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Background: Laparoscopic radical resection has become the most important treatment for resectable colorectal cancer (CRC). However, there is still a lack of researches on the efficacy and safety of reduced-port laparoscopic surgery (RPLS) versus conventional laparoscopic surgery (CLS) in the treatment of CRC. Patients and methods: From January 2019 to July 2022, 698 patients with CRC received surgical treatment in the Sixth Affiliated Hospital of Sun Yat-sen University were enrolled in this retrospective cohort study. Patients were divided into RPLS group (n = 220) and CLS group (n = 478) according to their surgical procedures. Propensity score matching (PSM) was used to adjust the differences in baseline characteristics. The incidence of perioperative outcomes and survival rates related results were analyzed after PSM. Results: Four hundred twenty-two patients were equally divided into RPLS group (n = 211) and CLS group (n = 211) after PSM. There were no statistically significant differences in overall survival (OS) and progression-free survival (PFS) between the two groups (P value was 0.773 and 0.579 respectively). The perioperative outcomes of patients between the two groups were comparable, except that patients in the RPLS group had a shorter postoperative hospital stay (P value < 0.001). Conclusion: For patients with CRC, both RPLS and CLS might be acceptable surgical options. No significant differences in perioperative outcomes, PFS rates and OS rates were observed between the two groups. For certain cases, RPLS was superior to CLS in terms of postoperative recovery. [ABSTRACT FROM AUTHOR]

Introduction Cervical cancer (CC) is the fourth most common cancer and represents one of the leading causes of cancer-related mortality in women worldwide, with approximately 570,000 new cases and 311,000 [...], BACKGROUND. Adoptive cell therapy (ACT) with tumor-infiltrating lymphocytes (TILs) has achieved remarkable clinical efficacy in metastatic cancers such as melanoma and cervical cancer (CC). Here, we explored the safety, feasibility, and preliminary tumor response and performed translational investigations of adjuvant immunotherapy using infusion of autogenous TILs (auto-TILs) following concurrent chemoradiotherapy (CCRT) in patients with CC who had locally advanced disease. METHODS. Twenty-seven patients with CC with stage III-IV disease were recruited in this single-center, phase I study. TILs were isolated from lesions in the uterine cervix and generated under good manufacturing practice (GMP) conditions and then infused after CCRT plus i.m. IL-2 injections. RESULTS. TILs from 20 of the 27 patients were successfully expanded, with a feasibility of 74.1%. Twelve patients received TILs following CCRT. Adverse events (AEs) were primarily attributable to CCRT. Only 1 (8.3%) patient experienced severe toxicity with a grade 3 hypersensitivity reaction after TIL infusion. No autoimmune AEs, such as pneumonitis, hepatitis, or myocarditis, occurred, and there were no treatment-related mortalities. Nine of 12 patients (75.0%) attained a complete response, with a disease control duration of 9-22 months. Translational investigation showed that the transcriptomic characteristics of the infused TIL products and some immune biomarkers in the tumor microenvironment and serum of patients with CC at baseline were correlated with the clinical response. CONCLUSION. TIL-based ACT following CCRT was safe in an academic center setting, with potentially effective responses in patients with locally advanced CC. "Hot" inflammatory immune environments were beneficial to the clinical efficacy of TIL-based ACT as adjuvant therapy. TRIAL REGISTRATION. ClinicalTrials.gov NCT04443296. FUNDING. National Key R&D Program; Sci-Tech Key Program of the Guangzhou City Science Foundation; the Guangdong Province Sci-Tech International Key Program; the National Natural Science Foundation of China.

Reliability-based multidisciplinary design optimization (RBMDO) has been considered as an efficient technology for addressing complex engineering design optimization problems under uncertainties. Current RBMDO methods, however, perform design optimization either in a sequential manner or in an all-at-once manner, which does not support design autonomy in various disciplines and has low computational efficiency. In this article, a reliability-based multidisciplinary concurrent design optimization (RBMCDO) method is proposed to solve the problems of lack of design autonomy and low computational efficiency in current RBMDO methods. In RBMCDO, the multidisciplinary reliability constraints are first transformed into deterministic constraints using the multidisciplinary probabilistic constraint transformation method, developed in this work based on the performance measure approach and Karush–Kuhn–Tucker conditions. The RBMDO problem is then decomposed into several optimization problems of a single discipline, which are solved in parallel based on the collaborative optimization strategy. Two examples are used to verify the proposed method. [ABSTRACT FROM AUTHOR]

Currently, there are no specific therapeutic agents available for the treatment of coronavirus disease 2019 (Covid-19). The present study aimed to assess the efficacy of high-dose ulinastatin for the treatment of patients with Covid-19. A total of 12 patients hospitalized with confirmed severe acute respiratory syndrome coronavirus 2 infection were treated with a high dose of ulinastatin alongside standard care. Changes in clinical manifestations, laboratory examinations and chest images were retrospectively analyzed. A total of 10 patients with severe Covid-19 and two patients with moderate Covid-19 received ulinastatin treatment. The average age of the patients was 68.0±11.9 years (age range, 48-87 years). In total, nine of the 12 patients (75.0%) had one or more comorbidities. The most common symptoms on admission were fever (8/12, 66.7%), cough (5/12, 41.7%) and dyspnea (5/12, 41.7%). The percentage of lymphocytes was decreased in 41.7% of patients (5/12) and 58.3% of patients (7/12) had elevated hypersensitive C-reactive protein (CRP) levels (mean, 49.70±77.70 mg/l). The white blood cell levels and the percentage of lymphocytes returned to normal in all of the patients, and CRP was significantly decreased and returned to normal in 83.3% of patients (10/12; mean, 6.87±6.63 mg/l) on day 7 after ulinastatin treatment. Clinical symptoms were relieved synchronously. The peripheral oxygen saturation improved and 66.7% of the patients (8/12) did not require further oxygen therapy 7 days after ulinastatin treatment. No patients required intensive care unit admission or mechanical ventilation. All patients revealed different degrees of absorption of pulmonary lesions after treatment. Compared with the standard care group, ulinastatin treatment significantly prevented illness deterioration. In conclusion, these preliminary data revealed that high-dose ulinastatin treatment was safe and exhibited a potential beneficial effect for patients with Covid-19. [ABSTRACT FROM AUTHOR]

Dune is often considered as a degraded ecosystem. Natural vegetation restoration and stable artificial vegetation construction are the basic means restoring dune ecosystem. Based on long-term study of dune ecosystem, by taking into consideration both the philosophical principles of unity of opposites and dynamic change, and related ecological theories, we put forward some ecological relations that should be paid attention to in the study of vegetation assembly from the perspective of the uniqueness of dune ecosystem. We discussed the necessity of coupling relationships of scale-pattern-process and the transformation of synergy-tradeoff relationships, interpreted the importance of distinguishing sand dune stabilized and shifting phases, disturbance and stress, wind erosion and sand burial in the study of vegetation process. We further explored the applied value of niche law or neutral law in the study of dune vegetation process. Finally, we discussed the issues that should be paid attention to in the study of dune vegetation process from the aspects of adaptability to aeolian activities and drought tolerance, physiological and reproductive process, sexual and asexual reproduction of plants. This study would provide theoretical supports for vegetation restoration and stable vegetation construction of dune ecosystem.

We established the systematic concept framework of shelterbelt construction, with "shelterbelts" as the core concern in the construction of integrated ecosystems including mountain, river, forest, farmland, lake, grassland and sandy-land in semi-arid wind-sand areas. In the construction of shelterbelts, it is necessary to adhere to the principles of scientific coordination and systematic management, considering the carrying capacity of water resources, the demand for dust control, the greening and beautification effects, as well as the principle of improving economic benefits. In practice, the construction methods should base on the types and temporal-spatial distribution of shelterbelts, following the shelterbelts construction theory and technology to form different structure and service functions, achieving the functional goals of shelterbelts. By focusing on the key elements including people, forests, grass, fields, water, and sand, we put forward the timeliness, practicality, and scientificity of shelterbelt construction, proposing construction methods for farmland shelterbelts, pastureland shelterbelts, windbreak and sand-fixing forests and protective forest around village (city), which might provide production technical support for the high-quality construction of green ecological barrier in northern China.

Integrated management of "mountain-river-forest-farmland-lake-grassland-sandland" has become an important concept of ecological environment construction in arid areas. Although some major projects have been implemented in the sand areas, but the scientific and technical principles of integrated management are not clear and have not been fully reflected in these projects. Considering such cases, we discussed the challenges, scientific principles, technical principles and implementation priorities of the integrated management of Horqin Sand Land. In Horqin Sand Land, the relationships between forest and farmland, forest and forest, forest and water, farmland and water, forest and grassland, sand land and water, farmland and grassland were not well coordinated, resulting in resource imbalance and low ecologic services. The integrated management should follow scientific principles and laws, including aeolian sand movement law, grassland interface theory, water resource balance theory, biodiversity maintenance theory, landscape ecology theory, and ecosystem services. At the technical level, the principles of water-sediment relationship coordination, landscape design optimization, prevention and control technologies and modes multi-directional synergia, natural and man-made landscapes harmonies, "production-ecological" space layout balance should be highlighted. The key points of integrated management should focus on the function improvement of sand dunes and shelter forests, the efficiency improvement of farmlands and grasslands, the ecological conservation of lakes, the greening and beautification of human settlements, the ecological restoration of engineering projects. This review could provide reference for the integrated ecological environment construction in Horqin Sand Land and the sand areas of northern China.

Objective: To evaluate the association of longitudinal changes in physical activity (PA) with long-term outcomes after implantable cardioverter-defibrillator (ICD) or cardiac resynchronization therapy defibrillator (CRT-D) implantation., Methods: Patients with ICD/CRT-D implantation from SUMMIT registry were retrospectively analyzed. Accelerometer-derived PA changes over 12 months post implantation were obtained from the archived home monitoring data. The primary endpoints were cardiac death and all-cause mortality. The secondary endpoints were the first ventricular arrthymia (VA) and first appropriate ICD shock., Results: In 705 patients, 446 (63.3%) patients showed improved PA over 12 months after implantation. During a mean 61.5-month follow-up duration, 99 cardiac deaths (14.0%) and 153 all-cause deaths (21.7%) occurred. Compared to reduced/unchanged PA, improved PA over 12 months could result in significantly reduced risks of cardiac death (improved PA ≤ 30 min: hazard ratio (HR) = 0.494, 95% CI: 0.288-0.848; > 30 min: HR = 0.390, 95% CI: 0.235-0.648) and all-cause mortality (improved PA ≤ 30 min: HR = 0.467, 95%CI: 0.299-0.728; > 30 min: HR = 0.451, 95% CI: 0.304-0.669). No differences in the VAs or ICD shocks were observed across different groups of PA changes. PA changes can predict the risks of cardiac death only in the low baseline PA group, but improved PA was associated with 56.7%, 57.4%, and 62.3% reduced risks of all-cause mortality in the low, moderate, and high baseline PA groups, respectively, than reduced/unchanged PA., Conclusions: Improved PA could protect aganist cardiac death and all-cause mortality, probably reflecting better clinical efficacy after ICD/CRT-D implantation. Low-intensity exercise training might be encouraged among patients with different baseline PA levels., (Copyright and License information: Journal of Geriatric Cardiology 2022.)