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Diabetic retinopathy (DR) is a major cause of irreversible blindness in the working-age population. Neovascularization is an important hallmark of advanced DR. There is evidence that Yes-associated protein (YAP)/transcriptional co-activator with a PDZ binding domain (TAZ) plays an important role in angiogenesis and that its activity is regulated by vascular endothelial growth factor (VEGF). Therefore, the aim of this study was to investigate the effect of YAP/TAZ-VEGF crosstalk on the angiogenic capacity of human retinal microvascular endothelial cells (hRECs) in a high-glucose environment. The expression of YAP and TAZ of hRECs under normal conditions, hypertonic conditions and high glucose were observed. YAP overexpression (OE-YAP), YAP silencing (sh-YAP), VEGF overexpression (OE-VEGF) and VEGF silencing (sh-VEGF) plasmids were constructed. Cell counting kit-8 assay was performed to detect cells proliferation ability, transwell assay to detect cells migration ability, and tube formation assay to detect tube formation ability. The protein expression of YAP, TAZ, VEGF, matrix metalloproteinase (MMP)-8, MMP-13, vessel endothelium (VE)-cadherin and alpha smooth muscle actin (α-SMA) was measured by western blot. The proliferation of hRECs was significantly higher in the high glucose group compared with the normal group, as well as the protein expression of YAP and TAZ (p < 0.01). YAP and VEGF promoted the proliferation, migration and tube formation of hRECs in the high glucose environment (p < 0.01), and increased the expression of TAZ, VEGF, MMP-8, MMP-13 and α-SMA while reducing the expression of VE-cadherin (p < 0.01). Knockdown of YAP effectively reversed the above promoting effects of OE-VEGF (p < 0.01) and overexpression of YAP significantly reversed the inhibition effects of sh-VEGF on above cell function (p < 0.01). In a high-glucose environment, YAP/TAZ can significantly promote the proliferation, migration and tube formation ability of hRECs, and the mechanism may be related to the regulation of VEGF expression. [ABSTRACT FROM AUTHOR]

Background: The role of intraoperative use of indocyanine green (ICG) fluorescence angiography (ICGFA) to prevent anastomotic leakage (AL) in rectal cancer surgery remains controversial. Methods: The systematic review for studies evaluating ICGFA in patients undergoing rectal cancer surgery in PubMed, Embase, Web of Science, and the Cochrane Library was performed up to April 30, 2020. The primary outcome was the incidence of AL. The analysis was performed using RevMan v5.3 and Stata v12.0 software. Results: Eighteen studies comprising 4038 patients were included. In the present meta-analysis, intraoperative use of ICGFA markedly reduced AL rate (OR = 0.33; 95% CI: 0.24–0.45; P < 0.0001; I2 = 0%) in rectal cancer surgery, which was still significant in surgeries limited to symptomatic AL (OR = 0.44; 95% CI: 0.31–0.64; P < 0.0001; I2 = 22%). This intervention was also associated with shorter postoperative stays (MD = − 1.27; 95% CI: − 2.42 to − 0.13; P = 0.04; I2 = 60%). However, reoperation rate (OR = 0.61; 95% CI: 0.34–1.10; P = 0.10; I2 = 6%), ileus rate (OR = 1.30; 95% CI: 0.60–2.82; P = 0.51; I2 = 56%), and surgical site infection rate (OR = 1.40; 95% CI: 0.62–3.20; P = 0.42; I2 = 0%) were not significantly different between the two groups. Conclusion: The use of ICGFA was associated with a lower AL rate after rectal cancer resection. However, more multi-center RCTs with large sample size are required to further verify the value of ICGFA in rectal cancer surgery. [ABSTRACT FROM AUTHOR]

• The fuzzy FJSP with variable processing speeds constraint is surveyed. • A multi-objective hybrid evolutionary immune algorithm is proposed. • A reference point-based angle selection mechanism is adopted. • A Pareto similar information-based crossover operator is developed. • Four objective-driven neighborhood structures are proposed. In this study, a fuzzy flexible job shop scheduling problem with variable processing speeds is considered. To address this problem, a multi-objective hybrid evolutionary immune algorithm (HEIA) is proposed, where the fuzzy maximum completion time (makespan) and fuzzy total energy consumption are optimized simultaneously. In the proposed HEIA, a two left-shift heuristic based active decoding method is proposed to optimize the fuzzy makespan. Then, two hybrid evolutionary strategies are used to separately enhance the exploration ability and exploitation ability, where a reference point-based angle selection strategy is incorporated to optimize the search mechanism. For the first evolutionary strategy, a Pareto similar information-based crossover operator is adopted to improve population diversity. For the second evolutionary strategy, a deep local search mechanism and four objective-driven neighborhood structures are developed. Finally, five types of instances are generated to verify the effectiveness of the proposed HEIA. [ABSTRACT FROM AUTHOR]

The flexible job shop problem (FJSP), as one branch of the job shop scheduling, has been studied during recent years. However, several realistic constraints including the transportation time between machines and energy consumptions are generally ignored. To fill this gap, this study investigated a FJSP considering energy consumption and transportation time constraints. A sequence-based mixed integer linear programming (MILP) model based on the problem is established, and the weighted sum of maximum completion time and energy consumption is optimized. Then, we present a combinational meta-heuristic algorithm based on a simulated annealing (SA) algorithm and an artificial immune algorithm (AIA) for this problem. In the proposed algorithm, the AIA with an information entropy strategy is utilized for global optimization. In addition, the SA algorithm is embedded to enhance the local search abilities. Eventually, the Taguchi method is used to evaluate various parameters. Computational comparison with the other meta-heuristic algorithms shows that the improved artificial immune algorithm (IAIA) is more efficient for solving FJSP with different problem scales. [ABSTRACT FROM AUTHOR]

Power economic dispatch (ED) plays an important role in energy saving in power system operations. The penalty function method is widely used to handle equality constraints involved in ED problems. However, it is sometimes difficult to select the optimal penalty coefficients. To solve this problem, a Two-Stage strategy is proposed in this paper to handle equality constraints in artificial bee colony algorithm (ABC)-based ED problems, called as TSABC. Two groups of onlooker bees are employed in the first stage to search for feasible solutions satisfying all constraints. Then, in the second stage, a novel searching strategy with dynamic bounds for the elements of the solutions is introduced to keep the constraints always satisfied during the optimization process. The TSABC method does not require more control parameters and is easy to implement. Both based on basic ABC algorithm, the Two-Stage strategy is compared with the penalty function method (PFABC) for handling equality constraints in both static and dynamic economic dispatch problems. The comparative analysis reveals that the proposed TSABC method has merit in terms of effectiveness, reliability and solution quality. [ABSTRACT FROM AUTHOR]

Objective: To design and evaluate the accuracy of a novel navigation template suitable for posterior cervical screw placement surgery by using 3D printing technology to improve the existing guiding template design. Methods: The researchers (including spine surgeons and technicians) used CT to perform thin-slice scanning on 12 cases of normal upper cervical vertebral specimens and defined the screw channels that were completely located in the pedicle without penetrating the cortex as ideal screw channels, then designed the ideal channel of the upper cervical vertebral (atlantoaxial) pedicle screw by computer software which was regarded as the preset values, and recorded the screw entrance point, transverse angle and sagittal angle of the ideal channel. Then, researchers designed the novel navigation templates for placement pedicle screw according to the ideal screw channel preset values and manufactured them with one for every single vertebra by 3D printer. A senior spine surgeon performed the posterior surgery to implant pedicle screw on the specimens by the novel navigation templates, then performed CT thin-slice scanning on the specimens again after removing the screws, and reconstructed the actual screws channel by computer software, recorded the screw entrance point, transverse angle and sagittal angle of the actual channels which were defined as the actual values and evaluated them according to Kawaguchi’s pedicle screw evaluation standard finally. The differences between the preoperative preset values of ideal screw channel and the postoperative actual values of actual screw channel were compared by a nonparametric paired rank test. Results: 48 screws were placed on 12 cases of upper cervical vertebral specimens in total. It showed that the grade 0, I, II, III channels in this study were 47, 1, 0, 0, respectively. The grade 0 channels accounted for 97.92% of the total number of channels. There was no significant difference with regard to the screw entrance point, the transverse angle, and the sagittal angle between the preoperative preset values of ideal screw channels and the postoperative actual values of actual screw channels. Conclusion: To implant pedicle screw assisted with the novel individually navigation template designed by 3D printed in the posterior cervical surgery can improve accuracy of pedicle screw placement and safety of the surgery. [ABSTRACT FROM AUTHOR]

Abstract Efficient utilization of limited resources is crucial in controlling disease outbreaks. Usually, in the process of disease control, medical resources are either controlled globally by the government or allocated locally among individuals. Here, to explore systematically which of the two strategies is more efficient in suppressing the outbreaks of disease, a hybrid strategy is proposed, in which, a tunable parameter is introduced to tune the preference of global and local resource allocation. By studying the interplay between the resource allocation and disease spreading based on a generalized susceptible–infected–susceptible (SIS) model, we show that the global resource allocation has more advantages in controlling disease than local allocation. Besides, the hybrid resource allocation has significant influence on the dynamics of disease spreading. There is first order phase transition of the final infected fraction of nodes on homogeneous networks, however, the transition type changes from hybrid transitions to first order transition at a critical value of the tunable parameter on heterogeneous networks. When considering the initial conditions, hysteresis loops appear on both homogeneous and heterogeneous networks. Using mean-field approximation and a generalized dynamical message passing (GDMP) approach, we calculate exactly the fraction of infected nodes at the steady state, as well as the epidemic thresholds and the phase diagram of the disease on the homogeneous networks and heterogeneous networks respectively. Highlights • We propose a hybrid resource allocation model in suppressing the disease spreading. • The more globally the resources are allocated, the more efficiently the disease can be suppressed. • The strategy of resource allocation can alter the phase transition on heterogeneous networks. • Hysteresis loops appear on both homogeneous and heterogeneous networks. [ABSTRACT FROM AUTHOR]

Resources are limited in epidemic containment; how to optimally allocate the limited resources in suppressing the epidemic spreading has been a challenging problem. To find an effective resource allocation strategy, we take the infectiousness of each infected node into consideration. By studying the interplay between the resource allocation and epidemic spreading, we find that the spreading dynamics of epidemic is affected by the preferential resource allocation. There are double phase transitions of the fraction of infected nodes, which are different from the classical epidemic model. More importantly, we find that the preferential resource allocation has double-edged sword effects on the disease spreading. When there is a small transmission rate, the infected fraction at the steady state decreases with the increment of degree of resource allocation preference, which indicates that resources of the healthy nodes should be allocated preferentially to the high infectious nodes to constrain the disease spreading. Moreover, when there is a large transmission rate, the fraction of infected nodes at the steady state increases with the increment of the degree of the preference, but the resource allocation is determined by the stage of epidemic spreading. Namely, in the early stage of the disease spreading, resources should be allocated preferentially to the high infectious nodes similar to the case of a small transmission rate. While after the early stage, resources should be allocated to the low infectious nodes. Based on the findings, we propose a simple resource allocation strategy that can adaptively change with the current fraction of infected nodes and the disease can be suppressed to the most extent under the proposed strategy. [ABSTRACT FROM AUTHOR]

Highlights • Based on the distance reject option of the EKNN rule, only normal operating data is needed to construct the CMEW-EKNN model. • An adaptive discounting factor is suggested to tune the EKNN rule, so as to improve the performance of the CMEW-EKNN method. • Based on the framework of evidence theory, the uncertainty of the equipment's operating condition can be described well. Abstract It is essential and challenging to monitor complex industrial processes and thus make an early warning for abnormal conditions, in particular when no fault samples can be observed under unknown uncertainties. To solve this problem, this paper proposes a so-called CMEW-EKNN method, i.e., condition monitoring and early warning method based on the evidential k -nearest neighbor (EKNN) rule in the framework of Evidence Theory. By employing the distance reject option in the EKNN rule, only normal operating data is needed to construct the early warning model. An adaptive discounting factor is adopted to make the early warning boundary adaptive to local distribution characteristics of the training samples, so as to improve both effectiveness and robustness of CMEW-EKNN. Comparisons on two practical applications in power plant demonstrate that the proposed CMEW-EKNN, which adopts the adaptive discounting factor, yields superior fault early warning performance than the PCA-based and FD-kNN fault detection approaches. [ABSTRACT FROM AUTHOR]

Abstract Researches about complex contagions on complex networks always neglect the reinforcement effect from different layers and neighbors simultaneously. In this paper we propose a non-Markovian model to describe complex contagions in which a susceptible node becoming adopted must take the social reinforcement from different layers and neighbors into consideration. Through extensive numerical simulations we find that the final adoption size will increase sharply with the information transmission probability at a large adoption threshold. In addition, for small values of adoption threshold, a few seeds could trigger a global contagion. However, there is a critical seed size below which the global contagion becomes impossible for large values of adoption threshold. Besides that, we develop an edge-based compartmental (EBC) theory to describe the proposed model, and it agrees well with numerical simulations. Highlights • Proposing a non-Markovian social contagion model on multiplex networks. • The final adoption size increases sharply with information transmission probability at a large adoption threshold. • There is a critical seed size below which the global contagion becomes impossible for large value of adoption threshold. • An edge-based compartmental theory is developed. [ABSTRACT FROM AUTHOR]

Abstract An individual's credibility is strongly affected by their social status. Assuming that a person's level of credibility correlates with their degree from a microscopic perspective, we propose a non-Markovian model to understand how the heterogeneity of credibility levels affects social contagions within a population. To describe the model, we develop a heterogeneous edge-based compartmental theory. Through extensive numerical simulations, we find that the growth pattern of the final adoption size versus the information transmission probability is discontinuous, and that in ER networks the final adoption size increases when hubs have high levels of credibility. When hubs in an ER network have low levels of credibility, the growth pattern is continuous. We also study social contagions on SF networks and find that the growth pattern versus information transmission probability is always continuous. On both ER and SF networks, the final adoption size versus the heterogeneity parameter exhibits a discontinuous pattern. The results of our theory agree well with those of numerical simulations. Highlights • Proposed a non-Markovian model to understand how the heterogeneity of credibility from a microscopic perspective. • The growth pattern of the final adoption size is continuous when hubs in an ER network have low levels of credibility. • The growth pattern versus information transmission probability is always continuous on SF networks. • On both ER and SF networks, the final adoption size versus the heterogeneity parameter exhibits a discontinuous pattern. [ABSTRACT FROM AUTHOR]

Refractory ischemic ulcers that occur in patients with diabetes present a major clinical challenge. Embryonic artery cluster of differentiation 133+ cells (EACCs) may promote the healing of diabetic ulcers; however, the high glucose environment in the diabetic ulcers decreases the survival rate of transplanted EACCs and inhibit their biological function. Furthermore, microcirculation in diabetic ischemic ulcers is impaired, which inhibits the beneficial effect of EACCs. In the current study, the Sirt1 agonist SRT1720 was selected as a therapeutic drug and loaded into a dressing composed of PLGA, collagen and silk (PCSS) formed using electrospinning technology. EACCs were seeded onto the PCSS dressing and this was used to treat diabetic ulcers. The results indicated that SRT1720 promotes the proliferation of EACCs, enhances the secretion of vascular endothelial growth factor A, interluekin 8 and basic fibroblast growth factor, and inhibits the secretion of tumor necrosis factor α. Furthermore, SRT1720 promoted the paracrine function of EACCs and promoted the proliferation and migration of human umbilical vein endothelial cells. PCSS induced the steady release of SRT1720 over a 15-day period and PCSS seeded with EACCs (PCSS-EACCs) were transplanted into the diabetic ischemic ulcers of mice with diabetes. The results of these experiments indicated that angiogenesis and the healing of diabetic ischemic ulcers was significantly improved following the transplantation of PCSS-EACCs. Therefore, PCSS-EACCs may be a novel and effective treatment for diabetic ischemic ulcers. [ABSTRACT FROM AUTHOR]

Background The association between vitamin D receptor (VDR) gene polymorphisms and multiple sclerosis (MS) has been extensively studied, but results were controversial. Methods This meta-analysis aimed to confirm whether VDR gene polymorphisms were associated with MS. Meta-analysis on the association between MS and VDR Apa I, Bsm I, Taq I and Fok I polymorphisms were conducted using allelic contrast, recessive, homozygotes and dominant models. Data were extracted by standardized forms and odds ratios (OR) with 95% confidence intervals (CI) were calculated using the random effects model if the results were heterogeneous. Stratification analysis by the selected study characteristics were performed to detect potential source of heterogeneity. Results A total of 21 relevant studies involving 3593 MS patients and 3917 controls were included in the analysis. The association between Taq I polymorphism and MS risk was significant in the homozygous model (p = 0.006) indicated a significant protective effect of TT Taq I genotype. High latitude (40.1–50°N) was also found markedly influenced Taq I polymorphism and MS risk in the recessive and homozygous models (p = 0.045 and p = 0.015, respectively). Additionally, Asian or low latitude (20.1–30°N) people with Apa I homozygous genotype, ‘> 2013’ publication year people in the allele contrast and dominant models of Fok I, ‘> 40 years’ age people with Bsm I recessive model also indirectly significantly affected the association between VDR gene polymorphisms and MS risk. Conclusion Taq I polymorphism is a significant protective factor for MS. However, the associations between Apa I, Fok I and Bsm I polymorphisms and MS were found only by study characteristics. [ABSTRACT FROM AUTHOR]

The cleaner production of environmentally friendly materials for the controlled adsorption and desorption of ammonium and phosphate in wastewater treatment and soil fertility maintenance is a challenge. Here we show that a class of clay mineral-biochar composites which were produced via a facile cleaner pyrolysis process starting from two abundant natural materials (montmorillonite and bamboo powder). The montmorillonite-biochar composites (MBC) were characterized by X-ray powder diffraction, Fourier transform infrared spectroscopy, N 2 adsorption/desorption isotherms, thermogravimetric analysis, and scanning electron microscopy. The adsorption and slow-release characteristics of MBC samples for NH 4 + and PO 4 3− in aqueous solution were evaluated. Montmorillonite (Mt) acted as a solid acidic catalyst and catalyzed the pyrolysis of bamboo powder to biochar and lower the pyrolysis temperatures. Both biochar and Mt contributed to the texture and structure, which provided varied surface and various adsorptive sites. The Langmuir maximum adsorption capacity of MBC samples for NH 4 + and PO 4 3− was 12.52 mg·g −1 and 105.28 mg·g −1 . The adsorption of NH 4 + onto the MBC sample was primarily controlled by surface adsorption and partially by a CEC process. The adsorption capacity of PO 4 3− resulted from the electrostatic attraction or ionic bonding between PO 4 3− and cations in the MBC samples such as Ca 2+ , Mg 2+ , Al 3+ and Fe 3+ . The release of NH 4 + and PO 4 3− from the NH 4 + - and PO 4 3− -laden MBC samples was merely 0.30–4.92% and 2.63–5.09% within 2–88 h. These findings implied that the MBC samples prepared from low-cost Mt and bamboo can remove NH 4 + and PO 4 3− from aqueous solution by adsorption and the resultant NH 4 + - and PO 4 3− -laden MBC samples can be used as an effective slow-release fertilizer of N and P. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to assess the outcome of symptomatic lumbar degenerative disease treated with topping-off technique (Coflex(™) combined with fusion) and compare two-segment fusion at mid-long term follow-up; and find out whether the topping-off technique can reduce the rate of adjacent segment degeneration (ASD) after fusion.Methods: One hundred and fifty-four consecutive patients who received topping-off surgery (76 patients) and two-segment fusion surgery (88 patients) from March 2009 to March 2012 were studied. All patients included in the analysis had a minimum of three years of follow-up. Radiographic and clinical outcomes between the two groups were compared. A logistic regression analysis was used to analyze risk factors for developing radiographic ASD.Results: Significant differences in clinical outcomes were observed between these two groups at three post-operative years (all, p < 0.05). Compared with the fusion group, the topping-off group showed preserved mobility at the Coflex(™) level (p = 0.000), which is associated with less blood loss (p = 0.000), shorter duration of surgery (p = 0.000) and lower incidence of ASD (Chi-square test, rate topping-off vs fusion = 13.2 vs 26.1 %, p = 0.039). There were no differences in complications between the two groups.Conclusion: Mid-long term follow-up efficacy and safety between topping-off and fusion were similar, while topping-off reduced the rate of ASD. Under strict indications, topping-off surgery is an acceptable alternative to fusion surgery for the treatment of two-segment lumbar disease. [ABSTRACT FROM AUTHOR]

Background. The impact of perioperative blood transfusion on the prognosis of gastric adenocarcinoma patients is still controversial. The aim of this study was to elucidate the impact of perioperative blood transfusion on postoperative complications and prognosis of patients who underwent gastrectomy for gastric adenocarcinoma with different levels of preoperative hemoglobin value (POHb). Method. From 2003 to 2011, 1199 patients who underwent curative gastrectomy were retrospectively enrolled and followed up to December 2014. Clinicopathological features and survival outcomes were compared between transfused and nontransfused patients. Results. In this study, transfused patients had more postoperative complications than nontransfused ones (P=0.002). In survival analysis, the difference was not significant between transfused and nontransfused patients with POHb between 70 and 100 g/L (P=0.191). However, in patients with POHb >100 g/L, transfused patients had significantly worse prognosis (P<0.001), especially in TNM III stage patients (P=0.002). And intraoperative blood transfusion predicted poor prognosis (P=0.001). Conclusion. Perioperative blood transfusion might lead to poor survival in gastric adenocarcinoma patients with POHb >100 g/L and transfused patients had more postoperative complications; thus it is better to refrain from unnecessary perioperative blood transfusion especially intraoperative transfusion. [ABSTRACT FROM AUTHOR]

Background. The studies on risk factors and metastatic rate of retropancreatic (number 13) lymph nodes in gastric adenocarcinoma were few and the results were still controversial. The aim of this study was to elucidate risk factors and prognostic significance of number 13 lymph nodes in gastric adenocarcinoma. Method. From January 2000 to December 2011, 114 patients who underwent gastrectomy with number 13 lymph nodes dissection were enrolled and followed up to January 2014. Patients were grouped according to whether number 13 lymph nodes were positive or negative. Results. The metastatic rate of number 13 lymph nodes was 22.8%. In multivariate analysis, pT stage (P=0.027), pN stage (P=0.005), and number 11p (P=0.015) lymph nodes were independent risk factors of positive number 13 lymph nodes. In all patients (P<0.001) and subpopulation with TNM III stage (P=0.007), positive number 13 lymph nodes had significantly worse prognosis than those of patients with negative number 13 LNs in Kaplan-Meier analysis. Conclusion. Number 13 lymph nodes had relatively high metastatic rate and led to poor prognosis. pT stage, pN stage, and number 11p lymph nodes were independent risk factors of positive number 13 lymph nodes. [ABSTRACT FROM AUTHOR]

Objectives: To compare surgical efficacy and postoperative recovery of ultrasonic scalpel (USS) with conventional techniques for the resection of gastric carcinoma. Methods: A systematic search of major medical databases (PubMed, Embase, CCRT and CNKI) was conducted. Both randomized and non-randomized controlled trials (RCTs and nRCTs) were considered eligible. Operation time (OT), intraoperative blood loss (BL) and postoperative complications (POC) rates as well as postoperative hospitalization days, number of dissected lymph nodes, abdominal drainage volume and time for recovery of gastrointestinal functions were synthesized and compared. Results: Nineteen studies were included (7 RCTs and 12 nRCTs), in which 1930 patients were enrolled totally (946 in the USS group and 984 in the conventional group). Monopolar electrocautery and ligation were used as the conventional methods. Comparative meta-analysis showed perioperative outcomes were significantly improved using USS compared with conventional surgical instrumentation. OT was reduced from a weighted mean of 185.3 min in the conventional group to 151.0 min in the USS group (MD = −33.30, 95% CI [−41.75, −24.86], p<0.001) and intraoperative BL was decreased from a weighted mean of 217.9 ml in the conventional group to 111.6 ml in the USS group (MD = −113.42, 95% CI [−142.05, −84.79], p<0.001). Results from RCTs subgroup were consistent with those from nRCTs subgroup. The weighted cumulative risk of POC accounted for 8.9% (0%–25%) and 12.9% (5.5%–45%) in the USS and conventional groups, respectively. Pooled estimated results from nRCTs (OR = 0.54, 95% CI [0.27, 1.06], p = 0.07) and RCTs (RR = 0.75, 95% CI [0.44, 1.26], p = 0.27) showed no significant difference between the USS and control groups. Analysis of secondary outcomes showed the improvements of the USS group over control group regarding the number of dissected lymph nodes, postoperative hospitalization days, abdominal drainage volume and time for recovery of gastrointestinal functions. Conclusion: Compared with conventional electrosurgery, the USS is a safe and effective technique with more short-term advantages in open surgery for gastric cancer. [ABSTRACT FROM AUTHOR]

Background: The metastatic rate and risk factors of splenic hilar (No.10) lymph nodes (LNs) in gastric adenocarcinoma were still variable and uncertain, and the prognostic significance of No.10 LNs was also controversial. The aim of this retrospective study was to analyze the metastatic rate, risk factors and prognostic significance of No.10 LNs in gastric adenocarcinoma. Methods: From August 2007 to December 2011, 205 patients who were diagnosed with primary gastric adenocarcinoma and underwent total or proximal gastrectomy plus No.10 LNs dissection in West China Hospital were enrolled. Clinicopathological features and survival outcomes were retrospectively analyzed. Results: Mean numbers of harvested LNs and metastatic LNs were 34.8±12.6 (15–73) and 8.7±10.8 (0–67), respectively. The proportion of cases with positive No.10 LNs was 8.8% (18/205). In all 204 dissected No.10 LNs, 47 LNs (23.0%) were metastatic. In 52.2% (107/205) patients, the dissected splenic hilar tissues were histologically determined as only fat tissues but without LNs structure. Histological evidence of LNs structure was found in 98 (47.8%) patients with 18.4% (18/98) metastatic No.10 LNs. In multivariate logistic regression analysis, metastasis of No.10 LNs was significantly correlated with No.4sa LNs (p = 0.010) and pN stage (p = 0.012). Regarding survival analysis, 199 (97.1%) patients were followed up (0.6–74.8 months). In all patients with R0 resection, metastatic No.10 LNs caused significantly worse prognosis both in Kaplan-Meier (p = 0.006) and Cox regression analysis (p = 0.031). Conclusions: Although the metastatic rate of No.10 LNs was 8.8%, dissection of No.10 LNs might be meaningful due to the poor prognosis of positive cases. And attentions should be also paid to its correlated factors including pN stage and No.4sa LNs. [ABSTRACT FROM AUTHOR]

Surgical case scheduling is a key issue in the field of medician, which is a challenging work because of the difficulty in assigning resources to patients. This study regards the surgical case scheduling problem as a flexible job shop scheduling problem (FJSP). Considering the switching and preparation time of patients in different stage, an improved multi-objective imperialist competitive algorithm (IMOICA), which adopts the non-dominant sorting method, is proposed to optimize the whole scheduling. First, the social hierarchy strategy is developed to initialize the empire. Then, to enhance the global search ability of the algorithm, the concept of attraction and repulsion (AR) is introduced into the assimilation strategy. Moreover, to increase the diversity of the population, the revolution strategy is utilized. Finally, the variable neighborhood search (VNS) strategy is embedded to improve its exploitation capacity further. Experiments show that scheduling in advance saves time and cost, and IMOICA can solve the surgical case scheduling problem studied efficiently. [ABSTRACT FROM AUTHOR]

[Display omitted] The gene polymorphisms of ABCB1 , EPHX1 , and SCN1A were found to influence carbamazepine (CBZ) metabolism and resistance in epilepsy patients, but the relevance remains controversial. To reveal the relationships among the gene polymorphisms of ABCB1 , EPHX1, SCN1A and the metabolism and resistance of CBZ, the databases of PubMed, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure, Chinese Science and Technique Journals, China Biology medicine disc and Wan Fang were retrieved for suitable studies up to April 2021. 18 studies containing 3293 epilepsy patients were included. The result revealed the gene polymorphism of ABCB1 c.3435C > T is significantly associated with altered concentration–dose ratios of CBZ (CDR CBZ) (CC vs. CT, OR = 0.25 (95% CI: 0.08–0.42), P = 0.004), and EPHX c.416A > G gene polymorphism may also significantly adjusted the concentration–dose ratios of carbamazepine-10, 11-trans dihydrodiol (CDR CBZD) (AA vs. GG, OR = 0.48 (95% CI: 0.01–0.96), P = 0.045; AG vs. GG, OR = 0.68 (95% CI: 0.16–1.20), P = 0.010, respectively) and the ratio of CBZD:carbamazepine-10,11-epoxide (CBZE) (CDR CBZD :CDR CBZE) (AG vs GG, OR = 0.83 (95% CI: 0.31–1.36), P = 0.002). Furthermore, ABCB1 c.3435C > T polymorphism was also observed to be significantly influenced CBZ resistance (CC vs TT, OR = 1.78 (95% CI: 1.17–2.72), P = 0.008; CT vs TT, OR = 1.60 (95% CI: 1.12–2.30), P = 0.01; CC + CT vs TT, OR = 1.61 (95% CI: 1.15–2.26), P = 0.006, respectively). Therefore, CBZ metabolism and resistance in patients with epilepsy may be adjusted by the gene polymorphisms of ABCB1 c.3435C > T and EPHX1 c.416A > G which provides the further scientific basis for clinical individualized therapy of epilepsy. However, larger sample size studies are still needed to provide further conclusive evidence. [ABSTRACT FROM AUTHOR]

Background: Gastric carcinoma (GC) is one of the highest cancer-mortality diseases with a high incidence rate in Asia. For surgically unfit but medically fit patients, palliative chemotherapy is the main treatment. The chemotherapy regimen of docetaxel, cisplatin and 5-fluorouracil (DCF) has been used to treat the advanced stage or metastatic GC. It is necessary to compare effectiveness and toxicities of DCF regimen with non-taxane-containing palliative chemotherapy for GC. Methods: PubMed, EmBase, Cochrane Central Register of Controlled Trials and China National Knowledge Infrastructure databases were searched to select relative randomized controlled trials (RCTs) comparing DCF to non-taxane-containing chemotherapy for patients with palliatively resected, unresectable, recurrent or metastatic GC. Primary outcome measures were 1-year and 2-year overall survival (OS) rates. Secondary outcome measures were median survival time (MST), median time to progression (TTP), response rate and toxicities. Results: Twelve RCTs were eligible and 1089 patients were analyzed totally (549 in DCF and 540 in control). DCF regimen increased partial response rate (38.8% vs 27.9%, p = 0.0003) and reduced progressive disease rate (18.9% vs 33.3%, p = 0.0005) compared to control regimen. Significant improvement of 2-year OS rate was found in DCF regimen (RR = 2.03, p = 0.006), but not of 1-year OS rate (RR = 1.22, p = 0.08). MST was significantly prolonged by DCF regimen (p = 0.039), but not median TTP (p = 0.054). Both 1-year OS rate and median TTP had a trend of prolongation by DCF regimen. Chemotherapy-related mortality was comparable (RR = 1.23, p = 0.49) in both regimens. In grade I-IV toxicities, DCF regimen showed a major raise of febrile neutropenia (RR = 2.33, p<0.0001) and minor raises of leucopenia (RR = 1.25, p<0.00001), neutropenia (RR = 1.19, p<0.00001), and diarrhea (RR = 1.59, p<0.00001), while in other toxicities there were no significant differences. Conclusion: DCF regimen has better response than non-taxane containing regimen and could potentially improve the survival outcomes. The chemotherapy-related toxicity of DCF regimen is acceptable to some extent. [ABSTRACT FROM AUTHOR]

Abstract: Rice straw is a by-product of rice production, and a great bioresource as raw biomass material for manufacturing value-adding protein for animal feedstock, which has been paid more and more attention. In the present work, utilizing rice straw hydrolysate as a substrate for microbial biomass production in 11.5L external-loop airlift bioreactors was investigated. Rice straw hydrolysate obtained through acid-hydrolyzing rice straw was used for the culture of yeast Candida arborea AS1.257. The influences of gas flow rate, initial liquid volume, hole diameter of gas sparger and numbers of sieve plates on microbial biomass production were examined. The best results in the external-loop airlift bioreactor were obtained under 9.0L initial liquid volume, 1.1(v/v)/min gas flow rate during culture time of 0–24h and 1.4(v/v)/min gas flow rate of 24–48h at 29±1°C. The addition of the sieve plates in the riser of the external-loop airlift bioreactor increased productivity. After 48h, under optimized operation conditions, crude protein productivity with one sieve and two sieves were 13.6mg/mL and 13.7mg/mL, respectively, comparing 12.7mg/mL without sieves in the airlift bioreactor and 11.7mg/mL in the in the 10-L mechanically stirred tank bioreactor. It is feasible to operate the external-loop airlift bioreactors and possible to reduce the production cost for microbial biomass production from the rice straw hydrolysate. [Copyright &y& Elsevier]

During recent years, the outpatient scheduling problem has attracted much attention from both academic and medical fields. This paper considers the outpatient scheduling problem as an extension of the flexible job shop scheduling problem (FJSP), where each patient is considered as one job. Two realistic constraints, i.e., switching and preparation times of patients are considered simultaneously. To solve the outpatient scheduling problem, a hybrid imperialist competitive algorithm (HICA) is proposed. In the proposed algorithm, first, the mutation strategy with different mutation probabilities is utilized to generate feasible and efficient solutions. Then, the diversified assimilation strategy is developed. The enhanced global search heuristic, which includes the simulated annealing (SA) algorithm and estimation of distribution algorithm (EDA), is adopted in the assimilation strategy to improve the global search ability of the algorithm.?Moreover, four kinds of neighborhood search strategies are introduced to?generate new?promising?solutions.?Finally, the empires invasion strategy?is?proposed to?increase the diversity of the population. To verify the performance of the proposed HICA, four efficient algorithms, including imperialist competitive algorithm, improved genetic algorithm, EDA, and modified artificial immune algorithm, are selected for detailed comparisons. The simulation results confirm that the proposed algorithm can solve the outpatient scheduling problem with high efficiency. [ABSTRACT FROM AUTHOR]

Background: In recent years, indocyanine green fluorescence lymphography has been introduced for lymphatic mapping in gastric cancer surgery. The aim of this study was to investigate the efficacy of ICGFL in lymph node dissection during minimally invasive surgery for gastric cancer. Methods: A systematic review of electronic databases including PubMed, Embase, Web of Science, the Cochrane Library, and China National Knowledge Infrastructure was performed from the inception to January 2021 for all studies comparing ICGFL with non-ICGFL in GC patients undergoing minimal access gastrectomy. The primary outcome was the total number of harvested lymph nodes. The secondary endpoints were the number of metastatic LNs, operative time, estimated blood loss, and postoperative complications. The registration number of this protocol is PROSPERO CRD42020203443. Results: A total of 13 studies including 1882 participants were included. In this meta-analysis, the use of ICGFL was associated with a higher number of harvested LNs (40.33 vs. 33.40; MD = 6.93; 95%CI: 4.28 to 9.58; P < 0.0001; I2 = 86%). No significant difference was found between the ICGFL and control groups in terms of metastatic LNs (2.63 vs. 2.42; MD = 0.21; 95%CI: −0.46 to 0.87; P = 0.54; I2 = 0%). In addition, the use of ICGFL could be safely performed without increasing the operative time (P = 0.49), estimated blood loss (P = 0.26) and postoperative complications (P = 0.54). Conclusion: The use of ICGFL may be a useful tool facilitating complete lymph node dissection during minimally invasive GC resection. However, more high-quality RCTs with large sample size are needed to validate this issue. [ABSTRACT FROM AUTHOR]

We present a study of charm and beauty isolation based on a data-driven method with recent measurements on heavy flavor hadrons and their decay electrons in Au+Au collisions at s NN = 200 GeV at RHIC. The individual electron p T spectra, R AA and v 2 distributions from charmed and beauty hadron decays are obtained. We find that the electron R AA from beauty hadron decays (R AA b → e) is suppressed in minimum bias Au+Au collisions but less suppressed compared with that from charmed hadron decays at p T > 3.5 GeV/ c , which indicates that beauty quark interacts with the hot-dense medium with depositing its energy and is consistent with the mass-dependent energy loss scenario. For the first time, the non-zero electron v 2 from beauty hadron decays (v 2 b → e) at p T > 3.0 GeV/ c is observed and shows smaller elliptic flow compared with that from charmed hadron decays at p T < 4.0 GeV/ c. At 2.5 GeV/ c < p T < 4.5 GeV/ c , v 2 b → e is smaller than a number-of-constituent-quark (NCQ) scaling hypothesis. This suggests that beauty quark is unlikely thermalized and too heavy to be moved in a partonic collectivity in heavy-ion collisions at the RHIC energy. [ABSTRACT FROM AUTHOR]

Background: Following neoadjuvant chemotherapy, surgical resection is one of the most preferred treatment options for locally advanced gastric cancer patients. However, the optimal time interval between chemotherapy and surgery is unclear. This review aimed to identify the optimal time interval between neoadjuvant chemotherapy and surgery for advanced gastric cancer. Methods: Beginning on November 12, 2022, we searched the PubMed, Cochrane Library, Web of Science databases, and Embase.com databases for relevant English-language research. Two authors independently screened the studies, assessed their quality, extracted the data, and analyzed the results. The primary goal was to investigate the relationship between the time interval to surgery (TTS) and long-term survival outcomes for patients. This study has been registered with PROSPERO (CRD42022365196). Results: After an initial search of 4880 articles, the meta-analysis review ultimately included only five retrospective studies. Ultimately, this meta-analysis included 1171 patients, of which 411 patients had TTS of < 4 weeks, 507 patients had TTS of 4–6 weeks, and 253 patients had TTS of > 6 weeks. In survival analysis, patients with TTS of > 6 weeks had poorer overall survival outcomes than patients with TTS of 4–6 weeks (HR = 1.34, 95% CI: 1.03–1.75, P = 0.03). No significant differences were found in terms of disease-free survival the groups. Conclusion: Based on the current clinical evidence, patients with locally advanced gastric cancer may benefit better with a TTS of 4–6 weeks; however, this option still needs additional study. [ABSTRACT FROM AUTHOR]

Objectives: This case–control study was aimed to investigate associations between HBV infection and extrahepatic digestive system cancers. Methods: The patients of gastric, small intestinal, colonic, rectal, anal, biliary tract, and pancreatic cancers were retrospectively collected between 2016.5 and 2017.12. Simultaneously, the healthy controls were collected from the health check‐up registry, and cancer‐free status was confirmed based on medical records. Propensity score matching was performed to reduce bias. Multinomial logit model and conditional logistic regression model were used to assess the risk of individual cancer according to HBV serological markers and classifications. Results: Totally, 4748 patients involving seven cancers, and 57,499 controls were included. After matching, HBsAg was associated with increased risk of gastric cancer (aOR = 1.39, 95% CI: 1.05–1.85), and anti‐HBs served as a protective factor for gastric (aOR = 0.72, 95% CI: 0.61–0.85), colonic (aOR = 0.73, 95% CI: 0.60–0.89), rectal (aOR = 0.73, 95% CI: 0.63–0.85), and pancreatic (aOR = 0.58, 95% CI: 0.42–0.82) cancers. Compared to subgroups with non‐infection and vaccination status, inactive HBsAg carriers and active HBV infection subgroup were correlated with gastric carcinogenesis (aOR = 1.41, 95% CI: 1.03–1.93). However, no clear association was found between HBV infection and other cancers. Conclusions: HBV infection was potentially associated with an increased risk of gastric cancer. The development mechanism of HBV‐associated gastric cancer needs to investigate further. [ABSTRACT FROM AUTHOR]

Objectives. This preliminary study is aimed at enriching and isolating peritoneal metastatic cancer stem cells (pMCSCs) of gastric cancer and assessing their epithelial-mesenchymal transition (EMT) phenotype and invasiveness. Methods. Cancer stem cells of human gastric cancer (CSC-hGC) were previously isolated and transfected with green fluorescent protein and luciferase genes to validate the mouse model of peritoneal metastasis established via transplantation. The first and second generations ([G1] and [G2], respectively) of pMCSCs were isolated from intraperitoneally transplanted CSC-hGC (pMCSC-tGC) by spherical culture. CSC and EMT-related markers and regulators in the two generations of intraperitoneally transplanted tumors were examined by immunohistochemistry, immunofluorescence staining, and quantitative PCR. Cell mobility was examined by a transwell assay. Results. The nude mouse model of intraperitoneally transplanted CSC-hGC was successful in establishing sequential formation of peritoneal tumors and enrichment of pMCSCs. CD44 and CD54 were consistently expressed in the two generations of transplanted tumors. In vitro cell (migration) assays and immunocytofluorescence assays showed that in pMCSC-tGC[G2], E-cad, Survivin, and Vimentin expression was stable; α-SMA expression was decreased; and OVOL2, GRHL2, and ZEB1 expression was increased. PCR analysis indicated that in pMCSC-tGC[G2], the mRNA expression of E-cad, α-SMA, MMP9, MMP2, and Vimentin was downregulated, while that of ZEB1, OVOL2, and GRHL2 was upregulated. In vivo tumor (homing) assays and immunohistochemical assays demonstrated that in pMCSC-tGC[G2], E-cad and Snail were upregulated, while α-SMA was downregulated. The numbers of migrated and invaded pMCSC-tGC[G1] and pMCSC-tGC[G2] were significantly higher than those of CSC-hGC in migration and invasion assays. Conclusions. pMCSCs might be a specific subpopulation that can be sequentially enriched by intraperitoneal transplantation. pMCSCs exhibited a tendency towards partial mesenchymal-epithelial transition, enhancing their invasiveness during homing and the formation of peritoneal tumors. However, these preliminary findings require validation in further experiments. [ABSTRACT FROM AUTHOR]

Aim: To explore the feasibility and value of transthoracic echocardiography (TTE) postprocessing subtraction technique in the detection of a stent in the coronary artery. Method: Transthoracic echocardiography was used to examine 46 coronary artery stents in 30 patients by two‐dimensional ultrasound postprocessing subtraction technique. The shape of each stent and its flow patency were observed. The patency was assessed according to blood flow and mosaic flow in the stent. Then, the results were compared with those of percutaneous coronary intervention (PCI) records and coronary angiography (CAG). Results: Transthoracic echocardiography detected 36 stents among 46 stents (two in the LMCA, 23 in the LAD, seven in the RCA, and two in the LCX); the detection rate was 78.3%. The average length of the stents was 21.8 ± 4.1 mm, and the average diameter was 2.4 ± 0.5 mm; both are shorter than those from PCI records (P <.001). Of the 36 stents, blood flow could be observed in 27. Compared with the results of CAG, TTE had 75% feasibility and 92.6% accuracy in detecting flow patency in the stents. Conclusion: Transthoracic echocardiography postprocessing subtraction technique could be a noninvasive method for detecting a coronary artery stent and, although the measurements of stent length and diameter were shorter than those of PCI records, an accurate detection of flow patency in the stents was achieved. [ABSTRACT FROM AUTHOR]

One of the most important problems in complex network is the identification of the influential nodes. For this purpose, the use of differences and similarities of structure to enrich the centrality method in complex networks is proposed. The centrality method called ECDS centrality used is the eigen-centrality which is based on the Jaccard similarities between the two random nodes. This can be described by an eigenvalues problem. Here, we use a tunable parameter α to adjust the influence of the differences and similarities. Comparing with the results of the Susceptible Infected Recovered (SIR) model for four real networks, the ECDS centrality could identify influential nodes more accurately than the tradition centralities such as the k -shell, degree and closeness centralities. Especially, in the Erdös network, the Kendall’s tau could be reached to 0.93 when the spreading rate is 0.12. In the US airline network, the Kendall’s tau could be reached to 0.95 when the spreading rate is 0.06. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the prognostic effects of combining serum circulating tumor cells (CTCs) and squamous cell carcinoma antigen (SCC-Ag) levels on patients with locally advanced cervical cancer treated with radiotherapy. Methods: Ninety-nine patients with locally advanced cervical cancer ([FIGO] stage IIB-IVA) undergoing radiotherapy (RT) or concurrent chemoradiotherapy (CCRT) were identified. The association between serum CTC level and clinicopathological parameters was examined. Univariate and multivariate survival analyses were performed by using Cox’s proportional hazards regression model. Results: Elevated CTC and SCC-Ag levels were significantly associated with poor disease-free survival (DFS). Multivariate analysis suggest that serum CTC level, FIGO stage and serum SCC-Ag level were independent prognostic factors for two-year DFS. When CTC and SCC-Ag levels were combined into a new risk model to predict disease progression of cervical cancer patients, it performed a significantly better predictive efficiency compared with either biomarker alone. Conclusion: Serum CTC and SCC-Ag levels are potentially useful biomarkers for prediction of prognosis in locally advanced cervical cancer patients and their combination significantly improves predictive ability for survival in locally advanced cervical cancer patients. [ABSTRACT FROM AUTHOR]

Background. Total flavonoids of Rhododendron (TFR) is extracted from Rhododendron, a herbal medicine widely used in China. The main components are flavone compounds such as warfarin, rutin, quercetin, and hyperoside. We investigated the role of TRPV4 channel in the TFR induced endothelium-dependent hyperpolarizing factor- (EDHF-) mediated responses against ischemia/reperfusion injury (IR) in cerebral IR (CIR) rats. Methods. The morphological changes of cerebral cortex, the relaxation of cerebral basal artery (CBA), and cell membrane potential recording were studied in CIR rats. The outward potassium current in smooth muscle cell was recorded by whole-cell patch clamp recording. The protein expression of TRPV4, SKca, and IKca was determined. Confocal laser was used to measure the Ca2+ fluorescence intensity. Results. After treatment with TFR, the number of pyramidal cells in brain tissue increased and the number of empty or lightly stained cells decreased and these effects were eliminated by using HC-067047, Apamin, or TRAM-34. TFR induced and EDHF-mediated dilatation and hyperpolarization in CBA were also attenuated by using these inhibitors. The increased outward current density elicited by TFR in acutely isolated CBA smooth muscle cells was abolished by using TRAM-34 and Apamin. TFR upregulated the protein expression of TRPV4, SKca, and IKca that was also eliminated by these inhibitors. Laser scanning showed that the increased mean fluorescence intensity of Ca2+ by CIR was decreased by using TFR and that this effect was again eliminated by the above inhibitors. Conclusions. We conclude that in the CBA of the CIR rats the protective effect of TFR on ischemic cerebrovascular injury may be related to the activation of the TRPV4 in both endothelium and smooth muscle by increasing its expression and activity. The activation of TRPV4 channel in the endothelium may be linked to the opening of endothelial IKca/SKca channels that induces EDHF-mediated relaxation and hyperpolarization in the smooth muscle cell. In addition, the activation of TRPV4 in the smooth muscle cell in CBA may be linked with the activation of BKCa channel through a TRPV4-dependent pathway, reduce Ca2+ concentration in the cell, and relaxes the vessel. These findings may form a new therapeutic target for protection of ischemic brain injury and facilitate the use of Chinese medicine in brain protection. [ABSTRACT FROM AUTHOR]

Presents a study which determined the crystal structure of LaFe[sub9]Si[sub4] intermetallic compound using X-ray powder diffraction. Details of experimental techniques used; Lattice parameters of LaFe[sub9]Si[sub4] intermetallic compound; Discussion on the structural transformation of the intermetallic compound.

Background: Liver tumor remains an important cause of cancer-related death. Nanosecond pulsed electric fields (nsPEFs) are advantageous in the treatment of melanoma and pancreatic cancer, but their therapeutic application on liver tumors need to be further studied. Methods: Hep3B cells were treated with nsPEFs. The biological behaviors of cells were detected by Cell Counting Kit-8, 5-ethynyl-20-deoxyuridine, and transmission electron microscopy (TEM) assays. In vivo, rabbit VX2 liver tumor models were ablated by ultrasound-guided nsPEFs and radiofrequency ablation (RFA). Contrast-enhanced ultrasound (CEUS) was used to evaluate the ablation effect. HE staining and Masson staining were used to evaluate the tissue morphology after ablation. Immunohistochemistry was performed to determine the expression of Ki67, proliferating cell nuclear antigen, and α-smooth muscle actin at different time points after ablation. Results: The cell viability of Hep3B cells was continuously lower than that of the control group within 3 days after pulse treatment. The proliferation of Hep3B cells was significantly affected by nsPEFs. TEM showed that Hep3B cells underwent significant morphological changes after pulse treatment. In vivo, CEUS imaging showed that nsPEFs could completely ablate model rabbit VX2 liver tumors. After nsPEFs ablation, the area of tumor fibrosis and the expression of Ki67, proliferating cell nuclear antigen, and α-smooth muscle actin were decreased. However, after RFA, rabbit VX2 liver tumor tissue showed complete necrosis, but the expression of PCNA and α-smooth muscle actin did not decrease compared to the tumor group. Conclusions: nsPEFs can induce Hep3B cells apoptosis and ablate rabbit VX2 liver tumors in a non-thermal manner versus RFA. The ultrasound contrast agent can monitor immediate effect of nsPEF ablation. This study provides a basis for the clinical study of nsPEFs ablation of liver cancer. [ABSTRACT FROM AUTHOR]

Simple Summary: Since nodal metastasis is the main pattern for gastric cancer (GC) metastasis, lymph node (LN) dissection is essential for accurate staging and improving prognosis. However, debates exist regarding the necessity of No. 12a LN dissection (LND) in D2 gastrectomy. Moreover, the compliance rate for No. 12a LND in practice is low. To explore No. 12a LND noncompliance's effect on long-term prognosis in GC patients after D2 gastrectomy, we performed a retrospective propensity score matching study with 2788 patients included. The results showed that patients with No. 12a LND had a significantly greater OS than those without it before and after PSM. This study is the first propensity score matching study to demonstrate the prognostic impact of No. 12a LND noncompliance on patients who undergo D2 gastrectomy. This large population-based study may provide guidance on No. 12a LND. LN dissection is essential for accurately staging and improving GC patient prognosis. However, the compliance rate for No. 12a LND in practice is low, and its necessity is controversial. Data from GC patients who underwent total gastrectomy (TG)/distal gastrectomy (DG) plus D2 lymphadenectomy between January 2000 and December 2017 at West China Hospital, Sichuan University were reviewed. No. 12a LND noncompliance's effect on the long-term prognosis of patients with GC after D2 gastrectomy was explored. Of the 2788 patients included, No. 12a LND noncompliance occurred in 1753 patients (62.9%). Among 1035 patients with assessable LNs from station 12a, 98 (9.5%) had positive LNs detected at station 12a. No. 12a LN metastasis patients (stage IV not included) had significantly better overall survival (OS) than TNM stage IV patients (p = 0.006). Patients with No. 12a LND compliance had a significantly higher OS than those without, both before (p < 0.001) and after (p < 0.001) PSM. Cox multivariate analysis confirmed that No. 12a LND noncompliance was an independent prognostic factor before (HR 1.323, 95% CI 1.171–1.496, p < 0.001) and after (HR 1.353, 95% CI 1.173–1.560, p < 0.001) PSM. In conclusion, noncompliance with No. 12a LND compromised the long-term survival of patients who underwent D2 gastrectomy for GC. [ABSTRACT FROM AUTHOR]

Purpose: The optimal surgical procedure, whether total gastrectomy (TG) or proximal gastrectomy (PG), for Siewert type II/III adenocarcinoma of esophagogastric junction (AEG) has not been standardised, primarily because the optimal extent of lymph node (LN) dissection for AEG based on the metastatic rate of perigastric LNs remains under debate. The aim of this study was to investigate the metastatic incidence and prognostic significance of lower perigastric lymph nodes (LPLN), including No.4d, 5, 6 and 12a LN stations, in Siewert type II/III AEG. Methods: A total of 701 patients with Siewert type II/III AEG who received transabdominal open gastrectomy (425 patients with TG and 276 patients with PG) from 2010 to 2015 in West China Hospital were retrospectively included. Based on the clinicopathological information of TG patients, the risk factors of LPLN-positive patients were evaluated, and the metastatic incidence as well as the therapeutic value (TV) index of each LN station was assessed. Moreover, the 5-year overall survival (OS) rates between LPLN-positive and LPLN-negative groups were compared in TG patients, and the postoperative survival difference between TG and PG patients was also compared, using propensity score matching (PSM) method. Results: Tumour size (≥ 5 cm, OR = 1.481, p = 0.002) and pT stage (pT4, OR = 2.755, p = 0.024) were significant risk factors for patients with LPLN metastasis. For patients with tumour size more than 5 cm or pT4 stage, the metastatic rates of LPLN for Siewert type II, III and II/III AEG were 31.67%, 34.69% and 33.03%, whereas the TV indexes of LPLN for them were 5.76, 5.62 and 5.38, respectively. LPLN was a significant independent prognostic factor (HR = 1.422, p = 0.028), and positive LPLN was related to worse prognosis (p < 0.05). For patients with tumour size more than 5 cm or pT4 stage, TG patients were illustrated to have a better prognosis than PG patients, with 5-year OS rates of 58.9% vs 38.2% for Siewert type II AEG (χ2 = 4.159, p = 0.041), 68.9% vs 50.2% for Siewert type III AEG (χ2 = 5.630, p = 0.018) and 65.1% vs 40.3% for Siewert type II/III AEG (χ2 = 12.604, p < 0.001), respectively. Conclusions: LPLN metastasis is a poor prognostic factor for patients with Siewert II/III AEG. LPLN dissection may improve the long-term survival of patients with tumour size more than 5 cm or pT4 stage, and TG might be more suitable for this kind of cancer. [ABSTRACT FROM AUTHOR]

Mn-based superconductors are very rare and their superconductivity has only been reported in three-dimensional MnP and quasi-one-dimensional KMn6Bi5 and RbMn6Bi5 with [Mn6Bi5]âˆ' columns under high pressures. Here we report the synthesis, magnetism, electrical resistivity, and specific heat capacity of the newly discovered quasi-one-dimensional NaMn6Bi5. Compared with other A Mn6Bi5 (A = K, Rb, and Cs), NaMn6Bi5 has abnormal Bi-Bi bond lengths and two antiferromagnetic-like transitions at 47.3 K and 51.8 K. Anisotropic resistivity and low-temperature non-Fermi liquid behavior are observed. Heat capacity measurement reveals that the Sommerfeld coefficient for NaMn6Bi5 is unusually large. Using first-principles calculations, an unusual enhancement of density of states near the Fermi level is demonstrated for NaMn6Bi5. The features make NaMn6Bi5 a more suitable platform to explore the interplay of magnetism and superconductivity. [ABSTRACT FROM AUTHOR]

Natural compounds bearing maleimide rings are a series of secondary metabolites derived from fungi/marine microorganisms, which are characterized by a general structure –CO–N(R)–CO–, and the R group is normally substituted with alkyl or aryl groups. Maleimide compounds show various biological activities such as antibacterial, antifungal, and anticancer activity. In this review, the broad-spectrum antimicrobial activities of 15 maleimide compounds from natural sources and 32 artificially synthesized maleimides were summarized, especially against Candida albicans, Sclerotinia sclerotiorum, and Staphylococcus aureus. It highlights that maleimide scaffold has tremendous potential to be utilized in the development of novel antimicrobial agents. [ABSTRACT FROM AUTHOR]

In the field of HPC, CPU/GPU co-processing technology has become one of the effective approaches for obtaining quick computing results. In the latest version of typical structural mechanics calculation software; ANSYS and Abaqus, CPU/GPU co-processing technology is adopted for improving the efficiency of problem solving. In the paper, a research is conducted by using typical structural problems, and NVIDIA Tesla M2090 GPU and "Hummingbird" supercomputing platforms from Shanghai Supercomputing Center, to compare and analyze problem solving efficiency of ANSYS and Abaqus before and after the acceleration of GPU. Results indicate that in the situation of parallel scale less than 16 cores, GPU acceleration can reduce solution time at different levels. However, the performance shows a decreasing trend with increasing parallel scale. In addition, the effect of Multi-GPU collaborative solution on enhancing acceleration performance is not obvious. Therefore, in practical application, the selection of appropriate parallel approach and co-processing model should be associated with problem type and current hardware architecture. [ABSTRACT FROM AUTHOR]

Background: Data about whether laparoscopic gastrectomy (LG) is applicable in serosa-positive (pT4a) gastric cancer patients remain rare. The purpose of this study is to compare the perioperative and long-term outcomes between the laparoscopic and open gastrectomy (OG) in pT4a gastric cancer patients who underwent curative resection. Methods: A total of 1086 consecutive pT4a patients (101 patients with LG and 985 with OG) who underwent curative gastrectomy in a high-volume center between 2006 and 2016 were evaluated. Demographics, surgical, and oncologic outcomes were analyzed. Propensity score matching (PSM) analysis was performed to balance baseline confounders, and COX regression analysis was performed to identify independent prognostic factors. Results: After PSM adjustment, a well-balanced cohort comprising 101 patients who underwent LG and 201 who underwent OG was analyzed. Operative time (288.7 vs. 234.2 min; P < 0.001) was significantly longer, while estimated blood loss (172.8 vs. 220.7 ml; P < 0.001) was significantly less in the LG group compared with the OG group. There were no significant differences between groups in total number of harvested lymph nodes, postoperative stays, readmission rate, and postoperative complication rate. The 3-year overall survival (OS) rate was not significant different in the LG and OG groups (66.7% vs. 62.8%, P = 0.668), and the subsequent multivariate analysis revealed that the surgical approach was not an independent prognostic factor for OS (HR = 1.123; 95%CI: 0.803–1.570; P = 0.499). In sensitivity analysis including 78 pairs well-matched patients operated by an experienced surgeon, the results were similar to these for the matched entire cohort. Conclusion: LG can be a safe and feasible approach for pT4a gastric cancer treatment. However, well-designed high-quality RCTs are expected to draw a definitive conclusion on this topic. [ABSTRACT FROM AUTHOR]

Purpose: Petersen's hernia (PH) is a serious complication after gastrectomy for gastric cancer. The aim of this study was to investigate whether closure of Petersen's defect (PD) can decrease the rates of PH and suspected Petersen's hernia (SPH). Methods: Patients who underwent gastrectomy with PD were enrolled. From January 2014 to January 2017, we performed gastrectomy without PD closure (non-closure group). From February 2017 to June 2018, we closed PDs during gastrectomy (closure group). The rates of PH and SPH were compared between the two groups. The last follow-up was updated in August 2020. Results: Among a total of 1213 patients, 12 patients (1.0%) developed PH, and 23 patients (1.9%) developed SPH. The rate of PH in the closure group was significantly lower than that in the non-closure group (1/385, 0.3% versus 11/828, 1.3%, p = 0.042, log-rank test). The rate of SPH in the closure group was significantly lower than that in the non-closure group (1/385, 0.3% versus 22/828, 2.7%, p = 0.008, log-rank test). Non-closure of PD was a risk factor for PH and SPH (odds ratio (OR) 7.72, 95% CI 1.84–32.35, p = 0.006). Conclusions: PD closure is recommended after gastrectomy for gastric cancer, as the rates of PH and SPH were significantly decreased. [ABSTRACT FROM AUTHOR]

Background: Due to the controversy over the prognostic significance of Borrmann type in patients with gastric cancer (GC), the present study was to investigate the clinical value of Borrmann type in advanced GC. Methods: We retrospectively evaluated 2092 patients with advanced GC and subsequently examined the clinicopathological characteristics and prognosis of patients stratified by Borrmann type. Results: Patients were divided into three groups according to Borrmann type (Borrmann types I+II, III, and IV). Patients with Borrmann types III and IV had larger size, more poorly differentiated tumor type, more advanced tumor stage, and higher chance of involving the entire stomach. The overall survival (OS) rates were significantly different among the three groups (p < 0.001). Stratification analysis revealed significant OS rates among the three groups in tumor-node-metastasis (TNM) stage III (p < 0.001) and TNM stage IV (p = 0.008). Multivariate analysis revealed that Borrmann types, adjuvant chemotherapy, curative resection, and TNM stage were all independent predictors of OS among GC patients. The subgroup analysis indicated that Borrmann type was an independent predictor of OS among GC patients who undergone curative resection and with TNM stage III cancer. However, curative resection and postoperative chemotherapy failed to prolong the survival of patients with Borrmann type IV. Conclusions: The clinicopathological characteristics and prognosis of patients with three Borrmann types of GC were different. Borrmann type can be simply used as a valuable factor to predict survival in advanced GC patients, especially in those TNM stage III undergoing curative resection. Additionally, more attention should be paid to the treatment for Borrmann type IV GC. [ABSTRACT FROM AUTHOR]

Background: Obesity may impact surgical outcomes of gastrectomy. Whether visceral fat area (VFA) is a better obesity parameter than body mass index (BMI) is still controversial. The aim of this study is to compare the accuracy and effectiveness of VFA and BMI in predicting the short-term surgical outcomes of gastrectomy.Methods: Patients who were diagnosed with gastric cancer were measured for BMI and VFA preoperatively and then divided into a VFA-H (VFA-high) group and VFA-L (VFA-low) group, at the cutoff point of 100 cm2, and a BMI-H (BMI-high) group and BMI-L (BMI-low) group, at the cutoff point of 25 kg/m2. The short-term surgical outcomes were compared between the different groups.Results: In total, 276 patients were enrolled in this study; 55 (19.9%) patients were classified into the BMI-H group, and 122 (44.2%) patients were classified into the VFA-H group. There was a significant correlation between BMI and VFA (r = 0.652, p < 0.001). Compared with the VFA-L group, the VFA-H group had a higher incidence of postoperative complications (31.1% vs. 13.0%; p < 0.001), longer operation duration (270.0 (235.0-305.0) vs. 255.0 (223.8-295.0), p = 0.046), and more blood loss (100.0 (100.0-150.0) vs. 80.0 (80.0-100.0), p < 0.001), while the BMI-H group had more blood loss than the BMI-L group (100.0 (100.0-120.0) vs. 100.0(80.0-100.0), p = 0.006). Logistic regression showed that VFA was an independent risk factor for postoperative complications (odds ratio 2.813, 95% CI 1.523-5.194; p = 0.001).Conclusion: For gastric cancer patients, VFA is superior to BMI in accurately and effectively illuminating the impact of obesity on short-term surgical outcomes.Trial Registration: Clinicaltrials.gov: NCT02800005. [ABSTRACT FROM AUTHOR]

Background: The prognostic significance of preoperative plasma fibrinogen in patients with operable gastric cancer remains under debate. This study aimed to elucidate the prognostic value of fibrinogen in gastric cancer patients underwent gastrectomy. Methods: A total of 4351 patients with gastric cancer collected from three comprehensive medical centers were retrospectively evaluated. Patients were categorized by minimum P value using X‐tile, while the baseline confounders for fibrinogen was balanced through propensity score matching (PSM). The relationships between fibrinogen and other clinicopathologic features were evaluated, and nomogram was constructed to assess its prognostic improvement compared with TNM staging system. Results: Fibrinogen was significantly correlated with macroscopic type, tumor differentiation, tumor size, and T and N stage. The factors, fibrinogen and T stage as well as N stage, were identified to be independent prognostic factors after PSM. Nomogram based on fibrinogen demonstrated a smaller Akaike information criterion (AIC) and a larger concordance index (C‐index) than TNM staging system, illustrating that fibrinogen might be able to improve the prognostic accuracy. Conclusions: Preoperative plasma fibrinogen levels in gastric cancer patients were significantly correlated with tumor progression, which could be regarded as a reliable marker for survival prognostic prediction. [ABSTRACT FROM AUTHOR]

Background. The da Vinci robotic system was considered an effectively alternative treatment option for early gastric cancer patients in recent years. The aim of our study was to evaluate the safety and feasibility of robot-assisted gastrectomy in our center. Methods. This study included 33 patients who underwent robot-assisted gastrectomy (RAG) and 88 patients who underwent laparoscopic-assisted gastrectomy (LAG) between January 2016 and April 2018. Clinicopathological characteristics, surgical parameters, postoperative recovery, and the learning curves of RAG were evaluated. Results. Baseline characteristics between two groups were well balanced. The operation time of RAG was longer than that of LAG (333.1±61.4 min vs. 290.6±39.0 min, p=0.001), and the estimated blood loss was 62.4±41.2 ml in the RAG group and 77.7±32.3 ml in the LAG group (p=0.005), respectively. The mean number of examined lymph nodes in RAG was less than that in LAG (30.3±10.2 vs. 37.4±13.7, p=0.008). However, RAG had an advantage in the dissection of No. 9 lymph nodes (3.4±2.1 vs. 2.5±1.6, p=0.039). The incidence of postoperative complications was similar in both groups (p=0.735). There were no significant differences in terms of postoperative recovery between the two groups. The learning curve of RAG showed that the CUSUM value decreased from the 8th case, which suggested a rapid learning curve among experienced surgeons on LAG operations. Conclusions. RAG was safe and feasible for gastric cancer patients, with superiority in the dissection of No. 9 lymph nodes. [ABSTRACT FROM AUTHOR]

Background: The new 8th TNM system attributes AEG Siewert type II to esophageal classification system. However, the gastric and esophageal classification system which was more suitable for type II remains in disputation. This study aimed to illuminate the 8th TNM-EC or TNM-GC system which was more rational for type II, especially for patients underwent transhiatal approaches. Methods: We collected the database of patients with AEG who underwent radical surgical resection from two high-volume institutions in China: West China Hospital (N = 773) and Xi Jing Hospital of Fourth Military University (N = 637). The cases were randomly matched into 705 training cohort and 705 validation cohort. All the cases were reclassified by the 8th edition of TNM-EC and TNM-GC. The distribution of patients in each stage, the hazard ratio of each stage, and the separation of the survival were compared. Multivariate analysis was performed using the Cox proportional hazard model. Comparisons between the different staging systems for the prognostic prediction were performed with the rcorrp.cens package in Hmisc in R (version 3.4.4. http://www.R-project.org/). The validity of these two systems was evaluated by Akaike information criterion (AIC) and concordance index (C-index). Results: By univariate analysis, the HRs from stage IA/IB to stage IV/IVB were monotonously increased according to TNM-GC scheme in both cohorts (training 2.63, 3.91, 5.02, 8.64, 15.51 and 29.64; validation 1.54, 3.55, 4.91, 7.14, 11.67, 18.71 and 48.32) whereas only a fluctuating increased tendency was found when staged by TNM-EC. After the multivariate analysis, TNM-GC (P < 0.001), TNM-EC (P = 0.001) in training cohort and TNM-GC (P < 0.001) TNM-EC (P < 0.001) in the validation cohort were both independent prognostic factors. The C-index value for the TNM-GC scheme was larger than that of TNM-EC system in both training (0.721 vs. 0.690, P < 0.001) and validation (0.721 vs. 0.696, P < 0.001) cohorts. After stratification analysis for Siewert type II, the C-index for TNM-GC scheme was still larger than that of TNM-EC in both training (0.724 vs. 0.694, P = 0.005) and validation (0.723 vs. 0.699, P < 0.001) cohorts. Conclusions: The 8th TNM-GC scheme is superior to TNM-EC in predicting the prognosis of AEG especially for type II among patients underwent transhiatal approaches. [ABSTRACT FROM AUTHOR]

Background: The preoperative work-up has limitations on finding peritoneal dissemination (PD) in gastric cancer patients. Laparoscopic exploration (LE) can discover radiographically occult PD, obtain accurate stage and avert futile laparotomy. The aim of our study was to introduce "Four-Step Procedure" LE in West China Hospital and further evaluate its safety and feasibility.Methods: We conducted a retrospective analysis on 165 patients from July 2016 to December 2017 who underwent "Four-Step Procedure" LE in gastrointestinal surgery department of West China Hospital. All the patients were diagnosed with gastric adenocarcinoma without explicit distant metastasis through Computed Tomography and/or Gastrointestinal Ultrasonography. Peritoneal lavage cytological examination (CY) was routinely performed during LE in our research. The "Four-Step" technical process of LE was introduced comprehensively. The clinicopathologic features and the presence of PD or CY at LE were analyzed, and the stratified analysis by cT and cN stages on the proportion of P1 and/or CY1 was also reported in this study.Results: Total of 165 patients accepted LE in our study, among these patients: 27 (16.4%) patients with P1 and/or CY1: 19 (11.5%) patients were found PD (P1), 17 (10.3%) patients with positive cytological examination (CY1) and 9 (3.6%) patients with P1Cy1. The stratified analysis by cT stage indicated that there was no P1 and/or Cy1 in cT1-cT2 stages, 1 (2.7%) patient with P1 and 1 (2.7%) with Cy1 in cT3 stage, 18 (20.0%) patients with P1 and 16 (17.8%) with Cy1 in cT4 stage. After LE, there were 74 (44.8%) patients underwent laparoscopic assistant gastrectomy, 25 (15.2%) patients with open gastrectomy, 50 (30.3%) patients with neoadjuvant chemotherapy and 16 (9.7%) patients with palliative chemotherapy and/or conversion therapy.Conclusion: "Four-Step Procedure" LE is reliable and feasible for gastric cancer. From our study, LE has unique superiority on ascertaining PD and cytological examination and LE should be recommended in cT4 stage gastric cancer before resection. [ABSTRACT FROM AUTHOR]

Abstract Diabetic retinopathy (DR) is a progressive microvascular complication associated with diabetes, and remains the leading cause of preventable blindness worldwide. Recent studies have revealed that microRNAs (miRNAs) were involving in the physiological and pathophysiological processes of diabetes and its microvascular and macrovascular complications. The purpose of the current investigation is to identify the candidate miR-211 as a novel biomarker for occurrence and progression of DR in clinical study and experimental research. Firstly, miR-211 was considered as a candidate miRNA identifying by miRNA microarray analysis, Venn diagram analysis, real-time quantitative reverse-transcription polymerase chain reaction (qRT-PCR) and receiver operating characteristic curve in clinical study. Then, the predicted Sirtuin 1 (SIRT1) may be the target gene of miR-211 searching by TargetScan 7.2. Moreover, miR-211 was significantly up-regulated, while SIRT1 mRNA significantly down-regulated measuring by qRT-PCR, meanwhile, SIRT1 protein was significantly down-regulated in coincidence with SIRT1 mRNA detecting by western blot, and even aggravated associated with diabetes duration in diabetic retinal tissues of vivo experiment. Additionally, miR-211 was directly targeted SIRT1 confirming by dual-luciferase reporter assay. Furthermore, with transfection of antagomiR-211, the apoptosis of HUVECs was significantly suppressed employing by flow cytometry analysis, nevertheless the viability of HUVECs was significantly promoted exploiting by Cell Counting Kit-8 assay. Finally, SIRT1 mRNA and SIRT1 protein were significantly up-regulated testing by qRT-PCR and western blot respectively in hyperglycemic HUVECs transfected with antagomiR-211 of vitro experiment. Consequently, the current clinical study and experimental research imply that serum miR-211 as a novel biomarker with high sensitivity and specificity could be associated with occurrence and progression of DR via targeting SIRT1. Highlights • Serum miR-211 was significantly up-regulated in patients with diabetic retinopathy. • miR-211 was significantly up-regulated associated with diabetes duration. • miR-211 could directly target SIRT1 and may regulate the expression of SIRT1. • Serum miR-211 as a biomarker for diabetic retinopathy via modulating Sirtuin 1. [ABSTRACT FROM AUTHOR]

Background and aims: Microalgae are ubiquitous in paddy soils. However, their roles in arsenic (As) accumulation and transport in rice plants remains unknown.Methods: Two green algae and five cyanobacteria were used in pot experiments under continuously flooded conditions to ascertain whether a microalgal inoculation could influence rice growth and rice grain As accumulation in plants grown in As-contaminated soils.Results: The microalgal inoculation greatly enhanced nutrient uptake and rice growth. The presence of representative microalga Anabaena azotica did not significantly differ the grain inorganic As concentrations but remarkably decreased the rice root and grain DMA concentrations. The translocation of As from roots to grains was also markedly decreased by rice inoculated with A. azotica. This subsequently led to a decrease in the total As concentration in rice grains.Conclusions: The results of the study indicate that the microalgal inoculation had a strong influence on soil pH, soil As speciation, and soil nutrient bioavailability, which significantly affected the rice growth, nutrient uptake, and As accumulation and translocation in rice plants. The results suggest that algae inoculation can be an effective strategy for improving nutrient uptake and reducing As translocation from roots to grains by rice grown in As-contaminated paddy soils. [ABSTRACT FROM AUTHOR]