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Temperature plays a crucial role in influencing the mechanical properties of materials. Accurately measuring the temperature of devices is essential for understanding the evolution of their mechanical properties under stress and evaluating their health and lifespan. However, traditional methods encounter challenges in measuring transient temperatures and lack sufficient time-resolution capability, particularly when it comes to the rapid temperature changes at the solder interface during the switching process of power devices. In this paper, based on the close correlation between the intensities of the characteristic spectral lines of the laser-induced elements and the temperatures, a method of measuring the surface temperatures with the time-resolved capability of the order of microsecond is proposed, and a quantitative relationship between the surface temperatures of the sample and the spectral characteristics is established. The findings demonstrate that an increase in the surface temperature of the material results in enhanced intensity and signal-to-noise ratio of laser-induced plasma spectra. This enhancement is influenced by the spectral acquisition delay and gate width. To establish a quantitative relationship between surface temperature and spectral properties, back propagation-artificial neural network (BP-ANN) and partial least squares (PLS) are employed for fitting and calibration. The fitted models can achieve linear correlation coefficient indexes exceeding 0.99. Notably, the BP-ANN fitted model exhibites a small fitting bias, with a root mean squared error (RMSE) of 2.582 and a correctness rate of 98.3%. The method provides an effective means for transient temperature measurement of objects and gives a strong support for the assessment of the health status of the soldering interface of power devices.

Critically ill patients are at high risk for hospital acquired infections, which can significantly increase the mortality rate and treatment costs for these patients. Therefore, in the process of treating the primary disease, strict prevention and control of new hospital infections is an essential component of the treatment for critically ill patients. The treatment of critically ill patients involves multiple steps and requires a concerted effort from various aspects such as theory, management, education, standards, and supervision to achieve effective prevention and control of hospital infections. However, there is currently a lack of unified understanding and standards for hospital infection prevention and control. To address this, in March 2024, a group of experts in critical care medicine, infectious diseases, and hospital infection from China discussed the current situation and issues of hospital infection control in the intensive care unit together. Based on a review of the latest evidence-based medical evidence from both domestic and international sources, 2024 Expert Consensus on Hospital Acquired Infection Control Principles in the Department of Critical Care Medicine was formed, aiming to provide a basis for the development of hospital infection prevention and control strategies in the field of critical care medicine.

A steady-state sinusoidal and distortion-free excitation source is very important for the accuracy and consistency of the calibration parameters of micro-electro-mechanical systems (MEMS) inertial sensors. To solve the problem that the current MEMS inertial measurement unit (IMU) calibration device is unable to reproduce the spatial motion of linear and angular vibration coupling, research topics on the coupling vibration characteristics and parameter identification for an electromagnetic linear-angular vibration exciter are proposed. This research paper used Ampere’s law and Lorentz force to establish the analytical expressions for the electromagnetic force and electromagnetic torque of the electromagnetic linear-angular vibration exciter. Then, the main purpose of this paper is to establish uniaxial and coupled vibration electromechanical analogy models containing mechanical parameters based on the admittance-type electromechanical analogy principle, and the parameter identification model is also obtained by combining the impedance formula with the additional mass method. Finally, the validity of the coupling vibration characteristics and the parameter identification model are verified by the frequency response simulation and the additional mass method, and the relative error of each parameter identification is within 5% in this paper.

Serine/threonine kinase 11 (STK11), a tumor suppressor gene, exhibits frequent mutations in lung adenocarcinoma (LUAD). However, the specific molecular mechanisms by which STK11 mutations exert an influence on the biosynthesis of monounsaturated fatty acids (MUFAs) and subsequently affect ferroptosis in LUAD remain indistinct. In this study, bioinformatic analysis was employed to probe into the linkage between STK11 and key inhibitory genes of ferroptosis, namely SLC7A11 and SCD1, in LUAD tissues. Quantitative reverse transcription polymerase chain reaction was employed to assess the expression of STK11 in both wild-type and mutant STK11 LUAD cells, cell counting kit-8 to assess cell viability, and flow cytometry to detect apoptosis. A transmission electron microscope was utilized to observe mitochondrial morphology, and Western blot to ascertain the protein expression of STK11, ferroptosis-related proteins, and the enzyme SCD1 involved in MUFA synthesis. Oil red O staining was employed to test the distribution of lipid droplets in cancer cells, and a lipid quantification method to measure the content of MUFAs. Commercial kits were employed to assess the levels of lipid reactive oxygen species, malondialdehyde, glutathione, and Fe2+ in cells. The result revealed a negative correlation between STK11 and SLC7A11 as well as SCD1, with STK11 expression downregulated in mutant STK11 LUAD cells. Furthermore, STK11 mutations were found to suppress ferroptosis in LUAD cells by affecting MUFA synthesis. Subsequent rescue assays demonstrated that STK11 mutations hindered ferroptosis by impacting the synthesis of MUFAs in LUAD cells. This study provided evidence that STK11 mutations suppressed ferroptosis in LUAD cells by promoting MUFA synthesis, thus offering a novel research direction in the management of LUAD.

Fano resonance from photonic crystal nanobeam cavity (PCNC) is important building block for large-scale photonic integrated circuits (PICs) to enable photonic switches and sensors with superior characteristics. Nevertheless, most state-of-the-art demonstrations rely on electron beam lithography (EBL) and operate in dielectric mode. Hence, we theoretically, numerically and experimentally present the characteristics of Fano resonance from optical interference between the discrete state of air-mode PCNC and the continuum mode of side-coupled line-defect waveguide with partially transmitting element (PTE) using deep ultraviolet (DUV) lithography for the first time. Experimentally high average Q-factor of ∼1.58 × 104 is achieved for 30 measured devices, which indicates the feasibility of mass manufacture of high-Q Fano resonance from air-mode PTE-PCNC. Additionally, the thermo-optic bi-stability and thermal tuning characterizations of the proposed device are discussed. This work will contribute to building ultra-compact lab-on-chip resonance-based photonic components.

Device clamps are used for connecting and fastening lines， and their health condition directly affects the reliability of power supply. In view of the line faults largely caused by the failure of device clamps under marine environment， the clamp failure mechanism is analyzed and a life assessment method based on an improved neural network A-DBiLSTM is introduced. Firstly， a correlation model between the failure process and environmental factors is established through the simulation experiment of device clamp operation environment， and the key failure characteristics are extracted to develop the life state assessment index. Secondly， the A-DBiLSTM model is constructed， and the influence of multi-environmental factors and highly correlated environmental characteristics on the operating state of clamps is considered. The life assessment of clamps is achieved by focusing on the assignment of typical strong meteorological characteristics through the Attention mechanism. Finally， the method is validated based on the actual operation data of device clamps in an island distribution network in Zhejiang province. The results show that the method can accurately assess the life state of device clamps of distribution networks under different marine environments and is of practical value for ensuring line reliability， improving clamp operation management， and enhancing device quality.

Objective To investigate the changes of intestinal microbiome in patients with varicocele (VC) with macrogenomics. Methods Fresh feces from 15 VC patients and 15 healthy individuals were collected, and DNA sequences were extracted from the feces. The diversity and functional characteristics were analyzed by metagenome sequencing methods. Results There were no statistical differences in age and body mass index (BMI) between the 2 groups (P > 0.05). The Alpha diversity results showed no significant difference was observed between them (P > 0.05). The Beta diversity results indicated that the species diversity had significant differences in the feces between the VC patients and healthy individuals (P < 0.01). The dominant floras in both the VC patients and healthy individuals were mainly Firmicutes, Bacteroidetes, Proteobacteria, Actinobacteria and Fusobacteria. At species level, the dominant floras in VC patients included Flavonifractor plautii, Methanobrevibacter smithii, Enterobacter roggenkampii, etc, and those in the healthy individuals were Phascolarctobacterium faecium, Romboutsia ilealis, Bifidobacterium bifidum, Prevotella jejuni, Clostridium perfringens, etc. Metagenomics data identified significant up-regulation of D-glucarate degradation pathways, including D-galactarate degradation I, superpathway of D-glucarate and D-galactarate degradation, D-glucarate degradation I, etc. The alterations were associated with intestinal microbiomes Enterococcus faecalis, Flavonifractor plautii, Raoultella terrigena, etc. Conclusion There are obvious characteristics changes in microflora structure between VC patients and healthy controls. Up-regulation of D-glucarate degradation pathways are found in VC patients. These changes of intestinal microbiome might be one of the underlying pathophysiological mechanism of VC.

With the explosive growth of global network traffic and the consequent increase in bandwidth and energy consumption required for data transmission, traditional electronic interconnection architectures are no longer able to meet the requirement of the growing bandwidth and energy conservation. Silicon-based photonics featured as high bandwidth, low energy consumption, and more importantly, compatibility with Complementary Metal-Oxide-Semiconductor (CMOS) technologies enables the large-scale Photonic Integrated Circuits (PIC) and Electronic Integrated Circuits (EIC) to be integrated in a single substrate, hence it is regarded as one of the most promising solutions to address these challenges. However, with the increasing frequency of signals and the increasing number of integrated photonics and electronic devices, parasitic effects are becoming more prominent, leading to a significant degradation in the integration density, bandwidth density, and energy efficiency of the chip. 2.5D/3D integration technologies can effectively reduce the electrical interconnect length and chip size, thus reducing parasitic effects and power consumption, as well as increasing integration density. This paper presents different schemes of silicon based optoelectronic integration and its recent advances, and looks forward to the application prospects of 2.5D/3D integration technologies in data communication, Light Detection and Ranging (LiDAR), biochemical sensing, and optical computing, et al.

Critical care medicine in China has developed rapidly and played an irreplaceable role in the treatment of critically ill patients, emergency disasters and public health events. The standardized training of specialists is not only an important part of medical education after graduation, but also a conventional way to train qualified specialized clinicians. As the second batch of national pilot specialties, critical care medicine has established a national unified specialist training system, which has become an important way to cultivate professionals. This study compares the similarities and differences of critical care medicine specialty training in foreign countries from the aspects of training system and platform construction, so as to provide reference for promoting the continuous improvement of critical care specialist training system in China.

Shock of condensed matter is ubiquitous in nature, yet a full understanding of the response when shock waves propagate into solids is still lacking because of a lack of real-time microstructural data. Pulsed X-ray diffraction technique is being developed as a microscopic lattice diagnostic technique for shocked crystals, and it can provide transient information of lattice structure from the shock front. In this thesis, a pulsed X-ray diffraction measurement system was established by using a molybdenum-target miniaturized flash X-ray source with the half width of 25 ns and digital X-ray photography equipment. Real-time measurement of lattice response under one-dimensional strain loading was realized, and useful information for understanding the response of shocked solids was acquired using this system. The model of pulsed X-ray diffraction measurement of lattice deformation rate was established. The influence on X-ray diffraction measurement from impact tilt and translation of the crystal sample was analyzed and the quantitative data correction method was proposed. The uncertainty analysis method was implemented and uncertainty of lattice deformation rate including all kinds of uncertainty factors was obtained. The pulsed X-ray diffraction measurement system built was used to study the lattice response of shocked LiF single crystals under one-dimensional strain loading experiments based on the one-stage gas gun loading experimental platform. Single pulsed X-ray diffraction data from LiF single crystals were obtained when loading along the ［100］ direction. In the experiment, the initial input stress obtained in sample was 3.65 GPa. The reflected stress from the LiF/back-plane interface was reduced to 2.33 GPa. In the experimental data, two shocked diffraction peak has appeared. The experimental results show that reflected rarefaction wave was moving back through the LiF crystal during Xray exposure time. The LiF crystal ahead of the rarefaction wave front was in one shocked state, while the LiF crystal between the rarefaction wave front and the LiF/backplane interface was in another shocked state. Quantitative measurement of lattice deformation related to shock pressure (233 Gpa and 365 GPa) was achieved, and the lattice deformation results measured are in agreement with the calculated results from Hugoniot relation. The results reveal an isotropic compression of the unit cell in shocked plastic deformation of LiF(100). The present work has provides an effective means to study the microscopic lattice response under shock compression experiment. However, further work is needed when using diffraction methods to a broader range of problems. For example, time resolution can be enhanced with a brighter X-ray source, and continuum measurement can be conducted to accurate the relationship between the continuum response and microscopic lattice response.

Bacterial outer membrane vesicles (OMVs) are spherical microbubbles that contain biological content and are produced by gram-negative bacteria. The use of OMVs as adjuvants for cancer immunotherapy or as drug carriers for targeted therapies has attracted the interest of many scholars. However, it is unclear whether OMVs can exert direct antitumor effects and whether OMVs can inhibit pediatric tumors. Here, we explore the potential of Escherichia coli-derived OMVs to directly suppress neuroblastoma. Our results demonstrate the antitumor effects of OMVs in vitro and in vivo, and no serious adverse reactions were observed. OMV uptake into the cytoplasm and nucleus directly decreases cell stemness, DNA damage, apoptosis and cell cycle arrest, which may be the mechanisms by which OMVs suppress tumors. Our results demonstrate the potential of bacterial OMVs to be used as antitumor adjuvant therapies, increasing the number of candidates for the development of cancer therapies in the future. More relevant studies are urgently needed to demonstrate the efficacy and safety of OMVs.

Objective To investigate the alleviating effects of alpha-ketoglutarate (AKG) on bile duct ligation (BDL)-induced cholestatic liver injury in mice and its possible mechanism. Methods Thirty-two C57BL/6 male mice were randomly assigned to 4 groups (n=8): sham operation group (Sham), sham operation+AKG group (Sham+AKG), BDL group and BDL+AKG group. Liver and blood samples were collected from all groups in 7 d after operation, and the serum levels of ALT, AST, TBIL, TBA and ALP were measured. HE staining and immunohistochemistry were used to detect the severity of liver injury and the expression of F4/80 and myeloperoxidase (MPO) in each group, respectively. qRT-PCR was adopted to determine the mRNA expression of pro-inflammatory cytokines. Hepatocyte apoptosis was evaluated by TUNEL assay. Results As compared with the BDL group, the BDL+AKG group showed significantly lower concentrations of ALT, AST, TBIL, TBA and ALP (P < 0.05), obviously relieved liver histologic injury (P < 0.05), reduced expression levels of F4/80 and MPO as well as pro-inflammatory cytokines (P < 0.05), and decreased number of TUNEL positive hepatocytes (P < 0.05). Conclusion AKG alleviates hepatic injury in BDL-induced cholestasis model mice, and its mechanism is possibly related to the inhibition of inflammatory response and hepatic cell apoptosis.

Condenser titanium tubes are easily to generate many defects in nuclear power plants, such as corrosion, damage, and wall thickness thinning. Eddy current technology is the main method of condenser titanium tubes in-service inspection, but manual operation has the problem of low efficiency. This article designed one new titanium tube eddy current inspection system based on automatic push-puller, and successfully applied in the nuclear power plant in China. The results show that this system can realize eddy current inspection in the condenser tubes with push-puller machine.

Background and purpose: There are many anastomoses between stomach and esophagus in esophageal cancer surgery, each of which has its own advantages and disadvantages. The aim of this study was to investigate the safety and feasibility of end-to-end double-layer esophagogastric anastomosis and gastric fundus embedding during minimally invasive esophagectomy for esophageal cancer. Methods: The clinicopathological data of 129 patients who underwent minimally invasive esophagectomy from April 2019 to April 2021 in Zigong Fourth People’s Hospital were retrospectively reviewed. All patients were treated with thoracoscopy and laparoscopy combined with minimally invasive cervicothoracic and abdominal tri-incision (McKeown procedure) esophageal cancer resection. The thoracic procedure was performed with thoracoscopy, and the abdominal procedure with laparoscopy. The patients were divided into end-to-end double-layer esophagogastric anastomosis and gastric fundus embedding group (87 cases) and end-to-side anastomosis group (42 cases). Patients were followed up for evaluation of associated complications, of which anastomotic leakage, anastomotic stenosis and gastroesophageal reflux were the primary objectives of this study. Results: All the 129 patients underwent esophagectomy. Neoadjuvant therapy was more common in the end-to-end doubled anastomosis group (12.0% vs 2.3%, P = 0.037). There was no statistically significant difference in other basic clinical data between the two groups (P>0.05). There was no significant difference in the mean operation time between the two groups. The anastomosis time was less in end-to-side stapling group than in end-to-end stapling group[(32.0±6.8) min vs (15.0±5.4) min, P = 0.021]. The differences in the incidences of anastomotic leakage (1.1% vs 11.9%, P = 0.023), gastroesophageal reflux (9.1% vs 26.1%, P = 0.012), pneumonia (12.6% vs 30.9%, P = 0.023) and arrhythmia (10.3% vs 26.1.%, P = 0.020) were statistically significant between the two groups. Conclusion: The method of end-to-end double-layer anastomosis and gastric fundus embedding is safe and stable in esophagectomy. It can effectively prevent anastomotic leakage and gastroesophageal reflux.

Paraffin phase change composite material (PPCCM) has attracted increasing attention and research from scholars at home and abroad because of its excellent latent heat value and high energy storage density. As an important class of medium and low temperature phase change materials, PPCCM is the first choice to prepare room temperature and low-temperature composite phase change materials. However, the risk of low thermal conductivity and some defects are obstacles for the industrialization of PPCCM. Due to the unique structure of carbon nanotubes (CNTs) with complex coils and excellent thermal conductivity, CNTs is considered as one of the important candidate materials that are expected to improve the thermal performance of PPCCM significantly. Therefore, the combination of CNTs and paraffin has become a hot issue. In this review, according to the current research status of CNTs and PPCCM in the past few years, the preparation, microencapsulation and practical application were systematically summarized. The challenges(complex preparation process, poor stability, few actual evaluation, etc.) and possible research priorities(doping ratio, wettability, economy, etc.) were also discussed.

Objective To analyze the changes in intestinal fungi and compositions in patients with cholestatic liver disease from healthy individuals. Methods Fresh feces from 20 patients with cholestatic liver disease and 22 healthy individuals were collected. The intestinal fungi were determined by ITS2 DNA sequencing, and the differences of fungal flora diversity, structure and functional characteristics between the 2 groups were analyzed by bioinformatics methods, and the correlation between intestinal fungi and clinical parameters was analyzed. Results There were no significant differences in age, sex composition and smoking between the 2 groups (P>0.05). The serological indexes were significantly higher in the patients with cholestatic liver disease than the healthy controls (P < 0.05). No significant difference was seen in the Alpha diversity of intestinal fungi between the 2 groups (P>0.05), but significant differences were observed in Beta diversity (P < 0.01). The relative abundance of Myceliophthora was increased (P < 0.01) and that of Diutina was decreased (P < 0.01) in the patients with cholestatic liver disease. LEfSe analysis showed that Myceliophthora was significantly enriched in the patients, and the abundance of Saprotroph-Symbiotroph was significantly lower in the patients than the healthy controls. Spearman correlation coefficient analysis showed that Myceliophthora was positively correlated with alanine transaminase (ALT, P < 0.05), and aspartate transaminase (AST), alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT) and total bilirubin (TBIL) (P < 0.01). Conclusion Characteristic changes are seen in intestinal fungal compositions between the patients with cholestatic liver disease and the healthy controls. Myceliophthora is closely associated with the severity of the disease.

L-band radio frequency is in the range of 1 GHz~2 GHz，which is widely used in rader, communication and navigation. The main research content of this paper is to design an L-band broadband, high dynamic RF digital receiver using RF digital receiver demodulation technology. In this paper, the design of L-band RF digital receiver is research at RF sampling, digital channel separation, receiver dynamic expansion and high-speed signal demodulation, and give a specific implement scheme of digital channel separation, high-speed signal demodulation based on FPGA digital signal process platform.

In the present study, we deal with the space–time fractional KdV–MKdV equation and the space–time fractional Konopelchenko–Dubrovsky equation in the sense of the conformable fractional derivative. By means of the extend (G′G)\left(\tfrac{G^{\prime} }{G}\right)-expansion method, many exact solutions are obtained, which include hyperbolic function solutions, trigonometric function solutions and rational solutions. The results show that the extend (G′G)\left(\tfrac{G^{\prime} }{G}\right)-expansion method is an efficient technique for solving nonlinear fractional partial equations. We also provide some graphical representations to demonstrate the physical features of the obtained solutions.

Objective To investigate the expression of heparanase-2 (HPSE2) in gastric cancer tissues, and explore its effect on the survival and prognosis of the cancer and invasion and migration of the cancer cells. Methods Immunohistochemical staining of HPSE2 was performed on gastric cancer tissue chip to examine the expression level of HPSE2 in gastric cancer and paracancerous tissues. The correlation of HPSE2 expression level with clinical features, survival, prognosis and prognostic factors were analyzed. The lentival vectors of HPSE2 overexpression were constructed, and then transfected in gastric cancer cell lines SGC7901 and MKN28. The effect of HPSE2 overexpression on invasion and migration of gastric cancer cells were detected using Transwell analysis. Results The mean pathological score of HPSE2 was 4.56 in gastric cancer tissue, and 7.18 in paracancer tissues, showing that the expression was significantly lower in gastric cancer than paracancer tissues (P < 0.05). The expression level of HPSE2 was closely correlated with the tumor size, lymph node metastasis, and clinical staging. The patients with higher HPSE2 expression had obviously shorter median survival time and cumulative survival rate than those with lower expression (P < 0.05). Cox proportional risk model showed that clinical stage, tumor size and HPSE2 protein expression were risk factors for prognosis of gastric cancer patients (P < 0.05). Overexpression of HPSE2 could remarkably inhibit the invasion and migration of gastric cancer cells. Conclusion HPSE2 is lowly expressed in gastric cancer tissues, and is associated with the tumor size, lymph node metastasis, survival and prognosis of gastric cancer. Overexpression of HPSE2 could inhibit the invasion and migration of gastric cancer cells.

BACKGROUND Magnesium isotope fractionation effect during low-temperature geochemical processes is the foundation of tracing supergene evolution and material cycle of the earth. OBJECTIVES To summarize the magnesium isotope composition of different geological reservoirs and investigate the controlling factors of the magnesium isotope fractionation during the formation of carbonate minerals. METHODS Systematic collection and summary of previous research results. RESULTS Magnesium isotope compositions of igneous rocks were relatively homogeneous. The weathering products were relatively enriched in heavy isotopes of magnesium with significant variation. Carbonate rocks showed enrichment in light isotopes of magnesium in general. The large variation of magnesium isotope composition of river water was affected by lithology, weathering degree and vegetation. Magnesium isotope composition of seawater was homogeneous with an average of -0.83‰. At low temperature, the factors controlling the fractionation of magnesium isotopes in the inorganic process of carbonate minerals were mineral phase, precipitation rate and temperature, of which mineral phase was the main controlling factor. The factors influencing the magnesium isotope composition of biogenic carbonate minerals were forms of utilization of magnesium carbonate minerals by organisms. In addition to considering the mechanisms that were similar to inorganic carbonate precipitation, the selective absorption of light and heavy magnesium isotopes by different species should be considered. Almost all biogenic marine carbonate minerals were transformed from the original amorphous phase carbonate precursor, and their original magnesium isotope composition was masked by the later magnesium isotope composition during transformation. Therefore, the magnesium isotope composition of biogenic marine carbonate minerals cannot represent the fluid isotope composition from which the original amorphous carbonate precursor formed. CONCLUSIONS Magnesium isotopes have a good fractionation effect at low temperature. With the development of analytical technology and the accumulation and improvement of magnesium isotope composition data in different geological reservoirs, many problems related to the mechanism of magnesium isotope fractionation in the supergene environment will be solved gradually. Magnesium isotopes will play a greater role in revealing the evolution of the supergene environment and the material cycle of the earth.

Purpose: The objective of this study was to explore the risk factors for anorectal dysfunction after intersphincteric resection in patients with low rectal cancer.Methods: A total of 251 patients who underwent intersphincteric resection from July 2014 to June 2020 were included in this study, for which the Kirwan's grade, Wexner score, and anorectal manometric index were used to evaluate the anorectal function and other parameters including demographics, surgical features, and clinical and pathological characteristics. These parameters were analysed to explore the potential risk factors for anorectal function after intersphincteric resection.Results: In the 251 included patients, 98 patients underwent partial intersphincteric resection, 87 patients underwent subtotal intersphincteric resection, and 66 patients underwent total intersphincteric resection. There were 53 (21.1%) patients who had postoperative complications, while no significant difference was observed between the three groups. Furthermore, 30 patients (45.5%) in the total intersphincteric resection group were classified as having anorectal dysfunction (Kirwan's grade 3–5), which was significantly higher than that in the partial intersphincteric resection group (27.6%) and subtotal intersphincteric resection group (29.9%). The mean Wexner score of patients that underwent total intersphincteric resection was 7.9, which was higher than that of patients that had partial intersphincteric resection (5.9, p = 0.002) and subtotal intersphincteric resection (6.4, p = 0.027). The initial perceived volume was lower in the total intersphincteric resection group than in the partial and subtotal intersphincteric resection groups at 1, 3, and 6 months after intersphincteric resection. In addition, the resting pressure, maximum squeeze pressure, and maximum tolerated volume in the total intersphincteric resection group were worse than those in the partial and subtotal groups at 3 and 6 months after intersphincteric resection. Univariate and multivariate analyses suggested that an age ≥65, total intersphincteric resection, and preoperative chemoradiotherapy were independent risk factors for anorectal dysfunction (P = 0.023, P = 0.003, and P = 0.008, respectively). Among the 66 patients who underwent total intersphincteric resection, 17 patients received preoperative chemoradiotherapy, of which 12 patients (70.6%) were classified as having anorectal dysfunction.Conclusion: The current study concluded that age ≥65, total intersphincteric resection, and preoperative chemoradiotherapy were risk factors for anorectal dysfunction after intersphincteric resection. The morbidity of anorectal dysfunction after total intersphincteric resection for patients who received preoperative chemoradiotherapy was relatively high, and the indication should be carefully evaluated.

Objective To discuss the role of a multidisciplinary team (MDT) in the diagnosis and treatment of colorectal cancer with liver metastases. Methods A MDT involving specialists from the departments of radiology, pathology, general surgery, hepatobiliary surgery, oncology and radiotherapy participated in the treatment planning and assessment throughout the treatment in a case of colonic cancer with liver metastases. The patient received comprehensive treatments provided by the MDT to maximize the treatment benefits. Results Examination of the patient showed that the metastatic foci in the liver were resectable. After translational treatment and several rounds of multidisciplinary discussions, the patient received surgical resection of the primary and metastatic lesions with postoperative systemic treatments. Follow-up of the patient showed no evidence of disease after chemotherapy, and survival benefits were achieved from the treatments. Conclusion The multidisciplinary approach is capable of providing the patients with colorectal cancer with specific, precise and individualized treatments to maximize the treatment benefits.

We aim to establish a prediction model for pregnancy outcomes through a combinatorial analysis of circulating biomarkers and maternal characteristics to effectively identify pregnant women with higher risks of preeclampsia in the first and third trimesters within the Asian population. A total of two hundred and twelve pregnant women were screened for preeclampsia through a multicenter study conducted in four recruiting centers in Taiwan from 2017 to 2020. In addition, serum levels of sFlt-1/PlGF ratio, miR-181a, miR-210 and miR-223 were measured and transformed into multiples of the median. We thus further developed statistically validated algorithmic models by designing combinations of different maternal characteristics and biomarker levels. Through the performance of the training cohort (0.848 AUC, 0.73–0.96 95% CI, 80% sensitivity, 85% specificity, p < 0.001) and the validation cohort (0.852 AUC, 0.74–0.98 95% CI, 75% sensitivity, 87% specificity, p < 0.001) from one hundred and fifty-two women with a combination of miR-210, miR-181a and BMI, we established a preeclampsia prediction model for the first trimester. We successfully identified pregnant women with higher risks of preeclampsia in the first and third trimesters in the Asian population using the established prediction models that utilized combinatorial analysis of circulating biomarkers and maternal characteristics.

Purpose: To evaluate the effectiveness of the comprehensive post-operative management including low-frequency endo-anal electrical stimulation and daily suppository usage on post-operative anal functional recovery for low rectal cancer patients who underwent robotic total intersphincteric resection (ISR).Methods: A retrospective analysis was performed on 42 low rectal cancer patients who underwent robotic total ISR, of which 23 patients received comprehensive post-operative management, including biofeedback low-frequency endo-anal electrical stimulation and daily suppository usage (management group). Wexner score and anorectal manometric values, including resting pressure (RP), maximum squeeze pressure (MSP), initial perceived volume (IPV), and maximum tolerated volume (MTV), were assessed and compared.Results: A total of 42 low rectal cancer patients were included in our study. The RP at 6 months after ISR (40.95 ± 6.95 mmHg vs. 33.29 ± 5.40 mmHg, p = 0.002) and MSP at 3 and 6 months after ISR (72.05 ± 10.16 mmHg vs. 69.05 ± 8.67 mmHg, p = 0.031; 91.57 ± 15.47 mmHg vs. 84.05 ± 12.94 mmHg, p = 0.039, respectively) were significantly higher in the management group. The median IPV at 1 and 3 months after ISR (17.81 ± 3.61 ml vs. 15.43 ± 5.08 ml, p = 0.038; 20.19 ± 4.35 ml vs. 17.67 ± 5.16 ml, p = 0.044, respectively) and MTV at 3 months after ISR (83.71 ± 5.44 ml vs. 76.10 ± 8.42 ml, p = 0.012) were significantly higher in the management group. Wexner scores at 1 and 3 months after closure of stoma (COS) in the management group were significantly lower (11.3 ± 2.9 vs. 13.4 ± 3.0, p = 0.041; 8.9 ± 2.0 vs. 10.6 ± 2.4, p = 0.036, respectively).Conclusions: Comprehensive post-operative management could accelerate the recovery of sphincteric function and anal sensitivity after robotic total ISR and could also contribute to treatment of fecal incontinence followed by COS.

Introduction: Laparoscopic repeat liver resection (LRLR) is a safe and effective treatment in recurrent hepatocellular carcinoma (rHCC) in particular patients. However, there are less reports about surgery strategy of LRLR for rHCC. The aim of this study was to perform a systematic strategy for bleeding of liver to increase the safety and feasibility of LRLR for rHCC. Methods: In this study, a total of 13 cases of LRLR for rHCC, including 8 males and 5 females; aged 28–72 years, mean age 54 years, who were received at least one laparotomy due to HCC. We employ to block the local blood flow, ligation of the left or right hepatic artery and/or approach of Pringle according to the assessment of the degree of adhesions in the abdominal and the first hepatic portal, the location of the tumour (edge/central). Results: Three cases were less adhesions, nine cases were dense adhesions but 1 case was serious adhesions. Two cases were employed to block the local blood flow, 3 cases were employed to ligation of the left or right hepatic artery and 7 cases were employed to approach of Pringle. Twelve cases were successfully completed by LRLR whereas 1 case was completed by transfer to the open resection, including massive resection in 3 cases (the diameter of resection ≥3 cm), small hepatectomy in 10 cases (the diameter of resection