The presence of endogenous neural stem/progenitor cells in the adult mammalian brain suggests that the central nervous system can be repaired and regenerated after injury.However,whether it is possible to stimulate ne...The presence of endogenous neural stem/progenitor cells in the adult mammalian brain suggests that the central nervous system can be repaired and regenerated after injury.However,whether it is possible to stimulate neurogenesis and reconstruct cortical layers II to VI in non-neurogenic regions,such as the cortex,remains unknown.In this study,we implanted a hyaluronic acid collagen gel loaded with basic fibroblast growth factor into the motor cortex immediately following traumatic injury.Our findings reveal that this gel effectively stimulated the proliferation and migration of endogenous neural stem/progenitor cells,as well as their differentiation into mature and functionally integrated neurons.Importantly,these new neurons reconstructed the architecture of cortical layers II to VI,integrated into the existing neural circuitry,and ultimately led to improved brain function.These findings offer novel insight into potential clinical treatments for traumatic cerebral cortex injuries.展开更多
BACKGROUND Gastrointestinal(GI)tumors are among the most prevalent malignancies,and surgical intervention remains a primary treatment modality.However,the complexity of GI surgery often leads to prolonged recovery and...BACKGROUND Gastrointestinal(GI)tumors are among the most prevalent malignancies,and surgical intervention remains a primary treatment modality.However,the complexity of GI surgery often leads to prolonged recovery and high postoperative complication rates,which threaten patient safety and functional outcomes.Enhanced recovery after surgery(ERAS)principles have been shown to improve perioperative outcomes through evidence-based,multidisciplinary care pathways.Despite its widespread adoption,there is a paucity of research focusing specifically on optimizing ERAS-guided nursing processes in the post-anesthesia care unit(PACU)and evaluating its impact on perioperative safety in patients undergoing GI tumor surgery.This study aimed to investigate whether an ERASbased PACU nursing protocol could enhance recovery,reduce complications,and improve patient safety in this surgical population.AIM To explore the impact of optimizing the recovery room nursing process based on ERAS on the perioperative safety of patients with GI tumors.METHODS A total of 260 patients with GI tumors who underwent elective surgeries under general anesthesia in our hospital from August 2023 to August 2025 and were then observed in the recovery unit(PACU)were selected.They were randomly divided into the observation group(the PACU nursing process was optimized based on ERAS)and the control group(the conventional PACU nursing process was adopted)by the random number grouping method,with 130 cases in each group.The time of gastric tube removal,urinary catheter removal,defecation time,hospital stay,time of leaving the room after tube removal,retention time in the recovery room,occurrence of complications,satisfaction and readmission rate were compared between the two groups after entering the room.Compare the occurrence of adverse events in the PACU nursing process between the two groups.RESULTS The time of gastric tube removal,urinary catheter removal,defecation time,hospital stay,retention time in the recovery room,total incidence of complications and readmission rate in the observation group were significantly lower than those in the control group,and the satisfaction rate was higher than that in the control group(P<0.05).The occurrence of adverse events in the PACU nursing process in the observation group was lower than that in the control group(P<0.05).CONCLUSION Optimizing the PACU nursing process based on ERAS can effectively accelerate the recovery process of patients undergoing GI tumor surgery,reduce adverse events,improve nursing satisfaction,and at the same time,lower the incidence of adverse events in the PACU nursing process,providing a more refined management basis for clinical practice.展开更多
The recovery of precious metals(PMs)from secondary resources is critical for addressing global supply-chain vulnerabilities and sustainable resource utilization.This review systematically examines the transformative p...The recovery of precious metals(PMs)from secondary resources is critical for addressing global supply-chain vulnerabilities and sustainable resource utilization.This review systematically examines the transformative potential of metal-organic frameworks(MOFs)as next-generation adsorbents for PM recovery,focusing on their synthesis,functionalization,and multiscale adsorption mechanisms.We critically analyze conventional pyrometallurgical and hydrometallurgical methods and highlight their limitations in terms of selectivity,energy consumption,and secondary pollution.In contrast,MOFs offer tunable porosity,abundant active sites,and tunable surface chemistry,enabling efficient PM capture via synergistic physical and chemical adsorption.Advanced modification techniques,including direct synthesis and post-synthetic modification,are reviewed to propose strategies for enhancing the adsorption kinetics and selectivity for Au,Ag,Pt,and Pd.Key structure-property relationships are established through multiscale characterization and thermodynamic models,revealing the critical roles of hierarchical porosity,soft donor atoms,and framework stability.Industrial challenges,such as aqueous stability and scalability,are addressed via Zr-O bond strengthening,hydrophobic functionalization,and support immobilization.This study consolidates the experimental and theoretical advances in MOF-based PM recovery and provides a roadmap for translating laboratory innovations into practical applications within the circular-economy framework.展开更多
This study aims to explore the impact of combined health education and dietary guidance on the speed of postoperative recovery in patients with gastrointestinal polyps.A specific number of patients who underwent gastr...This study aims to explore the impact of combined health education and dietary guidance on the speed of postoperative recovery in patients with gastrointestinal polyps.A specific number of patients who underwent gastrointestinal polyp resection were selected and randomly divided into a control group and an experimental group.The control group received routine nursing,while the experimental group implemented combined health education and dietary guidance on this basis.By comparing the recovery indicators of the two groups,it was found that the recovery speed of the experimental group was significantly faster than that of the control group,indicating that this combined intervention method can effectively promote patient recovery.展开更多
This editorial examines the emerging potential of traditional Chinese medicine(TCM)in enhancing postoperative recovery following gastroenteroscopy,highlighted by a 2025 randomized controlled trial by Hong et al.The st...This editorial examines the emerging potential of traditional Chinese medicine(TCM)in enhancing postoperative recovery following gastroenteroscopy,highlighted by a 2025 randomized controlled trial by Hong et al.The study,involving 120 patients,demonstrates that meridian flow injection(MFI)combined with transcutaneous electrical acupoint stimulation(TEAS)significantly improves gastrointestinal(GI)function,evidenced by a reduced time to first defecation(3.20±1.04 days vs 3.98±1.27 days,P<0.001),lowers stress biomarkers(e.g.,reduced cortisol and norepinephrine),and enhances clinical efficacy(93.33%vs 75.00%,P=0.006).Leveraging TCM’s five-element theory and Ziwu Liuzhu timing,the intervention targets key acupoints such as Zusanli(ST36)with a herbal paste comprising Qingpi,Houpu,and rhubarb,delivered transdermally to optimize bioavailability.This approach harmonizes ancient TCM principles with contemporary evidence-based practice,offering a holistic strategy to address postoperative nausea,delayed motility,and patient discomfort.Currently,integrative methods like MFI-TEAS are gaining traction,supported by recent meta-analyses that affirm TEAS’s efficacy in accelerating GI recovery across surgical contexts,including shortened times to first exhaust and defecation.This reflects a growing recognition of TCM’s role in perioperative care amidst rising global endoscopy demands.Looking forward,future research should prioritize multicenter,doubleblinded trials to enhance generalizability,adhere to standardized reporting frameworks such as CONSORT and STRICTA,and employ advanced tools like multiomics and functional magnetic resonance imaging to elucidate mechanistic pathways,including gut-brain axis modulation and microbiota-immune interactions.Such developments promise to refine these interventions,fostering a seamless integration of TCM with Western medicine and delivering tailored,patientcentered solutions to improve postoperative outcomes worldwide.展开更多
Convex feasibility problems are widely used in image reconstruction, sparse signal recovery, and other areas. This paper is devoted to considering a class of convex feasibility problem arising from sparse signal recov...Convex feasibility problems are widely used in image reconstruction, sparse signal recovery, and other areas. This paper is devoted to considering a class of convex feasibility problem arising from sparse signal recovery. We first derive the projection formulas for a vector onto the feasible sets. The centralized circumcentered-reflection method is designed to solve the convex feasibility problem. Some numerical experiments demonstrate the feasibility and effectiveness of the proposed algorithm, showing superior performance compared to conventional alternating projection methods.展开更多
Carbon monoxide-from toxicity to therapeutic potential:Carbon monoxide(CO)has long been known as a toxic gas,primarily associated with environmental pollution and poisoning.Its strong affinity for hemoglobin causes th...Carbon monoxide-from toxicity to therapeutic potential:Carbon monoxide(CO)has long been known as a toxic gas,primarily associated with environmental pollution and poisoning.Its strong affinity for hemoglobin causes the formation of carboxyhemoglobin,which reduces oxygen delivery to the tissues and organs and leads to hypoxia.Despite its well-documented toxicity,previous studies have confirmed that CO also acts as a signaling molecule in the body and plays important physiological roles(Motterlini and Otterbein,2010).展开更多
The recovery of gold from waste electronic and electric equipment(WEEE) has gained great attention with the increased number of WEEE,because it can largely alleviate the pressure on the environment and resources.Coval...The recovery of gold from waste electronic and electric equipment(WEEE) has gained great attention with the increased number of WEEE,because it can largely alleviate the pressure on the environment and resources.Covalent organic frameworks(COFs) are ideal adsorbents for gold recovery owing to their large surface area,good stability,easily functionalized ability,periodic structures,and definitive nanopores.Herein,a cyano-functionalized COF(COF-CN) with high crystallinity was large-scale prepared under mild conditions for the recovery of gold.The introduction of cyano groups enable COF-CN to exhibit excellent gold recovery performance,which possesses fast adsorption kinetics,high cycling stability,and adsorption capacity up to 663.67 mg/g.Excitingly,COF-CN showed extremely high selectivity for gold ions,even in the presence of various competing cations and anions.The COF-CN maintained excellent selectivity and removal efficiency in gold recovery experiments from WEEE.The facile synthesis of COF-CN and its outstanding selectivity in actual samples make it an attractive opportunity for practical gold recovery.展开更多
Spinal cord injury(SCI) often results in permanent dysfunction of locomotion,sensation,and autonomic regulation,imposing a substantial burden on both individuals and society(Anjum et al.,2020).SCI has a complex pathop...Spinal cord injury(SCI) often results in permanent dysfunction of locomotion,sensation,and autonomic regulation,imposing a substantial burden on both individuals and society(Anjum et al.,2020).SCI has a complex pathophysiology:an initial primary injury(mechanical trauma,axonal disruption,and hemorrhage) is followed by a progressive secondary injury cascade that involves ischemia,neuronal loss,and inflammation.Given the challenges in achieving regeneration of the injured spinal cord,neuroprotection has been at the forefront of clinical research.展开更多
We found the qualitative study by Xu et al.on how patients feel about laparoscopic incisions under enhanced recovery after surgery(ERAS)protocols to be very interesting.1 Xu et al.carried out a qualitative study on pa...We found the qualitative study by Xu et al.on how patients feel about laparoscopic incisions under enhanced recovery after surgery(ERAS)protocols to be very interesting.1 Xu et al.carried out a qualitative study on patient experience with laparoscopic incisions under an ERAS protocol to highlight the problem of psychosocial and aesthetic concerns,which are often overlooked when planning surgical operations.This study,which involved semistructured interviews with sixteen people,aimed to narrow perioperative education and the decision-making process for incision site selection,thus making the processes more focused on patient priorities.The study is based on a timely but under-researched subject area;however,it is possible to outline four possible areas of improvement that would allow the study to be more transparent and,at the same time,more applicable to clinical practice.展开更多
Delayed neurocognitive recovery following anesthesia and surgery is a common complication in older adult patients.Synapses are fundamental to cognitive function.The activity of synapses heavily depends on the energy s...Delayed neurocognitive recovery following anesthesia and surgery is a common complication in older adult patients.Synapses are fundamental to cognitive function.The activity of synapses heavily depends on the energy supplied by synaptic mitochondria,which are significantly influenced by oxidative stress.Sirtuin 3 is a histone deacetylase located in the mitochondrial matrix that plays a pivotal role in regulating mitochondrial function.However,it remains unclear whether and how sirtuin 3 is involved in the development of delayed cognitive recovery.Therefore,in this study,we investigated the potential role of sirtuin 3 in synapses during delayed neurocognitive recovery.Our results showed that anesthesia and surgery induced cognitive impairment in mice and reduced sirtuin 3 protein expression.Overexpression of sirtuin 3 inhibited opening of the mitochondrial permeability transition pore by reducing acetylation of K166 on cyclophilin D and also rescued cognitive impairment.Aged mice carrying the cyclophilin D-K166R mutation exhibited significantly reduced cognitive impairment.Similarly,administering the mitochondrial permeability transition pore blocker,cyclosporine A,effectively alleviated the decline in synaptic mitochondrial function and cognitive impairment caused by anesthesia and surgery in aged mice.These results indicate that the sirtuin 3/cyclophilin D-K166/mPTP signaling pathway in hippocampal synaptic mitochondria is involved in delayed neurocognitive recovery of aged mice,suggesting this pathway could serve as a potential target for treatment.展开更多
Spontaneous recovery frequently proves maladaptive or insufficient because the plasticity of the injured adult mammalian central nervous system is limited.This limited plasticity serves as a primary barrier to functio...Spontaneous recovery frequently proves maladaptive or insufficient because the plasticity of the injured adult mammalian central nervous system is limited.This limited plasticity serves as a primary barrier to functional recovery after brain injury.Neuromodulation technologies represent one of the fastest-growing fields in medicine.These techniques utilize electricity,magnetism,sound,and light to restore or optimize brain functions by promoting reorganization or long-term changes that support functional recovery in patients with brain injury.Therefore,this review aims to provide a comprehensive overview of the effects and underlying mechanisms of neuromodulation technologies in supporting motor function recovery after brain injury.Many of these technologies are widely used in clinical practice and show significant improvements in motor function across various types of brain injury.However,studies report negative findings,potentially due to variations in stimulation protocols,differences in observation periods,and the severity of functional impairments among participants across different clinical trials.Additionally,we observed that different neuromodulation techniques share remarkably similar mechanisms,including promoting neuroplasticity,enhancing neurotrophic factor release,improving cerebral blood flow,suppressing neuroinflammation,and providing neuroprotection.Finally,considering the advantages and disadvantages of various neuromodulation techniques,we propose that future development should focus on closed-loop neural circuit stimulation,personalized treatment,interdisciplinary collaboration,and precision stimulation.展开更多
The year 2025 marks the 120th anniversary of the birth of Chinese filmmaking.From the first film Dingjun Mountain released in 1905,which captured scenes from Peking opera,to the present day where artificial intelligen...The year 2025 marks the 120th anniversary of the birth of Chinese filmmaking.From the first film Dingjun Mountain released in 1905,which captured scenes from Peking opera,to the present day where artificial intelligence(AI)is utilised in film production,the Chinese film industry has been developing for over a century.Data from the China Film Administration shows that China’s 2025 box o"ce revenue topped 51.8 billion yuan($7.4 billion),realising a year-on-year increase of nearly 22 percent.展开更多
The major aim of stroke therapy is to stimulate brain repair and improve behavioral recovery after cerebral ischemia.One option is to stimulate endogenous neurogenesis in the subventricular zone and direct the newly f...The major aim of stroke therapy is to stimulate brain repair and improve behavioral recovery after cerebral ischemia.One option is to stimulate endogenous neurogenesis in the subventricular zone and direct the newly formed neurons to the damaged area.However,only a small percentage of these neurons survive,and many do not reach the damaged area,possibly because the corpus callosum impedes the migration of subventricular zone-derived stem cells into the lesioned cortex.A second major obstacle to stem cell therapy is the strong inflammatory reaction induced by cerebral ischemia,whereby the associated phagocytic activity of brain macrophages removes both therapeutic cells and/or cell-based drug carriers.To address these issues,neurogenesis was electrically stimulated in the subventricular zone,followed by isolation of proliferating cells,including newly formed neurons,which were subsequently mixed with a nutritional hydrogel.This mixture was then transferred to the stroke cavity of day 14 post-stroke mice.We found that the performance of the treated animals improved in behavioral tests,including novel object,open field,hole board,grooming,and“time-to-feel”adhesive tape tests.Furthermore,immunostaining revealed that the stem cell marker nestin,the neuroepithelial marker Mash1,and the immature neuronal marker doublecortin-positive cells survived in the transplanted area for 2 weeks,possibly due to reduced phagocytic activity and supportive angiogenesis.These results clearly indicate that the transplantation of committed subventricular zone stem cells combined with a protective nutritional gel directly into the infarct cavity after the peak of stroke-induced neuroinflammation represents a feasible approach to improve neurorestoration after cerebral ischemia.展开更多
The remodeling of axonal connections following injury is an important feature driving functional recovery.The reticulospinal tract is an interesting descending motor tract that contains both excitatory and inhibitory ...The remodeling of axonal connections following injury is an important feature driving functional recovery.The reticulospinal tract is an interesting descending motor tract that contains both excitatory and inhibitory fibers.While the reticulospinal tract has been shown to be particularly prone to axonal growth and plasticity following injuries of the spinal cord,the differential capacities of excitatory and inhibitory fibers for plasticity remain unclear.As adaptive axonal plasticity involves a sophisticated interplay between excitatory and inhibitory input,we investigated in this study the plastic potential of glutamatergic(vGlut2)and GABAergic(vGat)fibers originating from the gigantocellular nucleus and the lateral paragigantocellular nucleus,two nuclei important for locomotor function.Using a combination of viral tracing,chemogenetic silencing,and AI-based kinematic analysis,we investigated plasticity and its impact on functional recovery within the first 3 weeks following injury,a period prone to neuronal remodeling.We demonstrate that,in this time frame,while vGlut2-positive fibers within the gigantocellular and lateral paragigantocellular nuclei rewire significantly following cervical spinal cord injury,vGat-positive fibers are rather unresponsive to injury.We also show that the acute silencing of excitatory axonal fibers which rewire in response to lesions of the spinal cord triggers a worsening of the functional recovery.Using kinematic analysis,we also pinpoint the locomotion features associated with the gigantocellular nucleus or lateral paragigantocellular nucleus during functional recovery.Overall,our study increases the understanding of the role of the gigantocellular and lateral paragigantocellular nuclei during functional recovery following spinal cord injury.展开更多
The Neogene Shawan Formation in the Chepaizi Uplift of the Junggar Basin(NW China)has obtained high oil flow,demonstrating a good potential for oil and gas exploration.The multi-source hydrocarbon generation backgroun...The Neogene Shawan Formation in the Chepaizi Uplift of the Junggar Basin(NW China)has obtained high oil flow,demonstrating a good potential for oil and gas exploration.The multi-source hydrocarbon generation background and strong tectonic activity have led to the simultaneous production of heavy oil and light oil from multi-layer in the area,which makes it very difficult to identify oil origins,presently,the hot debate on the oil origins needs to be clarified.In this paper,due to the selective consumption of different types of compounds in crude oils by severe and intense biodegradation,the commonly used oilsource correlation tools are ineffective or may produce misleading results,this study adopted a biomarker recovery method based on the principle of mass conservation that uses the sum of the mass of the residual biomarkers and their corresponding biodegradation products to obtain the mass of the original biomarkers,improving the reliability of oil origins determination.Based on the nature and occurrence of crude oils,the investigated oils are subdivided into three types,Group A,Group B and Group C.Group A,light oils occurred mainly in lower structure Neogene Shawan Formation in the western Chepaizi Uplift,while Group B,heavy oils occurred mainly in higher structure Neogene Shawan Formation in the western Chepaizi Uplift.The two types of crude oils may come from the mixed source of Jurassic Badaowan Formation source rocks(J_(1)b)and Paleogene Anjihaihe Formation source rocks(E_(2-3)a)in the Sikeshu Sag,and Jurassic Badaowan Formation source rocks(J_(1)b)are the main source of crude oils.Group C,heavy oils occurred mainly in Neogene Shawan Formation in the eastern Chepaizi Uplift,showing good correlation with the Permian(P_(1)f and P_(2)w)source rocks in the Shawan Sag.At the same time,by combining stable carbon isotope and parameters related to triaromatic steroids,the accuracy of the oilsource correlation results by biomarker recovery method was further verified.展开更多
In the early stages of traumatic spinal cord injury,extensive accumulation of autophagosomes creates a neurotoxic microenvironment,exacerbating neuronal cell death and worsening tissue damage,ultimately hindering neur...In the early stages of traumatic spinal cord injury,extensive accumulation of autophagosomes creates a neurotoxic microenvironment,exacerbating neuronal cell death and worsening tissue damage,ultimately hindering neurofunctional recovery.Activin A is a critical growth factor necessary for the development of the embryonic nervous system and for maintaining neuronal function in the adult cerebral cortex.It can inhibit excessive autophagy in ischemic stroke to reduce neuronal damage.However,the specific mechanism through which Activin A functions in the spinal cord remains poorly understood.In this study,we administered different concentrations of Activin A to neural stem cells from the spinal cord and found that Activin A stimulated the proliferation and neuronal differentiation of neural stem cells.Then,we established an in vitro oxidative stress model by using hydrogen peroxide to stimulate the neural stem cells-induced neurons.We found that Activin A could reduce apoptosis caused by oxidative stress.Subsequently,we treated a mouse model of spinal cord contusion with intrathecal injection of Activin A.Behavioral and electrophysiological results showed that Activin A promoted recovery of motor function and reconstruction of neural circuits in the model mice.Finally,RNA sequencing indicated that Activin A inhibited autophagy by activating the PI3K/AKT/mTOR pathway and upregulating the expression of synaptogenesis-related factor Sema3A in the spinal cord.These results suggest that Activin A may mediate the excessive autophagic response after spinal cord injury,promote the reconstruction of damaged neural circuits,and restore neurological function in the injured spinal cord.展开更多
Objective Combine olfactory ensheathing glia （OEG） implantation with ex vivo non-viral vector-based neurotrophin- 3 （NT-3） gene therapy in attempting to enhance regeneration after thoracic spinal cord injury （SCI...Objective Combine olfactory ensheathing glia （OEG） implantation with ex vivo non-viral vector-based neurotrophin- 3 （NT-3） gene therapy in attempting to enhance regeneration after thoracic spinal cord injury （SCI）. Methods Primary OEG were transfected with cationic liposome-mediated recombinant plasmid pcDNA3.1 （＋）-NT3 and subsequently implanted into adult Wistar rats directly after the thoracic spinal cord （T9） contusion by the New York University impactor. The animals in 3 different groups received 4x 1050EG transfected with pcDNA3.1 （＋）-NT3 or pcDNA3.1 （＋） plasmids, or the OEGs without any plasmid transfection, respectively; the fourth group was untreated group, in which no OEG was implanted. Results NT-3 production was seen increased both ex vivo and in vivo in pcDNA3.1 （＋）-NT3 transfected OEGs. Three months after implantation of NT-3-transfected OEGs, behavioral analysis revealed that the hindlimb function of SCI rats was improved. All spinal cords were filled with regenerated neurofilament-positive axons. Retrograde tracing revealed enhanced regenerative axonal sprouting. Conclusion Non-viral vector-mediated genetic engineering of OEG was safe and more effective in producing NT- 3 and promoting axonal outgrowth followed by enhancing SCI recovery in rats.展开更多
To change the undesirable present situation of recovering and using converter gas in steel plants in China, the basic approaches to improving the converter gas recovery rate were analyzed theoretically along with the ...To change the undesirable present situation of recovering and using converter gas in steel plants in China, the basic approaches to improving the converter gas recovery rate were analyzed theoretically along with the change curves of the converter gas component content, based on the converter gas recovery system of Baosteel No. 2 steel- making plant. The effects of converter device, raw material, air imbibed quantity, recovery restricted condition, and intensity of oxygen blowing on the converter gas recovery rate were studied. Among these, the effects of the air im bibed quantity, recovery restricted condition, and intensity of oxygen blowing are remarkable. Comprehensive measures were put forward for improving the converter gas recovery from the point of devices, etc. , and good results were achieved.展开更多
Background: The enhanced recovery after surgery (ERAS) protocol is an evidence-based perioperative care program aimed at reducing surgical stress response and accelerating recovery. However, a small propor- tion of pa...Background: The enhanced recovery after surgery (ERAS) protocol is an evidence-based perioperative care program aimed at reducing surgical stress response and accelerating recovery. However, a small propor- tion of patients fail to bene t from the ERAS program following pancreaticoduodenectomy. This study aimed to identify the risk factors associated with failure of ERAS program in pancreaticoduodenectomy. Methods: Between May 2014 and December 2017, 176 patients were managed with ERAS program fol-lowing pancreaticoduodenectomy. ERAS failure was indicated by prolonged hospital stay, unplanned read- mission or unplanned reoperation. Demographics, postoperative recovery and compliance were compared of those ERAS failure groups to the ERAS success group. Results: ERAS failure occurred in 59 patients, 33 of whom had prolonged hospital stay, 18 were readmitted to hospital within 30 days after discharge, and 8 accepted reoperation. Preoperative American Society of Anesthesiologists (ASA) score of ≥III (OR = 2.736;95% CI: 1.276 6.939;P=0.028) and albumin (ALB) level of <35g/L (OR=3.589;95% CI: 1.403 9.181;P=0.008) were independent risk factors associated with prolonged hospital stay. Elderly patients (>70 years) were on a high risk of unplanned reoperation (62.5% vs. 23.1%, P=0.026). Patients with prolonged hospital stay and unplanned reoperation had delayed intake and increased intolerance of oral foods. Prolonged stay patients got off bed later than ERAS success patients did (65h vs. 46h, P =0.012). Unplanned reoperation patients tended to experience severer pain than ERAS success patients did (3 score vs. 2 score, P =0.035). Conclusions: Patients with high ASA score, low ALB level or age >70 years were at high risk of ERAS failure in pancreaticoduodenectomy. These preoperative demographic and clinical characteristics are important determinants to obtain successful postoperative recovery in ERAS program.展开更多
基金supported by the National Natural Science Foundation of China,Nos.82272171(to ZY),82271403(to XL),81941011(to XL),31971279(to ZY),31730030(to XL)the Natural Science Foundation of Beijing,No.7222004(to HD).
文摘The presence of endogenous neural stem/progenitor cells in the adult mammalian brain suggests that the central nervous system can be repaired and regenerated after injury.However,whether it is possible to stimulate neurogenesis and reconstruct cortical layers II to VI in non-neurogenic regions,such as the cortex,remains unknown.In this study,we implanted a hyaluronic acid collagen gel loaded with basic fibroblast growth factor into the motor cortex immediately following traumatic injury.Our findings reveal that this gel effectively stimulated the proliferation and migration of endogenous neural stem/progenitor cells,as well as their differentiation into mature and functionally integrated neurons.Importantly,these new neurons reconstructed the architecture of cortical layers II to VI,integrated into the existing neural circuitry,and ultimately led to improved brain function.These findings offer novel insight into potential clinical treatments for traumatic cerebral cortex injuries.
基金Supported by 2025 Henan Medical Education Research Project,No.WJLX2025038.
文摘BACKGROUND Gastrointestinal(GI)tumors are among the most prevalent malignancies,and surgical intervention remains a primary treatment modality.However,the complexity of GI surgery often leads to prolonged recovery and high postoperative complication rates,which threaten patient safety and functional outcomes.Enhanced recovery after surgery(ERAS)principles have been shown to improve perioperative outcomes through evidence-based,multidisciplinary care pathways.Despite its widespread adoption,there is a paucity of research focusing specifically on optimizing ERAS-guided nursing processes in the post-anesthesia care unit(PACU)and evaluating its impact on perioperative safety in patients undergoing GI tumor surgery.This study aimed to investigate whether an ERASbased PACU nursing protocol could enhance recovery,reduce complications,and improve patient safety in this surgical population.AIM To explore the impact of optimizing the recovery room nursing process based on ERAS on the perioperative safety of patients with GI tumors.METHODS A total of 260 patients with GI tumors who underwent elective surgeries under general anesthesia in our hospital from August 2023 to August 2025 and were then observed in the recovery unit(PACU)were selected.They were randomly divided into the observation group(the PACU nursing process was optimized based on ERAS)and the control group(the conventional PACU nursing process was adopted)by the random number grouping method,with 130 cases in each group.The time of gastric tube removal,urinary catheter removal,defecation time,hospital stay,time of leaving the room after tube removal,retention time in the recovery room,occurrence of complications,satisfaction and readmission rate were compared between the two groups after entering the room.Compare the occurrence of adverse events in the PACU nursing process between the two groups.RESULTS The time of gastric tube removal,urinary catheter removal,defecation time,hospital stay,retention time in the recovery room,total incidence of complications and readmission rate in the observation group were significantly lower than those in the control group,and the satisfaction rate was higher than that in the control group(P<0.05).The occurrence of adverse events in the PACU nursing process in the observation group was lower than that in the control group(P<0.05).CONCLUSION Optimizing the PACU nursing process based on ERAS can effectively accelerate the recovery process of patients undergoing GI tumor surgery,reduce adverse events,improve nursing satisfaction,and at the same time,lower the incidence of adverse events in the PACU nursing process,providing a more refined management basis for clinical practice.
基金supported by the National Natural Science Foundation of China(No.52304329)the Yunnan Fundamental Research Projects(No.202201BE070001-003),Guo Lin would like to acknowledge Xing Dian talent support program of Yunnan Province.
文摘The recovery of precious metals(PMs)from secondary resources is critical for addressing global supply-chain vulnerabilities and sustainable resource utilization.This review systematically examines the transformative potential of metal-organic frameworks(MOFs)as next-generation adsorbents for PM recovery,focusing on their synthesis,functionalization,and multiscale adsorption mechanisms.We critically analyze conventional pyrometallurgical and hydrometallurgical methods and highlight their limitations in terms of selectivity,energy consumption,and secondary pollution.In contrast,MOFs offer tunable porosity,abundant active sites,and tunable surface chemistry,enabling efficient PM capture via synergistic physical and chemical adsorption.Advanced modification techniques,including direct synthesis and post-synthetic modification,are reviewed to propose strategies for enhancing the adsorption kinetics and selectivity for Au,Ag,Pt,and Pd.Key structure-property relationships are established through multiscale characterization and thermodynamic models,revealing the critical roles of hierarchical porosity,soft donor atoms,and framework stability.Industrial challenges,such as aqueous stability and scalability,are addressed via Zr-O bond strengthening,hydrophobic functionalization,and support immobilization.This study consolidates the experimental and theoretical advances in MOF-based PM recovery and provides a roadmap for translating laboratory innovations into practical applications within the circular-economy framework.
文摘This study aims to explore the impact of combined health education and dietary guidance on the speed of postoperative recovery in patients with gastrointestinal polyps.A specific number of patients who underwent gastrointestinal polyp resection were selected and randomly divided into a control group and an experimental group.The control group received routine nursing,while the experimental group implemented combined health education and dietary guidance on this basis.By comparing the recovery indicators of the two groups,it was found that the recovery speed of the experimental group was significantly faster than that of the control group,indicating that this combined intervention method can effectively promote patient recovery.
文摘This editorial examines the emerging potential of traditional Chinese medicine(TCM)in enhancing postoperative recovery following gastroenteroscopy,highlighted by a 2025 randomized controlled trial by Hong et al.The study,involving 120 patients,demonstrates that meridian flow injection(MFI)combined with transcutaneous electrical acupoint stimulation(TEAS)significantly improves gastrointestinal(GI)function,evidenced by a reduced time to first defecation(3.20±1.04 days vs 3.98±1.27 days,P<0.001),lowers stress biomarkers(e.g.,reduced cortisol and norepinephrine),and enhances clinical efficacy(93.33%vs 75.00%,P=0.006).Leveraging TCM’s five-element theory and Ziwu Liuzhu timing,the intervention targets key acupoints such as Zusanli(ST36)with a herbal paste comprising Qingpi,Houpu,and rhubarb,delivered transdermally to optimize bioavailability.This approach harmonizes ancient TCM principles with contemporary evidence-based practice,offering a holistic strategy to address postoperative nausea,delayed motility,and patient discomfort.Currently,integrative methods like MFI-TEAS are gaining traction,supported by recent meta-analyses that affirm TEAS’s efficacy in accelerating GI recovery across surgical contexts,including shortened times to first exhaust and defecation.This reflects a growing recognition of TCM’s role in perioperative care amidst rising global endoscopy demands.Looking forward,future research should prioritize multicenter,doubleblinded trials to enhance generalizability,adhere to standardized reporting frameworks such as CONSORT and STRICTA,and employ advanced tools like multiomics and functional magnetic resonance imaging to elucidate mechanistic pathways,including gut-brain axis modulation and microbiota-immune interactions.Such developments promise to refine these interventions,fostering a seamless integration of TCM with Western medicine and delivering tailored,patientcentered solutions to improve postoperative outcomes worldwide.
基金Supported by the Natural Science Foundation of Guangxi Province(Grant Nos.2023GXNSFAA026067,2024GXN SFAA010521)the National Natural Science Foundation of China(Nos.12361079,12201149,12261026).
文摘Convex feasibility problems are widely used in image reconstruction, sparse signal recovery, and other areas. This paper is devoted to considering a class of convex feasibility problem arising from sparse signal recovery. We first derive the projection formulas for a vector onto the feasible sets. The centralized circumcentered-reflection method is designed to solve the convex feasibility problem. Some numerical experiments demonstrate the feasibility and effectiveness of the proposed algorithm, showing superior performance compared to conventional alternating projection methods.
基金supported in part by the NIH(R01NS113556,to KA).
文摘Carbon monoxide-from toxicity to therapeutic potential:Carbon monoxide(CO)has long been known as a toxic gas,primarily associated with environmental pollution and poisoning.Its strong affinity for hemoglobin causes the formation of carboxyhemoglobin,which reduces oxygen delivery to the tissues and organs and leads to hypoxia.Despite its well-documented toxicity,previous studies have confirmed that CO also acts as a signaling molecule in the body and plays important physiological roles(Motterlini and Otterbein,2010).
基金financially supported by the National Natural Science Foundation of China (No.51972302)。
文摘The recovery of gold from waste electronic and electric equipment(WEEE) has gained great attention with the increased number of WEEE,because it can largely alleviate the pressure on the environment and resources.Covalent organic frameworks(COFs) are ideal adsorbents for gold recovery owing to their large surface area,good stability,easily functionalized ability,periodic structures,and definitive nanopores.Herein,a cyano-functionalized COF(COF-CN) with high crystallinity was large-scale prepared under mild conditions for the recovery of gold.The introduction of cyano groups enable COF-CN to exhibit excellent gold recovery performance,which possesses fast adsorption kinetics,high cycling stability,and adsorption capacity up to 663.67 mg/g.Excitingly,COF-CN showed extremely high selectivity for gold ions,even in the presence of various competing cations and anions.The COF-CN maintained excellent selectivity and removal efficiency in gold recovery experiments from WEEE.The facile synthesis of COF-CN and its outstanding selectivity in actual samples make it an attractive opportunity for practical gold recovery.
文摘Spinal cord injury(SCI) often results in permanent dysfunction of locomotion,sensation,and autonomic regulation,imposing a substantial burden on both individuals and society(Anjum et al.,2020).SCI has a complex pathophysiology:an initial primary injury(mechanical trauma,axonal disruption,and hemorrhage) is followed by a progressive secondary injury cascade that involves ischemia,neuronal loss,and inflammation.Given the challenges in achieving regeneration of the injured spinal cord,neuroprotection has been at the forefront of clinical research.
文摘We found the qualitative study by Xu et al.on how patients feel about laparoscopic incisions under enhanced recovery after surgery(ERAS)protocols to be very interesting.1 Xu et al.carried out a qualitative study on patient experience with laparoscopic incisions under an ERAS protocol to highlight the problem of psychosocial and aesthetic concerns,which are often overlooked when planning surgical operations.This study,which involved semistructured interviews with sixteen people,aimed to narrow perioperative education and the decision-making process for incision site selection,thus making the processes more focused on patient priorities.The study is based on a timely but under-researched subject area;however,it is possible to outline four possible areas of improvement that would allow the study to be more transparent and,at the same time,more applicable to clinical practice.
基金supported by the National Natural Science Foundation of China,Nos.81701040(to HM),82071180(to HM),82271206(to TL),82171191(to YW),82371211(to YW)the Natural Science Foundation of Beijing,No.7212023(to HM)Key Subject of the Natural Science Foundation ofJiangsu Province for Colleges and Universities,No.23KJA320009(to YW).
文摘Delayed neurocognitive recovery following anesthesia and surgery is a common complication in older adult patients.Synapses are fundamental to cognitive function.The activity of synapses heavily depends on the energy supplied by synaptic mitochondria,which are significantly influenced by oxidative stress.Sirtuin 3 is a histone deacetylase located in the mitochondrial matrix that plays a pivotal role in regulating mitochondrial function.However,it remains unclear whether and how sirtuin 3 is involved in the development of delayed cognitive recovery.Therefore,in this study,we investigated the potential role of sirtuin 3 in synapses during delayed neurocognitive recovery.Our results showed that anesthesia and surgery induced cognitive impairment in mice and reduced sirtuin 3 protein expression.Overexpression of sirtuin 3 inhibited opening of the mitochondrial permeability transition pore by reducing acetylation of K166 on cyclophilin D and also rescued cognitive impairment.Aged mice carrying the cyclophilin D-K166R mutation exhibited significantly reduced cognitive impairment.Similarly,administering the mitochondrial permeability transition pore blocker,cyclosporine A,effectively alleviated the decline in synaptic mitochondrial function and cognitive impairment caused by anesthesia and surgery in aged mice.These results indicate that the sirtuin 3/cyclophilin D-K166/mPTP signaling pathway in hippocampal synaptic mitochondria is involved in delayed neurocognitive recovery of aged mice,suggesting this pathway could serve as a potential target for treatment.
基金supported by the National Natural Science Foundation of China,No.82371399(to YY)the Natural Science Foundation of Jiangsu Province,No.BK20221206(to YY)+1 种基金the Young Elite Scientists Sponsorship Program of Jiangsu Province,No.TJ-2022-028(to YY)the Scientific Research Program of Wuxi Health Commission,No.Z202302(to LY)。
文摘Spontaneous recovery frequently proves maladaptive or insufficient because the plasticity of the injured adult mammalian central nervous system is limited.This limited plasticity serves as a primary barrier to functional recovery after brain injury.Neuromodulation technologies represent one of the fastest-growing fields in medicine.These techniques utilize electricity,magnetism,sound,and light to restore or optimize brain functions by promoting reorganization or long-term changes that support functional recovery in patients with brain injury.Therefore,this review aims to provide a comprehensive overview of the effects and underlying mechanisms of neuromodulation technologies in supporting motor function recovery after brain injury.Many of these technologies are widely used in clinical practice and show significant improvements in motor function across various types of brain injury.However,studies report negative findings,potentially due to variations in stimulation protocols,differences in observation periods,and the severity of functional impairments among participants across different clinical trials.Additionally,we observed that different neuromodulation techniques share remarkably similar mechanisms,including promoting neuroplasticity,enhancing neurotrophic factor release,improving cerebral blood flow,suppressing neuroinflammation,and providing neuroprotection.Finally,considering the advantages and disadvantages of various neuromodulation techniques,we propose that future development should focus on closed-loop neural circuit stimulation,personalized treatment,interdisciplinary collaboration,and precision stimulation.
文摘The year 2025 marks the 120th anniversary of the birth of Chinese filmmaking.From the first film Dingjun Mountain released in 1905,which captured scenes from Peking opera,to the present day where artificial intelligence(AI)is utilised in film production,the Chinese film industry has been developing for over a century.Data from the China Film Administration shows that China’s 2025 box o"ce revenue topped 51.8 billion yuan($7.4 billion),realising a year-on-year increase of nearly 22 percent.
基金supported by European Union Funding Programme,PNRR,No. 760058(to DMH)the UEFISCDI Project,No. PN-III-P4-IDPCE-2020-059(to APW)
文摘The major aim of stroke therapy is to stimulate brain repair and improve behavioral recovery after cerebral ischemia.One option is to stimulate endogenous neurogenesis in the subventricular zone and direct the newly formed neurons to the damaged area.However,only a small percentage of these neurons survive,and many do not reach the damaged area,possibly because the corpus callosum impedes the migration of subventricular zone-derived stem cells into the lesioned cortex.A second major obstacle to stem cell therapy is the strong inflammatory reaction induced by cerebral ischemia,whereby the associated phagocytic activity of brain macrophages removes both therapeutic cells and/or cell-based drug carriers.To address these issues,neurogenesis was electrically stimulated in the subventricular zone,followed by isolation of proliferating cells,including newly formed neurons,which were subsequently mixed with a nutritional hydrogel.This mixture was then transferred to the stroke cavity of day 14 post-stroke mice.We found that the performance of the treated animals improved in behavioral tests,including novel object,open field,hole board,grooming,and“time-to-feel”adhesive tape tests.Furthermore,immunostaining revealed that the stem cell marker nestin,the neuroepithelial marker Mash1,and the immature neuronal marker doublecortin-positive cells survived in the transplanted area for 2 weeks,possibly due to reduced phagocytic activity and supportive angiogenesis.These results clearly indicate that the transplantation of committed subventricular zone stem cells combined with a protective nutritional gel directly into the infarct cavity after the peak of stroke-induced neuroinflammation represents a feasible approach to improve neurorestoration after cerebral ischemia.
基金supported by the Deutsche Forschungsgemeinschaft(DFG),TRR274(Project ID 408885537,Sy Nergy,EXC 2145/ID 390857198,to FMB)。
文摘The remodeling of axonal connections following injury is an important feature driving functional recovery.The reticulospinal tract is an interesting descending motor tract that contains both excitatory and inhibitory fibers.While the reticulospinal tract has been shown to be particularly prone to axonal growth and plasticity following injuries of the spinal cord,the differential capacities of excitatory and inhibitory fibers for plasticity remain unclear.As adaptive axonal plasticity involves a sophisticated interplay between excitatory and inhibitory input,we investigated in this study the plastic potential of glutamatergic(vGlut2)and GABAergic(vGat)fibers originating from the gigantocellular nucleus and the lateral paragigantocellular nucleus,two nuclei important for locomotor function.Using a combination of viral tracing,chemogenetic silencing,and AI-based kinematic analysis,we investigated plasticity and its impact on functional recovery within the first 3 weeks following injury,a period prone to neuronal remodeling.We demonstrate that,in this time frame,while vGlut2-positive fibers within the gigantocellular and lateral paragigantocellular nuclei rewire significantly following cervical spinal cord injury,vGat-positive fibers are rather unresponsive to injury.We also show that the acute silencing of excitatory axonal fibers which rewire in response to lesions of the spinal cord triggers a worsening of the functional recovery.Using kinematic analysis,we also pinpoint the locomotion features associated with the gigantocellular nucleus or lateral paragigantocellular nucleus during functional recovery.Overall,our study increases the understanding of the role of the gigantocellular and lateral paragigantocellular nuclei during functional recovery following spinal cord injury.
基金co-funded by the National Natural Science Foundation of China(42372160,42072172)。
文摘The Neogene Shawan Formation in the Chepaizi Uplift of the Junggar Basin(NW China)has obtained high oil flow,demonstrating a good potential for oil and gas exploration.The multi-source hydrocarbon generation background and strong tectonic activity have led to the simultaneous production of heavy oil and light oil from multi-layer in the area,which makes it very difficult to identify oil origins,presently,the hot debate on the oil origins needs to be clarified.In this paper,due to the selective consumption of different types of compounds in crude oils by severe and intense biodegradation,the commonly used oilsource correlation tools are ineffective or may produce misleading results,this study adopted a biomarker recovery method based on the principle of mass conservation that uses the sum of the mass of the residual biomarkers and their corresponding biodegradation products to obtain the mass of the original biomarkers,improving the reliability of oil origins determination.Based on the nature and occurrence of crude oils,the investigated oils are subdivided into three types,Group A,Group B and Group C.Group A,light oils occurred mainly in lower structure Neogene Shawan Formation in the western Chepaizi Uplift,while Group B,heavy oils occurred mainly in higher structure Neogene Shawan Formation in the western Chepaizi Uplift.The two types of crude oils may come from the mixed source of Jurassic Badaowan Formation source rocks(J_(1)b)and Paleogene Anjihaihe Formation source rocks(E_(2-3)a)in the Sikeshu Sag,and Jurassic Badaowan Formation source rocks(J_(1)b)are the main source of crude oils.Group C,heavy oils occurred mainly in Neogene Shawan Formation in the eastern Chepaizi Uplift,showing good correlation with the Permian(P_(1)f and P_(2)w)source rocks in the Shawan Sag.At the same time,by combining stable carbon isotope and parameters related to triaromatic steroids,the accuracy of the oilsource correlation results by biomarker recovery method was further verified.
基金supported by the National Natural Science Foundation of China,Nos.82271419,81901902(to YZ),82202702(to ZW),82202351(to XH),82301550(to LYang),82271418(to XX)the Shanghai Rising-Star Program,No.22QA1408200(to YZ)the Fundamental Research Fundsfor the Central Universities,No.22120220555(to YZ).
文摘In the early stages of traumatic spinal cord injury,extensive accumulation of autophagosomes creates a neurotoxic microenvironment,exacerbating neuronal cell death and worsening tissue damage,ultimately hindering neurofunctional recovery.Activin A is a critical growth factor necessary for the development of the embryonic nervous system and for maintaining neuronal function in the adult cerebral cortex.It can inhibit excessive autophagy in ischemic stroke to reduce neuronal damage.However,the specific mechanism through which Activin A functions in the spinal cord remains poorly understood.In this study,we administered different concentrations of Activin A to neural stem cells from the spinal cord and found that Activin A stimulated the proliferation and neuronal differentiation of neural stem cells.Then,we established an in vitro oxidative stress model by using hydrogen peroxide to stimulate the neural stem cells-induced neurons.We found that Activin A could reduce apoptosis caused by oxidative stress.Subsequently,we treated a mouse model of spinal cord contusion with intrathecal injection of Activin A.Behavioral and electrophysiological results showed that Activin A promoted recovery of motor function and reconstruction of neural circuits in the model mice.Finally,RNA sequencing indicated that Activin A inhibited autophagy by activating the PI3K/AKT/mTOR pathway and upregulating the expression of synaptogenesis-related factor Sema3A in the spinal cord.These results suggest that Activin A may mediate the excessive autophagic response after spinal cord injury,promote the reconstruction of damaged neural circuits,and restore neurological function in the injured spinal cord.
文摘Objective Combine olfactory ensheathing glia （OEG） implantation with ex vivo non-viral vector-based neurotrophin- 3 （NT-3） gene therapy in attempting to enhance regeneration after thoracic spinal cord injury （SCI）. Methods Primary OEG were transfected with cationic liposome-mediated recombinant plasmid pcDNA3.1 （＋）-NT3 and subsequently implanted into adult Wistar rats directly after the thoracic spinal cord （T9） contusion by the New York University impactor. The animals in 3 different groups received 4x 1050EG transfected with pcDNA3.1 （＋）-NT3 or pcDNA3.1 （＋） plasmids, or the OEGs without any plasmid transfection, respectively; the fourth group was untreated group, in which no OEG was implanted. Results NT-3 production was seen increased both ex vivo and in vivo in pcDNA3.1 （＋）-NT3 transfected OEGs. Three months after implantation of NT-3-transfected OEGs, behavioral analysis revealed that the hindlimb function of SCI rats was improved. All spinal cords were filled with regenerated neurofilament-positive axons. Retrograde tracing revealed enhanced regenerative axonal sprouting. Conclusion Non-viral vector-mediated genetic engineering of OEG was safe and more effective in producing NT- 3 and promoting axonal outgrowth followed by enhancing SCI recovery in rats.
基金Item Sponsored by National Natural Science Foundation of China (50334020)
文摘To change the undesirable present situation of recovering and using converter gas in steel plants in China, the basic approaches to improving the converter gas recovery rate were analyzed theoretically along with the change curves of the converter gas component content, based on the converter gas recovery system of Baosteel No. 2 steel- making plant. The effects of converter device, raw material, air imbibed quantity, recovery restricted condition, and intensity of oxygen blowing on the converter gas recovery rate were studied. Among these, the effects of the air im bibed quantity, recovery restricted condition, and intensity of oxygen blowing are remarkable. Comprehensive measures were put forward for improving the converter gas recovery from the point of devices, etc. , and good results were achieved.
基金supported by grants from the Project of Medical and Health Technology Platform of Zhejiang Province(2017RC003)the National High Technology Research and Development Pro-gram of China(SS2015AA020405)+4 种基金the General Program of the National Natural Science Foundation of China(81871925)the General Program of the National Natural Science Foundation of China(81672337)the Key Innovative Team for the Diagnosis and Treatment of Pancreatic Cancer of Zhejiang Province(2013TD06)the Key Program of National Natural Science Foundation of China(81530079)the Key Research and Development Project of Zhejiang Province(2015C03044)
文摘Background: The enhanced recovery after surgery (ERAS) protocol is an evidence-based perioperative care program aimed at reducing surgical stress response and accelerating recovery. However, a small propor- tion of patients fail to bene t from the ERAS program following pancreaticoduodenectomy. This study aimed to identify the risk factors associated with failure of ERAS program in pancreaticoduodenectomy. Methods: Between May 2014 and December 2017, 176 patients were managed with ERAS program fol-lowing pancreaticoduodenectomy. ERAS failure was indicated by prolonged hospital stay, unplanned read- mission or unplanned reoperation. Demographics, postoperative recovery and compliance were compared of those ERAS failure groups to the ERAS success group. Results: ERAS failure occurred in 59 patients, 33 of whom had prolonged hospital stay, 18 were readmitted to hospital within 30 days after discharge, and 8 accepted reoperation. Preoperative American Society of Anesthesiologists (ASA) score of ≥III (OR = 2.736;95% CI: 1.276 6.939;P=0.028) and albumin (ALB) level of <35g/L (OR=3.589;95% CI: 1.403 9.181;P=0.008) were independent risk factors associated with prolonged hospital stay. Elderly patients (>70 years) were on a high risk of unplanned reoperation (62.5% vs. 23.1%, P=0.026). Patients with prolonged hospital stay and unplanned reoperation had delayed intake and increased intolerance of oral foods. Prolonged stay patients got off bed later than ERAS success patients did (65h vs. 46h, P =0.012). Unplanned reoperation patients tended to experience severer pain than ERAS success patients did (3 score vs. 2 score, P =0.035). Conclusions: Patients with high ASA score, low ALB level or age >70 years were at high risk of ERAS failure in pancreaticoduodenectomy. These preoperative demographic and clinical characteristics are important determinants to obtain successful postoperative recovery in ERAS program.
