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.

Clinical characteristics and risk factors of post-operative intestinal flora disorder following laparoscopic colonic surgery: A propensity-score-matching analysis.

BACKGROUND: Intestinal flora disorder (IFD) poses a significant challenge after laparoscopic colonic surgery, and no standard criteria exists for its diagnosis and treatment. AIM: To analyze the clinical features and risk factors of IFD. METHODS: Patients with colon cancer receiving laparoscopic surgery were included using propensity-score-matching (PSM) methods. Based on the occurrence of IFD, patients were categorized into IFD and non-IFD groups. The clinical characteristics and treatment approaches for patients with IFD were analyzed. Multivariate regression analysis was performed to identify the risk factors of IFD. RESULTS: The IFD incidence after laparoscopic surgery was 9.0% (97 of 1073 patients). After PSM, 97 and 194 patients were identified in the IFD and non-IFD groups, respectively. The most common symptoms of IFD were diarrhea and abdominal, typically occurring on post-operative days 3 and 4. All patients were managed conservatively, including modulation of the intestinal flora (90.7%), oral/intravenous application of vancomycin (74.2%), and insertion of a gastric/ileus tube for decompression (23.7%). Multivariate regression analysis identified that pre-operative intestinal obstruction [odds ratio (OR) = 2.79, 95%CI: 1.04-7.47, P = 0.041] and post-operative antibiotics (OR = 8.57, 95%CI: 3.31-23.49, P < 0.001) were independent risk factors for IFD, whereas pre-operative parenteral nutrition (OR = 0.12, 95%CI: 0.06-0.26, P < 0.001) emerged as a protective factor. CONCLUSION: A stepwise approach of probiotics, vancomycin, and decompression could be an alternative treatment for IFD. Special attention is warranted post-operatively for patients with pre-operative obstruction or early use of antibiotics.

Risk Factors for Postoperative Complications of Laparoscopic Right Colectomy: A Post Hoc Analysis of RELARC Trial.

BACKGROUND: There is concern regarding the possibility of postoperative complications for laparoscopic right colectomy. OBJECTIVE: To evaluate the risk factors of postoperative complications for patients undergoing laparoscopic right colectomy. DESIGN: This was an observational study. SETTINGS: This was a post-hoc analysis of a prospective, multicenter, randomized controlled trial (RELARC trial, NCT02619942). PATIENTS: Patients included in the modified intention-to-treat analysis in RELARC trial were all enrolled in this study. MAIN OUTCOME MEASURES: Risk factors for postoperative complications were identified using univariate and multivariable logistic regression analysis. RESULTS: Of 995 patients, 206 (20.7%) had postoperative complications. Comorbidity (p = 0.02, OR: 1.544, 95% CI: 1.077-2.212) and operative time >180 min (p = 0.03, OR: 1.453, 95% CI: 1.032-2.044) were independent risk factors for postoperative complications. While female (p = 0.04, OR: 0.704, 95% CI: 0.506-0.980) and extracorporeal anastomosis (p < 0.001, OR: 0.251, 95% CI: 0.166-0.378) were protective factors. Eighty (8.0%) had overall surgical site infection, 53 (5.3%) had incisional SSI, and 33 (3.3%) had organ/space SSI. Side-to-side anastomosis was a risk factor for overall surgical site infection (p < 0.001, OR: 1.912, 95% CI: 1.118-3.268) and organ/space surgical site infection (p = 0.005, OR: 3.579, 95% CI: 1.455-8.805). Extracorporeal anastomosis was associated with a reduced risk of overall surgical site infection (p < 0.001, OR: 0.239, 95% CI: 0.138-0.413), organ/space surgical site infection (p = 0.002 OR: 0.296, 95% CI: 0.136-0.646), and incisional surgical site infection (p < 0.001, OR: 0.179, 95% CI: 0.099-0.322). Diabetes (p = 0.039 OR: 2.090, 95% CI: 1.039-4.205) and conversion to open surgery (p = 0.013 OR: 5.403, 95% CI: 1.437-20.319) were risk factors for incisional surgical site infection. LIMITATIONS: Due to the retrospective nature, the key limitation is the lack of prospective documentation and standardization about perioperative management of these patients such as preoperative optimization, bowel prep regimes and antibiotic regimes, which may be confounder factors of complications. All surgeries were done by experienced surgeons and the patients enrolled were relatively young, generally healthy, and non-obese. It is unclear whether the results will be generalizable to obese and other populations worldwide. CONCLUSIONS: Male, comorbidity, prolonged operative time, and intracorporeal anastomosis were independent risk factors of postoperative complications of laparoscopic right colectomy. Side-to-side anastomosis was associated with an increased risk of organ/space surgical site infection. Extracorporeal anastomosis could reduce the incidence of overall surgical site infection. Diabetes and conversion to open surgery were associated with an increased risk of incisional surgical site infection. See Video Abstract.

Robot-assisted radical resection of colorectal cancer using the KangDuo surgical robot versus the da Vinci Xi robotic system: short-term outcomes of a multicentre randomised controlled noninferiority trial.

BACKGROUND: The KangDuo surgical robot (KD-SR-01) was recently developed in China. This study aims to evaluate the short-term outcomes of KD-SR-01 for colorectal cancer surgery. METHODS: This is a multicentre randomised controlled noninferiority trial conducted in three centers in China. Enrolled patients were randomly assigned at a 1:1 ratio to receive surgery using the KD-SR-01 system (KD group) or the da Vinci Xi (DV) robotic system (DV group). The primary endpoint was the success rate of operation. The second endpoints were surgical outcomes, pathological outcomes, and postoperative outcomes. RESULTS: Between July 2022 and May 2023. A total of 100 patients were included in the trial and randomly assigned to the KD group (50 patients) and the DV group (50 patients). All cases were completed successfully without conversion to laparoscopic surgery. The time to flatus and the incidence of postoperative complications of Clavien-Dindo grade II or higher grade were comparable between the two groups. Surgeons reported a high level of comfort with the KD-SR-01 system. In the subgroup analysis of different operative procedures, there were no significant differences in docking time, console time, blood loss, and the length of the incision for extraction between the two groups. There were no differences in pathological outcomes including maximum tumor diameter, circumferential resection margin, distal resection margin, and number of harvested lymph nodes. CONCLUSIONS: The KD-SR-01 system was a viable option for colorectal cancer robotic surgery, with acceptable short-term outcomes comparable to the da Vinci Xi robotic system.

Genome-Wide Identification and Abiotic Stress Expression Analysis of CKX and IPT Family Genes in Cucumber (Cucumis sativus L.).

Cytokinins (CKs) are among the hormones that regulate plants' growth and development, and the CKX and IPT genes, which are CK degradation and biosynthesis genes, respectively, play important roles in fine-tuning plants' cytokinin levels. However, the current research on the function of IPT and CKX in cucumber's growth, development, and response to abiotic stress is not specific enough, and their regulatory mechanisms are still unclear. In this study, we focused on the IPT and CKX genes in cucumber, analyzed the physiological and biochemical properties of their encoded proteins, and explored their expression patterns in different tissue parts and under low light, salt stress, and drought stress. Eight CsCKX and eight CsIPT genes were identified from the cucumber genome. We constructed a phylogenetic tree from the amino acid sequences and performed prediction analyses of the cis-acting elements of the CsCKX and CsIPT promoters to determine whether CsCKXs and CsIPTs are responsive to light, abiotic stress, and different hormones. We also performed expression analysis of these genes in different tissues, and we found that CsCKXs and CsIPTs were highly expressed in roots and male flowers. Thus, they are involved in the whole growth and development process of the plant. This paper provides a reference for further research on the biological functions of CsIPT and CsCKX in regulating the growth and development of cucumber and its response to abiotic stress.

Interaction analysis of high-risk pathological features on adjuvant chemotherapy survival benefit in stage II colon cancer patients: a multi-center, retrospective study.

BACKGROUND: We aimed to analyze the benefit of adjuvant chemotherapy in high-risk stage II colon cancer patients and the impact of high-risk factors on the prognostic effect of adjuvant chemotherapy. METHODS: This study is a multi-center, retrospective study, A total of 931 patients with stage II colon cancer who underwent curative surgery in 8 tertiary hospitals in China between 2016 and 2017 were enrolled in the study. Cox proportional hazard model was used to assess the risk factors of disease-free survival (DFS) and overall survival (OS) and to test the multiplicative interaction of pathological factors and adjuvant chemotherapy (ACT). The additive interaction was presented using the relative excess risk due to interaction (RERI). The Subpopulation Treatment Effect Pattern Plot (STEPP) was utilized to assess the interaction of continuous variables on the ACT effect. RESULTS: A total of 931 stage II colon cancer patients were enrolled in this study, the median age was 63 years old (interquartile range: 54-72 years) and 565 (60.7%) patients were male. Younger patients (median age, 58 years vs 65 years; P < 0.001) and patients with the following high-risk features, such as T4 tumors (30.8% vs 7.8%; P < 0.001), grade 3 lesions (36.0% vs 22.7%; P < 0.001), lymphovascular invasion (22.1% vs 6.8%; P < 0.001) and perineural invasion (19.4% vs 13.6%; P = 0.031) were more likely to receive ACT. Patients with perineural invasion showed a worse OS and marginally worse DFS (hazardous ratio [HR] 2.166, 95% confidence interval [CI] 1.282-3.660, P = 0.004; HR 1.583, 95% CI 0.985-2.545, P = 0.058, respectively). Computing the interaction on a multiplicative and additive scale revealed that there was a significant interaction between PNI and ACT in terms of DFS (HR for multiplicative interaction 0.196, p = 0.038; RERI, -1.996; 95%CI, -3.600 to -0.392) and OS (HR for multiplicative interaction 0.112, p = 0.042; RERI, -2.842; 95%CI, -4.959 to -0.725). CONCLUSIONS: Perineural invasion had prognostic value, and it could also influence the effect of ACT after curative surgery. However, other high-risk features showed no implication of efficacy for ACT in our study. TRIAL REGISTRATION: This study is registered on ClinicalTrials.gov, NCT03794193 (04/01/2019).

Pathological and perioperative outcomes of extracorporeal versus intracorporeal anastomosis in laparoscopic transverse colon cancer resection: retrospective multicentre study.

BACKGROUND: The aim of this study was to compare the pathological and perioperative outcomes of extracorporeal versus intracorporeal anastomosis after laparoscopic transverse colon cancer resection. METHODS: In this retrospective study, patients from seven institutions in China who underwent laparoscopic resection of transverse colon cancer between 2019 and 2021 were selected and included. Either extended right hemicolectomy or transverse colectomy/extended left hemicolectomy was performed. The clinical characteristics and the pathological and perioperative outcomes were compared between patients undergoing extracorporeal or intracorporeal anastomosis. Resection margin lengths were measured on formalin-fixed specimens and an inadequate margin was defined as less than 4.2 cm between the division and the tumour. The outcome of interest was the prevalence of specimens with an inadequate margin. Length of incision, bowel function recovery, hospital stay, early postoperative pain (first day after surgery), 30-day complications, and nodal harvest were investigated as secondary outcomes. RESULTS: Of 411 patients treated during the study interval, 370 patients with transverse colon cancer were included (23.2 per cent treated with intracorporeal anastomosis and 76.8 per cent treated with extracorporeal anastomosis). The prevalence of specimens with inadequate margins was lower in the intracorporeal anastomosis group compared with the extracorporeal anastomosis group in patients undergoing extended right hemicolectomy (P = 0.045) and in patients undergoing transverse colectomy/extended left hemicolectomy (P = 0.030). In multivariate analysis, extracorporeal anastomosis (OR 2.94 (95 per cent c.i. 1.33 to 6.49), P = 0.008) and transverse colectomy/extended left hemicolectomy (OR 1.75 (95 per cent c.i. 1.03 to 2.96), P = 0.038) were independent risk factors for specimens with an inadequate margin. Intracorporeal anastomosis was associated with a shorter incision length (P < 0.001), an earlier recovery of bowel function (P = 0.035), a shorter postoperative hospital stay (P = 0.042), less early postoperative pain (P < 0.001), a longer specimen length (P = 0.042), a longer resection margin (P = 0.007), and a greater lymph node harvest (P = 0.036). There was no statistically significant difference in 30-day complications. CONCLUSION: Patients with transverse colon cancer have better perioperative outcomes, fewer margins of less than 4.2 cm, and larger lymph node harvests when the anastomosis is performed intracorporeally. Further studies are needed to confirm these findings. REGISTRATION NUMBER: NCT05061199 (www.clinicaltrials.gov).

Intracorporeal Anastomosis Versus Extracorporeal Anastomosis in Laparoscopic Right Colectomy: An Observational Cohort Study.

BACKGROUND: Current studies did not draw definitive conclusions on comparison of intracorporeal anastomosis (ICA) with extracorporeal anastomosis (ECA) in laparoscopic right colectomy. Whether the intraperitoneal contamination induced by ICA can result in higher risk of postoperative abdominal infection remains unclear. This study was aimed to compare the short-term outcomes, especially the risk of abdominal infection after ICA versus ECA. METHODS: This was an observational cohort study as a secondary analysis of a randomized controlled trial (RCT)-RELARC trial (NCT02619942). The patients enrolled in the RELARC trial were diagnosed with primary colon adenocarcinoma without distant metastasis and underwent radical laparoscopic right colectomy between Jan 2016 and Dec 2019. In our study the patients who converted to open surgery in RELARC trial were excluded. The short-term outcomes were compared between ICA and ECA. The primary endpoint was abdominal infection. The inverse probability of treatment weighting (IPTW) and propensity score matching (PSM) was used for adjusting the potential confounders. RESULTS: This study enrolled 975 patients with 119 patients undergoing ICA and 856 patients undergoing ECA. The incidence of abdominal infection was higher in ICA group (9.2% versus 1.5%, RR from IPTW = 5.7 (95%CI: 2.6-12.6), P < 0.001) as well as the incidence of wound infection (14.3% vs 3.3%, RR from IPTW = 5.0 (95%CI: 2.9-8.6), P < 0.001). ICA was associated with higher incidence of Clavien-Dindo (CD) grade I and II complications (CD-I: 15.1% versus 6.8%, RR from IPTW = 2.4 (95%CI: 1.5-3.9), P < 0.001; CD-II: 26.9% versus 8.2%, RR from IPTW = 3.6 (95%CI: 2.5-5.1), P < 0.001) but similar incidence of CD-III ~ IV complications compared to ECA (3.4% vs 2.1%, RR from IPTW = 1.2 (95%CI: 0.4-4.0), P = 0.73). In ICA group, choosing another incision rather than lengthening main port site decreased the incidence of wound infection although without statistical significance (17.3% (14/81) versus 7.9% (3/38), crude RR = 2.2 (95%CI: 0.7-7.2), P = 0.17). CONCLUSION: ICA is likely to be associated with higher risk of abdominal infection and CD-I ~ II complications.

Comparison of safety of loop ileostomy and loop transverse colostomy for low-lying rectal cancer patients undergoing anterior resection: A retrospective, single institution, propensity score-matched study.

INTRODUCTION: This study was to compare the prevalence of stoma-related complications and stoma reversal perioperative complications of patients with low-lying rectal cancer who received preventative loop ileostomy and those who underwent loop transverse colostomy. METHODS: This retrospective single-center study analyzed the clinicopathologic and surgical data of 288 patients with pathologically proven primary rectal cancer who underwent anterior resection with either preventative loop ileostomy (n = 82) or loop transverse colostomy. To achieve comparability of a propensity score matching method was used to match patients from each group in a 1:2 ratio. Determinants of stoma-related complications were analyzed by multivariate logistic regression analysis. RESULTS: Forty-nine (74.3%) patients in the loop ileostomy group experienced stoma-related complications versus 48.7% in the loop transverse colostomy group (P < 0.01). Irritant dermatitis was the most frequent complication in both groups. The loop ileostomy group had a significantly higher rate (24.24%) of stoma reversal perioperative complications than the loop transverse colostomy group. Multivariate logistic regression analysis showed that ileostomy versus loop transverse colostomy was a significant independent risk for stoma-related complications and stoma reversal perioperative complications. Furthermore, by Clavien-Dindo classification, patients receiving loop ileostomy had an overall higher rate of complications and stoma reversal perioperative complications versus those undergoing loop transverse colostomy (P < 0.01). The rate of grade II complications was significantly higher in the loop ileostomy group (43.9%) than that of loop transverse colostomy group (13.5%, P < 0.01), whereas the rate of grade I, and grade IIIa and IIIb complications and stoma reversal perioperative complications was comparable between the two groups. CONCLUSION: The study has demonstrated that loop transverse colostomy is associated with significantly lower rates of stoma-related complications and stoma reversal perioperative complications compared to loop transverse colostomy.

Ultrafast plasma method allows rapid immobilization of monatomic copper on carboxyl-deficient g-C3N4 for efficient photocatalytic hydrogen production.

Transition-metal monometallic photocatalysts have received extensive attention owing to the maximization of atomic utilization efficiency. However, in previous related works, single-atom loading and stability are generally low due to limited anchor sites and mechanisms. Recently, adding transition-metal monatomic sites to defective carbon nitrides has a good prospect, but there is still lack of diversity in defect structures and preparation techniques. Here, a strategy for preparing defect-type carbon-nitride-coupled monatomic copper catalysts by an ultrafast plasma method is reported. In this method, oxalic acid and commercial copper salt are used as a carboxyl defect additive and a copper source, respectively. Carbon nitride samples containing carboxyl defects and monatomic copper can be processed within 10 min by one-step argon plasma treatment. Infrared spectroscopy and nuclear magnetic resonance prove the existence of carboxyl defects. Spherical aberration electron microscopy and synchrotron radiation analysis confirm the existence of monatomic copper. The proportion of monatomic copper is relatively high, and the purity is high and very uniform. The Cu PCN as-prepared shows not only high photo-Fenton pollutant degradation ability but also high photocatalytic hydrogen evolution ability under visible light. In the photocatalytic reaction, the reversible change of Cu+/Cu2+ greatly promotes the separation and transmission of photogenerated carriers and improves the utilization of photoelectrons. The photocatalytic hydrogen evolution rate of the optimized sample is 8.34 mmol g-1·h-1, which is 4.54 times that of the raw carbon nitride photocatalyst. The cyclic photo-Fenton experiment confirms the catalyst has excellent repeatability in a strong oxidation environment. The synergistic mechanism of the photocatalyst obtained by this plasma is the coordination of single-atom copper sites and carboxyl defect sites. The single copper atoms incorporated can act as an electron-rich active center, enhancing the h+ adsorption and reduction capacity of Cu PCN. At the same time, the carboxyl defect sites can form hydrogen bonds to stabilize the production of hydrogen atoms and subsequently convert them to hydrogen because of the unstable hydrogen bond structure. This plasma strategy is green, convenient, environment-friendly, and waste-free. More importantly, it has the potential for large-scale production, which brings a new way for the general preparation of high-quality monatomic catalysts.

High-performance temperature and pressure dual-parameter sensor based on a polymer-coated tapered optical fiber.

Based on the polymer encapsulation method, a compact structure and high-sensitivity temperature and pressure dual parametric sensor was developed in this paper by wrapping an optical microfiber coupler (OMC) in polydimethylsiloxane (PDMS). Benefiting from the stable chemical properties and good optical field control ability of PDMS, the sensor showed good stability and repeatability. The dependence of the sensor sensitivity on wavelength, temperature, and pressure was experimentally investigated. The results showed that the temperature and pressure sensitivity could reach -2.283 nm/°C and 3.301 nm/Mpa in the C-band range. To overcome the cross-sensitivity of sensor temperature and pressure, a sensitivity matrix was established to realize dual-parameter simultaneous demodulation. In addition, the pressure repeatability of the sensor was tested. Based on this, the sensitivity matrix was further calibrated to reduce the error and improve the accuracy of demodulation. Finally, we also designed a protective shell for the sensor to meet the requirements of practical marine applications. Compared with other existing types of optical fiber sensors, this sensor has the advantages of simple fabrication, high sensitivity, and environmental adaptability, and has great potential for application in the field of marine environmental monitoring.

Spatial-Temporal Response of Reactive Oxygen Species and Salicylic Acid Suggest Their Interaction in Pumpkin Rootstock-Induced Chilling Tolerance in Watermelon Plants.

Grafting with pumpkin rootstock could improve chilling tolerance in watermelon, and salicylic acid (SA) as a signal molecule is involved in regulating plant tolerance to chilling and other abiotic stresses. To clarify the mechanism in pumpkin rootstock-induced systemic acquired acclimation in grafted watermelon under chilling stress, we used self-grafted (Cl/Cl) and pumpkin rootstock-grafted (Cl/Cm) watermelon seedlings to study the changes in lipid peroxidation, photosystem II (PSII) activity and antioxidant metabolism, the spatio-temporal response of SA biosynthesis and H2O2 accumulation to chilling, and the role of H2O2 signal in SA-induced chilling tolerance in grafted watermelon. The results showed that pumpkin rootstock grafting promoted SA biosynthesis in the watermelon scions. Chilling induced hydrolysis of conjugated SA into free SA in the roots and accumulation of free SA in the leaves in Cl/Cm plants. Further, pumpkin rootstock grafting induced early response of antioxidant enzyme system in the roots and increased activities of ascorbate peroxidase and glutathione reductase in the leaves, thus maintaining cellular redox homeostasis. Exogenous SA improved while the inhibition of SA biosynthesis reduced chilling tolerance in Cl/Cl seedlings. The application of diphenyleneiodonium (DPI, inhibitor of NADPH oxidase) and dimethylthiourea (DMTU, H2O2 scavenger) decreased, while exogenous H2O2 improved the PSII activity in Cl/Cl plants under chilling stress. Additionally, the decrease of the net photosynthetic rate in DMTU- and DPI-pretreated Cl/Cl plants under chilling conditions could be alleviated by subsequent application of H2O2 but not SA. In conclusion, pumpkin rootstock grafting induces SA biosynthesis and redistribution in the leaves and roots and participates in the regulation of antioxidant metabolism probably through interaction with the H2O2 signal, thus improving chilling tolerance in watermelon.

CmRCC1 Gene From Pumpkin Confers Cold Tolerance in Tobacco by Modulating Root Architecture and Photosynthetic Activity.

Low-temperature stress is the main limiting factor of cucurbit crop cultivation as it affects crop yield and quality. The identification of genes involved in cold tolerance is a crucial aspect of pumpkin rootstock breeding. Here, we examined the function of a pumpkin Regulator of Chromosome Condensation 1 (CmRCC1) gene in the root development and cold stress responses of tobacco (Nicotiana benthamiana). CmRCC1 expression was differentially induced in pumpkin root, stem, and leaf under cold stress. Transient transformation showed that CmRCC1 is located in the nucleus. CmRCC1 overexpression in tobacco increased the gravitropic set-point angle in lateral roots, as well as root diameter and volume. The expression of auxin polar transport factors, PIN1 and PIN3, decreased and increased in CmRCC1-overexpressed plants, respectively. Yeast two-hybrid verification and luciferase complementation imaging assay showed that CmRCC1 interacts with CmLAZY1. Furthermore, the decreases in maximum quantum yield of PS II, the effective quantum yield of PS II, and electron transfer rate and the increases in quantum yield of nonregulated energy dissipation and malondialdehyde content were compromised in transgenic plants compared with wild-type plants under cold stress. The results suggest that CmRCC1 plays an important role in the regulation of root architecture and positively modulates cold tolerance.

Application of boron reduces vanadium toxicity by altering the subcellular distribution of vanadium, enhancing boron uptake and enhancing the antioxidant defense system of watermelon.

Vanadium (V) is the fifth most abundant transition metal, elevated levels of V are hazardous to plants. Boron (B) is an essential micronutrient for plants and can mitigate heavy metal toxicity. However, the mechanism used by B to promote tolerance to vanadium is unknown. In this study, a combination of physiological and gene expression analysis was used to explain mechanism of B (75 µM) induced V (40 mg L-1) stress tolerance in watermelon. V stress severely reduced root and shoot growth and increased the accumulation of ROS. B application improved tolerance to V by enhancing the expression of B transporter genes (ClaNIP5;1-1, ClaNIP5;1-2, ClaBOR4) that facilitated B uptake and transport while restricting V transport in plant tissues. At cellular level, the higher V retention in leaves was achieved by cell wall chelation, whereas, the higher V exclusion in vacuole of root cell was driven by elevated vacuolar H+-ATPase, H+-PPase activities, and transcript level of ClaVHP1;1, ClaPDR12-1 and ClaPDR12-2 genes facilitated by B application. Moreover, B application reduced tissue ROS cascade by enhancing antioxidant enzymatic activity and expression of superoxide dismutase (ClaCSD1-1, ClaCSD1-2, ClaCSD3, ClaMSD1) and catalase (ClaCAT2-1, ClaCAT2-2) genes that enhanced the defense mechanism of the V treated plants, improved root and shoot growth and tolerance index of watermelon. In conclusion, we demonstrate that ameliorative effect of B in tolerance to V of watermelon was based on B homeostasis and improved antioxidant defense system. These findings might help to increase watermelon production in V polluted soils.

Magnetic field and temperature two-parameter sensor based on optical microfiber coupler interference (OMCI) wrapped with magnetic fluid and PDMS.

In this paper, an optical fiber magnetic field and temperature sensor based on an optical microfiber coupler (OMC), Polydimethylsiloxane (PDMS), and magnetic fluid (MF) is proposed, and its magnetic field and temperature sensing characteristics are analyzed theoretically and verified experimentally. Based on the OMC and using MF as the sensing medium, the sensor can respond to the magnetic field and temperature respectively after encapsulated by PDMS. The experimental results show that the maximum magnetic field sensitivity is 96.8 pm/Oe, and the maximum temperature sensitivity is 919.1 pm/°C. To overcome the cross-sensitivity of the magnetic field and temperature of the sensor, the sensitivity matrix is established and demodulated. In addition, we discuss the optimization of the sensitivity demodulation matrix by the size design of the PDMS package and the OMC structure. The proposed two-parameter sensor in this article has the advantages of high sensitivity, low cost, small volume and high integration, which is of great significance for the multi-parameter sensing of basic physical parameters such as magnetic field and temperature.

Optical Microfiber All-Optical Phase Modulator for Fiber Optic Hydrophone.

In order to meet the needs of phase generated carrier (PGC) demodulation technology for interferometric fiber optic hydrophones, we proposed an optical microfiber all-optical phase modulator (OMAOPM) based on the photo-induced thermal phase shift effect, which can be used as a phase carrier generation component, so as to make the modulation efficiency and working bandwidth of this type of modulator satisfy the requirements of underwater acoustic signal demodulation applications. We analyzed the modulation principle of this modulator and optimized the structural parameters of the optical microfiber (OM) when the waist length and waist diameter of OM are 15 mm and 1.4 µm, respectively. The modulation amplitude of the modulator can reach 1 rad, which can meet the requirements of sensing applications. On this basis, the fiber optical hydrophone PGC-Atan demodulation system was constructed, and the simulated underwater acoustic signal test demodulation research was carried out. Experimental results showed that the system can demodulate underwater acoustic signals below 1 kHz.

Development of a Four-mRNA Expression-Based Prognostic Signature for Cutaneous Melanoma.

We aim to find a biomarker that can effectively predict the prognosis of patients with cutaneous melanoma (CM). The RNA sequencing data of CM was downloaded from The Cancer Genome Atlas (TCGA) database and randomly divided into training group and test group. Survival statistical analysis and machine-learning approaches were performed on the RNA sequencing data of CM to develop a prognostic signature. Using univariable Cox proportional hazards regression, random survival forest algorithm, and receiver operating characteristic (ROC) in the training group, the four-mRNA signature including CD276, UQCRFS1, HAPLN3, and PIP4P1 was screened out. The four-mRNA signature could divide patients into low-risk and high-risk groups with different survival outcomes (log-rank p < 0.001). The predictive efficacy of the four-mRNA signature was confirmed in the test group, the whole TCGA group, and the independent GSE65904 (log-rank p < 0.05). The independence of the four-mRNA signature in prognostic prediction was demonstrated by multivariate Cox analysis. ROC and timeROC analyses showed that the efficiency of the signature in survival prediction was better than other clinical variables such as melanoma Clark level and tumor stage. This study highlights that the four-mRNA model could be used as a prognostic signature for CM patients with potential clinical application value.

High relative humidity improve chilling tolerance by maintaining leaf water potential in watermelon seedlings.

Low temperature is a major environmental factor that severely impairs plant growth and productivity. Although the response to low temperature stress is well studied, the mechanisms of chilling tolerance are still not well understood. Here, we describe experiments that aimed to determine whether relative humidity (RH) contribute to chilling tolerance by regulating leaf water potential in watermelon seedlings. Plants exposed to chilling stress (10 °C/5 °C day/night) were severely wilted, and the water potential in their leaves was decreased. We found that maintaining high RH when plants were subjected to chilling-stress conditions attenuated the reduction in leaf water potential, reduced electrolyte leakage, improved the stability of photosynthesis, and alleviated chilling damage. Pretreatment with ABA increased chilling tolerance in low RH conditions but became ineffective in high RH conditions. Analysis of endogenous ABA content indicated that water potential mediated chilling tolerance was independent of ABA. Analysis of stomatal resistance indicated that the maintenance of water potential was related to stomatal resistance but that the balance between water absorption and loss is more important. In conclusion, high RH maintained leaf water potential and cell turgor, maintained better cell morphology, improved stomatal conductance and thus, ultimately improved the chilling tolerance of watermelon seedlings.

The incidence and risk factors of low anterior resection syndrome (LARS) after sphincter-preserving surgery of rectal cancer: a systematic review and meta-analysis.

BACKGROUND: Many patients after sphincter-preserving surgery experienced anorectal functional disturbances which were known as low anterior resection syndrome (LARS). Although many studies investigated LARS, there was inconsistency of their assessment tools and results. The aim of this systematic review was to elucidate the incidence and risk factors of LARS by a validated tool-LARS score. METHODS: A systematic literature search in Pubmed, Embase, and Cochrane Library was conducted in April 2020. Studies investigating patients who were evaluated by LARS score 1 year after their sphincter-preserving surgery due to rectal cancer were included. Meta-analysis of incidence was conducted using the double arcsine method. Meta-analysis of each risk factor was conducted using a random effects model. RESULTS: A total of 50 studies were included. The pooled incidence of major LARS was 44% (95% CI 40-48%; I2 = 88%; 36 studies). Long course neoadjuvant radiotherapy (OR 2.89, 95% CI 2.06-4.05; I2 = 47%; P < 0.01; 10 studies), total mesorectal excision (TME) (OR 2.13, 95% CI 1.49-3.04; I2 = 53%; P < 0.01; 7 studies), anastomotic leak (OR 1.98, 95% CI 1.34-2.93; I2 = 39%; P < 0.01; 9 studies), and diverting stoma (OR 1.89, 95% CI 1.58-2.27; I2 = 0%; P < 0.01; 13 studies) were associated with increased risk of major LARS. No significant difference was found in major LARS incidence between transanal TME and laparoscopic TME (OR 1.36, 95% CI 0.78-2.40; I2 = 19%; P = 0.28; 4 studies). Pouch reconstruction failed to lower the risk of major LARS in long term (OR 1.43, 95% CI 0.88-2.33; I2 = 70%; P = 0.29; 9 studies). CONCLUSION: The incidence of major LARS after sphincter-preserving surgery is relatively high. Neoadjuvant radiotherapy, TME, anastomostic leak, and diverting stoma are major risk factors. No significant differences in postoperative anorectal functions were observed between transanal and laparoscopic TME. Pouch reconstruction was not found to be significantly beneficial to anorectal functions in long term.

Short-term outcomes of pure transvaginal laparoscopic right colectomy: A novel surgery approach based on an Idea, Development, Exploration, Assessment, Long-term framework stage IIa study.

BACKGROUND AND OBJECTIVES: The application of pure natural orifice translumenal endoscopic surgery (NOTES) to intra-abdominal visceral resections remains limited due to the complexity of the dissection. This study aimed to assess the safety and feasibility of laparoscopic right colectomy using a purely transvaginal approach. METHODS: The data of 12 continuous patients with colon neoplasia who underwent transvaginal right colectomy from November 2018 to July 2020 were prospectively collected, and their perioperative events were recorded. RESULTS: The patients' median age was 70.4 years. Four were diagnosed with colon adenoma and eight with adenocarcinoma. The median operative time was 185 min, with a median blood loss of 25 ml. The median time to gas passing was 32.5 h after surgery. The median postoperative hospital stay was 6 days. One operation was converted to hybrid NOTES due to difficulty with the anastomosis, and one was converted to laparoscopic surgery because of vascular injury. Three cases were grades I, II, and III according to the Clavien-Dindo classification. CONCLUSION: Pure NOTES right colectomy using the transvaginal approach is feasible and safe with good short-term outcomes. We recommend this novel technique for highly-selected patients with no more than a D2 dissection performed by experienced colorectal surgeons.