[Treatment strategies of cytoreductive surgery plus intraperitoneal hyperthermic chemotherapy for gastric cancer with peritoneal metastasis: a systematic review].

Peritoneal metastasis in gastric cancer is associated with rapid disease progression. Hyperthermic intraoperative peritoneal chemotherapy (HIPEC) done immediately after cytoreductive surgery (CRS) has become an important treatment for peritoneal metastasis in gastric cancer patients. However, different treatment options for HIPEC exist with potential influence on survival rates and prognosis in patients, exist. These treatment options include open or closed abdomen technique, perfusion solution, number of catheters, temperature, duration, and drug regimens. This paper aims to provide more evidence on standardization of HIPEC treatment options and technologies by systematically reviewing different drug regimens and technical approaches. The study included 2 randomized controlled trials, 3 phase I/II clinical trials, 2 prospective cohort studies, and 34 retrospective cohort studies, involving 1511 patients. The most common HIPEC option is to dissolve 50-75 mg/m2 of Cisplatin and 30-40 mg/m2 of Mitomycin C in 3-4 L saline solution at 42-43℃. After gastrointestinal anastomosis, 2-3 catheters are used in the HIPEC system with a perfusion flow rate of 500 ml/min. The duration is 60-90 minutes. Anastomotic leakage was low in studies where HIPEC was performed after gastrointestinal anastomosis. The utilization of open HIPEC and a two-drug regimen resulted in improved overall survival rates. The future development of HIPEC aims to enhance tumor-specific therapy by optimizing various aspects, such as identifying the safest and most effective chemotherapy regimens, refining patient selection criteria, and improving perioperative care.

[Epidemiological investigation of constipation in urban areas of Hangzhou, China].

Objective: To determine the prevalence and risk factors of constipation in Hangzhou urban areas by analyzing data from a recent epidemiological survey. Methods: From August 2022 to June 2023, a cross-sectional survey was conducted on 43 communities on eight streets in suburbs of Hangzhou, including Wangjiang, Sijiqing, Puyan, Changhe, Ziyang, Xiaoshanchengxiang, Zhuantang, and Banshan. Written questionnaires were filled out face to face by community doctors. The prevalence of constipation was investigated using a combination of the Bristol stool typing method and the Rome IV criteria. The risk factors for constipation were analyzed using multivariate logistic regression analysis. Results: The study cohort comprised 10,479 participants, 5551 of whom were male (53.0%) and 4928 female (47.0%). The overall prevalence of constipation was 10.6% (1107/10,479). The prevalence was 11.0% (613/5551) for male and 10.0% (494/4928) for female participants; this difference is not statistically significant (P>0.05).There were no significant differences in the prevalence of constipation between different categories of body mass index (P>0.05). The prevalence of constipation was highest in individuals aged 70 years and above, accounting for 15.4% (264/1717) of all cases. There were significant differences in the prevalence of constipation between different occupations, marital statuses, and educational levels (P<0.001). Patients with hypertension or diabetes mellitus had a higher prevalence of constipation than those without these conditions, those who had been taking long-term medication had a higher prevalence of constipation than those who did not, parents of children with constipation had a higher prevalence of constipation than those with children who did not have constipation, and there were other significant differences in various variables (P<0.001). Multivariate logistic regression analysis of modifiable factors revealed that eating less fruit (OR=1.284, 95%CI: 1.061-1.553, P=0.010), liking spicy and salty food (OR=1.234, 95%CI: 1.039-1.466, P=0.016), sleeping for too long (OR=1.644, 95%CI: 1.260-2.144, P<0.001), irregular sleep patterns (OR=1.370, 95%CI: 1.127-1.665, P=0.002) and minimal exercise (OR=1.388, 95% CI: 1.168-1.649, P<0.001) were all risk factors for constipation; whereas mix diets (OR=0.709,95%CI:0.608-0.826, P<0.001), meat diets (OR=0.604,95%CI: 0.495-0.736, P<0.001), moderate alcohol consumption (OR=0.659, 95% CI: 0.534-0.812, P<0.001), less or no drinking (OR=0.523, 95% CI: 0.428-0.638, P<0.001), and non-smoking (OR=0.819, 95%CI:0.674-0.995, P<0.001) protected against constipation. We found no association between dietary preferences and the risk of constipation (refined grains: OR=1.147, 95%CI:0.944-1.393, P=0.167; no specific preference: OR=0.935, 95%CI:0.783-1.117, P=0.459). The rate of agreement between self-evaluation of constipation by the respondents and objective criteria was higher for negatives (95.8%) than for positives (38.0%). Conclusion: The prevalence of constipation is relatively high in the urban population of Hangzhou. A good lifestyle and diet can significantly reduce its incidence. There should be more emphasis on preventive education, promotion of prevention of constipation, and advocacy for a healthy lifestyle.

[Comparison of mid-cheek tumors endoscopically assisted dissection between a single preauricular or transoral incision].

Objective: To summarize the preliminary experience of endoscopically assisted mid-cheek benign tumor resection using a single preauricular or transoral incision and to evaluate its indications, advantages, and disadvantages. Methods: Thirty-six patients with benign mid-cheek tumors were prospectively enrolled, including 11 males and 25 females, aged (37.2±15.9) years and ranged from 11 to 65 years old. The patients were randomly divided into two groups: endoscope-assisted tumor dissections through a single preauricular incision (19 cases) or transoral incision (17 cases). Their surgical approaches were introduced, and the tumor long-axis length, incision length, operative time, estimated intraoperative bleeding, postoperative drainage amount and time, aesthetic satisfaction, perioperative complications, and follow-up were recorded and analyzed. Results: The difference between the tumor long-axis lengths in the preauricular group [(2.2±0.9) cm] and the transoral group [(2.1±0.7) cm] was not statistically significant (t=0.46, P=0.687), and all surgical procedures were completed as planned. There was no significant difference in the incision size (t=1.57, P=0.100) or operative time (t=0.44, P=0.736). Compared with the preauricular group [(30.8±8.7) ml], transoral incision [(23.6±8.9) ml] reduced intraoperative blood loss (t=2.97, P=0.006) and improved aesthetic pleasure (t=3.44, P=0.015). Two cases of earlobe numbness and one case of temporary facial palsy were observed in the preauricular group; two cases of postoperative effusion were noted in the transoral group, and no signs of nerve injury were detected. No tumor recurrence was found during the 1-54-month of follow-up. perioperative complications. Conclusions: Endoscopic-assisted preauricular or transoral incision for dissecting mid-cheek benign tumors provides excellent aesthetic and minimally invasive results, reducing complications and obtaining satisfactory aesthetic results.

Solution-Processed Organic Photodetector Using Hafnium Oxide as an Electron Blocking Layer.

Organic photodetector (OPD) performance is affected significantly by leakage current. In this study, to decrease OPD leakage current, we introduced hafnium oxide as an electron blocking material, using a solution fabrication process. We fabricated an OPD consisting of ITO/HfO2/PCHT:PC60BM/Yb/Al, and measured its J-V characteristics, external quantum efficiency, and transient photocurrents. We found that the thickness of the hafnium oxide layer affected the detectivity of the prepared OPD. In particular, a device having an ultrathin hafnium oxide film (5.5 nm thick) exhibited a high on-off current ratio of up to 2.26 × 105 at -1 V, which is two times higher than that of a device having a PEDOT:PSS electron blocking layer.

High-detectivity perovskite-based photodetector using a Zr-doped TiO x cathode interlayer.

We investigated the incorporation of Zr into TiO x cathode interlayers used as hole-blocking layers in an organometallic halide perovskite-based photodetector. The device configuration is ITO/PEDOT:PSS/CH3NH3PbI x Cl3-x /PC60BM/Zr-TiO x /Al. The use of Zr-TiO x in the perovskite photodetector reduces the leakage current and improves carrier extraction. The performance of the perovskite photodetector was confirmed by analyzing the current-voltage characteristics, impedance behaviors, and dynamic characteristics. The device with a Zr-TiO x layer has a high specific detectivity of 1.37 × 1013 Jones and a bandwidth of 2.1 MHz at a relatively low reverse bias and light intensity. Therefore, it can be effectively applied to devices such as image and optical sensors.

First Report of Lettuce Chlorotic Leaf Rot Disease Caused by Phytoplasma in China.

Lettuce (Lactuca sativa) as annual or biennial crop is an important vegetable in China. The lettuce variety Feiqiao, which is extensively cultivated in autumn and winter, is grown for its stem and is a characteristic species bred in Yong'an City. Since October 2005, a new disease of lettuce has been observed sporadically in the fields. Initially, chlorotic symptoms, or a faded red color, were observed on the inner leaves of the infected lettuce plants. Then, the inner leaves bleached and appeared pale, while the top leaves became straight and elongated, and stopped growing. Gummosis was observed at the base of young leaves, and the whole plant became stunted and died. The disease was named lettuce chlorotic leaf rot disease. In 2008, there was a disease outbreak in Yong'an City with an incidence of approximately 30%. In 2012, total DNA was extracted from 0.1 g of leaf tissue collected from 20 symptomatic and five asymptomatic lettuce plants using the CTAB method. A PCR analysis was performed using the phytoplasma-specific primer set R16mF2/R16mR1 (1). An approximately 1.4-kb amplicon was obtained from all 20 symptomatic plants, but no corresponding DNA fragment was amplified from the five asymptomatic plants. PCR products were cloned in Escherichia coli DH5α, using the pMD18-T vector (TaKaRa, Japan), and two isolates were sequenced. The two 1,431-bp sequences were identical (GenBank Accession No. KJ668578). A BLAST analysis revealed a 99% identity between lettuce chlorotic leaf rot phytoplasma and mulberry dwarf phytoplasma, a group 16SrI phytoplasma described by Win et al. in 2012 (3). After analyzing with iPhyclassifier, the virtual RFLP pattern derived from the 16S rDNA F2n/R2 fragment was most similar to the reference pattern of the 16Sr group I, subgroup B (NC_005303), with a pattern similarity coefficient of 0.99 (2). Additionally, the leaf veins and roots with symptoms were processed for ultrastructural examinations using transmission electron microscopy. Many typical phytoplasma-like bodies were observed in the sieve elements in the leaf veins and roots, and they were spherical to oval or dumbbell shaped and 200 to 800 nm in diameter. In agreement with these findings, seven strains of phytoplasma from 16SrI-A and 16SrI-B subgroups were reported in association with lettuce plants exhibiting various types of symptoms which were not completely consistent with those observed in China (4). To our knowledge, this is the first report of a phytoplasma associated with lettuce in China. References: (1) R. E. Davis et al. Microbiol. Res. 158:229, 2003. (2) W. Wei et al. Int. J. Syst. Evol. Microbiol. 57:1855, 2006. (3) N. K. K. Win et al. J. Gen. Plant Pathol. 78:264, 2012. (4) J. Zhang et al. Phytopathology 94:842, 2004.

Promoter-dependent and -independent activation of insulin-like growth factor binding protein-5 gene expression by prostaglandin E2 in primary rat osteoblasts.

Insulin-like growth factor (IGF) action is mediated by high affinity cell surface IGF receptors and modulated by a family of secreted IGF binding proteins (IGFBPs). IGFBP-5, the most conserved of six IGFBPs characterized to date, uniquely potentiates the anabolic actions of IGF-I for skeletal cells. In osteoblasts, IGFBP-5 production is stimulated by prostaglandin E2 (PGE2), a local factor that mediates certain effects induced by parathyroid hormone, cytokines such as interleukin-1 and transforming growth factor-beta, and mechanical strain. In this study, we show that transcriptional and post-transcriptional events initiated by PGE2 collaborate to enhance IGFBP-5 gene expression in primary fetal rat osteoblast cultures. PGE2 treatment stimulated up to a 7-fold rise in steady-state levels of IGFBP-5 mRNA throughout 32 h of incubation. Analysis of nascent IGFBP-5 mRNA suggested that PGE2 had only a modest stimulatory effect on IGFBP-5 gene transcription, and transient transfection studies with IGFBP-5 promoter-reporter genes confirmed that PGE2 enhanced promoter activity by approximately 2-fold. Similar stimulatory effects were seen with forskolin. A DNA fragment with only 51 base pairs of the 5'-flanking sequence retained hormonal responsiveness, which may be mediated by a binding site for transcription factor AP-2 located at positions -44 to -36 in the proximal IGFBP-5 promoter. Incubation of osteoblasts with the mRNA transcriptional inhibitor 5,6-dichloro-1-beta-D-ribofuranosylbenzimidazole demonstrated that PGE2 enhanced IGFBP-5 mRNA stability by 2-fold, increasing the t1/2 from 9 to 18 h. The effects of PGE2 on steady-state IGFBP-5 transcripts were abrogated by preincubating cells with cycloheximide, indicating that the effects of PGE2 on both gene transcription and mRNA stability required ongoing protein synthesis. Therefore, both promoter-dependent and -independent pathways converge to enhance IGFBP-5 gene expression in response to PGE2 in osteoblasts.

Granular cell tumour of the neurohypophysis.

Granular cell tumours of the neurohypophysis are very rare. Their aetiology and nature are uncertain. Most investigators consider them to arise from pituicytes or Schwann cells of the posterior lobe of the hypophysis. They are found most commonly in older people. A surgically proven symptomatic case is reported.