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Background: The surgical approach for patients with Siewert type II AEG remains controversial. Several studies have described a new laparoscopic radical resection approach of Siewert type II AEG through the left diaphragm. However, the technical safety and feasibility of the new surgical approach compared with the transhiatal approach have not yet been tested. Study design: We retrospectively reviewed patients with AEG who underwent TSLG and LTH operations in the Guangdong Provincial Hospital of Chinese Medicine between January 2017 and April 2021. Histologically confirmed AEG and D2 lymphadenectomy with curative R0 patients were included, and patients with Siewert I/III AEG or distant metastasis were excluded. Blood loss, the amount of harvested lymph node, and complications related to surgery were evaluated. Results: A total of 99 patients with Siewert type II AEG were analyzed, 44 in the TSLG group and 55 in the LTH group. There was no difference in clinicopathological features between the two groups. The more harvested lymph node (23.33 ± 11.41 vs. 32.18 ± 12.85, p< 0.01), lower mediastinal lymph node (1.07 ± 2.08 vs. 3.25 ± 3.31, p< 0.01), and longer proximal margin length (3.08 ± 1.19 vs. 4.47 ± 0.95 cm, p< 0.01) were observed in the TSLG group. The rate of cure (R0 gastrectomy) in the TSLG group was higher than that in the LTH group (100% vs. 89.09%, p= 0.03). Conclusion: The TSLG approach is associated with improved surgical views, simplified lymphatic dissection in the inferior mediastinum, and more reliable margins. TSLG surgery may be an effective addition to LTH surgery, particularly when lower mediastinal lymph node metastases are suspected. Graphical abstract:

In response to the insufficient detection capability of laser paint stripping effects for a single modality and the high operational and cost requirements of existing multi-monitoring technologies, a method is proposed to integrate visual and auditory signals for evaluating laser paint stripping effects. Utilizing wavelet packet transformation for a more detailed understanding of the variations in paint-stripping sound signals, more representative energy features are extracted. The EfficientNetv2 network, optimized with an attention mechanism, further enhances the focus on crucial features. The image feature vectors are concatenated with the energy features extracted from the sound signals, forming a new and more informative feature vector for paint stripping effect discrimination. Experimental results demonstrate that the multi-feature fusion detection algorithm significantly improves the accuracy of paint stripping effect discrimination, reaching 98.7%. The 98.9% F1-Score and the smoothly converging loss curve also indicate the algorithm's effective control over category imbalance and training stability. This research is of paramount importance for improving the evaluation of laser cleaning technology effects and provides insights into multi-modal feature fusion for other relevant fields of study.

Axitinib is emerging as a first-line combination treatment drug for metastatic renal cell carcinoma, but the acquired resistance significantly bothers the treatment efficacy. This article is to investigate the impact of fragile X mental retardation autosomal homolog 1 (FXR1) and its mechanistic involvement with Kelch-like epoxy chloropropan-associated protein 1 (KEAP1)/NF-E2-related factor 2 (Nrf2) pathway on cell resistance to axitinib in clear cell renal cell carcinoma (ccRCC). Establishment of axitinib resistance cells (786-O, Caki-1, 786-O/axitinib, or Caki-1/axitinib) was made, and the cells were then transfected with sh-FXR1, or co-transfected with sh-FXR1 and sh-KEAP1. The quantitative real-time PCR (qRT-PCR) and western blotting assays were employed to measure the expression of FXR1, KEAP1, Nrf2, LC3 II/I, Beclin 1, p62, MDR-1, and MRP-1. In addition, the binding between FXR1 and KEAP1 was verified by RNA-immunoprecipitation and RNA pull-down assays, and FXR1-dependent KEAP1 mRNA degradation was determined. Herein, FXR1 was demonstrated to be overexpressed in ccRCC cells, and showed higher expression in 786-O/axitinib and Caki-1/axitinib cells. Mechanistically, FXR1 enriched KEAP1 mRNA, and pulled downed by biotinylated KEAP1 probes. Results of RNA stability assay reveled that KEAP mRNA stability was suppressed by FXR1. Furthermore, knockdown of FXR1 promoted cell apoptosis and showed a restrained feature on cell resistance to axitinib. Of note, KEAP1 knockdown suppressed cell autophagy, oxidative stress, resistance to axitinib, and promoted apoptosis, despite FXR1 was downregulated in ccRCC cells. In conclusion, FXR1 played an encouraging role in ccRCC cell resistance to axitinib by modulating KEAP/Nrf2 pathway.

Molybdenum dialkyldithiocarbamate (MoDTC) is widely used as a friction modifier in engine lubricating oil. Under MoDTC lubrication, the friction and wear behaviors of tungsten-doped diamond-like carbon (W-DLC) films annealed at 100–400 °C were discussed and evaluated using scanning electron microscopy (SEM), atomic force microscopy (AFM), and Raman spectroscopy. Under (polymerized alpha olefin) PAO + MoDTC lubrication, the coefficient of friction of all samples decreased, but the wear rates of the W-DLC films annealed at 300 °C increased significantly. By interacting with zinc dialkyldithiophosphate (ZDDP), the wear rates of W-DLC films annealed at different temperatures declined significantly owing to the formation of dense phosphate tribofilms on the worn surfaces.

Pregnancy complicated with ovarian endometrioma is a risk factor for preterm delivery and rupture or infection during pregnancy. This study aimed to clarify the effectiveness and safety of transvaginal aspiration during pregnancy for endometrioma diagnosed in the first trimester.

Diamond-like carbon (DLC) coatings containing 0.7%, 5.8%, and 23.3% Ti were deposited via pulsed cathodic arc deposition and magnetron sputtering on AISI 316L stainless steel substrates. The varied Ti content was controlled by setting Ti target current at 3, 5, and 7A. The composition, microstructure, mechanical, and tribological properties of Ti-doped DLC (Ti-DLC) coatings were investigated using X-ray photoelectron spectroscopy, Raman spectroscopy, nanoindentation, and ball-on-disc tribometer. The results show that TiC formed when Ti content in the coating was higher than 5.8 at% and the ID/IG ratios increased gradually with the increasing Ti content. Ti-DLC with 0.7 at% Ti had the highest H/E and H3/E2 ratios and exhibited optimal tribological properties under lubrication, especially when zinc dialkyldithio-phosphate (ZDDP) was contained in the oil. Furthermore, ZDDP tribofilms played an important role in wear reduction by protecting the rubbing surfaces against the adhesion and suppressing the tribo-induced graphitization of DLC coatings.

Nutrients stimulate the anabolic synthesis of proteins and lipids, but selective insulin resistance in obesity biases the anabolic program toward lipogenesis. Here, we report the identification of a DNAJB9-driven program that favors protein synthesis and energy production over lipid accumulation. We show there are two pools of DNAJB9 cochaperone. DNAJB9 in the ER lumen promotes the degradation of the lipogenic transcription factor SREBP1c through ERAD, whereas its counterpart on the ER membrane promotes the assembly of mTORC2 in the cytosol and stimulates the synthesis of proteins and ATP. The expression of Dnajb9is induced by nutrients and downregulated in the obese mouse liver. Restoration of hepatic DNAJB9 expression effectively improves insulin sensitivity, restores protein synthesis, and suppresses food intake, accompanied by reduced hepatic steatosis and adiposity in multiple mouse models of obesity. Therefore, targeting the anabolic balance may provide a unique opportunity to tackle obesity and diabetes.

The contribution of angiogenesis inhibitor TNP-470 to the growth and metastasis of ACHN renal cell carcinoma (RCC) was studied. TNP-470 (40 mg/kg, every two days) was administrated to BABL/c nude mice bearing ACHN RCC. The mice were sacrificed after a treatment duration of 31 days and the weight and volume of subcutaneous tumors as well as foci of lung metastasis were measured. The microvascular density (MVD) of the tumor as well as the PCNA index and apoptotic index of the tumor cells were evaluated immunohistochemically. Result showed that the growth of ACHN RCC was suppressed significantly and none metastasis was observed in TNP-470-treated mice. Compared with the control group, the MVD was decreased markedly (P<0.01) and the apoptotic index was increased significantly (P<0.01) in the treated group. The tumor volume was positively correlated to the MVD (r=0.7144,P<0.01) and inversely correlated to the apoptotic index (r=−0.8607,P<0.01), and MVD was conversely correlated to the apoptotic index. It was determined that TNP-470 could effectively inhibit angiogenesis of ACHN RCC, which resulting in ischemia and hypoxia, leading to increased apoptosis, thus obviously suppressing the growth and metastasis of ACHN RCC in nude mice.