Golgi apparatus(GA)-associated secretome runs through the endomembrane system and is critical for inter-and intracellular communication networks.However,achieving in situ dissection of the GA-associated secretome rema...Golgi apparatus(GA)-associated secretome runs through the endomembrane system and is critical for inter-and intracellular communication networks.However,achieving in situ dissection of the GA-associated secretome remains challenging owing to the scarcity of specific labeling methods.This work develops an aggregation-induced emission(AIE)luminogen-mediated photocatalytic proximity labeling strategy that allows profiling of the GA-associated secretome with high spatiotemporal precision.Leveraging an AIE luminogen-derived GA-targeting photocatalyst,this strategy achieves efficient labeling of proteins in minutes within the Golgi lumen upon light activation,which enables spatiotemporally resolved modification of histidine and tyrosine residues.We succeed in profiling secretome in both living HeLa cells and hard-to-transfect macrophage HMC3 cells,and a significant subset of GA-associated secretome with 80%specificity is determined,linking the distinct GA-associated secretory profiles to cellular characteristics.The method is further applied to proteome mapping of brain and bone metastatic lung cancer cells,which reveals the underlying roles the GA-associated secretome plays in extracellular matrix organization during metastasis.This work delivers a robust tool to break the dilemma of chemical labeling of GA-associated secretome in living cells,and provides mechanistic insights into secretion regulation at the subcellular level.展开更多
Establishing a Regional Marine Innovation Ecosystem(RMIE)is crucial for advancing China’s maritime power strategy.Concurrently,developing a competitive RMIE serves as a strategic lever to enhance the global competiti...Establishing a Regional Marine Innovation Ecosystem(RMIE)is crucial for advancing China’s maritime power strategy.Concurrently,developing a competitive RMIE serves as a strategic lever to enhance the global competitiveness of China’s marine science sector.However,research on the competitiveness of RMIE is limited.To this end,this study constructs an evaluation index system based on ecological niche theory to assess the competitiveness of RMIE in China from 2008 to 2020.The findings indicate generally fluctuating upward trends in RMIE’s competitiveness,with Shandong,Jiangsu,and Guangdong showing relatively strong positions.Notably,there are significant intra-regional imbalances and inter-regional asynchrony in RMIE’s competitiveness across China’s three major marine economic circles.Recognizing that forecasting RMIE competitiveness can inform policy formulation,this paper proposes a systematic multivariate grey interval prediction model that incorporates spatial proximity effects.This model effectively captures the interval and uncertainty characteristics of RMIE’s competitiveness while considering spatial relationships among regions.Results from comparative analysis,robustness tests,and sensitivity analysis demonstrate its superior applicability and forecasting accuracy.Additionally,interval forecasts and scenario analyses suggest that RMIE competitiveness will maintain stable growth,although unbalanced and unsynchronized development is likely to persist.Overall,the approach developed for evaluating and forecasting RMIE competitiveness offers valuable insights for effective policy formulation.展开更多
BACKGROUND Gastric cancer(GC)is a major global health challenge,and the treatment of proximal GC in particular presents unique clinical and surgical complexities.Currently,there is no consensus on whether proximal gas...BACKGROUND Gastric cancer(GC)is a major global health challenge,and the treatment of proximal GC in particular presents unique clinical and surgical complexities.Currently,there is no consensus on whether proximal gastrectomy(PG)or total gastrectomy(TG)should be used for advanced proximal GC,and the choice of postoperative gastrointestinal reconstruction method remains controversial.AIM To compare the short-term efficacy,long-term survival,and postoperative reflux outcomes of PG with tubular stomach reconstruction vs TG with Roux-en-Y re-construction in patients with proximal GC following neoadjuvant chemotherapy(NACT)in an effort to provide valuable insights for clinical decision-making regarding the optimal surgical approach.METHODS A multicenter retrospective cohort study was conducted at two Chinese medical centers between December,2012 and December,2022.Patients with histologically confirmed proximal GC who received NACT followed by either PG with tubular stomach reconstruction or TG with Roux-en-Y reconstruction were included.Propensity score matching(PSM)was performed to balance baseline characteristics,and the primary endpoint was 5-year overall survival(OS).Se-condary endpoints included recurrence-free survival(RFS),postoperative complications,and reflux severity.RESULTS After PSM,244 patients(122 PG,122 TG)were finally included and all baseline characteristics were comparable between groups.The PG group had a significantly shorter operation time compared to the TG group(189.50 vs 215.00 minutes,P<0.001),with no differences in intraoperative blood loss or postoperative complications(19.68%vs 14.75%,P=0.792).The 5-year OS rates were 52.7%vs 45.5%(P=0.330),and 5-year RFS rates were 54.3%vs 47.6%(P=0.356)for the PG and TG groups,respectively.Reflux symptoms(18.0%vs 31.1%,P=0.017)and clinically significant reflux based on gastroesophageal reflux disease questionnaire scores≥8(7.4%vs 21.3%,P<0.001)were significantly less frequent in the PG group.Multivariate analysis identified histological differentiation(HR=2.98,95%CI:2.03-4.36,P<0.001)and tumor size(HR=0.26,95%CI:0.17-0.41 for tumors≤4 cm,P<0.001)as independent prognostic factors.CONCLUSION PG with tubular stomach reconstruction is comparable to TG in terms of surgical safety and long-term oncological outcomes for proximal GC patients following NACT.Additionally,PG has the advantages of shorter operation time and lower rates of postoperative reflux,suggesting potential benefits for patient quality of life.Notably,the analysis of postoperative prognostic factors,including histological differentiation and tumor size,further informs clinical decision-making and highlights the importance of individualized treatment strategies.展开更多
In this study,we explore some of the best proximity point results for generalized proximal contractions in the setting of double-controlled metric-type spaces.A non-trivial example is given to elucidate our analysis,a...In this study,we explore some of the best proximity point results for generalized proximal contractions in the setting of double-controlled metric-type spaces.A non-trivial example is given to elucidate our analysis,and some novel results are derived.The discovered results generalize previously known results in the context of a double controlled metric type space environment.This article’s proximity point results are the first of their kind in the realm of controlled metric spaces.To build on the results achieved in this article,we present an application demonstrating the usability of the given results.展开更多
BACKGROUND According to statistics,the incidence of proximal gastric cancer has gradually increased in recent years,posing a serious threat to human health.Tubular gastroesophageal anastomosis and double-channel anast...BACKGROUND According to statistics,the incidence of proximal gastric cancer has gradually increased in recent years,posing a serious threat to human health.Tubular gastroesophageal anastomosis and double-channel anastomosis are two relatively mature anti-reflux procedures.A comparison of these two surgical procedures,tubular gastroesophageal anastomosis and double-channel anastomosis,has rarely been reported.Therefore,this study aimed to investigate the effects of these two reconstruction methods on the quality of life of patients with proximal gastric cancer after proximal gastrectomy.AIM To compare short-term clinical results of laparoscopic proximal gastrectomy with double-channel anastomosis vs tubular gastric anastomosis.METHODS Patients who underwent proximal gastrectomy at our hospital between January 2020 and January 2023 were enrolled in this retrospective cohort study.The patients were divided into an experimental group(double-channel anastomosis,33 cases)and a control group(tubular gastric anastomosis,30 cases).Baseline characteristics,surgical data,postoperative morbidities,and postoperative nutrition were recorded.RESULTS The differences in baseline data,surgical data,and postoperative complications(20.0%vs 21.2%)were not statistically significant between the two groups.There were no statistically significant differences in the levels of postoperative nutrition indicators between the two groups of patients during the preoperative period and at 3 months postoperatively.In addition,the levels of postoperative nutrition indicators in patients in the experimental group declined significantly less at 6 months and 12 months postoperatively compared with those of the control group(P<0.05).At 12 months postoperatively,the difference in anastomotic reflux esophagitis between the two groups was statistically significant(P<0.05)with the experimental group showing less reflux esophagitis.CONCLUSION Both double-channel anastomosis and tubular gastric anastomosis after proximal gastrectomy are safe and feasible.Double-channel anastomosis has a better anti-reflux effect and is more beneficial in improving the postoperative nutritional status.展开更多
BACKGROUND Proximal gastrectomy(PG)for gastric cancer requires a delicate balance between oncological radicality and postoperative quality of life to mitigate reflux complications.Although the Kamikawa anastomosis has...BACKGROUND Proximal gastrectomy(PG)for gastric cancer requires a delicate balance between oncological radicality and postoperative quality of life to mitigate reflux complications.Although the Kamikawa anastomosis has gained attention for its theoretical anti-reflux advantages,robust clinical evidence remains limited.AIM To comprehensively evaluate the efficacy,safety,and nutritional outcomes of the Kamikawa anastomosis in PG,thereby addressing a critical gap in surgical decision-making.METHODS Following PRISMA guidelines,we systematically searched PubMed,Embase,and the Cochrane Library for studies on Kamikawa anastomosis after PG.Data were pooled using fixed-or random-effects models based on heterogeneity levels(I2 statistics).The risk of bias was evaluated using Risk of Bias in Non-randomized Studies of Interventions.The protocol was prospectively registered in PROSPERO.RESULTS Of 106 screened studies,20 involving 2291 patients were included.Most studies(85%)originated from Japan,with a mean patient age of 54-73 years and a male predominance(68.1%).Overall pooled incidence of 30-day postoperative complications was 9.9%[95%confidence interval(95%CI):6.8-12.9],with major complications(Clavien-Dindo grade≥III)occurring in 6.1%(95%CI:4.6-7.7).Anastomosis-related complications were observed in 7.2%of cases,comprising leakage 1.8%(95%CI:1.1-2.4),stenosis in 7.2%(95%CI:5.8-8.5),and bleeding in 0.7%(95%CI:0.1-1.2).Pooled incidence of reflux esophagitis was 4%(95%CI:2.7-5.3)for all LA grades at 12-month follow-up,with 28.3%(95%CI:14.7-41.9)of patients requiring regular proton pump inhibitor use.Operative outcomes demonstrated a pooled mean operative time of 349.5 minutes(95%CI:331-380),estimated blood loss of 351.5 mL(95%CI:264-495),and postoperative hospital stay of 12.3 days(95%CI:11.5-13.1).Nutritional outcomes revealed 11.4%(95%CI:10.6-12.2)body weight loss at one year.Comparative analyses showed equivalent safety profiles between the Kamikawa anastomosis and double-tract reconstruction but longer operative times(P<0.001)compared with total gastrectomy.CONCLUSION These findings underscore the clinical viability of the Kamikawa anastomosis following PG,demonstrating favorable anti-reflux efficacy,acceptable incidence of anastomotic strictures,and preservation of nutritional status.展开更多
Ru-based nanomaterials have been demonstrated to be highly active electrocatalysts for hydrogen evo-lution reaction(HER),yet weak water adsorption and splitting ability in neutral media thus it is rather difficult for...Ru-based nanomaterials have been demonstrated to be highly active electrocatalysts for hydrogen evo-lution reaction(HER),yet weak water adsorption and splitting ability in neutral media thus it is rather difficult for the intermediates to adsorb on the active site.Herein,we introduce a concept of the prox-imity effect,com prising adjacent Ru and RuO_(2) nanoparticles coupled on TiO_(2)(Ru/RuO_(2)-TiO_(2)),for the synergic promotion of water molecule adsorption and splitting,significantly enhancing HER electrocatal-ysis performance.The in-situ spectroscopy experiments and density function theory(DFT)simulations demonstrated that the proximity effect between the adjacent Ru nanoparticles and RuO_(2) nanoparticles can accelerate water adsorption and splitting.As a result,the as-made Ru/RuO_(2)-TiO_(2) only need overpo-tentials of 52.7,16.0,and 16.4 mV to achieve the current density of 10 mA cm-2 in neutral,acid,and alkaline media,respectively.The mass activity of Ru/RuO_(2)-TiO_(2) in neutral media is 320 and 117 times higher than that of commercial Ru/C and Pt/C at the overpotential of 100 mV,respectively.This work emphasizes the proximity effect for activation of reactants which can be extended to other electrocat-alytic reactions.展开更多
A new method for determining proximity parameters α,β ,and η in electron beam lithography is introduced on the assumption that the point exposure spread function is composed of two Gaussians.A single line i...A new method for determining proximity parameters α,β ,and η in electron beam lithography is introduced on the assumption that the point exposure spread function is composed of two Gaussians.A single line is used as test pattern to determine proximity effect parameters and the normalization approach is adopted in experimental data transaction in order to eliminate the need of measuring exposure clearing dose of the resist.Furthermore,the parameters acquired by this method are successfully used for proximity effect correction in electron beam lithography on the same experimental conditions.展开更多
Utilizing small molecules as markers for specific cells or organs within biosystems is a crucial approach for studying and regulating physiological processes. However, current tagging strategies, due to the presence o...Utilizing small molecules as markers for specific cells or organs within biosystems is a crucial approach for studying and regulating physiological processes. However, current tagging strategies, due to the presence of exposed highly reactive groups, suffer from drawbacks such as low tagging efficiency or insufficient spatial specificity, thereby diminishing their expected effectiveness. Consequently, there is a pressing need to develop a strategy capable of in situ labeling of active groups in response to cellular or in vivo stimuli, ensuring both high tagging efficiency and spatial specificity. In this work, we devised a strategy for releasing aldehyde groups activated by hypochlorous acid(HOCl). Compounds synthesized through this strategy can release the fiuorophore methylene blue(MB) and aldehyde-based compounds upon HOCl activation. Given high reactivity of the released aldehyde group, it can effectively interact with macromolecules in biological systems, facilitating tagging and enabling prolonged imaging. To validate this concept, we further incorporated a naphthalimide structure with stable light emission to create SW-110. SW-110 can specifically respond to in vitro and endogenous HOCl, when release MB, it also releases naphthalimide fiuorophore with highly reactive aldehyde group for tagging within cells. This strategy provides a simple but efficient strategy for proximity tagging in situ.展开更多
Electrocatalytic conversion of nitrate to ammonia(NITRR)can simultaneously achieve the removal of nitrate and the synthesis of value-added ammonia,a promising candidate to replace Haber-Bosch process with low carbon d...Electrocatalytic conversion of nitrate to ammonia(NITRR)can simultaneously achieve the removal of nitrate and the synthesis of value-added ammonia,a promising candidate to replace Haber-Bosch process with low carbon dioxide emissions.However,high hydrogenation energy barrier for*NO intermediates and insufficient supply of active hydrogen cause slow hydrogenation process,and further result in low efficiency of nitrate conversion and ammonia synthesis.Herein,a series of tandem catalysts,one-dimensional coordination polymers(1D CCPs)with dual sites are synthesized and obtained 190.4 mg h^(-1)mgcat^(-1)ammonia production rate with Faradaic efficiency of 97.16%,outperforming to the most of recent reported catalysts.The catalytic performances are well-maintained even after a long-term stability test of 1200 h,laying the foundation for practical applications.Density functional theory results reveal that the stationary adsorbed*NO on Ni site induced proximity electronic effect could reduce the energy barrier for hydrogenation of*NO intermediates over Cu site.In addition,the Ni site in the dual sites 1D CCPs is conducive to generating active hydrogen,providing rich proton source to boost the hydrogenation of*NO,and further enhancing the compatibility of deoxygenation and hydrogenation process.Our work paves a new insight into the mechanism of NITRR process and will inspire more research interests in exploring the proximity electronic effect in catalytic process.展开更多
BACKGROUND Proximal gastrectomy(PG)with double tract reconstruction(DTR)has recently emerged as a function-preserving alternative to total gastrectomy(TG)with Rouxen-Y(RNY)reconstruction in patients with proximally lo...BACKGROUND Proximal gastrectomy(PG)with double tract reconstruction(DTR)has recently emerged as a function-preserving alternative to total gastrectomy(TG)with Rouxen-Y(RNY)reconstruction in patients with proximally located gastric cancer.AIM To evaluate the current evidence comparing PG-DTR with TG-RNY in terms of perioperative outcomes,long-term survival,complication rates,nutritional status and reflux esophagitis.METHODS A systematic literature search was conducted using PubMed,MEDLINE,Web of Science and the Cochrane Library for studies published between 2010 and January 2025.Search terms included gastric cancer,DTR and TG.Trials comparing PGDTR with TG-RNY or PG-esophagogastrostomy(EG)were included.Data on operative details,lymph node yield,complications(Clavien-Dindo≥III),nutritional markers and incidence of reflux were extracted.Nineteen trials met the inclusion criteria.The review followed the PRISMA guidelines.RESULTS PG-DTR was found to have comparable long-term oncological outcomes to TGRNY,despite a lower extent of lymph node dissection.Operative time and intraoperative blood loss were generally similar,with some studies favouring PGDTR.Rates of major postoperative complications were comparable between techniques.Notably,PG-DTR showed a significantly lower incidence of reflux esophagitis than PG-EG and was comparable or superior to TG-RNY in reflux control.Nutritionally,PG-DTR was associated with better post-operative weight maintenance and biochemical parameters such as haemoglobin,albumin and vitamin B12 levels compared to TG-RNY.No significant nutritional differences were observed between PG-DTR and PG-EG.PG-DTR appears to offer a balanced approach to the surgical treatment of proximal gastric cancer,combining oncological safety with functional and nutritional benefits.CONCLUSION Its superiority over TG-RNY in postoperative nutrition and reflux prevention,together with comparable complication rates and survival,supports its consideration as a preferred reconstruction method in selected patients.展开更多
BACKGROUND Although surgery remains the primary treatment for proximal gastric cancer(PGC),ongoing refinements in surgical strategies are essential to improving clinical outcomes.AIM To investigate the effect of doubl...BACKGROUND Although surgery remains the primary treatment for proximal gastric cancer(PGC),ongoing refinements in surgical strategies are essential to improving clinical outcomes.AIM To investigate the effect of double-tract reconstruction(DTR)on immune function and stress response in patients undergoing laparoscopic proximal gastrectomy(LPG).METHODS In total,78 patients with PGC admitted between August 2020 and August 2024 were enrolled.The research group consisted of 39 patients who underwent DTR+LPG,whereas the control group comprised 39 patients who underwent laparoscopic total gastrectomy with Roux-en-Y esophagojejunostomy.Perioperative indices(intraoperative blood loss,digestive tract anastomosis time,and time to first postoperative flatus),postoperative complications(intestinal obstruction,anastomotic ulcer,diarrhea,dumping syndrome,and gastroesophageal reflux),nutritional parameters(serum albumin,hemoglobin,and body mass index),immune function immunoglobulin(IgG,IgA,and IgM),and stress response indicators(C-reactive protein,interleukin-6,and tumor necrosis factor-α)were collected and analyzed for both groups.RESULTS The intraoperative blood loss was lower(P<0.05),and the time to first postoperative flatus time was shorter(P<0.001)in the research group than in the control group.The two groups had comparable digestive tract anastomosis time(P>0.05).The overall complication rate was significantly lower in the research group than in the control group(P=0.042).Compared with the control group,the research group exhibited notably higher albumin,hemoglobin,and body mass index levels at 2 and 3 months postoperatively,as well as considerably high immunoglobulin(Ig)G,IgA,and IgM levels on postoperative day 1(P<0.05).The postoperative levels of C-reactive protein,interleukin-6,and tumor necrosis factor-αwere also lower in the research group than in the control group(P<0.001).CONCLUSION The combination of DTR and LPG in the treatment of patients with PGC is more effective in enhancing immune function and suppressing stress responses,showing more advantages over laparoscopic total gastrectomy.展开更多
Acute lung injury(ALI)is a serious clinical condition with a high mortality rate.Oxidative stress and inflammatory responses play pivotal roles in the pathogenesis of ALI.ONOO^(−)is a key mediator that exacerbates oxi...Acute lung injury(ALI)is a serious clinical condition with a high mortality rate.Oxidative stress and inflammatory responses play pivotal roles in the pathogenesis of ALI.ONOO^(−)is a key mediator that exacerbates oxidative damage and microvascular permeability in ALI.Accurate detection of ONOO^(−)would facilitate early diagnosis and intervention in ALI.Near-infrared fluorescence(NIRF)probes offer new solutions due to their sensitivity,depth of tissue penetration,and imaging capabilities.However,the developed ONOO^(−)fluorescent probes face problems such as interference from other reactive oxygen species and easy intracellular diffusion.To address these issues,we introduced an innovative self-immobilizing NIRF probe,DCI2F-OTf,which was capable of monitoring ONOO^(−)in vitro and in vivo.Importantly,leveraging the high reactivity of the methylene quinone(QM)intermediate,DCI2F-OTf was able to covalently label proteins in the presence of ONOO^(−),enabling in situ imaging.In mice models of ALI,DCI2F-OTf enabled real-time imaging of ONOO^(−)levels and found that ONOO^(−)was tightly correlated with the progression of ALI.Our findings demonstrated that DCI2F-OTf was a promising chemical tool for the detection of ONOO^(−),which could help to gain insight into the pathogenesis of ALI and monitor treatment efficacy.展开更多
BACKGROUND Proximal gastrectomy for gastric cancer often leads to postoperative gastroeso-phageal reflux(GER).This study compares the impact of forearm anastomosis and posterior wall anastomosis techniques on GER in p...BACKGROUND Proximal gastrectomy for gastric cancer often leads to postoperative gastroeso-phageal reflux(GER).This study compares the impact of forearm anastomosis and posterior wall anastomosis techniques on GER in patients undergoing this procedure.AIM To identify the most effective method for reducing reflux symptoms while preserving gastrointestinal integrity and nutritional status.METHODS A retrospective evaluation was conducted on 60 patients who underwent proximal gastrectomy between December 2020 and December 2023,divided equally into two groups based on the anastomosis technique used(forearm or posterior wall).GER symptoms were assessed using the GER disease ques-tionnaire(GerdQ)preoperatively and on the first postoperative day.Biochemical markers[diamine oxidase(DAO),D-lactic acid,and endotoxin(ETX)]and nutritional indicators[serum ferritin(SF),prealbumin(PA),and albumin(ALB)]were measured to evaluate gastrointestinal barrier function and nutritional status.RESULTS Both groups showed significant improvements in GerdQ scores and reflux symptom scores post-treatment,with the observation group exhibiting greater reductions.Biochemical markers indicated enhanced gastrointestinal barrier function post-treatment in both groups,with notable increases in DAO,D-lactic,and ETX levels.Nutritional status indicators also demonstrated significant changes,with reductions in SF,PA,and ALB levels,suggesting an impact of treatment on inflammatory and nutritional status.CONCLUSION The forearm anastomosis technique appears to be more effective in reducing GER symptoms and preserving gastrointestinal health in patients undergoing proximal gastrectomy for gastric cancer compared to the posterior wall anastomosis technique.These preliminary findings advocate for further research to confirm the benefits and potentially standardize Forearm Anastomosis in surgical practice for gastric cancer.展开更多
BACKGROUND In intertrochanteric fractures,the positive medial cortex support reduction is considered to provide a non-anatomical buttress that helps in controlled collapse.AIM To analyze the concept of medial cortical...BACKGROUND In intertrochanteric fractures,the positive medial cortex support reduction is considered to provide a non-anatomical buttress that helps in controlled collapse.AIM To analyze the concept of medial cortical reduction(MCR)and its clinical and radiological association in geriatric intertrochanteric femur fractures.METHODS Geriatric patients who presented with AO/OTA 31A1 and 31A2 femur fractures and treated with proximal femoral nailing between July 2021 and June 2023 were include in this prospective cohort study.Based on the degree of MCR,they were divided into positive,neutral,or negative MCR groups.The demographic baseline characteristics,postoperative radiographic femoral neck-shaft angle and neck length were analyzed at 6,12 and 24 weeks post-surgery.Functional outcomes such as modified Harris Hip Score(HHS)and time to full-weight bearing were also analyzed.RESULTS 47 patients(Male:Famale 35:12)with mean age of 65.8±4.2 years were included in this study.Twenty-two cases had neutral support,nine had negative support,and sixteen had positive support in the medial cortex postoperatively.Baseline characteristics of the three groups were comparable.No significant differences were found in the femur neck length and femur neck-shaft angle changes post-surgery between the groups.The modified HHS was not found to be significant between the groups(P=0.883)as that of the time to full weight bearing(P=0.789).CONCLUSION The type of reduction achieved based on medial cortical alignment does not affect the femur neck length shortening or varus collapse.Future randomized controlled trials are needed to validate the findings noted in the study.展开更多
BACKGROUND The efficacy of various bariatric surgeries varies in reducing blood glucose levels.Given the distinct mechanisms and anatomical alterations associated with each procedure,it is crucial to compare their gly...BACKGROUND The efficacy of various bariatric surgeries varies in reducing blood glucose levels.Given the distinct mechanisms and anatomical alterations associated with each procedure,it is crucial to compare their glycemic control outcomes.We hypothesize that proximal small intestinal bypass(PSIB)is superior in blood glucose reduction over Roux-en-Y gastric bypass(RYGB)and jejunoileal bypass(JIB).AIM To compare the effectiveness of PSIB,RYGB,and JIB in lowering blood glucose.METHODS Rats with streptozotocin-induced diabetes were randomly divided into PSIB,RYGB,JIB,and sham-operated groups.Body weight,food intake,fasting blood glucose level,oral glucose tolerance test,insulin tolerance test,liver enzymes,and blood lipids were measured.RESULTS Postoperatively,only the JIB group had a lower body weight compared to the sham group.The food intake of the rats in all three surgical groups was significantly less than that in the sham group.Fasting blood glucose was reduced in all surgical groups and was lower in the PSIB group than in the RYGB and JIB groups.Glucose tolerance and insulin sensitivity improved in all three surgical groups compared to the sham group,but the improvement appeared earliest in the PSIB group.At six weeks postsurgery,the PSIB group showed a reduction in alanine transaminase levels and maintained a normal lipid profile.CONCLUSION PSIB demonstrated excellent hypoglycemic effects in the early postoperative period,and had better efficacy than RYGB and JIB.展开更多
Background:This study aimed to evaluate the prognostic value of the lymphocyte-to-monocyte ratio(LMR)and cancer antigen 724(CA724)in patients with proximal gastric cancer residing in cold climate regions.Methods:A ret...Background:This study aimed to evaluate the prognostic value of the lymphocyte-to-monocyte ratio(LMR)and cancer antigen 724(CA724)in patients with proximal gastric cancer residing in cold climate regions.Methods:A retrospective analysis was conducted on 313 patients diagnosed with proximal gastric cancer in cold climate regions between 2014 and 2017.Preoperative hematological markers,including LMR and CA724,were assessed.Receiver operating characteristic(ROC)curves were used to determine optimal cutoff values,which were then combined to form the LMR+CA724 score.Statistical analyses included Kaplan-Meier survival curves,log-rank tests,and Cox proportional hazards regression.Results:A high preoperative LMR+CA724 score was significantly associated with older age,advanced pTNM stage,vascular invasion,and elevated levels of NMPVR,NMR,and AAR.The LMR+CA724 score demonstrated a higher area under the curve(AUC)compared to LMR or CA724 alone.Multivariate analysis identified pTNM stage,Borrmann type,histological type,and the LMR+CA724 score as independent prognostic factors for overall survival(OS).A nomogram incorporating these four variables achieved an AUC of 0.817,indicating strong predictive performance.Conclusion:The LMR+CA724 score is a reliable and independent prognostic indicator for patients with proximal gastric cancer in cold climate regions.Its integration into clinical practice may support treatment planning and long-term management by enhancing personalized care.Further prospective studies are warranted to validate these findings in broader and more diverse patient populations.展开更多
BACKGROUND Proximal humerus fractures(PHFs)are common,especially in the elderly,and optimal surgical management remains debated.This study compares clinical,functional,and radiographic outcomes of deltoid split(DS)vs ...BACKGROUND Proximal humerus fractures(PHFs)are common,especially in the elderly,and optimal surgical management remains debated.This study compares clinical,functional,and radiographic outcomes of deltoid split(DS)vs deltopectoral(DP)approaches in PHFs treated with locking plates.AIM To evaluate and compare the clinical,functional,and radiographic outcomes-as well as postoperative complication rates-associated with the DS vs the DP surgical approach in the open reduction and internal fixation(ORIF)of PHFs using locking plate constructs.METHODS A multicenter retrospective study of 120 patients undergoing ORIF for closed Neer type II-IV PHFs between January 2023 and December 2023.Patients were grouped by surgical approach[DS(n=70),DP(n=50)].Outcome measures included Numeric Rating Scale(NRS)for pain,Quick-Disabilities in Arm,Shoulder,and Hand questionnaire(QuickDASH),Constant-Murley score,Short Form Health Survey-12v2,and radiographic alignment.Complication rates were recorded.Statistical significance was defined as P<0.05.RESULTS Early outcomes favored the DS group:(1)Lower NRS(3.1 vs 5.9);(2)Higher Constant-Murley(68.2 vs 50.5);and(3)Better QuickDASH(25.4 vs 37.1).Complication rate was lower in the DS group(1.66%vs 5.81%).Radiographic outcomes were comparable.Long-term results were similar between groups.CONCLUSION While both approaches yield satisfactory long-term outcomes,the DS approach is associated with faster early recovery and fewer complications,supporting its use in selected cases.展开更多
基金support from the National Key R&D Program of China(2023YFA0913902)the National Natural Science Foundation of China(32088101,22074140,and 22474136)the Dalian Institute of Chemical Physics,Chinese Academy of Sciences(DICP-I202316).
文摘Golgi apparatus(GA)-associated secretome runs through the endomembrane system and is critical for inter-and intracellular communication networks.However,achieving in situ dissection of the GA-associated secretome remains challenging owing to the scarcity of specific labeling methods.This work develops an aggregation-induced emission(AIE)luminogen-mediated photocatalytic proximity labeling strategy that allows profiling of the GA-associated secretome with high spatiotemporal precision.Leveraging an AIE luminogen-derived GA-targeting photocatalyst,this strategy achieves efficient labeling of proteins in minutes within the Golgi lumen upon light activation,which enables spatiotemporally resolved modification of histidine and tyrosine residues.We succeed in profiling secretome in both living HeLa cells and hard-to-transfect macrophage HMC3 cells,and a significant subset of GA-associated secretome with 80%specificity is determined,linking the distinct GA-associated secretory profiles to cellular characteristics.The method is further applied to proteome mapping of brain and bone metastatic lung cancer cells,which reveals the underlying roles the GA-associated secretome plays in extracellular matrix organization during metastasis.This work delivers a robust tool to break the dilemma of chemical labeling of GA-associated secretome in living cells,and provides mechanistic insights into secretion regulation at the subcellular level.
基金National Social Science Fund of China,No.24BTJ037Significant Project of the National Social Science Foundation of China,No.23&ZD102+1 种基金The Key Research Base for Philosophy and Social Sciences in Hangzhou:ESG and Sustainable Development Research Center,No.25JD053Zhejiang Provincial Statistical Scientific Research Project,No.25TJZZ12。
文摘Establishing a Regional Marine Innovation Ecosystem(RMIE)is crucial for advancing China’s maritime power strategy.Concurrently,developing a competitive RMIE serves as a strategic lever to enhance the global competitiveness of China’s marine science sector.However,research on the competitiveness of RMIE is limited.To this end,this study constructs an evaluation index system based on ecological niche theory to assess the competitiveness of RMIE in China from 2008 to 2020.The findings indicate generally fluctuating upward trends in RMIE’s competitiveness,with Shandong,Jiangsu,and Guangdong showing relatively strong positions.Notably,there are significant intra-regional imbalances and inter-regional asynchrony in RMIE’s competitiveness across China’s three major marine economic circles.Recognizing that forecasting RMIE competitiveness can inform policy formulation,this paper proposes a systematic multivariate grey interval prediction model that incorporates spatial proximity effects.This model effectively captures the interval and uncertainty characteristics of RMIE’s competitiveness while considering spatial relationships among regions.Results from comparative analysis,robustness tests,and sensitivity analysis demonstrate its superior applicability and forecasting accuracy.Additionally,interval forecasts and scenario analyses suggest that RMIE competitiveness will maintain stable growth,although unbalanced and unsynchronized development is likely to persist.Overall,the approach developed for evaluating and forecasting RMIE competitiveness offers valuable insights for effective policy formulation.
基金Supported by Special Fund for the Beijing Hope Marathon of the China Cancer Foundation,No.LC2019 L05and the Capital Health Development Research Special Fund Project,No.2024-2-4026.
文摘BACKGROUND Gastric cancer(GC)is a major global health challenge,and the treatment of proximal GC in particular presents unique clinical and surgical complexities.Currently,there is no consensus on whether proximal gastrectomy(PG)or total gastrectomy(TG)should be used for advanced proximal GC,and the choice of postoperative gastrointestinal reconstruction method remains controversial.AIM To compare the short-term efficacy,long-term survival,and postoperative reflux outcomes of PG with tubular stomach reconstruction vs TG with Roux-en-Y re-construction in patients with proximal GC following neoadjuvant chemotherapy(NACT)in an effort to provide valuable insights for clinical decision-making regarding the optimal surgical approach.METHODS A multicenter retrospective cohort study was conducted at two Chinese medical centers between December,2012 and December,2022.Patients with histologically confirmed proximal GC who received NACT followed by either PG with tubular stomach reconstruction or TG with Roux-en-Y reconstruction were included.Propensity score matching(PSM)was performed to balance baseline characteristics,and the primary endpoint was 5-year overall survival(OS).Se-condary endpoints included recurrence-free survival(RFS),postoperative complications,and reflux severity.RESULTS After PSM,244 patients(122 PG,122 TG)were finally included and all baseline characteristics were comparable between groups.The PG group had a significantly shorter operation time compared to the TG group(189.50 vs 215.00 minutes,P<0.001),with no differences in intraoperative blood loss or postoperative complications(19.68%vs 14.75%,P=0.792).The 5-year OS rates were 52.7%vs 45.5%(P=0.330),and 5-year RFS rates were 54.3%vs 47.6%(P=0.356)for the PG and TG groups,respectively.Reflux symptoms(18.0%vs 31.1%,P=0.017)and clinically significant reflux based on gastroesophageal reflux disease questionnaire scores≥8(7.4%vs 21.3%,P<0.001)were significantly less frequent in the PG group.Multivariate analysis identified histological differentiation(HR=2.98,95%CI:2.03-4.36,P<0.001)and tumor size(HR=0.26,95%CI:0.17-0.41 for tumors≤4 cm,P<0.001)as independent prognostic factors.CONCLUSION PG with tubular stomach reconstruction is comparable to TG in terms of surgical safety and long-term oncological outcomes for proximal GC patients following NACT.Additionally,PG has the advantages of shorter operation time and lower rates of postoperative reflux,suggesting potential benefits for patient quality of life.Notably,the analysis of postoperative prognostic factors,including histological differentiation and tumor size,further informs clinical decision-making and highlights the importance of individualized treatment strategies.
文摘In this study,we explore some of the best proximity point results for generalized proximal contractions in the setting of double-controlled metric-type spaces.A non-trivial example is given to elucidate our analysis,and some novel results are derived.The discovered results generalize previously known results in the context of a double controlled metric type space environment.This article’s proximity point results are the first of their kind in the realm of controlled metric spaces.To build on the results achieved in this article,we present an application demonstrating the usability of the given results.
基金Supported by the“521 Project”Funding Project Day of Lianyungang。
文摘BACKGROUND According to statistics,the incidence of proximal gastric cancer has gradually increased in recent years,posing a serious threat to human health.Tubular gastroesophageal anastomosis and double-channel anastomosis are two relatively mature anti-reflux procedures.A comparison of these two surgical procedures,tubular gastroesophageal anastomosis and double-channel anastomosis,has rarely been reported.Therefore,this study aimed to investigate the effects of these two reconstruction methods on the quality of life of patients with proximal gastric cancer after proximal gastrectomy.AIM To compare short-term clinical results of laparoscopic proximal gastrectomy with double-channel anastomosis vs tubular gastric anastomosis.METHODS Patients who underwent proximal gastrectomy at our hospital between January 2020 and January 2023 were enrolled in this retrospective cohort study.The patients were divided into an experimental group(double-channel anastomosis,33 cases)and a control group(tubular gastric anastomosis,30 cases).Baseline characteristics,surgical data,postoperative morbidities,and postoperative nutrition were recorded.RESULTS The differences in baseline data,surgical data,and postoperative complications(20.0%vs 21.2%)were not statistically significant between the two groups.There were no statistically significant differences in the levels of postoperative nutrition indicators between the two groups of patients during the preoperative period and at 3 months postoperatively.In addition,the levels of postoperative nutrition indicators in patients in the experimental group declined significantly less at 6 months and 12 months postoperatively compared with those of the control group(P<0.05).At 12 months postoperatively,the difference in anastomotic reflux esophagitis between the two groups was statistically significant(P<0.05)with the experimental group showing less reflux esophagitis.CONCLUSION Both double-channel anastomosis and tubular gastric anastomosis after proximal gastrectomy are safe and feasible.Double-channel anastomosis has a better anti-reflux effect and is more beneficial in improving the postoperative nutritional status.
文摘BACKGROUND Proximal gastrectomy(PG)for gastric cancer requires a delicate balance between oncological radicality and postoperative quality of life to mitigate reflux complications.Although the Kamikawa anastomosis has gained attention for its theoretical anti-reflux advantages,robust clinical evidence remains limited.AIM To comprehensively evaluate the efficacy,safety,and nutritional outcomes of the Kamikawa anastomosis in PG,thereby addressing a critical gap in surgical decision-making.METHODS Following PRISMA guidelines,we systematically searched PubMed,Embase,and the Cochrane Library for studies on Kamikawa anastomosis after PG.Data were pooled using fixed-or random-effects models based on heterogeneity levels(I2 statistics).The risk of bias was evaluated using Risk of Bias in Non-randomized Studies of Interventions.The protocol was prospectively registered in PROSPERO.RESULTS Of 106 screened studies,20 involving 2291 patients were included.Most studies(85%)originated from Japan,with a mean patient age of 54-73 years and a male predominance(68.1%).Overall pooled incidence of 30-day postoperative complications was 9.9%[95%confidence interval(95%CI):6.8-12.9],with major complications(Clavien-Dindo grade≥III)occurring in 6.1%(95%CI:4.6-7.7).Anastomosis-related complications were observed in 7.2%of cases,comprising leakage 1.8%(95%CI:1.1-2.4),stenosis in 7.2%(95%CI:5.8-8.5),and bleeding in 0.7%(95%CI:0.1-1.2).Pooled incidence of reflux esophagitis was 4%(95%CI:2.7-5.3)for all LA grades at 12-month follow-up,with 28.3%(95%CI:14.7-41.9)of patients requiring regular proton pump inhibitor use.Operative outcomes demonstrated a pooled mean operative time of 349.5 minutes(95%CI:331-380),estimated blood loss of 351.5 mL(95%CI:264-495),and postoperative hospital stay of 12.3 days(95%CI:11.5-13.1).Nutritional outcomes revealed 11.4%(95%CI:10.6-12.2)body weight loss at one year.Comparative analyses showed equivalent safety profiles between the Kamikawa anastomosis and double-tract reconstruction but longer operative times(P<0.001)compared with total gastrectomy.CONCLUSION These findings underscore the clinical viability of the Kamikawa anastomosis following PG,demonstrating favorable anti-reflux efficacy,acceptable incidence of anastomotic strictures,and preservation of nutritional status.
基金supported by the Young Project of the Education Department in Guizhou Province(No.2022099)the Natural Science Special of Guizhou University(No.X202220 Special Post A).
文摘Ru-based nanomaterials have been demonstrated to be highly active electrocatalysts for hydrogen evo-lution reaction(HER),yet weak water adsorption and splitting ability in neutral media thus it is rather difficult for the intermediates to adsorb on the active site.Herein,we introduce a concept of the prox-imity effect,com prising adjacent Ru and RuO_(2) nanoparticles coupled on TiO_(2)(Ru/RuO_(2)-TiO_(2)),for the synergic promotion of water molecule adsorption and splitting,significantly enhancing HER electrocatal-ysis performance.The in-situ spectroscopy experiments and density function theory(DFT)simulations demonstrated that the proximity effect between the adjacent Ru nanoparticles and RuO_(2) nanoparticles can accelerate water adsorption and splitting.As a result,the as-made Ru/RuO_(2)-TiO_(2) only need overpo-tentials of 52.7,16.0,and 16.4 mV to achieve the current density of 10 mA cm-2 in neutral,acid,and alkaline media,respectively.The mass activity of Ru/RuO_(2)-TiO_(2) in neutral media is 320 and 117 times higher than that of commercial Ru/C and Pt/C at the overpotential of 100 mV,respectively.This work emphasizes the proximity effect for activation of reactants which can be extended to other electrocat-alytic reactions.
文摘A new method for determining proximity parameters α,β ,and η in electron beam lithography is introduced on the assumption that the point exposure spread function is composed of two Gaussians.A single line is used as test pattern to determine proximity effect parameters and the normalization approach is adopted in experimental data transaction in order to eliminate the need of measuring exposure clearing dose of the resist.Furthermore,the parameters acquired by this method are successfully used for proximity effect correction in electron beam lithography on the same experimental conditions.
基金financially supported by the National Natural Science Foundation of China (Nos. 22177019, 22377010, 22371038)State Key Laboratory for Modification of Chemical Fibers and Polymer Materials (No. KF2206)。
文摘Utilizing small molecules as markers for specific cells or organs within biosystems is a crucial approach for studying and regulating physiological processes. However, current tagging strategies, due to the presence of exposed highly reactive groups, suffer from drawbacks such as low tagging efficiency or insufficient spatial specificity, thereby diminishing their expected effectiveness. Consequently, there is a pressing need to develop a strategy capable of in situ labeling of active groups in response to cellular or in vivo stimuli, ensuring both high tagging efficiency and spatial specificity. In this work, we devised a strategy for releasing aldehyde groups activated by hypochlorous acid(HOCl). Compounds synthesized through this strategy can release the fiuorophore methylene blue(MB) and aldehyde-based compounds upon HOCl activation. Given high reactivity of the released aldehyde group, it can effectively interact with macromolecules in biological systems, facilitating tagging and enabling prolonged imaging. To validate this concept, we further incorporated a naphthalimide structure with stable light emission to create SW-110. SW-110 can specifically respond to in vitro and endogenous HOCl, when release MB, it also releases naphthalimide fiuorophore with highly reactive aldehyde group for tagging within cells. This strategy provides a simple but efficient strategy for proximity tagging in situ.
文摘Electrocatalytic conversion of nitrate to ammonia(NITRR)can simultaneously achieve the removal of nitrate and the synthesis of value-added ammonia,a promising candidate to replace Haber-Bosch process with low carbon dioxide emissions.However,high hydrogenation energy barrier for*NO intermediates and insufficient supply of active hydrogen cause slow hydrogenation process,and further result in low efficiency of nitrate conversion and ammonia synthesis.Herein,a series of tandem catalysts,one-dimensional coordination polymers(1D CCPs)with dual sites are synthesized and obtained 190.4 mg h^(-1)mgcat^(-1)ammonia production rate with Faradaic efficiency of 97.16%,outperforming to the most of recent reported catalysts.The catalytic performances are well-maintained even after a long-term stability test of 1200 h,laying the foundation for practical applications.Density functional theory results reveal that the stationary adsorbed*NO on Ni site induced proximity electronic effect could reduce the energy barrier for hydrogenation of*NO intermediates over Cu site.In addition,the Ni site in the dual sites 1D CCPs is conducive to generating active hydrogen,providing rich proton source to boost the hydrogenation of*NO,and further enhancing the compatibility of deoxygenation and hydrogenation process.Our work paves a new insight into the mechanism of NITRR process and will inspire more research interests in exploring the proximity electronic effect in catalytic process.
文摘BACKGROUND Proximal gastrectomy(PG)with double tract reconstruction(DTR)has recently emerged as a function-preserving alternative to total gastrectomy(TG)with Rouxen-Y(RNY)reconstruction in patients with proximally located gastric cancer.AIM To evaluate the current evidence comparing PG-DTR with TG-RNY in terms of perioperative outcomes,long-term survival,complication rates,nutritional status and reflux esophagitis.METHODS A systematic literature search was conducted using PubMed,MEDLINE,Web of Science and the Cochrane Library for studies published between 2010 and January 2025.Search terms included gastric cancer,DTR and TG.Trials comparing PGDTR with TG-RNY or PG-esophagogastrostomy(EG)were included.Data on operative details,lymph node yield,complications(Clavien-Dindo≥III),nutritional markers and incidence of reflux were extracted.Nineteen trials met the inclusion criteria.The review followed the PRISMA guidelines.RESULTS PG-DTR was found to have comparable long-term oncological outcomes to TGRNY,despite a lower extent of lymph node dissection.Operative time and intraoperative blood loss were generally similar,with some studies favouring PGDTR.Rates of major postoperative complications were comparable between techniques.Notably,PG-DTR showed a significantly lower incidence of reflux esophagitis than PG-EG and was comparable or superior to TG-RNY in reflux control.Nutritionally,PG-DTR was associated with better post-operative weight maintenance and biochemical parameters such as haemoglobin,albumin and vitamin B12 levels compared to TG-RNY.No significant nutritional differences were observed between PG-DTR and PG-EG.PG-DTR appears to offer a balanced approach to the surgical treatment of proximal gastric cancer,combining oncological safety with functional and nutritional benefits.CONCLUSION Its superiority over TG-RNY in postoperative nutrition and reflux prevention,together with comparable complication rates and survival,supports its consideration as a preferred reconstruction method in selected patients.
文摘BACKGROUND Although surgery remains the primary treatment for proximal gastric cancer(PGC),ongoing refinements in surgical strategies are essential to improving clinical outcomes.AIM To investigate the effect of double-tract reconstruction(DTR)on immune function and stress response in patients undergoing laparoscopic proximal gastrectomy(LPG).METHODS In total,78 patients with PGC admitted between August 2020 and August 2024 were enrolled.The research group consisted of 39 patients who underwent DTR+LPG,whereas the control group comprised 39 patients who underwent laparoscopic total gastrectomy with Roux-en-Y esophagojejunostomy.Perioperative indices(intraoperative blood loss,digestive tract anastomosis time,and time to first postoperative flatus),postoperative complications(intestinal obstruction,anastomotic ulcer,diarrhea,dumping syndrome,and gastroesophageal reflux),nutritional parameters(serum albumin,hemoglobin,and body mass index),immune function immunoglobulin(IgG,IgA,and IgM),and stress response indicators(C-reactive protein,interleukin-6,and tumor necrosis factor-α)were collected and analyzed for both groups.RESULTS The intraoperative blood loss was lower(P<0.05),and the time to first postoperative flatus time was shorter(P<0.001)in the research group than in the control group.The two groups had comparable digestive tract anastomosis time(P>0.05).The overall complication rate was significantly lower in the research group than in the control group(P=0.042).Compared with the control group,the research group exhibited notably higher albumin,hemoglobin,and body mass index levels at 2 and 3 months postoperatively,as well as considerably high immunoglobulin(Ig)G,IgA,and IgM levels on postoperative day 1(P<0.05).The postoperative levels of C-reactive protein,interleukin-6,and tumor necrosis factor-αwere also lower in the research group than in the control group(P<0.001).CONCLUSION The combination of DTR and LPG in the treatment of patients with PGC is more effective in enhancing immune function and suppressing stress responses,showing more advantages over laparoscopic total gastrectomy.
基金supported by the National Natural Science Foundation of China(Nos.22264013,21961010)Hainan Province Science and Technology Special Fund(Nos.ZDYF2021SHFZ219,ZDYF2022SHFZ037)+4 种基金Special Funds of S&T Cooperation and Exchange Projects of Shanxi Province(No.202204041101040)Natural Science Research Talent Project of Hainan Medical University(No.JBGS202101)Postgraduate Innovative Research Project of Hainan(No.Qhys2021-384)Hainan Province Clinical Medical Center(2021)Project for Functional Materials and Molecular Imaging Science Innovation Group of Hainan Medical University.
文摘Acute lung injury(ALI)is a serious clinical condition with a high mortality rate.Oxidative stress and inflammatory responses play pivotal roles in the pathogenesis of ALI.ONOO^(−)is a key mediator that exacerbates oxidative damage and microvascular permeability in ALI.Accurate detection of ONOO^(−)would facilitate early diagnosis and intervention in ALI.Near-infrared fluorescence(NIRF)probes offer new solutions due to their sensitivity,depth of tissue penetration,and imaging capabilities.However,the developed ONOO^(−)fluorescent probes face problems such as interference from other reactive oxygen species and easy intracellular diffusion.To address these issues,we introduced an innovative self-immobilizing NIRF probe,DCI2F-OTf,which was capable of monitoring ONOO^(−)in vitro and in vivo.Importantly,leveraging the high reactivity of the methylene quinone(QM)intermediate,DCI2F-OTf was able to covalently label proteins in the presence of ONOO^(−),enabling in situ imaging.In mice models of ALI,DCI2F-OTf enabled real-time imaging of ONOO^(−)levels and found that ONOO^(−)was tightly correlated with the progression of ALI.Our findings demonstrated that DCI2F-OTf was a promising chemical tool for the detection of ONOO^(−),which could help to gain insight into the pathogenesis of ALI and monitor treatment efficacy.
文摘BACKGROUND Proximal gastrectomy for gastric cancer often leads to postoperative gastroeso-phageal reflux(GER).This study compares the impact of forearm anastomosis and posterior wall anastomosis techniques on GER in patients undergoing this procedure.AIM To identify the most effective method for reducing reflux symptoms while preserving gastrointestinal integrity and nutritional status.METHODS A retrospective evaluation was conducted on 60 patients who underwent proximal gastrectomy between December 2020 and December 2023,divided equally into two groups based on the anastomosis technique used(forearm or posterior wall).GER symptoms were assessed using the GER disease ques-tionnaire(GerdQ)preoperatively and on the first postoperative day.Biochemical markers[diamine oxidase(DAO),D-lactic acid,and endotoxin(ETX)]and nutritional indicators[serum ferritin(SF),prealbumin(PA),and albumin(ALB)]were measured to evaluate gastrointestinal barrier function and nutritional status.RESULTS Both groups showed significant improvements in GerdQ scores and reflux symptom scores post-treatment,with the observation group exhibiting greater reductions.Biochemical markers indicated enhanced gastrointestinal barrier function post-treatment in both groups,with notable increases in DAO,D-lactic,and ETX levels.Nutritional status indicators also demonstrated significant changes,with reductions in SF,PA,and ALB levels,suggesting an impact of treatment on inflammatory and nutritional status.CONCLUSION The forearm anastomosis technique appears to be more effective in reducing GER symptoms and preserving gastrointestinal health in patients undergoing proximal gastrectomy for gastric cancer compared to the posterior wall anastomosis technique.These preliminary findings advocate for further research to confirm the benefits and potentially standardize Forearm Anastomosis in surgical practice for gastric cancer.
文摘BACKGROUND In intertrochanteric fractures,the positive medial cortex support reduction is considered to provide a non-anatomical buttress that helps in controlled collapse.AIM To analyze the concept of medial cortical reduction(MCR)and its clinical and radiological association in geriatric intertrochanteric femur fractures.METHODS Geriatric patients who presented with AO/OTA 31A1 and 31A2 femur fractures and treated with proximal femoral nailing between July 2021 and June 2023 were include in this prospective cohort study.Based on the degree of MCR,they were divided into positive,neutral,or negative MCR groups.The demographic baseline characteristics,postoperative radiographic femoral neck-shaft angle and neck length were analyzed at 6,12 and 24 weeks post-surgery.Functional outcomes such as modified Harris Hip Score(HHS)and time to full-weight bearing were also analyzed.RESULTS 47 patients(Male:Famale 35:12)with mean age of 65.8±4.2 years were included in this study.Twenty-two cases had neutral support,nine had negative support,and sixteen had positive support in the medial cortex postoperatively.Baseline characteristics of the three groups were comparable.No significant differences were found in the femur neck length and femur neck-shaft angle changes post-surgery between the groups.The modified HHS was not found to be significant between the groups(P=0.883)as that of the time to full weight bearing(P=0.789).CONCLUSION The type of reduction achieved based on medial cortical alignment does not affect the femur neck length shortening or varus collapse.Future randomized controlled trials are needed to validate the findings noted in the study.
基金Supported by National Natural Science Foundation of China,No.82360168 and No.81960154Natural Science Foundation of Jiangxi Province,No.20212BAB206020the Foundation of Health Commission of Jiangxi Province,No.SKJP220225830.
文摘BACKGROUND The efficacy of various bariatric surgeries varies in reducing blood glucose levels.Given the distinct mechanisms and anatomical alterations associated with each procedure,it is crucial to compare their glycemic control outcomes.We hypothesize that proximal small intestinal bypass(PSIB)is superior in blood glucose reduction over Roux-en-Y gastric bypass(RYGB)and jejunoileal bypass(JIB).AIM To compare the effectiveness of PSIB,RYGB,and JIB in lowering blood glucose.METHODS Rats with streptozotocin-induced diabetes were randomly divided into PSIB,RYGB,JIB,and sham-operated groups.Body weight,food intake,fasting blood glucose level,oral glucose tolerance test,insulin tolerance test,liver enzymes,and blood lipids were measured.RESULTS Postoperatively,only the JIB group had a lower body weight compared to the sham group.The food intake of the rats in all three surgical groups was significantly less than that in the sham group.Fasting blood glucose was reduced in all surgical groups and was lower in the PSIB group than in the RYGB and JIB groups.Glucose tolerance and insulin sensitivity improved in all three surgical groups compared to the sham group,but the improvement appeared earliest in the PSIB group.At six weeks postsurgery,the PSIB group showed a reduction in alanine transaminase levels and maintained a normal lipid profile.CONCLUSION PSIB demonstrated excellent hypoglycemic effects in the early postoperative period,and had better efficacy than RYGB and JIB.
基金supported by the Postdoctoral Scientific Research Development Fund of Heilongjiang Province,2020(Grant No.LBH-Q20157).
文摘Background:This study aimed to evaluate the prognostic value of the lymphocyte-to-monocyte ratio(LMR)and cancer antigen 724(CA724)in patients with proximal gastric cancer residing in cold climate regions.Methods:A retrospective analysis was conducted on 313 patients diagnosed with proximal gastric cancer in cold climate regions between 2014 and 2017.Preoperative hematological markers,including LMR and CA724,were assessed.Receiver operating characteristic(ROC)curves were used to determine optimal cutoff values,which were then combined to form the LMR+CA724 score.Statistical analyses included Kaplan-Meier survival curves,log-rank tests,and Cox proportional hazards regression.Results:A high preoperative LMR+CA724 score was significantly associated with older age,advanced pTNM stage,vascular invasion,and elevated levels of NMPVR,NMR,and AAR.The LMR+CA724 score demonstrated a higher area under the curve(AUC)compared to LMR or CA724 alone.Multivariate analysis identified pTNM stage,Borrmann type,histological type,and the LMR+CA724 score as independent prognostic factors for overall survival(OS).A nomogram incorporating these four variables achieved an AUC of 0.817,indicating strong predictive performance.Conclusion:The LMR+CA724 score is a reliable and independent prognostic indicator for patients with proximal gastric cancer in cold climate regions.Its integration into clinical practice may support treatment planning and long-term management by enhancing personalized care.Further prospective studies are warranted to validate these findings in broader and more diverse patient populations.
文摘BACKGROUND Proximal humerus fractures(PHFs)are common,especially in the elderly,and optimal surgical management remains debated.This study compares clinical,functional,and radiographic outcomes of deltoid split(DS)vs deltopectoral(DP)approaches in PHFs treated with locking plates.AIM To evaluate and compare the clinical,functional,and radiographic outcomes-as well as postoperative complication rates-associated with the DS vs the DP surgical approach in the open reduction and internal fixation(ORIF)of PHFs using locking plate constructs.METHODS A multicenter retrospective study of 120 patients undergoing ORIF for closed Neer type II-IV PHFs between January 2023 and December 2023.Patients were grouped by surgical approach[DS(n=70),DP(n=50)].Outcome measures included Numeric Rating Scale(NRS)for pain,Quick-Disabilities in Arm,Shoulder,and Hand questionnaire(QuickDASH),Constant-Murley score,Short Form Health Survey-12v2,and radiographic alignment.Complication rates were recorded.Statistical significance was defined as P<0.05.RESULTS Early outcomes favored the DS group:(1)Lower NRS(3.1 vs 5.9);(2)Higher Constant-Murley(68.2 vs 50.5);and(3)Better QuickDASH(25.4 vs 37.1).Complication rate was lower in the DS group(1.66%vs 5.81%).Radiographic outcomes were comparable.Long-term results were similar between groups.CONCLUSION While both approaches yield satisfactory long-term outcomes,the DS approach is associated with faster early recovery and fewer complications,supporting its use in selected cases.
