The goal of this study was to investigate the clinical application of free/total prostate-specific antigen(F/T PSA)ratio,considering the new broad serum total PSA(T-PSA)“gray zone”of 2.0–25.0 ng ml^(−1)in different...The goal of this study was to investigate the clinical application of free/total prostate-specific antigen(F/T PSA)ratio,considering the new broad serum total PSA(T-PSA)“gray zone”of 2.0–25.0 ng ml^(−1)in differential diagnosis of prostate cancer(PCa)and benign prostate diseases(BPD)in men over 50 years in Western China.A total of 1655 patients were included,528 with PCa and 1127 with BPD.Serum T-PSA,free PSA(F-PSA),and F/T PSA ratio were analyzed.Receiver operating characteristic curves were used to assess the efficiency of PSA and F/T PSA ratio.There were 47.4%of cancer patients with T-PSA of 2.0–25.0 ng ml^(−1).When T-PSA was 2.0–4.0 ng ml^(−1),4.0–10.0 ng ml^(−1),and 10.0–25.0 ng ml^(−1),the area under the curve(AUC)of F/T PSA ratio was 0.749,0.769,and 0.761,respectively.The best AUC of F/T PSA ratio was 0.811 when T-PSA was 2.0–25.0 ng ml^(−1),with a specificity of 0.732,a sensitivity of 0.788,and an optimal cutoff value of 15.5%.The AUC of F/T PSA ratio in different age groups(50–59 years,60–69 years,70–79 years,and≥80 years)was 0.767,0.806,0.815,and 0.833,respectively,and the best sensitivity(0.857)and specificity(0.802)were observed in patients over 80 years.The T-PSA trend was in accordance with the Gleason score,tumor node metastasis(TNM)stage,and American Joint Committee on Cancer prognosis group.Therefore,the F/T PSA ratio can facilitate the differential diagnosis of PCa and BPD in the broad T-PSA“gray zone”.Serum T-PSA can be a Gleason score and prognostic indicator.展开更多
Aim: To evaluate the use of free/total prostate specific antigen ratio (fPSA/tPSA ratio) in improving the early diagnosis of prostate cancer. Methods: The fPSA/tPSA ratio in the serum was analyzed in 187 men with tPSA...Aim: To evaluate the use of free/total prostate specific antigen ratio (fPSA/tPSA ratio) in improving the early diagnosis of prostate cancer. Methods: The fPSA/tPSA ratio in the serum was analyzed in 187 men with tPSA ranging between 4.0 and 20.0 μg/L. All of them underwent ultrasound guided sextant prostatic biopsy. The results were calculated by SPSS 10.0 software. Results: (1) When the tPSA was within the ranges of 4.0 - 10.0 and 10.0 -20.0 μg/L, the prostate cancer detection rate was 18.1 % and 22.5 %, respectively; (2) The area under the curve (AUC) was bigger in fPSA/tPSA than in tPSA (P<0.05) in all the men; (3) When the cut off value of fPSA/tPSA ratio was set at 0.25 and the tPSA at 4.0 - 10.0 μg/L and 10.0 - 20.0 μg/L, the diagnostic sensitivity of tPSA was 90.5 % and 87.5 %, respectively. Thus at the tPSA ranges of 4.0 - 10.0 and 10.0 - 20.0 μg/L, 26.7 % and 11.3 % of biopsies could be avoided, respectively. Conclusion: The use of fPSA/tPSA ratio can improve the prostate cancer detection rate and reduce unnecessary biopsies when tPSA is within the range of 4.0 - 20.0 μg/L.展开更多
In order to better describe the phenomenon of biological invasion,this paper introduces a free boundary model of biological invasion.Firstly,the right free boundary is added to the equation with logistic terms.Secondl...In order to better describe the phenomenon of biological invasion,this paper introduces a free boundary model of biological invasion.Firstly,the right free boundary is added to the equation with logistic terms.Secondly,the existence and uniqueness of local solutions are proved by the Sobolev embedding theorem and the comparison principle.Finally,according to the relevant research data and contents of red fire ants,the diffusion area and nest number of red fire ants were simulated without external disturbance.This paper mainly simulates the early diffusion process of red fire ants.In the early diffusion stage,red fire ants grow slowly and then spread over a large area after reaching a certain number.展开更多
Comprehensive utilization of phosphogypsum(PG)has attracted much attention,especially for the recovery of rare earth elements(REEs)and gypsum due to the issues of stockpile,environmental pollution,and waste of associa...Comprehensive utilization of phosphogypsum(PG)has attracted much attention,especially for the recovery of rare earth elements(REEs)and gypsum due to the issues of stockpile,environmental pollution,and waste of associated resources.Traditional utilization methods suffered the issues of low REEs leaching efficiency,huge amount of CaSO_(4)saturated wastewater and high recovery cost.To solve these issues,this study investigated the occurrence of REEs in PG and the leaching of REEs.The results show that REEs in PG are in the forms of(1)REEs mineral inclusions,(2)REEs isomorphous substitution of Ca^(2+)in gypsum lattice,(3)dispersed soluble REEs salts.Acid leaching results demonstrate that(1)the dissolution of gypsum matrix is the control factor of REEs leaching;(2)H_(2)SO_(4)is a promising leachant considering the recycle of leachate;(3)the gypsum matrix suffers a recrystallization during the acid leaching and releases the soluble REEs from PG to aqueous solution.For the recovery of the undissolved REEs mineral inclusions,wet sieving concentrated 37.1 wt%of the REEs in a 10.7 wt%mass,increasing REEs content from 309 to 1071 ppm.Finally,a green process combining gravity separation and hydrometallurgy is proposed.This process owns the merits of wastewater free,considerable REEs recovery(about 10%increase compared with traditional processes),excellent gypsum purification(>95 wt%CaSO_(4)·2H_(2)O,with<0.06 wt%of soluble P_(2)O_(5) and<0.015 wt%of soluble F)and reagent saving(about 2/3less reagent consumption than non-cyclical leaching).展开更多
Owing to their low toxicity and remarkable stability, perovskites based on antimony and bismuth have garnered significant interest in recent years. However, A_(3)B_(2)X_(9) perovskite materials derived from antimony a...Owing to their low toxicity and remarkable stability, perovskites based on antimony and bismuth have garnered significant interest in recent years. However, A_(3)B_(2)X_(9) perovskite materials derived from antimony and bismuth face several challenges, including excessively wide band gaps, elevated defect densities, and suboptimal film quality, all of which hinder advancements in device efficiency. While extensive studies have been undertaken to investigate the effects of modulating the A-site and X-site elements in lead-free A_(3)B_(2)X_(9) perovskites, there remains a notable scarcity of reports addressing the impact of modifications to the B-site element. In this study, we investigated the alloying of antimony and bismuth within the 2D Cs_(3)B_(2)I_(6)Br_(3) perovskite. By systematically varying the ratios of two elements, we found that the incorporation of both antimony and bismuth at the B-site significantly enhances the quality of the perovskite films. Our findings indicate that a 1 : 1 ratio of antimony to bismuth produces the densest films, the highest photoluminescence intensity, and superior photovoltaic performance. Ultimately,the devices fabricated using this optimal ratio achieved an open-circuit voltage(VOC) of 1.01 V and a power conversion efficiency(PCE) of 0.645%.展开更多
Let G be a group.The family of all sets which are closed in every Hausdorf group topology of G form the family of closed sets of a T_(1) topology M_(G) on G called the Markov topology.Similarly,the family of all algeb...Let G be a group.The family of all sets which are closed in every Hausdorf group topology of G form the family of closed sets of a T_(1) topology M_(G) on G called the Markov topology.Similarly,the family of all algebraic subsets of G forms a family of closed sets for another T_(1)topology Z_(G) on G called the Zarski topology.A subgroup H of G is said to be Markov(resp.Zarski)embedded if the equality M_(G|H)=M_(H)(resp.Z_(G|H)=Z_(H))holds.I's proved that an abirary subgroup of a free group is both Zariski and Markov embedded in it.展开更多
Continuous research on Cephalotaxus plants has ultimately led to the US food and drug administration (FDA) ap-provalof homoharringtonine in 2012 for the treatment of chronic myeloid leukemia. Additionally, another imp...Continuous research on Cephalotaxus plants has ultimately led to the US food and drug administration (FDA) ap-provalof homoharringtonine in 2012 for the treatment of chronic myeloid leukemia. Additionally, another important class of natural products from Cephalotaxus plants is cephalotane diterpenoids. Since the discovery of the first member, harring-tonolide,in 1978, cephalotane diterpenoids have garnered significant attention from the scientific community due to their re-markableanti-cancer activity. The unique structural features of cephalotane diterpenoids, a 7/6/5/6-fused tetracyclic carbon skeleton and a bridged lactone, make them ideal targets for synthetic chemists. Successfully synthesizing these complex diterpenoids is of great importance for the discovery and development of anti-tumor drugs. To date, ten research groups have completed the total synthesis of 24 cephalotane diterpenoids. The latest progress in the total synthesis of cephalotane diterpe-noidsis reviewed, showcasing the importance of these innovative synthetic strategies in the efficient synthesis of complex natural products and their potential significance in advancing the field of drug discovery.展开更多
The alpine ecosystem has great potential for carbon sequestration.Soil organic carbon(SOC)and total nitrogen(TN)are highly sensitive to climate change,and their dynamics are crucial to revealing the effect of climate ...The alpine ecosystem has great potential for carbon sequestration.Soil organic carbon(SOC)and total nitrogen(TN)are highly sensitive to climate change,and their dynamics are crucial to revealing the effect of climate change on the structure,function,and services of the ecosystem.However,the spatial distribution and controlling factors of SOC and TN across various soil layers and vegetation types within this unique ecosystem remain inadequately understood.In this study,256 soil samples in 89 sites were collected from the Three River Headwaters Region(TRHR)in China to investigate SOC and TN and to explore the primary factors affecting their distribution,including soil,vegetation,climate,and geography factors.The results show that SOC and TN contents in 0-20,20-40,40-60,and 60-80 cm soil layers are 24.40,18.03,14.04,12.40 g/kg and 2.46,1.90,1.51,1.17 g/kg,respectively;with higher concentrations observed in the southeastern region compared to the northwest of the TRHR.One-way analysis of variance reveals that SOC and TN levels are elevated in the alpine meadow and the alpine shrub relative to the alpine steppe in the 0-60 cm soil layers.The structural equation model explores that soil water content is the main controlling factor affecting the variation of SOC and TN.Moreover,the geography,climate,and vegetation factors notably indirectly affect SOC and TN through soil factors.Therefore,it can effectively improve soil water and nutrient conditions through vegetation restoration,soil improvement,and grazing management,and the change of SOC and TN can be fully understood by establishing monitoring networks to better protect soil carbon and nitrogen.展开更多
BACKGROUND With the continuous development of laparoscopic techniques in recent years,laparoscopic total mesorectal excision(LapTME)and laparoscopic-assisted transanal total mesorectal excision(TaTME)have gradually be...BACKGROUND With the continuous development of laparoscopic techniques in recent years,laparoscopic total mesorectal excision(LapTME)and laparoscopic-assisted transanal total mesorectal excision(TaTME)have gradually become important surgical techniques for treating low-lying rectal cancer(LRC).However,there is still controversy over the efficacy and safety of these two surgical modalities in LRC treatment.AIM To compare the efficacy of LapTME vs TaTME in patients with LRC.METHODS Ninety-four patients with LRC who visited and were treated at the Affiliated Hengyang Hospital of Hunan Normal University&Hengyang Central Hospital between December 2022 and March 2024 were selected and divided into the LapTME(n=44)and TaTME(n=50)groups.Clinical operation indexes,postoperative recovery indicators,and postoperative complications were recorded.The anal resting pressure(ARP),anal maximum systolic pressure(MSP),and maximum tolerated volume(MTV)of the anal canal were also measured.The intestinal function of patients was evaluated by the Memorial Sloan Kettering Cancer Center(MSKCC)bowel function questionnaire.Serum norepinephrine(NE),adrenaline(AD),and cortisol(Cor)levels were measured.The Quality of Life Questionnaire Core 30(QLQC30)was used for quality of life assessment.RESULTS Compared with the LapTME group,the surgery time in the TaTME group was longer;intraoperative blood loss was low;time of anal exhaust,first postoperative ambulation,intestinal recovery,and hospital stay were shorter;and the distal incisal margin and specimen lengths were longer.The TaTME group also showed higher ARP,MSP,and MTV values and higher MSKCC and QLQ-C30 scores than the LapTME group 3 months postoperatively.Cor,AD,and NE levels were lower in the TaTME group than those in the LapTME group during recovery.CONCLUSION We demonstrated that TaTME better improved anal function,reduced postoperative stress,and accelerated postoperative recovery and,hence,was safer for patients with LRC.展开更多
Labor provisions have become a fundamental trade rule in regional and bilateral trade agreements.Although China’s legislation on pilot Free Trade Zones includes content related to labor protection,it primarily aligns...Labor provisions have become a fundamental trade rule in regional and bilateral trade agreements.Although China’s legislation on pilot Free Trade Zones includes content related to labor protection,it primarily aligns with labor indicators in“Doing Business”,the assessment of business situations issued by the World Bank.It differs from the labor rights protection focus emphasized in trade agreements.The latest strategic documents issued by the State Council of China have addressed this issue to fully achieve the goal of aligning Free Trade Zones with high-standard trade agreements.Building on the development of Free Trade Zone legislation and domestic labor law governance,China should proactively explore a tailored approach to labor provisions in Free Trade Agreements.In this approach,it should explicitly define the“baseline”and“ceiling”for labor provisions during negotiations and,within this framework,establish benchmarks for labor rights protection,enforcement mechanisms,and cross-border regulatory mechanisms suited to the specific conditions of the agreement parties.展开更多
Silicon,a leading candidate for electrode material for lithium-ion batteries,has garnered significant attention.During the initial lithiation process,the alloying reaction between silicon and lithium transforms the pr...Silicon,a leading candidate for electrode material for lithium-ion batteries,has garnered significant attention.During the initial lithiation process,the alloying reaction between silicon and lithium transforms the pristine silicon microstructure from crystalline to amorphous,resulting in plastic deformation of the amorphous phase.This study proposes the free volume theory to develop a fully coupled Cahn-Hilliard phase-field model that integrates viscoplastic deformation,free volume evolution,and diffusion.This model investigates the chemophysical phenomenon of self-limiting behavior occurring during the initial lithiation of silicon anodes.Unlike most existing models,the proposed model considers free volume-dependent diffusion using a physically-based approach.The model’s temporal variation in the lithiated phase thickness aligns well with experimental results,confirming the model’s accuracy.Stress field calculations reveal the coexistence of compressive and tensile stresses within the lithiated phase,which may not cause the limiting effect under the frame of the stress-induced diffusion.Analyses indicate that high effective stress increases free volume,enhancing lithium diffusion and augmenting the diffusion coefficient.Reducing the diffusion coefficient in the lithiated phase due to free volume evolution is the primary cause of self-limiting lithiation.展开更多
Coptis chinensis Franch.and Panax ginseng C.A.Mey.are traditional herbal medicines with millennia of documented use and broad therapeutic applications,including anti-diabetic properties.However,the synergistic effect ...Coptis chinensis Franch.and Panax ginseng C.A.Mey.are traditional herbal medicines with millennia of documented use and broad therapeutic applications,including anti-diabetic properties.However,the synergistic effect of total alkaloids from Coptis chinensis and total ginsenosides from Panax ginseng on type 2 diabetes mellitus(T2DM)and its underlying mechanism remain unclear.The research demonstrated that the optimal ratio of total alkaloids from Coptis chinensis and total ginsenosides from Panax ginseng was 4∶1,exhibiting maximal efficacy in improving insulin resistance and gluconeogenesis in primary mouse hepatocytes.This combination demonstrated significant synergistic effects in improving glucose tolerance,reducing fasting blood glucose(FBG),the weight ratio of epididymal white adipose tissue(eWAT),and the homeostasis model assessment of insulin resistance(HOMA-IR)in leptin receptor-deficient(db/db)mice.Subsequently,a T2DM liver-specific network was constructed based on RNA sequencing(RNA-seq)experiments and public databases by integrating transcriptional properties of disease-associated proteins and protein-protein interactions(PPIs).The network recovery index(NRI)score of the combined treatment group with a 4∶1 ratio exceeded that of groups treated with individual components.The research identified that activated adenosine 5'-monophosphate-activated protein kinase(AMPK)/acetyl-CoA carboxylase(ACC)signaling in the liver played a crucial role in the synergistic treatment of T2DM,as verified by western blot experiment in db/db mice.These findings demonstrate that the 4∶1 combination of total alkaloids from Coptis chinensis and total ginsenosides from Panax ginseng significantly improves insulin resistance and glucose and lipid metabolism disorders in db/db mice,surpassing the efficacy of individual treatments.The synergistic mechanism correlates with enhanced AMPK/ACC signaling pathway activity.展开更多
BACKGROUND The clinical impact of post-percutaneous coronary intervention (PCI) quantitative flow ratio (QFR) in patients treated with PCI for chronic total occlusion (CTO) was still undetermined.METHODS All CTO vesse...BACKGROUND The clinical impact of post-percutaneous coronary intervention (PCI) quantitative flow ratio (QFR) in patients treated with PCI for chronic total occlusion (CTO) was still undetermined.METHODS All CTO vessels treated with successful anatomical PCI in patients from PANDA Ⅲ trial were retrospectively measured for postPCI QFR.The primary outcome was 2-year vessel-oriented composite endpoints (VOCEs,composite of target vessel-related cardiac death,target vessel-related myocardial infarction,and ischemia-driven target vessel revascularization).Receiver operator characteristic curve analysis was conducted to identify optimal cutoff value of post-PCI QFR for predicting the 2-year VOCEs,and all vessels were stratified by this optimal cutoff value.Cox proportional hazards models were employed to calculate the hazard ratio (HR) with 95% CI.RESULTS Among 428 CTO vessels treated with PCI,353 vessels (82.5%) were analyzable for post-PCI QFR.31 VOCEs (8.7%) occurred at 2 years.Mean value of post-PCI QFR was 0.92±0.13.Receiver operator characteristic curve analysis shown the optimal cutoff value of post-PCI QFR for predicting 2-year VOCEs was 0.91.The incidence of 2-year VOCEs in the vessel with post-PCI QFR<0.91 (n=91) was significantly higher compared with the vessels with post-PCI QFR≥0.91 (n=262)(22.0%vs.4.2%,HR=4.98,95%CI:2.32–10.70).CONCLUSIONS Higher post-PCI QFR values were associated with improved prognosis in the PCI practice for coronary CTO.Achieving functionally optimal PCI results (post-PCI QFR value≥0.91) tends to get better prognosis for patients with CTO lesions.展开更多
As an important strategic fulcrum for China’s new round of opening-up,the Hainan Free Trade Port provides broad space for achieving high-quality development with its unique policy advantages and financial resources.I...As an important strategic fulcrum for China’s new round of opening-up,the Hainan Free Trade Port provides broad space for achieving high-quality development with its unique policy advantages and financial resources.In this context,integrating blockchain technology into the construction of the free trade port can not only help enhance the innovation and competitiveness of the talent cultivation system but also promote the coordinated development of the real economy and the industrial system.Based on the core characteristics of blockchain technology,such as“decentralization,traceability,and high credibility”,this paper focuses on the common problems in the cultivation of composite talents in current vocational colleges,including an imperfect school-enterprise cooperation guarantee mechanism,a lack of teaching resources,weak teaching staff,and insufficient practical conditions.It proposes a new idea of introducing blockchain technology into the vocational education system.Through the research on the cultivation model of composite-skilled talents in vocational colleges in the context of“blockchain+”,this paper aims to promote the in-depth integration of vocational education in vertical and horizontal aspects,and further promote the systematic,standardized,and high-quality development of composite talent cultivation.展开更多
The authors regret that in the original article,the structure of(–)-swainsonine(1)in Graphical abstract,Fig.1,Schemes 1 and 3 was incorrect.The correct structure is shown here.
BACKGROUND Total knee arthroplasty(TKA)aims to restore motion and alleviate pain,enabling patients to return to daily activities.Despite advances in implants,surgery,and perioperative care,patient dissatisfaction rate...BACKGROUND Total knee arthroplasty(TKA)aims to restore motion and alleviate pain,enabling patients to return to daily activities.Despite advances in implants,surgery,and perioperative care,patient dissatisfaction rates remain significant.AIM To determine whether ankle symptoms are associated with inferior results of functional recovery of the knee following TKA.METHODS This prospective study included all patients with advanced knee osteoarthritis who underwent a primary unilateral TKA between August 2019 and December 2019 with data documented by the treating surgeon and outpatient physical therapists.Patients were categorized based on ankle symptoms using the Ame-rican Orthopaedic Foot and Ankle Society(AOFAS)score:(1)Group 1(AOFAS≤85,n=30);and(2)Group 2(AOFAS>85,n=49).Active range of motion(ROM),the Knee Injury and Osteoarthritis Outcome Score(KOOS),and the visual ana-logue scale(VAS)were compared between two groups.RESULTS Postoperative KOOS,ROM,and VAS significantly improved in both groups(P<0.001).However,at three months,KOOS(P=0.02)and extension motion(P=0.01)improvements were significantly greater in group 2.CONCLUSION These findings suggest that preoperative ankle symptoms may negatively impact early knee functional recovery,particularly in KOOS scores and extension motion.展开更多
Retrieval analysis in total knee arthroplasty(TKA)has been little studied in the literature.A narrative review of the literature to understand the current importance of retrieval analysis in TKA has been conducted.On ...Retrieval analysis in total knee arthroplasty(TKA)has been little studied in the literature.A narrative review of the literature to understand the current importance of retrieval analysis in TKA has been conducted.On August 27,2024,a literature search was performed in PubMed using“TKA retrieval analysis”as keywords.A total of 160 articles were found,of which only 19 were analyzed because they were directly related to the subject of this article.Rotating-platform(mobile-bearing)TKA has no surface damage advantage over fixed-bearing TKA.TKAs with central locking mechanisms are more prone to debond from the cement mantle.No major wear of the polyethylene(PE)component in TKA using oxidized zirconium components occurs.Femoral components of cobalt-chromium roughen more than oxidized zirconium femoral components.The use of a polished tibial tray over an unpolished design is advised.At short-run assessment(15 months on average),antioxidant-stabilized highly crosslinked PE components are not clinically different in surface damage,density of crosslinking,or oxidation compared to standard remelted highly crosslinked PE components.A correlation between implant position and PE component surface damage has been reported.It shows the importance of optimizing component position to reduce PE component damage.Contemporary knee tumor megaendoprostheses show notable volumetric metal wear originated at the rotating hinge.Retrieval analysis in TKA renders relevant data on how different prosthetic designs described in the literature perform.Such information can help to improve future prosthetic designs to increase prosthetic survival.展开更多
BACKGROUND At present,the concept of surgical treatment of gastric cancer(GC)has changed from“radical treatment”to“care for patients”to a certain extent.The reconstruction method is the most likely to affect the p...BACKGROUND At present,the concept of surgical treatment of gastric cancer(GC)has changed from“radical treatment”to“care for patients”to a certain extent.The reconstruction method is the most likely to affect the postoperative life of the patient.Currently,the traditional Roux-en-Y esophagojejunostomy anastomosis is a commonly used method for gastrointestinal reconstruction after total gastrectomy for GC.However,more recent studies have shown that the traditional Roux-en-Y anastomosis is complicated in operation procedure,with more reconstruction steps and longer reconstruction time,and the incidence of postoperative complications such as adhesive intestinal obstruction,internal abdominal hernia and volvulus is high.Moreover,the incidence of Roux stasis syndrome is 10%-30%after traditional Roux-en-Y reconstruction.Thus,we modified the traditional Roux-en-Y alimentary tract reconstruction,and designed a new digestive tract reconstruction method for laparoscopy-assisted Roux-en-Y anastomosis for total gastrectomy of GC.AIM To evaluate the clinical advantages,feasibility,and safety of a modified Roux-en-Y digestive tract reconstruction in laparoscopy-assisted total gastrectomy for the treatment of GC compared with the traditional Roux-en-Y method.METHODS Ninety-seven patients who underwent laparoscopy-assisted D2 radical gastrectomy(total gastrectomy)for GC were divided into two groups:fifty-four in the conventional Roux-en-Y reconstruction group(Orr group)and forty-three in the modified Roux-en-Y reconstruction group(the modified group).Perioperative and short-term outcomes were analyzed,including complications,postoperative weight loss,hemoglobin levels,and nutritional status.RESULTS The Orr group and the modified group showed no statistically significant differences in baseline characteristics.Compared with the Orr group,the modified group had shorter digestive tract reconstruction and operation times,less intraoperative bleeding,and shorter postoperative hospital stays compared to the Orr group.Although both groups had similar amounts of intraoperative blood loss,postoperative recovery times,and hospital expenses,the Orr group experienced longer operation times and digestive tract reconstruction times.Furthermore,the modified Roux-en-Y group demonstrated significantly fewer short-term and long-term complications,with a reduced incidence of reflux esophagitis and improved nutritional status.CONCLUSION The modified Roux-en-Y digestive tract reconstruction method after laparoscopy-assisted total gastrectomy for GC offers safety,simplicity,and a reduction in bile reflux.This method shortens operation times and minimizes postoperative complications,aligns with modern rapid rehabilitation surgery trends and potentially improves patient prognosis and overall survival.This method warrants further clinical application and promotion.展开更多
Osteoarthritis(OA)is an extremely prevalent degenerative joint disease which commonly occurs in the knee.In severe cases of knee OA,total knee arthroplasty(TKA)is often indicated to relieve pain and restore limb align...Osteoarthritis(OA)is an extremely prevalent degenerative joint disease which commonly occurs in the knee.In severe cases of knee OA,total knee arthroplasty(TKA)is often indicated to relieve pain and restore limb alignment.While studies have shown how TKA improves knee symptoms,the relationship between the operated knee with the hip and ankle remains understudied.A prospective study by Buterin et al showed a significant relationship between reduced ankle symptoms and better TKA recovery.The objective of this paper is to explore ways to expand the completed study to make it more widely applicable.These include sampling patients from multiple surgical centers in different cultural backgrounds,including different etiologies of OA,extending the study time points,and evaluating the contralateral limb.Together,the study by Buterin et al combined with future work can elucidate new TKA rehabilitation techniques which focus on the entire lower extremity.展开更多
BACKGROUND The rising incidence of laryngeal cancer has led to an increasing number of total laryngectomy procedures.While voice prostheses have significantly improved post-laryngectomy rehabilitation,the risk of sali...BACKGROUND The rising incidence of laryngeal cancer has led to an increasing number of total laryngectomy procedures.While voice prostheses have significantly improved post-laryngectomy rehabilitation,the risk of salivary fistula remains a major complication.This study aims to compare the stapler and hand-sewn techniques for esophageal closure and evaluate their impact on fistula formation.AIM To compare stapler-assisted and hand-sewn esophageal closure techniques after laryngectomy regarding their impact on salivary fistula formation.METHODS A total of 52 patients(44 men,8 women),aged 43 to 77 years,underwent total laryngectomy.Esophageal reconstruction was performed using either a stapler(29 patients)or a hand-sewn technique(23 patients).A surgical stapler TA was used for esophageal closure in the stapler group.Patients were clinically monitored for fistula formation during the first 7 days postoperatively and again two weeks after discharge using fiberoptic examination.RESULTS A total of 22 salivary fistulas were recorded:17(77.3%)occurred following the hand-sewn technique,while 5(22.7%)developed in the stapler group.Addi-tionally,preoperative radiotherapy was identified as a statistically significant risk factor for fistula formation.No technical complications related to the stapler device were observed.CONCLUSION Although hand-sewn closure is commonly used after total laryngectomy,stapler-assisted closure shows lower fistula rates and is a viable esophageal reconstruction alternative.展开更多
基金This study was supported by the Sichuan Science and Technology Program(No.2020YFS0137).
文摘The goal of this study was to investigate the clinical application of free/total prostate-specific antigen(F/T PSA)ratio,considering the new broad serum total PSA(T-PSA)“gray zone”of 2.0–25.0 ng ml^(−1)in differential diagnosis of prostate cancer(PCa)and benign prostate diseases(BPD)in men over 50 years in Western China.A total of 1655 patients were included,528 with PCa and 1127 with BPD.Serum T-PSA,free PSA(F-PSA),and F/T PSA ratio were analyzed.Receiver operating characteristic curves were used to assess the efficiency of PSA and F/T PSA ratio.There were 47.4%of cancer patients with T-PSA of 2.0–25.0 ng ml^(−1).When T-PSA was 2.0–4.0 ng ml^(−1),4.0–10.0 ng ml^(−1),and 10.0–25.0 ng ml^(−1),the area under the curve(AUC)of F/T PSA ratio was 0.749,0.769,and 0.761,respectively.The best AUC of F/T PSA ratio was 0.811 when T-PSA was 2.0–25.0 ng ml^(−1),with a specificity of 0.732,a sensitivity of 0.788,and an optimal cutoff value of 15.5%.The AUC of F/T PSA ratio in different age groups(50–59 years,60–69 years,70–79 years,and≥80 years)was 0.767,0.806,0.815,and 0.833,respectively,and the best sensitivity(0.857)and specificity(0.802)were observed in patients over 80 years.The T-PSA trend was in accordance with the Gleason score,tumor node metastasis(TNM)stage,and American Joint Committee on Cancer prognosis group.Therefore,the F/T PSA ratio can facilitate the differential diagnosis of PCa and BPD in the broad T-PSA“gray zone”.Serum T-PSA can be a Gleason score and prognostic indicator.
文摘Aim: To evaluate the use of free/total prostate specific antigen ratio (fPSA/tPSA ratio) in improving the early diagnosis of prostate cancer. Methods: The fPSA/tPSA ratio in the serum was analyzed in 187 men with tPSA ranging between 4.0 and 20.0 μg/L. All of them underwent ultrasound guided sextant prostatic biopsy. The results were calculated by SPSS 10.0 software. Results: (1) When the tPSA was within the ranges of 4.0 - 10.0 and 10.0 -20.0 μg/L, the prostate cancer detection rate was 18.1 % and 22.5 %, respectively; (2) The area under the curve (AUC) was bigger in fPSA/tPSA than in tPSA (P<0.05) in all the men; (3) When the cut off value of fPSA/tPSA ratio was set at 0.25 and the tPSA at 4.0 - 10.0 μg/L and 10.0 - 20.0 μg/L, the diagnostic sensitivity of tPSA was 90.5 % and 87.5 %, respectively. Thus at the tPSA ranges of 4.0 - 10.0 and 10.0 - 20.0 μg/L, 26.7 % and 11.3 % of biopsies could be avoided, respectively. Conclusion: The use of fPSA/tPSA ratio can improve the prostate cancer detection rate and reduce unnecessary biopsies when tPSA is within the range of 4.0 - 20.0 μg/L.
基金Supported by National Natural Science Foundation of China(12101482)Postdoctoral Science Foundation of China(2022M722604)+2 种基金General Project of Science and Technology of Shaanxi Province(2023-YBSF-372)The Natural Science Foundation of Shaan Xi Province(2023-JCQN-0016)Shannxi Mathmatical Basic Science Research Project(23JSQ042)。
文摘In order to better describe the phenomenon of biological invasion,this paper introduces a free boundary model of biological invasion.Firstly,the right free boundary is added to the equation with logistic terms.Secondly,the existence and uniqueness of local solutions are proved by the Sobolev embedding theorem and the comparison principle.Finally,according to the relevant research data and contents of red fire ants,the diffusion area and nest number of red fire ants were simulated without external disturbance.This paper mainly simulates the early diffusion process of red fire ants.In the early diffusion stage,red fire ants grow slowly and then spread over a large area after reaching a certain number.
基金Project supported by the National Natural Science Foundation of China(52104354)the National Natural Science Foundation of China(51674036)+1 种基金Joint Fund for Nuclear Technology Innovation Sponsored by the National Natural Science Foundation of Chinathe China National Nuclear Corporation(U2067201)。
文摘Comprehensive utilization of phosphogypsum(PG)has attracted much attention,especially for the recovery of rare earth elements(REEs)and gypsum due to the issues of stockpile,environmental pollution,and waste of associated resources.Traditional utilization methods suffered the issues of low REEs leaching efficiency,huge amount of CaSO_(4)saturated wastewater and high recovery cost.To solve these issues,this study investigated the occurrence of REEs in PG and the leaching of REEs.The results show that REEs in PG are in the forms of(1)REEs mineral inclusions,(2)REEs isomorphous substitution of Ca^(2+)in gypsum lattice,(3)dispersed soluble REEs salts.Acid leaching results demonstrate that(1)the dissolution of gypsum matrix is the control factor of REEs leaching;(2)H_(2)SO_(4)is a promising leachant considering the recycle of leachate;(3)the gypsum matrix suffers a recrystallization during the acid leaching and releases the soluble REEs from PG to aqueous solution.For the recovery of the undissolved REEs mineral inclusions,wet sieving concentrated 37.1 wt%of the REEs in a 10.7 wt%mass,increasing REEs content from 309 to 1071 ppm.Finally,a green process combining gravity separation and hydrometallurgy is proposed.This process owns the merits of wastewater free,considerable REEs recovery(about 10%increase compared with traditional processes),excellent gypsum purification(>95 wt%CaSO_(4)·2H_(2)O,with<0.06 wt%of soluble P_(2)O_(5) and<0.015 wt%of soluble F)and reagent saving(about 2/3less reagent consumption than non-cyclical leaching).
基金financially supported by the Natural Science Foundation of Zhejiang Province, China (Grant No. LQ22F040001)China Postdoctoral Science Foundation (Grant No. 2022M723281)Science and Technology Planning Project of Shaoxing City (Grant No. 2023B41006)。
文摘Owing to their low toxicity and remarkable stability, perovskites based on antimony and bismuth have garnered significant interest in recent years. However, A_(3)B_(2)X_(9) perovskite materials derived from antimony and bismuth face several challenges, including excessively wide band gaps, elevated defect densities, and suboptimal film quality, all of which hinder advancements in device efficiency. While extensive studies have been undertaken to investigate the effects of modulating the A-site and X-site elements in lead-free A_(3)B_(2)X_(9) perovskites, there remains a notable scarcity of reports addressing the impact of modifications to the B-site element. In this study, we investigated the alloying of antimony and bismuth within the 2D Cs_(3)B_(2)I_(6)Br_(3) perovskite. By systematically varying the ratios of two elements, we found that the incorporation of both antimony and bismuth at the B-site significantly enhances the quality of the perovskite films. Our findings indicate that a 1 : 1 ratio of antimony to bismuth produces the densest films, the highest photoluminescence intensity, and superior photovoltaic performance. Ultimately,the devices fabricated using this optimal ratio achieved an open-circuit voltage(VOC) of 1.01 V and a power conversion efficiency(PCE) of 0.645%.
基金Supported by the Grant-in-Aid for Scientific Research(C)by the Japan Society for the Promotion of Science(20K03615)。
文摘Let G be a group.The family of all sets which are closed in every Hausdorf group topology of G form the family of closed sets of a T_(1) topology M_(G) on G called the Markov topology.Similarly,the family of all algebraic subsets of G forms a family of closed sets for another T_(1)topology Z_(G) on G called the Zarski topology.A subgroup H of G is said to be Markov(resp.Zarski)embedded if the equality M_(G|H)=M_(H)(resp.Z_(G|H)=Z_(H))holds.I's proved that an abirary subgroup of a free group is both Zariski and Markov embedded in it.
文摘Continuous research on Cephalotaxus plants has ultimately led to the US food and drug administration (FDA) ap-provalof homoharringtonine in 2012 for the treatment of chronic myeloid leukemia. Additionally, another important class of natural products from Cephalotaxus plants is cephalotane diterpenoids. Since the discovery of the first member, harring-tonolide,in 1978, cephalotane diterpenoids have garnered significant attention from the scientific community due to their re-markableanti-cancer activity. The unique structural features of cephalotane diterpenoids, a 7/6/5/6-fused tetracyclic carbon skeleton and a bridged lactone, make them ideal targets for synthetic chemists. Successfully synthesizing these complex diterpenoids is of great importance for the discovery and development of anti-tumor drugs. To date, ten research groups have completed the total synthesis of 24 cephalotane diterpenoids. The latest progress in the total synthesis of cephalotane diterpe-noidsis reviewed, showcasing the importance of these innovative synthetic strategies in the efficient synthesis of complex natural products and their potential significance in advancing the field of drug discovery.
基金supported by the National Science Foundation for Distinguished Young Scholars(No.42425107)Ecological Civilization Special Project of Key Research&and Development Program in Gansu Province(No.24YFFA009)the Top Talent Project of Gansu Province,Chinese Academy of Sciences Young Crossover Team Project(No.JCTD-2022-18)。
文摘The alpine ecosystem has great potential for carbon sequestration.Soil organic carbon(SOC)and total nitrogen(TN)are highly sensitive to climate change,and their dynamics are crucial to revealing the effect of climate change on the structure,function,and services of the ecosystem.However,the spatial distribution and controlling factors of SOC and TN across various soil layers and vegetation types within this unique ecosystem remain inadequately understood.In this study,256 soil samples in 89 sites were collected from the Three River Headwaters Region(TRHR)in China to investigate SOC and TN and to explore the primary factors affecting their distribution,including soil,vegetation,climate,and geography factors.The results show that SOC and TN contents in 0-20,20-40,40-60,and 60-80 cm soil layers are 24.40,18.03,14.04,12.40 g/kg and 2.46,1.90,1.51,1.17 g/kg,respectively;with higher concentrations observed in the southeastern region compared to the northwest of the TRHR.One-way analysis of variance reveals that SOC and TN levels are elevated in the alpine meadow and the alpine shrub relative to the alpine steppe in the 0-60 cm soil layers.The structural equation model explores that soil water content is the main controlling factor affecting the variation of SOC and TN.Moreover,the geography,climate,and vegetation factors notably indirectly affect SOC and TN through soil factors.Therefore,it can effectively improve soil water and nutrient conditions through vegetation restoration,soil improvement,and grazing management,and the change of SOC and TN can be fully understood by establishing monitoring networks to better protect soil carbon and nitrogen.
基金Supported by Health Research Project of Hunan Provincial Health Commission,No.D202315018915.
文摘BACKGROUND With the continuous development of laparoscopic techniques in recent years,laparoscopic total mesorectal excision(LapTME)and laparoscopic-assisted transanal total mesorectal excision(TaTME)have gradually become important surgical techniques for treating low-lying rectal cancer(LRC).However,there is still controversy over the efficacy and safety of these two surgical modalities in LRC treatment.AIM To compare the efficacy of LapTME vs TaTME in patients with LRC.METHODS Ninety-four patients with LRC who visited and were treated at the Affiliated Hengyang Hospital of Hunan Normal University&Hengyang Central Hospital between December 2022 and March 2024 were selected and divided into the LapTME(n=44)and TaTME(n=50)groups.Clinical operation indexes,postoperative recovery indicators,and postoperative complications were recorded.The anal resting pressure(ARP),anal maximum systolic pressure(MSP),and maximum tolerated volume(MTV)of the anal canal were also measured.The intestinal function of patients was evaluated by the Memorial Sloan Kettering Cancer Center(MSKCC)bowel function questionnaire.Serum norepinephrine(NE),adrenaline(AD),and cortisol(Cor)levels were measured.The Quality of Life Questionnaire Core 30(QLQC30)was used for quality of life assessment.RESULTS Compared with the LapTME group,the surgery time in the TaTME group was longer;intraoperative blood loss was low;time of anal exhaust,first postoperative ambulation,intestinal recovery,and hospital stay were shorter;and the distal incisal margin and specimen lengths were longer.The TaTME group also showed higher ARP,MSP,and MTV values and higher MSKCC and QLQ-C30 scores than the LapTME group 3 months postoperatively.Cor,AD,and NE levels were lower in the TaTME group than those in the LapTME group during recovery.CONCLUSION We demonstrated that TaTME better improved anal function,reduced postoperative stress,and accelerated postoperative recovery and,hence,was safer for patients with LRC.
基金result of the“Research on ESG Supply Chain Governance and Labor Rights Protection”(Project Number SUFE-ESG-20250315)a general subject project of the Fullgoal Institute for ESG Research,SUFE in 2025.
文摘Labor provisions have become a fundamental trade rule in regional and bilateral trade agreements.Although China’s legislation on pilot Free Trade Zones includes content related to labor protection,it primarily aligns with labor indicators in“Doing Business”,the assessment of business situations issued by the World Bank.It differs from the labor rights protection focus emphasized in trade agreements.The latest strategic documents issued by the State Council of China have addressed this issue to fully achieve the goal of aligning Free Trade Zones with high-standard trade agreements.Building on the development of Free Trade Zone legislation and domestic labor law governance,China should proactively explore a tailored approach to labor provisions in Free Trade Agreements.In this approach,it should explicitly define the“baseline”and“ceiling”for labor provisions during negotiations and,within this framework,establish benchmarks for labor rights protection,enforcement mechanisms,and cross-border regulatory mechanisms suited to the specific conditions of the agreement parties.
基金the National Natural Science Foundation of China under grant No.12372173the Natural Science Foundation of Shanghai under grant No.23ZR1468600.
文摘Silicon,a leading candidate for electrode material for lithium-ion batteries,has garnered significant attention.During the initial lithiation process,the alloying reaction between silicon and lithium transforms the pristine silicon microstructure from crystalline to amorphous,resulting in plastic deformation of the amorphous phase.This study proposes the free volume theory to develop a fully coupled Cahn-Hilliard phase-field model that integrates viscoplastic deformation,free volume evolution,and diffusion.This model investigates the chemophysical phenomenon of self-limiting behavior occurring during the initial lithiation of silicon anodes.Unlike most existing models,the proposed model considers free volume-dependent diffusion using a physically-based approach.The model’s temporal variation in the lithiated phase thickness aligns well with experimental results,confirming the model’s accuracy.Stress field calculations reveal the coexistence of compressive and tensile stresses within the lithiated phase,which may not cause the limiting effect under the frame of the stress-induced diffusion.Analyses indicate that high effective stress increases free volume,enhancing lithium diffusion and augmenting the diffusion coefficient.Reducing the diffusion coefficient in the lithiated phase due to free volume evolution is the primary cause of self-limiting lithiation.
基金supported by the Pioneer and Leading Goose R&D Program of Zhejiang Province(No.2024C03106)the National Natural Science Foundation of China(No.U23A20513)+1 种基金Ningbo Top Medical and Health Research Program(No.2022030309)the Innovation Team and Talents Cultivation Program of the National Administration of Traditional Chinese Medicine(No.ZYYCXTD-D-202002).
文摘Coptis chinensis Franch.and Panax ginseng C.A.Mey.are traditional herbal medicines with millennia of documented use and broad therapeutic applications,including anti-diabetic properties.However,the synergistic effect of total alkaloids from Coptis chinensis and total ginsenosides from Panax ginseng on type 2 diabetes mellitus(T2DM)and its underlying mechanism remain unclear.The research demonstrated that the optimal ratio of total alkaloids from Coptis chinensis and total ginsenosides from Panax ginseng was 4∶1,exhibiting maximal efficacy in improving insulin resistance and gluconeogenesis in primary mouse hepatocytes.This combination demonstrated significant synergistic effects in improving glucose tolerance,reducing fasting blood glucose(FBG),the weight ratio of epididymal white adipose tissue(eWAT),and the homeostasis model assessment of insulin resistance(HOMA-IR)in leptin receptor-deficient(db/db)mice.Subsequently,a T2DM liver-specific network was constructed based on RNA sequencing(RNA-seq)experiments and public databases by integrating transcriptional properties of disease-associated proteins and protein-protein interactions(PPIs).The network recovery index(NRI)score of the combined treatment group with a 4∶1 ratio exceeded that of groups treated with individual components.The research identified that activated adenosine 5'-monophosphate-activated protein kinase(AMPK)/acetyl-CoA carboxylase(ACC)signaling in the liver played a crucial role in the synergistic treatment of T2DM,as verified by western blot experiment in db/db mice.These findings demonstrate that the 4∶1 combination of total alkaloids from Coptis chinensis and total ginsenosides from Panax ginseng significantly improves insulin resistance and glucose and lipid metabolism disorders in db/db mice,surpassing the efficacy of individual treatments.The synergistic mechanism correlates with enhanced AMPK/ACC signaling pathway activity.
基金supported by the CAMS Innovation Fund for Medical Sciences(No.2021-I2M-1-008)the National High Level Hospital Clinical Research Funding(No.2023-GSP-GG-2&No.2023-GSP-QN-34&No.2023-GSPRC-05).
文摘BACKGROUND The clinical impact of post-percutaneous coronary intervention (PCI) quantitative flow ratio (QFR) in patients treated with PCI for chronic total occlusion (CTO) was still undetermined.METHODS All CTO vessels treated with successful anatomical PCI in patients from PANDA Ⅲ trial were retrospectively measured for postPCI QFR.The primary outcome was 2-year vessel-oriented composite endpoints (VOCEs,composite of target vessel-related cardiac death,target vessel-related myocardial infarction,and ischemia-driven target vessel revascularization).Receiver operator characteristic curve analysis was conducted to identify optimal cutoff value of post-PCI QFR for predicting the 2-year VOCEs,and all vessels were stratified by this optimal cutoff value.Cox proportional hazards models were employed to calculate the hazard ratio (HR) with 95% CI.RESULTS Among 428 CTO vessels treated with PCI,353 vessels (82.5%) were analyzable for post-PCI QFR.31 VOCEs (8.7%) occurred at 2 years.Mean value of post-PCI QFR was 0.92±0.13.Receiver operator characteristic curve analysis shown the optimal cutoff value of post-PCI QFR for predicting 2-year VOCEs was 0.91.The incidence of 2-year VOCEs in the vessel with post-PCI QFR<0.91 (n=91) was significantly higher compared with the vessels with post-PCI QFR≥0.91 (n=262)(22.0%vs.4.2%,HR=4.98,95%CI:2.32–10.70).CONCLUSIONS Higher post-PCI QFR values were associated with improved prognosis in the PCI practice for coronary CTO.Achieving functionally optimal PCI results (post-PCI QFR value≥0.91) tends to get better prognosis for patients with CTO lesions.
基金Exploration and Practice of the Application of Blockchain Technology in the Cultivation of Composite Talents in the Context of the Free Trade Port(Project No.:HKJG2023-18)。
文摘As an important strategic fulcrum for China’s new round of opening-up,the Hainan Free Trade Port provides broad space for achieving high-quality development with its unique policy advantages and financial resources.In this context,integrating blockchain technology into the construction of the free trade port can not only help enhance the innovation and competitiveness of the talent cultivation system but also promote the coordinated development of the real economy and the industrial system.Based on the core characteristics of blockchain technology,such as“decentralization,traceability,and high credibility”,this paper focuses on the common problems in the cultivation of composite talents in current vocational colleges,including an imperfect school-enterprise cooperation guarantee mechanism,a lack of teaching resources,weak teaching staff,and insufficient practical conditions.It proposes a new idea of introducing blockchain technology into the vocational education system.Through the research on the cultivation model of composite-skilled talents in vocational colleges in the context of“blockchain+”,this paper aims to promote the in-depth integration of vocational education in vertical and horizontal aspects,and further promote the systematic,standardized,and high-quality development of composite talent cultivation.
文摘The authors regret that in the original article,the structure of(–)-swainsonine(1)in Graphical abstract,Fig.1,Schemes 1 and 3 was incorrect.The correct structure is shown here.
文摘BACKGROUND Total knee arthroplasty(TKA)aims to restore motion and alleviate pain,enabling patients to return to daily activities.Despite advances in implants,surgery,and perioperative care,patient dissatisfaction rates remain significant.AIM To determine whether ankle symptoms are associated with inferior results of functional recovery of the knee following TKA.METHODS This prospective study included all patients with advanced knee osteoarthritis who underwent a primary unilateral TKA between August 2019 and December 2019 with data documented by the treating surgeon and outpatient physical therapists.Patients were categorized based on ankle symptoms using the Ame-rican Orthopaedic Foot and Ankle Society(AOFAS)score:(1)Group 1(AOFAS≤85,n=30);and(2)Group 2(AOFAS>85,n=49).Active range of motion(ROM),the Knee Injury and Osteoarthritis Outcome Score(KOOS),and the visual ana-logue scale(VAS)were compared between two groups.RESULTS Postoperative KOOS,ROM,and VAS significantly improved in both groups(P<0.001).However,at three months,KOOS(P=0.02)and extension motion(P=0.01)improvements were significantly greater in group 2.CONCLUSION These findings suggest that preoperative ankle symptoms may negatively impact early knee functional recovery,particularly in KOOS scores and extension motion.
文摘Retrieval analysis in total knee arthroplasty(TKA)has been little studied in the literature.A narrative review of the literature to understand the current importance of retrieval analysis in TKA has been conducted.On August 27,2024,a literature search was performed in PubMed using“TKA retrieval analysis”as keywords.A total of 160 articles were found,of which only 19 were analyzed because they were directly related to the subject of this article.Rotating-platform(mobile-bearing)TKA has no surface damage advantage over fixed-bearing TKA.TKAs with central locking mechanisms are more prone to debond from the cement mantle.No major wear of the polyethylene(PE)component in TKA using oxidized zirconium components occurs.Femoral components of cobalt-chromium roughen more than oxidized zirconium femoral components.The use of a polished tibial tray over an unpolished design is advised.At short-run assessment(15 months on average),antioxidant-stabilized highly crosslinked PE components are not clinically different in surface damage,density of crosslinking,or oxidation compared to standard remelted highly crosslinked PE components.A correlation between implant position and PE component surface damage has been reported.It shows the importance of optimizing component position to reduce PE component damage.Contemporary knee tumor megaendoprostheses show notable volumetric metal wear originated at the rotating hinge.Retrieval analysis in TKA renders relevant data on how different prosthetic designs described in the literature perform.Such information can help to improve future prosthetic designs to increase prosthetic survival.
文摘BACKGROUND At present,the concept of surgical treatment of gastric cancer(GC)has changed from“radical treatment”to“care for patients”to a certain extent.The reconstruction method is the most likely to affect the postoperative life of the patient.Currently,the traditional Roux-en-Y esophagojejunostomy anastomosis is a commonly used method for gastrointestinal reconstruction after total gastrectomy for GC.However,more recent studies have shown that the traditional Roux-en-Y anastomosis is complicated in operation procedure,with more reconstruction steps and longer reconstruction time,and the incidence of postoperative complications such as adhesive intestinal obstruction,internal abdominal hernia and volvulus is high.Moreover,the incidence of Roux stasis syndrome is 10%-30%after traditional Roux-en-Y reconstruction.Thus,we modified the traditional Roux-en-Y alimentary tract reconstruction,and designed a new digestive tract reconstruction method for laparoscopy-assisted Roux-en-Y anastomosis for total gastrectomy of GC.AIM To evaluate the clinical advantages,feasibility,and safety of a modified Roux-en-Y digestive tract reconstruction in laparoscopy-assisted total gastrectomy for the treatment of GC compared with the traditional Roux-en-Y method.METHODS Ninety-seven patients who underwent laparoscopy-assisted D2 radical gastrectomy(total gastrectomy)for GC were divided into two groups:fifty-four in the conventional Roux-en-Y reconstruction group(Orr group)and forty-three in the modified Roux-en-Y reconstruction group(the modified group).Perioperative and short-term outcomes were analyzed,including complications,postoperative weight loss,hemoglobin levels,and nutritional status.RESULTS The Orr group and the modified group showed no statistically significant differences in baseline characteristics.Compared with the Orr group,the modified group had shorter digestive tract reconstruction and operation times,less intraoperative bleeding,and shorter postoperative hospital stays compared to the Orr group.Although both groups had similar amounts of intraoperative blood loss,postoperative recovery times,and hospital expenses,the Orr group experienced longer operation times and digestive tract reconstruction times.Furthermore,the modified Roux-en-Y group demonstrated significantly fewer short-term and long-term complications,with a reduced incidence of reflux esophagitis and improved nutritional status.CONCLUSION The modified Roux-en-Y digestive tract reconstruction method after laparoscopy-assisted total gastrectomy for GC offers safety,simplicity,and a reduction in bile reflux.This method shortens operation times and minimizes postoperative complications,aligns with modern rapid rehabilitation surgery trends and potentially improves patient prognosis and overall survival.This method warrants further clinical application and promotion.
文摘Osteoarthritis(OA)is an extremely prevalent degenerative joint disease which commonly occurs in the knee.In severe cases of knee OA,total knee arthroplasty(TKA)is often indicated to relieve pain and restore limb alignment.While studies have shown how TKA improves knee symptoms,the relationship between the operated knee with the hip and ankle remains understudied.A prospective study by Buterin et al showed a significant relationship between reduced ankle symptoms and better TKA recovery.The objective of this paper is to explore ways to expand the completed study to make it more widely applicable.These include sampling patients from multiple surgical centers in different cultural backgrounds,including different etiologies of OA,extending the study time points,and evaluating the contralateral limb.Together,the study by Buterin et al combined with future work can elucidate new TKA rehabilitation techniques which focus on the entire lower extremity.
文摘BACKGROUND The rising incidence of laryngeal cancer has led to an increasing number of total laryngectomy procedures.While voice prostheses have significantly improved post-laryngectomy rehabilitation,the risk of salivary fistula remains a major complication.This study aims to compare the stapler and hand-sewn techniques for esophageal closure and evaluate their impact on fistula formation.AIM To compare stapler-assisted and hand-sewn esophageal closure techniques after laryngectomy regarding their impact on salivary fistula formation.METHODS A total of 52 patients(44 men,8 women),aged 43 to 77 years,underwent total laryngectomy.Esophageal reconstruction was performed using either a stapler(29 patients)or a hand-sewn technique(23 patients).A surgical stapler TA was used for esophageal closure in the stapler group.Patients were clinically monitored for fistula formation during the first 7 days postoperatively and again two weeks after discharge using fiberoptic examination.RESULTS A total of 22 salivary fistulas were recorded:17(77.3%)occurred following the hand-sewn technique,while 5(22.7%)developed in the stapler group.Addi-tionally,preoperative radiotherapy was identified as a statistically significant risk factor for fistula formation.No technical complications related to the stapler device were observed.CONCLUSION Although hand-sewn closure is commonly used after total laryngectomy,stapler-assisted closure shows lower fistula rates and is a viable esophageal reconstruction alternative.
