia coli (>99% antibacterial rates). Besides, the TZ@mMN-TENG can effectively promote cell proliferation and migration. In the diabetic rat full-thickness skin wound model infected with Staphylococcus aureus, the TZ@mMN-TENG can eliminate bacteria, accelerate epidermal growth (regenerative epidermis: ≈303.3 ± 19.1 µm), enhance collagen deposition, inhibit inflammation (lower TNF-α and IL-6 expression), and promote angiogenesis (higher CD31 and VEGF expression) to accelerate infected wound repair. Overall, the TZ@mMN-TENG provides a promising strategy for clinical application in diabetic wound repair.

Transformable Magnetic Liquid-Metal Nanoplatform for Intracellular Drug Delivery and MR Imaging-Guided Microwave Thermochemotherapy.

Improved techniques for the administration of chemotherapeutic drugs are required to enhance tumor therapy efficacy and reduce the side effects of chemotherapy due to insufficient targeting and limited intratumoral drug release. Controlled drug delivery systems combined with thermotherapy are expected to play an important role in personalized tumor therapy. Herein, a novel microwave-responsive transformable magnetic liquid-metal (MLM) nanoplatform is designed for effective endosomal escape that facilitates intracellular drug delivery and enhanced anticancer therapy. The MLM nanoplatform exhibits a sensitive magnetic resonance imaging function for imaging-guided therapy and brilliant synergistic effects of chemotherapy with microwave thermal therapy to kill tumor cells. Once endocytosed by targeted tumor cells, the deep penetration of microwave energy can be absorbed by the MLM nanoplatform to convert heat and reactive oxygen species, which induces the shape transformation from nanospheres to large rods, resulting in the physical disruption of the endosomal membrane for intracellular drug release. Furthermore, the MLM nanoplatform synergistic therapy could activate immunomodulatory effects by M1 macrophage polarization and T cell infiltration, thus inhibiting tumor growth and lung metastasis. This work based on microwave-driven transformable magnetic liquid-metal nanoplatform provides novel ways to precisely control drug delivery and high-efficiency cancer therapy.

Image-free single-pixel keypoint detection for privacy preserving human pose estimation.

Computer vision technology has been applied in various fields such as identification, surveillance, and robot vision. However, computer vision algorithms used for human-related tasks operate on human images, which raises data security and privacy concerns. In this Letter, we propose an image-free human keypoint detection technique using a few coded illuminations and a single-pixel detector. Our proposed method can complete the keypoint detection task at an ultralow sampling rate on a measured one-dimensional sequence without image reconstruction, thus protecting privacy from the data collection stage and preventing the acquisition of detailed visual information from the source. The network is designed to optimize both the illumination patterns and the human keypoint predictor with an encoder-decoder framework. For model training and validation, we used 2000 images from Leeds Sport Dataset and COCO Dataset. By incorporating EfficientNet backbone, the inference time is reduced from 4 s to 0.10 s. In the simulation, the proposed network achieves 91.7% average precision. Our experimental results show an average precision of 88.4% at a remarkably low sampling rate of 0.015. In summary, our proposed method has the advantages of privacy protection and resource efficiency, which can be applied to many monitoring and healthcare tasks, such as clinical monitoring, construction site monitoring, and home service robots.

Recent Advances in Interface Engineering for Enhanced Open-Circuit Voltage Regulation in Perovskite Solar Cells.

In recent years, perovskite solar cells (PSCs) have attracted significant attention due to their excellent photoelectric properties. However, several key performance parameters of these devices still fall short of their theoretical limits. Among these parameters, the regulation of open-circuit voltage (VOC ) has been a focal point of intensive research efforts, playing a pivotal role in advancing the efficiency of PSCs. This review first provides an overview of the generation and loss mechanism of VOC . It then discusses the significance of interface engineering in VOC regulation. Recent developments in high-efficiency PSCs realized via interface engineering have been summarized and categorized into three key areas: surface modification, interface structure optimization, and surface dimensional engineering. Finally, a comprehensive summary of past research in this domain and offered insights into the future prospects of enhancing VOC in PSCs is provided.

Assembly of Metal-Phenolic Networks onto Microbubbles for One-Step Generation of Functional Microcapsules.

The one-step assembly of metal-phenolic networks (MPNs) onto particle templates can enable the facile, rapid, and robust construction of hollow microcapsules. However, the required template removal step may affect the refilling of functional species in the hollow interior space or the in situ encapsulation of guest molecules during the formation of the shells. Herein, a simple strategy for the one-step generation of functional MPNs microcapsules is proposed. This method uses bovine serum albumin microbubbles (BSA MBs) as soft templates and carriers, enabling the efficient pre-encapsulation of guest species by leveraging the coordination assembly of tannic acid (TA) and FeIII ions. The addition of TA and FeIII induces a change in the protein conformation of BSA MBs and produces semipermeable capsule shells, which allow gas to escape from the MBs without template removal. The MBs-templated strategy can produce highly biocompatible capsules with controllable structure and size, and it is applicable to produce other MPNs systems like BSA-TA-CuII and BSA-TA-NiII . Finally, those MBs-templated MPNs capsules can be further functionalized or modified for the loading of magnetic nanoparticles and the pre-encapsulation of model molecules through covalence or physical adsorption, exhibiting great promise in biomedical applications.

From Conversion to Resection for Unresectable Hepatocellular Carcinoma: A Review of the Latest Strategies.

Hepatocellular carcinoma (HCC) is one of the most common malignant tumors in China, accounting for the majority of primary liver cancer cases. Liver resection is the preferred curative method for early-stage HCC. However, up to 80-85% of patients have already missed the opportunity of radical surgery due to tumor advances at the time of consultation. Conversion therapies are a series of medications and treatments for initially inoperable patients. For early-stage unresectable HCC (uHCC) patients, conversion therapies are designed to meet surgical requirements by increasing the volume of the residual liver. Meanwhile, for advanced cases, conversion therapies strive for tumor shrinkage and down-staging, creating the opportunity for liver resection or liver transplantation. This review summarizes the latest advances in conversion therapies and highlights their potential for improving the survival benefit of patients with uHCC.

Layer-by-layer microneedle patch with antibacterial and antioxidant dual activities for accelerating bacterial-infected wound healing.

Bacterial-infected wound healing has always been a huge challenge to humans. Owing to the appearance of antibiotic resistance, there is an emergency need to design antibiotic-free wound dressings to treat such wounds. Herein, a novel antibiotic-free microneedle patch was designed, which its backing layer with antioxidant effect was coated with sodium carboxymethyl cellulose, 2-O-α-D-glucopyranosyl-L-ascorbic acid (GLAA), and 2-hydroxypropyltrimethyl ammonium chloride chitosan through electrostatic interaction based on layer-by-layer self-assembly technique, and its tips consisted of gelatin and tannic acid (TA) via hydrogen bonding interaction (CGH/GTA MN patch). The obtained CGH/GTA MN patch could effectively puncture the skin, and exhibit properties of pH-responsive TA and GLAA release. In vitro experiments showed that the obtained CGH/GTA MN patch has excellent antioxidative (scavenging DPPH efficacy is above 80 %, and scavenging ABTS efficiency reaches about 100 %), antibacterial (antibacterial rates of nearly 100 % for both Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli)), biodegradable, and biocompatible properties. In the S. aureus-infected rat wounds, the CGH/GTA MN patch could efficiently accelerate infected-wound healing by eliminating S. aureus infection, inhibiting inflammation, promoting angiogenesis, and accelerating epidermal regeneration. Thus, this study will provide a promising strategy to heal bacterial-infected wounds.

Modulation of perovskite degradation with multiple-barrier for light-heat stable perovskite solar cells.

The long-term stability of perovskite solar cells remains one of the most important challenges for the commercialization of this emerging photovoltaic technology. Here, we adopt a non-noble metal/metal oxide/polymer multiple-barrier to suppress the halide consumption and gaseous perovskite decomposition products release with the chemically inert bismuth electrode and Al2O3/parylene thin-film encapsulation, as well as the tightly closed system created by the multiple-barrier to jointly suppress the degradation of perovskite solar cells, allowing the corresponding decomposition reactions to reach benign equilibria. The resulting encapsulated formamidinium cesium-based perovskite solar cells with multiple-barrier maintain 90% of their initial efficiencies after continuous operation at 45 °C for 5200 h and 93% of their initial efficiency after continuous operation at 75 °C for 1000 h under 1 sun equivalent white-light LED illumination.

Layer-by-Layer Microneedle-Mediated rhEGF Transdermal Delivery for Enhanced Wound Epidermal Regeneration and Angiogenesis.

Appropriate treatments for acute traumas tend to avoid hemorrhages, vascular damage, and infections. However, in the homeostasis-imbalanced wound microenvironment, currently developed therapies could not precisely and controllably deliver biomacromolecular drugs, which are confronted with challenges due to large molecular weight, poor biomembrane permeability, low dosage, rapid degradation, and bioactivity loss. To conquer this, we construct a simple and effective layer-by-layer (LBL) self-assembly transdermal delivery patch, bearing microneedles (MN) coated with recombinant human epidermal growth factor (LBL MN-rhEGF) for a sustained release to wound bed driven by typical electrostatic force. Pyramidal LBL MN-rhEGF patches hold so enough mechanical strength to penetrate the stratum corneum, and generated microchannels allow rhEGF direct delivery in situ. The administrable delivery of biomacromolecular rhEGF through hierarchically coated MN arrays follows the diffusion mechanism of Fick's second law. Numerous efforts further have illustrated that finger-pressing LBL MN-rhEGF patches could not only promote cell proliferation of normal human dermal fibroblasts (NHDF) and human umbilical vein endothelial cells (HUVEC) in vitro but also take significant effects (regenerative epidermis: ∼144 µm; pro-angiogenesis: higher CD31 expression) in accelerating wound healing of mechanically injured rats, compared to the traditional dressing, which relies on passive diffusion. Our proof-of-concept features novel LBL biomacromolecular drug-delivery systems and self-administrated precision medicine modes at the point of care.

Minimizing buried interfacial defects for efficient inverted perovskite solar cells.

Controlling the perovskite morphology and defects at the buried perovskite-substrate interface is challenging for inverted perovskite solar cells. In this work, we report an amphiphilic molecular hole transporter, (2-(4-(bis(4-methoxyphenyl)amino)phenyl)-1-cyanovinyl)phosphonic acid, that features a multifunctional cyanovinyl phosphonic acid group and forms a superwetting underlayer for perovskite deposition, which enables high-quality perovskite films with minimized defects at the buried interface. The resulting perovskite film has a photoluminescence quantum yield of 17% and a Shockley-Read-Hall lifetime of nearly 7 microseconds and achieved a certified power conversion efficiency (PCE) of 25.4% with an open-circuit voltage of 1.21 volts and a fill factor of 84.7%. In addition, 1-square centimeter cells and 10-square centimeter minimodules show PCEs of 23.4 and 22.0%, respectively. Encapsulated modules exhibited high stability under both operational and damp heat test conditions.

Zinc and selenium status in coronavirus disease 2019.

We systematically analyzed and attempted to discuss the possibility that deficiencies of zinc or selenium were associated with the incidence and severity of COVID-19. We searched for published and unpublished articles in PubMed, Embase, Web of Science and Cochrane up to 9 February 2023. And we selected healthy individuals, mild/severe, and even deceased COVID-19 patients to analyze their serum data. Data related to 2319 patients from 20 studies were analyzed. In the mild/severe group, zinc deficiency was associated with the degree of severe disease (SMD = 0.50, 95% CI 0.32-0.68, I2 = 50.5%) and we got an Egger's test of p = 0.784; but selenium deficiency was not associated with the degree of severe disease (SMD = - 0.03, 95% CI - 0.98-0.93, I2 = 96.7%). In the surviving/death group, zinc deficiency was not associated with mortality of COVID-19 (SMD = 1.66, 95%CI - 1.42-4.47), nor was selenium (SMD = - 0.16, 95%CI - 1.33-1.01). In the risk group, zinc deficiency was positively associated with the prevalence of COVID-19 (SMD = 1.21, 95% CI 0.96-1.46, I2 = 54.3%) and selenium deficiency was also positively associated with the prevalence of it (SMD = 1.16, 95% CI 0.71-1.61, I2 = 58.3%). Currently, serum zinc and selenium deficiencies increase the incidence of COVID-19 and zinc deficiency exacerbates the disease; however, neither zinc nor selenium was associated with mortality in patients with COVID-19. Nevertheless, our conclusions may change when new clinical studies are published.

Insights into the role of ·OH generated in Fe2+/CaO2/coal slime system for efficient extracellular polymeric substances degradation to improve dewaterability of sewage sludge.

The disposal of massive sewage sludge and coal slime is a problem facing municipalities in China. A hypothesis for the co-disposal of sludge and coal slime is proposed to improve dewaterability by utilizing the beneficial role of coal slime as a filter assist and CaO2 enhanced system in this research. Results showed that capillary suction time, specific resistance to filtration and water content decreased dramatically from 49.3 s, 13.2 × 1012 m/kg and 84.85% to 19.1 s, 1.0 × 1012 m/kg and 50.07%, respectively, under the optimal conditions with 0.3/0.1/0.3-Fe2+/CaO2/coal slime g/g DS. The hydroxyl radicals generated in the Fe2+/CaO2 process acted on extracellular polymeric substances (EPS), resulting in a drop in the ratio of α-helix/(ß-sheet + random coil) in the secondary structure of EPS proteins and a reduction in the concentration of aromatic proteins and tryptophan-like substances in TB-EPS, thereby enhancing the sludge dewaterability. Furthermore, coal slime as the skeleton building material induced a rise in sludge particle size and contact angle, lowering the hydrophilicity, compressibility of sludge and providing more channels to facilitate water flow. This work verified the promising application prospect of the Fe2+/CaO2/coal slime combined system in the enhancement of sludge dewaterability.

High Performance Inverted RbCsFAPbI3 Perovskite Solar Cells Based on Interface Engineering and Defects Passivation.

Lead halide-based perovskites solar cells (PSCs) are intriguing candidates for photovoltaic technology due to their high efficiency, low cost, and simple fabrication processes. Currently, PSCs with efficiencies of >25% are mainly based on methylammonium (MA)-free and bromide (Br) free, formamide lead iodide (FAPbI3 )-based perovskites, because MA is thermally unstable due to its volatile nature and Br incorporation will induce blue shift in the absorption spectrum. Therefore, MA-free, Br-free formamidine-based perovskites are drawing huge research attention in recent years. The hole transporting layer (HTL) is crucial in fabricating highly efficient and stable inverted p-i-n structured PSCs by enhancing charge extraction, lowering interfacial recombination, and altering band alignment, etc. Here, this work employs a NiOx /PTAA bi-layer HTL combined with GuHCl (guanidinium hydrochloride) additive engineering and PEAI (phenylethylammonium iodide) passivation strategy to optimize the charge carrier dynamics and tune defects chemistry in the MA-free, Br-free RbCsFAPbI3 -based perovskite absorber, which boosts the device efficiency up to 22.78%. Additionally, the device retains 95% of its initial performance under continuous 1 sun equivalent LED light illumination at 45 °C for up to 500 h.

Efficacy and safety of early drain removal following pancreatic resections: a meta-analysis.

BACKGROUND: No consensus was reached with regard to the effect of EDR on postoperative outcomes after pancreatic surgery. The meta-analysis was designed to explore the efficacy and safety of early drain removal (EDR). METHODS: Systematic literature search was performed. Data extraction and correction were performed by three researchers. For dichotomous and continuous outcomes, we calculated the pooled risk difference and mean difference with 95% confidence intervals, respectively. The heterogeneity of included studies was evaluated using Cochran's Q and I2 test. The stratified analyses of pancreaticoduodenectomy (PD) and distal pancreatectomy (DP) were performed. RESULTS: A total of 10 studies including 3 RCTs and 7 non RCTs were included for meta-analysis, among which 1780 patients with EDR and 5613 patients with late drain removal (LDR) were enrolled. The meta-analysis of both all the available studies and studies only with selected low risk patients indicated that EDR group had significantly lower incidences of Grade B/C postoperative pancreatic fistula (POPF) and total complications for both PD and DP. However, no advantages of EDR were observed in the meta-analysis of the 3 RCTs. In addition, EDR was associated with a lower incidence of intra-abdominal infection after PD. While for DP, EDR group had decreased risk of delayed gastric emptying and re-operation, and shorter postoperative in-hospital stay. CONCLUSIONS: The meta-analysis demonstrates that EDR is effective and safe for both PD and DP considering POPF and total complications, especially for patients with low concentration of postoperative drain fluid amylase.

LBL Noninvasively Peelable Biointerfacial Adhesives for Cutaneo-Inspired pH/Tactility Artificial Receptors.

Besides barrier functions, skin possesses multiple sentiences to external stimuli (e.g., temperature, force, and humidity) for human-outside interaction. Thus, skincare should be taken very seriously, especially by patients with sensory disorders. However, currently available skin-mimicking devices are always limited by so much insufficient response functions and nontunable interface behaviors so as not to realize precise health monitoring and self-defense against injury. Herein, a bioinspired cutaneous receptor-perceptual system (CRPS) patch is presented, integrating hybrid pH indicators and triboelectric nanogenerators into biointerface film-adhesives that are fabricated through facile layer-by-layer (LBL) self-assembly of amide and Schiff-base linkages between alginate grafted with N-hydroxysuccinimide ester (AN), tannic acid (TA), and polyethylenimine (PEI). This CRPS patch is adhered robustly to the soft-curved skin surface without failure via "molecular suturing," and amino acid enables its benign peel-on-demand from tissue interfaces. Postdamage self-healing brings it without surgical reoperation, avoiding extra cost, pain, as well as infection risks. Significantly, CRPS patches as artificial chemo/mechanoreceptors can remotely visualize skin physiological status by pH-induced chromism using smartphones and prevent skin contact injury by tactility-driven self-powered electrical signals. Overall, the LBL-based strategy to create controllably biointerface-adhesive CRPS patches will usher in a new era of the mobihealth care platform supporting smart diagnosis and self-protection.

Immunotherapy combination with regorafenib for refractory hepatocellular carcinoma: A real-world study.

PURPOSE: To compare the efficacy and safety of immunotherapy plus regorafenib versus regorafenib only in patients with pretreated hepatocellular carcinoma (HCC). METHODS: Immunotherapy plus regorafenib or regorafenib alone was analyzed in patients with advanced HCC with documented tumor progression on front-line therapy. Progression-free survival (PFS), overall survival (OS), disease control rate (DCR), and treatment-related adverse events (TRAEs) were assessed. RESULTS: Of the 125 patients enrolled in this study, 50 patients received combination (pCOM) treatment as front-line treatment, and 60 patients received monotherapy (pMONO) as front-line treatment. In the pCOM cohort, median OS was significantly longer with for patients regorafenib plus immunotherapy than regorafenib alone treatment (15.0 vs. 2.0 months; P = 0.035). The DCR numerically increased in the regorafenib plus immunotherapy treatment in both cohorts (40.6 % vs. 22.2 %, 72.7 % vs. 54.7 %, respectively). There were no differences in PFS with regorafenib according to whether or not regorafenib was combined with immunotherapy in the pCOM and pMONO cohorts (PFS, P = 0.17, P = 0.91, respectively). Regarding the number of TRAEs occurred, regorafenib plus immunotherapy group was comparable to regorafenib group in the pCOM cohort (65.6 % vs. 72.2 %). In the pMONO cohort, TRAEs occurred in fewer patients receiving regorafenib than regorafenib plus immunotherapy (69.8 % vs. 95.5 %). CONCLUSIONS: Immunotherapy plus regorafenib may significantly improve clinical outcomes and have a manageable safety profile compared with regorafenib monotherapy in advanced HCC after front-line therapy failure. The efficacy of combination therapy needs to be validated in prospective studies with large samples.

Safety evaluation of early drain removal following pancreaticoduodenectomy: A single-center retrospective cohort study.

Objectives: The effects of early drain removal (EDR) on postoperative complications after pancreaticoduodenectomy (PD) remains to be investigated. This single-center retrospective cohort study was designed to explore the safety of EDR after PD. Methods: A total of 112 patients undergoing PD with drain fluid amylase (DFA) on postoperative day (POD) 1 and 3 <= 5000 were divided into EDR and late drain removal (LDR). Propensity Score Matching (PSM) was used. We compared postoperative outcomes between two groups and explore the risk factors of total complications using univariate and multiple logistic regression analyses. Results: No statistical differences were found in primary outcomes, including Grade B/C postoperative pancreatic fistula (POPF) (Original cohort: 5.71% vs. 3.90%; P = 1.000; PSM cohort: 3.33% vs. 6.67%; P = 1.000), and total complications (Original cohort: 17.14% vs. 32.47%; P = 0.093; PSM cohort: 13.33% vs. 33.33%; P = 0.067). The EDR was associated with shorter in-hospital stay (Original cohort: 11 days vs. 15 days; P < 0.0001; PSM cohort: 11 days vs. 15 days; P < 0.0001). Conclusions: EDR on POD 3 is safe for patients undergoing PD with low risk of POPF.