BACKGROUND The surgical management of rectal cancer is continuously advancing,with a current emphasis on minimising the need for a permanent stoma.Understanding the risk factors influencing sphincter preservation is c...BACKGROUND The surgical management of rectal cancer is continuously advancing,with a current emphasis on minimising the need for a permanent stoma.Understanding the risk factors influencing sphincter preservation is crucial for guiding clinical decision-making and optimising preoperative patient evaluation.AIM To examine the risk factors influencing sphincter preservation in laparoscopic radical rectal cancer surgery.METHODS A retrospective analysis of the demographics,preoperative and intraoperative data,and pathological findings of 179 patients with rectal cancer who underwent laparoscopic radical rectal cancer surgery at our hospital between January 2022 and December 2023 was conducted.These clinical data were compared between two groups:Patients with sphincter preservation and those without,categorised as the sphincter-preserved and sphincter-unpreserved groups,respectively.RESULTS Of the 179 patients analysed,150 were in the sphincter-preserved group and 29 were in the sphincter-unpreserved group.Tumour height was significantly greater in the sphincter-preserved group compared to the sphincter-unpreserved group.Conversely,elevated levels of carcinoembryonic antigen,carbohydrate antigen 19-9,and plasma D-dimer were significantly higher in the sphincter-unpreserved group.Significant differences were also observed between the two groups in terms of place of residence,presence of colonic polyps,neoadjuvant chemotherapy,preoperative radiotherapy,mucinous adenocarcinoma,nerve invasion,and tumour height.No significant differences were observed for other parameters.Logistic regression analysis identified colonic polyps,mucinous adenocarcinoma,nerve invasion,and tumour height as independent risk factors for sphincter preser-vation.CONCLUSION Several risk factors influencing sphincter preservation in laparoscopic radical rectal cancer surgery were identified.These factors could be valuable tools for guiding clinical decision-making and optimising preoperative patient evaluations.展开更多
Li_(2)NiO_(2)has emerged as a promising cathode pre-lithiation additive capable of substantially enhancing the energy density and cycling durability of next-generation lithium-ion batteries.However,its practical deplo...Li_(2)NiO_(2)has emerged as a promising cathode pre-lithiation additive capable of substantially enhancing the energy density and cycling durability of next-generation lithium-ion batteries.However,its practical deployment is hindered by intrinsic surface structural instability under ambient conditions.Although prior studies have reported residual alkali formation on Li_(2)NiO_(2)surfaces and proposed coating strategies,critical knowledge gaps persist regarding the temporal evolution of alkali byproducts and industrially viable modification approaches.Through multiscale in situ characterizations combining X-ray diffraction(XRD),Raman spectroscopy,and X-ray photoelectron spectroscopy(XPS),we reveal a stratified residual alkali architecture:the inner layer predominantly comprises Li_(2)CO_(3)while the outer layer is dominated by LiOH,despite minimal bulk structural alterations.Leveraging these insights,we developed a facile carbon-coating strategy enabling scalable synthesis of hundred-gram batches.The conformal carbon layer effectively mitigates structural degradation and suppresses alkali formation,facilitating the integration of high-content pre-lithiation additives.LiFePO_(4)||graphite pouch cells incorporating 2.5% modified Li_(2)NiO_(2)demonstrate enhanced specific capacity with exceptional stability—exhibiting negligible energy decay(99.58%retention)over 500 cycles at 0.5P and maintaining 81.15% energy retention under aggressive 4P/4P cycling conditions over 1000 cycles.Remarkably,pouch cells with 8% additive loading achieve zero energy density decay after 1000 cycles at 4P/4P.This work provides a practical and scalable solution for advancing high-energy-density lithium-ion battery technologies.展开更多
BACKGROUND Laparoscopic anatomical liver resection has become more challenging because some subsegmental Glissonean pedicles are hard to dissect.Here,we introduce how to dissect every(sub)segmental Glissonean pedicle ...BACKGROUND Laparoscopic anatomical liver resection has become more challenging because some subsegmental Glissonean pedicles are hard to dissect.Here,we introduce how to dissect every(sub)segmental Glissonean pedicle from the first porta hepatis and perform standardized(sub)segmentectomy[from segment 1(S1)to S8].AIM To summarize our methods of laparoscopic anatomical segmental and subseg-mental liver resection.METHODS The Glisson sheath and liver capsule were separated along the Laennec mem-brane.The Glissonean pedicle could be isolated and transected with little or no parenchymal damage through this extra-Glissonean dissection approach.The basin of the(sub)segment was determined by the ischemia demarcation line or indocyanine green staining.The hepatic vein or intersegmental vein was also used to guide the plane of parenchymal transection.RESULTS All segmental or subsegmental pedicles or even the pedicle of the cone unit could be dissected along the Laennec membrane using our novel technique through the first porta hepatis.The dorsal branches of S8,the branches of S4a and the paracaval portion branches(b/c vein)of the caudate lobe were the most difficult to dissect.CONCLUSION The novel techniques of liver segmental and subsegmental pedicle anatomy is feasible for laparoscopic liver resection and can help accurately guide(sub)segmentectomy from S1 to S8.展开更多
BACKGROUND Prion diseases are a group of degenerative nerve diseases that are caused by infectious prion proteins or gene mutations.In humans,prion diseases result from mutations in the prion protein gene(PRNP).Only a...BACKGROUND Prion diseases are a group of degenerative nerve diseases that are caused by infectious prion proteins or gene mutations.In humans,prion diseases result from mutations in the prion protein gene(PRNP).Only a limited number of cases involving a specific PRNP mutation at codon 196(E196A)have been reported.The coexistence of Korsakoff syndrome in patients with Creutzfeldt-Jakob disease(CJD)caused by E196A mutation has not been documented in the existing literature.CASE SUMMARY A 61-year-old Chinese man initially presented with Korsakoff syndrome,followed by rapid-onset dementia,visual hallucinations,akinetic mutism,myoclonus,and hyperthermia.The patient had no significant personal or familial medical history.Magnetic resonance imaging of the brain revealed extensive hyperintense signals in the cortex,while positron emission tomography/computed tomography showed a diffuse reduction in cerebral cortex metabolism.Routine biochemical and microorganism testing of the cerebrospinal fluid(CSF)yielded normal results.Tests for thyroid function,human immunodeficiency virus,syphilis,vitamin B1 and B12 levels,and autoimmune rheumatic disorders were normal.Blood and CSF tests for autoimmune encephalitis and autoantibody-associated paraneoplastic syndrome yielded negative results.A test for 14-3-3 protein in the CSF yielded negative results.Whole-genome sequencing revealed a diseasecausing mutation in PRNP.The patient succumbed to the illness 11 months after the initial symptom onset.CONCLUSION Korsakoff syndrome,typically associated with alcohol intoxication,also manifests in CJD patients.Individuals with CJD along with PRNP E196A mutation may present with Korsakoff syndrome.展开更多
基金Supported by The National Natural Science Foundation of China,No.82460107Science and Technology Talent Support Program of Shaanxi Provincial People's Hospital,No.2021 LJ-05.
文摘BACKGROUND The surgical management of rectal cancer is continuously advancing,with a current emphasis on minimising the need for a permanent stoma.Understanding the risk factors influencing sphincter preservation is crucial for guiding clinical decision-making and optimising preoperative patient evaluation.AIM To examine the risk factors influencing sphincter preservation in laparoscopic radical rectal cancer surgery.METHODS A retrospective analysis of the demographics,preoperative and intraoperative data,and pathological findings of 179 patients with rectal cancer who underwent laparoscopic radical rectal cancer surgery at our hospital between January 2022 and December 2023 was conducted.These clinical data were compared between two groups:Patients with sphincter preservation and those without,categorised as the sphincter-preserved and sphincter-unpreserved groups,respectively.RESULTS Of the 179 patients analysed,150 were in the sphincter-preserved group and 29 were in the sphincter-unpreserved group.Tumour height was significantly greater in the sphincter-preserved group compared to the sphincter-unpreserved group.Conversely,elevated levels of carcinoembryonic antigen,carbohydrate antigen 19-9,and plasma D-dimer were significantly higher in the sphincter-unpreserved group.Significant differences were also observed between the two groups in terms of place of residence,presence of colonic polyps,neoadjuvant chemotherapy,preoperative radiotherapy,mucinous adenocarcinoma,nerve invasion,and tumour height.No significant differences were observed for other parameters.Logistic regression analysis identified colonic polyps,mucinous adenocarcinoma,nerve invasion,and tumour height as independent risk factors for sphincter preser-vation.CONCLUSION Several risk factors influencing sphincter preservation in laparoscopic radical rectal cancer surgery were identified.These factors could be valuable tools for guiding clinical decision-making and optimising preoperative patient evaluations.
基金financial support from the Science and Technology Projects of State Grid Corporation of China(5100-202499473A-3-6-RW)。
文摘Li_(2)NiO_(2)has emerged as a promising cathode pre-lithiation additive capable of substantially enhancing the energy density and cycling durability of next-generation lithium-ion batteries.However,its practical deployment is hindered by intrinsic surface structural instability under ambient conditions.Although prior studies have reported residual alkali formation on Li_(2)NiO_(2)surfaces and proposed coating strategies,critical knowledge gaps persist regarding the temporal evolution of alkali byproducts and industrially viable modification approaches.Through multiscale in situ characterizations combining X-ray diffraction(XRD),Raman spectroscopy,and X-ray photoelectron spectroscopy(XPS),we reveal a stratified residual alkali architecture:the inner layer predominantly comprises Li_(2)CO_(3)while the outer layer is dominated by LiOH,despite minimal bulk structural alterations.Leveraging these insights,we developed a facile carbon-coating strategy enabling scalable synthesis of hundred-gram batches.The conformal carbon layer effectively mitigates structural degradation and suppresses alkali formation,facilitating the integration of high-content pre-lithiation additives.LiFePO_(4)||graphite pouch cells incorporating 2.5% modified Li_(2)NiO_(2)demonstrate enhanced specific capacity with exceptional stability—exhibiting negligible energy decay(99.58%retention)over 500 cycles at 0.5P and maintaining 81.15% energy retention under aggressive 4P/4P cycling conditions over 1000 cycles.Remarkably,pouch cells with 8% additive loading achieve zero energy density decay after 1000 cycles at 4P/4P.This work provides a practical and scalable solution for advancing high-energy-density lithium-ion battery technologies.
基金Supported by General Project of Natural Science Foundation of Chongqing,No.cstc2021jcyj-msxmX0604Chongqing Doctoral“Through Train”Research Program,No.CSTB2022BSXM-JCX0045.
文摘BACKGROUND Laparoscopic anatomical liver resection has become more challenging because some subsegmental Glissonean pedicles are hard to dissect.Here,we introduce how to dissect every(sub)segmental Glissonean pedicle from the first porta hepatis and perform standardized(sub)segmentectomy[from segment 1(S1)to S8].AIM To summarize our methods of laparoscopic anatomical segmental and subseg-mental liver resection.METHODS The Glisson sheath and liver capsule were separated along the Laennec mem-brane.The Glissonean pedicle could be isolated and transected with little or no parenchymal damage through this extra-Glissonean dissection approach.The basin of the(sub)segment was determined by the ischemia demarcation line or indocyanine green staining.The hepatic vein or intersegmental vein was also used to guide the plane of parenchymal transection.RESULTS All segmental or subsegmental pedicles or even the pedicle of the cone unit could be dissected along the Laennec membrane using our novel technique through the first porta hepatis.The dorsal branches of S8,the branches of S4a and the paracaval portion branches(b/c vein)of the caudate lobe were the most difficult to dissect.CONCLUSION The novel techniques of liver segmental and subsegmental pedicle anatomy is feasible for laparoscopic liver resection and can help accurately guide(sub)segmentectomy from S1 to S8.
文摘BACKGROUND Prion diseases are a group of degenerative nerve diseases that are caused by infectious prion proteins or gene mutations.In humans,prion diseases result from mutations in the prion protein gene(PRNP).Only a limited number of cases involving a specific PRNP mutation at codon 196(E196A)have been reported.The coexistence of Korsakoff syndrome in patients with Creutzfeldt-Jakob disease(CJD)caused by E196A mutation has not been documented in the existing literature.CASE SUMMARY A 61-year-old Chinese man initially presented with Korsakoff syndrome,followed by rapid-onset dementia,visual hallucinations,akinetic mutism,myoclonus,and hyperthermia.The patient had no significant personal or familial medical history.Magnetic resonance imaging of the brain revealed extensive hyperintense signals in the cortex,while positron emission tomography/computed tomography showed a diffuse reduction in cerebral cortex metabolism.Routine biochemical and microorganism testing of the cerebrospinal fluid(CSF)yielded normal results.Tests for thyroid function,human immunodeficiency virus,syphilis,vitamin B1 and B12 levels,and autoimmune rheumatic disorders were normal.Blood and CSF tests for autoimmune encephalitis and autoantibody-associated paraneoplastic syndrome yielded negative results.A test for 14-3-3 protein in the CSF yielded negative results.Whole-genome sequencing revealed a diseasecausing mutation in PRNP.The patient succumbed to the illness 11 months after the initial symptom onset.CONCLUSION Korsakoff syndrome,typically associated with alcohol intoxication,also manifests in CJD patients.Individuals with CJD along with PRNP E196A mutation may present with Korsakoff syndrome.
