Total laparoscopic versus laparoscopic-assisted transabdominal posterior mediastinal digestive tract reconstruction in the treatment of Siewert II adenocarcinoma of the esophagogastric junction: A retrospective study.

Background: The method of operation and the range of resection for Siewert II adenocarcinoma of the esophagogastric junction (AEG) remain controversial. This study aims to evaluate the safety, feasibility, and short-term postoperative effect of total laparoscopic versus laparoscopic-assisted transabdominal posterior mediastinal digestive tract reconstruction in the treatment of Siewert II AEG. Methods: Total laparoscopic or laparoscopic-assisted gastrointestinal reconstruction through abdominal posterior mediastinum was performed in 108 patients with Siewert II AEG from October 2017 to February 2019. This study evaluated the loss of intraoperative blood, the number of lymph nodes, the marginal of the tumor, short-term postoperative complications (within 30 days), the rate of survival at follow-up, and the economic cost, feasibility, and effect of short-term postoperative recovery for patients who received these two operations. Result: There were no significant differences in general data between the total laparoscopic group and the laparoscopic-assisted group (P > 0.05). However, the total laparoscopic group cost more time on the surgical procedure and digestive tract reconstruction, lost less intraoperative blood, and had more mediastinal lymph nodes compared with the laparoscopic-assisted group (P < 0.05). The total laparoscopic group was significantly better than the laparoscopic-assisted group compared with the short-term postoperative recovery indexes, such as the first exhaust time, the first defecation time, the first fluid time, the first semi-fluid diet time, the postoperative hospital stay, and other postoperative recovery indexes (P < 0.05). In addition, there were no significant differences in postoperative complications, postoperative pathological indexes, the recurrence rate, and mortality between the total laparoscopic group and laparoscopic-assisted group (P > 0.05). Conclusions: The safety, feasibility, and short-term effect of total laparoscopic transabdominal posterior mediastinal digestive tract reconstruction in the treatment of Siewert II AEG were better than those for the laparoscopic-assisted group.

Early-Age Mechanical Characteristics and Microstructure of Concrete Containing Mineral Admixtures under the Environment of Low Humidity and Large Temperature Variation.

The application of concrete containing mineral admixtures was attempted in Northwest China in this study, where the environment has the characteristics of low humidity and large temperature variation. The harsh environment was simulated by using an environmental chamber in the laboratory and four types of concrete were prepared, including ordinary concrete and three kinds of mineral admixture concretes with different contents of fly ash and blast-furnace slag. These concretes were cured in the environmental chamber according to the real curing conditions during construction. The compression strength, fracture properties, SEM images, air-void characteristics, and X-ray diffraction features were researched at the early ages of curing before 28 d. The results showed that the addition of fly ash and slag can improve the compression strength and fracture properties of concrete in the environment of low humidity and large temperature variation. The optimal mixing of mineral admixture was 10% fly ash and 20% slag by replacing the cement in concrete, which can improve the compression strength, initial fracture toughness, unstable fracture toughness, and fracture energy by 23.9%, 25.2%, 45.3%, and 22.6%, respectively, compared to ordinary concrete. Through the analysis of the microstructure of concrete, the addition of fly ash and slag can weaken the negative effects of the harsh environment of low humidity and large temperature variation on concrete microstructure and cement hydration.

Evaluation of the impact of extreme floods on the biodiversity of terrestrial animals.

Extreme floods seriously affect the biodiversity of terrestrial animals (birds, mammals, reptiles, amphibians, and insects). The degree of impact depends on many factors, e.g., animal characteristics, natural conditions, and flood characteristics. Previous evaluation methods are not suitable for assessing the impact of floods on the biodiversity of all species in the entire submerged area, nor do they accurately reflect variability in the degree of impact. First, the influencing factors were boiled down to four: ratio of flood duration to survival time of animals in floods (D), ratio of flood depth to plant height (S), migration ability of animals (M), and temperature (T), which are represented by a coefficient I. Then, we proposed a calculation method for I based on the four factors. Third, we proposed the total and average biodiversity impact indices, namely, the TBI and ABI, respectively, indicating the overall and average impacts of floods on biodiversity in the submerged area, with the calculation method considering both the number of species and I. An extreme flood was simulated to obtain the flood parameters. In addition, we analyzed monthly changes in partial influencing factors. Finally, the impact of extreme floods on the biodiversity of terrestrial animals in the submerged area was evaluated monthly, and it was found that (1) TBI and ABI changed with space; (2) the ABI of different animals in descending order were mammals, insects, reptiles, amphibians, and birds; (3) the ABI of different land use types in descending order were cropland, orchard and shrubland, grassland, and forest and for TBI were orchard and shrubland, cropland, forest, and grassland; and (4) the TBI and ABI of different animals and land use types changed over time. The proposed method and indices are suitable for assessing the impact of floods on the biodiversity of any organism in any area.

Impact of extreme floods on plants considering various influencing factors downstream of Luhun Reservoir, China.

Extreme floods caused by dike or dam breaks have led to substantial damage to various types of vegetation, including forests, orchards, grass, and crops. Many factors affect the impacts of extreme floods on plants, e.g., flood parameters, plant characteristics and natural factors. However, these factors have never been systematically analyzed or considered when evaluating the impacts of extreme floods on plants. Firstly, we summarized the main influencing factors and simplified them into six categories: temperature, geomorphic change, plant age, flood velocity, ratio of the flood depth to the plant height, and ratio of the flood duration to the plant waterlogging tolerance time. Secondly, we proposed the two indices of unit risk biomass (URB) and total risk biomass (TRB) to represent the impacts of floods on plants regionally and over the entire inundated area, respectively. In addition, the calculation methods of URB and TRB considering plant biomass and the comprehensive influence coefficient (I) were put forward. To calculate I, we considered the six influencing factors with different weights according to their importance and varying conditions. The flood parameters and geomorphic changes caused by a simulated dam-break flood of Luhun Reservoir in China were then calculated. Furthermore, we divided a year into six time periods according to the species and growth characteristics of the plants in the inundated area. Then we evaluated the impacts of the dam-break flood on the plants during each period. The results showed that: (a) the URB varied with space in the inundated area; (b) because of the large inundation area of crops, the TRB was far greater than that of forests and orchards and affected the TRB of the whole inundated area; and (c) both the URB and TRB changed with time with the changes in crop species, crop parameters and temperature.

Self-Healing Concrete Using Rubber Particles to Immobilize Bacterial Spores.

Bacteria-based self-healing concrete is a construction material used to repair cracks in concrete, in which the bacterial spores are immobilized by bacteria carriers. However, the currently available bacteria carriers are not always suitable due to a complicated procedure or high cost. To develop a more suitable bacteria carrier as well as improve the anti-crack capability of self-healing concrete, in this study we evaluate the feasibility of using rubber particles as a novel bacteria carrier in self-healing concrete. Two types of self-healing concrete are prepared with rubber particles of different sizes to quantify the crack-healing effect. In addition, the fluidity and mechanical properties of the self-healing rubber concrete are compared with those of plain concrete and normal rubber concrete. The experimental results show that the self-healing rubber concrete with a particle size of 1~3 mm has a better healing capacity than the self-healing rubber concrete with a particle size of 0.2~0.4 mm, and the width value of the completely healed crack is 0.86 mm. The self-healing rubber concrete has a higher slump than the plain concrete and normal rubber concrete. According to the strength tests, the compressive strengths of the self-healing rubber concrete are low early on but they exceed those of the corresponding normal rubber concrete at 28 days. Moreover, the self-healing rubber concrete has higher splitting tensile strengths than the plain concrete and a better anti-crack capability. The results of a comparison to the other two representative bacterial carriers indicate that rubber particles have potential to be a widely used bacteria carrier for practical engineering applications in self-healing concrete.

Antituberculosis drug prescribing for inpatients in a national tuberculosis hospital in China, 2011-2015.

OBJECTIVES: This study aimed to describe trends in antituberculosis drug prescribing for inpatients from 2011-2015 in a Chinese national tuberculosis (TB) hospital. METHODS: This retrospective study, performed in March 2016, reviewed the medical records of all inpatients from Beijing Chest Hospital diagnosed with TB between 2011-2015. Medication used for TB treatment during the inpatient period was recorded. RESULTS: A total of 11465 inpatients were enrolled in the study. The most frequently prescribed drug for inpatients was isoniazid (71.2%; 8164/11465), followed by ethambutol (67.5%; 7738/11465), pyrazinamide (59.7%; 6839/11465) and rifampicin (40.0%; 4589/11465). In addition, amikacin (16.5%; 1889/11465), levofloxacin (33.0%; 3789/11465), para-aminosalicylic acid (12.4%; 1422/11465) and clarithromycin (3.5%; 406/11465) were the most common drugs used in the treatment of inpatients for Group II, III, IV and V drugs, respectively. A significant increasing trend in prescribing was found for rifampicin, pyrazinamide, capreomycin, moxifloxacin, prothionamide, para-aminosalicylic acid, cycloserine, clofazimine and linezolid, respectively, whilst there was a significant decreasing trend in the rate of prescribing of ethambutol, amikacin, levofloxacin, amoxicillin/clavulanic acid and clarithromycin during the 5-year study period (Ptrend<0.01). CONCLUSIONS: These data demonstrate that prescription of anti-TB drugs varied greatly across clinical diagnostic categories, treatment history and drug susceptibility profiles of TB patients. The World Health Organization (WHO)-endorsed standard regimen should be more extensively employed under conditions where drug susceptibility testing is unavailable in order to guide clinicians to formulate a suitable treatment regimen for TB patients.