BACKGROUND Gastric cancer has a high incidence and fatality rate,and surgery is the preferred course of treatment.Nonetheless,patient survival rates are still low,and the incidence of major postoperative complications...BACKGROUND Gastric cancer has a high incidence and fatality rate,and surgery is the preferred course of treatment.Nonetheless,patient survival rates are still low,and the incidence of major postoperative complications cannot be disregarded.The systemic inflammatory response,nutritional level,and coagulation status are key factors affecting the postoperative recovery and prognosis of gastric cancer patients.The systemic inflammatory response index(SIRI)and the albumin fibrinogen ratio(AFR)are two valuable comprehensive indicators of the severity and prognosis of systemic inflammation in various medical conditions.AIM To assess the clinical importance and prognostic significance of the SIRI scores and the AFR on early postoperative outcomes in patients undergoing radical gastric cancer surgery.METHODS We conducted a retrospective analysis of the clinicopathological characteristics and relevant laboratory indices of 568 gastric cancer patients from January 2018 to December 2019.We calculated and compared two indicators of inflammation and then examined the diagnostic ability of combined SIRI and AFR values for serious early postoperative complications.We scored the patients and categorized them into three groups based on their SIRI and AFR levels.COX analysis was used to compare the three groups of patients the prognostic value of various preoperative SIRI-AFR scores for 5-year overall survival(OS)and disease-free survival(DFS).RESULTS SIRI-AFR scores were an independent risk factor for prognosis[OS:P=0.004;hazards ratio(HR)=3.134;DFS:P<0.001;HR=3.543]and had the highest diagnostic power(area under the curve:0.779;95%confidence interval:0.737-0.820)for early serious complications in patients with gastric cancer.The tumor-node-metastasis stage(P=0.001),perioperative transfusion(P=0.044),positive carcinoembryonic antigen(P=0.014)findings,and major postoperative complications(P=0.011)were factors associated with prognosis.CONCLUSION Preoperative SIRI and AFR values were significantly associated with early postoperative survival and the occurrence of severe complications in gastric cancer patients.展开更多
T23 steel(2.25Cr–1Mo–1.6W–0.24V–0.05Nb,in wt.%)has been widely used as water walls in ultra-supercritical(USC)power plants.However,high reheat cracking susceptibility of T23 steel hazarded the safety of USC power ...T23 steel(2.25Cr–1Mo–1.6W–0.24V–0.05Nb,in wt.%)has been widely used as water walls in ultra-supercritical(USC)power plants.However,high reheat cracking susceptibility of T23 steel hazarded the safety of USC power plants.It is aimed to improve the reheat cracking susceptibility of T23 steel from the perspective of modifying chemical composition.Gleeble-3800 thermal simulator was used to simulate the coarse-grained heat-affected zone(CGHAZ)in T23 and modified T23 steels via thermal simulation of welding,and then evaluate the reheat cracking susceptibility in CGHAZ of T23 and modified T23 steels by the isothermal slow strain rate tensile test.The microstructure was systematically investigated by optical microscopy,scanning electron microscopy and transmission electron microscopy.The results show that the reheat cracking susceptibility of modified T23 steel is extremely improved.Compared with T23 steel,there are fewer M23C6 particles at the grain boundaries in modified T23 steel,and the degree of intergranular weakening is smaller.At the same time,not only MX in the grain interiors but also the solid-solutioned C and W in the matrix decrease in modified T23 steel,leading to the decline of intragranular strengthening.In addition,small grain size is beneficial to the improvement of the reheat cracking susceptibility of modified T23 steel.The decreased number of M23C6 at grain boundaries helps to retard the formation and propagation of reheat cracks because of decreased denuded zones.展开更多
基金the National Natural Science Foundation of China,No.8236110677Central to guide local scientific and Technological Development,No.ZYYDDFFZZJ-1+1 种基金Natural Science Foundation of Gansu Province,China,No.18JR2RA033Gansu Da Vinci Robot High-End Diagnosis and Treatment Team Construction Project,National Key Research and Development Program,No.2020RCXM076.
文摘BACKGROUND Gastric cancer has a high incidence and fatality rate,and surgery is the preferred course of treatment.Nonetheless,patient survival rates are still low,and the incidence of major postoperative complications cannot be disregarded.The systemic inflammatory response,nutritional level,and coagulation status are key factors affecting the postoperative recovery and prognosis of gastric cancer patients.The systemic inflammatory response index(SIRI)and the albumin fibrinogen ratio(AFR)are two valuable comprehensive indicators of the severity and prognosis of systemic inflammation in various medical conditions.AIM To assess the clinical importance and prognostic significance of the SIRI scores and the AFR on early postoperative outcomes in patients undergoing radical gastric cancer surgery.METHODS We conducted a retrospective analysis of the clinicopathological characteristics and relevant laboratory indices of 568 gastric cancer patients from January 2018 to December 2019.We calculated and compared two indicators of inflammation and then examined the diagnostic ability of combined SIRI and AFR values for serious early postoperative complications.We scored the patients and categorized them into three groups based on their SIRI and AFR levels.COX analysis was used to compare the three groups of patients the prognostic value of various preoperative SIRI-AFR scores for 5-year overall survival(OS)and disease-free survival(DFS).RESULTS SIRI-AFR scores were an independent risk factor for prognosis[OS:P=0.004;hazards ratio(HR)=3.134;DFS:P<0.001;HR=3.543]and had the highest diagnostic power(area under the curve:0.779;95%confidence interval:0.737-0.820)for early serious complications in patients with gastric cancer.The tumor-node-metastasis stage(P=0.001),perioperative transfusion(P=0.044),positive carcinoembryonic antigen(P=0.014)findings,and major postoperative complications(P=0.011)were factors associated with prognosis.CONCLUSION Preoperative SIRI and AFR values were significantly associated with early postoperative survival and the occurrence of severe complications in gastric cancer patients.
基金National Key Research and Development Program of China(2016YFC0801901).
文摘T23 steel(2.25Cr–1Mo–1.6W–0.24V–0.05Nb,in wt.%)has been widely used as water walls in ultra-supercritical(USC)power plants.However,high reheat cracking susceptibility of T23 steel hazarded the safety of USC power plants.It is aimed to improve the reheat cracking susceptibility of T23 steel from the perspective of modifying chemical composition.Gleeble-3800 thermal simulator was used to simulate the coarse-grained heat-affected zone(CGHAZ)in T23 and modified T23 steels via thermal simulation of welding,and then evaluate the reheat cracking susceptibility in CGHAZ of T23 and modified T23 steels by the isothermal slow strain rate tensile test.The microstructure was systematically investigated by optical microscopy,scanning electron microscopy and transmission electron microscopy.The results show that the reheat cracking susceptibility of modified T23 steel is extremely improved.Compared with T23 steel,there are fewer M23C6 particles at the grain boundaries in modified T23 steel,and the degree of intergranular weakening is smaller.At the same time,not only MX in the grain interiors but also the solid-solutioned C and W in the matrix decrease in modified T23 steel,leading to the decline of intragranular strengthening.In addition,small grain size is beneficial to the improvement of the reheat cracking susceptibility of modified T23 steel.The decreased number of M23C6 at grain boundaries helps to retard the formation and propagation of reheat cracks because of decreased denuded zones.
