The focus of this paper is the process of radicalization of the San Bernardino attackers and their source of inspiration and affiliations.The literature on the pathway to terrorism and jihad appears to agree that path...The focus of this paper is the process of radicalization of the San Bernardino attackers and their source of inspiration and affiliations.The literature on the pathway to terrorism and jihad appears to agree that pathways and triggers are varied and many with no clear set of traits that one can identify to predict individual paths to jihadism,in short,it is an idiosyncratic process.So,while the psychological profiling of high risk jihadist individuals has yet to be fruitful,the psycho/sociological behaviors associated with jihadism appear to offer greater promise.This paper will divide into four actions:their pathway to radicalization,affiliations/relations,source of inspiration,and the conclusion.展开更多
This paper explores the recent findings of some empirical research concerning Islamic State of Iraq and al-Sham＇s （ISIS＇） communication and tries to synthesize them under the theoretical frame of propaganda＇s con...This paper explores the recent findings of some empirical research concerning Islamic State of Iraq and al-Sham＇s （ISIS＇） communication and tries to synthesize them under the theoretical frame of propaganda＇s concept and practices. Many authors demonstrated how ISIS propaganda campaigns, in particular those deployed on cyberspace, proved to be effective in recruiting new members in both western and Muslim countries. However, while most of the researches focused on ISIS＇s communication contents and narratives, few works considered other methods and techniques used for actually delivering them. This is a regrettable missing point given the fact that communication＇s and neurosciences＇ studies demonstrate that not only what is communicated but also the techniques adopted bear important consequences on the receiver＇s perceptions and behavior. Therefore, this article analyzes in particular the findings of researches carried out by communication scholars, social psychologists, and neuro-cognitive scientists on ISIS＇ persuasive communication techniques and demonstrates their importance for security studies＇ analysis of ISIS＇ propaganda. It argues that ISIS＇ success in mobilizing people and make them prone to violent action relies on-among other factors-its knowledge and exploitation of sophisticated methods of perceptions＇ manipulation and behavior＇s influence. This, in turn, demonstrates ISIS＇ possession of state-like soft power capabilities effectively deployed in propaganda campaigns and therefore calls for a more complex understanding of its agency.展开更多
The following article presents the results of a research-action and an online communication campaign on the prevention of radicalization of second-generation young Italian Muslims as a part of a project called“Oltre...The following article presents the results of a research-action and an online communication campaign on the prevention of radicalization of second-generation young Italian Muslims as a part of a project called“Oltre”(the Italian acronym means“Beyond”)financed by European Union.After a short presentation of the four steps of the prevention communication model PKIC,a deepening on the radicalization factors,and a focus on the research-action methodology,the results of the research on some fundamental issues like the relationship with family and the relation with media and social media of the young interviewees,are shown.Finally,in the last part of the article,the interventions carried out by the second-generation young moderators of the social media campaign carried on Facebook and Instagram,are presented in the framework of the online communication campaign born out of the research-action to discuss if and how a prevention process and consequent change with regard to the radicalization factors took place.展开更多
A new cobalt(Ⅱ)-radical complex:[Co(im4-py)_(2)(PNB)_(2)](im4-py=2-(4'-pyridyl)-4,4,5,5-tetramethylimidazole-1-oxyl,HPNB=p-nitrobenzoic acid)has been synthesized and characterized by X-ray diffraction analysis,el...A new cobalt(Ⅱ)-radical complex:[Co(im4-py)_(2)(PNB)_(2)](im4-py=2-(4'-pyridyl)-4,4,5,5-tetramethylimidazole-1-oxyl,HPNB=p-nitrobenzoic acid)has been synthesized and characterized by X-ray diffraction analysis,elemental analysis,IR,and magnetic properties.X-ray diffraction analysis shows that the complex exists as mononuclear molecules and Co(Ⅱ)ion is four-coordinated with two radicals and two PNB-ligands.The magnetic susceptibility study indicates the complex exhibits weak ferromagnetic interactions between cobalt(Ⅱ)and im4-py radical.The magnetic property is explained by the magnetic and structure exchange mechanism.CCDC:976028.展开更多
Radical prostatectomy is a commonly used surgical method in cases of localized prostate cancer.In recent years,with the advent of new medical technologies and surgical techniques,the evolution of radical prostatectomy...Radical prostatectomy is a commonly used surgical method in cases of localized prostate cancer.In recent years,with the advent of new medical technologies and surgical techniques,the evolution of radical prostatectomy has revolutionized,especially in robot-assisted radical prostatectomy(RARP).The evolution of surgical approaches for radical prostatectomy has occurred in three stages:open surgery,laparoscopic intervention,and robot-assisted surgery.Regarding the functional recovery of patients who underwent laparoscopic radical prostatectomy or RARP,with the improvement of disease conditions,oncological prognosis of patients was not compromised.Particularly,RARP boasts distinguished novel techniques and approaches for maintaining urinary continence and sexual function in the short-and long-term.In addition,studies in the last two decades have shown its correlation with decreasing postoperative morbidity.In this paper,the available literatures related to the surgical approaches ranging from open surgery to RARP were reviewed,the superiority of any novel procedure was analyzed,and the advantages and disadvantages among the three modalities were compared,hoping to provide guidance to urologists when considering surgical approaches in the treatment of localized prostate cancer.展开更多
BACKGROUND Gastric cancer remains a significant global health concern.Radical gastrectomy is the primary curative treatment.Diabetes mellitus is a common comorbidity in patients undergoing surgery for gastric cancer,i...BACKGROUND Gastric cancer remains a significant global health concern.Radical gastrectomy is the primary curative treatment.Diabetes mellitus is a common comorbidity in patients undergoing surgery for gastric cancer,including radical gastrectomy.Previous studies have suggested that diabetes can negatively affect postoperative outcomes,such as wound healing,infection rates,and overall recovery.However,the specific impact of diabetes on recovery after radical gastrectomy for gastric cancer remains poorly understood.evaluate the influence of diabetes on postope-rative recovery,including hospital stay duration,complications,and readmission rates,in patients undergoing gastrectomy for gastric cancer.Understanding these effects could help optimize perioperative management and improve patient out-comes.gastric cancer and associated postoperative outcomes.METHODS This retrospective cohort study was performed at the Endocrinology Department of Xuanwu Hospital,Capital Medical University,Beijing,China.We examined patients who underwent radical gastrectomy for cancer between January 2010 and December 2020.The patients were divided into the diabetes and non-diabetes groups.The main outcomes included length of hospital stay,postoperative com-plications,and 30-day readmission rate.Secondary outcomes included quality of life indicators.Propensity score matching was used to adjust for potential con-founding factors.RESULTS A total of 1210 patients were included in the study,with 302 diabetic patients and 908 non-diabetic patients.After propensity score matching,280 patients were included in each group.Diabetic patients demonstrated significantly longer hospital stays(mean difference 2.3 days,95%CI:1.7-2.9,P<0.001)and higher rates of postoperative complications(OR 1.68,95%CI:1.32-2.14,P<0.001).The 30-day readmission rate was also higher in the diabetic group as compared to the non-diabetic group(12.5%vs 7.8%,P=0.02).CONCLUSION Patients with diabetes mellitus undergoing radical gastrectomy for gastric cancer experience prolonged hospital stay,increased postoperative complications,and higher readmission rates,thus requiring optimized perioperative management strategies.展开更多
BACKGROUND Coagulation status is closely related to the progression of malignant tumors.In the era of neoadjuvant immunochemotherapy(NICT),the prognostic utility of coagulation indicators in patients with locally adva...BACKGROUND Coagulation status is closely related to the progression of malignant tumors.In the era of neoadjuvant immunochemotherapy(NICT),the prognostic utility of coagulation indicators in patients with locally advanced gastric cancer(LAGC)undergoing new treatments remains to be determined.AIM To determine whether hypercoagulation is an effective prognostic indicator in patients with LAGC who underwent radical resection after NICT.METHODS A retrospective analysis of clinical data from 104 patients with LAGC,who underwent radical resection after NICT between 2020 and 2023,was performed.Ddimer and fibrinogen concentrations were measured one week before NICT,and again one week before surgery,to analyze the association between these two indicators and their combined indices[non-hypercoagulation(D-dimer and fibrinogen concentrations within the upper limit of normal)vs hypercoagulation(D-dimer or fibrinogen concentrations above the upper limit of normal)]with prognosis.After radical resection,patients were followed-up periodically.The median follow-up duration was 21 months.RESULTS Data collected after NICT revealed that the three-year overall survival(OS)and disease-free survival(DFS)rates the non-hypercoagulation group were significantly better than those in the hypercoagulation group[94.4%vs 78.0%(P=0.019)and 87.0%vs 68.0%(P=0.027),respectively].Multivariate analysis indicated that hypercoagulation after NICT was an independent factor for poor postoperative OS[hazard ratio(HR)4.436,P=0.023]and DFS(HR 2.551,P=0.039).Pre-NICT data demonstrated no statistically significant difference in three-year OS between the non-hypercoagulation and hypercoagulation groups(88.3%vs 84.1%,respectively;P=0.443).CONCLUSION Hypercoagulation after NICT is an effective prognostic indicator in patients with LAGC undergoing radical gastrectomy.展开更多
Syzygium cumini Linn.,commonly known as Jamun,is a member of the Myrtaceae family and is also referred to by synonyms such as Eugenia djouant Perr.,Eugenia cumini,Eugenia jambolana Lam.,Syzygium jambolana Lam.,and Myr...Syzygium cumini Linn.,commonly known as Jamun,is a member of the Myrtaceae family and is also referred to by synonyms such as Eugenia djouant Perr.,Eugenia cumini,Eugenia jambolana Lam.,Syzygium jambolana Lam.,and Myrtus cumini Linn.This review provides an overview of its medicinal value,including taxonomical classification,geographic distribution,cultivation techniques,pharmacognostical aspects,phytochemical constituents,traditional uses,and pharmacological applications.In India,‘Ram Jamun’or‘Raja Jamun’is cultivated in the north,while the‘Paras’variety is grown in central regions.Various components of S.cumini fruits are utilized to enhance the nutritional quality of wines,jellies,jams,and fermented products.Rich in essential nutrients like vitamins,carbohydrates,minerals,antioxidants,and anthocyanins,S.cumini also contains bioactive phytoconstituents such as gallic acid,tannins,and polyphenols,which contribute to its pharmacological properties.Traditionally,black plums have been used as carminatives,diuretics,and remedies for stomach ailments,spleen enlargement,diarrhea,and urinary retention.Additionally,S.cumini has been historically administered to women post-abortion and is recognized for its role in managing diabetes and dysentery.Polyphenolic compounds in Jamun exhibit potential therapeutic benefits against diabetes,arthritis,cancer,asthma,and cardiovascular diseases.Given its promising ethnopharmacological profile,extensive research has been conducted on various plant parts,highlighting their antioxidant,antifungal,antibacterial,antidiabetic,and anticancer properties.This review aims to provide a comprehensive understanding of Syzygium cumini’s traditional and therapeutic significance,serving as a valuable resource for future research.展开更多
This article explored the application of dexmedetomidine(Dex),a highly selective alpha-2 agonist,in managing postoperative cognitive dysfunction(POCD)in elderly patients undergoing radical colon cancer surgery.Aging i...This article explored the application of dexmedetomidine(Dex),a highly selective alpha-2 agonist,in managing postoperative cognitive dysfunction(POCD)in elderly patients undergoing radical colon cancer surgery.Aging is associated with a progressive decline in physiological functions and an increased risk of adverse surgical outcomes,including POCD,which encompasses many neurocognitive disorders that manifest during the perioperative period.The aging population is at a higher risk for POCD,which can lead to prolonged hospital stays,delayed recovery,and increased healthcare costs.Dex has neuroprotective,opioid-sparing,and sympatholytic properties,which reduces the incidence and severity of POCD.Dex was introduced for sedation in patients receiving mechanical ventilation but has since been adopted in anesthesia due to its multifaceted benefits.Its appli-cation extends to sedation,analgesia,maintenance of anesthesia,and controlling delirium.Its neuroprotective and anti-inflammatory effects have been explored in managing POCD.This article discussed the broad range of patient and procedure-related risk factors for POCD.Early identification and intervention are crucial to prevent the progression of POCD,which can have severe physical,psychological,and economic consequences.The article underscored the importance of a mul-tidisciplinary approach in managing POCD,involving the optimization of comor-bidities,depth of anesthesia monitoring,hemodynamic stability,and cerebral oxygenation monitoring.展开更多
The Fenton-like reaction between Cu^(2+)and H_(2)O_(2)was employed in chemical mechanical polishing to achieve efficient and high-quality processing of tungsten.The microstructure evolution and material removal rate o...The Fenton-like reaction between Cu^(2+)and H_(2)O_(2)was employed in chemical mechanical polishing to achieve efficient and high-quality processing of tungsten.The microstructure evolution and material removal rate of tungsten during polishing process were investigated via scanning electron microscopy,X-ray photoelectron spectroscopy,ultraviolet−visible spectrophotometry,and electrochemical experiments.The passivation behavior and material removal mechanism were discussed.Results show that the use of mixed H_(2)O_(2)+Cu(NO_(3))_(2)oxidant can achieve higher polishing efficiency and surface quality compared with the single oxidant Cu(NO_(3))_(2)or H_(2)O_(2).The increase in material removal rate is attributed to the rapid oxidation of W into WO_(3)via the chemical reaction between the substrate and hydroxyl radicals produced by the Fenton-like reaction.In addition,material removal rate and static etch rate exhibit significantly different dependencies on the concentration of Cu(NO_(3))_(2),while the superior oxidant for achieving the balance between polishing efficiency and surface quality is 0.5 wt.%H_(2)O_(2)+1.0 wt.%Cu(NO_(3))_(2).展开更多
BACKGROUND Patients with gastric cancer may have a risk of depression after radical surgery,which affects recovery and requires intensive intervention.AIM To explore the role of Bifidobacterium triple viable bacteria-...BACKGROUND Patients with gastric cancer may have a risk of depression after radical surgery,which affects recovery and requires intensive intervention.AIM To explore the role of Bifidobacterium triple viable bacteria-assisted mirtazapine in patients with depression after radical surgery for gastric cancer.METHODS This study included 80 patients with gastric cancer who experienced depression after undergoing radical surgery from January 2022 to December 2023 at Jiangnan University Hospital in Wuxi city in Jiangsu province.The patients were categorized into the control group(n=40)treated with mirtazapine and observation group(n=40)treated with combined Bifidobacterium triple viable bacteria-assisted mirtazapine.Neuroendocrine index,intestinal flora level,nutrition status,and patient quality of life were analyzed.RESULTS Before drug index level,no statistically significant difference was observed between the two groups (P>0.05).After drug administration,both groups experienced a decline in depression scores,cortisol,Escherichia coli,Enterococcus faecalis levels,and quality of life scores,whereas dopamine,serotonin,Lactobacillus,Bifidobacteria,hemoglobin,serum albumin and prealbumin levels increased.The observation group demonstrated significantly greater improvements across these indicators,with significant differences within groups and between groups(P<0.05).CONCLUSION Bifidobacterium has a relieving effect on depression in patients after radical surgery for gastric cancer,improves neuroendocrine status,regulates intestinal flora,and improves nutritional status and quality of life.展开更多
BACKGROUND Gastric cancer(GC)is a prevalent tumor in the digestive system,with around one million new cases reported annually,ranking it as the third most common malignancy.Reducing pain is a key research focus.This s...BACKGROUND Gastric cancer(GC)is a prevalent tumor in the digestive system,with around one million new cases reported annually,ranking it as the third most common malignancy.Reducing pain is a key research focus.This study evaluates the effect of nalbuphine on the analgesic effect and the expression of pain factors in patients after radical resection.AIM To provide a reference for postoperative analgesia methods.METHODS One hundred eight patients with GC,admitted between January 2022 and June 2024,underwent radical gastrectomy.They received a controlled analgesia pump and a transverse abdominis muscle plane block,divided into two groups of 54 patients in each group.The control group received sufentanil,while the observation group received nalbuphine as an analgesic.Postoperative analgesic effects,pain factor expression,and adverse effects were compared.RESULTS The resting pain and activity pain scores in the observation group at 6,12,24 and 48 hours were significantly lower than those in the control group.Additionally,the number of presses and consumption of the observation group at 48 hours were lower than those of the control group;and the response rate of the observation group was higher than that of the control group(P<0.05).The prostaglandin E2,substance P,and serotonin levels 24 hours after the observation group were lower than those in the control group,and the incidence of adverse reactions was 5.56%lower than 22.22%in the control group(P<0.05).CONCLUSION The findings suggest that nalbuphine enhances postoperative multimodal analgesia in patients with radical GC,effectively improving postoperative analgesic effect,relieving postoperative resting and active pain,and reducing postoperative pain factor expression,demonstrating its potential for clinical application.展开更多
BACKGROUND The incidence of gastric cancer in the elderly is increasing;however,standardized surgical approaches are lacking.AIM To investigate the effects of radical surgery on the trauma response,postoperative compl...BACKGROUND The incidence of gastric cancer in the elderly is increasing;however,standardized surgical approaches are lacking.AIM To investigate the effects of radical surgery on the trauma response,postoperative complications,and long-term prognosis in elderly patients with gastric cancer.METHODS Between January 2020 and December 2023,110 gastric cancer patients admitted to the Department of Oncology Jiangnan University Medical Center were cate-gorized into a control group(40 cases)and an observation group(70 cases)based on surgical method differences.The control and observation group received palli-ative surgery and radical surgery,respectively,and were further divided into open(25 cases)and laparoscopic(45 cases)surgery.Surgical outcomes,trauma indicators,complication rates,and long-term survival at 6 months,1-,and 2-years were compared.RESULTS Laparoscopic surgery showed superior surgical outcomes compared to the open surgery and control groups(P<0.05).Trauma indicators were lowest in the lapa-roscopic group and highest in the control group(P<0.05).No significant difference was observed in the complication rates between the open and laparo-scopic groups(P>0.05),but both were higher than those in the control group(P<0.05).No significant differences were found in survival rates at different follow-up periods between the laparoscopic and open groups(P>0.05);however,both groups showed higher survival rates than the control group(P<0.05).CONCLUSION Radical surgery in elderly patients with gastric cancer reduces surgical trauma response,facilitates postoperative recovery,and improves long-term survival rates,albeit with an increased risk of complications.Laparoscopic radical surgery further minimizes postoperative trauma,with no significant difference in complication rates and survival prognosis compared with open radical surgery.展开更多
BACKGROUND Esophageal cancer constitutes one of the most aggressive malignant neoplasms associated with poor clinical outcomes.While surgical resection remains the cornerstone of curative intervention,optimization of ...BACKGROUND Esophageal cancer constitutes one of the most aggressive malignant neoplasms associated with poor clinical outcomes.While surgical resection remains the cornerstone of curative intervention,optimization of perioperative care protocols has emerged as an essential strategy to reduce postoperative complications and potentially improve long-term survival rates in patients undergoing esophagectomy.However,substantial debate persists regarding the relative importance of various perioperative risk factors and their impact on post-resection outcomes.AIM To identify perioperative factors affecting prognosis after radical esophagectomy,aiming to improve patient outcomes through targeted interventions.METHODS A retrospective study analyzed 378 patients with esophageal cancer who underwent radical esophagectomy(McKeown,Sweet,or Ivor-Lewis procedures)from January 2022 through December 2023.All operations were performed by experienced surgeons following standardized perioperative protocols.The investigation gathered data on patient demographics,surgical parameters,tumor pathology(using the 8th edition American Joint Committee on Cancer staging system),and survival outcomes.Statistical analyses utilized Kaplan-Meier estimates and Cox proportional hazards modeling,with adjustment for confounding variables.RESULTS Multivariate Cox proportional hazards analysis identified three independent predictors of survival:Tumor-nodemetastasis staging[Hazard ratio(HR)=2.31,95%confidence interval(CI):1.72-3.10,P<0.001],tumor differentiation(moderate:HR=1.46,95%CI:1.02-2.09,P=0.038;poor:HR=2.15,95%CI:1.47-3.14,P<0.001),and extended postoperative analgesic use(>5 days)(HR=1.43,95%CI:1.08-1.89,P=0.012).Kaplan-Meier analysis demonstrated significantly lower overall survival rates in patients requiring analgesics for>5 days compared to≤5 days(P=0.003),with consistent patterns observed for both opioid(P=0.019)and nonsteroidal anti-inflammatory drug use(P=0.028).The extended analgesic group exhibited a higher proportion of elderly patients(48.47%vs 35.57%,P=0.015),while other baseline characteristics and tumor features remained comparable between groups.CONCLUSION Tumor-node-metastasis staging,tumor differentiation,and duration of postoperative analgesic use independently predict survival following radical esophagectomy,underscoring the significance of optimal pain management protocols.展开更多
BACKGROUND Colorectal cancer(CRC)is a malignant tumor with high morbidity and mortality rates worldwide.With the development of medical imaging technology,imaging features are playing an increasingly important role in...BACKGROUND Colorectal cancer(CRC)is a malignant tumor with high morbidity and mortality rates worldwide.With the development of medical imaging technology,imaging features are playing an increasingly important role in the prognostic evaluation of CRC.Laparoscopic radical resection is a common surgical approach for treating CRC.However,research on the link between preoperative imaging and short-term prognosis in this context is limited.We hypothesized that specific preope-rative imaging features can predict the short-term prognosis in patients under-going laparoscopic CRC resection.AIM To investigate the imaging features of CRC and analyze their correlation with the short-term prognosis of laparoscopic radical resection.METHODS This retrospective study conducted at the Affiliated Cancer Hospital of Shandong First Medical University included 122 patients diagnosed with CRC who under-went laparoscopic radical resection between January 2021 and February 2024.All patients underwent magnetic resonance imaging(MRI)and were diagnosed with CRC through pathological examination.MRI data and prognostic indicators were collected 30 days post-surgery.Logistic regression analysis identified imaging fea-tures linked to short-term prognosis,and a receiver operating characteristic(ROC)curve was used to evaluate the predictive value.RESULTS Among 122 patients,22 had irregular,low-intensity tumors with adjacent high signals.In 55,tumors were surrounded by alternating signals in the muscle layer.In 32,tumors extended through the muscular layer and blurred boundaries with perienteric adipose tissue.Tumor signals appeared in the adjacent tissues in 13 patients with blurred gaps.Logistic regression revealed differences in longitudinal tumor length,axial tumor length,volume transfer constant,plasma volume fraction,and apparent diffusion coefficient among patients with varying prognostic results.ROC analysis indicated that the areas under the curve for these parameters were 0.648,0.927,0.821,0.809,and 0.831,respectively.Sensitivity values were 0.643,0.893,0.607,0.714,and 0.714,and specificity 0.702,0.904,0.883,0.968,and 0.894(P<0.05).CONCLUSION The imaging features of CRC correlate with the short-term prognosis following laparoscopic radical resection.These findings provide valuable insights for clinical decision-making.展开更多
BACKGROUND Radical gastrectomy(RGE)for gastric carcinoma(GC)has exerted definite therapeutic efficacy in treating patients with GC.However,a notable risk of postoperative complications(POCs)persists among middle-aged ...BACKGROUND Radical gastrectomy(RGE)for gastric carcinoma(GC)has exerted definite therapeutic efficacy in treating patients with GC.However,a notable risk of postoperative complications(POCs)persists among middle-aged and elderly patients with compromised physiological functions.Hence,developing and implementing reliable nursing interventions to optimize the comprehensive management of these patients is deemed imperative.AIM To analyze the association of multi-channel continuous nursing intervention with POCs,negative emotions(NEs),and quality of life(QoL)of patients undergoing RGE for GC.METHODS This retrospective study selected 99 patients who underwent RGE for GC in our hospital from May 2020 to May 2023.Participants were categorized into the control(n=49 cases)and research groups(n=50 cases)receiving routine and multi-channel continuous nursing care,respectively.Comparative analysis involved data on postoperative rehabilitation(time to first anal exhaust,oral feeding and ambulation,and hospital stay),complications(nausea and vomiting,delayed gastric emptying,and abdominal distension),NEs[Self-rating Anxiety(SAS)/Depression Scale(SDS)],treatment compliance,self-efficacy,and QoL[World Health Organization QoL Brief Version(WHOQOL-BREF)].RESULTS Compared to the control group,the research group demonstrated earlier first postoperative anal exhaust,oral feeding,and ambulation,shorter hospital stay,lower POC rate,and more reduced SAS and SDS scores postintervention,which was significantly lower than the baseline.The treatment compliance scores were significantly higher in the research group than in the control group in terms of medication adherence,daily exercise,reasonable diet,and regular review.Further,the research group demonstrated increased self-efficacy scores in terms of positive attitude,self-stress relief,and self-decision-making,as well as the overall score postintervention,which were higher than the control group.Moreover,the research group reported notably higher WHOQOL-BREF scores in domains such as physiology,psychology,social relations,and environment.CONCLUSION Multi-channel continuous nursing intervention prevents POCs in patients undergoing RGE for GC as well as significantly alleviates patients’NEs and boosts their QoL.展开更多
BACKGROUND Gastric cancer is the most common malignancy of the digestive system and surgical resection is the primary treatment.Advances in surgical technology have reduced the risk of complications after radical gast...BACKGROUND Gastric cancer is the most common malignancy of the digestive system and surgical resection is the primary treatment.Advances in surgical technology have reduced the risk of complications after radical gastrectomy;however,post-surgical pancreatic fistula remain a serious issue.These fistulas can lead to abdominal infections,anastomotic leakage,increased costs,and pain;thus,early diagnosis and prevention are crucial for a better prognosis.Currently,C-reactive protein(CRP),procalcitonin(PCT),and total bilirubin(TBil)levels are used to predict post-operative infections and anastomotic leakage.However,their predictive value for pancreatic fistula after radical gastrectomy for gastric cancer remains unclear.The present study was conducted to determine their predictive value.AIM To determine the predictive value of CRP,PCT,and TBil levels for pancreatic fistula after gastric cancer surgery.METHODS In total,158 patients who underwent radical gastrectomy for gastric cancer at our hospital between January 2019 and January 2023 were included.The patients were assigned to a pancreatic fistula group or a non-pancreatic fistula group.Multivariate logistic analysis was conducted to assess the factors influencing development of a fistula.Receiver operating characteristic(ROC)curves were used to determine the predictive value of serum CRP,PCT,and TBil levels on day 1 postsurgery.RESULTS On day 1 post-surgery,the CRP,PCT,and TBil levels were significantly higher in the pancreatic fistula group than in the non-pancreatic fistula group(P<0.05).A higher fistula grade was associated with higher levels of the indices.Univariate analysis revealed significant differences in the presence of diabetes,hyperlipidemia,pancreatic injury,splenectomy,and the biomarker levels(P<0.05).Logistic multivariate analysis identified diabetes,hyperlipidemia,pancreatic injury,CRP level,and PCT level as independent risk factors.ROC curves yielded predictive values for CRP,PCT,and TBil levels,with the PCT level having the highest area under the curve(AUC)of 0.80[95%confidence interval(CI):0.72-0.90].Combined indicators improved the predictive value,with an AUC of 0.86(95%CI:0.78-0.93).CONCLUSION Elevated CRP,PCT,and TBil levels predict risk of pancreatic fistula post-gastrectomy for gastric cancer.展开更多
Photocatalytic oxygen reduction for hydrogen peroxide(H_(2)O_(2))synthesis presents a green and costeffective production method.However,achieving highly selective H_(2)O_(2)synthesis remains challenging,necessitating ...Photocatalytic oxygen reduction for hydrogen peroxide(H_(2)O_(2))synthesis presents a green and costeffective production method.However,achieving highly selective H_(2)O_(2)synthesis remains challenging,necessitating precise control over free radical reaction pathways and minimizing undesirable oxidative by-products.Herein,we report for the visible light-driven simultaneous co-photocatalytic reduction of O2to H_(2)O_(2)and oxidation of biomass using the atomic rubidium-nitride modified carbon nitride(CNRb).The optimized CNRb catalyst demonstrates a record photoreduction rate of 8.01 mM h^(-1)for H_(2)O_(2)generation and photooxidation rate of 3.75 mM h^(-1)for furfuryl alcohol to furoic acid,achieving a remarkable solar-to-chemical conversion(SCC)efficiency of up to 2.27%.Experimental characterizations and DFT calculation disclosed that the introducing atomic Rb–N configurations allows for the high-selective generation of superoxide radicals while suppressing hydroxyl free radical formation.This is because the Rb–N serves as the new alternative site to perceive a stronger connection position for O2adsorption and reinforce the capability to extract protons,thereby triggering a high selective redox product formation.This study holds great potential in precisely regulating reactive radical processes at the atomic level,thereby paving the way for efficient synthesis of H_(2)O_(2)coupled with biomass valorization.展开更多
The ideology of Jihadi-Salafism seeks to suspend the dialectic through the positing of an ahistorical state which exists under an unmediated divine sovereignty,through the full exclusion of the“other”.Thus the perio...The ideology of Jihadi-Salafism seeks to suspend the dialectic through the positing of an ahistorical state which exists under an unmediated divine sovereignty,through the full exclusion of the“other”.Thus the period of the salaf is understood as a golden age,which can be revived without regard to historical context.The“Islamic State”is considered as existing directly under the rule(hakimiyya)of God by way of the shari’a code.There is an attempt to sever oneself from apostates by exercising al-walawa’l-bara and the practice of takfir.The reaching of the perfect end state,however,necessarily entails an activist pursuit of violent change whereby all opposition elements are forcibly removed.Despite its ahistorical pretension,the Islamist ideology developed through distinct stages in Islamic history.The present essay depicts the historical formation of the Jihadi-Salafi ideological principles by tracing back the trajectory.Through attention to the deductive logic implied in the principles,the paper reveals an absolute standpoint precluding the possibility for any form of mediation that has come to be formed.With the delineation of the reasoning underlying Jihadi-Salafi concepts,the basis for the rejection of dialectical development is demonstrated,as well as the implications of the absolutist standpoint for the intensification of extremism culminating in the“Islamic State”.展开更多
BACKGROUND Propofol and sevoflurane are commonly used anesthetic agents for maintenance anesthesia during radical resection of gastric cancer.However,there is a debate concerning their differential effects on cognitiv...BACKGROUND Propofol and sevoflurane are commonly used anesthetic agents for maintenance anesthesia during radical resection of gastric cancer.However,there is a debate concerning their differential effects on cognitive function,anxiety,and depression in patients undergoing this procedure.AIM To compare the effects of propofol and sevoflurane anesthesia on postoperative cognitive function,anxiety,depression,and organ function in patients undergoing radical resection of gastric cancer.METHODS A total of 80 patients were involved in this research.The subjects were divided into two groups:Propofol group and sevoflurane group.The evaluation scale for cognitive function was the Loewenstein occupational therapy cognitive assessment(LOTCA),and anxiety and depression were assessed with the aid of the self-rating anxiety scale(SAS)and self-rating depression scale(SDS).Hemodynamic indicators,oxidative stress levels,and pulmonary function were also measured.RESULTS The LOTCA score at 1 d after surgery was significantly lower in the propofol group than in the sevoflurane group.Additionally,the SAS and SDS scores of the sevoflurane group were significantly lower than those of the propofol group.The sevoflurane group showed greater stability in heart rate as well as the mean arterial pressure compared to the propofol group.Moreover,the sevoflurane group displayed better pulmonary function and less lung injury than the propofol group.CONCLUSION Both propofol and sevoflurane could be utilized as maintenance anesthesia during radical resection of gastric cancer.Propofol anesthesia has a minimal effect on patients'pulmonary function,consequently enhancing their postoperative recovery.Sevoflurane anesthesia causes less impairment on patients'cognitive function and mitigates negative emotions,leading to an improved postoperative mental state.Therefore,the selection of anesthetic agents should be based on the individual patient's specific circumstances.展开更多
文摘The focus of this paper is the process of radicalization of the San Bernardino attackers and their source of inspiration and affiliations.The literature on the pathway to terrorism and jihad appears to agree that pathways and triggers are varied and many with no clear set of traits that one can identify to predict individual paths to jihadism,in short,it is an idiosyncratic process.So,while the psychological profiling of high risk jihadist individuals has yet to be fruitful,the psycho/sociological behaviors associated with jihadism appear to offer greater promise.This paper will divide into four actions:their pathway to radicalization,affiliations/relations,source of inspiration,and the conclusion.
文摘This paper explores the recent findings of some empirical research concerning Islamic State of Iraq and al-Sham＇s （ISIS＇） communication and tries to synthesize them under the theoretical frame of propaganda＇s concept and practices. Many authors demonstrated how ISIS propaganda campaigns, in particular those deployed on cyberspace, proved to be effective in recruiting new members in both western and Muslim countries. However, while most of the researches focused on ISIS＇s communication contents and narratives, few works considered other methods and techniques used for actually delivering them. This is a regrettable missing point given the fact that communication＇s and neurosciences＇ studies demonstrate that not only what is communicated but also the techniques adopted bear important consequences on the receiver＇s perceptions and behavior. Therefore, this article analyzes in particular the findings of researches carried out by communication scholars, social psychologists, and neuro-cognitive scientists on ISIS＇ persuasive communication techniques and demonstrates their importance for security studies＇ analysis of ISIS＇ propaganda. It argues that ISIS＇ success in mobilizing people and make them prone to violent action relies on-among other factors-its knowledge and exploitation of sophisticated methods of perceptions＇ manipulation and behavior＇s influence. This, in turn, demonstrates ISIS＇ possession of state-like soft power capabilities effectively deployed in propaganda campaigns and therefore calls for a more complex understanding of its agency.
文摘The following article presents the results of a research-action and an online communication campaign on the prevention of radicalization of second-generation young Italian Muslims as a part of a project called“Oltre”(the Italian acronym means“Beyond”)financed by European Union.After a short presentation of the four steps of the prevention communication model PKIC,a deepening on the radicalization factors,and a focus on the research-action methodology,the results of the research on some fundamental issues like the relationship with family and the relation with media and social media of the young interviewees,are shown.Finally,in the last part of the article,the interventions carried out by the second-generation young moderators of the social media campaign carried on Facebook and Instagram,are presented in the framework of the online communication campaign born out of the research-action to discuss if and how a prevention process and consequent change with regard to the radicalization factors took place.
文摘A new cobalt(Ⅱ)-radical complex:[Co(im4-py)_(2)(PNB)_(2)](im4-py=2-(4'-pyridyl)-4,4,5,5-tetramethylimidazole-1-oxyl,HPNB=p-nitrobenzoic acid)has been synthesized and characterized by X-ray diffraction analysis,elemental analysis,IR,and magnetic properties.X-ray diffraction analysis shows that the complex exists as mononuclear molecules and Co(Ⅱ)ion is four-coordinated with two radicals and two PNB-ligands.The magnetic susceptibility study indicates the complex exhibits weak ferromagnetic interactions between cobalt(Ⅱ)and im4-py radical.The magnetic property is explained by the magnetic and structure exchange mechanism.CCDC:976028.
文摘Radical prostatectomy is a commonly used surgical method in cases of localized prostate cancer.In recent years,with the advent of new medical technologies and surgical techniques,the evolution of radical prostatectomy has revolutionized,especially in robot-assisted radical prostatectomy(RARP).The evolution of surgical approaches for radical prostatectomy has occurred in three stages:open surgery,laparoscopic intervention,and robot-assisted surgery.Regarding the functional recovery of patients who underwent laparoscopic radical prostatectomy or RARP,with the improvement of disease conditions,oncological prognosis of patients was not compromised.Particularly,RARP boasts distinguished novel techniques and approaches for maintaining urinary continence and sexual function in the short-and long-term.In addition,studies in the last two decades have shown its correlation with decreasing postoperative morbidity.In this paper,the available literatures related to the surgical approaches ranging from open surgery to RARP were reviewed,the superiority of any novel procedure was analyzed,and the advantages and disadvantages among the three modalities were compared,hoping to provide guidance to urologists when considering surgical approaches in the treatment of localized prostate cancer.
文摘BACKGROUND Gastric cancer remains a significant global health concern.Radical gastrectomy is the primary curative treatment.Diabetes mellitus is a common comorbidity in patients undergoing surgery for gastric cancer,including radical gastrectomy.Previous studies have suggested that diabetes can negatively affect postoperative outcomes,such as wound healing,infection rates,and overall recovery.However,the specific impact of diabetes on recovery after radical gastrectomy for gastric cancer remains poorly understood.evaluate the influence of diabetes on postope-rative recovery,including hospital stay duration,complications,and readmission rates,in patients undergoing gastrectomy for gastric cancer.Understanding these effects could help optimize perioperative management and improve patient out-comes.gastric cancer and associated postoperative outcomes.METHODS This retrospective cohort study was performed at the Endocrinology Department of Xuanwu Hospital,Capital Medical University,Beijing,China.We examined patients who underwent radical gastrectomy for cancer between January 2010 and December 2020.The patients were divided into the diabetes and non-diabetes groups.The main outcomes included length of hospital stay,postoperative com-plications,and 30-day readmission rate.Secondary outcomes included quality of life indicators.Propensity score matching was used to adjust for potential con-founding factors.RESULTS A total of 1210 patients were included in the study,with 302 diabetic patients and 908 non-diabetic patients.After propensity score matching,280 patients were included in each group.Diabetic patients demonstrated significantly longer hospital stays(mean difference 2.3 days,95%CI:1.7-2.9,P<0.001)and higher rates of postoperative complications(OR 1.68,95%CI:1.32-2.14,P<0.001).The 30-day readmission rate was also higher in the diabetic group as compared to the non-diabetic group(12.5%vs 7.8%,P=0.02).CONCLUSION Patients with diabetes mellitus undergoing radical gastrectomy for gastric cancer experience prolonged hospital stay,increased postoperative complications,and higher readmission rates,thus requiring optimized perioperative management strategies.
基金Natural Science Foundation of Hubei Province of China,No.2024AFB655Key Research and Development Program of Hubei Province of China,No.2021BCA116National Natural Science Foundation of China,No.82072736,No.82003205,No.
文摘BACKGROUND Coagulation status is closely related to the progression of malignant tumors.In the era of neoadjuvant immunochemotherapy(NICT),the prognostic utility of coagulation indicators in patients with locally advanced gastric cancer(LAGC)undergoing new treatments remains to be determined.AIM To determine whether hypercoagulation is an effective prognostic indicator in patients with LAGC who underwent radical resection after NICT.METHODS A retrospective analysis of clinical data from 104 patients with LAGC,who underwent radical resection after NICT between 2020 and 2023,was performed.Ddimer and fibrinogen concentrations were measured one week before NICT,and again one week before surgery,to analyze the association between these two indicators and their combined indices[non-hypercoagulation(D-dimer and fibrinogen concentrations within the upper limit of normal)vs hypercoagulation(D-dimer or fibrinogen concentrations above the upper limit of normal)]with prognosis.After radical resection,patients were followed-up periodically.The median follow-up duration was 21 months.RESULTS Data collected after NICT revealed that the three-year overall survival(OS)and disease-free survival(DFS)rates the non-hypercoagulation group were significantly better than those in the hypercoagulation group[94.4%vs 78.0%(P=0.019)and 87.0%vs 68.0%(P=0.027),respectively].Multivariate analysis indicated that hypercoagulation after NICT was an independent factor for poor postoperative OS[hazard ratio(HR)4.436,P=0.023]and DFS(HR 2.551,P=0.039).Pre-NICT data demonstrated no statistically significant difference in three-year OS between the non-hypercoagulation and hypercoagulation groups(88.3%vs 84.1%,respectively;P=0.443).CONCLUSION Hypercoagulation after NICT is an effective prognostic indicator in patients with LAGC undergoing radical gastrectomy.
文摘Syzygium cumini Linn.,commonly known as Jamun,is a member of the Myrtaceae family and is also referred to by synonyms such as Eugenia djouant Perr.,Eugenia cumini,Eugenia jambolana Lam.,Syzygium jambolana Lam.,and Myrtus cumini Linn.This review provides an overview of its medicinal value,including taxonomical classification,geographic distribution,cultivation techniques,pharmacognostical aspects,phytochemical constituents,traditional uses,and pharmacological applications.In India,‘Ram Jamun’or‘Raja Jamun’is cultivated in the north,while the‘Paras’variety is grown in central regions.Various components of S.cumini fruits are utilized to enhance the nutritional quality of wines,jellies,jams,and fermented products.Rich in essential nutrients like vitamins,carbohydrates,minerals,antioxidants,and anthocyanins,S.cumini also contains bioactive phytoconstituents such as gallic acid,tannins,and polyphenols,which contribute to its pharmacological properties.Traditionally,black plums have been used as carminatives,diuretics,and remedies for stomach ailments,spleen enlargement,diarrhea,and urinary retention.Additionally,S.cumini has been historically administered to women post-abortion and is recognized for its role in managing diabetes and dysentery.Polyphenolic compounds in Jamun exhibit potential therapeutic benefits against diabetes,arthritis,cancer,asthma,and cardiovascular diseases.Given its promising ethnopharmacological profile,extensive research has been conducted on various plant parts,highlighting their antioxidant,antifungal,antibacterial,antidiabetic,and anticancer properties.This review aims to provide a comprehensive understanding of Syzygium cumini’s traditional and therapeutic significance,serving as a valuable resource for future research.
文摘This article explored the application of dexmedetomidine(Dex),a highly selective alpha-2 agonist,in managing postoperative cognitive dysfunction(POCD)in elderly patients undergoing radical colon cancer surgery.Aging is associated with a progressive decline in physiological functions and an increased risk of adverse surgical outcomes,including POCD,which encompasses many neurocognitive disorders that manifest during the perioperative period.The aging population is at a higher risk for POCD,which can lead to prolonged hospital stays,delayed recovery,and increased healthcare costs.Dex has neuroprotective,opioid-sparing,and sympatholytic properties,which reduces the incidence and severity of POCD.Dex was introduced for sedation in patients receiving mechanical ventilation but has since been adopted in anesthesia due to its multifaceted benefits.Its appli-cation extends to sedation,analgesia,maintenance of anesthesia,and controlling delirium.Its neuroprotective and anti-inflammatory effects have been explored in managing POCD.This article discussed the broad range of patient and procedure-related risk factors for POCD.Early identification and intervention are crucial to prevent the progression of POCD,which can have severe physical,psychological,and economic consequences.The article underscored the importance of a mul-tidisciplinary approach in managing POCD,involving the optimization of comor-bidities,depth of anesthesia monitoring,hemodynamic stability,and cerebral oxygenation monitoring.
文摘The Fenton-like reaction between Cu^(2+)and H_(2)O_(2)was employed in chemical mechanical polishing to achieve efficient and high-quality processing of tungsten.The microstructure evolution and material removal rate of tungsten during polishing process were investigated via scanning electron microscopy,X-ray photoelectron spectroscopy,ultraviolet−visible spectrophotometry,and electrochemical experiments.The passivation behavior and material removal mechanism were discussed.Results show that the use of mixed H_(2)O_(2)+Cu(NO_(3))_(2)oxidant can achieve higher polishing efficiency and surface quality compared with the single oxidant Cu(NO_(3))_(2)or H_(2)O_(2).The increase in material removal rate is attributed to the rapid oxidation of W into WO_(3)via the chemical reaction between the substrate and hydroxyl radicals produced by the Fenton-like reaction.In addition,material removal rate and static etch rate exhibit significantly different dependencies on the concentration of Cu(NO_(3))_(2),while the superior oxidant for achieving the balance between polishing efficiency and surface quality is 0.5 wt.%H_(2)O_(2)+1.0 wt.%Cu(NO_(3))_(2).
文摘BACKGROUND Patients with gastric cancer may have a risk of depression after radical surgery,which affects recovery and requires intensive intervention.AIM To explore the role of Bifidobacterium triple viable bacteria-assisted mirtazapine in patients with depression after radical surgery for gastric cancer.METHODS This study included 80 patients with gastric cancer who experienced depression after undergoing radical surgery from January 2022 to December 2023 at Jiangnan University Hospital in Wuxi city in Jiangsu province.The patients were categorized into the control group(n=40)treated with mirtazapine and observation group(n=40)treated with combined Bifidobacterium triple viable bacteria-assisted mirtazapine.Neuroendocrine index,intestinal flora level,nutrition status,and patient quality of life were analyzed.RESULTS Before drug index level,no statistically significant difference was observed between the two groups (P>0.05).After drug administration,both groups experienced a decline in depression scores,cortisol,Escherichia coli,Enterococcus faecalis levels,and quality of life scores,whereas dopamine,serotonin,Lactobacillus,Bifidobacteria,hemoglobin,serum albumin and prealbumin levels increased.The observation group demonstrated significantly greater improvements across these indicators,with significant differences within groups and between groups(P<0.05).CONCLUSION Bifidobacterium has a relieving effect on depression in patients after radical surgery for gastric cancer,improves neuroendocrine status,regulates intestinal flora,and improves nutritional status and quality of life.
文摘BACKGROUND Gastric cancer(GC)is a prevalent tumor in the digestive system,with around one million new cases reported annually,ranking it as the third most common malignancy.Reducing pain is a key research focus.This study evaluates the effect of nalbuphine on the analgesic effect and the expression of pain factors in patients after radical resection.AIM To provide a reference for postoperative analgesia methods.METHODS One hundred eight patients with GC,admitted between January 2022 and June 2024,underwent radical gastrectomy.They received a controlled analgesia pump and a transverse abdominis muscle plane block,divided into two groups of 54 patients in each group.The control group received sufentanil,while the observation group received nalbuphine as an analgesic.Postoperative analgesic effects,pain factor expression,and adverse effects were compared.RESULTS The resting pain and activity pain scores in the observation group at 6,12,24 and 48 hours were significantly lower than those in the control group.Additionally,the number of presses and consumption of the observation group at 48 hours were lower than those of the control group;and the response rate of the observation group was higher than that of the control group(P<0.05).The prostaglandin E2,substance P,and serotonin levels 24 hours after the observation group were lower than those in the control group,and the incidence of adverse reactions was 5.56%lower than 22.22%in the control group(P<0.05).CONCLUSION The findings suggest that nalbuphine enhances postoperative multimodal analgesia in patients with radical GC,effectively improving postoperative analgesic effect,relieving postoperative resting and active pain,and reducing postoperative pain factor expression,demonstrating its potential for clinical application.
文摘BACKGROUND The incidence of gastric cancer in the elderly is increasing;however,standardized surgical approaches are lacking.AIM To investigate the effects of radical surgery on the trauma response,postoperative complications,and long-term prognosis in elderly patients with gastric cancer.METHODS Between January 2020 and December 2023,110 gastric cancer patients admitted to the Department of Oncology Jiangnan University Medical Center were cate-gorized into a control group(40 cases)and an observation group(70 cases)based on surgical method differences.The control and observation group received palli-ative surgery and radical surgery,respectively,and were further divided into open(25 cases)and laparoscopic(45 cases)surgery.Surgical outcomes,trauma indicators,complication rates,and long-term survival at 6 months,1-,and 2-years were compared.RESULTS Laparoscopic surgery showed superior surgical outcomes compared to the open surgery and control groups(P<0.05).Trauma indicators were lowest in the lapa-roscopic group and highest in the control group(P<0.05).No significant difference was observed in the complication rates between the open and laparo-scopic groups(P>0.05),but both were higher than those in the control group(P<0.05).No significant differences were found in survival rates at different follow-up periods between the laparoscopic and open groups(P>0.05);however,both groups showed higher survival rates than the control group(P<0.05).CONCLUSION Radical surgery in elderly patients with gastric cancer reduces surgical trauma response,facilitates postoperative recovery,and improves long-term survival rates,albeit with an increased risk of complications.Laparoscopic radical surgery further minimizes postoperative trauma,with no significant difference in complication rates and survival prognosis compared with open radical surgery.
文摘BACKGROUND Esophageal cancer constitutes one of the most aggressive malignant neoplasms associated with poor clinical outcomes.While surgical resection remains the cornerstone of curative intervention,optimization of perioperative care protocols has emerged as an essential strategy to reduce postoperative complications and potentially improve long-term survival rates in patients undergoing esophagectomy.However,substantial debate persists regarding the relative importance of various perioperative risk factors and their impact on post-resection outcomes.AIM To identify perioperative factors affecting prognosis after radical esophagectomy,aiming to improve patient outcomes through targeted interventions.METHODS A retrospective study analyzed 378 patients with esophageal cancer who underwent radical esophagectomy(McKeown,Sweet,or Ivor-Lewis procedures)from January 2022 through December 2023.All operations were performed by experienced surgeons following standardized perioperative protocols.The investigation gathered data on patient demographics,surgical parameters,tumor pathology(using the 8th edition American Joint Committee on Cancer staging system),and survival outcomes.Statistical analyses utilized Kaplan-Meier estimates and Cox proportional hazards modeling,with adjustment for confounding variables.RESULTS Multivariate Cox proportional hazards analysis identified three independent predictors of survival:Tumor-nodemetastasis staging[Hazard ratio(HR)=2.31,95%confidence interval(CI):1.72-3.10,P<0.001],tumor differentiation(moderate:HR=1.46,95%CI:1.02-2.09,P=0.038;poor:HR=2.15,95%CI:1.47-3.14,P<0.001),and extended postoperative analgesic use(>5 days)(HR=1.43,95%CI:1.08-1.89,P=0.012).Kaplan-Meier analysis demonstrated significantly lower overall survival rates in patients requiring analgesics for>5 days compared to≤5 days(P=0.003),with consistent patterns observed for both opioid(P=0.019)and nonsteroidal anti-inflammatory drug use(P=0.028).The extended analgesic group exhibited a higher proportion of elderly patients(48.47%vs 35.57%,P=0.015),while other baseline characteristics and tumor features remained comparable between groups.CONCLUSION Tumor-node-metastasis staging,tumor differentiation,and duration of postoperative analgesic use independently predict survival following radical esophagectomy,underscoring the significance of optimal pain management protocols.
文摘BACKGROUND Colorectal cancer(CRC)is a malignant tumor with high morbidity and mortality rates worldwide.With the development of medical imaging technology,imaging features are playing an increasingly important role in the prognostic evaluation of CRC.Laparoscopic radical resection is a common surgical approach for treating CRC.However,research on the link between preoperative imaging and short-term prognosis in this context is limited.We hypothesized that specific preope-rative imaging features can predict the short-term prognosis in patients under-going laparoscopic CRC resection.AIM To investigate the imaging features of CRC and analyze their correlation with the short-term prognosis of laparoscopic radical resection.METHODS This retrospective study conducted at the Affiliated Cancer Hospital of Shandong First Medical University included 122 patients diagnosed with CRC who under-went laparoscopic radical resection between January 2021 and February 2024.All patients underwent magnetic resonance imaging(MRI)and were diagnosed with CRC through pathological examination.MRI data and prognostic indicators were collected 30 days post-surgery.Logistic regression analysis identified imaging fea-tures linked to short-term prognosis,and a receiver operating characteristic(ROC)curve was used to evaluate the predictive value.RESULTS Among 122 patients,22 had irregular,low-intensity tumors with adjacent high signals.In 55,tumors were surrounded by alternating signals in the muscle layer.In 32,tumors extended through the muscular layer and blurred boundaries with perienteric adipose tissue.Tumor signals appeared in the adjacent tissues in 13 patients with blurred gaps.Logistic regression revealed differences in longitudinal tumor length,axial tumor length,volume transfer constant,plasma volume fraction,and apparent diffusion coefficient among patients with varying prognostic results.ROC analysis indicated that the areas under the curve for these parameters were 0.648,0.927,0.821,0.809,and 0.831,respectively.Sensitivity values were 0.643,0.893,0.607,0.714,and 0.714,and specificity 0.702,0.904,0.883,0.968,and 0.894(P<0.05).CONCLUSION The imaging features of CRC correlate with the short-term prognosis following laparoscopic radical resection.These findings provide valuable insights for clinical decision-making.
文摘BACKGROUND Radical gastrectomy(RGE)for gastric carcinoma(GC)has exerted definite therapeutic efficacy in treating patients with GC.However,a notable risk of postoperative complications(POCs)persists among middle-aged and elderly patients with compromised physiological functions.Hence,developing and implementing reliable nursing interventions to optimize the comprehensive management of these patients is deemed imperative.AIM To analyze the association of multi-channel continuous nursing intervention with POCs,negative emotions(NEs),and quality of life(QoL)of patients undergoing RGE for GC.METHODS This retrospective study selected 99 patients who underwent RGE for GC in our hospital from May 2020 to May 2023.Participants were categorized into the control(n=49 cases)and research groups(n=50 cases)receiving routine and multi-channel continuous nursing care,respectively.Comparative analysis involved data on postoperative rehabilitation(time to first anal exhaust,oral feeding and ambulation,and hospital stay),complications(nausea and vomiting,delayed gastric emptying,and abdominal distension),NEs[Self-rating Anxiety(SAS)/Depression Scale(SDS)],treatment compliance,self-efficacy,and QoL[World Health Organization QoL Brief Version(WHOQOL-BREF)].RESULTS Compared to the control group,the research group demonstrated earlier first postoperative anal exhaust,oral feeding,and ambulation,shorter hospital stay,lower POC rate,and more reduced SAS and SDS scores postintervention,which was significantly lower than the baseline.The treatment compliance scores were significantly higher in the research group than in the control group in terms of medication adherence,daily exercise,reasonable diet,and regular review.Further,the research group demonstrated increased self-efficacy scores in terms of positive attitude,self-stress relief,and self-decision-making,as well as the overall score postintervention,which were higher than the control group.Moreover,the research group reported notably higher WHOQOL-BREF scores in domains such as physiology,psychology,social relations,and environment.CONCLUSION Multi-channel continuous nursing intervention prevents POCs in patients undergoing RGE for GC as well as significantly alleviates patients’NEs and boosts their QoL.
文摘BACKGROUND Gastric cancer is the most common malignancy of the digestive system and surgical resection is the primary treatment.Advances in surgical technology have reduced the risk of complications after radical gastrectomy;however,post-surgical pancreatic fistula remain a serious issue.These fistulas can lead to abdominal infections,anastomotic leakage,increased costs,and pain;thus,early diagnosis and prevention are crucial for a better prognosis.Currently,C-reactive protein(CRP),procalcitonin(PCT),and total bilirubin(TBil)levels are used to predict post-operative infections and anastomotic leakage.However,their predictive value for pancreatic fistula after radical gastrectomy for gastric cancer remains unclear.The present study was conducted to determine their predictive value.AIM To determine the predictive value of CRP,PCT,and TBil levels for pancreatic fistula after gastric cancer surgery.METHODS In total,158 patients who underwent radical gastrectomy for gastric cancer at our hospital between January 2019 and January 2023 were included.The patients were assigned to a pancreatic fistula group or a non-pancreatic fistula group.Multivariate logistic analysis was conducted to assess the factors influencing development of a fistula.Receiver operating characteristic(ROC)curves were used to determine the predictive value of serum CRP,PCT,and TBil levels on day 1 postsurgery.RESULTS On day 1 post-surgery,the CRP,PCT,and TBil levels were significantly higher in the pancreatic fistula group than in the non-pancreatic fistula group(P<0.05).A higher fistula grade was associated with higher levels of the indices.Univariate analysis revealed significant differences in the presence of diabetes,hyperlipidemia,pancreatic injury,splenectomy,and the biomarker levels(P<0.05).Logistic multivariate analysis identified diabetes,hyperlipidemia,pancreatic injury,CRP level,and PCT level as independent risk factors.ROC curves yielded predictive values for CRP,PCT,and TBil levels,with the PCT level having the highest area under the curve(AUC)of 0.80[95%confidence interval(CI):0.72-0.90].Combined indicators improved the predictive value,with an AUC of 0.86(95%CI:0.78-0.93).CONCLUSION Elevated CRP,PCT,and TBil levels predict risk of pancreatic fistula post-gastrectomy for gastric cancer.
基金National Natural Science Foundation of China(22309032,22109120,and 62104170)Guangdong Basic and Applied Basic Research Foundation(2022A1515011737)+2 种基金Science and Technology Program of Guangzhou(2023A04J1395)GDAS’Project of Science and Technology Development(2021GDASYL-20210102010)Zhejiang Provincial Natural Science Foundation of China(LY23F040001)。
文摘Photocatalytic oxygen reduction for hydrogen peroxide(H_(2)O_(2))synthesis presents a green and costeffective production method.However,achieving highly selective H_(2)O_(2)synthesis remains challenging,necessitating precise control over free radical reaction pathways and minimizing undesirable oxidative by-products.Herein,we report for the visible light-driven simultaneous co-photocatalytic reduction of O2to H_(2)O_(2)and oxidation of biomass using the atomic rubidium-nitride modified carbon nitride(CNRb).The optimized CNRb catalyst demonstrates a record photoreduction rate of 8.01 mM h^(-1)for H_(2)O_(2)generation and photooxidation rate of 3.75 mM h^(-1)for furfuryl alcohol to furoic acid,achieving a remarkable solar-to-chemical conversion(SCC)efficiency of up to 2.27%.Experimental characterizations and DFT calculation disclosed that the introducing atomic Rb–N configurations allows for the high-selective generation of superoxide radicals while suppressing hydroxyl free radical formation.This is because the Rb–N serves as the new alternative site to perceive a stronger connection position for O2adsorption and reinforce the capability to extract protons,thereby triggering a high selective redox product formation.This study holds great potential in precisely regulating reactive radical processes at the atomic level,thereby paving the way for efficient synthesis of H_(2)O_(2)coupled with biomass valorization.
基金This paper is supported by the Fundamental Research Funds for the Central Universities of China,the Research Funds of Renmin University of China(14XNJ005).
文摘The ideology of Jihadi-Salafism seeks to suspend the dialectic through the positing of an ahistorical state which exists under an unmediated divine sovereignty,through the full exclusion of the“other”.Thus the period of the salaf is understood as a golden age,which can be revived without regard to historical context.The“Islamic State”is considered as existing directly under the rule(hakimiyya)of God by way of the shari’a code.There is an attempt to sever oneself from apostates by exercising al-walawa’l-bara and the practice of takfir.The reaching of the perfect end state,however,necessarily entails an activist pursuit of violent change whereby all opposition elements are forcibly removed.Despite its ahistorical pretension,the Islamist ideology developed through distinct stages in Islamic history.The present essay depicts the historical formation of the Jihadi-Salafi ideological principles by tracing back the trajectory.Through attention to the deductive logic implied in the principles,the paper reveals an absolute standpoint precluding the possibility for any form of mediation that has come to be formed.With the delineation of the reasoning underlying Jihadi-Salafi concepts,the basis for the rejection of dialectical development is demonstrated,as well as the implications of the absolutist standpoint for the intensification of extremism culminating in the“Islamic State”.
文摘BACKGROUND Propofol and sevoflurane are commonly used anesthetic agents for maintenance anesthesia during radical resection of gastric cancer.However,there is a debate concerning their differential effects on cognitive function,anxiety,and depression in patients undergoing this procedure.AIM To compare the effects of propofol and sevoflurane anesthesia on postoperative cognitive function,anxiety,depression,and organ function in patients undergoing radical resection of gastric cancer.METHODS A total of 80 patients were involved in this research.The subjects were divided into two groups:Propofol group and sevoflurane group.The evaluation scale for cognitive function was the Loewenstein occupational therapy cognitive assessment(LOTCA),and anxiety and depression were assessed with the aid of the self-rating anxiety scale(SAS)and self-rating depression scale(SDS).Hemodynamic indicators,oxidative stress levels,and pulmonary function were also measured.RESULTS The LOTCA score at 1 d after surgery was significantly lower in the propofol group than in the sevoflurane group.Additionally,the SAS and SDS scores of the sevoflurane group were significantly lower than those of the propofol group.The sevoflurane group showed greater stability in heart rate as well as the mean arterial pressure compared to the propofol group.Moreover,the sevoflurane group displayed better pulmonary function and less lung injury than the propofol group.CONCLUSION Both propofol and sevoflurane could be utilized as maintenance anesthesia during radical resection of gastric cancer.Propofol anesthesia has a minimal effect on patients'pulmonary function,consequently enhancing their postoperative recovery.Sevoflurane anesthesia causes less impairment on patients'cognitive function and mitigates negative emotions,leading to an improved postoperative mental state.Therefore,the selection of anesthetic agents should be based on the individual patient's specific circumstances.
