The clinical outcomes of laparoscopic proximal gastrectomy with double-tract reconstruction versus tube-like stomach reconstruction in patients with adenocarcinoma of the esophagogastric junction based on propensity score-matching: a multicenter cohort study

PurposeLaparoscopic proximal gastrectomy with double-tract reconstruction (LPG-DTR) and laparoscopic proximal gastrectomy with tube-like stomach reconstruction (LPG-TLR) are both function-preserving procedures performed for treating AEG. However, there is no clinical consensus on the selection of digestive tract reconstruction after proximal gastrectomy, and the best way to reconstruct the digestive tract remains controversial. This study aimed at comparing the clinical outcomes of LPG-DTR and LPG-TLR to provide some reference to the choice of AEG surgical modalities.MethodsThis was a multicenter, retrospective cohort study. we collected clinicopathological and follow-up data of patients with consecutive cases diagnosed with AEG from January 2016 to June 2021 in five medical centers. According to the way of digestive tract reconstruction after tumor resection, patients who underwent LPG-DTR or LPG-TLR were included in the present study. Propensity score matching (PSM) was performed to balance baseline variables that might affect the study outcomes. The QOL of the patients was evaluated using the Visick grade.ResultsA total of 124 eligible consecutive cases were finally included. Patients in both groups were matched using the PSM method, and 55 patients from each group were included in the analysis after PSM. There was no statistically significant difference between the two groups in terms of the operation time, amount of intraoperative blood loss, days of postoperative abdominal drainage tube placement, postoperative hospitalization days, total hospitalization cost, the total number of lymph nodes cleared, and the number of positive lymph nodes (P>0.05). There was a statistically significant difference between the two groups in terms of time to first flatus after surgery and postoperative soft food recovery time (P<0.05). For the nutritional status, the weight levels at 1 year after surgery was better in the LPG-DTR group than in the LPG-TLR group (P<0.05). There was no significant difference in Visick grade between the two groups (P>0.05).ConclusionThe anti-reflux effect and quality of life of LPG-DTR for AEG were comparable to those of LPG-TLR. Compared with LPG-TLR, LPG-DTR provide better nutrition status for patients with AEG. LPG-DTR is a superior reconstruction method after proximal gastrectomy

Identification of floR Variants Associated With a Novel Tn4371-Like Integrative and Conjugative Element in Clinical Pseudomonas aeruginosa Isolates

Florfenicol is widely used to control respiratory diseases and intestinal infections in food animals. However, there are increasing reports about florfenicol resistance of various clinical pathogens. floR is a key resistance gene that mediates resistance to florfenicol and could spread among different bacteria. Here, we investigated the prevalence of floR in 430 Pseudomonas aeruginosa isolates from human clinical samples and identified three types of floR genes (designated floR, floR-T1 and floR-T2) in these isolates, with floR-T1 the most prevalent (5.3%, 23/430). FloR-T2 was a novel floR variant identified in this study, and exhibited less identity with other FloR proteins than FloRv. Moreover, floR-T1 and floR-T2 identified in P. aeruginosa strain TL1285 were functionally active and located on multi-drug resistance region of a novel incomplete Tn4371-like integrative and conjugative elements (ICE) in the chromosome. The expression of the two floR variants could be induced by florfenicol or chloramphenicol. These results indicated that the two floR variants played an essential role in the host’s resistance to amphenicol and the spreading of these floR variants might be related with the Tn4371 family ICE

Double-pore structure porous Mo–Si–B intermetallics fabricated by elemental powder metallurgy method using NH4HCO3 as pore-forming agent

The multiphase porous intermetallic compounds Mo _3 Si-Mo _5 Si _3 -Mo _5 SiB _2 of a double-pore structure has been successfully fabricated by combining the in situ reaction synthesis with the pore-forming agent method. The effects of NH _4 HCO _3 content and size on porosity, pore diameter distribution, permeability, and compressive strength were investigated systematically. The results show that: with the NH _4 HCO _3 increasing from 0 to 60 vol%, the total porosity increases from 46.6% to 73.2%, the big pores volume increases from 2.3% to 69.4%, the gas permeability increases from 5.34 × 10 ^−7 l/(min · cm ^2  · Pa) to 1.74 × 10 ^−4 l/(min · cm ^2  · Pa), and the compressive strength decreases from 392 MPa to 14.8 MPa; on the other side, with the NH _4 HCO _3 size increased from 48 μ m to 230 μ m, the parameters of this porous intermetallics changed slightly except to the significant increase of big pores diameter. An exponential equation of σ _c  =  σ _s (1- ρ ) ^1/0.254 based on generalized mixture rule (GMR) has been put forward to quantitatively describe porosity-compressive strength behaviors. Results from this study indicate the potential applications in various filtration environments by tailoring the shape, contents, and size of the pore-forming agent

Solvent effects on the measured bubble-point pressures and pseudo bubble-point pressures of different heavy crude oil−solvent systems

In this paper, the bubble-point pressures and pseudo bubble-point pressures of various heavy crude oil−solvent systems were measured and studied by conducting the constant-composition-expansion (CCE) tests, during which the test pressure was depleted in a stepwise manner. A total of fourteen CCE tests were performed for five heavy crude oil−CO2 systems, four heavy crude oil−CH4 systems, and five heavy crude oil−C3H8 systems, respectively. All the CCE tests were conducted by using a pressure−volume−temperature (PVT) system. It was found that for most heavy crude oil−solvent systems with relatively low solvent concentrations, the measured PVT cell pressure vs. molar volume (Pcell−νmix) data in the CCE tests had three distinct regions, which were one-liquid phase region (Regions I), foamy-oil region (Region II) and two-phase region (Region III). Accordingly, the PVT cell pressure at the intersection point of Regions I and II was referred to as the measured bubble-point pressure, whereas the PVT cell pressure at the intersection point of Regions II and III was termed as the measured pseudo bubble-point pressure. For some heavy crude oil−solvent systems with high solvent concentrations, however, the measured Pcell−νmix data may have two regions only. In this special case, the PVT cell pressure at the intersection point of the two regions was considered as the measured bubble-point pressure and no pseudo bubble-point pressure could be obtained. It was also found that the heavy crude oil−CH4 system had not only the highest bubble-point pressure and pseudo bubble-point pressure but also the largest difference between the bubble-point pressure and pseudo bubble-point pressure, in comparison with the heavy crude oil−CO2 system and the heavy crude oil−C3H8 system at the same solvent concentration. These facts indicate that CH4 not only is the most volatile solvent but also can remain as dispersed gas bubbles to induce the most stable foamy oil in the largest pressure range after it is nucleated from a live heavy oil

Preparation and hydration mechanism of aluminum formate/aluminum sulfate based alkali-free composite accelerator for sprayed concrete

The high alkali content of alkaline accelerators has a negative influence on the late strength and durability of concrete. Further, their corrosive nature is harmful to the skin of construction personnel, posing safety concerns. Therefore, the development of alkali-free accelerators has gained interest, especially in shotcrete-based constructions. The production process of aluminum-sulfate-based alkali-free accelerators is simple and less exothermic, with no negative impact on the later strength of concrete, aspects that are widely recognized and very important in construction. However, their high sulfate content may have a significant impact on the durability of concrete; therefore, reducing the sulfate content plays an important role in enhancing the durability of concrete. In this study, an alkali-free liquid accelerator was synthesized by replacing aluminum sulfate with aluminum formate, which effectively reduced the sulfate content. Experiments were performed on concrete samples in which aluminum sulfate was replaced with aluminum formate at different levels. The results showed that the formate and 3CaO·Al _2 O _3 (C _3 A) of the alkali-free liquid accelerator prepared from aluminum formate form calcium aluminate, similar to the ettringite phase. The formate promoted the dissolution of Ca _3 SiO _5 (C _3 S), thus accelerating the hydration of concrete. Meanwhile, aluminum ions hydrolyzed by aluminum formate also participated in the reaction, resulting in the dual participation of cations and anions in hydration, leading to a synergistic effect with aluminum sulfate

Interleukin-13 +1923C/T Polymorphism Is Associated with Asthma Risk: A Meta-Analysis

There are controversies on the association between interleukin-13 (IL-13) +1923C/T polymorphism (rs1295686) and the risk of asthma. We performed this study to assess the association by the method of meta-analysis. A systematic search current to October 16, 2012, was conducted using PubMed, EMBASE, and China National Knowledge Infrastructure (CNKI) and identified ten studies comprising 13698 cases and 38209 controls. The pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. There was a significant association between IL-13 +1923C/T polymorphism and asthma risk in codominant model. When stratified by ethnicity, IL-13 +1923C/T polymorphism remained significantly associated with higher asthma risk in Asians and Caucasians. In the subgroup analysis by study quality, a significantly increased asthma risk was observed in high quality studies. Sensitivity analysis and cumulative analysis further strengthened the validity of the results. No publication bias was found in this meta-analysis. In conclusion, results from this meta-analysis suggested that IL-13 +1923C/T polymorphism was a risk factor of asthma

A typical neurofibromatosis type 1 in adult with intracranial T2 hyperintensities and pinealoma: A Case Report

Neurofibromatosis type 1 (NF-1) is a common autosomal dominant inherited disorder. Aside from typical symptoms like pigmentary manifestation, patients with NF-1 can also have unspecified T2 hyperintensities (T2Hs) on the brain and may develop benign or malignant tumours in central nervous system or other parts of the body. In this article, we reported a 54-year-old female diagnosed as NF-1 combined with T2Hs and pinealoma that was proved to be a high-grade glioma in later follow-up. We noticed some clinical manifestations such as pigmented teeth and dentition defects that had not been described before. There were some reflections from the poor prognosis of this patient. Even though the course of the disease is relatively indolent most of the time, long-term surveillance is in need and treatment may be required in those with symptoms or unstable imaging findings.</p

Green ecological grain storage technology and quality control in China: Presentation

Green ecological grain storage technologies (GEGSTs) are the means of controlling stored grain quality, and quality changes of stored grain are the basis of GEGSTs control. This paper introduces that GEGSTs are widely used in China, including monitoring and early warning of stored grain pest and mould, pest control by using food-grade materials, controlled atmosphere for pest control, ventilation for lowering and equalizing temperature, low and quasi-low temperature grain storage, treatment of hot spots, etc. And it introduces that grain processing enterprises’ and market’s request for grain quality, is called “quality control”. It also clarifies that stored grain quality control is the purpose, and emphasizes that GEGSTs control is the process, so GEGSTs control should serve for quality control. Therefore, we propose that the technology application and the quality control of grain storage are equally important, and without the quality control, the technology application could be invalid, especially for sensitive areas in grain bulks. In the process of grain storage, special attention should be paid to quality changes in the sensitive areas, like real-time monitoring. Identify and utilize scientific and reasonable technology accordingly, including related technologies and equipment, to improve "overall" quality control level of stored grain bulks, and to gradually standardize them. By means of GEGSTs, positive ecological storage conditions are effectively utilized, which helps us achieve the purposes of safety, no pollution, high quality and nutrition during grain storage.Green ecological grain storage technologies (GEGSTs) are the means of controlling stored grain quality, and quality changes of stored grain are the basis of GEGSTs control. This paper introduces that GEGSTs are widely used in China, including monitoring and early warning of stored grain pest and mould, pest control by using food-grade materials, controlled atmosphere for pest control, ventilation for lowering and equalizing temperature, low and quasi-low temperature grain storage, treatment of hot spots, etc. And it introduces that grain processing enterprises’ and market’s request for grain quality, is called “quality control”. It also clarifies that stored grain quality control is the purpose, and emphasizes that GEGSTs control is the process, so GEGSTs control should serve for quality control. Therefore, we propose that the technology application and the quality control of grain storage are equally important, and without the quality control, the technology application could be invalid, especially for sensitive areas in grain bulks. In the process of grain storage, special attention should be paid to quality changes in the sensitive areas, like real-time monitoring. Identify and utilize scientific and reasonable technology accordingly, including related technologies and equipment, to improve "overall" quality control level of stored grain bulks, and to gradually standardize them. By means of GEGSTs, positive ecological storage conditions are effectively utilized, which helps us achieve the purposes of safety, no pollution, high quality and nutrition during grain storage

Machine learning assisted design of aluminum-lithium alloy with high specific modulus and specific strength

Advanced aluminum-lithium alloys are the key structural materials urgently needed for the development of light-weighted aircraft in the aerospace field. In this study, we employ a machine learning approach accompanied by domain knowledge to realize the accelerated design of aluminum-lithium alloy with high specific modulus and specific strength by identifying an optimal combination of key features through a three-step feature filtering of datasets containing 145 alloys. The maximum specific modulus in the experimental alloys that screened from the predicted results increases by 4 % compared with the maximum specific modulus in the comparative dataset. The specific modulus of the designed alloy with the best comprehensive performance increased by 12.6 % compared with the widely used 2195-T8 alloy while maintaining a similar specific strength. Machine learning shows appealing feasibility and reliability in the field of materials design