BACKGROUND Colorectal cancer,one of the most common malignancies,is primarily treated through surgery.With the widespread use of laparoscopy,gastrointestinal reconstruction remains a key area of research.The choice be...BACKGROUND Colorectal cancer,one of the most common malignancies,is primarily treated through surgery.With the widespread use of laparoscopy,gastrointestinal reconstruction remains a key area of research.The choice between intraperitoneal anastomosis(IA)and extraperitoneal anastomosis(EA)remains a subject of considerable debate.This study uses intraperitoneal isoperistaltic side-to-side anastomosis(IISSA)with hand-sewn closure of the common opening to evaluate its safety and short-term outcomes.It is hypothesized that this technique may offer better short-term outcomes than EA.AIM To investigate the safety and short-term outcomes of IISSA with hand-sewn closure of the common opening compared to EA.METHODS Patients who underwent laparoscopic radical colon cancer surgery between January 2018 and June 2022 at the First Affiliated Hospital of Xiamen University were retrospectively analyzed.Surgical,postoperative,and pathological features of the IA and EA groups were observed before and after propensity score matching.Patients with right-sided and left-sided colon cancer were separated,each further divided into IA and EA groups(R-IA vs R-EA for right-sided,L-IA vs L-EA for left-sided),for stratified analysis of the aforementioned indicators.RESULTS After propensity score matching,63 pairs were matched in each group.In surgical characteristics,the IA group exhibited less blood loss and shorter incisions than the EA group.Regarding postoperative recovery,the IA group showed earlier recovery of gastrointestinal function.Pathologically,the IA group had greater lymph node clearance.Relative to the R-EA group,the R-IA group experienced reduced blood loss,shorter assisted incisions,earlier recovery of gastrointestinal functions and greater lymph node dissection.When compared to the L-EA group,the L-IA group demonstrated earlier postoperative anal exhaust and defecation,along with a reduced length of hospitalization.Regarding postoperative complications,no statistically significant differences were found between the groups either after matching or in the stratified analyses.CONCLUSION Compared to EA,IISSA with hand-sewn closure of the common opening is a safe and feasible option for laparoscopic radical colon cancer surgery.展开更多
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
Sesame is a multi-purpose high-value oilseed crop,which can beused in the food,feed,and cosmetics applica-tions.The low yield of sesame is due to the lack of high-yielding and locally adapted varieties,which have the ...Sesame is a multi-purpose high-value oilseed crop,which can beused in the food,feed,and cosmetics applica-tions.The low yield of sesame is due to the lack of high-yielding and locally adapted varieties,which have the susceptibility to capsule shattering and biotic and abiotic stresses.The breeding gains in sesame are low and stagnant compared to other oilseed crops such as canola,groundnut and sunflower.Breeding for enhanced yieldrelated,oil quantity and quality,biotic and abiotic stresses tolerant varieties is vital to the adaptation of the climate change.Several genes and quantitative trait loci(QTLs)related to yield-related,oil quantity and quality,biotic and abiotic stresses tolerant have been identified through modern plant breeding tools in sesame.The depth understanding of the genetic basis,molecular mechanisms and regulatory genes involved in yield-related,oil quantity and quality,biotic and abiotic stresses tolerant in sesame is important for the improvement of sesame breeding programs.This article reviews and documents these achievements will provide fundamental data and references for practical applications of sesam research.展开更多
BACKGROUND Laparoscopic radical gastrectomy is widely used,and perioperative complications have become a highly concerned issue.AIM To develop a predictive model for complications in laparoscopic radical gastrectomy f...BACKGROUND Laparoscopic radical gastrectomy is widely used,and perioperative complications have become a highly concerned issue.AIM To develop a predictive model for complications in laparoscopic radical gastrectomy for gastric cancer to better predict the likelihood of complications in gastric cancer patients within 30 days after surgery,guide perioperative treatment strategies for gastric cancer patients,and prevent serious complications.METHODS In total,998 patients who underwent laparoscopic radical gastrectomy for gastric cancer at 16 Chinese medical centers were included in the training group for the complication model,and 398 patients were included in the validation group.The clinicopathological data and 30-d postoperative complications of gastric cancer patients were collected.Three machine learning methods,lasso regression,random forest,and artificial neural networks,were used to construct postoperative complication prediction models for laparoscopic distal gastrectomy and laparoscopic total gastrectomy,and their prediction efficacy and accuracy were evaluated.RESULTS The constructed complication model,particularly the random forest model,could better predict serious complications in gastric cancer patients undergoing laparoscopic radical gastrectomy.It exhibited stable performance in external validation and is worthy of further promotion in more centers.CONCLUSION Using the risk factors identified in multicenter datasets,highly sensitive risk prediction models for complications following laparoscopic radical gastrectomy were established.We hope to facilitate the diagnosis and treatment of preoperative and postoperative decision-making by using these models.展开更多
BACKGROUND Transanal endoscopic intersphincteric resection(ISR)surgery currently lacks sufficient clinical research and reporting.AIM To investigate the clinical effectiveness of transanal endoscopic ISR,in order to p...BACKGROUND Transanal endoscopic intersphincteric resection(ISR)surgery currently lacks sufficient clinical research and reporting.AIM To investigate the clinical effectiveness of transanal endoscopic ISR,in order to promote the clinical application and development of this technique.METHODS This study utilized a retrospective case series design.Clinical and pathological data of patients with lower rectal cancer who underwent transanal endoscopic ISR at the First Affiliated Hospital of Xiamen University between May 2018 and May 2023 were included.All patients underwent transanal endoscopic ISR as the surgical approach.We conducted this study to determine the perioperative recovery status,postoperative complications,and pathological specimen charac-teristics of this group of patients.RESULTS This study included 45 eligible patients,with no perioperative mortalities.The overall incidence of early complications was 22.22%,with a rate of 4.44%for Clavien-Dindo grade≥III events.Two patients(4.4%)developed anastomotic leakage after surgery,including one case of grade A and one case of grade B.Postoperative pathological examination confirmed negative circumferential resection margins and distal resection margins in all patients.The mean distance between the tumor lower margin and distal resection margin was found to be 2.30±0.62 cm.The transanal endoscopic ISR procedure consistently yielded high quality pathological specimens.CONCLUSION Transanal endoscopic ISR is safe,feasible,and provides a clear anatomical view.It is associated with a low incidence of postoperative complications and favorable pathological outcomes,making it worth further research and application.展开更多
In nature, many physical phenomena follow the least-action principle, which is also abided by the course of explosive welding of stainless steel/steel. The optimal welding interface can be obtained with the least expl...In nature, many physical phenomena follow the least-action principle, which is also abided by the course of explosive welding of stainless steel/steel. The optimal welding interface can be obtained with the least explosive charge by theoretical analysis and interface test. The bonding energy can be acknowledged as the ＂action＂ in explosive welding. To minimize the bonding energy, these rules must be followed such as the lower limit of explosive charge, the upper limit of span and the explosive of critical explosion velocity. The principle of least-action is achieved in the course of explosive welding, and the interface will be optimum.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
Trehalose and its precursor,trehalose-6-phosphate,play critical roles in plant metabolism and response to abiotic stresses.Trehalose-6-phosphate synthase(TPS)is a key enzyme in the trehalose synthesis pathway.Hence th...Trehalose and its precursor,trehalose-6-phosphate,play critical roles in plant metabolism and response to abiotic stresses.Trehalose-6-phosphate synthase(TPS)is a key enzyme in the trehalose synthesis pathway.Hence this study identified TPS genes in sesame(SiTPSs)and examined their expression patterns under various abiotic stresses.Totally,ten SiTPSs were identified and comprehensively characterized.SiTPSs were found to be unevenly distributed on five out of 13 sesame chromosomes and were predicted to be localized in chloroplasts and vacuoles of cells.Phylogenetic analysis classified SiTPS proteins into two groups(I and II),which was supported by gene structure and conserved motif analyses.Analysis of cis-acting elements in promoter regions of SiTPSs revealed that they might primarily involve developmental and environmental responses.SiTPSs exhibited different expression patterns in different tissues and under different abiotic stresses.Most group II SiTPS genes(SiTPS4-SiTPS10)were strongly induced by drought,salt,waterlogging,and osmotic stress.Particularly,SiTPS10 was the most significantly up-regulated under various abiotic stresses,indicating it is a candidate gene for improving sesame tolerance to multiple abiotic stresses.Our results provide insight into the TPS gene family in sesame and fundamental resources for genomics studies towards dissecting SiTPS genes’functions.展开更多
BACKGROUND Immunoinflammatory markers such as the peripheral blood neutrophil-tolymphocyte ratio(NLR)and the platelet-to-lymphocyte ratio(PLR)have gained considerable attention as prognostic markers in gastrointestina...BACKGROUND Immunoinflammatory markers such as the peripheral blood neutrophil-tolymphocyte ratio(NLR)and the platelet-to-lymphocyte ratio(PLR)have gained considerable attention as prognostic markers in gastrointestinal stromal tumors(GISTs).AIM To assess the prognostic value of Onodera’s Prognostic Nutritional Index(OPNI)for GISTs.METHODS All patients who had undergone surgical resection for a primary,localized GIST from 2009 to 2016 at our cancer center were initially and retrospectively identified.Recurrence-free survival(RFS)was calculated by the Kaplan-Meier method and compared by the log-rank test.We used multivariate Cox proportional hazard regression models to identify associations with outcome variables.RESULTS A total of 235 GISTs were identified and included for analysis under our inclusion criteria.Univariate and multivariate analyses both identified the OPNI as an independent prognostic marker,and the OPNI was associated with the primary site,tumor size,mitotic index,tumor rupture,necrosis,and modified NIH risk classification.Low OPNI(<51.30;hazard ratio=5.852;95% confidence interval:1.072–31.964;P=0.0414)was associated with worse RFS.The 2-and 5-year RFS rates of the patients with a low OPNI were 92.83% and 76.22%,respectively,whereas 100% and 98.41% were achieved by the patients with a high OPNI.CONCLUSION The preoperative OPNI is a novel and useful prognostic marker for GISTs.展开更多
The influence of explosive charge thickness on the quality of explosive welding of dissimilar metals was investigated.The lower limit law should be followed in the course of explosive welding.Three welding experiments...The influence of explosive charge thickness on the quality of explosive welding of dissimilar metals was investigated.The lower limit law should be followed in the course of explosive welding.Three welding experiments of stainless steel（410S）and steel（Q345R）were carried out in three different kinds of explosive charge thicknesses,namely 15,25and 35mm.Interfaces of morphology and mechanical properties of three samples were observed and tested.It was found that micro and small wavy bonding is mainly formed for charge thickness of 15mm whose strength is the highest with minor deformation and few defects in the interface;small and middle wavy bonding are mainly formed for charge thickness of 25 mm whose strength is comparatively mediocre;big wavy bonding is mainly formed for charge thickness of 35 mm whose strength is the lowest.The cause of high bonding strength of the micro and small wavy interface was analyzed and verified on the basis of the results of Electron Probe Micro-Analyzer（EPMA）tests of three selected samples.展开更多
Sesame(Sesamum indicum L.) plays a crucial role in Ethiopian agriculture,serving both subsistence and commercial purposes.However,our understanding of the extensive genetic diversity and population structure of Ethiop...Sesame(Sesamum indicum L.) plays a crucial role in Ethiopian agriculture,serving both subsistence and commercial purposes.However,our understanding of the extensive genetic diversity and population structure of Ethiopian sesame remains limited.To address this knowledge gap,we genotyped 368 Ethiopian sesame germplasms,categorizing into four distinct breeding groups:Accessions,landraces,improved varieties,and wild types,using a comprehensive set of 28 polymorphic markers,including 23 simple sequence repeat(SSR) and five Insertion-Deletion(InDel) markers.These markers ensured robust genomic representation,with at least two markers per linkage group.Our results unveiled substantial genetic diversity,identifying a total of 535 alleles across all accessions.On average,each locus displayed 8.83 alleles,with observed and expected heterozygosity values of 0.30 and 0.36,respectively.Gene Diversity and Polymorphic Information Content(PIC) were recorded at 0.37 and 0.35.The percentage of polymorphic loci varied significantly among breeding groups,ranging from8.00% to 82.40%,indicating high diversity in accessions(82.4%),moderate diversity in improved varieties(31.20%) and landraces(29.60%),and limited diversity in wild types(8.00).Analysis of Molecular Variance(AMOVA) results emphasized significant genetic differentiation among populations,with substantial diversity(P<0.001) within each population.Approximately 8% of the entire genetic diversity could be attributed to distinctions among populations,while the larger proportion of genetic diversity(92%) resided within each individual sesame population,showcasing heightened diversity within each group.Our study’s findings received support from both Bayesian clustering and Neighbor-joining(NJ) analysis,reaffirming the credibility of our genetic structure insights.Notably,Population structure analysis at its highest Δk value(k=2) revealed the existence of two primary genetic clusters,further subdivided into four sub-populations at k=4.Similarly,NJ analysis identified two prominent clusters,each displaying additional sub-clustering.In conclusion,our research provides a comprehensive understanding of genetic groups,subpopulations,and overall diversity within Ethiopian sesame populations.These findings underscore the significant genetic diversity and population structure within Ethiopian sesame germplasm collections.This genetic richness holds promise for breeding and conservation efforts,highlighting the importance of preserving genetic diversity to ensure adaptation to changing environments and meet the needs of farmers and consumers.展开更多
Objective:To observe the expression of endometrial homologous box gene A10(HOXA10),Integrinαvβ3 and leukemia suppressor factor(LIF)in peri-implantation mice,and to investigate the effect of controlled superovulation...Objective:To observe the expression of endometrial homologous box gene A10(HOXA10),Integrinαvβ3 and leukemia suppressor factor(LIF)in peri-implantation mice,and to investigate the effect of controlled superovulation(COH)on endometrial receptivity in mice.Methods:After COH model preparation and blastocyst transplantation,kunming pure-bred mature mice were randomly divided into natural blastocyst+natural pseudocyst group,COH blastocyst+natural pseudocyst group,natural blastocyst+COH pseudocyst group,and COH blastocyst+COH pseudocyst group.The pregnancy rate and average number of beds in each group were observed on day 6 of conception.Western blot and RT-PCR were used to detect the expression of HOXA10,Integrinααvβ3,LIF protein and mRNA in the endometria of mice on day 5 of conception.Results:The pregnancy rate and average number of beds in the COH group were lower than those in the natural receptor group.The expression of HOXA10,Integrinααvβ3 and LIF in endometrium was significantly lower than that of the natural receptor mice(P<0.01).Conclusion:Superovulation drugs down-regulate the expression of HOXA10,Integrinαvβ3 and LIF in endometrium during the implantation window,reduce endometrial receptivity,and lead to low clinical pregnancy rate.展开更多
Objective:To identify risk factors for anastomotic leakage after gastrectomy in patients with Siewert type II/III adenocarcinoma(AEG)of the esophagogastric junction.Methods:This was a retrospective case-control study ...Objective:To identify risk factors for anastomotic leakage after gastrectomy in patients with Siewert type II/III adenocarcinoma(AEG)of the esophagogastric junction.Methods:This was a retrospective case-control study of 903 patients with Siewert type II/III AEG treated from January 2012 to January 2015 at the Shanxi Cancer Hospital in China.All patients underwent gastrectomy,and their clinical characteristics were analyzed to identify associations with anastomotic leakage.Independent risk factors were identified by binary logistic regression.The 2-year disease-free survival was calculated and compared between patients with anastomotic leakage and control patients.The study was approved by the Institutional Review Board of Shanxi Medical University(approval No.2014-09-39)on September 19,2014.Results:Out of the 903 patients were included in the study,80(8.86%,80/903)experienced anastomotic leakage.The mortality rate attributed to anastomotic leakage was 8.75%(7/80).Logistic regression analysis revealed that preoperative hypoalbuminemia(odds ratio(OR)=3.249,95%confidence interval(CI):1.569-6.725,P=0.002),type of reconstruction(OR=1.795,95%CI:1.026-3.142,P=0.040),and combined organ resection(OR=1.807,95%CI:1.069-3.055,P=0.027)were independent risk factors for anastomotic leakage.Conclusion:Preoperative hypoalbuminemia,type of reconstruction,and combined organ resection were identified as risk factors for anastomotic leakage in patients undergoing gastrectomy for Siewert type Ⅱ/Ⅲ AEG.展开更多
Cold stress is one of the major abiotic stress factors affecting rice growth and development,leading to significant yield loss in the context of global climate change.Exploring natural variants that confer cold resist...Cold stress is one of the major abiotic stress factors affecting rice growth and development,leading to significant yield loss in the context of global climate change.Exploring natural variants that confer cold resistance and the underlying molecular mechanism responsible for this is the major strategy to breed cold-tolerant rice varieties.Here,we show that natural variations of a SIMILAR to RCD ONE(SRO)gene,OsSRO1c,confer cold tolerance in rice at both seedling and booting stages.Our in vivo and in vitro experiments demonstrated that OsSRO1c possesses intrinsic liquid–liquid phase-separation ability and recruits OsDREB2B,an AP2/ERF transcription factor that functions as a positive regulator of cold stress,into its biomolecular condensates in the nucleus,resulting in elevated transcriptional activity of OsDREB2B.We found that the OsSRO1c-OsDREB2B complex directly responds to low temperature through dynamic phase transitions and regulates key cold-response genes,including COLD1.Furthermore,we showed that introgression of an elite haplotype of OsSRO1c into a cold-susceptible indica rice could significantly increase its cold resistance.Collectively,our work reveals a novel cold-tolerance regulatory module in rice and provides promising genetic targets for molecular breeding of cold-tolerant rice varieties.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
Metastasis-associated drug resistance accounts for high mortality in ovarian cancer and remains to be a major barrier for effective treatment. In this study, SKOV3/T4, a metastatic subpopulation of ovarian cancer SKOV...Metastasis-associated drug resistance accounts for high mortality in ovarian cancer and remains to be a major barrier for effective treatment. In this study, SKOV3/T4, a metastatic subpopulation of ovarian cancer SKOV3 cells, was enriched to explore potential interventions against metastaticassociated drug resistance. Quantitative genomic and functional analyses were performed and found that slug was significantly increased in the SKOV3/T4 subpopulation and contributed to the high resistance of SKOV3/T4. Further studies showed that slug activated c-Met in a ligand-independent manner due to elevated levels of fibronectin and provoked integrin α V function, which was confirmed by the significant correlation of slug and p-Met levels in 121 ovarian cancer patient samples. Intriguingly,c-Met inhibitor(s) exhibited greatly enhanced anti-cancer effects in slug-positive ovarian cancer models both in vitro and in vivo. Additionally, IHC analyses revealed that slug levels were highly correlated with reduced survival of ovarian cancer patients. Taken together, this study not only uncovers the critical roles of slug in drug resistance in ovarian cancer but also highlights a promising therapeutic strategy by targeting the noncanonical activation of c-Met in slug-positive ovarian cancer patients with poor prognosis.展开更多
The power electronic transformer(PET) has recently emerged as a type of power converter. It features the basic functions of power conversion and isolation as well as additional functions related to power quality contr...The power electronic transformer(PET) has recently emerged as a type of power converter. It features the basic functions of power conversion and isolation as well as additional functions related to power quality control. A novel PET for a distribution grid called a flexible power distribution unit is proposed in this paper, and the energy exchange mechanism between the network and the load is revealed. A 30 kW 600 VAC/220 VAC/110 VDC medium-frequency isolated prototype is developed and demonstrated. This paper also presents key control strategies of the PET for electrical distribution grid applications,especially under grid voltage disturbance conditions.Moreover, stability issues related to the grid-connected three-phase PET are discussed and verified with an impedance-based analysis. The PET prototype is tested, and it passes the voltage-disturbance ride-through function. The experimental results verify the power quality control abilities of the PET.展开更多
To the Editor:Gastric cancer is one of the most common cancers in China.It is mainly found in the middle/lower part of the stomach,[1]where it commonly metastasizes from the infrapyloric lymph node(No.6).Previous stud...To the Editor:Gastric cancer is one of the most common cancers in China.It is mainly found in the middle/lower part of the stomach,[1]where it commonly metastasizes from the infrapyloric lymph node(No.6).Previous studies reported that the risk of No.6 lymph node metastasis was different based on tumor locations.In lower gastric cancer patients,the metastatic rate of No.6 lymph node can reach up to 18.7%,and in upper gastric cancer,the rate is merely 1.9%.[2]The distance between the primary tumor and the pylorus was proved to be related to No.6 lymph node metastasis.However,most of the studies were retrospective and their lymph nodes dissection’s quality control was controversial.展开更多
基金Bethune Charitable Foundation Project,No.HZB-20190528-10Natural Science Foundation of Fujian Province,No.2020J011230.
文摘BACKGROUND Colorectal cancer,one of the most common malignancies,is primarily treated through surgery.With the widespread use of laparoscopy,gastrointestinal reconstruction remains a key area of research.The choice between intraperitoneal anastomosis(IA)and extraperitoneal anastomosis(EA)remains a subject of considerable debate.This study uses intraperitoneal isoperistaltic side-to-side anastomosis(IISSA)with hand-sewn closure of the common opening to evaluate its safety and short-term outcomes.It is hypothesized that this technique may offer better short-term outcomes than EA.AIM To investigate the safety and short-term outcomes of IISSA with hand-sewn closure of the common opening compared to EA.METHODS Patients who underwent laparoscopic radical colon cancer surgery between January 2018 and June 2022 at the First Affiliated Hospital of Xiamen University were retrospectively analyzed.Surgical,postoperative,and pathological features of the IA and EA groups were observed before and after propensity score matching.Patients with right-sided and left-sided colon cancer were separated,each further divided into IA and EA groups(R-IA vs R-EA for right-sided,L-IA vs L-EA for left-sided),for stratified analysis of the aforementioned indicators.RESULTS After propensity score matching,63 pairs were matched in each group.In surgical characteristics,the IA group exhibited less blood loss and shorter incisions than the EA group.Regarding postoperative recovery,the IA group showed earlier recovery of gastrointestinal function.Pathologically,the IA group had greater lymph node clearance.Relative to the R-EA group,the R-IA group experienced reduced blood loss,shorter assisted incisions,earlier recovery of gastrointestinal functions and greater lymph node dissection.When compared to the L-EA group,the L-IA group demonstrated earlier postoperative anal exhaust and defecation,along with a reduced length of hospitalization.Regarding postoperative complications,no statistically significant differences were found between the groups either after matching or in the stratified analyses.CONCLUSION Compared to EA,IISSA with hand-sewn closure of the common opening is a safe and feasible option for laparoscopic radical colon cancer surgery.
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 National Key Research and Devel-opment Program of China(2024YFD1600100)the Talented Young Scientist Program(TYSP)+5 种基金the Agricultural Science and Technology Innovation Program of the Chinese Academy of Agricultural Sciences(CAAS-ASTIP-2024-OCRI)China Agriculture Research System(CARS-14)Hubei International Science and Technology Cooperation Project(2022EHB034,2024EHA055)Science and Technology Innovation Project of Hubei province(2024-620-000-001-031)Fundamental Research Funds for Central Non-profit Scientific Institution(1610172023003)the National Center for Crops Germplasm Re-sources(NCCGR-2024-016).
文摘Sesame is a multi-purpose high-value oilseed crop,which can beused in the food,feed,and cosmetics applica-tions.The low yield of sesame is due to the lack of high-yielding and locally adapted varieties,which have the susceptibility to capsule shattering and biotic and abiotic stresses.The breeding gains in sesame are low and stagnant compared to other oilseed crops such as canola,groundnut and sunflower.Breeding for enhanced yieldrelated,oil quantity and quality,biotic and abiotic stresses tolerant varieties is vital to the adaptation of the climate change.Several genes and quantitative trait loci(QTLs)related to yield-related,oil quantity and quality,biotic and abiotic stresses tolerant have been identified through modern plant breeding tools in sesame.The depth understanding of the genetic basis,molecular mechanisms and regulatory genes involved in yield-related,oil quantity and quality,biotic and abiotic stresses tolerant in sesame is important for the improvement of sesame breeding programs.This article reviews and documents these achievements will provide fundamental data and references for practical applications of sesam research.
基金Natural Science Foundation of Fujian Province,No.2021J011360,and No.2020J011230Natural Science Foundation of Xiamen,China,No.3502Z20214ZD1018,and No.3502Z20227096+2 种基金Medical Innovation Project of Fujian Provincial Health Commission,No.2021CXB019Youth Scientific Research Project of Fujian Provincial Health Commission,No.2022QNB013Bethune Charitable Foundation,No.HZB-20190528-10.
文摘BACKGROUND Laparoscopic radical gastrectomy is widely used,and perioperative complications have become a highly concerned issue.AIM To develop a predictive model for complications in laparoscopic radical gastrectomy for gastric cancer to better predict the likelihood of complications in gastric cancer patients within 30 days after surgery,guide perioperative treatment strategies for gastric cancer patients,and prevent serious complications.METHODS In total,998 patients who underwent laparoscopic radical gastrectomy for gastric cancer at 16 Chinese medical centers were included in the training group for the complication model,and 398 patients were included in the validation group.The clinicopathological data and 30-d postoperative complications of gastric cancer patients were collected.Three machine learning methods,lasso regression,random forest,and artificial neural networks,were used to construct postoperative complication prediction models for laparoscopic distal gastrectomy and laparoscopic total gastrectomy,and their prediction efficacy and accuracy were evaluated.RESULTS The constructed complication model,particularly the random forest model,could better predict serious complications in gastric cancer patients undergoing laparoscopic radical gastrectomy.It exhibited stable performance in external validation and is worthy of further promotion in more centers.CONCLUSION Using the risk factors identified in multicenter datasets,highly sensitive risk prediction models for complications following laparoscopic radical gastrectomy were established.We hope to facilitate the diagnosis and treatment of preoperative and postoperative decision-making by using these models.
文摘BACKGROUND Transanal endoscopic intersphincteric resection(ISR)surgery currently lacks sufficient clinical research and reporting.AIM To investigate the clinical effectiveness of transanal endoscopic ISR,in order to promote the clinical application and development of this technique.METHODS This study utilized a retrospective case series design.Clinical and pathological data of patients with lower rectal cancer who underwent transanal endoscopic ISR at the First Affiliated Hospital of Xiamen University between May 2018 and May 2023 were included.All patients underwent transanal endoscopic ISR as the surgical approach.We conducted this study to determine the perioperative recovery status,postoperative complications,and pathological specimen charac-teristics of this group of patients.RESULTS This study included 45 eligible patients,with no perioperative mortalities.The overall incidence of early complications was 22.22%,with a rate of 4.44%for Clavien-Dindo grade≥III events.Two patients(4.4%)developed anastomotic leakage after surgery,including one case of grade A and one case of grade B.Postoperative pathological examination confirmed negative circumferential resection margins and distal resection margins in all patients.The mean distance between the tumor lower margin and distal resection margin was found to be 2.30±0.62 cm.The transanal endoscopic ISR procedure consistently yielded high quality pathological specimens.CONCLUSION Transanal endoscopic ISR is safe,feasible,and provides a clear anatomical view.It is associated with a low incidence of postoperative complications and favorable pathological outcomes,making it worth further research and application.
基金Sponsored by Jiangsu Provincial Foundation of Technology Achievement Transform of China(BA2012030)
文摘In nature, many physical phenomena follow the least-action principle, which is also abided by the course of explosive welding of stainless steel/steel. The optimal welding interface can be obtained with the least explosive charge by theoretical analysis and interface test. The bonding energy can be acknowledged as the ＂action＂ in explosive welding. To minimize the bonding energy, these rules must be followed such as the lower limit of explosive charge, the upper limit of span and the explosive of critical explosion velocity. The principle of least-action is achieved in the course of explosive welding, and the interface will be optimum.
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funded by the Agricultural Science and Technology Innovation Project of the Chinese Academy of Agricultural Sciences(CAAS-ASTIP-2021-OCRI)the Key Research Projects of Hubei province(2020BBA045,2020BHB028)+1 种基金the Fundamental Research Funds for Central Non-profit Scientific Institution(Y2022XK11).the Open Project of Key Laboratory of Biology and Genetic Improvement of Oil Crops,Ministry of Agriculture and Rural Affairs,P.R.China.(KF2022002)China Agriculture Research System(CARS-14).
文摘Trehalose and its precursor,trehalose-6-phosphate,play critical roles in plant metabolism and response to abiotic stresses.Trehalose-6-phosphate synthase(TPS)is a key enzyme in the trehalose synthesis pathway.Hence this study identified TPS genes in sesame(SiTPSs)and examined their expression patterns under various abiotic stresses.Totally,ten SiTPSs were identified and comprehensively characterized.SiTPSs were found to be unevenly distributed on five out of 13 sesame chromosomes and were predicted to be localized in chloroplasts and vacuoles of cells.Phylogenetic analysis classified SiTPS proteins into two groups(I and II),which was supported by gene structure and conserved motif analyses.Analysis of cis-acting elements in promoter regions of SiTPSs revealed that they might primarily involve developmental and environmental responses.SiTPSs exhibited different expression patterns in different tissues and under different abiotic stresses.Most group II SiTPS genes(SiTPS4-SiTPS10)were strongly induced by drought,salt,waterlogging,and osmotic stress.Particularly,SiTPS10 was the most significantly up-regulated under various abiotic stresses,indicating it is a candidate gene for improving sesame tolerance to multiple abiotic stresses.Our results provide insight into the TPS gene family in sesame and fundamental resources for genomics studies towards dissecting SiTPS genes’functions.
基金Supported by Health Commission of Shanxi Province,No.2020130 and No.2020TD27the Science and Technology Planning Project of Yangzhou City,No.YZ2018092。
文摘BACKGROUND Immunoinflammatory markers such as the peripheral blood neutrophil-tolymphocyte ratio(NLR)and the platelet-to-lymphocyte ratio(PLR)have gained considerable attention as prognostic markers in gastrointestinal stromal tumors(GISTs).AIM To assess the prognostic value of Onodera’s Prognostic Nutritional Index(OPNI)for GISTs.METHODS All patients who had undergone surgical resection for a primary,localized GIST from 2009 to 2016 at our cancer center were initially and retrospectively identified.Recurrence-free survival(RFS)was calculated by the Kaplan-Meier method and compared by the log-rank test.We used multivariate Cox proportional hazard regression models to identify associations with outcome variables.RESULTS A total of 235 GISTs were identified and included for analysis under our inclusion criteria.Univariate and multivariate analyses both identified the OPNI as an independent prognostic marker,and the OPNI was associated with the primary site,tumor size,mitotic index,tumor rupture,necrosis,and modified NIH risk classification.Low OPNI(<51.30;hazard ratio=5.852;95% confidence interval:1.072–31.964;P=0.0414)was associated with worse RFS.The 2-and 5-year RFS rates of the patients with a low OPNI were 92.83% and 76.22%,respectively,whereas 100% and 98.41% were achieved by the patients with a high OPNI.CONCLUSION The preoperative OPNI is a novel and useful prognostic marker for GISTs.
基金supported by the National Natural Science Foundation of China(No.51541112)Special Fund Achievement Transformation Projects in Jiangsu(No.BA2012030)
文摘The influence of explosive charge thickness on the quality of explosive welding of dissimilar metals was investigated.The lower limit law should be followed in the course of explosive welding.Three welding experiments of stainless steel（410S）and steel（Q345R）were carried out in three different kinds of explosive charge thicknesses,namely 15,25and 35mm.Interfaces of morphology and mechanical properties of three samples were observed and tested.It was found that micro and small wavy bonding is mainly formed for charge thickness of 15mm whose strength is the highest with minor deformation and few defects in the interface;small and middle wavy bonding are mainly formed for charge thickness of 25 mm whose strength is comparatively mediocre;big wavy bonding is mainly formed for charge thickness of 35 mm whose strength is the lowest.The cause of high bonding strength of the micro and small wavy interface was analyzed and verified on the basis of the results of Electron Probe Micro-Analyzer（EPMA）tests of three selected samples.
基金funded by the Agricultural Science and Technology Innovation Program of the Chinese Academy of Agricultural Sciences(CAAS-ASTIP-2021-OCRI)China Agriculture Research System(CARS14)+2 种基金Hubei International Science and Technology Cooperation Project(2022EHB034)the Science and Technology Innovation Project of Hubei Province(2021-620-000-001-035)the Fundamental Research Funds for Central Non-profit Scientific Institution(2013).
文摘Sesame(Sesamum indicum L.) plays a crucial role in Ethiopian agriculture,serving both subsistence and commercial purposes.However,our understanding of the extensive genetic diversity and population structure of Ethiopian sesame remains limited.To address this knowledge gap,we genotyped 368 Ethiopian sesame germplasms,categorizing into four distinct breeding groups:Accessions,landraces,improved varieties,and wild types,using a comprehensive set of 28 polymorphic markers,including 23 simple sequence repeat(SSR) and five Insertion-Deletion(InDel) markers.These markers ensured robust genomic representation,with at least two markers per linkage group.Our results unveiled substantial genetic diversity,identifying a total of 535 alleles across all accessions.On average,each locus displayed 8.83 alleles,with observed and expected heterozygosity values of 0.30 and 0.36,respectively.Gene Diversity and Polymorphic Information Content(PIC) were recorded at 0.37 and 0.35.The percentage of polymorphic loci varied significantly among breeding groups,ranging from8.00% to 82.40%,indicating high diversity in accessions(82.4%),moderate diversity in improved varieties(31.20%) and landraces(29.60%),and limited diversity in wild types(8.00).Analysis of Molecular Variance(AMOVA) results emphasized significant genetic differentiation among populations,with substantial diversity(P<0.001) within each population.Approximately 8% of the entire genetic diversity could be attributed to distinctions among populations,while the larger proportion of genetic diversity(92%) resided within each individual sesame population,showcasing heightened diversity within each group.Our study’s findings received support from both Bayesian clustering and Neighbor-joining(NJ) analysis,reaffirming the credibility of our genetic structure insights.Notably,Population structure analysis at its highest Δk value(k=2) revealed the existence of two primary genetic clusters,further subdivided into four sub-populations at k=4.Similarly,NJ analysis identified two prominent clusters,each displaying additional sub-clustering.In conclusion,our research provides a comprehensive understanding of genetic groups,subpopulations,and overall diversity within Ethiopian sesame populations.These findings underscore the significant genetic diversity and population structure within Ethiopian sesame germplasm collections.This genetic richness holds promise for breeding and conservation efforts,highlighting the importance of preserving genetic diversity to ensure adaptation to changing environments and meet the needs of farmers and consumers.
基金General program of national natural science foundation of China(No.81674060)Promotion project for special subjects of Jianghan University(No.03100041)。
文摘Objective:To observe the expression of endometrial homologous box gene A10(HOXA10),Integrinαvβ3 and leukemia suppressor factor(LIF)in peri-implantation mice,and to investigate the effect of controlled superovulation(COH)on endometrial receptivity in mice.Methods:After COH model preparation and blastocyst transplantation,kunming pure-bred mature mice were randomly divided into natural blastocyst+natural pseudocyst group,COH blastocyst+natural pseudocyst group,natural blastocyst+COH pseudocyst group,and COH blastocyst+COH pseudocyst group.The pregnancy rate and average number of beds in each group were observed on day 6 of conception.Western blot and RT-PCR were used to detect the expression of HOXA10,Integrinααvβ3,LIF protein and mRNA in the endometria of mice on day 5 of conception.Results:The pregnancy rate and average number of beds in the COH group were lower than those in the natural receptor group.The expression of HOXA10,Integrinααvβ3 and LIF in endometrium was significantly lower than that of the natural receptor mice(P<0.01).Conclusion:Superovulation drugs down-regulate the expression of HOXA10,Integrinαvβ3 and LIF in endometrium during the implantation window,reduce endometrial receptivity,and lead to low clinical pregnancy rate.
基金the Wu Jieping Medical Foundation(Nos.320.6750.2020-11-5 and 320.6750.2020-11-6)Key Research and Development(R&D)Projects of Shanxi Province(No.201703D321008).
文摘Objective:To identify risk factors for anastomotic leakage after gastrectomy in patients with Siewert type II/III adenocarcinoma(AEG)of the esophagogastric junction.Methods:This was a retrospective case-control study of 903 patients with Siewert type II/III AEG treated from January 2012 to January 2015 at the Shanxi Cancer Hospital in China.All patients underwent gastrectomy,and their clinical characteristics were analyzed to identify associations with anastomotic leakage.Independent risk factors were identified by binary logistic regression.The 2-year disease-free survival was calculated and compared between patients with anastomotic leakage and control patients.The study was approved by the Institutional Review Board of Shanxi Medical University(approval No.2014-09-39)on September 19,2014.Results:Out of the 903 patients were included in the study,80(8.86%,80/903)experienced anastomotic leakage.The mortality rate attributed to anastomotic leakage was 8.75%(7/80).Logistic regression analysis revealed that preoperative hypoalbuminemia(odds ratio(OR)=3.249,95%confidence interval(CI):1.569-6.725,P=0.002),type of reconstruction(OR=1.795,95%CI:1.026-3.142,P=0.040),and combined organ resection(OR=1.807,95%CI:1.069-3.055,P=0.027)were independent risk factors for anastomotic leakage.Conclusion:Preoperative hypoalbuminemia,type of reconstruction,and combined organ resection were identified as risk factors for anastomotic leakage in patients undergoing gastrectomy for Siewert type Ⅱ/Ⅲ AEG.
基金supported by grants from the National Key Research and Development Program of China(2022YFF1001604)distinguished young scholar grant from the Department of Science and Technology of Hubei Province(2023AFA095)+1 种基金Fundamental Research Fund of Central Universities(2662023PY002 and 2662022SKYJ003)The computations in this paper were run on the bioinformatics computing platform of the National Key Laboratory of Crop Genetic Improvement,Huazhong Agricultural University.
文摘Cold stress is one of the major abiotic stress factors affecting rice growth and development,leading to significant yield loss in the context of global climate change.Exploring natural variants that confer cold resistance and the underlying molecular mechanism responsible for this is the major strategy to breed cold-tolerant rice varieties.Here,we show that natural variations of a SIMILAR to RCD ONE(SRO)gene,OsSRO1c,confer cold tolerance in rice at both seedling and booting stages.Our in vivo and in vitro experiments demonstrated that OsSRO1c possesses intrinsic liquid–liquid phase-separation ability and recruits OsDREB2B,an AP2/ERF transcription factor that functions as a positive regulator of cold stress,into its biomolecular condensates in the nucleus,resulting in elevated transcriptional activity of OsDREB2B.We found that the OsSRO1c-OsDREB2B complex directly responds to low temperature through dynamic phase transitions and regulates key cold-response genes,including COLD1.Furthermore,we showed that introgression of an elite haplotype of OsSRO1c into a cold-susceptible indica rice could significantly increase its cold resistance.Collectively,our work reveals a novel cold-tolerance regulatory module in rice and provides promising genetic targets for molecular breeding of cold-tolerant rice varieties.
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].
基金supported by the National Natural Science Foundation for Distinguished Young Scholar of China (81625024 and 91529304, to Bo Yang)National Natural Science Foundation of China (81673458, to Hong Zhu+2 种基金 81503095, to Xiaoyang Dai)Zhejiang Provincial Natural Science Foundation (LY16H310004, to Xiaoyang Dai China)
文摘Metastasis-associated drug resistance accounts for high mortality in ovarian cancer and remains to be a major barrier for effective treatment. In this study, SKOV3/T4, a metastatic subpopulation of ovarian cancer SKOV3 cells, was enriched to explore potential interventions against metastaticassociated drug resistance. Quantitative genomic and functional analyses were performed and found that slug was significantly increased in the SKOV3/T4 subpopulation and contributed to the high resistance of SKOV3/T4. Further studies showed that slug activated c-Met in a ligand-independent manner due to elevated levels of fibronectin and provoked integrin α V function, which was confirmed by the significant correlation of slug and p-Met levels in 121 ovarian cancer patient samples. Intriguingly,c-Met inhibitor(s) exhibited greatly enhanced anti-cancer effects in slug-positive ovarian cancer models both in vitro and in vivo. Additionally, IHC analyses revealed that slug levels were highly correlated with reduced survival of ovarian cancer patients. Taken together, this study not only uncovers the critical roles of slug in drug resistance in ovarian cancer but also highlights a promising therapeutic strategy by targeting the noncanonical activation of c-Met in slug-positive ovarian cancer patients with poor prognosis.
基金supported in part by the National Basic Research Program of China(No.2016YFB0900404)the National Natural Science Foundation of China(No.51477030,No.51207023)+2 种基金the Cooperative Innovation Fund of Jiangsu Province–the Prospective and Joint Research Project(No.BY2015070-18)the Basic and Prospective Science and Technology Project of State Grid Corporation of China(No.PD71-17-024)the Fundamental Research Funds for the Central Universities(No.2242017K40159)
文摘The power electronic transformer(PET) has recently emerged as a type of power converter. It features the basic functions of power conversion and isolation as well as additional functions related to power quality control. A novel PET for a distribution grid called a flexible power distribution unit is proposed in this paper, and the energy exchange mechanism between the network and the load is revealed. A 30 kW 600 VAC/220 VAC/110 VDC medium-frequency isolated prototype is developed and demonstrated. This paper also presents key control strategies of the PET for electrical distribution grid applications,especially under grid voltage disturbance conditions.Moreover, stability issues related to the grid-connected three-phase PET are discussed and verified with an impedance-based analysis. The PET prototype is tested, and it passes the voltage-disturbance ride-through function. The experimental results verify the power quality control abilities of the PET.
文摘To the Editor:Gastric cancer is one of the most common cancers in China.It is mainly found in the middle/lower part of the stomach,[1]where it commonly metastasizes from the infrapyloric lymph node(No.6).Previous studies reported that the risk of No.6 lymph node metastasis was different based on tumor locations.In lower gastric cancer patients,the metastatic rate of No.6 lymph node can reach up to 18.7%,and in upper gastric cancer,the rate is merely 1.9%.[2]The distance between the primary tumor and the pylorus was proved to be related to No.6 lymph node metastasis.However,most of the studies were retrospective and their lymph nodes dissection’s quality control was controversial.
