Resection of polyps involving the appendiceal orifice by combined endo-laparoscopic surgery: Two case reports.

BACKGROUND: The management of polyps involving the appendiceal orifice (AO) presents notable challenges. Endoscopic resection is frequently hindered by operational complexities, a heightened risk of incomplete removal, and an elevated risk of procedural complications, including appendicitis. Conversely, surgical resection may entail unnecessary excision of intestinal segments, leading to potential morbidity. CASE SUMMARY: Here, we reported two patients who presented with polyps deeply situated within the AO, with indistinct boundaries making it challenging to ensure completeness using traditional endoscopic resection. To overcome these challenges, we employed combined endo-laparoscopic surgery (CELS), achieving curative resection without postoperative complications. CONCLUSION: The application of CELS in managing polyps involving the AO is emerging as a safe and effective treatment modality.

Deep-Learning-Assisted Simultaneous Target Sensing and Super-Resolution Imaging.

Metasurfaces have recently experienced revolutionary progress in sensing and super-resolution imaging fields, mainly due to their manipulation of electromagnetic waves on subwavelength scales. However, on the one hand, the addition of metasurfaces can multiply the complexity of retrieving target information from detected electromagnetic fields. On the other hand, many existing studies utilize deep learning methods to provide compelling tools for electromagnetic problems but mainly concentrate on resolving one single function, limiting their versatilities. In this work, a multifunctional deep learning network is demonstrated to reconstruct diverse target information in a metasurface-target interactive system. First, a preliminary experiment verifies that the metasurface-involved scenario can tolerate the system noises. Then, the captured electric field distributions are fed into the multifunctional network, which can not only accurately sense the quantity and relative permittivity of targets but also generate super-resolution images precisely. The deep learning network, thus, paves an alternative way to recover the targets' information in metasurface-target interactive systems, accelerating the progression of target sensing and superimaging areas. Besides, another new network that allows forward electromagnetic prediction is also proposed and demonstrated. To sum up, the deep learning methodology may hold promise for inverse reconstructions or forward predictions in many electromagnetic scenarios.

Development and validation of a sensitive LC-MS/MS method for simultaneous analysis of clopidogrel and simvastatin and their main metabolites in beagles: Application to pharmacokinetic drug interactions.

Clopidogrel (CLP) and simvastatin (SV) are commonly used in combination therapies as anti-cardiovascular drugs. However, the effect of coadministration on the absorption and metabolism of the two drugs in vivo is not clear. This study developed and validated an LC-MS/MS method for the simultaneous determination of CLP, clopidogrel carboxylic acid (CLPCA), 2-oxo-clopidogrel (2-O-CLP), SV, and simvastatin hydroxy acid (SVA) in beagle plasma. Chromatographic separation was achieved on an InfinityLab Poroshell 120 SB-C8 column (2.1 × 100 mm, 2.7 µm) using methanol and 0.1% formic acid in water as the mobile phase at a flow rate of 0.3 mL/min in gradient mode. The lower limits of quantification are 0.1, 0.8, 0.05, 0.05, and 0.05 ng/mL for CLP, CLPCA, 2-O-CLP, SV, and SVA, respectively. The selectivity, linearity, accuracy, precision, extraction recovery, matrix effect, and stability were validated within acceptable criteria. This method was successfully applied to the pharmacokinetic drug interaction study between CLP and SV, and the results revealed that combined administration affected the metabolic rate of CLP, SV, and their metabolites. This study is the first to detect CLP, CLPCA, 2-O-CLP, SV, and SVA simultaneously.

Spin-decoupled excitation and wavefront shaping of structured surface waves via on-chip terahertz metasurfaces.

Surface waves (SWs) are of great importance in terahertz (THz) photonics applications due to their subwavelength properties. Hence, it is crucial to develop surface wavefront shaping techniques, which is urgent in modern information technologies. In this paper, a new scheme is proposed to realize SW excitation and spin-decoupled wavefront shaping with an ultracompact planar meta-device working in the THz range. The meta-device is composed of two parts: meta-atoms (in the center) and plasmonic metals (on the left and right sides). By carefully setting the geometry size and rotation angle of each meta-atom, the encoded spin-decoupled phase distributions for both left circularly polarized (LCP) and right circularly polarized (RCP) incident THz waves are determined. In this way, circularly polarized (CP) incident THz waves can be converted to SWs propagating along plasmonic metals with unique wavefront profiles, i.e., Bessel and focusing profiles. Full-wave simulations and THz near-field scanning experiments were performed to verify the functionalities of the meta-device, both of which are in great agreement with theoretical predictions. Our findings may provide more solutions to design THz integrated photonic devices and systems.

Survival outcome of adjuvant radiotherapy after local excision for T2 early rectal cancer: An analysis based on the surveillance, epidemiology, and end result registry database.

BACKGROUND: Major resection (MR) is recommended for cases with T2 finding after local excision (LE) of early rectal cancer, but the revision procedure is accompanied with high morbidity. We evaluated the oncological safety of LE followed by adjuvant radiotherapy as a rectum-preserving alternative to MR for T2 early rectal cancer. METHODS: A total of 3786 patients with T2N0M0 rectal adenocarcinoma between 1998 and 2013 were included from the SEER database. Survival rates were compared using the Kaplan-Meier method with a log-rank test, and multivariate analyses were performed using Cox proportional regression models. RESULTS: Of these patients included, 429 (11.3%) treated with LE alone (LE group), 3067 (81.0%) treated with MR (MR group), and 290 (7.7%) treated with LE followed by adjuvant radiotherapy (LE + adjuvant RT group). The 5-year cancer specific survival (CSS) rate and 5-year overall survival (OS) rate were significantly lower in LE patients group than those in MR patients group (70.5% vs. 81.8%, P < 0.001; 57.3% vs. 72.3%, P < 0.001). The 5-year CSS rate and 5-year OS rate were similar between LE + adjuvant RT and MR groups (78.4% vs. 81.8%, P = 0.975, and 70.7% vs. 72.3%, P = 0.311, respectively). Multivariate Cox regression revealed that treatment strategies, age and CEA status were independently associated with CSS and OS. After age adjustment, LE was associated with reduced CSS (using MR as a reference, HR, 1.784; P < 0.001) and reduced OS (HR, 1.739; P < 0.001). However, CSS and OS related to LE + adjuvant RT of T2 rectal cancer group weren't be affected (HR, 0.994; P = 0.962 and HR, 0.904; P = 0.302, respectively). CONCLUSIONS: When MR is inappropriate for T2 early rectal cancer patients because of patients refusal or co-morbidities, LE + adjuvant RT can provide acceptable levels of long-term survival.