Light-Induced Dynamic Activation of Copper/Silicon Interface for Highly Selective Carbon Dioxide Reduction.

Numerous studies have shown a fact that phase transformation and/or reconstruction are likely to occur and play crucial roles in electrochemical scenarios. Nevertheless, a decisive factor behind the diverse photoelectrochemical activity and selectivity of various copper/silicon photoelectrodes is still largely debated and missing in the community, especially the possibly dynamic behaviors of metal catalyst/semiconductor interface. Herein, through in situ X-ray absorption spectroscopy and transmission electron microscope, a model system of Cu nanocrystals with well-defined facets on black p-type silicon (BSi) is unprecedentedly demonstrated to reveal the dynamic phase transformation of forming irreversible silicide at Cu nanocrystal-BSi interface during photoelectrocatalysis, which is validated to originate from the atomic interdiffusion between Cu and Si driven by light-induced dynamic activation process. Significantly, the adaptive junction at Cu-Si interface is activated by an expansion of interatomic Cu-Cu distance for CO2 electroreduction, which efficiently restricts the C-C coupling pathway but strengthens the bonding with key intermediate of *CHO for CH4 yield, resulting in a remarkable 16-fold improvement in the product ratio of CH4/C2 products and an intriguing selectivity switch. This work offers new insights into dynamic structural transformations of metal/semiconductor junction and design of highly efficient catalysts toward photosynthesis.

Propofol-based total intravenous anesthesia improves survival compared to desflurane anesthesia in gastric cancer surgery: A retrospective analysis.

Surgical management of cancer may induce stress and increase the likelihood of cancer metastasis and recurrence. Appropriate surgical and anesthetic techniques may affect the patient's outcome. Although numerous studies have been performed, conflicting results have been obtained regarding the effect of anesthetic techniques on the outcome of patients with cancer. We conducted this study to evaluate the association of anesthetic techniques with overall and recurrence-free survival in patients who had undergone gastric cancer surgery.This retrospective study reviewed the electronic medical records of patients, who had visited our hospital and had been diagnosed with gastric cancer between July 1st, 2006 to June 30th, 2016. Univariate analysis of the potential prognostic factors was performed using the log-rank test for categorical factors, and parameters with a P-value < .05 at the univariate step were included in the multivariate regression analysis. Propensity Score Matching was performed to account for differences in baseline characteristics: propofol or desflurane, in a 1:1 ratio.A total of 408 patients anesthetized with desflurane (218) and propofol (190) were eligible for analysis. After propensity matching, 167 patients remained in each group. The overall mortality rate was significantly higher in the desflurane group (56%) than in the propofol group (34%) during follow-up (P < .001). In addition, a greater percentage of patients in the desflurane group (41%) exhibited postoperative metastasis than those in the propofol group (19%, P < .001).The authors found some association between types of anesthesia used and the long-term prognosis of gastric cancer. Propofol-based total intravenous anesthesia improved survival and reduced the risk of recurrence and metastasis during the 5-year follow-up period after gastric cancer surgery.

Insomnia as an independent predictor of suicide attempts: a nationwide population-based retrospective cohort study.

BACKGROUND: Numerous studies have verified that insomnia is associated with suicidal ideation, suicide attempts, and death by suicide. Limited population-based cohort studies have been conducted to examine the association. The present study aimed to analyze whether insomnia increases the risk of suicide attempts and verify the effects of insomnia on suicide risk. METHODS: This study is a cohort study using 2000-2013 hospitalization data from the National Health Insurance Research Database (NHIRD) to track the rate of suicide attempts among insomnia patients aged 15 years or older. In addition, a 1:2 pairing based on sex, age, and date of hospitalization was conducted to identify the reference cohort (patients without insomnia). Cox proportional hazard model was used to assess the effects of insomnia on suicide risk. RESULTS: The total number of hospitalized patients aged 15 years or older was 479,967 between 2000 and 2013 (159,989 patients with insomnia and 319,978 patients without insomnia). After adjusting for confounders, suicide risk in insomnia patients was 3.533-fold that of patients without insomnia (adjusted hazard ratio [HR] = 3.533, 95% confidence interval [CI] = 3.059-4.080, P < 0.001). Suicide risk in low-income patients was 1.434-fold (adjusted HR = 1.434, 95% CI = 1.184-1.736, P < 0.001) that of non-low-income patients. Suicide risk in patients with drug dependence and with mental disorders was 1.592-fold (adjusted HR = 1.592, 95% CI = 1.220-2.077, P < 0.001) and 4.483-fold (adjusted HR = 4.483, 95% CI = 3.934-5.109, P < 0.001) that of patients without drug dependence and without mental disorders, respectively. In the female population, suicide risk in insomnia patients was 4.186-fold (adjusted HR = 4.186, 95% CI = 3.429-5.111, P < 0.001) that of patients without insomnia. Among patients aged 25-44 years, suicide risk in insomnia patients was 5.546-fold (adjusted HR = 5.546, 95% CI = 4.236-7.262, P < 0.001) that of patients without insomnia. Furthermore, the suicide risk of insomnia patients with mental disorders was 18.322-fold that of patients without insomnia and mental disorders (P < 0.001). CONCLUSION: Insomnia, low income, drug dependence, and mental disorders are independent risk factors for suicide attempts. Female patients and those aged 25-44 years are at high risk of suicide due to insomnia. Insomnia, mental disorders, and low income exhibit a synergistic effect on suicide attempts. Clinicians should pay attention to mental status and income level of insomnia patients.

[Effect of branch chain amino acid enriched formula on postoperative fatigue and nutritional status after digestive surgery].

OBJECTIVE: To evaluate the effect of branch chain amino acid (BCAA) enriched formula on nutritional status and postoperative fatigue for digestive surgery patients. METHODS: Forty patients who underwent digestive surgery were randomly received parenteral nutrition with either BCAA enriched (study group, n=20) or routine amino acid (control group, n=20) for seven consecutive days. Nitrogen balance,serum total protein, albumin, prealbumin, transferrin, retinol binding protein and postoperative fatigue score were monitored during the postoperative period. RESULTS: The cumulative postoperative fatigue scores were lower in BCAA group than that in the control group at the 4th, 5th and 7th day after operation (P< 0.05). Patients achieved positive nitrogen balance 2 days earlier in the study group than that in the control group, but there was no significant difference in cumulative nitrogen balance between the two groups. There was no significant difference in elevation of serum total protein, albumin, prealbumin, transferrin at the 7th day after operation between the two groups (P > 0.05), compared with those at the first day after operation. The serum level of retinol binding protein was higher in BCAA-enriched group than that in the control group (P=0.004). CONCLUSION: TPN with BCAA enriched formula can reduce postoperative fatigue score and improve the nutritional status for digestive surgery patients.

[Surgical treatments of preoperative unsuspected gallbladder carcinoma].

OBJECTIVE: To explore the surgical treatment of preoperative unsuspected gallbladder carcinoma (UGC) and its prognosis. METHODS: Eighteen patients of UGC admitted in our hospital from January 1996 to December 2003 were analyzed retrospectively. The clinicopathological characters and surgical treatment of UGC patients were compared with the preoperative diagnosed gallbladder carcinoma (DGC) patients admitted in the same period. The cumulative survival rate of the patients received radical resection in two groups was analyzed by Kaplan-Meier method. RESULTS: The serous layer was not invaded by tumor in 10 patients of UGC group (55.5%, 10/18), while the serous layer invaded and regional lymph node metastasis were detected in 39 patients of DGC group (90.7%, 39/43). Radical resection rate was 72.2% (13/18) in UGC group and 39.5% (17/43) in DGC group, and 5-year survival rates in those with radical resection were 54.6% and 23.5%, respectively (chi(L)(2) = 16.33, P < 0.01). Compared with the patients underwent palliative operation, the patients with radical resection has a longer median survival time (43.3 months vs 10.5 months, chi(L)(2) = 31.10, P < 0.01). CONCLUSIONS: The prognosis of UGC is better than that of DGC generally. Reoperation for UGC should be performed as soon as possible, and the prognosis can be improved by radical resection.

Metastasis of primary gallbladder carcinoma in lymph node and liver.

AIM: To evaluate the patterns with metastasis of gallbladder carcinoma in lymph nodes and liver. METHODS: A total of 45 patients who had radical surgery were selected. The patterns with metastasis of primary gallbladder carcinoma in lymph nodes and liver were examined histopathologically and classified as TNM staging of the American Joint Committee on Cancer. RESULTS: Of the 45 patients, 29 (64.4%) had a lymph node positive disease and 20 (44.4%) had a direct invasion of the liver. The frequency of involvement of lymph nodes was strongly influenced by the depth of the primary tumor (P = 0.0001). The postoperative survival rate of patients with negative lymph node metastasis was significantly higher than that of patients with positive lymph node metastasis (P = 0.004), but the postoperative survival rate of patients with N1 lymph node metastasis was not significantly different from that of patients with N2 lymph node metastasis (P = 0.3874). The postoperative survival rate of patients without hepatic invasion was significantly better than that of patients with hepatic invasion (P = 0.0177). CONCLUSION: Complete resection of the regional lymph nodes is important in advanced primary gallbladder carcinoma (PGC). The initial sites of liver spread are located mostly in segments IV and V. It is necessary to achieve negative surgical margins 2 cm from the tumor. In patients with hepatic hilum invasion, extended right hepatectomy with or without bile duct resection or portal vein resection is necessary for curative resection.

Differential expression of human Dlg in cervical intraepithelial neoplasias.

OBJECTIVES: To evaluate the potential role of human discs large (hDlg) protein in the pathogenesis of cervical neoplasia by examining the changes of hDlg protein expression in normal cervical epithelium as well as various stages of cervical dysplasia. MATERIALS AND METHOD: Archived formalin-fixed, paraffin-embedded cervical tissue sections with known status of human Papillomavirus (HPV) infection were examined for hDlg expression using immunohistochemical staining by a monoclonal antibody generated against hDlg. The specimens include normal epithelium, low-grade and high-grade squamous intraepithelial lesions, and squamous cell carcinoma. RESULTS: The hDlg protein localized primarily in the basolateral membrane of glandular columnar cells in normal endocervical epithelium. In the squamous epithelium, the hDlg staining is strong in the basal and parabasal layers and rapidly fades away in the superficial layers. Although predominantly membrane-associated, some cytoplasmic staining of hDlg is also detectable that decreases in intensity from basal to superficial layers. In low-grade squamous intraepithelial lesion, there is a moderate increase in the membranous as well as cytoplasmic staining of hDlg in the cells of superficial layer and a modest loss of membranous staining of hDlg in the basal layer. This "reverse staining pattern" for hDlg is more prominent and constant feature of high-grade squamous intraepithelial lesions. The changes of the hDlg expression are, however, invariable regardless the subtypes of HPV infection of the specimens. In the invasive squamous cell carcinoma, membranous staining of hDlg is reduced or absent with some mitotic cells showing evidence of hDlg accumulation in the midbody zone. CONCLUSIONS: These data suggest a functional role of hDlg in the development and progression of cervical neoplasia with implications in cytokinesis, viral trafficking, and metastasis pathways.

A case report of localized gastric amyloidosis.

AIM: To elucidate the clinical and laboratory features of localized gastric amyloidosis via a rare report along with a review of related literatures. METHODS: The clinical manifestations, laboratory results and surgical treatment of a female patient with localized gastric amyloidosis in our hospital were summarized. The relevant literatures were reviewed on the etiology, clinical features, diagnosis, treatment and prognosis of this disease. RESULTS: The patient was lack of specific clinical manifestations and positive laboratory results. Prior to the treatment, she was suspected to be of malignization from gastric ulcer by both gastroscopy and endoscopic ultrasonography, which was denied by the gastric biopsy. The patient was treated with subtotal gastrectomy and clearance of perigastric lymph nodes. The postoperative pathological diagnosis determined the lesion to be the deposition of amyloid materials in the gastric mucosa, submucosa and blood vessel walls with intestinal metaplasia and atrophy of the gastric glands, in which no malignant tumor was found. Congo red staining with prior potassium permanganate incubation confirmed the AA type of amyloid in this case. Multiple biopsies from esophagus, remnant stomach, duodenum, colon and bone marrow in the follow-up survey showed no amyloidal deposition in these tissues and organs. Up to the present, no signs of recurrence have been found in this patient. CONCLUSION: Localized gastric amyloidosis, being rare in incidence, should be considered in the differentiation of gastric tumors, in which biopsy is the only means to confirm the diagnosis. Currently, surgical resection of pathological tissue and circumambient lymph nodes may be a preferable therapeutic strategy for the localized amyloidosis to prevent possible complications. Although with a benign prognosis, gastric amyloidosis possesses a recurrent tendency as suggested by the literatures.