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Purpose: To compare and analyze the incidence of postoperative reflux esophagitis (RE) in patients with early- and intermediate-stage proximal gastric cancer after proximal gastrectomy plus esophagus-remnant stomach anterior wall anastomosis with proper spacing between the reserved anastomotic stoma and the stump of the remnant stomach versus total gastrectomy plus Roux-en-Y anastomosis and to analyze the advantages and disadvantages of these anastomosis approaches. Methods: Hospitalization data of 23 patients with early- and intermediate-stage proximal gastric cancer were retrospectively analyzed. They were divided into an observation group who underwent proximal gastrectomy plus esophagus-remnant stomach anterior wall anastomosis with proper spacing between the reserved anastomotic stoma and the stump of the remnant stomach and a control group who underwent total gastrectomy plus Roux-en-Y anastomosis. Quality observation indicators were compared between the two groups. Results: There was no statistically significant difference between the groups in the number of lymph nodes cleared or the recurrence rate at 12 months postoperatively. The incidence of postoperative RE was significantly lower in the observation group (25%) than in the control group (80%). The operation time, postoperative length of hospital stay, appetite change, body mass index, and hemoglobin level at 6 months postoperatively were significantly better in the observation group than in the control group (P < .05). Conclusion: Proximal gastrectomy plus esophagus-remnant stomach anterior wall anastomosis with proper spacing between the reserved anastomotic stoma and the stump of the remnant stomach can be used as a preferred surgical procedure for early- and mid-stage proximal gastric cancer. [ABSTRACT FROM AUTHOR]

Background: The greater omentum has played a unique biological role in regenerative surgery. The aim of our study was to alter the anterior sacral structure by filling the anterior sacral space with the greater omentum and evaluate its effect on the low anterior resection syndrome (LARS) after total mesorectal excision (TME) surgery for low rectal cancer. Methods: We retrospectively collected clinical data of patients with primary low rectal cancer who underwent TME and ileostomy closure in our hospital from March 2018 to March 2020. Spearman correlation analysis was conducted to analyze the correlation between postoperative mesorectal fascia (MRF) thickness and LARS score. Subsequently, we prospectively used a tipped greater omental flap graft to reconstruct the anterior rectal sacral structures (MRF reconstruction) in 17 patients and compared LARS scores and rectal compliance (RC) at week 12 after closure of the ileostomy in both groups. Results: There were 47 patients with No-MRF reconstruction (31 males, mean age 60.68 ± 9.21 years) and 17 with MRF reconstruction (10 males, mean age 49.82 ± 14.74 years). Correlation analysis indicated that MRF thickness and RC were negatively correlated with LARS severity (p < 0.05). The LARS score of patients with MRF reconstruction at 12 weeks was significantly better than that of those with No-MRF reconstruction (32.97 ± 2.65 vs. 26.94 ± 1.52, p = 0.001), and the RC of MRF reconstruction were lower (2.80 ± 0.55 vs. 3.67 ± 0.38, p = 0.001). In addition, MRF reconstruction and No-MRF reconstruction have the similar incidence of postoperative complications (p = 0.156). No hemorrhage or necrosis of the greater omentum flap was observed in any of the patients. Conclusions: Greater omentum flap transplantation can significantly improve the symptoms of LARS at 12 weeks after ileostomy closure and we expect it to become a new surgical procedure for the treatment of low rectal cancer. [ABSTRACT FROM AUTHOR]

For lithium-ion capacitors, electrode potential tuning has been widely regarded as an efficient technology to improve their performance where the anode is usually pre-lithiated for desired potentials. However, the attention on the cathode is quite rare which denies the further excavation of this promising strategy. Herein, we reported the precious regulation of the potential of a cathode made of nitrogen-doped carbon nanosheets to fully leverage the merit of the electrode materials and the electrolyte potential window. Specifically, the nitrogen-doped carbon nanosheets in the optimized potential range of 1.6–4.5 V vs Li/Li+ show a specific capacity of around 150 mA h g−1 at 0.2 A g−1, which is four-time higher than that of the typical activated carbon cathode without potential tuning, and could be stably cycled for over 10 000 cycles without obvious decay. After pairing with a pre-lithiated anode, the as-assembled lithium-ion capacitors based on such a cathode can lead to simultaneously optimize the specific capacitance and voltage window of the device that contributes to a 17-fold increase in energy density, large power density, and long-term stability. The simple and effective strategy demonstrated here may inspire an alternative avenue to regulate the real performance of hybrid energy storage devices. The elaborately regulated carbon cathode is capable of working in a reasonable potential window for stably delivering a large specific capacity. After carefully pairing with the pre-lithiated anode, the device based on these electrodes exhibits high energy, large power, and long cyclic life. [Display omitted] [ABSTRACT FROM AUTHOR]

Achieving rate‐capable and high mass‐loaded lithium/sodium storage plays a pivotal role in promoting real world applications of many emerging electrode materials. Herein, such an electrode material is reported made of Mo and Fe‐based polyoxometalates firmly bonded on MXene nanosheets through a mild in situ growth procedure. The polyoxometalate nanoparticles can efficiently prevent the restacking of the MXene nanosheets, enabling an electrolyte‐permeable architecture at high mass loadings while the metallic conductivity of MXenes allows rapid electron transfer contributing to the full exploration of the rich redox capability of polyoxometalates even at high rates. The optimal structure delivers a high capacity of 297 and 191 mA h g–1 at 1.0 A g–1 for lithium and sodium storage, respectively, even after a thousand of cycles. The kinetic analysis suggests high capacitive contributions of 81.6% and 67.4% for lithium and sodium uptake/release at 1.0 mV s–1, respectively. Moreover, a decent capacity remains even after 13.5‐fold increase of loading mass. The lithium/sodium‐ion hybrid supercapacitors based on this composite deliver remarkable energy density and power capability. The results demonstrated in this work may offer an alternative selection of electrodes based on rationally designed polyoxometalates and MXenes. [ABSTRACT FROM AUTHOR]

Background: The use of 3-dimensional (3D) endoscopic thyroidectomy (ET) has been increasing, but its feasibility and safety have not been well documented for thyroidectomy. Hence, to systematically investigate the comparative outcomes during 3D-ET and 2-dimensional (2D) ET for benign and malignant lesions, we conducted this meta-analysis. Methods: Based on the PRISMA guidelines, a systematic database search of the PubMed, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), and Chinese Wanfang databases was performed. The eligible studies were published in English and Chinese up to October 2020. The major endpoints evaluated were procedure time, blood loss, postoperative drainage, postoperative hospitalization, postoperative complications, total number of lymph node dissections (LNDs), and total cost. Results: A total of 15 relevant studies including 1190 patients (583 for 3D-ET and 607 for 2D-ET) compared the application of 3D and 2D laparoscopic systems in thyroid surgery, of which 8 were endoscopic benign thyroidectomy (EBT) and 7 were endoscopic malignant thyroidectomy (EMT). Our meta-analysis indicated that 3D-ET generally had advantages over 2D-ET in terms of procedure time (P = 0.000), blood loss (P = 0.000), postoperative drainage (P = 0.000), postoperative complications (P = 0.000), and LNDs (P = 0.006). However, there were no significant differences between the two systems in terms of total cost (P = 0.245) or postoperative hospitalization (P = 0.068). Subgroup analysis showed consistency of the overall outcomes in each subset, but a shorter postoperative hospitalization in 3D-EBT was revealed. Conclusions: Compared to 2D-ET, 3D endoscopic thyroidectomy is an efficient, safe, and reliable method with better depth perception and stereoscopic vision, and an equally satisfactory outcome. More clinical RCTs with long-term follow-up are required to reproduce these promising results. [ABSTRACT FROM AUTHOR]

Video S1 introduces the case of 39-year-old female patient in whom a pedicled greater omentum flap was transplanted into the posterior rectal space after TME + total ISR for ultra-low rectal cancer in order to relieve LARS. From the splenic curvature, the greater omentum was released and dissociated along the right side of the vascular arch of the greater omentum, and the vertical vessels and marginal vessels on the right side of the greater omentum were retained. Total mesorectal excision plus total intersphincteric resection combined with pedicled omentum flap transplantation - A video vignette. [Extracted from the article]

Ordered macro/mesoporous SnS 2 /TiO 2 composite was successfully prepared via a template-free aqueous technique using tetrabutyl titanate as the titanium precursor and SnCl 4 •5H 2 O as the tin precursor. The photocatalytic activity of SnS 2 /TiO 2 composite was tested by the degradation of Methyl Orange (MO) aqueous solution under irradiation of the simulated sunlight. It was found that SnS 2 /TiO 2 composite displayed an enhanced photocatalytic activity with a 0.055 min −1 apparent rate constant (degradation efficiency of 90.9% within 50 min). The ordered macro/mesoporous structure and SnS 2 /TiO 2 heterostructure were considered to play synergistic effects in its enhanced photocatalytic performance, because the ordered porous structure can improve mass transfer and light capture, and heterostructure between SnS 2 and TiO 2 can reduce the recombination rate of photogenerated electrons and holes. [ABSTRACT FROM AUTHOR]

Purpose: To achieve excellent postoperative bowel function in familial adenomatous polyposis (FAP) patients, it is important to reconstruct the digestive tract. The aim of this study is to preliminarily discuss the advantages of total proctocolectomy with straight ileoanal anastomosis (TPC-SIAA) plus pedicled omental transposition for FAP. Methods: A retrospective study was carried out in two hospitals analysing data for FAP patients who underwent surgical treatments between 2015 and 2021. Perioperative outcomes and early and mid-term anal functions were analysed. Results: After excluding 4 patients who underwent total proctocolectomy with permanent ileostomy, 10 patients were enrolled in the study. Among the 10 patients, 3 received TPC-SIAA plus pedicled omental transposition, 3 received total proctocolectomy with ileal pouch-anal anastomosis (TPC-IPAA), and 4 received total colectomy with ileal pouch-rectal anastomosis (TC-IPRA). Except for one case conversion to laparotomy, laparoscopic surgery was performed for the other cases. The incidence of early postoperative complications was apparently higher with pouch anastomosis (57.1%) than straight anastomosis (0%). Frequencies of bowel movement and low anterior resection syndrome (LARS) score were higher for TPC-SIAA than the other two surgical procedures in the early term; over time, however, the frequencies of bowel movement and LARS score both showed a decreasing trend. In addition, combined with anorectal pressure detection and magnetic resonance imaging defecography at the 3rd month after TPC-SIAA plus pedicled omental transposition, defecation coordination was good. The dynamics and receptivity of the new rectum tended to be as expected. Conclusion: Although the three surgical procedures are safe and feasible surgical options for FAP, TPC-SIAA plus pedicled omental transposition is more consistent with intestinal physiology, with good intestinal compliance, and anal function tended to be as expected over time. Nevertheless, more extensive studies are needed to confirm these benefits. [ABSTRACT FROM AUTHOR]

Background: Three-dimensional (3D) laparoscopy has the advantages and characteristics of more radical procedures in the treatment of gastric cancer. The objective of this research was to investigate the short-term efficacy and safety of 3D laparoscopic procedures in the treatment of advanced distal gastric cancer. Methods: We retrospectively analyzed the clinical data of 124 patients treated with 3D and two-dimensional (2D) laparoscopic D2 lymphadenectomy for distal gastric cancer at the China Academy of Medical Sciences Cancer Hospital and the Affiliated Cancer Hospital of Guangxi Medical University from January 2014 to January 2015. The effects on operative time, bleeding, hospitalization time, complications, and the number of lymph nodes removed were analyzed. Results: The difference between the general data of the two groups was not statistically significant (P.0.05). In analysis of the subgroups, the number of lymph nodes removed in the 3D laparoscopic group was significantly higher than in the 2D laparoscopic group ([2.52±1.88] vs [2.22±1.80], P=0.001; [2.22±1.80] vs [1.47±1.99], P=0.019). However, the differences among the total number of lymph nodes removed, operative time, intraoperative blood loss, intraoperative complications, postoperative complications, postoperative recovery time, and postoperative hospital stay were not statistically significant. Conclusion: 3D laparoscopic-assisted radical gastrectomy for distal advanced gastric cancer is safe and feasible. [ABSTRACT FROM AUTHOR]

Three-dimensional (3D) printing has stood out as a reliable technology to construct carbon microlattice electrodes for supercapacitors (SCs) in the field of custom areal electrochemical performance needed. The complex structural parameters of 3D-printed (3DP) electrodes make customization of the 3DP electrodes low efficient and time-consuming. Herein, we integrate machine learning (ML) to deeply unravel the influence of typical structural parameters of 3DP electrodes made of graphene and carbon nanotubes (CNTs). The dependence of areal performance on electrode structures was established through selecting only 9 experimental points combined with random forest (RF) algorithm, where the valuable information and the hidden correlations were quickly extracted. By using the as-established model, the electrodes with desired performance could be printed based on structural parameters directly selected from the model, offering an essentially improved performance for target performance. Specifically, the areal performance could be tuned from 0.032 to 1.6 F cm−2, covering an extremely large range. Moreover, the electrochemical surface area (ECSA) and finite element analysis (FEA) were employed to analyze the dependence of areal performance on structural parameters, agreeing well with the model information. The idea proposed in this work could largely increase the efficiency of developing new electrode architectures for desired performance. [Display omitted] A machine learning framework is established to develop a prediction model between structural parameters and areal capacitance of 3DP electrodes. The well-fitted machine learning model constructed by random forest indicated that the feature importance is geometric area > electrode thickness > gap distance. Based on this model, the customization of areal capacitance could be realized, fulfilling the diverse requirements of actual applications. • 3D printing exhibits huge advantages in fabricating customized supercapacitors. • Machine learning model is established to guide 3D printing supercapacitors with desired performance. • Structural parameters influence areal capacitance by regulating electrochemical surface area and current distribution. [ABSTRACT FROM AUTHOR]

Background: Total mesorectal resection (TME) has become the standard surgical procedure for resection of colorectal cancer tumors. We presented a systematic meta-analysis to evaluate the surgical outcomes of laparoscopic TME surgery with preservation or nonpreservation of both the superior rectum artery (SRA) and left colonic artery (LCA) for upper-rectal and sigmoid colon cancers. Methods: The comparative studies were systematically searched on PubMed, Science Direct, Web of Science, Wanfang Data, and China National Knowledge Infrastructure (CNKI) up to April 2021. Primary outcomes were oncology outcomes. And secondary outcomes involved surgical outcomes of interest and postoperative recovery. Results: Five relevant studies with a total of 761 patients undergoing laparoscopic TME surgery were eligible for meta-analysis. Three hundred seven patients received TME with preservation of both SRA and LCA (Group A), and 454 received TME surgery alone (Group B), respectively. Our results indicated that Group A had a less total postoperative complications (P = .000), lower anastomotic leakage rate (P = .002), shorter length of stay (P = .008), and longer operative time (P = .002). However, there was no significant difference between the two groups in terms of lymph node dissections (P = .188), intraoperative bleeding (P = .474), the first postoperative defecation (P = .943), recurrence rate (P = .547), and conversive rate (P = .504). Conclusions: Based on our meta-analysis, laparoscopic TME surgery with preservation of both the SRA and LCA for upper-rectal and sigmoid colon cancers may significantly receive better clinical and surgical outcomes. More well-designed large sample studies are required to replicate the short-term benefits and long-term oncologic outcomes. [ABSTRACT FROM AUTHOR]

Background: KRAS gene is the most common type of mutation reported in colorectal cancer (CRC). KRAS mutation-mediated regulation of immunophenotype and immune pathways in CRC remains to be elucidated.Methods: 535 CRC patients were used to compare the expression of immune-related genes (IRGs) and the abundance of tumor-infiltrating immune cells (TIICs) in the tumor microenvironment between KRAS-mutant and KRAS wild-type CRC patients. An independent dataset included 566 cases of CRC and an in-house RNA sequencing dataset were served as validation sets. An in-house dataset consisting of 335 CRC patients were used to analyze systemic immune and inflammatory state in the presence of KRAS mutation. An immue risk (Imm-R) model consist of IRG and TIICs for prognostic prediction in KRAS-mutant CRC patients was established and validated.Results: NF-κB and T-cell receptor signaling pathways were significantly inhibited in KRAS-mutant CRC patients. Regulatory T cells (Tregs) was increased while macrophage M1 and activated CD4 memory T cell was decreased in KRAS-mutant CRC. Prognosis correlated with enhanced Tregs, macrophage M1 and activated CD4 memory T cell and was validated. Serum levels of hypersensitive C-reactive protein (hs-CRP), CRP, and IgM were significantly decreased in KRAS-mutant compared to KRAS wild-type CRC patients. An immune risk model composed of VGF, RLN3, CT45A1 and TIICs signature classified CRC patients with distinct clinical outcomes.Conclusions: KRAS mutation in CRC was associated with suppressed immune pathways and immune infiltration. The aberrant immune pathways and immune cells help to understand the tumor immune microenvironments in KRAS-mutant CRC patients. [ABSTRACT FROM AUTHOR]

Fluoropyrimidine-based chemotherapy is an essential component of systemic chemotherapy for colorectal cancer (CRC). The immune response is implicated in chemotherapy-induced cytotoxicity. Here, we reported an immune risk (Imm-R) model for prognostic prediction in patients receiving fluoropyrimidine-based chemotherapy. Gene expression profiles and corresponding clinical information were collected from four data sets and divided into training set (n = 183) and validation set (validation set1: n = 34; validation set2: n = 99). The composition of 22 tumor-infiltrating immune cells (TIICs) populations was characterized with the CIBERSORT deconvolution algorithm. A prognostic Imm-R model for predicting overall survival was established by performing least absolute shrinkage and selection operator (LASSO) penalized COX regression analysis. T follicular helper cells and M0 macrophages were associated with better survival, while eosinophils were associated with worse survival. TIICs signature was constructed based on the above three immune cell types. Furthermore, a Imm-R model was created by integrating TIICs signature with immune-related genes (IRGs), which effectively in distinguishing CRC patients with poorer prognosis. The Imm-R model was associated with activation of the TGF-beta signaling and suppression of DNA damage. Results of this research provide new insights into the role of immunity for in fluoropyrimidine-based chemotherapy as well as a useful tools to predict the outcome of CRC patients receiving fluoropyrimidine-based chemotherapy. [ABSTRACT FROM AUTHOR]