Pyrus pyrifolia Nakai‘Whangkeumbae'is a sand pear fruit with excellent nutritional quality and taste.However,the industrial development of pear fruit is significantly limited by its short shelf life.Salicylic aci...Pyrus pyrifolia Nakai‘Whangkeumbae'is a sand pear fruit with excellent nutritional quality and taste.However,the industrial development of pear fruit is significantly limited by its short shelf life.Salicylic acid(SA),a well-known phytohormone,can delay fruit senescence and improve shelf life.However,the mechanism by which SA regulates CONSTANS-LIKE genes(COLs)during fruit senescence and the role of COL genes in mediating fruit senescence in sand pear are poorly understood.In this study,22 COL genes were identified in sand pear,including four COLs(Pp COL8,Pp COL9a,Pp COL9b,and Pp COL14)identified via transcriptome analysis and 18 COLs through genome-wide analysis.These COL genes were divided into three subgroups according to the structural domains of the COL protein.Pp COL8,with two B-box motifs and one CCT domain,belonged to the first subgroup.In contrast,the other three Pp COLs,Pp COL9a,Pp COL9b,and Pp COL14,with similar conserved protein domains and gene structures,were assigned to the third subgroup.The four COLs showed different expression patterns in pear tissues and were preferentially expressed at the early stage of fruit development.Moreover,the expression of Pp COL8 was inhibited by exogenous SA treatment,while SA up-regulated the expression of Pp COL9a and Pp COL9b.Interestingly,Pp COL8 interacts with Pp MADS,a MADS-box protein preferentially expressed in fruit,and SA up-regulated its expression.While the production of ethylene and the content of malondialdehyde(MDA)were increased in Pp COL8-overexpression sand pear fruit,the antioxidant enzyme(POD and SOD)activity and the expression of Pp POD1 and Pp SOD1 in the sand pear fruits were down-regulated,which showed that Pp COL8 promoted sand pear fruit senescence.In contrast,the corresponding changes were the opposite in Pp MADS-overexpression sand pear fruits,suggesting that Pp MADS delayed sand pear fruit senescence.The co-transformation of Pp COL8 and Pp MADS also delayed sand pear fruit senescence.The results of this study revealed that Pp COL8 can play a key role in pear fruit senescence by interacting with Pp MADS through the SA signaling pathway.展开更多
BACKGROUND Previous studies have demonstrated the benefits of ideal cardiovascular health(CVH) in reducing cardiovascular risk.However,its role in subclinical atherosclerosis(SA) progression remains unclear.We aim to ...BACKGROUND Previous studies have demonstrated the benefits of ideal cardiovascular health(CVH) in reducing cardiovascular risk.However,its role in subclinical atherosclerosis(SA) progression remains unclear.We aim to examine the association of CVH,estimated by the American Heart Association's new Life's Essential 8(LE8),with the progression of SA.METHODS This prospective cohort study was conducted among 972 asymptomatic Chinese participants and followed up for5.7 years.The LE8 score(range,0–100) consisted of blood pressure,lipids,glucose,body mass index,smoking status,diet health,physical activity and sleep health was evaluated in 1998 and 2008–2009.Progression of SA was determined by carotid plaque and coronary artery calcification(CAC) in 2008–2009 and 2013–2014.Log-binomial regression model was used to estimate the association of LE8 score with SA progression.RESULTS Each 10 points increment in LE8 score was associated with 15.2%(RR:0.848,95% CI:0.797–0.902),17.7%(RR:0.823,95% CI:0.766–0.884) and 12.0%(RR:0.880,95% CI:0.845–0.916) lower risks of carotid plaque,CAC and overall SA progression,respectively.Compared with participants with non-ideal CVH at both visits,the participants with ideal CVH at both visits had39.1%(RR:0.609,95% CI:0.494–0.752),41.0%(RR:0.590,95% CI:0.456–0.764) and 29.7%(RR:0.703,95% CI:0.598–0.825) lower risks of carotid plaque,CAC and overall SA progression,respectively.CONCLUSIONS Higher LE8 scores were associated with lower risks of SA progression.Besides,long-term maintenance of optimal CVH was more beneficial to prevent SA progression.展开更多
Background and Objective:iASPP, an inhibitory member of the apoptosis-stimulating proteins of p53 (ASPP) family, has been found to be up-regulated in various human tumor types.This study was to construct an efficient ...Background and Objective:iASPP, an inhibitory member of the apoptosis-stimulating proteins of p53 (ASPP) family, has been found to be up-regulated in various human tumor types.This study was to construct an efficient doxycycline-regulated, lentiviral vector-mediated knockdown system for iASPP that will allow for inducible down-regulation of iASPP gene expression and preliminary functional analysis.Methods:A pair of complementary oligos with hairpin structures targeting the iASPP gene and a negative control were synthesized, then ligated with pLVTHM vector and sequenced.The fragment containing the shRNA cassette was cloned to pLVCT-tTR-KRAB plasmid.The recombinant vectors were co-transfected with viral packaging mix into 293T cells, and viral supernatant was harvested to determine the titer.After treatment with or without doxycycline, HepG2 cells infected with virus were harvested and the expression of iASPP was detected by reverse transcription-polymerase chain reaction (RT-PCR) and Western blot analysis.Its effects on tumor growth were characterized using MTS assay, soft agar colony formation, and flow cytometry analysis.Results:The lentiviral vector expressing shRNA that targets to the oncogene iASPP was constructed successfully.HepG2 infected with the lentivirus expressing shRNA against iASPP inhibited the expression of iASPP in the presence of doxycycline, which resulted in the repression of tumor cell proliferation and anchorage-independent growth potential.Conclusions:The lentiviral vector-mediated tet-on system demonstrates efficient and inducible knockdown of iASPP in hepatocellular carcinoma cells.iASPP gene may be involved in tumorigenesis and progression of human tumors.展开更多
BACKGROUND Time in range(TIR),as a novel metric for glycemic control,has robust relevance with diabetic complications.Diabetic peripheral neuropathy(DPN)is characterized by sudomotor dysfunction.AIM To explore the rel...BACKGROUND Time in range(TIR),as a novel metric for glycemic control,has robust relevance with diabetic complications.Diabetic peripheral neuropathy(DPN)is characterized by sudomotor dysfunction.AIM To explore the relationship between TIR obtained from continuous glucose monitoring(CGM)and sudomotor function detected by SUDOSCAN in subjects with type 2 diabetes.METHODS The research enrolled 466 inpatients with type 2 diabetes.All subjects underwent 3-d CGM and SUDOSCAN.SUDOSCAN was assessed with electrochemical skin conductance in hands(HESC)and feet(FESC).Average feet ESC<60μS was defined as sudomotor dysfunction(+),otherwise it was sudomotor dysfunction(-).TIR refers to the percentage of time when blood glucose is between 3.9-10 mmol/L during 1 d period.RESULTS Among the enrolled subjects,135(28.97%)presented with sudomotor dysfunction.Patients with sudomotor dysfunction(+)showed a decreased level of TIR(P<0.001).Compared to the lowest tertile of TIR,the middle and the highest tertiles of TIR was associated with an obviously lower prevalence of sudomotor dysfunction(20.51%and 21.94%vs 44.52%)(P<0.001).In addition,with the increase of TIR,HESC and FESC increased(P<0.001).Regression analysis demonstrated that TIR was inversely and independently linked with the prevalence of sudomotor dysfunction after adjusting for confounding values(odds ratio=0.979,95%CI:0.971-0.987,P<0.001).CONCLUSION The tight glycemic control assessed by TIR is of vitally protective value for sudomotor dysfunction in type 2 diabetes mellitus.展开更多
AIM:To evaluate the effect of reducing the use of antibiotics in the treatment of infant bacterial dacryocystitis after probing of the lacrimal duct.METHODS:A total of 542 cases of children under one year old and acce...AIM:To evaluate the effect of reducing the use of antibiotics in the treatment of infant bacterial dacryocystitis after probing of the lacrimal duct.METHODS:A total of 542 cases of children under one year old and accepting nasolacrimal duct probing treatment were divided into two groups, which were treated with topical and oral antibiotics, respectively.Conjunctival sac secretions were used as a control index of bacterial infection, whereas the disappearance of epiphora symptoms and lacrimal passage patency were used as cure indexes. The χ2test was used to compare enumeration and measurement data, and a statistical significance was set at P 【0.05. The therapeutic effect on the two groups of postoperative patients was investigated.RESULTS:In the two study groups, no significant differences in gender, age and postoperative control of lacrimal sac infection were observed. The cure rates after three probing operations also showed no significant difference.CONCLUSION:After probing of the lacrimal passage,results of this study confirmed that postoperative medication without oral antibiotics but an ophthalmic dosage of antibiotics was a simple and effective treatment method.展开更多
·AIM: To evaluate the difference in angle parameters and clinical outcome following phacoemulsification and combined phacotrabeculectomy in patients with acute primary angle closure(APAC) using ultrasound biomicr...·AIM: To evaluate the difference in angle parameters and clinical outcome following phacoemulsification and combined phacotrabeculectomy in patients with acute primary angle closure(APAC) using ultrasound biomicroscopy(UBM).·METHODS: Patients(n =23, 31 eyes) were randomized to receive phacoemulsification or combined phacotrabeculectomy(n =24, 31 eyes). Best-corrected visual acuity(BCVA), intraocular pressure(IOP), the main complications following surgery, and indentation gonioscopy and angle parameters measured using UBM were documented preoperatively and postoperatively.· RESULTS: The improvement in BCVA in the phacoemulsification group was significantly greater than in the combined group(P 【0.05). IOP in the phacoemulsification group was slightly higher than in the combined group following 1wk of follow-up(P 【0.05),whereas there was no significant difference between the two groups at the latter follow-up(P 】0.05).Phacoemulsification alone resulted in a slight increase in the trabecular ciliary processes distance compared with the combined surgery(P 【0.05), whereas the other angle parameters showed no significant difference between the groups. Complications in combined group were greater than phacoemulsification only group.·CONCLUSION: Both surgeries effectively opened the drainage angle and deepened the anterior chamber, and IOP was well controlled postoperatively. However,phacoemulsification showed better efficacy in improving visual function and showed reduced complications following surgery.展开更多
Published data on earthquake-associated peripheral nerve injury is very limited. Ultrasonography has been proven to be efficient in the clinic to diagnose peripheral nerve injury. The aim of this study was to assess t...Published data on earthquake-associated peripheral nerve injury is very limited. Ultrasonography has been proven to be efficient in the clinic to diagnose peripheral nerve injury. The aim of this study was to assess the role of ultrasound in the evaluation of persistent peripheral nerve injuries 1 year after the Wenchuan earthquake. Thirty-four patients with persistent clinical symptoms and neurologic signs of impaired nerve function were evaluated with sonography prior to surgi- cal repair. Among 34 patients, ultrasonography showed that 48 peripheral nerves were entrapped, and 11 peripheral nerves were disrupted. There was one case of misdiagnosis on ultrasonogra- phy. The concordance rate of ultrasonographic findings with those of surgical findings was 98%. A total of 48 involved nerves underwent neurolysis and the symptoms resolved. Only five nerves had scar tissue entrapment. Preoperative and postoperative clinical and ultrasonographic results were concordant, which verified that ultrasonography is useful for preoperative diagnosis and postoperative evaluation of injured peripheral nerves.展开更多
HSP90 AA1 is part of the heat shock protein 90 gene family and has important functions against heat stress. We report a case of molecular level parallel evolution of the HSP90 AA1 gene in high elevation amphibians. HS...HSP90 AA1 is part of the heat shock protein 90 gene family and has important functions against heat stress. We report a case of molecular level parallel evolution of the HSP90 AA1 gene in high elevation amphibians. HSP90 AA1 gene sequences of four high-elevation anurans, Bufo gargarizans, Nanorana parkeri, Rana kukunoris, and Scutiger boulengeri, were compared along with five of their low-elevation relatives. A total of 16 amino-acid sites were identified as parallel evolution between N. parkeri and R. kukunoris. We generated both model based（Zhang and Kumar＇s test） and empirical data based（parallel/divergence plotting） null distributions for non-parallel evolution, and both methods clearly determined that the observed number of parallel substitutions were significantly more than the null expectation. Furthermore, on the HSP90 AA1 gene tree, N. parkeri and R. kukunoris formed a strongly supported clade that was away from their respective relatives. This study provides a clear case of molecular parallel evolution, which may have significant implications in understanding the genetic mechanisms of high-elevation adaptation.展开更多
With the development and expansion of China's economy, people's artistic and cultural forms have also been significantly improved and developed. At the same time, the educational development of art design in c...With the development and expansion of China's economy, people's artistic and cultural forms have also been significantly improved and developed. At the same time, the educational development of art design in colleges and universities has also become a common trend, for the shaping of the Chinese women's top of the artistic design concept has laid a good cornerstone. At the same time, the Chinese nation after five thousand years of development, the formation of the vast treasures of art and culture, in the origins of circulation is still endless, to the later Chinese children to provide valuable artistic learning resources. The fusion of Chinese folk art culture in the art design education of colleges and universities has a crucial influence on broadening students 'artistic vision, cultivating students' artistic innovation thinking and inheriting Chinese traditional folk art culture. Through the combination of folk art and modern art, the art education of colleges and universities has very far-reaching foresight significance.展开更多
Assimilation of the Advanced Geostationary Radiance Imager(AGRI)clear-sky radiance in a regional model is performed.The forecasting effectiveness of the assimilation of two water vapor(WV)channels with conventional ob...Assimilation of the Advanced Geostationary Radiance Imager(AGRI)clear-sky radiance in a regional model is performed.The forecasting effectiveness of the assimilation of two water vapor(WV)channels with conventional observations for the“21·7”Henan extremely heavy rainfall is analyzed and compared with a baseline test that assimilates only conventional observations in this study.The results show that the 24-h cumulative precipitation forecast by the assimilation experiment with the addition of the AGRI exceeds 500 mm,compared to a maximum value of 532.6 mm measured by the national meteorological stations,and that the location of the maximum precipitation is consistent with the observations.The results for the short periods of intense precipitation processes are that the simulation of the location and intensity of the 3-h cumulative precipitation is also relatively accurate.The analysis increment shows that the main difference between the two sets of assimilation experiments is over the ocean due to the additional ocean observations provided by FY-4A,which compensates for the lack of ocean observations.The assimilation of satellite data adjusts the vertical and horizontal wind fields over the ocean by adjusting the atmospheric temperature and humidity,which ultimately results in a narrower and stronger WV transport path to the center of heavy precipitation in Zhengzhou in the lower troposphere.Conversely,the WV convergence and upward motion in the control experiment are more dispersed;therefore,the precipitation centers are also correspondingly more dispersed.展开更多
The use of aeolian sand(AS)as an aggregate to prepare coal mine cemented filling materials can resolve the problems of gangue shortage and excessive AS deposits.Owing to the lack of research on the mechanism of cement...The use of aeolian sand(AS)as an aggregate to prepare coal mine cemented filling materials can resolve the problems of gangue shortage and excessive AS deposits.Owing to the lack of research on the mechanism of cemented AS backfill(CASB),the response surface method(RSM)was adopted in this study to analyze the influence of ordinary Portland cement(PO)content(x_(1)),fly ash(FA)-AS(FA-AS)ratio(x_(2)),and concentration(x_(3))on the mechanical and microscopic properties of the CASB.The hydration characteristics and internal pore structure of the backfill were assessed through thermogravimetric/derivative thermogravimetric analysis,mercury intrusion porosimetry,and scanning electron microscopy.The RSM results show that the influence of each factor and interaction term on the response values is extremely significant(except x_(1)x_(3),which had no obvious effect on the 28 d strength).The uniaxial compressive strength(UCS)increased with the PO content,FA-AS ratio,and concentration.The interaction effects of x_(1)x_(2),x_(1)x_(3),and x_(2)x_(3) on the UCS at 3,7,and 28 d were analyzed.In terms of the influence of interaction items,an improvement in one factor promoted the strengthening effect of another factor.The enhancement mechanism of the curing time,PO content,and FA-AS ratio on the backfill was reflected in the increase in hydration products and pore structure optimization.By contrast,the enhancement mechanism of the concentration was mainly the pore structure optimization.The UCS was positively correlated with weight loss and micropore content but negatively correlated with the total porosity.The R^(2) value of the fitting function of the strength and weight loss,micropore content,and total porosity exceeded 0.9,which improved the characterization of the enhancement mechanism of the UCS based on the thermogravimetric analysis and pore structure.This work obtained that the influence rules and mechanisms of the PO,FA-AS,concentration,and interaction terms on the mechanical properties of the CASB provided a certain theoretical and engineering guidance for CASB filling.展开更多
Nanowires with gate-all-around(GAA) structures are widely considered as the most promising candidate for 3-nm technology with the best ability of suppressing the short channel effects,and tunneling field effect transi...Nanowires with gate-all-around(GAA) structures are widely considered as the most promising candidate for 3-nm technology with the best ability of suppressing the short channel effects,and tunneling field effect transistors(TFETs)based on GAA structures also present improved performance.In this paper,a non-quasi-static(NQS) device model is developed for nanowire GAA TFETs.The model can predict the transient current and capacitance varying with operation frequency,which is beyond the ability of the quasi-static(QS) model published before.Excellent agreements between the model results and numerical simulations are obtained.Moreover,the NQS model is derived from the published QS model including the current-voltage(I-V) and capacitance-voltage(C-V) characteristics.Therefore,the NQS model is compatible with the QS model for giving comprehensive understanding of GAA TFETs and would be helpful for further study of TFET circuits based on nanowire GAA structure.展开更多
BACKGROUND The femoral neck dynamic intersection system(FNS)is mechanically more stable than other internal fixation techniques.Current studies have confirmed that the structural design of FNS has good biomechanical p...BACKGROUND The femoral neck dynamic intersection system(FNS)is mechanically more stable than other internal fixation techniques.Current studies have confirmed that the structural design of FNS has good biomechanical properties in European and American populations.However,whether the suitability of the FNS's 130°main nail angle design for Asian populations has been thoroughly investigated remains unclear.AIM To compare the biomechanical stability differences among different main nail angles of the FNS in the treatment of femoral neck fractures in Asian populations.METHODS Computed tomography data of the femur of healthy adult male volunteers were imported into Mimics software to create a three-dimensional model of the femur.The model was adapted to the curve using Geomagic software and imported into Solidworks software to construct the Pauwels I femoral neck fracture model and design the FNS internal fixation model using different main nail angles.Afterward,the models were assembled with the FNS fracture model and meshed using the preprocessing Hypermesh software.Subsequently,they were imported into Abaqus software to analyze and evaluate the biomechanical effects of different angles of the FNS main nail on the treatment of femoral neck fractures.RESULTS The peak displacement of the proximal femur under different angles of FNS fixation under stress was 7.446 millimeters in the 120°group and 7.416 millimeters in the 125°group;in the 130°,135°,and 140°FNS fixation groups,the peak displacement was 7.324 millimeters,8.138 millimeters,and 8.246 millimeters,respectively.In the 120°and 125°FNS fixation groups,the maximum stresses were concentrated at the main nail and the anti-rotation screw,which intersected the fracture line of the femur neck,resulting in peak stresses of 200.7 MPa and 138.8 MPa,respectively.Peak stresses of 208.8 MPa,219.8 MPa,and 239.3 MPa were observed on the angular locking plate distal to the locking screw in the 130°,135°,and 140°fixation groups.CONCLUSION FNS has significant stress distribution properties,a minimal proximal femoral displacement,and an optimal stability for treating femoral neck fractures in Asian populations when performed with a 130°main nail angle.展开更多
AIM： To observe the attenuation of ethanol extract of Herba Scutellaria barbata （SE） against diabetic retinopathy （DR） and its engaged mechanism. METHODS： C57BL/6J mice were intraperitoneally injected with stre...AIM： To observe the attenuation of ethanol extract of Herba Scutellaria barbata （SE） against diabetic retinopathy （DR） and its engaged mechanism. METHODS： C57BL/6J mice were intraperitoneally injected with streptozotocin （STZ, 55 mg/kg） for 5 consecutive days to induce diabetes, The diabetic mice were orally given with SE （100, 200 mg/kg） for lmo at lmo after STZ injection. Blood-retinal barrier （BRB） breakdown was detected by using Evans blue permeation assay. Real-time polymerase chain reaction （RT-PCR）, Western blot and immunofiuorescence staining were used to detect mRNA and protein expression. Enzyme-linked immunosorbent assay （ELISA） was used to detect serum contents of tumor necrosis factor-e （TNF-a） and interleukin （IL）-II. RESULTS： SE （100, 200 mg/kg） reversed the breakdown of BRB in STZ-induced diabetic mice. The decreased expression of retinal claudin-1 and claudin-19, which are both tight junction （T J） proteins, was reversed by SE. SE decreased the increased serum contents and retinal mRNA expression of TNF-a and IL-113. SE also decreased the increased retinal expression of intercellular cell adhesion molecule-1 （ICAM-1）. SE reduced the increased phosphorylation of nuclear factor kappa B （NFKB） p65 and its subsequent nuclear translocation in retinas from STZ- induced diabetic mice. Results of Western blot and retinal immunofluorescence staining of ionized calcium-binding adapter molecule 1 （Ibal） demonstrated that SE abrogated the activation of microglia cells in STZ-induced diabetic mice. CONCLUSION： SE attenuates the development of DR by inhibiting retinal inflammation and restoring the decreased expression of TJ proteins including claudin-1 and claudin-19.展开更多
A chemical co-precipitation strategy was employed to synthesize a series of(Gd_(0.95−x)Lu_(x)Eu_(0.05))_(3)Al_(5)O_(12)(x=0.1−0.95)powder phosphors,followed by vacuum sintering to achieve transparent garnet ceramic ph...A chemical co-precipitation strategy was employed to synthesize a series of(Gd_(0.95−x)Lu_(x)Eu_(0.05))_(3)Al_(5)O_(12)(x=0.1−0.95)powder phosphors,followed by vacuum sintering to achieve transparent garnet ceramic phosphors.The density functional theory indicated Lu_(3)Al_(5)O_(12) was formed in priority compared with Gd_(3)Al_(5)O_(12) during solid-phase reaction.Upon high-temperature sintering,the Lu^(3+)substitution for Gd^(3+)suppressed point mass diffusion leading to a smaller grain size.The in-line transmittances of bulk specimens with x=0.1,0.3,0.5,0.7,and 0.95 nm were~83.5%,80.1%,68.8%,73.7%,and 82.2%at 710 nm(Eu^(3+)emission center),respectively,among which the sample of x=0.1 exhibited the optical grade with near-zero optical loss in agreement with the defect-free single crystal(~100%of the theoretical transmittance).The resulting particle and ceramic materials both presented characteristic Eu^(3+)emission arising from 5D0→7FJ(J=1−4)transition,where the dominant far-red emission at~710 nm arising from ^(5)D_(0)→^(7)F_(4) transition overlapped with the absorption of phytochrome(PFR).The photoluminescence excitation and photoluminescence intensities of(Gd_(0.95−x)Lu_(x)Eu_(0.05))_(3)Al_(5)O_(12) powders and ceramics generally increased at a higher Gd^(3+)/Lu^(3+)ratio.Lu^(3+)dopants delayed the fluorescence lifetime while the bulk samples had shorter lifetime compared to the particle counterparts.The transparent(Gd_(0.85)Lu_(0.1)Eu_(0.05))3Al_(5)O_(12) ceramic phosphor exhibited good thermal stability with a high thermal quenching temperature above 533 K.The designed ceramic phosphor-converted light-emitting diode had a saturation injection current of 435 mA and a current-dependent color rendering index.More importantly,our report marked the developmental stage of transparent ceramic materials towards zero optical loss.展开更多
The human brain, a marvel of intricate connections, functions as a complex network comprising structurally and functionally integrated regions. This network orchestrates a multitude of complex patterns through high-le...The human brain, a marvel of intricate connections, functions as a complex network comprising structurally and functionally integrated regions. This network orchestrates a multitude of complex patterns through high-level integration and continuous cooperation, essential for overall brain functionality [1].展开更多
AIM:To compare postoperative complications and prognosis of esophageal squamous cell carcinoma patients treated with different routes of reconstruction. METHODS:After obtaining approval from the Medical Ethics Committ...AIM:To compare postoperative complications and prognosis of esophageal squamous cell carcinoma patients treated with different routes of reconstruction. METHODS:After obtaining approval from the Medical Ethics Committee of the Sun Yat-Sen University Cancer Center, we retrospectively reviewed data from 306 consecutive patients with histologically diagnosed esophageal squamous cell carcinoma who were treated between 2001 and 2011. All patients underwent radical McKeown-type esophagectomy with at least two-field lymphadenectomy. Regular follow-up was performed in our outpatient department. Postoperative complica-tions and long-term survival were analyzed by treatment modality, baseline patient characteristics, and operative procedure. Data from patients treated via the retrosternal and posterior mediastinal routes were compared. RESULTS:The posterior mediastinal and retrosternal reconstruction routes were employed in 120 and 186 patients, respectively. Pulmonary complications were the most common complications experienced during the postoperative period (46.1% of all patients; 141/306). Compared to the retrosternal route, the posterior mediastinal reconstruction route was associated with a lower incidence of anastomotic stricture (15.8% vs 27.4%, P = 0.018) and less surgical bleeding (242.8 ± 114.2 mL vs 308.2 ± 168.4 mL, P < 0.001). The median survival time was 26.8 mo (range:1.6-116.1 mo). Upon uni/multivariate analysis, a lower preoperative albumin level (P = 0.009) and a more advanced pathological stage (pT; P = 0.006; pN; P < 0.001) were identified as independent factors predicting poor prognosis. The reconstruction route did not influence prognosis (P = 0.477). CONCLUSION:The posterior mediastinal route of reconstruction reduces incidence of postoperative complications but does not affect survival. This route is recommended for resectable esophageal squamous cell carcinoma.展开更多
基金supported by the National Natural Science Foundation of China(32272654)the Natural Science Foundation of Hebei Province China(C2023204016)+2 种基金the Hebei Province Introduced Overseas-Scholar Fund China(C20220361)the S&T Program of Hebei China(20326330D)the Hebei Province Outstanding Youth Fund China(2016,2019)。
文摘Pyrus pyrifolia Nakai‘Whangkeumbae'is a sand pear fruit with excellent nutritional quality and taste.However,the industrial development of pear fruit is significantly limited by its short shelf life.Salicylic acid(SA),a well-known phytohormone,can delay fruit senescence and improve shelf life.However,the mechanism by which SA regulates CONSTANS-LIKE genes(COLs)during fruit senescence and the role of COL genes in mediating fruit senescence in sand pear are poorly understood.In this study,22 COL genes were identified in sand pear,including four COLs(Pp COL8,Pp COL9a,Pp COL9b,and Pp COL14)identified via transcriptome analysis and 18 COLs through genome-wide analysis.These COL genes were divided into three subgroups according to the structural domains of the COL protein.Pp COL8,with two B-box motifs and one CCT domain,belonged to the first subgroup.In contrast,the other three Pp COLs,Pp COL9a,Pp COL9b,and Pp COL14,with similar conserved protein domains and gene structures,were assigned to the third subgroup.The four COLs showed different expression patterns in pear tissues and were preferentially expressed at the early stage of fruit development.Moreover,the expression of Pp COL8 was inhibited by exogenous SA treatment,while SA up-regulated the expression of Pp COL9a and Pp COL9b.Interestingly,Pp COL8 interacts with Pp MADS,a MADS-box protein preferentially expressed in fruit,and SA up-regulated its expression.While the production of ethylene and the content of malondialdehyde(MDA)were increased in Pp COL8-overexpression sand pear fruit,the antioxidant enzyme(POD and SOD)activity and the expression of Pp POD1 and Pp SOD1 in the sand pear fruits were down-regulated,which showed that Pp COL8 promoted sand pear fruit senescence.In contrast,the corresponding changes were the opposite in Pp MADS-overexpression sand pear fruits,suggesting that Pp MADS delayed sand pear fruit senescence.The co-transformation of Pp COL8 and Pp MADS also delayed sand pear fruit senescence.The results of this study revealed that Pp COL8 can play a key role in pear fruit senescence by interacting with Pp MADS through the SA signaling pathway.
基金funded by the Chinese Academy of Medical Sciences(CAMS)Innovation Fund for Medical Sciences(2021-I2M-1-010,2019-I2M-2-003,and 2017-I2M-1-004)National Natural Science Foundation of China(82030102,12126602,82330106,82322059,and 91857118)+1 种基金National High Level Hospital Clinical Research Funding(2022-GSP-GG-1,and 2022-GSP-GG-2)National Key Research and Development Program of China(2021YFC2500500).
文摘BACKGROUND Previous studies have demonstrated the benefits of ideal cardiovascular health(CVH) in reducing cardiovascular risk.However,its role in subclinical atherosclerosis(SA) progression remains unclear.We aim to examine the association of CVH,estimated by the American Heart Association's new Life's Essential 8(LE8),with the progression of SA.METHODS This prospective cohort study was conducted among 972 asymptomatic Chinese participants and followed up for5.7 years.The LE8 score(range,0–100) consisted of blood pressure,lipids,glucose,body mass index,smoking status,diet health,physical activity and sleep health was evaluated in 1998 and 2008–2009.Progression of SA was determined by carotid plaque and coronary artery calcification(CAC) in 2008–2009 and 2013–2014.Log-binomial regression model was used to estimate the association of LE8 score with SA progression.RESULTS Each 10 points increment in LE8 score was associated with 15.2%(RR:0.848,95% CI:0.797–0.902),17.7%(RR:0.823,95% CI:0.766–0.884) and 12.0%(RR:0.880,95% CI:0.845–0.916) lower risks of carotid plaque,CAC and overall SA progression,respectively.Compared with participants with non-ideal CVH at both visits,the participants with ideal CVH at both visits had39.1%(RR:0.609,95% CI:0.494–0.752),41.0%(RR:0.590,95% CI:0.456–0.764) and 29.7%(RR:0.703,95% CI:0.598–0.825) lower risks of carotid plaque,CAC and overall SA progression,respectively.CONCLUSIONS Higher LE8 scores were associated with lower risks of SA progression.Besides,long-term maintenance of optimal CVH was more beneficial to prevent SA progression.
文摘Background and Objective:iASPP, an inhibitory member of the apoptosis-stimulating proteins of p53 (ASPP) family, has been found to be up-regulated in various human tumor types.This study was to construct an efficient doxycycline-regulated, lentiviral vector-mediated knockdown system for iASPP that will allow for inducible down-regulation of iASPP gene expression and preliminary functional analysis.Methods:A pair of complementary oligos with hairpin structures targeting the iASPP gene and a negative control were synthesized, then ligated with pLVTHM vector and sequenced.The fragment containing the shRNA cassette was cloned to pLVCT-tTR-KRAB plasmid.The recombinant vectors were co-transfected with viral packaging mix into 293T cells, and viral supernatant was harvested to determine the titer.After treatment with or without doxycycline, HepG2 cells infected with virus were harvested and the expression of iASPP was detected by reverse transcription-polymerase chain reaction (RT-PCR) and Western blot analysis.Its effects on tumor growth were characterized using MTS assay, soft agar colony formation, and flow cytometry analysis.Results:The lentiviral vector expressing shRNA that targets to the oncogene iASPP was constructed successfully.HepG2 infected with the lentivirus expressing shRNA against iASPP inhibited the expression of iASPP in the presence of doxycycline, which resulted in the repression of tumor cell proliferation and anchorage-independent growth potential.Conclusions:The lentiviral vector-mediated tet-on system demonstrates efficient and inducible knockdown of iASPP in hepatocellular carcinoma cells.iASPP gene may be involved in tumorigenesis and progression of human tumors.
基金National Natural Science Foundation of China,No.81774134 and No.81873174Natural Science Foundation of Jiangsu Province of China,No.BK20150558 and No.BK20171331+2 种基金Postdoctoral Foundation of Jiangsu Province of China,No.1501120CJiangsu Province 333 Talent Funding Project,No.BRA2017595Young Medical Key Talents Project of Jiangsu Province,No.QNRC2016902.
文摘BACKGROUND Time in range(TIR),as a novel metric for glycemic control,has robust relevance with diabetic complications.Diabetic peripheral neuropathy(DPN)is characterized by sudomotor dysfunction.AIM To explore the relationship between TIR obtained from continuous glucose monitoring(CGM)and sudomotor function detected by SUDOSCAN in subjects with type 2 diabetes.METHODS The research enrolled 466 inpatients with type 2 diabetes.All subjects underwent 3-d CGM and SUDOSCAN.SUDOSCAN was assessed with electrochemical skin conductance in hands(HESC)and feet(FESC).Average feet ESC<60μS was defined as sudomotor dysfunction(+),otherwise it was sudomotor dysfunction(-).TIR refers to the percentage of time when blood glucose is between 3.9-10 mmol/L during 1 d period.RESULTS Among the enrolled subjects,135(28.97%)presented with sudomotor dysfunction.Patients with sudomotor dysfunction(+)showed a decreased level of TIR(P<0.001).Compared to the lowest tertile of TIR,the middle and the highest tertiles of TIR was associated with an obviously lower prevalence of sudomotor dysfunction(20.51%and 21.94%vs 44.52%)(P<0.001).In addition,with the increase of TIR,HESC and FESC increased(P<0.001).Regression analysis demonstrated that TIR was inversely and independently linked with the prevalence of sudomotor dysfunction after adjusting for confounding values(odds ratio=0.979,95%CI:0.971-0.987,P<0.001).CONCLUSION The tight glycemic control assessed by TIR is of vitally protective value for sudomotor dysfunction in type 2 diabetes mellitus.
文摘AIM:To evaluate the effect of reducing the use of antibiotics in the treatment of infant bacterial dacryocystitis after probing of the lacrimal duct.METHODS:A total of 542 cases of children under one year old and accepting nasolacrimal duct probing treatment were divided into two groups, which were treated with topical and oral antibiotics, respectively.Conjunctival sac secretions were used as a control index of bacterial infection, whereas the disappearance of epiphora symptoms and lacrimal passage patency were used as cure indexes. The χ2test was used to compare enumeration and measurement data, and a statistical significance was set at P 【0.05. The therapeutic effect on the two groups of postoperative patients was investigated.RESULTS:In the two study groups, no significant differences in gender, age and postoperative control of lacrimal sac infection were observed. The cure rates after three probing operations also showed no significant difference.CONCLUSION:After probing of the lacrimal passage,results of this study confirmed that postoperative medication without oral antibiotics but an ophthalmic dosage of antibiotics was a simple and effective treatment method.
文摘·AIM: To evaluate the difference in angle parameters and clinical outcome following phacoemulsification and combined phacotrabeculectomy in patients with acute primary angle closure(APAC) using ultrasound biomicroscopy(UBM).·METHODS: Patients(n =23, 31 eyes) were randomized to receive phacoemulsification or combined phacotrabeculectomy(n =24, 31 eyes). Best-corrected visual acuity(BCVA), intraocular pressure(IOP), the main complications following surgery, and indentation gonioscopy and angle parameters measured using UBM were documented preoperatively and postoperatively.· RESULTS: The improvement in BCVA in the phacoemulsification group was significantly greater than in the combined group(P 【0.05). IOP in the phacoemulsification group was slightly higher than in the combined group following 1wk of follow-up(P 【0.05),whereas there was no significant difference between the two groups at the latter follow-up(P 】0.05).Phacoemulsification alone resulted in a slight increase in the trabecular ciliary processes distance compared with the combined surgery(P 【0.05), whereas the other angle parameters showed no significant difference between the groups. Complications in combined group were greater than phacoemulsification only group.·CONCLUSION: Both surgeries effectively opened the drainage angle and deepened the anterior chamber, and IOP was well controlled postoperatively. However,phacoemulsification showed better efficacy in improving visual function and showed reduced complications following surgery.
基金supported by a grant from the National High Technology Research and Development Program of China(863 Program),No.2008AA022400a grant from the Sichuan Technology Department of Sichuan Province,No.2009Y0174a grant from the Chengdu Technology Department of Chengdu City,No.(2012)530021
文摘Published data on earthquake-associated peripheral nerve injury is very limited. Ultrasonography has been proven to be efficient in the clinic to diagnose peripheral nerve injury. The aim of this study was to assess the role of ultrasound in the evaluation of persistent peripheral nerve injuries 1 year after the Wenchuan earthquake. Thirty-four patients with persistent clinical symptoms and neurologic signs of impaired nerve function were evaluated with sonography prior to surgi- cal repair. Among 34 patients, ultrasonography showed that 48 peripheral nerves were entrapped, and 11 peripheral nerves were disrupted. There was one case of misdiagnosis on ultrasonogra- phy. The concordance rate of ultrasonographic findings with those of surgical findings was 98%. A total of 48 involved nerves underwent neurolysis and the symptoms resolved. Only five nerves had scar tissue entrapment. Preoperative and postoperative clinical and ultrasonographic results were concordant, which verified that ultrasonography is useful for preoperative diagnosis and postoperative evaluation of injured peripheral nerves.
基金supported by the National Nature Science Foundation of China (grant number 31328021 to Jinzhong FU)NSERC of Canada (a discovery grant to Jinzhong FU)
文摘HSP90 AA1 is part of the heat shock protein 90 gene family and has important functions against heat stress. We report a case of molecular level parallel evolution of the HSP90 AA1 gene in high elevation amphibians. HSP90 AA1 gene sequences of four high-elevation anurans, Bufo gargarizans, Nanorana parkeri, Rana kukunoris, and Scutiger boulengeri, were compared along with five of their low-elevation relatives. A total of 16 amino-acid sites were identified as parallel evolution between N. parkeri and R. kukunoris. We generated both model based（Zhang and Kumar＇s test） and empirical data based（parallel/divergence plotting） null distributions for non-parallel evolution, and both methods clearly determined that the observed number of parallel substitutions were significantly more than the null expectation. Furthermore, on the HSP90 AA1 gene tree, N. parkeri and R. kukunoris formed a strongly supported clade that was away from their respective relatives. This study provides a clear case of molecular parallel evolution, which may have significant implications in understanding the genetic mechanisms of high-elevation adaptation.
文摘With the development and expansion of China's economy, people's artistic and cultural forms have also been significantly improved and developed. At the same time, the educational development of art design in colleges and universities has also become a common trend, for the shaping of the Chinese women's top of the artistic design concept has laid a good cornerstone. At the same time, the Chinese nation after five thousand years of development, the formation of the vast treasures of art and culture, in the origins of circulation is still endless, to the later Chinese children to provide valuable artistic learning resources. The fusion of Chinese folk art culture in the art design education of colleges and universities has a crucial influence on broadening students 'artistic vision, cultivating students' artistic innovation thinking and inheriting Chinese traditional folk art culture. Through the combination of folk art and modern art, the art education of colleges and universities has very far-reaching foresight significance.
基金supported by the National Key R&D Program of China(Grant Nos.2017YFC1501803 and 2017YFC1502102)。
文摘Assimilation of the Advanced Geostationary Radiance Imager(AGRI)clear-sky radiance in a regional model is performed.The forecasting effectiveness of the assimilation of two water vapor(WV)channels with conventional observations for the“21·7”Henan extremely heavy rainfall is analyzed and compared with a baseline test that assimilates only conventional observations in this study.The results show that the 24-h cumulative precipitation forecast by the assimilation experiment with the addition of the AGRI exceeds 500 mm,compared to a maximum value of 532.6 mm measured by the national meteorological stations,and that the location of the maximum precipitation is consistent with the observations.The results for the short periods of intense precipitation processes are that the simulation of the location and intensity of the 3-h cumulative precipitation is also relatively accurate.The analysis increment shows that the main difference between the two sets of assimilation experiments is over the ocean due to the additional ocean observations provided by FY-4A,which compensates for the lack of ocean observations.The assimilation of satellite data adjusts the vertical and horizontal wind fields over the ocean by adjusting the atmospheric temperature and humidity,which ultimately results in a narrower and stronger WV transport path to the center of heavy precipitation in Zhengzhou in the lower troposphere.Conversely,the WV convergence and upward motion in the control experiment are more dispersed;therefore,the precipitation centers are also correspondingly more dispersed.
基金financially supported by the National Natural Science Foundation of China (NO.52174095)。
文摘The use of aeolian sand(AS)as an aggregate to prepare coal mine cemented filling materials can resolve the problems of gangue shortage and excessive AS deposits.Owing to the lack of research on the mechanism of cemented AS backfill(CASB),the response surface method(RSM)was adopted in this study to analyze the influence of ordinary Portland cement(PO)content(x_(1)),fly ash(FA)-AS(FA-AS)ratio(x_(2)),and concentration(x_(3))on the mechanical and microscopic properties of the CASB.The hydration characteristics and internal pore structure of the backfill were assessed through thermogravimetric/derivative thermogravimetric analysis,mercury intrusion porosimetry,and scanning electron microscopy.The RSM results show that the influence of each factor and interaction term on the response values is extremely significant(except x_(1)x_(3),which had no obvious effect on the 28 d strength).The uniaxial compressive strength(UCS)increased with the PO content,FA-AS ratio,and concentration.The interaction effects of x_(1)x_(2),x_(1)x_(3),and x_(2)x_(3) on the UCS at 3,7,and 28 d were analyzed.In terms of the influence of interaction items,an improvement in one factor promoted the strengthening effect of another factor.The enhancement mechanism of the curing time,PO content,and FA-AS ratio on the backfill was reflected in the increase in hydration products and pore structure optimization.By contrast,the enhancement mechanism of the concentration was mainly the pore structure optimization.The UCS was positively correlated with weight loss and micropore content but negatively correlated with the total porosity.The R^(2) value of the fitting function of the strength and weight loss,micropore content,and total porosity exceeded 0.9,which improved the characterization of the enhancement mechanism of the UCS based on the thermogravimetric analysis and pore structure.This work obtained that the influence rules and mechanisms of the PO,FA-AS,concentration,and interaction terms on the mechanical properties of the CASB provided a certain theoretical and engineering guidance for CASB filling.
基金Project supported by the National Natural Science Foundation of China (Grant Nos. 62004119 and 62201332)the Applied Basic Research Plan of Shanxi Province, China (Grant Nos. 20210302124647 and 20210302124028)。
文摘Nanowires with gate-all-around(GAA) structures are widely considered as the most promising candidate for 3-nm technology with the best ability of suppressing the short channel effects,and tunneling field effect transistors(TFETs)based on GAA structures also present improved performance.In this paper,a non-quasi-static(NQS) device model is developed for nanowire GAA TFETs.The model can predict the transient current and capacitance varying with operation frequency,which is beyond the ability of the quasi-static(QS) model published before.Excellent agreements between the model results and numerical simulations are obtained.Moreover,the NQS model is derived from the published QS model including the current-voltage(I-V) and capacitance-voltage(C-V) characteristics.Therefore,the NQS model is compatible with the QS model for giving comprehensive understanding of GAA TFETs and would be helpful for further study of TFET circuits based on nanowire GAA structure.
基金Supported by Tianjin Science and Technology planning Project,No.21JCQNJC01060Key Project of Tianjin Natural Science Foundation,No.22JCZDJC00340National Key Research and Development Project of China,No.2022YFC3601904.
文摘BACKGROUND The femoral neck dynamic intersection system(FNS)is mechanically more stable than other internal fixation techniques.Current studies have confirmed that the structural design of FNS has good biomechanical properties in European and American populations.However,whether the suitability of the FNS's 130°main nail angle design for Asian populations has been thoroughly investigated remains unclear.AIM To compare the biomechanical stability differences among different main nail angles of the FNS in the treatment of femoral neck fractures in Asian populations.METHODS Computed tomography data of the femur of healthy adult male volunteers were imported into Mimics software to create a three-dimensional model of the femur.The model was adapted to the curve using Geomagic software and imported into Solidworks software to construct the Pauwels I femoral neck fracture model and design the FNS internal fixation model using different main nail angles.Afterward,the models were assembled with the FNS fracture model and meshed using the preprocessing Hypermesh software.Subsequently,they were imported into Abaqus software to analyze and evaluate the biomechanical effects of different angles of the FNS main nail on the treatment of femoral neck fractures.RESULTS The peak displacement of the proximal femur under different angles of FNS fixation under stress was 7.446 millimeters in the 120°group and 7.416 millimeters in the 125°group;in the 130°,135°,and 140°FNS fixation groups,the peak displacement was 7.324 millimeters,8.138 millimeters,and 8.246 millimeters,respectively.In the 120°and 125°FNS fixation groups,the maximum stresses were concentrated at the main nail and the anti-rotation screw,which intersected the fracture line of the femur neck,resulting in peak stresses of 200.7 MPa and 138.8 MPa,respectively.Peak stresses of 208.8 MPa,219.8 MPa,and 239.3 MPa were observed on the angular locking plate distal to the locking screw in the 130°,135°,and 140°fixation groups.CONCLUSION FNS has significant stress distribution properties,a minimal proximal femoral displacement,and an optimal stability for treating femoral neck fractures in Asian populations when performed with a 130°main nail angle.
基金Supported by the National Natural Science Foundation of China(No.81173517No.81322053)
文摘AIM： To observe the attenuation of ethanol extract of Herba Scutellaria barbata （SE） against diabetic retinopathy （DR） and its engaged mechanism. METHODS： C57BL/6J mice were intraperitoneally injected with streptozotocin （STZ, 55 mg/kg） for 5 consecutive days to induce diabetes, The diabetic mice were orally given with SE （100, 200 mg/kg） for lmo at lmo after STZ injection. Blood-retinal barrier （BRB） breakdown was detected by using Evans blue permeation assay. Real-time polymerase chain reaction （RT-PCR）, Western blot and immunofiuorescence staining were used to detect mRNA and protein expression. Enzyme-linked immunosorbent assay （ELISA） was used to detect serum contents of tumor necrosis factor-e （TNF-a） and interleukin （IL）-II. RESULTS： SE （100, 200 mg/kg） reversed the breakdown of BRB in STZ-induced diabetic mice. The decreased expression of retinal claudin-1 and claudin-19, which are both tight junction （T J） proteins, was reversed by SE. SE decreased the increased serum contents and retinal mRNA expression of TNF-a and IL-113. SE also decreased the increased retinal expression of intercellular cell adhesion molecule-1 （ICAM-1）. SE reduced the increased phosphorylation of nuclear factor kappa B （NFKB） p65 and its subsequent nuclear translocation in retinas from STZ- induced diabetic mice. Results of Western blot and retinal immunofluorescence staining of ionized calcium-binding adapter molecule 1 （Ibal） demonstrated that SE abrogated the activation of microglia cells in STZ-induced diabetic mice. CONCLUSION： SE attenuates the development of DR by inhibiting retinal inflammation and restoring the decreased expression of TJ proteins including claudin-1 and claudin-19.
基金supported by Zhejiang Provincial Natural Science Foundation of China(Grant No.LY23F050007).
文摘A chemical co-precipitation strategy was employed to synthesize a series of(Gd_(0.95−x)Lu_(x)Eu_(0.05))_(3)Al_(5)O_(12)(x=0.1−0.95)powder phosphors,followed by vacuum sintering to achieve transparent garnet ceramic phosphors.The density functional theory indicated Lu_(3)Al_(5)O_(12) was formed in priority compared with Gd_(3)Al_(5)O_(12) during solid-phase reaction.Upon high-temperature sintering,the Lu^(3+)substitution for Gd^(3+)suppressed point mass diffusion leading to a smaller grain size.The in-line transmittances of bulk specimens with x=0.1,0.3,0.5,0.7,and 0.95 nm were~83.5%,80.1%,68.8%,73.7%,and 82.2%at 710 nm(Eu^(3+)emission center),respectively,among which the sample of x=0.1 exhibited the optical grade with near-zero optical loss in agreement with the defect-free single crystal(~100%of the theoretical transmittance).The resulting particle and ceramic materials both presented characteristic Eu^(3+)emission arising from 5D0→7FJ(J=1−4)transition,where the dominant far-red emission at~710 nm arising from ^(5)D_(0)→^(7)F_(4) transition overlapped with the absorption of phytochrome(PFR).The photoluminescence excitation and photoluminescence intensities of(Gd_(0.95−x)Lu_(x)Eu_(0.05))_(3)Al_(5)O_(12) powders and ceramics generally increased at a higher Gd^(3+)/Lu^(3+)ratio.Lu^(3+)dopants delayed the fluorescence lifetime while the bulk samples had shorter lifetime compared to the particle counterparts.The transparent(Gd_(0.85)Lu_(0.1)Eu_(0.05))3Al_(5)O_(12) ceramic phosphor exhibited good thermal stability with a high thermal quenching temperature above 533 K.The designed ceramic phosphor-converted light-emitting diode had a saturation injection current of 435 mA and a current-dependent color rendering index.More importantly,our report marked the developmental stage of transparent ceramic materials towards zero optical loss.
基金supported by the Sci-Tech Innovation 2030-Major Project of Brain Science and Brain-inspired Intelligence Technology (2021ZD0200600)the National Natural Science Foundation of China (82122035,81671774,81630031)+3 种基金the Key Research Program of the Chinese Academy of Sciences (ZDBSSSW-JSC006)Beijing Nova Program of Science and Technology (Z191100001119104 and 20230484465)Beijing Natural Science Foundation (J230040)the Scientific Foundation of Institute of Psychology,Chinese Academy of Sciences (E2CX4425YZ)。
文摘The human brain, a marvel of intricate connections, functions as a complex network comprising structurally and functionally integrated regions. This network orchestrates a multitude of complex patterns through high-level integration and continuous cooperation, essential for overall brain functionality [1].
基金Supported by Science and Technology Project of Guangdong Province, China, No. 2010B031600220 and 2008B030303008
文摘AIM:To compare postoperative complications and prognosis of esophageal squamous cell carcinoma patients treated with different routes of reconstruction. METHODS:After obtaining approval from the Medical Ethics Committee of the Sun Yat-Sen University Cancer Center, we retrospectively reviewed data from 306 consecutive patients with histologically diagnosed esophageal squamous cell carcinoma who were treated between 2001 and 2011. All patients underwent radical McKeown-type esophagectomy with at least two-field lymphadenectomy. Regular follow-up was performed in our outpatient department. Postoperative complica-tions and long-term survival were analyzed by treatment modality, baseline patient characteristics, and operative procedure. Data from patients treated via the retrosternal and posterior mediastinal routes were compared. RESULTS:The posterior mediastinal and retrosternal reconstruction routes were employed in 120 and 186 patients, respectively. Pulmonary complications were the most common complications experienced during the postoperative period (46.1% of all patients; 141/306). Compared to the retrosternal route, the posterior mediastinal reconstruction route was associated with a lower incidence of anastomotic stricture (15.8% vs 27.4%, P = 0.018) and less surgical bleeding (242.8 ± 114.2 mL vs 308.2 ± 168.4 mL, P < 0.001). The median survival time was 26.8 mo (range:1.6-116.1 mo). Upon uni/multivariate analysis, a lower preoperative albumin level (P = 0.009) and a more advanced pathological stage (pT; P = 0.006; pN; P < 0.001) were identified as independent factors predicting poor prognosis. The reconstruction route did not influence prognosis (P = 0.477). CONCLUSION:The posterior mediastinal route of reconstruction reduces incidence of postoperative complications but does not affect survival. This route is recommended for resectable esophageal squamous cell carcinoma.
