Objective:This study aimed to develop and validate a predictive model for postoperative complications in gastrointestinal cancer patients using a large multicenter database,based on machine learning algorithms.Methods...Objective:This study aimed to develop and validate a predictive model for postoperative complications in gastrointestinal cancer patients using a large multicenter database,based on machine learning algorithms.Methods:We analyzed the clinicopathological data of 3,926 gastrointestinal cancer patients from the Prevalence of Abdominal Complications After GastroEnterological surgery(PACAGE)database,covering 20 medical centers from December 2018 to December 2020.The predictive performance was evaluated using receiver operating characteristic(ROC)curves and Brier Score.Results:The patients were divided into gastric(2,271 cases)and colorectal cancer(1,655 cases)groups and further divided into training and external validation sets.The overall postoperative complication rates for gastric and colorectal cancer groups were 18.1%and 14.8%,respectively.The most common complication was the intraabdominal infection in both gastric and colorectal cancer groups.In the training set,the Random Forest(RF)model predicted the highest mean area under the curve(AUC)values for overall complications and different types of complications,in both the gastric cancer group and the colorectal cancer group,with similar results obtained in the external validation set.ROC curve analysis showed good predictive performance of the RF model for overall and infectious complications.An application-based clinical tool was developed for easy application in clinical practice.Conclusions:This model demonstrated good predictive performance for overall and infectious complications based on the multi-center database,supporting clinical decision-making and personalized treatment strategies.展开更多
The biochemical methane potentials for typical fruit and vegetable waste （FVW） and food waste （FW） from a northern China city were investigated, which were 0.30, 0.56 m3 CH4/kgVS （volatile solids） with biodegrad...The biochemical methane potentials for typical fruit and vegetable waste （FVW） and food waste （FW） from a northern China city were investigated, which were 0.30, 0.56 m3 CH4/kgVS （volatile solids） with biodegradabilities of 59.3% and 83.6%, respectively. Individual anaerobic digestion testes of FVW and FW were conducted at the organic loading rate （OLR） of 3 kg VS/（m3-day） using a lab-scale continuous stirred-tank reactor at 35°C. FVW could be digested stably with the biogas production rate of 2.17 ma/（m3-day） and methane production yield of 0.42 m3 CH4/kg VS. However, anaerobic digestion process for FW was failed due to acids accumulation. The effects of FVW： FW ratio on co-digestion stability and performance were further investigated at the same OLR. At FVW and FW mixing ratios of 2：1 and 1：1, the performance and operation of the digester were maintained stable, with no accumulation of volatile fatty acids （VFA） and ammonia. Changing the feed to a higher FW content in a ratio of FVW to FW 1：2, resulted in an increase in VFAs concentration to 1100-1200 rag/L, and the methanogenesis was slightly inhibited. At the optimum mixture ratio 1：1 for co-digestion of FVW with FW, the methane production yield was 0.49 m3 CH4/kg VS, and the volatile solids and soluble chemical oxygen demand （sCOD） removal efficiencies were 74.9% and 96.1%, respectively.展开更多
Excess phosphorus from non-point pollution sources is one of the key factors causing eutrophication in many lakes in China,so finding a cost-effective method to remove phosphorus from non-point pollution sources is ve...Excess phosphorus from non-point pollution sources is one of the key factors causing eutrophication in many lakes in China,so finding a cost-effective method to remove phosphorus from non-point pollution sources is very important for the health of the aqueous environment. Graphene was selected to support nanoscale zero-valent iron（nZVI）for phosphorus removal from synthetic rainwater runoff in this article. Compared with nZVI supported on other porous materials,graphene-supported nZVI（G-nZVI） could remove phosphorus more efficiently. The amount of nZVI in G-nZVI was an important factor in the removal of phosphorus by G-nZVI,and G-nZVI with 20 wt.% nZVI（20% G-nZVI）could remove phosphorus most efficiently. The nZVI was very stable and could disperse very well on graphene,as characterized by transmission electron microscopy（TEM） and scanning electron microscopy（SEM）. X-ray photoelectron spectroscopy（XPS）,Fourier Transform infrared spectroscopy（FT-IR） and Raman spectroscopy were used to elucidate the reaction process,and the results indicated that Fe-O-P was formed after phosphorus was adsorbed by G-nZVI. The results obtained from X-ray diffraction（XRD） indicated that the reaction product between nZVI supported on graphene and phosphorus was Fe3（PO4）2·8H2O（Vivianite）. It was confirmed that the specific reaction mechanism for the removal of phosphorus with nZVI or G-nZVI was mainly due to chemical reaction between nZVI and phosphorus.展开更多
Objective： Accurate estimation of lymph node metastasis （LNM） in intramucosal gastric cancer is essential to select less invasive treatment options and even avoid surgery. The aim of this study was to evaluate comb...Objective： Accurate estimation of lymph node metastasis （LNM） in intramucosal gastric cancer is essential to select less invasive treatment options and even avoid surgery. The aim of this study was to evaluate combined clinicopathological features to predict the presence of LNM. Methods： A retrospective review of data from 386 intramucosaL gastric cancer patients who underwent gastrectomy with extended lymphadenectomy from 2003 to 2010 was conducted. The mutual relation between clinicopathological characteristics and LNM was analyzed. Results： LNM was detected in 40 （10.4%） of the 386 patients. Histological typeand vascular or lymphatic invasion presence showed a positive correlation with LNM occurrence by univariate analysis. Multivariate analysis revealed that histological type was the only factor associated with LNM. Combined clinicopathologic characteristics would be more predictable for LNM. We found no LNM when we used combined clinicopathological characteristics conforming to Japanese absolute indications for endoscopic therapy. The LNM rate was as high as 8.7% when Japanese expanded criteria were used. Univariate analysis in cancer conformity to expand endoscopic submucosal dissection （ESD） indication also revealed that the undifferential type was the only significant factor for LNM. Conclusions： It was possible to predict intramucosal gastric cancer cases without LNM using combined clinicopathological characteristic analysis. Extended indication for ESD should be cautiously used for intramucosal gastric cancer patients.展开更多
Objective:Recent studies have highlighted the distinct value of tertiary lymphoid structure(TLS)for immunotherapeutic response prediction.However,it remains unclear whether TLS could play such roles in gastric cancer(...Objective:Recent studies have highlighted the distinct value of tertiary lymphoid structure(TLS)for immunotherapeutic response prediction.However,it remains unclear whether TLS could play such roles in gastric cancer(GC).Methods:In this study,tumor tissue slices from 292 GC patients from Zhongshan Hospital were firstly reviewed to explore the correlation between TLS and clinical characteristics.Subsequently,we curated 38 reported genes that may function as triggers of TLS and performed consensus molecular subtyping in public RNA-seq datasets to determine TLS patterns in GC.Based on the differentially expressed genes acquired from two TLS patterns,we quantified TLS-related genes on the principal component analysis(PCA)algorithm to develop TLS score.A Zhongshan immunotherapy cohort including 13 patients who received programmed cell death 1(PD1)blockade therapy was established to conduct RNA sequencing analysis and multiplex immunohistochemistry(mIHC)tests using formalin-fixed and paraffin-embedded(FFPE)tissues.The corresponding TLS score and immune cell counts were further compared based on therapeutic response variations.Results:Mature TLS was revealed as an independent prognostic factor in 292 GC patients.Patients with higher TLS score was characterized by prolonged survival time and superior response to immunotherapy.TLS score was correlated with immunotherapy-related characters,such as microsatellite instability(MSI)and tumor mutation burden(TMB).In addition,RNA-seq data analysis in the Zhongshan immunotherapy cohort indicated that a higher TLS score was correlated with a superior response to PD1 blockade therapy.mIHC tests also revealed that PD1+CD8+T cell counts were significantly increased in the high-TLS score group.Conclusions:This study highlighted that TLS was significantly associated with immune landscape diversity and complexity.Quantitatively evaluating TLS patterns of individual tumor will strengthen our understanding of TME characteristics and promote more effective immunotherapy strategies.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, ...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 of 34 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, χ2 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） in 154 （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 lab-scale continuously-stirred tank reactor （CSTR）, used for anaerobic co-digestion of fruit and vegetable waste （FVW） and food waste （FW） at different mixture ratios, was operated for 178 days at the organic ...A lab-scale continuously-stirred tank reactor （CSTR）, used for anaerobic co-digestion of fruit and vegetable waste （FVW） and food waste （FW） at different mixture ratios, was operated for 178 days at the organic loading rate of 3 kg VS （volatile solids）/（m3.day）. The dynamics of the Archaeal community and the correlations between environmental variables and methanogenic community structure were analyzed by polymerase chain reactions - denaturing gradient gel electrophoresis （PCR-DGGE） and redundancy analysis （RDA）, respectively. PCR-DGGE results demonstrated that the mixture ratio of FVW to FW altered the community composition of Archaea. As the FVW]FW ratio increased, Methanoculleus, Methanosaeta and Methanosarcina became the predominant methanogens in the community. Redundancy analysis results indicated that the shift of the methanogenic community was significantly correlated with the composition of acidogenic products and methane production yield. Different mixture ratios of substrates led to different compositions of intermediate metabolites, which may affect the methanogenic community. These results suggested that the analysis of microbial communities could be used to diagnose anaerobic processes.展开更多
Objective:The current standard D2 lymphadenectomy for gastric cancer(GC)includes dissection of lymph nodes(LNs)along the proper hepatic artery(No.12 a),however,the survival benefit remains controversial.The purpose of...Objective:The current standard D2 lymphadenectomy for gastric cancer(GC)includes dissection of lymph nodes(LNs)along the proper hepatic artery(No.12 a),however,the survival benefit remains controversial.The purpose of this study was to evaluate the pattern of No.12 a LN metastasis(LNM)in GC and explore the indications for No.12 a LN dissection.Methods:Medical records of 413 consecutive GC patients who underwent curative surgery in Zhongshan Hospital,Fudan University between January 2015 and December 2018 were enrolled and reviewed retrospectively.The correlation between No.12 a LNM and clinicopathologic characteristics of patients was analyzed.Results:The overall incidence of No.12 a LNM was 2.67%(11/413).Tumor location(P=0.012),depth of tumor infiltration(P<0.01)and N stage(P=0.018)were significant factors associated with No.12 a LNM.All the tumors with No.12 a LNM involved the lower third of the stomach and were in T3-4 stages.Patients with No.12 a LNM had extensive LNM than those without(20.91±4.25 vs.5.0±0.54,P<0.001).For advanced GC patients(stage III/IV)with tumors involving the lower third of the stomach,the incidence of No.12 a LNM increased to 10.7%(11/103).Patients with No.12 a LNM had a significantly poorer recurrence-free survival(RFS)(P=0.005)and overall survival(OS)(P=0.017).According to the result of multivariable Cox regression,No.12 a LNM was not an independent impact factor on RFS and OS.Conclusions:The overall incidence of No.12 a LNM was low but it was much higher in GC patients who had very advanced tumors involving the lower third of the stomach.No.12 a LN dissection should be considered for these patients to improve the survival outcomes.展开更多
Surgical quality is critical in cancer treatment,as it not only determines the radical resection of the primary tumor but also allows expedited postoperative recovery and early continuation of adjuvant therapy.Postope...Surgical quality is critical in cancer treatment,as it not only determines the radical resection of the primary tumor but also allows expedited postoperative recovery and early continuation of adjuvant therapy.Postoperative complications are valuable met-rics for assessing surgical quality.In gastric and colorectal cancer surgeries,postoperative complications substantially postpone patients'recovery and,in extreme cases,pose life-threatening risks[1].展开更多
Iron-modified corn straw biochar was used as an adsorbent to remove phosphorus from agricultural runoff. When agricultural runoffs with a total phosphorus （TP） concentration of 1.86 mg.L-1 to 2.47 mg.L-1 were filter...Iron-modified corn straw biochar was used as an adsorbent to remove phosphorus from agricultural runoff. When agricultural runoffs with a total phosphorus （TP） concentration of 1.86 mg.L-1 to 2.47 mg.L-1 were filtered at a hydraulic retention time of 2 h through a filtration column packed with the modified biochar, a TP removal efficiency of over 99% and an effluent TP concentration of less than 0.02mg.L-1 were achieved. The isotherms of the phosphorus adsorption by the modified biochar fitted the Freundlich equation better than the Langmuir equation. The mechanism of the phosphorus adsorbed by the modified biochar was analyzed by using various technologies, i.e. scanning electron microscopy （SEM）, X-ray diffraction （XRD） analysis, X-ray photoelectron spectroscopy （XPS）, and Fourier transform infrared spectroscopy （FTIR）. The results indicated that the surface of the modified biochar was covered by small iron granules, which were identified as Fe304. The results also showed that new iron oxides were formed on the surface of the modified biochar after the adsorption of phosphorus. Moreover, new bonds of Fe- O-P and P-C were found, which suggested that the new iron oxides tend to be Fe5（PO4）4（OH）3. Aside from removing phosphorus, adding the modified biochar into soil also improved soil productivity. When the modified biochar-to-soil rate was 5%, the stem, root, and bean of broad bean plants demonstrated increased growth rates of 91%, 64%, and 165%, respectively.展开更多
Objective The development of non-invasive methods for evaluating lymph node metastasis(LNM)preoperatively in gastric cancer(GC)is necessary.In this study,we developed a new radiomics model combining features from the ...Objective The development of non-invasive methods for evaluating lymph node metastasis(LNM)preoperatively in gastric cancer(GC)is necessary.In this study,we developed a new radiomics model combining features from the tumor and peritumor regions for predicting LNM and prognoses.Methods This was a retrospective observational study.In this study,two cohorts of patients with GC treated in Zhongshan Hospital Fudan University(Shanghai,China)were included.In total,193 patients were assigned to the internal training/validation cohort;another 98 patients were assigned to the independent testing cohort.The radiomics features were extracted from venous phase computerized tomography(CT)images.The radiomics model was constructed and the output was defined as the radiomics score(RS).The performance of the RS and CT-defined N status(ctN)for predicting LNM was compared using the area under the curve(AUC).The 5-year overall survival and progression-free survival were compared between different subgroups using Kaplan–Meier curves.Results In both cohorts,the RS was significantly higher in the LNM-positive group than that in the LNM-negative group(all P<0.001).The radiomics model combining features from the tumor and peri-tumor regions achieved the highest AUC in predicting LNM(AUC,0.779 and 0.724,respectively),which performed better than the radiomics model based only on the tumor region and ctN(AUC,0.717,0.622 and 0.710,0.603,respectively).The differences in 5-year overall survival and progression-free survival between high-risk and low-risk groups were significant(both P<0.001).Conclusions The radiomics model combining features from the tumor and peri-tumor regions could effectively predict the LNM in GC.Risk stratification based on the RS was capable of distinguishing patients with poor prognoses.展开更多
Adsorption of biochars(BC)produced from cash crop residuals is an economical and practical technology for removing nutrients from agricultural runoff.In this study,B C made of orange tree trunks and tea tree twigs fro...Adsorption of biochars(BC)produced from cash crop residuals is an economical and practical technology for removing nutrients from agricultural runoff.In this study,B C made of orange tree trunks and tea tree twigs from the Laoguanhe Basin were produced and modified by aluminum chloride(Al-modified)and ferric sulfate solutions(Fe-modified)under various pyrolysis temperatures(200℃-600℃)and residence times(2-5 h).All produced and modified B C were further analyzed for their abilities to adsorb ammonia and phosphorus with initial concentrations of 10-40 mg/L and 4-12 mg/L,respectively.Fe-modified Tea Tree B C 2h/400℃showed the highest phosphorus adsorption capacity of 0.56 mg/g.Al-modified Orange Tree B C 3h/500℃showed the best performance for ammonia removal with an adsorption capacity of 1.72 mg/g.FTIR characterization showed that P=O bonds were formed after the adsoiption of phosphorus by modified BC,N-H bonds were formed after ammonia adsorption.X P S analysis revealed that the key process of ammonia adsorption was the ion exchange between K+and N H 44.Phosphorus adsorption was related to oxidation and interaction between PO43-and Fe3+.According to X R D results,ammonia was found in the form of potassium amide,while phosphorus was found in the form of iron hydrogen phosphates.The sorption isotherms showed that the Freundlich equation fits better for phosphorus adsorption,while the Langmuir equation fits better for ammonia adsorption.The simulated runoff infiltration experiment showed that 97.3%of ammonia was removed by Al-modified Orange tree B C 3h/500℃,and 92.9%of phosphorus was removed by Fe-modified Tea tree B C 2h/400℃.展开更多
Background Although small-bowel perforation is a life-threatening emergency even after immediate surgical intervention,studies have rarely investigated surgical outcomes due to its relatively low incidence.This study ...Background Although small-bowel perforation is a life-threatening emergency even after immediate surgical intervention,studies have rarely investigated surgical outcomes due to its relatively low incidence.This study aimed to investigate the outcomes of emergency surgery for patients with small-bowel perforation transferred to the intensive care unit(ICU)and the risk factors for mortality.Methods Consecutive patients with small-bowel perforation who were confirmed via emergency surgery and transferred to the ICU in Zhongshan Hospital,Fudan University(Shanghai,China)between February 2011 and May 2020 were retrospectively analysed.Medical records were reviewed to determine clinical features,laboratory indicators,surgical findings,and pathology.Results A total of 104 patients were included in this study,among whom 18(17.3%),59(56.7%),and 27(26.0%)underwent perforation repair,segmental resection with primary anastomosis,and small-bowel ostomy,respectively.Malignant tumours were the leading cause of perforation in these patients(40.4%,42/104).The overall post-operative complication rate and mortality rates were 74.0%(77/104)and 19.2%(20/104),respectively.Malignant tumour-related perforation(odds ratio[OR],4.659;95%confidence interval[CI],1.269–17.105;P=0.020)and high post-operative arterial blood-lactate level(OR,1.479;95%CI,1.027–2.131;P=0.036)were identified as independent risk factors for post-operative mortality in patients with small-bowel perforation transferred to the ICU.Conclusions Patients with small-bowel perforation who are transferred to the ICU after emergency surgery face a high risk of post-operative complications and mortality.Moreover,those patients with malignant tumour-related perforation and higher post-operative blood-lactate levels have poor prognosis.展开更多
Fish artificial breeding and release is an important method to restore wild populations of endemic fish species around the world.Schizothorax wangchiachii(SW)is an endemic fish in the upper Yangtze River and is one of...Fish artificial breeding and release is an important method to restore wild populations of endemic fish species around the world.Schizothorax wangchiachii(SW)is an endemic fish in the upper Yangtze River and is one of the most important species for the artificial breeding and release program implemented in the Yalong River drainage system in China.It is unclear how artificially bred SW adapts to the changeable wild environment post-release,after being in a controlled and very different artificial environment.Thus,the gut samples were collected and analyzed for food composition and microbial 16S rRNA in artificially bred SW juveniles at day 0(before release),5,10,15,20,25,and 30 after release to the lower reaches of the Yalong River.The results indicated that SW began to ingest periphytic algae from the natural habitat before day 5,and this feeding habit is gradually stabilized at day 15.Prior to release,Fusobacteria are the dominant bacteria in the gut microbiota of SW,while Proteobacteria and Cyanobacteria generally are the dominant bacteria after release.The results of microbial assembly mechanisms illustrated that deterministic processes played a more prominent role than stochastic processes in the gut microbial community of artificially bred SW juveniles after releasing into the wild.Overall,the present study integrates the macroscopic and microscopic methods to provide an insight into the food and gut microbial reorganization in the released SW.This study will be an important research direction to explore the ecological adaptability of artificially bred fish after releasing into the wild.展开更多
基金supported by the Natural Science Foundation of Fujian Province(No.2022J01755)。
文摘Objective:This study aimed to develop and validate a predictive model for postoperative complications in gastrointestinal cancer patients using a large multicenter database,based on machine learning algorithms.Methods:We analyzed the clinicopathological data of 3,926 gastrointestinal cancer patients from the Prevalence of Abdominal Complications After GastroEnterological surgery(PACAGE)database,covering 20 medical centers from December 2018 to December 2020.The predictive performance was evaluated using receiver operating characteristic(ROC)curves and Brier Score.Results:The patients were divided into gastric(2,271 cases)and colorectal cancer(1,655 cases)groups and further divided into training and external validation sets.The overall postoperative complication rates for gastric and colorectal cancer groups were 18.1%and 14.8%,respectively.The most common complication was the intraabdominal infection in both gastric and colorectal cancer groups.In the training set,the Random Forest(RF)model predicted the highest mean area under the curve(AUC)values for overall complications and different types of complications,in both the gastric cancer group and the colorectal cancer group,with similar results obtained in the external validation set.ROC curve analysis showed good predictive performance of the RF model for overall and infectious complications.An application-based clinical tool was developed for easy application in clinical practice.Conclusions:This model demonstrated good predictive performance for overall and infectious complications based on the multi-center database,supporting clinical decision-making and personalized treatment strategies.
基金supported by the Ministry of Science and Technology of China (No. 2008BADC4B16, 2008BADC4B18,2008AA062401)
文摘The biochemical methane potentials for typical fruit and vegetable waste （FVW） and food waste （FW） from a northern China city were investigated, which were 0.30, 0.56 m3 CH4/kgVS （volatile solids） with biodegradabilities of 59.3% and 83.6%, respectively. Individual anaerobic digestion testes of FVW and FW were conducted at the organic loading rate （OLR） of 3 kg VS/（m3-day） using a lab-scale continuous stirred-tank reactor at 35°C. FVW could be digested stably with the biogas production rate of 2.17 ma/（m3-day） and methane production yield of 0.42 m3 CH4/kg VS. However, anaerobic digestion process for FW was failed due to acids accumulation. The effects of FVW： FW ratio on co-digestion stability and performance were further investigated at the same OLR. At FVW and FW mixing ratios of 2：1 and 1：1, the performance and operation of the digester were maintained stable, with no accumulation of volatile fatty acids （VFA） and ammonia. Changing the feed to a higher FW content in a ratio of FVW to FW 1：2, resulted in an increase in VFAs concentration to 1100-1200 rag/L, and the methanogenesis was slightly inhibited. At the optimum mixture ratio 1：1 for co-digestion of FVW with FW, the methane production yield was 0.49 m3 CH4/kg VS, and the volatile solids and soluble chemical oxygen demand （sCOD） removal efficiencies were 74.9% and 96.1%, respectively.
基金supported by the Major Science and Technology Programs for Water Pollution Control and Management of China (Nos.2011ZX07301-002 and 2012ZX07205-001)
文摘Excess phosphorus from non-point pollution sources is one of the key factors causing eutrophication in many lakes in China,so finding a cost-effective method to remove phosphorus from non-point pollution sources is very important for the health of the aqueous environment. Graphene was selected to support nanoscale zero-valent iron（nZVI）for phosphorus removal from synthetic rainwater runoff in this article. Compared with nZVI supported on other porous materials,graphene-supported nZVI（G-nZVI） could remove phosphorus more efficiently. The amount of nZVI in G-nZVI was an important factor in the removal of phosphorus by G-nZVI,and G-nZVI with 20 wt.% nZVI（20% G-nZVI）could remove phosphorus most efficiently. The nZVI was very stable and could disperse very well on graphene,as characterized by transmission electron microscopy（TEM） and scanning electron microscopy（SEM）. X-ray photoelectron spectroscopy（XPS）,Fourier Transform infrared spectroscopy（FT-IR） and Raman spectroscopy were used to elucidate the reaction process,and the results indicated that Fe-O-P was formed after phosphorus was adsorbed by G-nZVI. The results obtained from X-ray diffraction（XRD） indicated that the reaction product between nZVI supported on graphene and phosphorus was Fe3（PO4）2·8H2O（Vivianite）. It was confirmed that the specific reaction mechanism for the removal of phosphorus with nZVI or G-nZVI was mainly due to chemical reaction between nZVI and phosphorus.
文摘Objective： Accurate estimation of lymph node metastasis （LNM） in intramucosal gastric cancer is essential to select less invasive treatment options and even avoid surgery. The aim of this study was to evaluate combined clinicopathological features to predict the presence of LNM. Methods： A retrospective review of data from 386 intramucosaL gastric cancer patients who underwent gastrectomy with extended lymphadenectomy from 2003 to 2010 was conducted. The mutual relation between clinicopathological characteristics and LNM was analyzed. Results： LNM was detected in 40 （10.4%） of the 386 patients. Histological typeand vascular or lymphatic invasion presence showed a positive correlation with LNM occurrence by univariate analysis. Multivariate analysis revealed that histological type was the only factor associated with LNM. Combined clinicopathologic characteristics would be more predictable for LNM. We found no LNM when we used combined clinicopathological characteristics conforming to Japanese absolute indications for endoscopic therapy. The LNM rate was as high as 8.7% when Japanese expanded criteria were used. Univariate analysis in cancer conformity to expand endoscopic submucosal dissection （ESD） indication also revealed that the undifferential type was the only significant factor for LNM. Conclusions： It was possible to predict intramucosal gastric cancer cases without LNM using combined clinicopathological characteristic analysis. Extended indication for ESD should be cautiously used for intramucosal gastric cancer patients.
基金supported by grants from the National Natural Science Foundation of China(No.82172803 and No.82072679)the 2020 Zhongshan Hospital Clinical Research Special Fund(No.2020ZSLC15)。
文摘Objective:Recent studies have highlighted the distinct value of tertiary lymphoid structure(TLS)for immunotherapeutic response prediction.However,it remains unclear whether TLS could play such roles in gastric cancer(GC).Methods:In this study,tumor tissue slices from 292 GC patients from Zhongshan Hospital were firstly reviewed to explore the correlation between TLS and clinical characteristics.Subsequently,we curated 38 reported genes that may function as triggers of TLS and performed consensus molecular subtyping in public RNA-seq datasets to determine TLS patterns in GC.Based on the differentially expressed genes acquired from two TLS patterns,we quantified TLS-related genes on the principal component analysis(PCA)algorithm to develop TLS score.A Zhongshan immunotherapy cohort including 13 patients who received programmed cell death 1(PD1)blockade therapy was established to conduct RNA sequencing analysis and multiplex immunohistochemistry(mIHC)tests using formalin-fixed and paraffin-embedded(FFPE)tissues.The corresponding TLS score and immune cell counts were further compared based on therapeutic response variations.Results:Mature TLS was revealed as an independent prognostic factor in 292 GC patients.Patients with higher TLS score was characterized by prolonged survival time and superior response to immunotherapy.TLS score was correlated with immunotherapy-related characters,such as microsatellite instability(MSI)and tumor mutation burden(TMB).In addition,RNA-seq data analysis in the Zhongshan immunotherapy cohort indicated that a higher TLS score was correlated with a superior response to PD1 blockade therapy.mIHC tests also revealed that PD1+CD8+T cell counts were significantly increased in the high-TLS score group.Conclusions:This study highlighted that TLS was significantly associated with immune landscape diversity and complexity.Quantitatively evaluating TLS patterns of individual tumor will strengthen our understanding of TME characteristics and promote more effective immunotherapy strategies.
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 of 34 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, χ2 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） in 154 （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supported by the Ministry of Science and Technology of China(No.2008BADC4B16,2008BADC4B18,2008AA062401)
文摘A lab-scale continuously-stirred tank reactor （CSTR）, used for anaerobic co-digestion of fruit and vegetable waste （FVW） and food waste （FW） at different mixture ratios, was operated for 178 days at the organic loading rate of 3 kg VS （volatile solids）/（m3.day）. The dynamics of the Archaeal community and the correlations between environmental variables and methanogenic community structure were analyzed by polymerase chain reactions - denaturing gradient gel electrophoresis （PCR-DGGE） and redundancy analysis （RDA）, respectively. PCR-DGGE results demonstrated that the mixture ratio of FVW to FW altered the community composition of Archaea. As the FVW]FW ratio increased, Methanoculleus, Methanosaeta and Methanosarcina became the predominant methanogens in the community. Redundancy analysis results indicated that the shift of the methanogenic community was significantly correlated with the composition of acidogenic products and methane production yield. Different mixture ratios of substrates led to different compositions of intermediate metabolites, which may affect the methanogenic community. These results suggested that the analysis of microbial communities could be used to diagnose anaerobic processes.
基金supported by National Natural Science Fund(No.31842033)。
文摘Objective:The current standard D2 lymphadenectomy for gastric cancer(GC)includes dissection of lymph nodes(LNs)along the proper hepatic artery(No.12 a),however,the survival benefit remains controversial.The purpose of this study was to evaluate the pattern of No.12 a LN metastasis(LNM)in GC and explore the indications for No.12 a LN dissection.Methods:Medical records of 413 consecutive GC patients who underwent curative surgery in Zhongshan Hospital,Fudan University between January 2015 and December 2018 were enrolled and reviewed retrospectively.The correlation between No.12 a LNM and clinicopathologic characteristics of patients was analyzed.Results:The overall incidence of No.12 a LNM was 2.67%(11/413).Tumor location(P=0.012),depth of tumor infiltration(P<0.01)and N stage(P=0.018)were significant factors associated with No.12 a LNM.All the tumors with No.12 a LNM involved the lower third of the stomach and were in T3-4 stages.Patients with No.12 a LNM had extensive LNM than those without(20.91±4.25 vs.5.0±0.54,P<0.001).For advanced GC patients(stage III/IV)with tumors involving the lower third of the stomach,the incidence of No.12 a LNM increased to 10.7%(11/103).Patients with No.12 a LNM had a significantly poorer recurrence-free survival(RFS)(P=0.005)and overall survival(OS)(P=0.017).According to the result of multivariable Cox regression,No.12 a LNM was not an independent impact factor on RFS and OS.Conclusions:The overall incidence of No.12 a LNM was low but it was much higher in GC patients who had very advanced tumors involving the lower third of the stomach.No.12 a LN dissection should be considered for these patients to improve the survival outcomes.
基金supported by the National Natural Science Foundation of China(U20A20371)the National Key Technology Research and Development Program of the Ministry of Science and Technology of China(D171100006517004)+3 种基金Beijing Municipal Administration of Hospitals’Youth Program(QML20191103)Clinical Medicine Plus X-Young Scholars Project,Peking Universitythe Fundamental Research Funds for the Central Universitiesthe Science Foundation of Peking University Cancer Hospital。
文摘Surgical quality is critical in cancer treatment,as it not only determines the radical resection of the primary tumor but also allows expedited postoperative recovery and early continuation of adjuvant therapy.Postoperative complications are valuable met-rics for assessing surgical quality.In gastric and colorectal cancer surgeries,postoperative complications substantially postpone patients'recovery and,in extreme cases,pose life-threatening risks[1].
文摘Iron-modified corn straw biochar was used as an adsorbent to remove phosphorus from agricultural runoff. When agricultural runoffs with a total phosphorus （TP） concentration of 1.86 mg.L-1 to 2.47 mg.L-1 were filtered at a hydraulic retention time of 2 h through a filtration column packed with the modified biochar, a TP removal efficiency of over 99% and an effluent TP concentration of less than 0.02mg.L-1 were achieved. The isotherms of the phosphorus adsorption by the modified biochar fitted the Freundlich equation better than the Langmuir equation. The mechanism of the phosphorus adsorbed by the modified biochar was analyzed by using various technologies, i.e. scanning electron microscopy （SEM）, X-ray diffraction （XRD） analysis, X-ray photoelectron spectroscopy （XPS）, and Fourier transform infrared spectroscopy （FTIR）. The results indicated that the surface of the modified biochar was covered by small iron granules, which were identified as Fe304. The results also showed that new iron oxides were formed on the surface of the modified biochar after the adsorption of phosphorus. Moreover, new bonds of Fe- O-P and P-C were found, which suggested that the new iron oxides tend to be Fe5（PO4）4（OH）3. Aside from removing phosphorus, adding the modified biochar into soil also improved soil productivity. When the modified biochar-to-soil rate was 5%, the stem, root, and bean of broad bean plants demonstrated increased growth rates of 91%, 64%, and 165%, respectively.
基金supported by the Clinical Research Project of Zhongshan Hospital from Zhongshan Hospital,Fudan University[Grant No.2020ZSLC15]the National Natural Science Foundation of China[Grant No.91859107].
文摘Objective The development of non-invasive methods for evaluating lymph node metastasis(LNM)preoperatively in gastric cancer(GC)is necessary.In this study,we developed a new radiomics model combining features from the tumor and peritumor regions for predicting LNM and prognoses.Methods This was a retrospective observational study.In this study,two cohorts of patients with GC treated in Zhongshan Hospital Fudan University(Shanghai,China)were included.In total,193 patients were assigned to the internal training/validation cohort;another 98 patients were assigned to the independent testing cohort.The radiomics features were extracted from venous phase computerized tomography(CT)images.The radiomics model was constructed and the output was defined as the radiomics score(RS).The performance of the RS and CT-defined N status(ctN)for predicting LNM was compared using the area under the curve(AUC).The 5-year overall survival and progression-free survival were compared between different subgroups using Kaplan–Meier curves.Results In both cohorts,the RS was significantly higher in the LNM-positive group than that in the LNM-negative group(all P<0.001).The radiomics model combining features from the tumor and peri-tumor regions achieved the highest AUC in predicting LNM(AUC,0.779 and 0.724,respectively),which performed better than the radiomics model based only on the tumor region and ctN(AUC,0.717,0.622 and 0.710,0.603,respectively).The differences in 5-year overall survival and progression-free survival between high-risk and low-risk groups were significant(both P<0.001).Conclusions The radiomics model combining features from the tumor and peri-tumor regions could effectively predict the LNM in GC.Risk stratification based on the RS was capable of distinguishing patients with poor prognoses.
基金This research was supported by the Major Science and Technology Programs for Water Pollution Control and Management of China(Nos.2012ZX07205-001 and 2017ZX7103-007)。
文摘Adsorption of biochars(BC)produced from cash crop residuals is an economical and practical technology for removing nutrients from agricultural runoff.In this study,B C made of orange tree trunks and tea tree twigs from the Laoguanhe Basin were produced and modified by aluminum chloride(Al-modified)and ferric sulfate solutions(Fe-modified)under various pyrolysis temperatures(200℃-600℃)and residence times(2-5 h).All produced and modified B C were further analyzed for their abilities to adsorb ammonia and phosphorus with initial concentrations of 10-40 mg/L and 4-12 mg/L,respectively.Fe-modified Tea Tree B C 2h/400℃showed the highest phosphorus adsorption capacity of 0.56 mg/g.Al-modified Orange Tree B C 3h/500℃showed the best performance for ammonia removal with an adsorption capacity of 1.72 mg/g.FTIR characterization showed that P=O bonds were formed after the adsoiption of phosphorus by modified BC,N-H bonds were formed after ammonia adsorption.X P S analysis revealed that the key process of ammonia adsorption was the ion exchange between K+and N H 44.Phosphorus adsorption was related to oxidation and interaction between PO43-and Fe3+.According to X R D results,ammonia was found in the form of potassium amide,while phosphorus was found in the form of iron hydrogen phosphates.The sorption isotherms showed that the Freundlich equation fits better for phosphorus adsorption,while the Langmuir equation fits better for ammonia adsorption.The simulated runoff infiltration experiment showed that 97.3%of ammonia was removed by Al-modified Orange tree B C 3h/500℃,and 92.9%of phosphorus was removed by Fe-modified Tea tree B C 2h/400℃.
基金supported by National Nature Science Foundation of China(No.82172803).
文摘Background Although small-bowel perforation is a life-threatening emergency even after immediate surgical intervention,studies have rarely investigated surgical outcomes due to its relatively low incidence.This study aimed to investigate the outcomes of emergency surgery for patients with small-bowel perforation transferred to the intensive care unit(ICU)and the risk factors for mortality.Methods Consecutive patients with small-bowel perforation who were confirmed via emergency surgery and transferred to the ICU in Zhongshan Hospital,Fudan University(Shanghai,China)between February 2011 and May 2020 were retrospectively analysed.Medical records were reviewed to determine clinical features,laboratory indicators,surgical findings,and pathology.Results A total of 104 patients were included in this study,among whom 18(17.3%),59(56.7%),and 27(26.0%)underwent perforation repair,segmental resection with primary anastomosis,and small-bowel ostomy,respectively.Malignant tumours were the leading cause of perforation in these patients(40.4%,42/104).The overall post-operative complication rate and mortality rates were 74.0%(77/104)and 19.2%(20/104),respectively.Malignant tumour-related perforation(odds ratio[OR],4.659;95%confidence interval[CI],1.269–17.105;P=0.020)and high post-operative arterial blood-lactate level(OR,1.479;95%CI,1.027–2.131;P=0.036)were identified as independent risk factors for post-operative mortality in patients with small-bowel perforation transferred to the ICU.Conclusions Patients with small-bowel perforation who are transferred to the ICU after emergency surgery face a high risk of post-operative complications and mortality.Moreover,those patients with malignant tumour-related perforation and higher post-operative blood-lactate levels have poor prognosis.
基金The authors thank the Fish Reproduction Station of Jinping-Guandi,China for providing the place for dissecting experiments.This study was supported by grants from the Yalong River Hydropower Development Company,Ltd.(No.YLDC-ZBA-2018116)the National Natural Science Foundation of China(No.31900373).We thank Megan Price for her help with language editing.
文摘Fish artificial breeding and release is an important method to restore wild populations of endemic fish species around the world.Schizothorax wangchiachii(SW)is an endemic fish in the upper Yangtze River and is one of the most important species for the artificial breeding and release program implemented in the Yalong River drainage system in China.It is unclear how artificially bred SW adapts to the changeable wild environment post-release,after being in a controlled and very different artificial environment.Thus,the gut samples were collected and analyzed for food composition and microbial 16S rRNA in artificially bred SW juveniles at day 0(before release),5,10,15,20,25,and 30 after release to the lower reaches of the Yalong River.The results indicated that SW began to ingest periphytic algae from the natural habitat before day 5,and this feeding habit is gradually stabilized at day 15.Prior to release,Fusobacteria are the dominant bacteria in the gut microbiota of SW,while Proteobacteria and Cyanobacteria generally are the dominant bacteria after release.The results of microbial assembly mechanisms illustrated that deterministic processes played a more prominent role than stochastic processes in the gut microbial community of artificially bred SW juveniles after releasing into the wild.Overall,the present study integrates the macroscopic and microscopic methods to provide an insight into the food and gut microbial reorganization in the released SW.This study will be an important research direction to explore the ecological adaptability of artificially bred fish after releasing into the wild.
