Safety and feasibility of three-dimensional McKeown minimally invasive esophagectomy.

BACKGROUND: To compare the perioperative outcomes from McKeown minimally invasive esophagectomy (MIE) when performed in three-dimensional versus two-dimensional visualization system, and investigate the learning curve of a single surgeon who implemented three-dimensional McKeown MIE. METHODS: A total of 335 consecutive cases (three-dimensional or two-dimensional) were identified. Perioperative clinical parameters were compared and cumulative sum learning curve was plotted. Propensity score matching was used to reduce selection bias from confounding factors. RESULTS: Patients in three-dimensional group were associated with more chronic obstructive pulmonary disease (23.9% vs 3.0%, p < 0.01). After propensity score matching (108 matched patients in each groups), this finding was no longer statistically significant. Comparing to two-dimensional group, significant improvement in total retrieved lymph nodes (28 vs 33, p = 0.003) was observed in three-dimensional group. In addition, more lymph nodes around the right recurrent laryngeal nerve were harvested in three-dimensional group than that in two-dimensional group (p = 0.045). However, there were no significantly differences were found between the two groups in terms of other intraoperative parameters (e.g., operative time) and postoperative relevant outcomes (e.g., lung infection). Furthermore, the change point in the cumulative sum learning curves for intraoperative blood loss and thoracic procedure time was 33 procedures, respectively. CONCLUSION: Three-dimensional visualization system appears to be superior in performing lymphadenectomy during McKeown MIE to that of a two-dimensional technique. For surgeons proficient in performing two-dimensional McKeown MIE, the learning curve for a three-dimensional procedure appears to begin near proficiency after more than 33 cases.

Isopropoxy Tetramethyl Dioxaborolane on TiO2: Reaction Pathway and Formation of a Visible-Light-Sensitive Photocatalyst.

Borate toxicity is a concern in agriculture since a high level of borates may likely exist in irrigation water systems. In this research, transmission infrared spectroscopy and X-ray photoelectron spectroscopy are employed to study the thermal and photochemical reactions of isopropoxy tetramethyl dioxaborolane (ITDB) on TiO2, with the aid of density functional theory calculations. In addition, the possibility for the formation of a boron-modified TiO2 (B/TiO2) surface, using ITDB as the boron source, is explored and the photocatalytic activity of the B/TiO2 is tested. After adsorption of ITDB on TiO2 at 35 °C and heating the surface to a temperature higher than ∼200 °C in a vacuum, the surface is found to be covered with both the organic components of OC(CH3)2-C(CH3)2O and OCH(CH3)2 and the inorganic components of (TiO2)BO and Ti-B-O. The organic intermediates can be further thermally transformed into pinacolone and acetone; however, the inorganic parts exist at 400 °C, forming a boron-modified surface. The thermal decomposition of ITDB is proposed to be initiated by breaking one B-O bond, forming -OC(CH3)2-C(CH3)2O-B-OCH(CH3)2 on the surface. In the case of photoreaction, the ITDB on TiO2 decomposes under photoirradiation at 325 nm to form acetone. The boron-modified TiO2 surface can absorb visible light, likely due to the presence of new states in the band gap, and shows a photocatalytical activity in degrading methylene blue, under 500 nm irradiation in air.

A Multicenter Double-blind Phase II Study of Metformin With Gefitinib as First-line Therapy of Locally Advanced Non-Small-cell Lung Cancer.

We present the rationale and study design of the CGMT (combined gefitinib and metformin therapy) trial (www.ClinicalTrials.gov Identifier: NCT01864681), which is aimed at treating locally advanced non-small-cell lung cancer. The CGMT trial is a multicenter, phase II randomized, double-blinded, and placebo-controlled study, which is designed to evaluate the safety and efficacy of metformin in combination with gefitinib as first-line therapy in patients presenting with stage IIIb-IV non-small-cell lung cancer expressing the epidermal growth factor receptor mutant. Two therapies are proposed for this trial. The first regimen is comprised of gefitinib plus metformin. The second therapy is comprised of gefitinib plus placebo. The primary objective of this trail is to compare the progression-free survival rate at year 1 of the study. The secondary objective of this trial is to compare the 2-year overall survival, the 2-year progression-free survival, the objective response rate, and the disease-control rate, and to evaluate the relative safety of both therapies. Based on the statistical design, we plan to enroll approximately 200 patients.

Infrared Spectroscopic Study of the Adsorption Forms of Cyanuric Acid and Cyanuric Chloride on TiO2.

Cyanuric acid is often found to be the end product in the hydrolysis of waste melamine and in the TiO2-mediated photocatalytic decomposition of s-triazine-containing compounds used as herbicides or dyes. The photocatalytically recalcitrant nature of cyanuric acid on TiO2 may be closely related to its adsorption properties, including the tautomeric forms present on the surfaces and their bonding structures, which remain to be determined. In this paper, we present the optimized adsorption structures of the four tautomeric isomers (triketo, diketo, monoketo, and triol) of cyanuric acid on a model rutile-TiO2(110) surface and their vibrational absorptions. Experimentally, the adsorption structures of cyanuric acid and chloride on powdered TiO2 are analyzed on the basis of the theoretically obtained, characteristic infrared information. Cyanuric acid on TiO2 at 35 °C exists in triketo and hydroxylated forms, but the diketo becomes the predominant form on the surface at 250 °C, being bonded to a titanium site via one of its carbonyl groups and with a N-H···O hydrogen bonding interaction. Hydroxylation of cyanuric chloride occurs as it is adsorbed on TiO2 at 35 °C. Upon being heated to 200 °C, the surface is mainly covered with the diketo form of cyanuric acid after the adsorption of cyanuric chloride.

Efficacy of recombinant adenoviral human p53 gene in the treatment of lung cancer-mediated pleural effusion.

Pleural effusion induced by lung cancer exerts a negative impact on quality of life and prognosis. The aim of the present study was to evaluate the value of the recombinant adenoviral human p53 gene (rAd-p53) in the local treatment of lung cancer and its synergistic effect with chemotherapy. The present study retrospectively recruited 210 patients with lung cancer-mediated pleural effusion who had adopted a treatment strategy of platinum chemotherapy. Pleurodesis was performed via the injection of cisplatin or rAd-p53. Long-term follow-up was conducted to investigate the therapeutic effects of cisplatin and rAd-p53 administration on pleural effusion and other relevant clinical indicators. The short-term effect of pleurodesis was as follows: The efficacy rate of rAd-p53 therapy was significantly higher compared with cisplatin therapy (71.26 vs. 54.47%), and the efficacy of treatment with ≥2×1012 viral particles of rAd-p53 for pleurodesis was significantly greater than treatment with 40 mg cisplatin (P<0.05). Furthermore, efficacy analysis performed 6 and 12 months after pleurodesis indicated that the efficacy rate of rAd-p53 was significantly greater than that of cisplatin (P<0.05). A comparison of median progression-free survival (PFS) time identified a significant difference (P<0.05) between rAd-p53 and cisplatin therapy (3.3 vs. 2.7 months); however, a comparison of median overall survival time identified no significant difference (P>0.05) between rAd-p53 and cisplatin therapy (9.6 vs. 8.7 months). In addition, Cox regression analysis indicated that PFS was not affected by clinical indicators such as age, gender, prognostic staging and smoking status; however, PFS was affected by pathological subtype (adenocarcinoma or squamous carcinoma) in the rAd-p53 group. rAd-p53 administration for pleurodesis exerts long-term therapeutic effects on the local treatment of lung cancer. Thus, a combination of rAd-p53 and chemotherapy may exert a synergistic effect and reverse multidrug resistance.

Sequencing and analysis of the transcriptome of the acorn worm Ptychodera flava, an indirect developing hemichordate.

Hemichordates are the sister group of echinoderms, and together they are closely related to chordates within the deuterostome lineage. Therefore, hemichordates represent an important animal group for the understanding of both the evolution of developmental mechanisms in deuterostome animals and the origin of chordates. Recently, the majority of studies investigating hemichordates have focused on the direct-developing enteropneust hemichordate Saccoglossus kowalevskii; few have focused on the indirect-developing hemichordates, partly because of the lack of extensive genomic resources in these animals. In this study, we report the sequencing and analysis of a transcriptome from an indirect-developing enteropneust hemichordate Ptychodera flava. We sequenced a mixed cDNA library from six developmental stages using the Roche GS FLX Titanium System to generate more than 879,000 reads. These reads were assembled into 17,990 contigs with an average length of 1316bp. We found that 60% of the assembled contigs, along with 28% of the unassembled singleton reads, had significant hits to sequences in the NCBI database by a BLASTx search, and we also annotated these sequences and obtained Gene Ontology (GO) terms for 6744 contigs and 5802 singletons. We further identified candidate P. flava transcripts corresponding to genes involved in major developmental signaling pathways, including the Wnt, Notch and TGF-ß signaling pathways. Using available genome/transcriptome datasets from the direct-developing hemichordate S. kowalevskii, the echinoderm Strongylocentrotus purpuratus and the chordate Branchiostoma floridae, we found that 90%, 80% and 73% of the annotated protein sequences in these respective species matched our P. flava transcriptome in a homology search. We also constructed a database for the P. flava transcriptome, and researchers can easily access this dataset online. Our dataset significantly increases the amount of available P. flava sequence data and can serve as a reference transcriptome for future studies using this species.

Nanomechanical probing of the septum and surrounding substances on Streptococcus mutans cells and biofilms.

We report a unique bio-nanomechanical behavior at the septum (Z-ring) of Streptococcus mutans-containing biofilm through in situ measurements obtained by atomic force microscopy. A distinct serrated pattern on the releasing force-displacement curves can only be observed with the use of a sharp nanosized probe tip, and this was found at the septum of S. mutans. Further investigations suggested the serrated patterns could be due to the unfolding of some sub-surface divisome proteins. Seismometer measurements were conducted at the septum by placing an ultra-sensitive atomic force microscope probe on the surface. Unique periodic vibrations were observed at the septum under various biofilm conditions. This finding suggests the possibility of remodeling of the cell wall nanostructure at the septum of S. mutans.

Clinical significance of annexin II expression in human non-small cell lung cancer.

The aim of the present study is to explore the role of annexin II in the development and progression of human non-small cell lung cancer (NSCLC). Real-time quantitative reverse transcription-polymerase chain reaction was conducted to detect annexin II mRNA expression. Annexin II protein expression was also determined by western blot. In addition, annexin II expression was analyzed by immunohistochemistry in 137 clinicopathologically characterized NSCLC cases. The correlation of annexin II expression with patients' survival rate was assessed by Kaplan-Meier analysis and Cox regression. Our results showed that the expression levels of annexin II mRNA and protein in NSCLC tissues were significantly higher than those in non-cancerous tissues. Immunohistochemistry analysis showed that annexin II expression was significantly correlated with tumor diameter, pathological grade, pT status, pN status, and pleural invasion. The results of the Kaplan-Meier analysis indicated that a high expression level of annexin II resulted in a significantly poor prognosis of NSCLC patients. Multi-variate Cox regression analysis revealed that annexin II expression level was an independent prognostic parameter for the overall survival rate of NSCLC patients. In conclusion, these results suggested that annexin II up-regulation was associated with poor prognosis in NSCLC; therefore, it might act as a prognostic marker and a new potential target for NSCLC treatment.

[Degradation of dimethyl phthalate (DMP) in aqueous solution by UV/Si-FeOOH/H2O2].

In this study the new catalyst Si-FeOOH was synthesized by adding Si to the traditional FeOOH and the mechanic strength of this new catalyst could be enhanced greatly. The photo-degradation of dimethyl phthalate (DMP) by UV/Si-FeOOH/H2O2 was investigated. The new catalyst Si-FeOOH was amorphous structure with high surface area and low soluble iron by XRD, IR and SEM. The efficiency of DMP degradation by UV/Si-FeOOH/H2O2 could reach 97% after 30 min reaction time at pH 5, 0.5 g/L dosage of Si-FeOOH, and 2.0 mmol/L of H2O2 under 125W UV365 irradiation. DMP could be degraded effectively by synergistic effect of UV, Si-FeOOH and H2O2. The Si-FeOOH photocatalyst can be very easily recovered and its catalytic activity also remained after several rounds of reaction.

Biaryl construction through Kumada coupling with diaryl sulfates as one-by-one electrophiles under mild conditions.

Diaryl sulfates were successfully applied as one-by-one organo electrophiles in Kumada coupling to construct biaryls with the emission of harmless inorganic salts.

Surface reaction limited model for the evaluation of immobilized enzyme on planar surfaces.

Analysis of immobilized enzyme in situ is a crucial step to embed an enzyme onto the planar technology of standard integrated circuit (IC) and microelectromechanical systems (MEMS) for a bioreactor or enzyme-coupled biosensor. A surface reaction limited model, based on a systematized and standardized approach, mathematically derived from mass transfer dynamics and the Michaelis-Menten equation for the measuring the apparent K*(m) (Michaelis-Menten constant) and V*(max) (maximum reaction rate per unit surface area of catalyst) of an immobilized enzyme on a planar surface was developed. The derived equations for the kinetic model were simulated and experimentally confirmed. A platform of a microflow bioreactor with a one-sided planar catalytic surface that contained immobilized enzyme was constructed. The microfluidic bioreactor was designed to possess a channel height less than that of the diffusion layer thickness in a semi-infinite diffusion process, and K*(m) and V*(max) of rat phenol sulfotransferase (PST) immobilized on the silicon oxide surface were successfully determined in situ. Variation in kinetic constants and the possible differences in performance between free and immobilized PST are discussed.

[Removal of arsenic (II) by ferrate oxidation-coagulation from drinking water].

Ferrate is multi-function agent in water treatment and shows great oxidizing ability and excellent purifying effect. This experiment evaluated the performance of ferrate for arsenic removal. Experimental results show that the best rate of ferrate and arsenic (III) is 15:1, the efficiency of As removal can be achieved 98%, and the residual concentration of As3 + is < 0.05 mg/L. The optimum pH is 5.5 to approximately 7.5. The oxidative and coagulation time is 10 min and 30 min respectively. The salinity and hardness did not interfere with removal arsenic. This method is easy, very effective comparing with ferric method and KMnO4-Ferric method.