BACKGROUND With advancements in the development of endoscopic technologies,the endo-scopic submucosal dissection(ESD)has been one of the gold-standard therapies for early gastric cancer.AIM To investigate the efficacy...BACKGROUND With advancements in the development of endoscopic technologies,the endo-scopic submucosal dissection(ESD)has been one of the gold-standard therapies for early gastric cancer.AIM To investigate the efficacy and safety ESD in the treatment of early gastric cancer and precancerous lesions in the elderly patients.METHODS Seventy-eight elderly patients with early gastric cancer and precancerous lesions admitted to the Third Affiliated Hospital of Qiqihar Medical University were se-lected and classified into two groups according to the different surgical therapies they received between January 2021 and June 2022.Among them,39 patients treated with ESD were included in an experimental group,and 39 patients treated with endoscopic mucosal resection(EMR)were included in a control group.We compared the basic intraoperative conditions,postoperative short-term recovery,long-term recovery effects and functional status of gastric mucosa between the two groups;the basic intraoperative conditions included lesion resection,intra-operative bleeding and operation time;the postoperative short-term recovery assessment indexes were length of hospital stay and incidence of surgical complic-ations;and the long-term recovery assessment indexes were the recurrence rate at 1 year postoperatively and the survival situation at 1 year and 3 years postoper-atively;and we compared the preoperative and predischarge serum pepsinogen I(PG I)and PG II levels and PG I/PG II ratio in the two groups before surgery and discharge.RESULTS The curative resection rate and the rate of en bloc resection were higher in the experimental group than in the control group.The intraoperative bleeding volume was higher in the experimental group than in the control group.The operation time was longer in the experimental group than that in the control group,and the rate for base residual focus was lower in the experimental group than that of the control group,and the differences were all statistically significant(all P<0.05).The length of hospital stay was longer in the experi-mental group than in the control group,and the incidence of surgical complications,1-year postoperative recu-rrence rate and 3-year postoperative survival rate were lower in the experimental group than in the control group,and the differences were statistically significant(all P<0.05).However,the difference in the 1-year postoperative survival rate was not statistically significant between the two groups(P>0.05).Before discharge,PG I and PG I/PG II ratio were elevated in both groups compared with the preoperative period,and the above indexes were higher in the experimental group than those in the control group,and the differences were statistically significant(both P<0.05).Moreover,before discharge,PG II level was lower in both groups compared with the preoperative period,and the level was lower in the experimental group than in the control group,and the differences were all statistically significant(all P<0.05).CONCLUSION Compared with EMR,ESD surgery is more thorough.It reduces the rate of base residual focus,recurrence rate,surgical complications,and promotes the recovery of gastric cells and glandular function.It is safe and suitable for clinical application.展开更多
A three-dimensional(3D)multiple phase field model,which takes into account the grain boundary(GB)energy anisotropy caused by texture,is established based on real grain orientations and Read-Shockley model.The model is...A three-dimensional(3D)multiple phase field model,which takes into account the grain boundary(GB)energy anisotropy caused by texture,is established based on real grain orientations and Read-Shockley model.The model is applied to the grain growth process of polycrystalline Mg(ZK60)alloy to investigate the evolution characteristics in different systems with varying proportions of low-angle grain boundary(LAGB)caused by different texture levels.It is found that the GB energy anisotropy can cause the grain growth kinetics to change,namely,higher texture levels(also means higher LAGB proportion)result in lower kinetics,and vice versa.The simulation results also show that the topological characteristics,such as LAGB proportion and distribution of grain size,undergo different evolution characteristics in different systems,and a more serious grain size fluctuation can be caused by a higher texture level.The mechanism is mainly the slower evolution of textured grains in their accumulation area and the faster coarsening rate of non-textured grains.Therefore,weakening the texture level is an effective way for implementing a desired homogenized microstructure in ZK60 Mg alloy.The rules revealed by the simulation results should be of great significance for revealing how the GB anisotropy affects the evolution of polycrystalline during the grain growth after recrystallization and offer the ideas for processing the alloy and optimizing the microstructure.展开更多
基金Supported by Qiqihar Scientific and Technological Plan Joint Guidance Projects,No.LSFGG-2023015.
文摘BACKGROUND With advancements in the development of endoscopic technologies,the endo-scopic submucosal dissection(ESD)has been one of the gold-standard therapies for early gastric cancer.AIM To investigate the efficacy and safety ESD in the treatment of early gastric cancer and precancerous lesions in the elderly patients.METHODS Seventy-eight elderly patients with early gastric cancer and precancerous lesions admitted to the Third Affiliated Hospital of Qiqihar Medical University were se-lected and classified into two groups according to the different surgical therapies they received between January 2021 and June 2022.Among them,39 patients treated with ESD were included in an experimental group,and 39 patients treated with endoscopic mucosal resection(EMR)were included in a control group.We compared the basic intraoperative conditions,postoperative short-term recovery,long-term recovery effects and functional status of gastric mucosa between the two groups;the basic intraoperative conditions included lesion resection,intra-operative bleeding and operation time;the postoperative short-term recovery assessment indexes were length of hospital stay and incidence of surgical complic-ations;and the long-term recovery assessment indexes were the recurrence rate at 1 year postoperatively and the survival situation at 1 year and 3 years postoper-atively;and we compared the preoperative and predischarge serum pepsinogen I(PG I)and PG II levels and PG I/PG II ratio in the two groups before surgery and discharge.RESULTS The curative resection rate and the rate of en bloc resection were higher in the experimental group than in the control group.The intraoperative bleeding volume was higher in the experimental group than in the control group.The operation time was longer in the experimental group than that in the control group,and the rate for base residual focus was lower in the experimental group than that of the control group,and the differences were all statistically significant(all P<0.05).The length of hospital stay was longer in the experi-mental group than in the control group,and the incidence of surgical complications,1-year postoperative recu-rrence rate and 3-year postoperative survival rate were lower in the experimental group than in the control group,and the differences were statistically significant(all P<0.05).However,the difference in the 1-year postoperative survival rate was not statistically significant between the two groups(P>0.05).Before discharge,PG I and PG I/PG II ratio were elevated in both groups compared with the preoperative period,and the above indexes were higher in the experimental group than those in the control group,and the differences were statistically significant(both P<0.05).Moreover,before discharge,PG II level was lower in both groups compared with the preoperative period,and the level was lower in the experimental group than in the control group,and the differences were all statistically significant(all P<0.05).CONCLUSION Compared with EMR,ESD surgery is more thorough.It reduces the rate of base residual focus,recurrence rate,surgical complications,and promotes the recovery of gastric cells and glandular function.It is safe and suitable for clinical application.
基金Project supported by the National Key Research and Development Program of China(Grant No.2016YFB0701204)the 111 Project,China(Grant No.B20029)+2 种基金the Fundamental Research Funds for the Central Universities,China(Grant Nos.N2002017 and N2007011)the National Natural Science Foundation of China(Grant No.51571055)the Science Fund from the Science and Technology Bureau of Jiangyin High-Tech Industrial Development Zone,China(Grant No.ZX20200062)。
文摘A three-dimensional(3D)multiple phase field model,which takes into account the grain boundary(GB)energy anisotropy caused by texture,is established based on real grain orientations and Read-Shockley model.The model is applied to the grain growth process of polycrystalline Mg(ZK60)alloy to investigate the evolution characteristics in different systems with varying proportions of low-angle grain boundary(LAGB)caused by different texture levels.It is found that the GB energy anisotropy can cause the grain growth kinetics to change,namely,higher texture levels(also means higher LAGB proportion)result in lower kinetics,and vice versa.The simulation results also show that the topological characteristics,such as LAGB proportion and distribution of grain size,undergo different evolution characteristics in different systems,and a more serious grain size fluctuation can be caused by a higher texture level.The mechanism is mainly the slower evolution of textured grains in their accumulation area and the faster coarsening rate of non-textured grains.Therefore,weakening the texture level is an effective way for implementing a desired homogenized microstructure in ZK60 Mg alloy.The rules revealed by the simulation results should be of great significance for revealing how the GB anisotropy affects the evolution of polycrystalline during the grain growth after recrystallization and offer the ideas for processing the alloy and optimizing the microstructure.
