BACKGROUND Gastric cancer(GC)and colorectal cancer(CRC)are the fifth and third most common cancer worldwide,respectively.Nowadays,GC is reported to have a potential predictive value for CRC,especially for advanced CRC...BACKGROUND Gastric cancer(GC)and colorectal cancer(CRC)are the fifth and third most common cancer worldwide,respectively.Nowadays,GC is reported to have a potential predictive value for CRC,especially for advanced CRC.AIM To evaluate the necessity of colonoscopy for gastric neoplasm(GN)patients.METHODS Four databases,including PubMed,EMBASE,the Cochrane Library,and Ovid,were used to perform the search strategy on May 2,2023.The prevalence of colorectal neoplasms(CRN)and baseline characteristics were compared between the neoplasm group and the control group.Continuous variables are expressed as the mean difference and standard deviation.Relationships of categorical variables in the two groups are expressed as odds ratios(OR)and 95%confidence intervals(95%CIs).Subgroup analysis according to different kinds of GNs was conducted for more in-depth analysis.The results of this study are represented by forest plots.Publication bias was evaluated by a funnel plot.All data analyses were performed by STATA SE 16.0 software.RESULTS A total of 3018 patients with GNs and 3905 healthy controls(age and sex matched)were enrolled for analysis.After comparing the prevalence of CRNs between the two groups,CRNs were detected significantly more frequently in GN patients than in controls(OR=1.69,95%CI=1.28 to 2.23,I^(2)=85.12%,P=0.00),especially in patients with GC(OR=1.80,95%CI=1.49 to 2.18,I^(2)=25.55%,P<0.1).Moreover,other risk factors including age(OR=1.08,95%CI=1.00 to 1.17,I^(2)=90.13%,P=0.00)and male sex(OR=2.31,95%CI=1.26 to 4.22,I^(2)=87.35%,P=0.00),were related to the prevalence of CRNs.For patients in the GN group,body mass index(BMI,OR=0.88,95%CI=0.80 to 0.98,I^(2)=0.00%,P=0.92)and smoking(OR=1.03,95%CI=1.01 to 1.05,I^(2)=0.00%,P=0.57)were protective and risk factors for CRNs,respectively.CONCLUSION Patients are recommended to undergo colonoscopy when diagnosed with GNs,especially GC patients with a low BMI and a history of smoking.展开更多
BACKGROUND This study aimed to evaluate the safety of enhanced recovery after surgery(ERAS)in elderly patients with gastric cancer(GC).AIM To evaluate the safety of ERAS in elderly patients with GC.METHODS The PubMed,...BACKGROUND This study aimed to evaluate the safety of enhanced recovery after surgery(ERAS)in elderly patients with gastric cancer(GC).AIM To evaluate the safety of ERAS in elderly patients with GC.METHODS The PubMed,EMBASE,and Cochrane Library databases were used to search for eligible studies from inception to April 1,2023.The mean difference(MD),odds ratio(OR)and 95%confidence interval(95%CI)were pooled for analysis.The quality of the included studies was evaluated using the Newcastle-Ottawa Scale scores.We used Stata(V.16.0)software for data analysis.RESULTS This study consists of six studies involving 878 elderly patients.By analyzing the clinical outcomes,we found that the ERAS group had shorter postoperative hospital stays(MD=-0.51,I2=0.00%,95%CI=-0.72 to-0.30,P=0.00);earlier times to first flatus(defecation;MD=-0.30,I²=0.00%,95%CI=-0.55 to-0.06,P=0.02);less intestinal obstruction(OR=3.24,I2=0.00%,95%CI=1.07 to 9.78,P=0.04);less nausea and vomiting(OR=4.07,I2=0.00%,95%CI=1.29 to 12.84,P=0.02);and less gastric retention(OR=5.69,I2=2.46%,95%CI=2.00 to 16.20,P=0.00).Our results showed that the conventional group had a greater mortality rate than the ERAS group(OR=0.24,I2=0.00%,95%CI=0.07 to 0.84,P=0.03).However,there was no statistically significant difference in major complications between the ERAS group and the conventional group(OR=0.67,I2=0.00%,95%CI=0.38 to 1.18,P=0.16).CONCLUSION Compared to those with conventional recovery,elderly GC patients who received the ERAS protocol after surgery had a lower risk of mortality.展开更多
BACKGROUND Ostomy is a common surgery usually performed to protect patients from clinical symptoms caused by distal anastomotic leakage after colorectal cancer(CRC)surgery and perforation or to relieve intestinal obst...BACKGROUND Ostomy is a common surgery usually performed to protect patients from clinical symptoms caused by distal anastomotic leakage after colorectal cancer(CRC)surgery and perforation or to relieve intestinal obstruction.AIM To analyze the complications after transverse colostomy closure.METHODS Patients who underwent transverse colostomy closure from Jan 2015 to Jan 2022 were retrospectively enrolled in a single clinical center.The differences between the complication group and the no complication group were compared.Logistic regression analyses were conducted to find independent factors for overall complications or incision infection.RESULTS A total of 102 patients who underwent transverse colostomy closure were enrolled in the current study.Seventy(68.6%)patients underwent transverse colostomy because of CRC related causes.Postoperative complications occurred in 30(29.4%)patients and the most frequent complication occurring after transverse colostomy closure was incision infection(46.7%).The complication group had longer hospital stays(P<0.01).However,no potential risk factors were identified for overall complications and incision infection.CONCLUSION The most frequent complication occurring after transverse colostomy closure surgery in our center was incision infection.The operation time,interval from transverse colostomy to reversal,and method of anastomosis might have no impact on the postoperative complications.Surgeons should pay more attention to aseptic techniques.展开更多
Objective:This study assessed the necessity of surgical re-staging in women with borderline ovarian tumors(BOTs)and evaluated the impact of complete surgical staging,lymphadenectomy,and omentectomy on disease recurren...Objective:This study assessed the necessity of surgical re-staging in women with borderline ovarian tumors(BOTs)and evaluated the impact of complete surgical staging,lymphadenectomy,and omentectomy on disease recurrence and survival.Methods:We retrospectively reviewed the medical records of patients with BOTs.A total of 901 patients were eligible for inclusion in the study,and we evaluated some of the variables and clinical/surgical characteristics of the cases.The effects of the type of surgical procedure,surgical staging,and complete or incomplete staging on recurrence were calculated.The rates of disease-free survival,overall survival,and recurrence were compared according to complete surgical staging.A Cox regression analysis was performed to identify potential prognostic factors,and survival curves were constructed using the Kaplan-Meier method.Results:The overall recurrence rate was 13.9%,and recurrence was comparable between the complete surgical staging group and the incomplete groups(P>0.05).The performance of complete surgical staging did not show an effect on long-term survival,and complete surgical staging,omentectomy,and lymphadenectomy had no effect on recurrence.In multivariate analyses,only radical surgery and adjuvant chemotherapy were risk factors for the recurrence of BOTs.Furthermore,we found that omentectomy led to a relatively low recurrence rate in patients with International Federation of Gynecology and Obstetrics(FIGO)stage>Ⅰ(P=0.022).Conclusion:Our results suggest that complete surgical staging should be considered a standard treatment for patients with advanced stage BOTs but not for those at FIGO stageⅠ.It might be safe to reduce the scope of surgical procedures in patients with early-stage BOTs.However,it is not necessary to perform re-staging operations for BOTs with a macroscopically normal extra-ovarian appearance.展开更多
BACKGROUND:Sepsis-induced liver injury is a fatal complication of sepsis.Trichostatin A(TSA)regulates inflammation and autophagy in some human diseases,and forkhead box O3a(FoxO3a)has been shown to regulate autophagy....BACKGROUND:Sepsis-induced liver injury is a fatal complication of sepsis.Trichostatin A(TSA)regulates inflammation and autophagy in some human diseases,and forkhead box O3a(FoxO3a)has been shown to regulate autophagy.The present study aims to investigate whether TSA exerts its effects on septic liver injury through the FoxO3a/autophagy signaling pathway.METHODS:A sepsis mouse model was constructed by the cecal ligation and puncture(CLP)method,and AML12 cells were pretreated with lipopolysaccharide(LPS)(1μg/mL)to establish a sepsis cell model.Forty mice were divided into four groups,namely control group,TSA group,CLP group,and CLP+TSA group,with 10 mice in each group.Cells were divided into control group,TSA group,LPS group,and LPS+TSA group.Hematoxylin-eosin(H&E)staining and biochemical methods were used to evaluate liver tissue injury.Enzyme-linked immunosorbent assay(ELISA)was applied to detect the expression of proinflammatory cytokines,and Western blotting and immunofluorescence were used to measure autophagy-related protein expression.RESULTS:Compared with the CLP group(mice),the proinflammatory cytokines(interleukin-β[IL-β]2,665.27±324.90 pg/mL to 2,080.26±373.66 pg/mL;interleukin-6[IL-6]399.01±60.98 pg/mL to 221.90±46.89 pg/mL)and the hepatocyte injury markers(aspartate transaminase[AST]from 198.18±27.07 U/L to 128.42±20.55 U/L;alanine aminotransferase[ALT]from 634.98±74.10 U/L to 478.60±32.56 U/L)were notably decreased after TSA intervention.Moreover,LC3 II and FoxO3a showed an obvious increase and P62 showed an obvious decrease in the CLP+TSA group.Cell experiment results showed the similar trend.After Fox O3a gene was knocked down in AML12 cells,the promotion of autophagy and the improvement of liver enzyme index and inflammation by TSA were weakened.CONCLUSION:TSA may improve the inflammatory response and liver injury in septic mice through Fox O3a/autophagy.展开更多
The excellent reverse breakdown characteristics of Schottky barrier varactor(SBV)are crucially required for the application of high power and high efficiency multipliers.The SBV with a novel Schottky structure named m...The excellent reverse breakdown characteristics of Schottky barrier varactor(SBV)are crucially required for the application of high power and high efficiency multipliers.The SBV with a novel Schottky structure named metal-brim is fabricated and systemically evaluated.Compared with normal structure,the reverse breakdown voltage of the new type SBV improves from-7.31 V to-8.75 V.The simulation of the Schottky metal-brim SBV is also proposed.Three factors,namely distribution of leakage current,the electric field,and the area of space charge region are mostly concerned to explain the physical mechanism.Schottky metal-brim structure is a promising approach to improve the reverse breakdown voltage and reduce leakage current by eliminating the accumulation of charge at Schottky electrode edge.展开更多
目的探讨肺泡动脉氧分压差[P_((A-a))O_2]对急性肺栓塞(APE)患者远期生存状况的影响。方法回顾性收集2011~2016年在唐山市3所三甲医院首次确诊为APE患者的病历资料,并电话随访收集患者的生存信息。根据P_((A-a))O_2与APE患者预后的ROC曲...目的探讨肺泡动脉氧分压差[P_((A-a))O_2]对急性肺栓塞(APE)患者远期生存状况的影响。方法回顾性收集2011~2016年在唐山市3所三甲医院首次确诊为APE患者的病历资料,并电话随访收集患者的生存信息。根据P_((A-a))O_2与APE患者预后的ROC曲线,将患者分成2组:P_((A-a))O_2<41.5 mm Hg组和P_((A-a))O_2≥41.5 mm Hg组。采用Kaplan-Meier法绘制生存曲线,采用COX比例风险回归模型分析P_((A-a))O_2水平与APE患者出院后死亡的关系。结果共432例APE患者进入分析,其中59例发生出院后死亡。P_((A-a))O_2<41.5 mm Hg组和P_((A-a))O_2≥41.5 mm Hg组的出院后病死率分别为2.7%和31.0%,调整其他影响因素后,P_((A-a))O_2≥41.5 mmHg可提高APE患者的出院死亡风险[H~^R=1.776(95%CI:1.006,3.136)]。结论P_((A-a))O_2水平可以预示APE患者的预后。展开更多
BACKGROUND Previous studies reported hypertension remission after gastrectomy for gastric cancer patients, and the remission rate was 11.1%-93.8%. We have reported the factors of hypertension remission previously, how...BACKGROUND Previous studies reported hypertension remission after gastrectomy for gastric cancer patients, and the remission rate was 11.1%-93.8%. We have reported the factors of hypertension remission previously, however, the follow-up time was six months. It is necessary to identify risk factors for hypertension for a relatively longer follow-up time.AIM To analyze the predictive factors for hypertension remission one year after gastrectomy of gastric cancer patients and to construct a risk model for hypertension remission.METHODS We retrospectively collected the medical information of patients with concurrent gastric cancer and hypertension in a single clinical center from January 2013 to December 2020. Univariate and multivariate logistic regression of hypertension remission were conducted, and a nomogram model was established.RESULTS A total of 209 patients with concurrent gastric cancer and hypertension were included in the current study. There were 108 patients in the remission group and 101 patients in the non-remission group. The hypertension remission rate was 51.7% one year after gastrectomy. The remission group had younger aged patients(P = 0.001), larger weight loss(P = 0.001), lower portion of coronary heart disease(P = 0.017), higher portion of II-degree hypertension(P = 0.033) and higher portion of total gastrectomy(P = 0.008) than the non-remission group. Younger age(P =0.011, odds ratio = 0.955, 95%CI: 0.922-0.990), higher weight loss(P = 0.019, odds ratio = 0.937,95%CI: 0.887-0.989) and total gastrectomy(P = 0.039, odds ratio = 2.091, 95%CI: 1.037-4.216) were independent predictors for hypertension remission. The concordance index of the model was 0.769and the calibration curve suggested great agreement. Furthermore, decision curve analysis showed that the model was clinically useful.CONCLUSION Younger age, higher weight loss and total gastrectomy were independent predictors for hypertension remission after gastrectomy for gastric cancer patients. The nomogram could visually display these results.展开更多
BACKGROUND The effect of chronic kidney disease(CKD)on the outcomes of colorectal cancer(CRC)patients after primary CRC surgery is controversial.AIM To analyze whether CKD had specific effect on the outcomes after CRC...BACKGROUND The effect of chronic kidney disease(CKD)on the outcomes of colorectal cancer(CRC)patients after primary CRC surgery is controversial.AIM To analyze whether CKD had specific effect on the outcomes after CRC surgery.METHODS We searched the PubMed,Embase,Cochrane Library databases and CNKI,from inception to March 14,2022.Newcastle-Ottawa Scale was used for the quality assessment in this meta-analysis,and we used RevMan 5.3 was used for data analysis.RESULTS A total of nine studies including 47771 patients were eligible for this metaanalysis.No significant difference was found in terms of overall postoperative complications[odds ratio(OR)=1.78,95%CI:0.64-4.94,P=0.27].We analyzed the specific complications and found that the CKD group had higher rates of pulmonary infection(OR=2.70,95%CI:1.82-4.00,P<0.01),cardiovascular complications(OR=3.39,95%CI:2.34-4.91,P<0.01)and short-term death(OR=3.01,95%CI:2.20-4.11,P<0.01).After pooling the hazard ratio(HR),the CKD group had worse overall survival(OS)(HR=1.51,95%CI:1.04-2.20,P=0.03).We performed subgroup analyses of the dialysis and non-dialysis groups,and no significant difference was found in the non-dialysis group(HR=1.20,95%CI:0.98-1.47,P=0.08).The dialysis group had worse OS(HR=3.36,95%CI:1.92-5.50,P<0.01)than the non-dialysis group.The CKD group had worse disease-free survival(DFS)(HR=1.41,95%CI:1.12-1.78,P<0.01),and in the subgroup analysis of the dialysis and non-dialysis groups,no significant difference was found in the non-dialysis group(HR=1.27,95%CI:0.97-1.66,P=0.08).The dialysis group had worse OS(HR=1.95,95%CI:1.23-3.10,P<0.01)than the non-dialysis group.CONCLUSION Preexisting CKD was associated with higher rates of pulmonary infection,higher rates of shortterm death,and worse OS and poorer DFS following CRC surgery.展开更多
We develop superconducting quantum interference device(SQUID)probes based on 3D nano-bridge junctions for the scanning SQUID microscopy.The use of these nano-bridge junctions enables imaging in the presence of a high ...We develop superconducting quantum interference device(SQUID)probes based on 3D nano-bridge junctions for the scanning SQUID microscopy.The use of these nano-bridge junctions enables imaging in the presence of a high magnetic field.Conventionally,a superconducting ground layer has been employed for better magnetic shielding.In our study,we prepare a number of scanning SQUID probes with and without a ground layer to evaluate their performance in external magnetic fields.The devices show the improved magnetic modulation up to 1.4 T.It is found that the ground layer reduces the inductance,and increases the modulation depth and symmetricity of the gradiometer design in the absence of the field.However,the layer is not compatible with the use of the scanning SQUID probe in the field because it decreases its working field range.Moreover,by adding the layer,the mutual inductance between the feedback coil and the SQUID also decreases linearly as a function of the field.展开更多
A 476 MHz resonant stripline beam position monitor(BPM)is planned to be installed in an infrared free electron laser machine at National Synchrotron Radiation Laboratory.This type of BPM was developed based on a stand...A 476 MHz resonant stripline beam position monitor(BPM)is planned to be installed in an infrared free electron laser machine at National Synchrotron Radiation Laboratory.This type of BPM was developed based on a standard stripline BPM by moving the coupling feedthrough closer to the short end downstream,which introduces a resonance and therefore a capability for higher resolution compared with broadband BPMs.The design and offline measurement results of the prototype are shown in this paper.The design goal is the optimization of the central frequencies and corresponding quality factors of the three intrinsic transverse electromagnetic modes to roughly476 MHz and 30,respectively,the fulfillment of which is demonstrated by a transmission parameter test via a network analyzer.Induced voltage signal modeling and an estimation of the position resolution of the designed BPM are shown in detail.Furthermore,a calibration test of the prototype using the stretched wire method is presented,including a description of the test stand and the evaluation of position sensitivities.展开更多
Objective:To explore the application effect of safety hazard self-examination mode in nursing risk management in hepatobiliary surgery.Methods:Sixty patients underwent hepatobiliary surgery in two tertiary hospitals i...Objective:To explore the application effect of safety hazard self-examination mode in nursing risk management in hepatobiliary surgery.Methods:Sixty patients underwent hepatobiliary surgery in two tertiary hospitals in Shandong Province from May 2021 to October 2021.According to the different implementation time,they were divided into 30 cases in the observation group and 30 cases in the control group.The control group adopts routine risk assessment,and the observation group adopts the self-examination mode of potential safety hazards on the basis of routine risk assessment to compare the incidence of nursing risk between the two groups.Results:The observation group had a significantly lower incidence of safety hazards in terms of missing surgical instruments,lack of aseptic operation,and postoperative pressure injuries than the control group(P<0.05).Conclusion:The appropriate hazard self-examination mode in the hepatobiliary operation room is of positive significance to improve the safety awareness of operating staff and the comprehensive ability of operating room nurses.展开更多
Objective:To explore the application effect of constructing professional teaching staff in low-level training in operating room,so as to further optimize the teaching strength of operating room in our hospital and imp...Objective:To explore the application effect of constructing professional teaching staff in low-level training in operating room,so as to further optimize the teaching strength of operating room in our hospital and improve the training effect of junior nurses.Methods:Thirty-eight low-level nurses in the operating room of a third-class hospital in Yantai were selected for half a year's nurse training.With theoretical scores,overall nursing performance,nurses'self-awareness evaluation system and nurses'satisfaction with tutors as evaluation criteria,and based on the selection of high-quality teachers,various evaluation indexes before and after the training of low-level nurses in the operating room were compared and evaluated through the cultivation of practical teaching teachers'ability and the application of a series of teaching methods based on the change of c ompetence-based education(CBE)teaching mode,the application of guided learning interactive canadian education(BOPPPS)teaching model and p roblem-b ased l earning(PBL)teaching method.Results:After the training,the examination scores of low-level nurses were significantly improved(P<0.05),the teaching quality was highly recognized by low-level nurses,the quality of low-level nurses was improved,and patients'satisfaction with nurses was improved.Conclusion:It is of great significance to assist the construction of professional teachers in evidence-based medicine.Through the training of practical teaching teachers'ability and the application of a series of teaching methods based on the change of CBE teaching model,the application of BOPPPS teaching model and PBL teaching method,the training results of nurses have been significantly improved and improved,which is worthy of clinical reference and promotion.展开更多
Foaming issues are encountered at the stages in crude oil production, transportation, processing, especially in chemical flooding enhanced oil recovery(EOR) oilfields. These accumulated foams would cause a lot of trou...Foaming issues are encountered at the stages in crude oil production, transportation, processing, especially in chemical flooding enhanced oil recovery(EOR) oilfields. These accumulated foams would cause a lot of trouble for downstream operation. The destruction of foams under ultrasonic has been increasingly paying attention in the background of green oilfield development. This study focuses on the decay kinetic characteristics of alkaline-surfactant-polymer-strengthened foams under the ultrasonic standing wave.The performance of the diverse foams was characterized. A decay kinetic model incorporating the energy correlation was developed and validated. The factors that affect the decay kinetic characteristics were discussed. The results indicated that the collapse rate and the collapse volume fraction decreased when the foam size decreased, the gas-liquid ratio decreased and the surface tension increased. Ultrasonic standing wave parameters have a significant impact on the decay behavior of the foam. Both the ultrasonic frequency and ultrasonic amplitude were increased by 50%, the collapse volume fraction of foams increased by about 1.25 times in the identical irradiation time. The relative deviation between the measured results and the model prediction was less than 10%. The potential collapse mechanism was also explained using the principle of energy correlation of foam surface. This study is not only beneficial to provide a robust and rigorous way to defoam of produced liquid in the alkaline/surfactant/polymer(ASP)flooding EOR process but also meaningful to well understand the decay process of oil-based foams.展开更多
At the High Energy Photon Source (HEPS),a high orbital stability of typically 10% of the beam size and angular divergence must be achieved.The beam size at the insertion devices is 10μm horizontally and 1μm vertical...At the High Energy Photon Source (HEPS),a high orbital stability of typically 10% of the beam size and angular divergence must be achieved.The beam size at the insertion devices is 10μm horizontally and 1μm vertically,which implies that the beam orbit must be stabilized to the sub-micrometer level.This results in stringent tolerance and quality control requirements for the series production of beam position monitor (BPM) pickups.In this study,analytical formulas were used and CST simulations were performed to analyze the effects of the mechanical tolerances of BPM pickups on beam position measurement.The results of electromagnetic?eld simulations revealed how various mechanical errors,such as button size and location accuracy,as well as the related button capacitance,exert different in?uences on the beam position measurement.The performance of an actual BPM pickup was measured,along with an assessment of the error on the beam position measurement.Additionally,a wake?eld analysis,including an investigation of trapped resonant modes and related thermal deformation,was conducted.展开更多
基金Supported by CQMU Program for Youth Innovation in Future Medicine,No.W0190.
文摘BACKGROUND Gastric cancer(GC)and colorectal cancer(CRC)are the fifth and third most common cancer worldwide,respectively.Nowadays,GC is reported to have a potential predictive value for CRC,especially for advanced CRC.AIM To evaluate the necessity of colonoscopy for gastric neoplasm(GN)patients.METHODS Four databases,including PubMed,EMBASE,the Cochrane Library,and Ovid,were used to perform the search strategy on May 2,2023.The prevalence of colorectal neoplasms(CRN)and baseline characteristics were compared between the neoplasm group and the control group.Continuous variables are expressed as the mean difference and standard deviation.Relationships of categorical variables in the two groups are expressed as odds ratios(OR)and 95%confidence intervals(95%CIs).Subgroup analysis according to different kinds of GNs was conducted for more in-depth analysis.The results of this study are represented by forest plots.Publication bias was evaluated by a funnel plot.All data analyses were performed by STATA SE 16.0 software.RESULTS A total of 3018 patients with GNs and 3905 healthy controls(age and sex matched)were enrolled for analysis.After comparing the prevalence of CRNs between the two groups,CRNs were detected significantly more frequently in GN patients than in controls(OR=1.69,95%CI=1.28 to 2.23,I^(2)=85.12%,P=0.00),especially in patients with GC(OR=1.80,95%CI=1.49 to 2.18,I^(2)=25.55%,P<0.1).Moreover,other risk factors including age(OR=1.08,95%CI=1.00 to 1.17,I^(2)=90.13%,P=0.00)and male sex(OR=2.31,95%CI=1.26 to 4.22,I^(2)=87.35%,P=0.00),were related to the prevalence of CRNs.For patients in the GN group,body mass index(BMI,OR=0.88,95%CI=0.80 to 0.98,I^(2)=0.00%,P=0.92)and smoking(OR=1.03,95%CI=1.01 to 1.05,I^(2)=0.00%,P=0.57)were protective and risk factors for CRNs,respectively.CONCLUSION Patients are recommended to undergo colonoscopy when diagnosed with GNs,especially GC patients with a low BMI and a history of smoking.
基金Supported by Chongqing Medical University Program for Youth Innovation in Future Medicine,No.W0190.
文摘BACKGROUND This study aimed to evaluate the safety of enhanced recovery after surgery(ERAS)in elderly patients with gastric cancer(GC).AIM To evaluate the safety of ERAS in elderly patients with GC.METHODS The PubMed,EMBASE,and Cochrane Library databases were used to search for eligible studies from inception to April 1,2023.The mean difference(MD),odds ratio(OR)and 95%confidence interval(95%CI)were pooled for analysis.The quality of the included studies was evaluated using the Newcastle-Ottawa Scale scores.We used Stata(V.16.0)software for data analysis.RESULTS This study consists of six studies involving 878 elderly patients.By analyzing the clinical outcomes,we found that the ERAS group had shorter postoperative hospital stays(MD=-0.51,I2=0.00%,95%CI=-0.72 to-0.30,P=0.00);earlier times to first flatus(defecation;MD=-0.30,I²=0.00%,95%CI=-0.55 to-0.06,P=0.02);less intestinal obstruction(OR=3.24,I2=0.00%,95%CI=1.07 to 9.78,P=0.04);less nausea and vomiting(OR=4.07,I2=0.00%,95%CI=1.29 to 12.84,P=0.02);and less gastric retention(OR=5.69,I2=2.46%,95%CI=2.00 to 16.20,P=0.00).Our results showed that the conventional group had a greater mortality rate than the ERAS group(OR=0.24,I2=0.00%,95%CI=0.07 to 0.84,P=0.03).However,there was no statistically significant difference in major complications between the ERAS group and the conventional group(OR=0.67,I2=0.00%,95%CI=0.38 to 1.18,P=0.16).CONCLUSION Compared to those with conventional recovery,elderly GC patients who received the ERAS protocol after surgery had a lower risk of mortality.
基金The ethics committee of the First Affiliated Hospital of Chongqing Medical University approved this study,No.K2024-008-01.
文摘BACKGROUND Ostomy is a common surgery usually performed to protect patients from clinical symptoms caused by distal anastomotic leakage after colorectal cancer(CRC)surgery and perforation or to relieve intestinal obstruction.AIM To analyze the complications after transverse colostomy closure.METHODS Patients who underwent transverse colostomy closure from Jan 2015 to Jan 2022 were retrospectively enrolled in a single clinical center.The differences between the complication group and the no complication group were compared.Logistic regression analyses were conducted to find independent factors for overall complications or incision infection.RESULTS A total of 102 patients who underwent transverse colostomy closure were enrolled in the current study.Seventy(68.6%)patients underwent transverse colostomy because of CRC related causes.Postoperative complications occurred in 30(29.4%)patients and the most frequent complication occurring after transverse colostomy closure was incision infection(46.7%).The complication group had longer hospital stays(P<0.01).However,no potential risk factors were identified for overall complications and incision infection.CONCLUSION The most frequent complication occurring after transverse colostomy closure surgery in our center was incision infection.The operation time,interval from transverse colostomy to reversal,and method of anastomosis might have no impact on the postoperative complications.Surgeons should pay more attention to aseptic techniques.
基金funded by the National Natural Science Foundation of China(No.81802612).
文摘Objective:This study assessed the necessity of surgical re-staging in women with borderline ovarian tumors(BOTs)and evaluated the impact of complete surgical staging,lymphadenectomy,and omentectomy on disease recurrence and survival.Methods:We retrospectively reviewed the medical records of patients with BOTs.A total of 901 patients were eligible for inclusion in the study,and we evaluated some of the variables and clinical/surgical characteristics of the cases.The effects of the type of surgical procedure,surgical staging,and complete or incomplete staging on recurrence were calculated.The rates of disease-free survival,overall survival,and recurrence were compared according to complete surgical staging.A Cox regression analysis was performed to identify potential prognostic factors,and survival curves were constructed using the Kaplan-Meier method.Results:The overall recurrence rate was 13.9%,and recurrence was comparable between the complete surgical staging group and the incomplete groups(P>0.05).The performance of complete surgical staging did not show an effect on long-term survival,and complete surgical staging,omentectomy,and lymphadenectomy had no effect on recurrence.In multivariate analyses,only radical surgery and adjuvant chemotherapy were risk factors for the recurrence of BOTs.Furthermore,we found that omentectomy led to a relatively low recurrence rate in patients with International Federation of Gynecology and Obstetrics(FIGO)stage>Ⅰ(P=0.022).Conclusion:Our results suggest that complete surgical staging should be considered a standard treatment for patients with advanced stage BOTs but not for those at FIGO stageⅠ.It might be safe to reduce the scope of surgical procedures in patients with early-stage BOTs.However,it is not necessary to perform re-staging operations for BOTs with a macroscopically normal extra-ovarian appearance.
基金Project supported by the New Staff Research Start-up Fund and the Innovation Fund(School of Materials Science and Engineering) of Southwest Petroleum University,China
基金This study was supported by a grant from National Natural Science Foundation of China (81871600)
文摘BACKGROUND:Sepsis-induced liver injury is a fatal complication of sepsis.Trichostatin A(TSA)regulates inflammation and autophagy in some human diseases,and forkhead box O3a(FoxO3a)has been shown to regulate autophagy.The present study aims to investigate whether TSA exerts its effects on septic liver injury through the FoxO3a/autophagy signaling pathway.METHODS:A sepsis mouse model was constructed by the cecal ligation and puncture(CLP)method,and AML12 cells were pretreated with lipopolysaccharide(LPS)(1μg/mL)to establish a sepsis cell model.Forty mice were divided into four groups,namely control group,TSA group,CLP group,and CLP+TSA group,with 10 mice in each group.Cells were divided into control group,TSA group,LPS group,and LPS+TSA group.Hematoxylin-eosin(H&E)staining and biochemical methods were used to evaluate liver tissue injury.Enzyme-linked immunosorbent assay(ELISA)was applied to detect the expression of proinflammatory cytokines,and Western blotting and immunofluorescence were used to measure autophagy-related protein expression.RESULTS:Compared with the CLP group(mice),the proinflammatory cytokines(interleukin-β[IL-β]2,665.27±324.90 pg/mL to 2,080.26±373.66 pg/mL;interleukin-6[IL-6]399.01±60.98 pg/mL to 221.90±46.89 pg/mL)and the hepatocyte injury markers(aspartate transaminase[AST]from 198.18±27.07 U/L to 128.42±20.55 U/L;alanine aminotransferase[ALT]from 634.98±74.10 U/L to 478.60±32.56 U/L)were notably decreased after TSA intervention.Moreover,LC3 II and FoxO3a showed an obvious increase and P62 showed an obvious decrease in the CLP+TSA group.Cell experiment results showed the similar trend.After Fox O3a gene was knocked down in AML12 cells,the promotion of autophagy and the improvement of liver enzyme index and inflammation by TSA were weakened.CONCLUSION:TSA may improve the inflammatory response and liver injury in septic mice through Fox O3a/autophagy.
文摘The excellent reverse breakdown characteristics of Schottky barrier varactor(SBV)are crucially required for the application of high power and high efficiency multipliers.The SBV with a novel Schottky structure named metal-brim is fabricated and systemically evaluated.Compared with normal structure,the reverse breakdown voltage of the new type SBV improves from-7.31 V to-8.75 V.The simulation of the Schottky metal-brim SBV is also proposed.Three factors,namely distribution of leakage current,the electric field,and the area of space charge region are mostly concerned to explain the physical mechanism.Schottky metal-brim structure is a promising approach to improve the reverse breakdown voltage and reduce leakage current by eliminating the accumulation of charge at Schottky electrode edge.
文摘目的探讨肺泡动脉氧分压差[P_((A-a))O_2]对急性肺栓塞(APE)患者远期生存状况的影响。方法回顾性收集2011~2016年在唐山市3所三甲医院首次确诊为APE患者的病历资料,并电话随访收集患者的生存信息。根据P_((A-a))O_2与APE患者预后的ROC曲线,将患者分成2组:P_((A-a))O_2<41.5 mm Hg组和P_((A-a))O_2≥41.5 mm Hg组。采用Kaplan-Meier法绘制生存曲线,采用COX比例风险回归模型分析P_((A-a))O_2水平与APE患者出院后死亡的关系。结果共432例APE患者进入分析,其中59例发生出院后死亡。P_((A-a))O_2<41.5 mm Hg组和P_((A-a))O_2≥41.5 mm Hg组的出院后病死率分别为2.7%和31.0%,调整其他影响因素后,P_((A-a))O_2≥41.5 mmHg可提高APE患者的出院死亡风险[H~^R=1.776(95%CI:1.006,3.136)]。结论P_((A-a))O_2水平可以预示APE患者的预后。
文摘BACKGROUND Previous studies reported hypertension remission after gastrectomy for gastric cancer patients, and the remission rate was 11.1%-93.8%. We have reported the factors of hypertension remission previously, however, the follow-up time was six months. It is necessary to identify risk factors for hypertension for a relatively longer follow-up time.AIM To analyze the predictive factors for hypertension remission one year after gastrectomy of gastric cancer patients and to construct a risk model for hypertension remission.METHODS We retrospectively collected the medical information of patients with concurrent gastric cancer and hypertension in a single clinical center from January 2013 to December 2020. Univariate and multivariate logistic regression of hypertension remission were conducted, and a nomogram model was established.RESULTS A total of 209 patients with concurrent gastric cancer and hypertension were included in the current study. There were 108 patients in the remission group and 101 patients in the non-remission group. The hypertension remission rate was 51.7% one year after gastrectomy. The remission group had younger aged patients(P = 0.001), larger weight loss(P = 0.001), lower portion of coronary heart disease(P = 0.017), higher portion of II-degree hypertension(P = 0.033) and higher portion of total gastrectomy(P = 0.008) than the non-remission group. Younger age(P =0.011, odds ratio = 0.955, 95%CI: 0.922-0.990), higher weight loss(P = 0.019, odds ratio = 0.937,95%CI: 0.887-0.989) and total gastrectomy(P = 0.039, odds ratio = 2.091, 95%CI: 1.037-4.216) were independent predictors for hypertension remission. The concordance index of the model was 0.769and the calibration curve suggested great agreement. Furthermore, decision curve analysis showed that the model was clinically useful.CONCLUSION Younger age, higher weight loss and total gastrectomy were independent predictors for hypertension remission after gastrectomy for gastric cancer patients. The nomogram could visually display these results.
文摘BACKGROUND The effect of chronic kidney disease(CKD)on the outcomes of colorectal cancer(CRC)patients after primary CRC surgery is controversial.AIM To analyze whether CKD had specific effect on the outcomes after CRC surgery.METHODS We searched the PubMed,Embase,Cochrane Library databases and CNKI,from inception to March 14,2022.Newcastle-Ottawa Scale was used for the quality assessment in this meta-analysis,and we used RevMan 5.3 was used for data analysis.RESULTS A total of nine studies including 47771 patients were eligible for this metaanalysis.No significant difference was found in terms of overall postoperative complications[odds ratio(OR)=1.78,95%CI:0.64-4.94,P=0.27].We analyzed the specific complications and found that the CKD group had higher rates of pulmonary infection(OR=2.70,95%CI:1.82-4.00,P<0.01),cardiovascular complications(OR=3.39,95%CI:2.34-4.91,P<0.01)and short-term death(OR=3.01,95%CI:2.20-4.11,P<0.01).After pooling the hazard ratio(HR),the CKD group had worse overall survival(OS)(HR=1.51,95%CI:1.04-2.20,P=0.03).We performed subgroup analyses of the dialysis and non-dialysis groups,and no significant difference was found in the non-dialysis group(HR=1.20,95%CI:0.98-1.47,P=0.08).The dialysis group had worse OS(HR=3.36,95%CI:1.92-5.50,P<0.01)than the non-dialysis group.The CKD group had worse disease-free survival(DFS)(HR=1.41,95%CI:1.12-1.78,P<0.01),and in the subgroup analysis of the dialysis and non-dialysis groups,no significant difference was found in the non-dialysis group(HR=1.27,95%CI:0.97-1.66,P=0.08).The dialysis group had worse OS(HR=1.95,95%CI:1.23-3.10,P<0.01)than the non-dialysis group.CONCLUSION Preexisting CKD was associated with higher rates of pulmonary infection,higher rates of shortterm death,and worse OS and poorer DFS following CRC surgery.
基金Supported by the National Key R&D Program of China(Grant Nos.2017YFF0206105,2016YFA0301002 and 2017YFA0303000)the Young Investigator Program of CAS(Grant No.2016217)+3 种基金the Frontier Science Key Programs of the CAS(Grant No.QYZDY-SSW-JSC033)the Strategic Priority Research Program of CAS(Grant No.XDA18000000)the Shanghai Municipal Science and Technology Major Project(Grant No.2019SHZDZX01)the National Natural Science Foundation of China(Grant No.11827805).
文摘We develop superconducting quantum interference device(SQUID)probes based on 3D nano-bridge junctions for the scanning SQUID microscopy.The use of these nano-bridge junctions enables imaging in the presence of a high magnetic field.Conventionally,a superconducting ground layer has been employed for better magnetic shielding.In our study,we prepare a number of scanning SQUID probes with and without a ground layer to evaluate their performance in external magnetic fields.The devices show the improved magnetic modulation up to 1.4 T.It is found that the ground layer reduces the inductance,and increases the modulation depth and symmetricity of the gradiometer design in the absence of the field.However,the layer is not compatible with the use of the scanning SQUID probe in the field because it decreases its working field range.Moreover,by adding the layer,the mutual inductance between the feedback coil and the SQUID also decreases linearly as a function of the field.
基金supported by the National Natural Science Foundation of China(Nos.11575181,21327901,11705203)the Anhui Provincial Natural Science Foundation(No.1808085QA24)the Fundamental Research Funds for Central Universities(No.WK2310000080)。
文摘A 476 MHz resonant stripline beam position monitor(BPM)is planned to be installed in an infrared free electron laser machine at National Synchrotron Radiation Laboratory.This type of BPM was developed based on a standard stripline BPM by moving the coupling feedthrough closer to the short end downstream,which introduces a resonance and therefore a capability for higher resolution compared with broadband BPMs.The design and offline measurement results of the prototype are shown in this paper.The design goal is the optimization of the central frequencies and corresponding quality factors of the three intrinsic transverse electromagnetic modes to roughly476 MHz and 30,respectively,the fulfillment of which is demonstrated by a transmission parameter test via a network analyzer.Induced voltage signal modeling and an estimation of the position resolution of the designed BPM are shown in detail.Furthermore,a calibration test of the prototype using the stretched wire method is presented,including a description of the test stand and the evaluation of position sensitivities.
文摘Objective:To explore the application effect of safety hazard self-examination mode in nursing risk management in hepatobiliary surgery.Methods:Sixty patients underwent hepatobiliary surgery in two tertiary hospitals in Shandong Province from May 2021 to October 2021.According to the different implementation time,they were divided into 30 cases in the observation group and 30 cases in the control group.The control group adopts routine risk assessment,and the observation group adopts the self-examination mode of potential safety hazards on the basis of routine risk assessment to compare the incidence of nursing risk between the two groups.Results:The observation group had a significantly lower incidence of safety hazards in terms of missing surgical instruments,lack of aseptic operation,and postoperative pressure injuries than the control group(P<0.05).Conclusion:The appropriate hazard self-examination mode in the hepatobiliary operation room is of positive significance to improve the safety awareness of operating staff and the comprehensive ability of operating room nurses.
文摘Objective:To explore the application effect of constructing professional teaching staff in low-level training in operating room,so as to further optimize the teaching strength of operating room in our hospital and improve the training effect of junior nurses.Methods:Thirty-eight low-level nurses in the operating room of a third-class hospital in Yantai were selected for half a year's nurse training.With theoretical scores,overall nursing performance,nurses'self-awareness evaluation system and nurses'satisfaction with tutors as evaluation criteria,and based on the selection of high-quality teachers,various evaluation indexes before and after the training of low-level nurses in the operating room were compared and evaluated through the cultivation of practical teaching teachers'ability and the application of a series of teaching methods based on the change of c ompetence-based education(CBE)teaching mode,the application of guided learning interactive canadian education(BOPPPS)teaching model and p roblem-b ased l earning(PBL)teaching method.Results:After the training,the examination scores of low-level nurses were significantly improved(P<0.05),the teaching quality was highly recognized by low-level nurses,the quality of low-level nurses was improved,and patients'satisfaction with nurses was improved.Conclusion:It is of great significance to assist the construction of professional teachers in evidence-based medicine.Through the training of practical teaching teachers'ability and the application of a series of teaching methods based on the change of CBE teaching model,the application of BOPPPS teaching model and PBL teaching method,the training results of nurses have been significantly improved and improved,which is worthy of clinical reference and promotion.
基金This work was supported by the National Natural Science Foundation of China （No.201374028 and No.21306034）, the Natural Science Foundation of Hebei Province （No.B2014201103）, and the Natural Science Foundation of Education Committee of Hebei Province （No.QN20131079）.
基金financially supported by the National Natural Science Foundation of China (Grant No.52174060)the PetroChina Innovation Foundation (Grant No.2019D-5007-0501)The Postdoctoral Scientific Foundation of Heilongjiang Province in China (Grant No. LBH-Q20012)。
文摘Foaming issues are encountered at the stages in crude oil production, transportation, processing, especially in chemical flooding enhanced oil recovery(EOR) oilfields. These accumulated foams would cause a lot of trouble for downstream operation. The destruction of foams under ultrasonic has been increasingly paying attention in the background of green oilfield development. This study focuses on the decay kinetic characteristics of alkaline-surfactant-polymer-strengthened foams under the ultrasonic standing wave.The performance of the diverse foams was characterized. A decay kinetic model incorporating the energy correlation was developed and validated. The factors that affect the decay kinetic characteristics were discussed. The results indicated that the collapse rate and the collapse volume fraction decreased when the foam size decreased, the gas-liquid ratio decreased and the surface tension increased. Ultrasonic standing wave parameters have a significant impact on the decay behavior of the foam. Both the ultrasonic frequency and ultrasonic amplitude were increased by 50%, the collapse volume fraction of foams increased by about 1.25 times in the identical irradiation time. The relative deviation between the measured results and the model prediction was less than 10%. The potential collapse mechanism was also explained using the principle of energy correlation of foam surface. This study is not only beneficial to provide a robust and rigorous way to defoam of produced liquid in the alkaline/surfactant/polymer(ASP)flooding EOR process but also meaningful to well understand the decay process of oil-based foams.
基金supported by the Youth Innovation Promotion Association CAS (Nos. 2019013 and Y202005)the National Natural Science Foundation of China (No. 11975254)
文摘At the High Energy Photon Source (HEPS),a high orbital stability of typically 10% of the beam size and angular divergence must be achieved.The beam size at the insertion devices is 10μm horizontally and 1μm vertically,which implies that the beam orbit must be stabilized to the sub-micrometer level.This results in stringent tolerance and quality control requirements for the series production of beam position monitor (BPM) pickups.In this study,analytical formulas were used and CST simulations were performed to analyze the effects of the mechanical tolerances of BPM pickups on beam position measurement.The results of electromagnetic?eld simulations revealed how various mechanical errors,such as button size and location accuracy,as well as the related button capacitance,exert different in?uences on the beam position measurement.The performance of an actual BPM pickup was measured,along with an assessment of the error on the beam position measurement.Additionally,a wake?eld analysis,including an investigation of trapped resonant modes and related thermal deformation,was conducted.
