AIM： To evaluate the clinical outcome of Ivor Lewis subtotal esophagectomy with two-field lymphadenectomy for patients with squamous cell carcinoma of the lower thoracic esophagus. METHODS： From January 1998 to Dece...AIM： To evaluate the clinical outcome of Ivor Lewis subtotal esophagectomy with two-field lymphadenectomy for patients with squamous cell carcinoma of the lower thoracic esophagus. METHODS： From January 1998 to December 2001, 73 patients with lower thoracic esophageal carcinoma underwent Ivor-Lewis subtotal esophagectomy with two-field lymphadenectomy. Clinicopathological information, postoperative complications, mortality and long term survival of all these patients were analyzed retrospectively. RESULTS： The operative morbidity and mortality was 15.1% and the mortality was 2.7%. Lymph node metastases were found in 52 patients （71.2%）. Nodal metastases to the upper, middle, lower mediastini and upper abdomen were found in 13 （17.8%）, 15 （20.5%）, 30 （41.1%）, and 25 （34.2%） patients, respectively. Postoperative staging was as follows： stage Ⅰ in 5 patients, stage Ⅱ in 34 patients, stage Ⅲ in 32 patients, and stage Ⅳ in 2 patients, respectively. The overall 5-year survival rate was 23.3%. For NO and N1 patients, the 5-year survival rate was 38.1% and 17.3%, respectively （X^2 = 22.65, P 〈 0.01）. The 5-year survival rate for patients in stages Ⅱ a, Ⅱ b and Ⅲ was 31.2%, 27.8% and 12.5%, repsectively （X^2 = 29.18, P 〈 0.01）. CONCLUSION： Ivor Lewis subtotal esophagectomy with two-field （total mediastinum） lymphadenectomy is a safe and appropriate operation for squamous cell carcinoma of the lower thoracic esophagus.展开更多
Boerhaave’s syndrome refers to the spontaneous transmural rupture of the esophagus. Primary repair may be performed in patients who present within 24 h of perforation, and such cases have the best outcomes...Boerhaave’s syndrome refers to the spontaneous transmural rupture of the esophagus. Primary repair may be performed in patients who present within 24 h of perforation, and such cases have the best outcomes as most complications have not yet developed. However, the treatment of late perforations remains controversial. Various approaches and strategies to repair late perforations have been described in the literature, but there is no uniform approach. We present a case of Boerhaave’s syndrome in which the patient underwent surgical repair 48 h after the acute event and was subsequently treated successfully. The initial approach included direct esophageal repair, a drainage series, and nutritional support via a feeding jejunostomy. Although the repair site was subsequently disrupted, the patient showed complete healing of the perforation after three weeks. We consider that our surgical treatment strategy is safe and technically feasible, and appears to be a promising alternative approach for the treatment of patients with late Boerhaave’s perforation.展开更多
Radon is recognized as a powerful tracer of certain geophysical processes in marine and aquatic environments.In the past few decades,the instruments and methods for measuring radon concentration in water have been dev...Radon is recognized as a powerful tracer of certain geophysical processes in marine and aquatic environments.In the past few decades,the instruments and methods for measuring radon concentration in water have been developed to some extent but still lack underwater in-situ measurements.Here we present an in-situ detection equipment for radon-in-water(pulsed ionization chamber(PIC)-radon)to measure dissolved radon in ocean and groundwater settings.The equipment has been successfully deployed in the Jiaozhou Bay in July 2022 and has achieved 14 d of unattended underwater in-situ observation.Then it was successfully placed in a groundwater monitoring well in the Laizhou Bay in November 2022 and monitored radon activities for over 30 d.The results showed that this instrument had a good indication of submarine groundwater discharge.The PIC-radon detector takes advantage of smaller size,lower power consumption,and is barely influenced by humidity,making it particularly suitable for long-term in-situ measurement,especially in harsh environments with limited human care or deployment spaces.展开更多
Patients with esophageal cancer often require esophagectomy with esophagogastrostomy.However,the incidence of complications,such as hemorrhage,during operations for esophageal cancer is high,even with minimally invasi...Patients with esophageal cancer often require esophagectomy with esophagogastrostomy.However,the incidence of complications,such as hemorrhage,during operations for esophageal cancer is high,even with minimally invasive surgery.Without the appropriate interventions,the risk of major intraoperative and postoperative hemorrhage is very high in patients with esophageal cancer and hemophilia.We report the case of a 45-year-old man with esophageal cancer and hemophilia B who underwent a successful hybrid,minimally invasive Ivor-Lewis esophagectomy with appropriate perioperative management.展开更多
A revised concept for urban water metabolism （UWM） is presented in this study to address the inadequacies in current research on UWM and the problems associated with the traditional urban water metabolic process. Fe...A revised concept for urban water metabolism （UWM） is presented in this study to address the inadequacies in current research on UWM and the problems associated with the traditional urban water metabolic process. Feedback loops can be analyzed to increase the water environmental carrying capacity （WECC） of the new urban water metabolism system （UWMS） over that of a traditional UWMS. An analysis of the feedback loops of an UWMS was used to construct a system dynamics （SD） model for the system under a WECC restriction. Water metabolic processes were simulated for different scenarios using the Tongzhou District in Beijing as an example. The results for the newly developed UWM case showed that a water environment of Tongzhou District could support a population of 1.1926 × 106, an irrigation area of 375.521 km2, a livestock of 0.7732 × 106, and an industrial value added of ￥193.14 × 109 （i.e. about US$28.285 × 109） in 2020. A sensitivity analysis showed that the WECC could be improved to some extent by constructing new sewage treatment facilities or by expanding the current sewage treatment facilities, using reclaimed water and improving the water circulation system.展开更多
Dental pulp stem cells(DPSCs)have demonstrated remarkable potential in enhancing peripheral nerve regeneration,though the precise mechanisms remain largely unknown.This study investigates how DPSCs alleviate Schwann c...Dental pulp stem cells(DPSCs)have demonstrated remarkable potential in enhancing peripheral nerve regeneration,though the precise mechanisms remain largely unknown.This study investigates how DPSCs alleviate Schwann cell pyroptosis and restore mitochondrial homeostasis through intercellular mitochondrial transfer.In a crab-eating macaque model,we first observed that DPSC-loaded nerve conduits significantly promoted long-term nerve regeneration,facilitating tissue proliferation and myelin recovery.We further established a rat facial nerve injury(FNI)model and found that DPSC treatment reduced pyroptosis and mitochondrial ROS production in Schwann cells.A pivotal mitochondrial protective mechanism,resembling the effects of a ROS-targeted inhibitor,involved the transfer of mitochondria from DPSCs to pyroptosis-induced Schwann cells via tunneling nanotubes,while blocking intercellular junctions or mitochondrial function diminished the therapeutic effects.TNFαsecreted by pyroptosis-induced Schwann cells activated the NF-κB pathway in DPSCs,enhancing mitochondrial transfer and adaptive stress responses,thereby promoting mitochondrial protection against pyroptosis in Schwann cells,as reflected in the improved therapeutic efficacy of TNF α-preconditioned DPSCs in the FNI model.These findings unveil a mechanism through which DPSCs foster nerve regeneration via mitochondrial transfer,presenting a promising strategy for enhancing stem cell-based therapies for nerve injuries.展开更多
文摘AIM： To evaluate the clinical outcome of Ivor Lewis subtotal esophagectomy with two-field lymphadenectomy for patients with squamous cell carcinoma of the lower thoracic esophagus. METHODS： From January 1998 to December 2001, 73 patients with lower thoracic esophageal carcinoma underwent Ivor-Lewis subtotal esophagectomy with two-field lymphadenectomy. Clinicopathological information, postoperative complications, mortality and long term survival of all these patients were analyzed retrospectively. RESULTS： The operative morbidity and mortality was 15.1% and the mortality was 2.7%. Lymph node metastases were found in 52 patients （71.2%）. Nodal metastases to the upper, middle, lower mediastini and upper abdomen were found in 13 （17.8%）, 15 （20.5%）, 30 （41.1%）, and 25 （34.2%） patients, respectively. Postoperative staging was as follows： stage Ⅰ in 5 patients, stage Ⅱ in 34 patients, stage Ⅲ in 32 patients, and stage Ⅳ in 2 patients, respectively. The overall 5-year survival rate was 23.3%. For NO and N1 patients, the 5-year survival rate was 38.1% and 17.3%, respectively （X^2 = 22.65, P 〈 0.01）. The 5-year survival rate for patients in stages Ⅱ a, Ⅱ b and Ⅲ was 31.2%, 27.8% and 12.5%, repsectively （X^2 = 29.18, P 〈 0.01）. CONCLUSION： Ivor Lewis subtotal esophagectomy with two-field （total mediastinum） lymphadenectomy is a safe and appropriate operation for squamous cell carcinoma of the lower thoracic esophagus.
文摘Boerhaave’s syndrome refers to the spontaneous transmural rupture of the esophagus. Primary repair may be performed in patients who present within 24 h of perforation, and such cases have the best outcomes as most complications have not yet developed. However, the treatment of late perforations remains controversial. Various approaches and strategies to repair late perforations have been described in the literature, but there is no uniform approach. We present a case of Boerhaave’s syndrome in which the patient underwent surgical repair 48 h after the acute event and was subsequently treated successfully. The initial approach included direct esophageal repair, a drainage series, and nutritional support via a feeding jejunostomy. Although the repair site was subsequently disrupted, the patient showed complete healing of the perforation after three weeks. We consider that our surgical treatment strategy is safe and technically feasible, and appears to be a promising alternative approach for the treatment of patients with late Boerhaave’s perforation.
基金The National Natural Science Foundation of China under contract Nos U22A20580 and 42130410the Fundamental Research Funds for the Central Universities under contract No.202341002the Pilot Project for the Integration of Science,Education,and Industry under contract No.2022PY069.
文摘Radon is recognized as a powerful tracer of certain geophysical processes in marine and aquatic environments.In the past few decades,the instruments and methods for measuring radon concentration in water have been developed to some extent but still lack underwater in-situ measurements.Here we present an in-situ detection equipment for radon-in-water(pulsed ionization chamber(PIC)-radon)to measure dissolved radon in ocean and groundwater settings.The equipment has been successfully deployed in the Jiaozhou Bay in July 2022 and has achieved 14 d of unattended underwater in-situ observation.Then it was successfully placed in a groundwater monitoring well in the Laizhou Bay in November 2022 and monitored radon activities for over 30 d.The results showed that this instrument had a good indication of submarine groundwater discharge.The PIC-radon detector takes advantage of smaller size,lower power consumption,and is barely influenced by humidity,making it particularly suitable for long-term in-situ measurement,especially in harsh environments with limited human care or deployment spaces.
文摘Patients with esophageal cancer often require esophagectomy with esophagogastrostomy.However,the incidence of complications,such as hemorrhage,during operations for esophageal cancer is high,even with minimally invasive surgery.Without the appropriate interventions,the risk of major intraoperative and postoperative hemorrhage is very high in patients with esophageal cancer and hemophilia.We report the case of a 45-year-old man with esophageal cancer and hemophilia B who underwent a successful hybrid,minimally invasive Ivor-Lewis esophagectomy with appropriate perioperative management.
文摘A revised concept for urban water metabolism （UWM） is presented in this study to address the inadequacies in current research on UWM and the problems associated with the traditional urban water metabolic process. Feedback loops can be analyzed to increase the water environmental carrying capacity （WECC） of the new urban water metabolism system （UWMS） over that of a traditional UWMS. An analysis of the feedback loops of an UWMS was used to construct a system dynamics （SD） model for the system under a WECC restriction. Water metabolic processes were simulated for different scenarios using the Tongzhou District in Beijing as an example. The results for the newly developed UWM case showed that a water environment of Tongzhou District could support a population of 1.1926 × 106, an irrigation area of 375.521 km2, a livestock of 0.7732 × 106, and an industrial value added of ￥193.14 × 109 （i.e. about US$28.285 × 109） in 2020. A sensitivity analysis showed that the WECC could be improved to some extent by constructing new sewage treatment facilities or by expanding the current sewage treatment facilities, using reclaimed water and improving the water circulation system.
基金supported by the National Natural Science Foundation of China(U22A20314)the State Key Project Ministry of Science and Technology of China(2022YFC2504200)+3 种基金the Key Research and Development Project of Hubei Province(2022BCA029)the Fundamental Research Funds for the Central Universities(2042023kf0198)the Chutian Researcher Project(X22020024)Noel Martin foundation at the University of Sydney(NMVC-2024Ye)。
文摘Dental pulp stem cells(DPSCs)have demonstrated remarkable potential in enhancing peripheral nerve regeneration,though the precise mechanisms remain largely unknown.This study investigates how DPSCs alleviate Schwann cell pyroptosis and restore mitochondrial homeostasis through intercellular mitochondrial transfer.In a crab-eating macaque model,we first observed that DPSC-loaded nerve conduits significantly promoted long-term nerve regeneration,facilitating tissue proliferation and myelin recovery.We further established a rat facial nerve injury(FNI)model and found that DPSC treatment reduced pyroptosis and mitochondrial ROS production in Schwann cells.A pivotal mitochondrial protective mechanism,resembling the effects of a ROS-targeted inhibitor,involved the transfer of mitochondria from DPSCs to pyroptosis-induced Schwann cells via tunneling nanotubes,while blocking intercellular junctions or mitochondrial function diminished the therapeutic effects.TNFαsecreted by pyroptosis-induced Schwann cells activated the NF-κB pathway in DPSCs,enhancing mitochondrial transfer and adaptive stress responses,thereby promoting mitochondrial protection against pyroptosis in Schwann cells,as reflected in the improved therapeutic efficacy of TNF α-preconditioned DPSCs in the FNI model.These findings unveil a mechanism through which DPSCs foster nerve regeneration via mitochondrial transfer,presenting a promising strategy for enhancing stem cell-based therapies for nerve injuries.
