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Background: Owing to poor organ function reserve, older adults have a high risk of postoperative complications. However, there is no well-established system for assessing the risk of complications after hepatectomy in older adults. Methods: This study aimed to design a risk assessment tool to predict the risk of complications after hepatectomy in adults older than 75 years. A total of 326 patients were identified. A logistic regression equation was used to create the Risk Assessment System of Hepatectomy in Adults (RASHA) for the prediction of complications (Clavien‒Dindo classification ≥ II). Results: Multivariate correlation analysis revealed that comorbidity (≥ 5 kinds of disease or < 5 kinds of disease, odds ratio [OR] = 5.552, P < 0.001), fatigue (yes or no, OR = 4.630, P = 0.009), Child‒Pugh (B or A, OR = 4.211, P = 0.004), number of liver segments to be removed (≥ 3 or ≤ 2, OR = 4.101, P = 0.001), and adjacent organ resection (yes or no, OR = 1.523, P = 0.010) were independent risk factors for postoperative complications after hepatectomy in older persons (aged ≥ 75 years). A binomial logistic regression model was established to evaluate the RASHA score (including the RASHA scale and RASHA formula). The area under the curve (AUC) for the RASHA scale was 0.916, and the cut-off value was 12.5. The AUC for the RASHA formula was 0.801, and the cut-off value was 0.2106. Conclusion: RASHA can be used to effectively predict the postoperative complications of hepatectomy through perioperative variables in adults older than 75 years. Trial registration: The Research Registry: researchregistry8531. https://www.researchregistry.com/browse-the-registry#home/registrationdetails/63901824ae49230021a5a0cf/. [ABSTRACT FROM AUTHOR]

The intermittent renewable energy in a virtual power plant (VPP) brings generation uncertainties, which prevents the VPP from providing a reliable and user-friendly power supply. To address this issue, this paper proposes a gated recurrent unit proximal policy optimization (GRUPPO)-based optimal VPP economic dispatch method. First, electrical generation, storage, and consumption are established to form a VPP framework by considering the accessibility of VPP state information. The optimal VPP economic dispatch can then be expressed as a partially observable Markov decision process (POMDP) problem. A novel deep reinforcement learning method called GRUPPO is further developed based on VPP time series characteristics. Finally, case studies are conducted over a 24-h period based on the actual historical data. The test results illustrate that the proposed economic dispatch can achieve a maximum operation cost reduction of 6.5% and effectively smooth the supply-demand uncertainties. [ABSTRACT FROM AUTHOR]

The deep Lower Jurassic Ahe Formation (J1a) in the Dibei‐Tuzi area of the Kuqa Depression has not been extensively explored because of the complex distribution of fractures. A study was conducted to investigate the relationship between the natural fracture distribution and structural style. The J1a fractures in this area were mainly high‐angle shear fractures. A backward thrust structure (BTS) is favorable for gas migration and accumulation, probably because natural fractures are more developed in the middle and upper parts of a thick competent layer. The opposing thrust structure (OTS) was strongly compressed, and the natural fractures in the middle and lower parts of the thick competent layer around the fault were more intense. The vertical fracture distribution in the thick competent layers of an imbricate‐thrust structure (ITS) differs from that of BTS and OTS. The intensity of the fractures in the ITS anticline is similar to that in the BTS. Fracture density in monoclinic strata in a ITS is controlled by faulting. Overall, the structural style controls the configuration of faults and anticlines, and the stress on the competent layers, which significantly affects deep gas reservoir fractures. The enrichment of deep tight sandstone gas is likely controlled by two closely spaced faults and a fault‐related anticline. [ABSTRACT FROM AUTHOR]

Distant metastasis is a major cause of treatment failure in cancer patients and a key challenge to improving cancer care today. We hypothesized that enhancing anti-cancer immune response and inhibiting circulating tumor cells (CTCs) adhesion and transendothelial migration through synergistic multi-target approaches may effectively prevent cancer metastasis. "Fuyuan Decoction" (FYD) is a traditional Chinese medicine compound that is widely used to prevent postoperative metastasis in cancer patients, but its underlying mechanism remains unclear. In this work, we systematically elucidated the underlying molecular mechanism by which FYD prevents cancer metastasis through multi-compound and multi-target synergies in vitro and in vivo . FYD significantly prevented cancer metastasis at non-cytotoxic concentrations by suppressing the adhesion of CTCs to endothelial cells and their subsequent transendothelial migration, as well as enhancing anti-cancer immune response. Mechanistically, FYD interrupts adhesion of CTCs to vascular endothelium by inhibiting TNF-α-induced CAMs expression via regulation of the NF-κB signaling pathway in endothelial cells. FYD inhibits invasion and migration of CTCs by suppressing EMT, PI3K/AKT and FAK signaling pathways. Moreover, FYD enhances the anti-cancer immune response by significantly increasing the population of Tc and NK cells in the peripheral immune system. In addition, the chemical composition of FYD was determined by UPLC-HRMS, and the results indicated that multiple compounds in FYD prevents cancer metastasis through multi-target synergistic treatment. This study provides a modern medical basis for the application of FYD in the prevention of cancer metastasis, and suggesting that multi-drug and multi-target synergistic therapy may be one of the most effective ways to prevent cancer metastasis., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Ye, Lin, Zhou, Wang, Yao, Su, Qi, Zheng, Zhong, Chen, Huang and Lu.)

Background: Ganoderma lucidum ( G . lucidum ) is a traditional Chinese herbal medicine that has shown potential as an alternative adjuvant therapy for cancer patients. However, the mechanisms and adjuvant therapeutic effects of G . lucidum in cancer treatment remain unclear., Methods: In this work, G . lucidum spore oil (GanoOil), a newly developed oily G . lucidum spore extract was used to investigate the mechanisms and adjuvant therapeutic effects of GanoOil in conjunction with the chemotherapeutic drug cyclophosphamide (CTX) for preventing breast cancer metastasis., Results: In the model of lung metastasis, orally administered GanoOil increased the population of CD8 + T cells and interleukin (IL)-6 cytokine levels in mouse blood, whereas also enhancing the activity of natural killer cells in the spleen. Furthermore, the combination of GanoOil and CTX effectively suppressed the lung metastasis of circulating breast cancer cells, alleviated CTX-induced weight loss, and reduced the ratio of lung and spleen weight to body weight in mice. Moreover, high concentrations of GanoOil exhibited no significant toxicity or side effects in both in vitro and in vivo experiments., Conclusion: In conclusion, GanoOil is a safe drug that can enhance immune activity in mice to achieve therapeutic effects on cancer, and can also synergistically inhibit tumor metastasis with CTX., Competing Interests: Conflicts of interest: The authors declare that they have no conflicts of interest related to the subject matter or materials discussed in this article., (Copyright © 2023, the Chinese Medical Association.)