BACKGROUND Laparoscopic radical gastrectomy is widely used,and perioperative complications have become a highly concerned issue.AIM To develop a predictive model for complications in laparoscopic radical gastrectomy f...BACKGROUND Laparoscopic radical gastrectomy is widely used,and perioperative complications have become a highly concerned issue.AIM To develop a predictive model for complications in laparoscopic radical gastrectomy for gastric cancer to better predict the likelihood of complications in gastric cancer patients within 30 days after surgery,guide perioperative treatment strategies for gastric cancer patients,and prevent serious complications.METHODS In total,998 patients who underwent laparoscopic radical gastrectomy for gastric cancer at 16 Chinese medical centers were included in the training group for the complication model,and 398 patients were included in the validation group.The clinicopathological data and 30-d postoperative complications of gastric cancer patients were collected.Three machine learning methods,lasso regression,random forest,and artificial neural networks,were used to construct postoperative complication prediction models for laparoscopic distal gastrectomy and laparoscopic total gastrectomy,and their prediction efficacy and accuracy were evaluated.RESULTS The constructed complication model,particularly the random forest model,could better predict serious complications in gastric cancer patients undergoing laparoscopic radical gastrectomy.It exhibited stable performance in external validation and is worthy of further promotion in more centers.CONCLUSION Using the risk factors identified in multicenter datasets,highly sensitive risk prediction models for complications following laparoscopic radical gastrectomy were established.We hope to facilitate the diagnosis and treatment of preoperative and postoperative decision-making by using these models.展开更多
Magnesium alloys are lightweight materials with great potential,and plasma electrolytic oxidation(PEO)is effective surface treatment for necessary improvement of corrosion resistance of magnesium alloys.However,the∼1...Magnesium alloys are lightweight materials with great potential,and plasma electrolytic oxidation(PEO)is effective surface treatment for necessary improvement of corrosion resistance of magnesium alloys.However,the∼14µm thick and rough PEO protection layer has inferior wear resistance,which limits magnesium alloys as sliding or reciprocating parts,where magnesium alloys have special advantages by their inherent damping and denoising properties and attractive light-weighting.Here a novel super wear-resistant coating for magnesium alloys was achieved,via the discontinuous sealing(DCS)of a 1.3µm thick polytetrafluoroethylene(PTFE)polymer layer with an initial area fraction(A_(f))of 70%on the necessary PEO protection layer by selective spraying,and the wear resistance was exceptionally enhanced by∼5500 times in comparison with the base PEO coating.The initial surface roughness(Sa)under PEO+DCS(1.54µm)was imperfectly 59%higher than that under PEO and conventional continuous sealing(CS).Interestingly,DCS was surprisingly 20 times superior for enhancing wear resistance in contrast to CS.DCS induced nano-cracks that splitted DCS layer into multilayer nano-blocks,and DCS also provided extra space for the movement of nano-blocks,which resulted in rolling friction and nano lubrication.Further,DCS promoted mixed wear of the PTFE polymer layer and the PEO coating,and the PTFE layer(HV:6 Kg·mm^(−2),A_(f):92.2%)and the PEO coating(HV:310 Kg·mm^(−2),A_(f):7.8%)served as the soft matrix and the hard point,respectively.Moreover,the dynamic decrease of Sa by 29%during wear also contributed to the super wear resistance.The strategy of depositing a low-frictional discontinuous layer on a rough and hard layer or matrix also opens a window for achieving super wear-resistant coatings in other materials.展开更多
AIM: To assess the impact of fast-track surgery (FTS) on hospital stay, cost of hospitalization and complications after radical total gastrectomy. METHODS: A randomized, controlled clinical trial was conducted from No...AIM: To assess the impact of fast-track surgery (FTS) on hospital stay, cost of hospitalization and complications after radical total gastrectomy. METHODS: A randomized, controlled clinical trial was conducted from November 2011 to August 2012 in the Department of Digestive Surgery, Xijing Hospital of Digestive Diseases, the Fourth Military Medical University. A total of 122 gastric cancer patients who met the selection criteria were randomized into FTS and conventional care groups on the first day of hospitalization. All patients received elective standard D2 total gastrectomy. Clinical outcomes, including duration of flatus and defecation, white blood cell count, postoperative pain, duration of postoperative stay, cost of hospitalization and complications were recorded and evaluated.Two specially trained doctors who were blinded to the treatment were in charge of evaluating postoperative outcomes, discharge and follow-up. RESULTS: A total of 119 patients finished the study, including 60 patients in the conventional care group and 59 patients in the FTS group. Two patients were excluded from the FTS group due to withdrawal of consent. One patient was excluded from the conventional care group because of a non-resectable tumor. Compared with the conventional group, FTS shortened the duration of flatus (79.03 ± 20.26 hvs 60.97 ± 24.40 h, P = 0.000) and duration of defecation (93.03 ± 27.95 h vs 68.00 ± 25.42 h, P = 0.000), accelerated the decrease in white blood cell count [P < 0.05 on postoperative day (POD) 3 and 4], alleviated pain in patients after surgery (P < 0.05 on POD 1, 2 and 3), reduced complications (P < 0.05), shortened the duration of postoperative stay (7.10 ± 2.13 dvs 5.68 ± 1.22 d,P = 0.000), reduced the cost of hospitalization (43783.25 ± 8102.36 RMBvs 39597.62 ± 7529.98 RMB,P = 0.005), and promoted recovery of patients. CONCLUSION: FTS could be safely applied in radical total gastrectomy to accelerate clinical recovery of gastric cancer patients.展开更多
Objective: Infra-pyloric artery(IPA) is an important anatomical landmark in treatment of gastric cancer and is the key vessel for pylorus-preserving gastrectomy and subgroup of infra-pyloric lymph nodes. However, its ...Objective: Infra-pyloric artery(IPA) is an important anatomical landmark in treatment of gastric cancer and is the key vessel for pylorus-preserving gastrectomy and subgroup of infra-pyloric lymph nodes. However, its anatomical variation is not thoroughly understood. Our study aimed to clarify the origination of the IPA.Methods: We did this prospective, multicenter, open-label, observational study at gastric surgery departments of34 hospitals in China. Gastric cancer patients aged 18 years or older and scheduled to undergo elective total or distal gastrectomy were assigned. During the surgery, IPA dissecting and exposing the origination point with photographs or video clips were required. The primary outcome was the origination of the IPA. Analysis of variance, χ~2 tests and Fisher's tests were used to analyze the differences between groups. The study is registered at Clinicaltrials.gov(No. NCT03071237).Results: Between May 8 and July 31, 2017, 429 patients were assigned for the study, and 419(97.7%) patients had the IPA dissected and recorded through photograph or video and were included in the primary outcome analysis. The median age was 62 years old, and 73.7% were male. Among the patients, 78.5% received laparoscopic surgery. Single IPA origination was identified in 398(95.0%) patients, including gastroduodenal artery(GDA) in154(36.8%) patients, anterior superior pancreaticoduodenal artery(ASPDA) in 130(31.0%) patients, and right gastroepiploic artery(RGEA) in 114(27.2%) patients. Fifteen(3.6%) patients were identified with multiple IPA and 6(1.4%) patients were identified as IPA absence. The differences in the distribution of surgical approach(P=0.003) and geographic area(P=0.030) were statistically significant. No difference was shown in sex, age,gastrectomy type, tumor location, and clinical T, N and M stage.Conclusions: Our study found that the IPA originates from GDA, ASPDA and RGEA in similar proportions.Laparoscopic surgery may be more helpful in dissection of the IPA than open surgery.展开更多
A fully dense carbon nanotubes (CNTs) reinforced AlSi matrix composite with the multiscale nacre-like architecture was designed and successfully realized by flake powder metallurgy followed by cold spraying (CS). The ...A fully dense carbon nanotubes (CNTs) reinforced AlSi matrix composite with the multiscale nacre-like architecture was designed and successfully realized by flake powder metallurgy followed by cold spraying (CS). The nanolaminated and ultrafine-grained structure initially created in the CNT/AlSi flaky powder was perfectly conserved, due to the typical ‘cold’ feature of CS. As discussed based on finite element analysis and single splat observation, self-alignment behavior of the flaky powders during impact also allowed the formation of the microlaminated structure. Hence, the scalable CS technique opens a new avenue for bioinspired material design and fabrication with complex shape.展开更多
Objective:The systemic inflammation index and body mass index(BMI)are easily accessible markers that can predict mortality.However,the prognostic value of the combined use of these two markers remains unclear.The goal...Objective:The systemic inflammation index and body mass index(BMI)are easily accessible markers that can predict mortality.However,the prognostic value of the combined use of these two markers remains unclear.The goal of this study was therefore to evaluate the association of these markers with outcomes based on a large cohort of patients with gastric cancer.Methods:A total of 2,542 consecutive patients undergoing radical surgery for gastric or gastroesophageal junction adenocarcinoma between 2009 and 2014 were included.Systemic inflammation was quantified by the preoperative neutrophil-to-lymphocyte ratio(NLR).High systemic inflammation was defined as NLR≥3,and underweight was defined as BMI<18.5 kg/m2.Results:Among 2,542 patients,NLR≥3 and underweight were common[627(25%)and 349(14%),respectively].In the entire cohort,NLR≥3 or underweight independently predicted overall survival(OS)[hazard ratio(HR):1.236,95%confidence interval(95%CI):1.069–1.430;and HR:1.600,95%CI:1.350–1.897,respectively]and recurrence-free survival(RFS)(HR:1.230,95%CI:1.054–1.434;and HR:1.658,95%CI:1.389–1.979,respectively).Patients with both NLR≥3 and underweight(vs.neither)had much worse OS(HR:2.445,95%CI:1.853–3.225)and RFS(HR:2.405,95%CI:1.802–3.209).Furthermore,we observed similar results in subgroup analyses according to pathological stage,age,and postoperative chemotherapy.Conclusions:Our results showed that preoperative elevated NLR and decreased BMI had a significant negative effect on survival.Underweight combined with severe inflammation could enhance prognostication.Taking active therapeutic measures to reduce inflammation and increase nutrition may help improve outcomes.展开更多
Objective: Recipients usually undergo posttransplant rejection in HLA-identical transplantations. Recent studies have shown that MHC class I related chain A (MICA) has been found to be associated with allograft surviv...Objective: Recipients usually undergo posttransplant rejection in HLA-identical transplantations. Recent studies have shown that MHC class I related chain A (MICA) has been found to be associated with allograft survival. The goal of this study is to investigate the correlation between matching rate of MICA alleles and posttransplant rejection in clinical living related donor transplantation (LRD) organ transplantations. Methods: Twenty pairs of blood samples were detected for HLA/MICA matching through polymerase chain reaction with sequence specific primers and for anti-MICA Abs using Luminex. At the same time, pathologic biopsies of all recipients were diagnosed and classified into different levels by the unified standard. Univariate Spearman’s analysis was established. Log-Rank analysis was performed twice, and Kaplan-Meier survival curves were generated to assess the relationship between MICA matching rates and posttransplant rejection in living-related donor transplantations. Results-The result showed that HLA matching of all recipients and donors were identical, whereas MICA matching was not. There was statistical difference between pathological classification and survival展开更多
[FeNi(3 nm)/Zn1-xCoxO(3 nm)]2/ZnO(d nm)/[Zn1-xCoxO(3 nm)/Co(3 nm)]2(d=3 and 10) semiconductor junctions were prepared by magnetron sputtering system and photolithography.The spin valve effect was observed in these jun...[FeNi(3 nm)/Zn1-xCoxO(3 nm)]2/ZnO(d nm)/[Zn1-xCoxO(3 nm)/Co(3 nm)]2(d=3 and 10) semiconductor junctions were prepared by magnetron sputtering system and photolithography.The spin valve effect was observed in these junctions because the utility of the ferromagnetic composite layers acted as soft and hard magnetic layers.The electrical detection was performed by measuring the magnetoresistance of these junctions to investigate the current spin polarization αsc in the ZnO layer and the spin injection efficiency η of spin-polarized electrons.αsc was reduced from 11.7%(and 10.5%) at 90 K to 7.31%(and 5.93%) at room temperature for d=3(and d=10).And η was reduced from 39.5%(and 35.5%) at 90 K to 24.7%(and 20.0%) at room temperature for d=3(and d=10).展开更多
Cold spraying(CS),or cold gas dynamic spray(CGDS),is an emerging solid-state powder deposition process,allowing fast and mass production and restoration of metallic components.CS of metal matrix composites(MMCs)has at...Cold spraying(CS),or cold gas dynamic spray(CGDS),is an emerging solid-state powder deposition process,allowing fast and mass production and restoration of metallic components.CS of metal matrix composites(MMCs)has attracted increasing attention from academia and industry over the last decades,especially in the area of Al matrix composites(AMCs),which have demonstrated a high potential for applications in aerospace,automotive,and electronics industries.This article aims to summarize the recent development of CS-processed AMCs in terms of composite powder preparation,deposition processing,microstructure evolution,mechanical and corrosion properties.Furthermore,this review also reports the relevant research progress with the focus on post-treatments of the AMCs for CS additive manufacturing applications including heat treatment,hot rolling,and friction stir processing.Finally,the challenges and perspectives on the fabrication of advanced AMCs by CS are addressed.展开更多
Background:Diabetes is the most common metabolic disease with many chronic complications,and cognitive disorders are one of the common complications in patients with diabetes.Previous studies have showed that autophag...Background:Diabetes is the most common metabolic disease with many chronic complications,and cognitive disorders are one of the common complications in patients with diabetes.Previous studies have showed that autophagy played important roles in the progression of metabolic syndrome,diabetes and other diseases.So we investigated whether aged diabetic mice are prone to be associated with the cognitive and affective disorders and whether Beclin-1-mediated autophagy might be involved in thepahological process.Methods:High-fat diet/streptozotocin(STZ)injection-induced diabetic C57 mice were adopted in this study.Cognitive disorders were detected by Morris water maze and fear conditional test.Affective disorders were detected by tail suspension test and forced swimming test.Magnetic resonance imaging was applied to observe changes of morphology and metabolism in the brain.The 18 F-fluorodeoxyglucose positron emission tomography(FDG-PET)was used to assess metabolism changes in the brain of aged diabetic mice.Autophagy were evaluated by Beclin-1,LC3II/I and P62,which were detected by western blot analysis and observed by electron microscopy.Results:1.Compared with control group,diabetes mice showed significantly decreasing abilities in spatial memory and conditioned fear memory(all P<0.05),and increasing tendency of depression(P<0.05).2.MRI showed that the majority of elderly diabetic mice were associated with multiple cerebral small vessel disease.Some even showed hippocampal atrophy,ventricular dilatation and leukoaraiosis.3.FDG-PET-CT discovered that the glucose metabolism in the amygdala and hippocampus was significantly decreased compared with normal aged mice(P<0.05).4.Electron microscopy found that,although autophagy bodies was not widespread,and there was no significant difference between the two groups,yet compared with normal aged mice,apparent cell edema,myelinated tow reduction and intracellular lipofuscin augmentation existed in elderly diabetic mice brain.5.The level of p62 was increased in the STZ-induced diabetic mice hippocampus and striatum,and beclin1 protein expression were significantly decreased in diabetic mice hippocampus compared with normal aged mice(P<0.05).There was a upward trend of the ratio of LC3II/I in hippocampus,cortex and striatum,but no statistically difference between the two groups.Conclusion:Compared with normal aged mice,diabetic aged mice were apt to cerebral small vessel disease and associated with cognitive and affective disorders,which may be related to the significantly reduced glucose metabolism in hippocampus and amygdala.Beclin1 mediated autophagy in hippocampus probably played an important role in cognitive and affective disorders of STZ-induced aged diabetic mice.展开更多
Insulin granule trafficking is a key step in the secretion of glucose-stimulated insulin from pancreaticβ-cells.The main feature of type 2 diabetes(T2D)is the failure of pancreaticβ-cells to secrete sufficient amoun...Insulin granule trafficking is a key step in the secretion of glucose-stimulated insulin from pancreaticβ-cells.The main feature of type 2 diabetes(T2D)is the failure of pancreaticβ-cells to secrete sufficient amounts of insulin to maintain normal blood glucose levels.In this work,we developed and applied tomography based on scanning transmission electron microscopy(STEM)to image intact insulin granules in theβ-cells of mouse pancreatic islets.Using three-dimensional(3D)recon-struction,we found decreases in both the number and the grey level of insulin granules in db/db mouse pan-creaticβ-cells.Moreover,insulin granules were closer to the plasma membrane in diabeticβ-cells than in control cells.Thus,3D ultra-structural tomography may provide new insights into the pathology of insulin se-cretion in T2D.展开更多
1.Introduction The artificial-designed segmentation cracks in the ceramic layer of the thermal barrier coatings is an excellent choice by using the atmospheric plasma spray(APS)method under a low cost on the applicati...1.Introduction The artificial-designed segmentation cracks in the ceramic layer of the thermal barrier coatings is an excellent choice by using the atmospheric plasma spray(APS)method under a low cost on the applications of aircraft engines or gas turbine engines.The residual thermal stress energy of the coatings with a certain inter-space of vertical cracks during the thermal cycling test is released through the cracks.展开更多
While precision medicine driven by genome sequencing has revolutionized cancer care,such as lung cancer,its impact on gastric cancer(GC)has been minimal.GC patients are routinely treated with chemotherapy,but only a f...While precision medicine driven by genome sequencing has revolutionized cancer care,such as lung cancer,its impact on gastric cancer(GC)has been minimal.GC patients are routinely treated with chemotherapy,but only a fraction of them receive the clinical benefit.There is an urgent need to develop biomarkers or algorithms to select chemo-sensitive patients or apply targeted therapy.Here,we carried out retrospective analyses of 1,020 formalin-fixed,paraffin-embedded GC surgical resection samples from 5 hospitals and developed a mass spectrometry-based workflow for proteomic subtyping of GC.We identified two proteomic subtypes:the chemo-sensitive group(CSG)and the chemo-insensitive group(CIG)in the discovery set.The 5-year overall survival of CSG was significantly improved in patients who had received adjuvant chemotherapy after surgery compared with those who received surgery only(64.2%vs.49.6%;Cox P-value=0.002),whereas no such improvement was observed in CIG(50.0%vs.58.6%;Cox P-value=0.495).We validated these results in an independent validation set.Further,differential proteome analysis uncovered 9 FDA-approved drugs that may be applicable for targeted therapy of GC.A prospective study is warranted to test these findings for future GC patient care.展开更多
Precipitation strengthening of nano-scale TiC is a promising method to improve mechanical properties of Fe–16Mn–9Al–0.8C (wt.%) low-density steel. This work attempted to introduce nano-scale TiC precipitates by add...Precipitation strengthening of nano-scale TiC is a promising method to improve mechanical properties of Fe–16Mn–9Al–0.8C (wt.%) low-density steel. This work attempted to introduce nano-scale TiC precipitates by adding 1 wt.% Ti element. The experimental results show that these precipitates with the total fraction of about 2 vol.% were formed and no coarse precipitates were observed despite the high Ti addition. It was interesting that the polygonal and needle-shaped TiC precipitates were observed in γ-austenite and δ-ferrite, respectively. Ti addition also decreased the volume fraction of γ-austenite significantly. Correspondingly, the yield strength was increased, but the elongation was significantly decreased due to the significant decrease of γ-austenite. Comparing with the Ti-free steel, the formation of TiC precipitates was the main reason for the increase in yield strength of Ti-bearing steel, and TiC precipitates also led to a higher strain hardening index at the first deformation stage. TiC precipitates promoted the Orowan strengthening, resulting in a higher strain hardening capability than Ti-free steel reinforced by shearable κ-carbide.展开更多
Dear Editor,Early diagnosis is critical for successful treatment of gastric adenocarcinoma(GA).However,the sensitivities of tumor markers carcinoembryonic antigen(CEA),cancer antigen 19-9(CA19-9)and CA72-4 for GA dete...Dear Editor,Early diagnosis is critical for successful treatment of gastric adenocarcinoma(GA).However,the sensitivities of tumor markers carcinoembryonic antigen(CEA),cancer antigen 19-9(CA19-9)and CA72-4 for GA detection are approximately 20%[1],and the sensitivities of all markers combined for early gastric cancer detection is still very low[2].DNA methylation plays a major role in tumorigenesis and therefore has obvious potential as a non-invasive biomarker for cancer detection[3].Through genome-wide methylation analysis and histological verification,we previously identified ring finger protein 180(RNF180)as a novel preferentially methylated gene in GA[4,5].展开更多
基金Natural Science Foundation of Fujian Province,No.2021J011360,and No.2020J011230Natural Science Foundation of Xiamen,China,No.3502Z20214ZD1018,and No.3502Z20227096+2 种基金Medical Innovation Project of Fujian Provincial Health Commission,No.2021CXB019Youth Scientific Research Project of Fujian Provincial Health Commission,No.2022QNB013Bethune Charitable Foundation,No.HZB-20190528-10.
文摘BACKGROUND Laparoscopic radical gastrectomy is widely used,and perioperative complications have become a highly concerned issue.AIM To develop a predictive model for complications in laparoscopic radical gastrectomy for gastric cancer to better predict the likelihood of complications in gastric cancer patients within 30 days after surgery,guide perioperative treatment strategies for gastric cancer patients,and prevent serious complications.METHODS In total,998 patients who underwent laparoscopic radical gastrectomy for gastric cancer at 16 Chinese medical centers were included in the training group for the complication model,and 398 patients were included in the validation group.The clinicopathological data and 30-d postoperative complications of gastric cancer patients were collected.Three machine learning methods,lasso regression,random forest,and artificial neural networks,were used to construct postoperative complication prediction models for laparoscopic distal gastrectomy and laparoscopic total gastrectomy,and their prediction efficacy and accuracy were evaluated.RESULTS The constructed complication model,particularly the random forest model,could better predict serious complications in gastric cancer patients undergoing laparoscopic radical gastrectomy.It exhibited stable performance in external validation and is worthy of further promotion in more centers.CONCLUSION Using the risk factors identified in multicenter datasets,highly sensitive risk prediction models for complications following laparoscopic radical gastrectomy were established.We hope to facilitate the diagnosis and treatment of preoperative and postoperative decision-making by using these models.
基金This work was financially supported by the Jiangsu Distinguished Professor Project,the Innovate UK(Project reference:10004694)the National Key R&D Program of China 2021YFB3401200.The Experimental Techniques Centre at Brunel University London and Nanjing University of Aeronautics and Astronautics are acknowledged.The authors also acknowledge the characterization facility at Shanghai Jiao Tong University,Central South University,University of Birmingham and University of Lille.
文摘Magnesium alloys are lightweight materials with great potential,and plasma electrolytic oxidation(PEO)is effective surface treatment for necessary improvement of corrosion resistance of magnesium alloys.However,the∼14µm thick and rough PEO protection layer has inferior wear resistance,which limits magnesium alloys as sliding or reciprocating parts,where magnesium alloys have special advantages by their inherent damping and denoising properties and attractive light-weighting.Here a novel super wear-resistant coating for magnesium alloys was achieved,via the discontinuous sealing(DCS)of a 1.3µm thick polytetrafluoroethylene(PTFE)polymer layer with an initial area fraction(A_(f))of 70%on the necessary PEO protection layer by selective spraying,and the wear resistance was exceptionally enhanced by∼5500 times in comparison with the base PEO coating.The initial surface roughness(Sa)under PEO+DCS(1.54µm)was imperfectly 59%higher than that under PEO and conventional continuous sealing(CS).Interestingly,DCS was surprisingly 20 times superior for enhancing wear resistance in contrast to CS.DCS induced nano-cracks that splitted DCS layer into multilayer nano-blocks,and DCS also provided extra space for the movement of nano-blocks,which resulted in rolling friction and nano lubrication.Further,DCS promoted mixed wear of the PTFE polymer layer and the PEO coating,and the PTFE layer(HV:6 Kg·mm^(−2),A_(f):92.2%)and the PEO coating(HV:310 Kg·mm^(−2),A_(f):7.8%)served as the soft matrix and the hard point,respectively.Moreover,the dynamic decrease of Sa by 29%during wear also contributed to the super wear resistance.The strategy of depositing a low-frictional discontinuous layer on a rough and hard layer or matrix also opens a window for achieving super wear-resistant coatings in other materials.
基金Supported by National Natural Scientific Foundation of China,No.31100643
文摘AIM: To assess the impact of fast-track surgery (FTS) on hospital stay, cost of hospitalization and complications after radical total gastrectomy. METHODS: A randomized, controlled clinical trial was conducted from November 2011 to August 2012 in the Department of Digestive Surgery, Xijing Hospital of Digestive Diseases, the Fourth Military Medical University. A total of 122 gastric cancer patients who met the selection criteria were randomized into FTS and conventional care groups on the first day of hospitalization. All patients received elective standard D2 total gastrectomy. Clinical outcomes, including duration of flatus and defecation, white blood cell count, postoperative pain, duration of postoperative stay, cost of hospitalization and complications were recorded and evaluated.Two specially trained doctors who were blinded to the treatment were in charge of evaluating postoperative outcomes, discharge and follow-up. RESULTS: A total of 119 patients finished the study, including 60 patients in the conventional care group and 59 patients in the FTS group. Two patients were excluded from the FTS group due to withdrawal of consent. One patient was excluded from the conventional care group because of a non-resectable tumor. Compared with the conventional group, FTS shortened the duration of flatus (79.03 ± 20.26 hvs 60.97 ± 24.40 h, P = 0.000) and duration of defecation (93.03 ± 27.95 h vs 68.00 ± 25.42 h, P = 0.000), accelerated the decrease in white blood cell count [P < 0.05 on postoperative day (POD) 3 and 4], alleviated pain in patients after surgery (P < 0.05 on POD 1, 2 and 3), reduced complications (P < 0.05), shortened the duration of postoperative stay (7.10 ± 2.13 dvs 5.68 ± 1.22 d,P = 0.000), reduced the cost of hospitalization (43783.25 ± 8102.36 RMBvs 39597.62 ± 7529.98 RMB,P = 0.005), and promoted recovery of patients. CONCLUSION: FTS could be safely applied in radical total gastrectomy to accelerate clinical recovery of gastric cancer patients.
基金funded by the Gastric Cancer Diagnose and Treatment Project(D171100006517004,D17110700650000)of Beijing Municipal Science&Technology Commissionsupported by Beijing Municipal Administration of Hospital Clinical Medicine Development of Special Funding Support(ZYLX201701)
文摘Objective: Infra-pyloric artery(IPA) is an important anatomical landmark in treatment of gastric cancer and is the key vessel for pylorus-preserving gastrectomy and subgroup of infra-pyloric lymph nodes. However, its anatomical variation is not thoroughly understood. Our study aimed to clarify the origination of the IPA.Methods: We did this prospective, multicenter, open-label, observational study at gastric surgery departments of34 hospitals in China. Gastric cancer patients aged 18 years or older and scheduled to undergo elective total or distal gastrectomy were assigned. During the surgery, IPA dissecting and exposing the origination point with photographs or video clips were required. The primary outcome was the origination of the IPA. Analysis of variance, χ~2 tests and Fisher's tests were used to analyze the differences between groups. The study is registered at Clinicaltrials.gov(No. NCT03071237).Results: Between May 8 and July 31, 2017, 429 patients were assigned for the study, and 419(97.7%) patients had the IPA dissected and recorded through photograph or video and were included in the primary outcome analysis. The median age was 62 years old, and 73.7% were male. Among the patients, 78.5% received laparoscopic surgery. Single IPA origination was identified in 398(95.0%) patients, including gastroduodenal artery(GDA) in154(36.8%) patients, anterior superior pancreaticoduodenal artery(ASPDA) in 130(31.0%) patients, and right gastroepiploic artery(RGEA) in 114(27.2%) patients. Fifteen(3.6%) patients were identified with multiple IPA and 6(1.4%) patients were identified as IPA absence. The differences in the distribution of surgical approach(P=0.003) and geographic area(P=0.030) were statistically significant. No difference was shown in sex, age,gastrectomy type, tumor location, and clinical T, N and M stage.Conclusions: Our study found that the IPA originates from GDA, ASPDA and RGEA in similar proportions.Laparoscopic surgery may be more helpful in dissection of the IPA than open surgery.
基金financial support from China Scholarship Council for his Ph.D. projectThe TEM facility in Lille, France, is supported by the Conseil Regional du Nord-Pas de Calais and the European Regional Development Fund
文摘A fully dense carbon nanotubes (CNTs) reinforced AlSi matrix composite with the multiscale nacre-like architecture was designed and successfully realized by flake powder metallurgy followed by cold spraying (CS). The nanolaminated and ultrafine-grained structure initially created in the CNT/AlSi flaky powder was perfectly conserved, due to the typical ‘cold’ feature of CS. As discussed based on finite element analysis and single splat observation, self-alignment behavior of the flaky powders during impact also allowed the formation of the microlaminated structure. Hence, the scalable CS technique opens a new avenue for bioinspired material design and fabrication with complex shape.
基金supported by the National Major Research and the Innovation Program of China(Grant No.2016YFC1303200)the National Key R&D Program of China(Grant No.2017YFC0908300)the National Natural Science Foundation of China(Grant No.81972761)。
文摘Objective:The systemic inflammation index and body mass index(BMI)are easily accessible markers that can predict mortality.However,the prognostic value of the combined use of these two markers remains unclear.The goal of this study was therefore to evaluate the association of these markers with outcomes based on a large cohort of patients with gastric cancer.Methods:A total of 2,542 consecutive patients undergoing radical surgery for gastric or gastroesophageal junction adenocarcinoma between 2009 and 2014 were included.Systemic inflammation was quantified by the preoperative neutrophil-to-lymphocyte ratio(NLR).High systemic inflammation was defined as NLR≥3,and underweight was defined as BMI<18.5 kg/m2.Results:Among 2,542 patients,NLR≥3 and underweight were common[627(25%)and 349(14%),respectively].In the entire cohort,NLR≥3 or underweight independently predicted overall survival(OS)[hazard ratio(HR):1.236,95%confidence interval(95%CI):1.069–1.430;and HR:1.600,95%CI:1.350–1.897,respectively]and recurrence-free survival(RFS)(HR:1.230,95%CI:1.054–1.434;and HR:1.658,95%CI:1.389–1.979,respectively).Patients with both NLR≥3 and underweight(vs.neither)had much worse OS(HR:2.445,95%CI:1.853–3.225)and RFS(HR:2.405,95%CI:1.802–3.209).Furthermore,we observed similar results in subgroup analyses according to pathological stage,age,and postoperative chemotherapy.Conclusions:Our results showed that preoperative elevated NLR and decreased BMI had a significant negative effect on survival.Underweight combined with severe inflammation could enhance prognostication.Taking active therapeutic measures to reduce inflammation and increase nutrition may help improve outcomes.
基金This work was supported by the National Natural Science Foundation of China under grant No. 50102019 and 50572053New Century Fund for Outstanding Scholars （Grant No. 040634）.
文摘Objective: Recipients usually undergo posttransplant rejection in HLA-identical transplantations. Recent studies have shown that MHC class I related chain A (MICA) has been found to be associated with allograft survival. The goal of this study is to investigate the correlation between matching rate of MICA alleles and posttransplant rejection in clinical living related donor transplantation (LRD) organ transplantations. Methods: Twenty pairs of blood samples were detected for HLA/MICA matching through polymerase chain reaction with sequence specific primers and for anti-MICA Abs using Luminex. At the same time, pathologic biopsies of all recipients were diagnosed and classified into different levels by the unified standard. Univariate Spearman’s analysis was established. Log-Rank analysis was performed twice, and Kaplan-Meier survival curves were generated to assess the relationship between MICA matching rates and posttransplant rejection in living-related donor transplantations. Results-The result showed that HLA matching of all recipients and donors were identical, whereas MICA matching was not. There was statistical difference between pathological classification and survival
基金supported by the State Key Project of Fundamental Research of China No.2007CB924903 and NSFC No.50572053
文摘[FeNi(3 nm)/Zn1-xCoxO(3 nm)]2/ZnO(d nm)/[Zn1-xCoxO(3 nm)/Co(3 nm)]2(d=3 and 10) semiconductor junctions were prepared by magnetron sputtering system and photolithography.The spin valve effect was observed in these junctions because the utility of the ferromagnetic composite layers acted as soft and hard magnetic layers.The electrical detection was performed by measuring the magnetoresistance of these junctions to investigate the current spin polarization αsc in the ZnO layer and the spin injection efficiency η of spin-polarized electrons.αsc was reduced from 11.7%(and 10.5%) at 90 K to 7.31%(and 5.93%) at room temperature for d=3(and d=10).And η was reduced from 39.5%(and 35.5%) at 90 K to 24.7%(and 20.0%) at room temperature for d=3(and d=10).
基金financial support of the Chinese Scholarship Council(No.201604490100)UniversitéBourgogne-Franche-Comté,and Centre National de la Recherche Scientifique(CNRS)+2 种基金supported by the Conseil Régional du Nord-Pas de Calaisthe European Regional Development Fund(ERDF)financial support from the National Natural Science Foundation of China(No.51875471)。
文摘Cold spraying(CS),or cold gas dynamic spray(CGDS),is an emerging solid-state powder deposition process,allowing fast and mass production and restoration of metallic components.CS of metal matrix composites(MMCs)has attracted increasing attention from academia and industry over the last decades,especially in the area of Al matrix composites(AMCs),which have demonstrated a high potential for applications in aerospace,automotive,and electronics industries.This article aims to summarize the recent development of CS-processed AMCs in terms of composite powder preparation,deposition processing,microstructure evolution,mechanical and corrosion properties.Furthermore,this review also reports the relevant research progress with the focus on post-treatments of the AMCs for CS additive manufacturing applications including heat treatment,hot rolling,and friction stir processing.Finally,the challenges and perspectives on the fabrication of advanced AMCs by CS are addressed.
基金This work was supported by grants from the National Natural Scientific Foundation,China(81170322,81571361,U1632120)Shanghai Natural Scientific Foundation,China(11ZR1405300)Shanghai Municipal Outstanding Talent Development Foundation(2012052).
文摘Background:Diabetes is the most common metabolic disease with many chronic complications,and cognitive disorders are one of the common complications in patients with diabetes.Previous studies have showed that autophagy played important roles in the progression of metabolic syndrome,diabetes and other diseases.So we investigated whether aged diabetic mice are prone to be associated with the cognitive and affective disorders and whether Beclin-1-mediated autophagy might be involved in thepahological process.Methods:High-fat diet/streptozotocin(STZ)injection-induced diabetic C57 mice were adopted in this study.Cognitive disorders were detected by Morris water maze and fear conditional test.Affective disorders were detected by tail suspension test and forced swimming test.Magnetic resonance imaging was applied to observe changes of morphology and metabolism in the brain.The 18 F-fluorodeoxyglucose positron emission tomography(FDG-PET)was used to assess metabolism changes in the brain of aged diabetic mice.Autophagy were evaluated by Beclin-1,LC3II/I and P62,which were detected by western blot analysis and observed by electron microscopy.Results:1.Compared with control group,diabetes mice showed significantly decreasing abilities in spatial memory and conditioned fear memory(all P<0.05),and increasing tendency of depression(P<0.05).2.MRI showed that the majority of elderly diabetic mice were associated with multiple cerebral small vessel disease.Some even showed hippocampal atrophy,ventricular dilatation and leukoaraiosis.3.FDG-PET-CT discovered that the glucose metabolism in the amygdala and hippocampus was significantly decreased compared with normal aged mice(P<0.05).4.Electron microscopy found that,although autophagy bodies was not widespread,and there was no significant difference between the two groups,yet compared with normal aged mice,apparent cell edema,myelinated tow reduction and intracellular lipofuscin augmentation existed in elderly diabetic mice brain.5.The level of p62 was increased in the STZ-induced diabetic mice hippocampus and striatum,and beclin1 protein expression were significantly decreased in diabetic mice hippocampus compared with normal aged mice(P<0.05).There was a upward trend of the ratio of LC3II/I in hippocampus,cortex and striatum,but no statistically difference between the two groups.Conclusion:Compared with normal aged mice,diabetic aged mice were apt to cerebral small vessel disease and associated with cognitive and affective disorders,which may be related to the significantly reduced glucose metabolism in hippocampus and amygdala.Beclin1 mediated autophagy in hippocampus probably played an important role in cognitive and affective disorders of STZ-induced aged diabetic mice.
基金supported by grants from the National Basic Research Program of China(No.2010CB833701)the National Natural Science Foundation of China(Grant Nos.31130065 and 31100596).
文摘Insulin granule trafficking is a key step in the secretion of glucose-stimulated insulin from pancreaticβ-cells.The main feature of type 2 diabetes(T2D)is the failure of pancreaticβ-cells to secrete sufficient amounts of insulin to maintain normal blood glucose levels.In this work,we developed and applied tomography based on scanning transmission electron microscopy(STEM)to image intact insulin granules in theβ-cells of mouse pancreatic islets.Using three-dimensional(3D)recon-struction,we found decreases in both the number and the grey level of insulin granules in db/db mouse pan-creaticβ-cells.Moreover,insulin granules were closer to the plasma membrane in diabeticβ-cells than in control cells.Thus,3D ultra-structural tomography may provide new insights into the pathology of insulin se-cretion in T2D.
基金This work was financially supported by the National Key R&D Program of China(Basic Research Project,No.2017YFB0306104)National Natural Science Foundation of China(Nos.91860114,51590894 and 51901011)the China Postdoctoral Foundation and National Science and Technology Major Project(No.2017-VI-0010-0081)。
文摘1.Introduction The artificial-designed segmentation cracks in the ceramic layer of the thermal barrier coatings is an excellent choice by using the atmospheric plasma spray(APS)method under a low cost on the applications of aircraft engines or gas turbine engines.The residual thermal stress energy of the coatings with a certain inter-space of vertical cracks during the thermal cycling test is released through the cracks.
基金supported by the National Key Research and Development Program of China(2017YFC1308900,2017YFC0908404,2018YFA0507503,2017YFA0505103)Beijing Municipal Government Key Research and Development Program(Z181100001918020,Z161100002616036)+4 种基金the National Natural Science Foundation of China(31870828,81972790,81672319)the Guangdong Provincial Key R&D Programmes(2019B020229002)the Science and Technology Program of Guangzhou(201902020009)the National Key Basic Research Program of China(2014CBA02002)the National Key Technology Support Program(2015BAI13B07).
文摘While precision medicine driven by genome sequencing has revolutionized cancer care,such as lung cancer,its impact on gastric cancer(GC)has been minimal.GC patients are routinely treated with chemotherapy,but only a fraction of them receive the clinical benefit.There is an urgent need to develop biomarkers or algorithms to select chemo-sensitive patients or apply targeted therapy.Here,we carried out retrospective analyses of 1,020 formalin-fixed,paraffin-embedded GC surgical resection samples from 5 hospitals and developed a mass spectrometry-based workflow for proteomic subtyping of GC.We identified two proteomic subtypes:the chemo-sensitive group(CSG)and the chemo-insensitive group(CIG)in the discovery set.The 5-year overall survival of CSG was significantly improved in patients who had received adjuvant chemotherapy after surgery compared with those who received surgery only(64.2%vs.49.6%;Cox P-value=0.002),whereas no such improvement was observed in CIG(50.0%vs.58.6%;Cox P-value=0.495).We validated these results in an independent validation set.Further,differential proteome analysis uncovered 9 FDA-approved drugs that may be applicable for targeted therapy of GC.A prospective study is warranted to test these findings for future GC patient care.
基金supported by the National Key Research and Development Program of China [2017YFC1311004]The Key Research and Development Program of Shanxi province [2017-ZDXM-SF-053].
基金the National Natural Science Foundation of China(No.51974184)National MCF Energy R&D Program of China(No.2018YFE0306102)Independent Research Project of State Key Laboratory of Advanced Special Steel and Shanghai Key Laboratory of Advanced Ferrometallurgy,Shanghai University.
文摘Precipitation strengthening of nano-scale TiC is a promising method to improve mechanical properties of Fe–16Mn–9Al–0.8C (wt.%) low-density steel. This work attempted to introduce nano-scale TiC precipitates by adding 1 wt.% Ti element. The experimental results show that these precipitates with the total fraction of about 2 vol.% were formed and no coarse precipitates were observed despite the high Ti addition. It was interesting that the polygonal and needle-shaped TiC precipitates were observed in γ-austenite and δ-ferrite, respectively. Ti addition also decreased the volume fraction of γ-austenite significantly. Correspondingly, the yield strength was increased, but the elongation was significantly decreased due to the significant decrease of γ-austenite. Comparing with the Ti-free steel, the formation of TiC precipitates was the main reason for the increase in yield strength of Ti-bearing steel, and TiC precipitates also led to a higher strain hardening index at the first deformation stage. TiC precipitates promoted the Orowan strengthening, resulting in a higher strain hardening capability than Ti-free steel reinforced by shearable κ-carbide.
基金supported by the National Key R&D Program of China(Grant no.2016YFC1303200,2022YFC2505100,2017YFC0908300,and 2018YFC1313101)Tianjin Key Medical Discipline(Specialty)Construction Project(Grant no.TJYXZDXK-009A)Beijing Munic-ipal Science&Technology Commission,Administrative Commission of Zhongguancun Science Park(Grant no.Z201100005420007).
文摘Dear Editor,Early diagnosis is critical for successful treatment of gastric adenocarcinoma(GA).However,the sensitivities of tumor markers carcinoembryonic antigen(CEA),cancer antigen 19-9(CA19-9)and CA72-4 for GA detection are approximately 20%[1],and the sensitivities of all markers combined for early gastric cancer detection is still very low[2].DNA methylation plays a major role in tumorigenesis and therefore has obvious potential as a non-invasive biomarker for cancer detection[3].Through genome-wide methylation analysis and histological verification,we previously identified ring finger protein 180(RNF180)as a novel preferentially methylated gene in GA[4,5].
