BACKGROUND Gastric cancer(GC)is a prevalent malignant tumor worldwide and ranks as the fourth leading cause of cancer-related mortality.Upper gastrointestinal bleeding(UGIB)is a frequent complication of GC.Radical gas...BACKGROUND Gastric cancer(GC)is a prevalent malignant tumor worldwide and ranks as the fourth leading cause of cancer-related mortality.Upper gastrointestinal bleeding(UGIB)is a frequent complication of GC.Radical gastrectomy and palliative therapy are widely used surgical procedures in the clinical management of GC.This study intends to probe the clinical efficacy and safety of radical gastrectomy and palliative therapy on the basis of exploratory laparotomy in patients with GC combined with UGIB,hoping to provide valuable information to aid patients in selecting the appropriate surgical intervention.AIM To investigate the clinical efficacy and safety of exploratory laparotomy^(+)radical gastrectomy and palliative therapy in patients with GC and UGIB combined.METHODS A total of 89 GC patients admitted to the First Affiliated Hospital of the University of South China between July 2018 and July 2020 were selected as participants for this study.The 89 patients were divided into two groups:radical resection group(n=46)treated with exploratory laparotomy^(+)radical gastrectomy and Palliative group(n=43)treated with palliative therapy.The study compared several variables between the two groups,including surgical duration,intraoperative blood transfusion volume,postoperative anal exhaust time,off-bed activity time,length of hospitalization,and incidence of complications such as duodenal stump rupture,anastomotic obstruction,and postoperative incision.Additionally,postoperative immune function indicators(including CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+),and CD3^(+)/HLADR^(+)),immunoglobulin(IgG and IgM),tumor markers(CEA,CA199,and CA125),and inflammatory factors(IL-6,IL-17,and TNF-α)were assessed.The surgical efficacy and postoperative quality of life recovery were also evaluated.The patients were monitored for survival and tumor recurrence at 6 mo,1 year,and 2 years post-surgery.RESULTS The results indicated that the duration of operation time and postoperative hospitalization did not differ between the two surgical procedures.However,patients in the radical resection group exhibited shorter intraoperative blood loss,anus exhaust time,off-bed activity time,and inpatient activity time than those in the Palliative group.Although there was no substantial difference in the occurrence of postoperative complications,such as duodenal stump rupture and anastomotic obstruction,between the radical resection group and Palliative group(P>0.05),the radical resection group exhibited higher postoperative immune function indicators(including CD3^(+),CD4^(+),CD8^(+),etc.)and immunoglobulin levels(IgG,IgM)than the Palliative group,while tumor markers and inflammatory factors levels were lower than those in the radical resection group.Additionally,surgical efficacy,postoperative quality of life,and postoperative survival rates were higher in patients who underwent radical gastrectomy than in those who underwent palliative therapy.Moreover,the probability of postoperative tumor recurrence was lower in the radical gastrectomy group compared to the palliative therapy group,and these differences were all statistically significant(P<0.05).CONCLUSION Compared to palliative therapy,exploratory laparotomy^(+)radical gastrectomy can improve immune function,reduce the levels of tumor markers and inflammatory factors,improve surgical efficacy,promote postoperative quality of life recovery,enhance survival rates,and attenuate the probability of tumor recurrence.展开更多
The bamboo fiber functionalized with phthalic anhydride underwent carbonization,yielding bam-boo cellulose-derived carbon nanomaterials(C-BCN).These C-BCN were subsequently integrated into an acrylamide precursor solu...The bamboo fiber functionalized with phthalic anhydride underwent carbonization,yielding bam-boo cellulose-derived carbon nanomaterials(C-BCN).These C-BCN were subsequently integrated into an acrylamide precursor solution to synthesize an ultra-robust,fatigue-resistant conductive hydrogel(PAM-C-BCN).During in situ polymerization,the abundant active sites on the C-BCN surface facilitated covalent cross-linking with the polyacrylamide(PAM)matrix.This interfacial interaction promoted strong adhesion between the PAM chains and the carbon nanostructures,forming a densely interpenetrated network through macromolecular entanglement.The synergis-tic coupling of the rigid C-BCN framework with the flexible polymer chains conferred exceptional mechanical resilience and energy dissipation capabilities to the composite hydrogel.Compared to the PAM hydrogel,the PAM-C-BCN hydrogel exhibited an improvement in mechanical prop-erties,with a fracture strength of 363 kPa(a 2.5%increase),an elongation of approximately 2254%(a 2.0%increase),a fracture energy of 30 kJ/m^(2)(a 3.1%increase),and a toughness of 3.04 MJ/m^(3)(a 4.1%increase).Moreover,PAM-C-BCN hydrogel demonstrated high adhesion(up to 7.5 kPa on pigskin)and conductivity(0.21 S/m).This strategy required neither complex design nor processing,offering a simple and efficient approach with great potential for hydrogel appli-cations requiring high mechanical performance.At the crack tip of PAM-C-BCN hydrogel,C-BCN exhibited superior crack propagation resistance compared to SiO2 nanoparticles.Importantly,this strategy offered valuable insights for developing tough and stretchable hydrogels.展开更多
文摘BACKGROUND Gastric cancer(GC)is a prevalent malignant tumor worldwide and ranks as the fourth leading cause of cancer-related mortality.Upper gastrointestinal bleeding(UGIB)is a frequent complication of GC.Radical gastrectomy and palliative therapy are widely used surgical procedures in the clinical management of GC.This study intends to probe the clinical efficacy and safety of radical gastrectomy and palliative therapy on the basis of exploratory laparotomy in patients with GC combined with UGIB,hoping to provide valuable information to aid patients in selecting the appropriate surgical intervention.AIM To investigate the clinical efficacy and safety of exploratory laparotomy^(+)radical gastrectomy and palliative therapy in patients with GC and UGIB combined.METHODS A total of 89 GC patients admitted to the First Affiliated Hospital of the University of South China between July 2018 and July 2020 were selected as participants for this study.The 89 patients were divided into two groups:radical resection group(n=46)treated with exploratory laparotomy^(+)radical gastrectomy and Palliative group(n=43)treated with palliative therapy.The study compared several variables between the two groups,including surgical duration,intraoperative blood transfusion volume,postoperative anal exhaust time,off-bed activity time,length of hospitalization,and incidence of complications such as duodenal stump rupture,anastomotic obstruction,and postoperative incision.Additionally,postoperative immune function indicators(including CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+),and CD3^(+)/HLADR^(+)),immunoglobulin(IgG and IgM),tumor markers(CEA,CA199,and CA125),and inflammatory factors(IL-6,IL-17,and TNF-α)were assessed.The surgical efficacy and postoperative quality of life recovery were also evaluated.The patients were monitored for survival and tumor recurrence at 6 mo,1 year,and 2 years post-surgery.RESULTS The results indicated that the duration of operation time and postoperative hospitalization did not differ between the two surgical procedures.However,patients in the radical resection group exhibited shorter intraoperative blood loss,anus exhaust time,off-bed activity time,and inpatient activity time than those in the Palliative group.Although there was no substantial difference in the occurrence of postoperative complications,such as duodenal stump rupture and anastomotic obstruction,between the radical resection group and Palliative group(P>0.05),the radical resection group exhibited higher postoperative immune function indicators(including CD3^(+),CD4^(+),CD8^(+),etc.)and immunoglobulin levels(IgG,IgM)than the Palliative group,while tumor markers and inflammatory factors levels were lower than those in the radical resection group.Additionally,surgical efficacy,postoperative quality of life,and postoperative survival rates were higher in patients who underwent radical gastrectomy than in those who underwent palliative therapy.Moreover,the probability of postoperative tumor recurrence was lower in the radical gastrectomy group compared to the palliative therapy group,and these differences were all statistically significant(P<0.05).CONCLUSION Compared to palliative therapy,exploratory laparotomy^(+)radical gastrectomy can improve immune function,reduce the levels of tumor markers and inflammatory factors,improve surgical efficacy,promote postoperative quality of life recovery,enhance survival rates,and attenuate the probability of tumor recurrence.
基金supported by Applied Basic Research Program of Yunnan Province(No.202301AS070041)National Natural Science Foundation of China(No.32171884)+5 种基金the Major Science and Technology Project of Yunnan Province(202402AE090027)Long Yang acknowledges Candidates of the Young and Middle-Aged Academic Leaders of Yunnan Province(No.202105AC160048)the Ten Thousand Talent Program for Young Topnotch Talents of Yunnan Province(No.YNWR-QNBJ-2020-136)Guanben Du acknowledges the Yunnan Provincial Academician Workstation(No.YSZJGZZ-2020052)the 111 Project(No.D21027)supported by the Scientific Research Fund project of Education Department of Yunnan Province(No.2025J0626).
文摘The bamboo fiber functionalized with phthalic anhydride underwent carbonization,yielding bam-boo cellulose-derived carbon nanomaterials(C-BCN).These C-BCN were subsequently integrated into an acrylamide precursor solution to synthesize an ultra-robust,fatigue-resistant conductive hydrogel(PAM-C-BCN).During in situ polymerization,the abundant active sites on the C-BCN surface facilitated covalent cross-linking with the polyacrylamide(PAM)matrix.This interfacial interaction promoted strong adhesion between the PAM chains and the carbon nanostructures,forming a densely interpenetrated network through macromolecular entanglement.The synergis-tic coupling of the rigid C-BCN framework with the flexible polymer chains conferred exceptional mechanical resilience and energy dissipation capabilities to the composite hydrogel.Compared to the PAM hydrogel,the PAM-C-BCN hydrogel exhibited an improvement in mechanical prop-erties,with a fracture strength of 363 kPa(a 2.5%increase),an elongation of approximately 2254%(a 2.0%increase),a fracture energy of 30 kJ/m^(2)(a 3.1%increase),and a toughness of 3.04 MJ/m^(3)(a 4.1%increase).Moreover,PAM-C-BCN hydrogel demonstrated high adhesion(up to 7.5 kPa on pigskin)and conductivity(0.21 S/m).This strategy required neither complex design nor processing,offering a simple and efficient approach with great potential for hydrogel appli-cations requiring high mechanical performance.At the crack tip of PAM-C-BCN hydrogel,C-BCN exhibited superior crack propagation resistance compared to SiO2 nanoparticles.Importantly,this strategy offered valuable insights for developing tough and stretchable hydrogels.
