Efficacy of modified thoraco-laparoscopic Ivor-Lewis versus traditional thoraco-laparoscopic Ivor-Lewis for esophageal cancer: Propensity score-matched analysis

ObjectiveTo compare the clinical results of the modified Ivor-Lewis procedure, which preserves the azygous vein, thoracic duct and surrounding tissues, with the traditional Ivor-Lewis procedure, which removes these tissues, for treating esophageal squamous cell carcinoma, and evaluating whether the azygous vein, thoracic duct and surrounding tissues are required to be removed for the surgery of esophageal cancer.MethodsTo retrospectively analyze the clinical data of patients suffering from esophageal cancer treated by thoracic-laparoscopic Ivor-Lewis procedure admitted to the Department of Thoracic Surgery of Gansu Provincial People’s Hospital from September 2017 to September 2019. According to the surgical method, they were divided into the modified thoracolaparoscopic Ivor-Lewis (modified group) and the traditional thoracolaparoscopic Ivor-Lewis (traditional group). Propensity score matching analysis (PSM) was applied to reduce the selection bias of confounding factors.ResultsA total of 245 patients who suffered from esophageal cancer and underwent thoracic-laparoscopic Ivor-Lewis were enrolled in the study. There were 124 cases in the modified group and 121 cases in the traditional group. The discrepancies in the age and T-stage among patients in the traditional and modified groups were statistically significant. After PSM, the above-mentioned factors became statistically insignificant. There were 86 patients in each group after PSM. Compared with the traditional group, the modified group has shorter operative time (p=0.007), less intraoperative bleeding (p=0.003) and less postoperative 3 days chest drainage(p=0.001), with a statistically significant difference. No significant difference in local recurrence (p=0.721) and distant metastasis (p=0.742) after surgery were found in the two groups, and the difference was not statistically significant. There was also no statistically significant difference in the 3-year postoperative survival rate (44.2% vs. 41.9%, p=0.605) between the modified and traditional groups.ConclusionThe modified Ivor-Lewis procedure, which preserves the azygous vein, thoracic duct, and surrounding tissue, reduces surgical trauma in esophageal cancer, has not increased postoperative recurrent metastases, while achieved the same long-term outcomes as expanded surgery

An anti-noise algorithm based on locally linear embedding and weighted XGBoost for fault diagnosis of T/R module

Due to the noise accompanied with fault signals, it is challenging to identify the discriminant information and the local geometric feature from the complex fault data for enhancing fault diagnosis accuracy. To address this challenge, this work proposed an anti-noise algorithm based on locally linear embedding integrated with diffusion distance and maximum correntropy criterion (DMLLE). In DMLLE, diffusion distance was adopted instead of the Euclidean distance for neighborhood construction. Meanwhile, the optimal weights were updated to reveal local geometry information based on the loss function of the maximum correntropy criterion. Subsequently, DMLLE is eventually developed to further restrain noise embedding into raw signals and obtain low dimensional features. Furthermore, weighted extreme gradient boosting is used to map the low dimensional features to the types of faults, which easily implements fault pattern recognition. Finally, two synthetic manifold datasets and fault data acquired from the transmit/receive (T/R) module are used to validate the performance of the proposed diagnosis methodology. Compared with the existing methods, the proposed diagnosis methodology generates a smoother flow structure by preserving the local neighborhood of the dataset with noises and realizes a higher accuracy of 94.41% on the T/R module dataset, which outperforms 3%–9% better than other classification models. Therefore, it can be concluded that the proposed diagnosis methodology can effectively extract intrinsic fault features by weakening the influence aroused by noise and achieve superior accuracy in fault diagnosis by addressing the problem of small sample size

A Novel Passive Wireless Sensor for Concrete Humidity Monitoring

This paper presents a passive wireless humidity sensor for concrete monitoring. After discussing the transmission of electromagnetic wave in concrete, a novel architecture of wireless humidity sensor, based on Ultra-High Frequency (UHF) Radio Frequency Identification (RFID) technology, is proposed for low-power application. The humidity sensor utilizes the top metal layer to form the interdigitated electrodes, which were then filled with polyimide as the humidity sensing layer. The sensor interface converts the humidity capacitance into a digital signal in the frequency domain. A two-stage rectifier adopts a dynamic bias-voltage generator to boost the effective gate-source voltage of the switches in differential-drive architecture. The clock generator employs a novel structure to reduce the internal voltage swing. The measurement results show that our proposed wireless humidity can achieve a high linearity with a normalized sensitivity of 0.55% %RH at 20 °C. Despite the high losses of concrete, the proposed wireless humidity sensor achieves reliable communication performances in passive mode. The maximum operating distance is 0.52 m when the proposed wireless sensor is embedded into the concrete at the depth of 8 cm. The measured results are highly consistent with the results measured by traditional methods

Diagenetic facies of dolomite and geochemical characteristics across the Cambrian-Ordovician transitions in the Central Uplift Zone, Tarim Basin

The identification and division of diagenetic facies is useful for the classification, evaluation and prediction of carbonate reservoirs.To clarify the type and characteristics of the diagenetic facies of dolomite near the Cambrian-Ordovician transitions in the Central Uplift Zone of Tarim Basin, in this work, the lithographic characteristics of dolomite were studied in detail, and the category of diagenetic facies was divided by core description, conventional and casting thin section observation, X diffraction analysis and grain size analysis.Based on this, the geochemical characteristics of different diagenetic facies were discussed, and their formation models were established by testing stable isotopes, which included oxygen and carbon isotope as well as major and trace elements(Fe, Mn, Sr, Li and U).The results show that the diagenetic facies of Cambrian-Ordovician dolomite in the Central Uplift Zone, Tarim Basin, can be divided into five types, including penecontemporaneous dolomatization diagenetic facies(PD-F), shallow latent reflux dolomatization diagenetic facies(SLRD-F), shallow active reflux dolomatization diagenetic facies(SARD-F), weathered crust karstification diagenetic facies(WK-F) and tectonic fracture diagenetic facies(TF-F).Among them, the dolomitic fluid of PD-F mode dolostones mainly come from saltwalized seawater and is affected by freshwater, which shows an obviously negative bias of oxygenisotopes and high Fe, Mn, Sr and Li contents. The dolostone formed in the SARD-F mode shows a consistent value with Ordovician sea water and relatively low Fe, Mn, and Sr contents because it mainly formed in normal sea water environment and individually experienced burial dissolution and recrystallization and was affected by freshwater.Because the diagenetic environment of dolostone formed in SLRD-F mode is relatively closed, this dolostone is characterized by consistent values of oxygenisotopes, relatively low Fe and Mn contents but high Sr contents.Dolostone samples formed in WK-F mode have high Fe and U but low Sr contents because they experienced dissolution of freshwater and burial dolomitization.The dolostone formed in the TF-F model is characterized by low Fe, Mn, U and Li because of the influence of structural hydrothermal fluids

Derived Neutrophil-Lymphocyte Ratio and C-Reactive Protein as Prognostic Factors for Early-Stage Non-Small Cell Lung Cancer Treated with Stereotactic Body Radiation Therapy

Objectives: To explore the relationship between peripheral blood inflammation parameters and overall survival (OS) and progression-free survival (PFS) of early-stage non-small cell lung cancer patients who underwent stereotactic body radiotherapy (SBRT). Patients and methods: In this study, eligible patients treated with SBRT from 2013 to 2018, and both serum complete blood count and blood biochemical results were available prior to (within 60 days) radiotherapy were included. Results: A review of hospital registries identified 148 patients, and the 5-year OS and PFS of the entire cohort were 69.8% and 65.6%, respectively, with the median follow-up time was 52.8 months. Multivariable analysis showed that derived neutrophil-lymphocyte ratio (dNLR) ≥1.4 and C-reactive protein (CRP) ≥2.9 were statistically and independently associated with worse OS (HR = 4.62, 95% CI 1.89–11.27, p = 0.001; HR = 2.92, 95% CI 1.49–5.70, p = 0.002, respectively). The 5-year OS for patients with dNLR below and equal to or above the 1.4 were 85.3% and 62.9% (p = 0.002), respectively, and 76.7% for the low CRP group versus 58.5% for the high CRP group (p = 0.030). Higher serum level of post-treatment CRP also independent parameters for inferior PFS (HR = 4.83, 95% CI 1.28–18.25, p = 0.020). Conclusions: Our results demonstrate that dNLR and CRP are associated with the outcomes of early-stage NSCLC patients treated with SBRT, which may assist in selecting optimal nursing care and therapeutic scheme for every individual

A comparative study of robotic surgery and thoracoscopic surgery for mediastinal cysts

Abstract Objective To compare the efficacy and safety of robotic-assisted thoracoscopic surgery (RATS) with video-assisted thoracoscopic surgery (VATS) in the treatment of mediastinal cysts. Methods Retrospective analysis on clinical data of 70 cases of minimally invasive surgery for mediastinal cysts completed in the Department of Thoracic Surgery, Gansu Provincial People’s Hospital from April 2014 to December 2022. There were 34 cases in the RATS group with a cyst diameter of (3.70 ± 1.16) cm and 36 cases in the VATS group with a cyst diameter of (4.07 ± 1.20) cm. All cysts were evaluated preoperatively using magnetic resonance imaging (MRI) or chest computed tomography (CT) localization. Surgery-related indices were compared among the two groups. Results All patients in two groups successfully completed resection of mediastinal cysts without perioperative deaths. Compared with the VATS group, the RATS group possessed shorter operative time [(75.32 ± 17.80) min vs. (102.22 ± 19.80) min, P  0.05). Conclusion Compared with VATS, RATS is safety and effectivity in the treatment of mediastinal cysts and thus has advantages in operative time, intraoperative bleeding, postoperative chest drainage time and postoperative hospital stay

Efficacy of using Maryland forceps versus electrocoagulation hooks in da Vinci robot-assisted thoracoscopic mediastinal tumor resection

Abstract Background To compare the difference of short-term curative effect between the use of Maryland forceps (MF) and electrocoagulation hooks (EH) in da Vinci robot-assisted thoracoscopic mediastinal tumor resection. Methods Retrospectively analyze 84 patients with mediastinal tumors who underwent robot-assisted thoracoscopic surgery (RATS) at the Department of Thoracic Surgery in Gansu Provincial Hospital from February 2019 to February 2023. Two groups were divided according to the intraoperative use of energy devices, including 41 cases in the MF group and 43 cases in the EH group. Perioperative clinical data was gathered to compare the short-term efficacy of patients in both groups. Results There were no significant differences in baseline characteristics such as sex (P = 0.685), age (P = 0.165), and tumor size (P = 0.339) between the two groups. Compared with the EH group, patients in the MF group have shorter operative time (P = 0.030), less intraoperative bleeding (P = 0.010), less total postoperative drainage volume (P = 0.001), shorter postoperative drainage time (P = 0.022), shorter hospital stay (P = 0.019), and lower levels of interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor-alpha (TNF-α), and cortisol. No statistically significant differences were found between the two groups in terms of total hospitalization costs (P = 0.123), postoperative visual analog scale (VAS) pain scores (P = 0.064), and postoperative complications (P = 0.431). Conclusion Using MF in RATS for mediastinal tumor is safe and effective, which can reduce the amount of bleeding, reduce the degree of inflammatory reaction, and conducive to the quick recovery of patients

Optimized protocol for double vaccine immunization against classical swine fever and porcine reproductive and respiratory syndrome

Abstract Background Classical swine fever and porcine reproductive and respiratory syndrome have seriously affected the development of the swine breeding industry in China. Vaccine immunization remains the main way to prevent these infections. The aim of this study was to establish an optimized protocol for vaccine immunization against classical swine fever virus (CSFV) and porcine reproductive and respiratory syndrome virus (PRRSV). Methods Blood samples were collected from the anterior vena cava of pigs after immunization, and blood indices, secreted levels of specific antibodies and neutralizing antibodies associated with humoral immunity, the proliferation capacity of T lymphocytes as a measure of cellular immunity, and secreted levels of IFN-γ and TNF-α were determined. Results The results showed that simultaneous immunization against CSFV and PRRSV infections induced strong and specific humoral and T-cellular immune responses, high levels of cytokine IFN-γ secretion and delayed secretion of cytokine TNF-α. Moreover, significantly higher lymphocyte percentages and red blood cell and leukocyte counts were found in the group simultaneously immunized against CSFV and PRRSV. However, no statistically significant differences were observed in hemoglobin values, neutrophil counts, and median cell percentages among the S + PRRS, PRRS-S, and S-PRRS groups. Conclusion This study demonstrated that simultaneous immunization against CSFV and PRRSV had the advantages of inducing a rapid, enhanced, and long-lasting immune response. These findings provide a theoretical basis for the establishment of a reasonable and optimized vaccine immunization protocol against CSFV and PRRSV in combination with a variety of other vaccine inoculations

Meta analysis of the diagnostic value of circulating miRNA in benign and malignant pulmonary nodules

Abstract Objective A meta-analysis was conducted to assess the impact of miRNAs in circulation on diagnosing benign and malignant pulmonary nodules (BPNs and MPNs). Methods Electronic databases such as Embase, PubMed, Web of Science, and The Cochrane Library were utilized for diagnostic tests of circulating miRNAs to diagnose BPNs and MPNs from the library creation to February 2023. Meta-analysis of the included literature was performed using Stata 16, Meta-Disc 1.4, and Review Manager 5.4 software. This study determined the combined sensitivity, specificity, diagnostic ratio (DOR), positive/negative likelihood ratios (PLR/NLR), as well as value of area under the receiver operating characteristic (ROC) curve. Results This meta-analysis included 14 publications and 17 studies. According to our findings, the pooled sensitivity for miRNA in diagnosing benign and malignant pulmonary nodules was 0.82 [95% CI (0.74, 0.88)], specificity was 0.84 [95% CI (0.79, 0.88)], whereas the DOR was 22.69 [95% CI (13.87, 37.13)], PLR was 5.00 [95% CI (3.87, 6.46)], NLR was 0.22 [95% CI (0.15, 0.32)], and the area under the working characteristic curve (AUC) of the subject was 0.89 [95% CI (0.86, 0.91)]. Conclusion Circulating miRNAs could be used with sensitivity, specificity, DOR, PLR, NLR, and AUC as biomarkers to diagnose pulmonary nodules (PNs). However, more research is needed to determine the optimum miRNA combinations for diagnosing PNs due to the significant heterogeneity on previous studies

Comparison of stereotactic body radiation therapy versus surgery for multiple primary lung cancers after prior radical resection: A multicenter retrospective study

Background: Patients who previously underwent surgical resection of initial primary lung cancer are at a high risk of developing multiple primary lung cancers (MPLCs). The purpose of this study was to compare the efficacy and safety between stereotactic body radiation therapy (SBRT) and surgery for MPLCs patients after prior radical resection for the first lung cancers. Methods: In this multicenter retrospective study, eligible MPLC patients with tumor diameter of 5.0 cm or less at N0M0 who underwent SBRT or reoperation between January 2013 and August 2020 were enrolled. The primary endpoint was the 3-year locoregional recurrence and treatment-related toxicity. Kaplan-Meier method was used to calculate survival rates. The χ2 test was adapted to assess the difference of categorical variables between the two subgroup patients. Results: A total of 203 (73 in the SBRT group and 130 in the surgery group) patients from three academic cancer centers were evaluated with a median follow-up of 38.3 months. The cumulative 1-, 2-, and 3-year incidences of locoregional recurrence were 5.6 %, 7.0 % and 13.1 % in the SBRT group versus 3.2 %, 4.8 % and 7.4 % in the surgery group, respectively [hazard ratio (HR), 1.97; 95 % confidence interval (CI), 0.74–5.24; P = 0.14]. The cancer-specific survival rates were 95.9 %, 94.5 % and 88.1 % versus 96.9 %, 94.6 % and 93.8 % in the SBRT and surgery groups respectively (HR, 1.72; 95 % CI, 0.67–4.44; P = 0.23). In the SBRT group, two patients (2.7 %) suffered from grade 3 radiation pneumonitis, while in the surgery group, grade 3 complications occurred in four (3.1 %) patients, and four cases were expired due to pneumonia or pulmonary heart disease within 90 days after surgery. Conclusions: SBRT is an effective therapeutic option with limited toxicity compared to surgery for patients with MPLCs after prior radical surgical resection, and it could be considered as an alternative treatment for those patients