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Aim: To investigate the relationship between thyroid function and weight regain in patients with obesity after metabolic surgery. Methods: This retrospective study enrolled 162 patients who underwent metabolic surgery. Correlations between decreases in thyroid hormone levels and changes in weight, waist circumference (WC) and the Chinese visceral adiposity index (CVAI) were assessed. Binary logistic regression and receiver operating characteristic (ROC) curves were used to identify predictors and clinically useful cut‐off values, respectively. Results: The levels of thyroid‐stimulating hormone (TSH) and free triiodothyronine (FT3) decreased markedly at 1 year after surgery, as did weight, body mass index (BMI), triglycerides, total cholesterol, high‐density lipoprotein cholesterol, low‐density lipoprotein cholesterol, WC and CVAI. Decreases in TSH and FT3 after metabolic surgery were associated with changes in weight, BMI and CVAI. Binary logistic regression and ROC curve analyses confirmed that decreases in TSH can predict good weight loss after metabolic surgery to some extent. Finally, binary logistic regression and ROC curve analyses confirmed that changes in TSH can predict weight regain after metabolic surgery. Conclusions: Changes in TSH and FT3 after metabolic surgery were correlated with changes in weight and CVAI. Changes in thyroid hormones can predict weight regain in patients with obesity who underwent metabolic surgery. [ABSTRACT FROM AUTHOR]

Objective To investigate clinical values of proportional postoperative reduction of albumin (ΔALB) in the prediction of postoperative complications following sphincter-preserving surgery for rectal cancer and evaluate whether it affects long-term outcomes. Methods A case-control trail was performed on 809 rectal cancer patients (345 females and 464 males, at an average age of 60.3±11.2 years) undergoing sphincter-preserving surgery in our department between July 2010 and June 2016. Postoperative complications were graded using Clavien-Dindo classification. Receiver operating characteristic (ROC) curve analysis was employed to assess the predictive values of ΔALB. The patients were divided into 3 groups based on the first and third quartiles of the ΔALB level. Chi-square test for trend was performed to analyze the change tendency in the incidence of postoperative complications among the 3 groups. Logistic regression analysis was conducted to identify independent risk factors for postoperative complications. Overall survival (OS) and disease-free survival (DFS) were calculated using Kaplan-Meier survival curve and compared by Log-rank test. Results Among the 809 surgical cases, laparoscopic surgery was accomplished in 669 cases, 22 cases required converted open surgery (a conversion rate of 3.2%), and 118 cases underwent open surgery. Postoperative complications occurred in 226 patients, with a rate of 27.9%, and an increased trend of the rate was displayed among the ΔALB groups (Chi-square=7.955, P=0.005). Multivariate analysis indicated that the risk for developing postoperative complications was 1.791 times higher in the patients with high ΔALB level (ΔALB≥34.7%) than those with low ΔALB level (ΔALB < 21.9%)(OR=1.791, 95%CI: 1.139~2.817, P=0.012). The complication and non-complication groups had a 5-year OS rate of 76.6% and 81.6% (Chi-square=2.836, P=0.092), and a 5-year DFS rate of 65.4% and 74.7%, respectively (Chi-square=5.875, P=0.015). There were no statistical differences in OS and DFS rate among the ΔALB groups. Conclusion ΔALB is an independent risk factor for postoperative complications in rectal cancer patients after sphincter-preserving surgery, with advantages of low-cost, convenience, and rapid response in prediction of postoperative complications. Since postoperative complications will influence patients' long-term survival, special attention should be paid to ΔALB to improve the long-term prognosis.

Disorders of gastrointestinal (GI) motility are associated with various symptoms such as nausea, vomiting, and constipation. However, the underlying causes of impaired GI motility remain unclear, which has led to variation in the efficacy of therapies to treat GI dysfunction. Optogenetics is a novel approach through which target cells can be precisely controlled by light and has shown great potential in GI motility research. Here, we summarized recent studies of GI motility patterns utilizing optogenetic devices and focused on the ability of opsins, which are genetically expressed in different types of cells in the gut, to regulate the excitability of target cells. We hope that our review of recent findings regarding optogenetic control of GI cells broadens the scope of application for optogenetics in GI motility studies. [ABSTRACT FROM AUTHOR]

5 Fu T, Liu Y, Li K. Hybrid transvaginal natural orifice transluminal endoscopic surgery of radical sigmoidectomy for sigmoid colon cancer. The sigmoid colon was pulled to the right, the lateral peritoneum was cut on the left side of the rectum, and the rectum and sigmoid colon were dissected up to the proximal end. To understand the procedure more intuitively, in the present video we report a step-by-step technique for performing hybrid transvaginal radical sigmoidectomy in a patient with sigmoid colon cancer. [Extracted from the article]

The THz wireless transmission system based on photonics has been a promising candidate for further 6G communication, which can provide hundreds of Gbps or even Tbps data capacity. In this paper, 144-Gbps dual polarization quadrature-phase-shift-keying (DP-QPSK) signal generation and transmission over a 20-km SSMF and 3-m wireless 2 × 2 multiple-input multiple-output (MIMO) link at 500 GHz have been demonstrated. To further compensate for the linear and nonlinear distortions during the fiber–wireless transmission, a novel joint Deep Belief Network (J-DBN) equalizer is proposed. Our proposed J-DBN-based schemes are mainly optimized based upon the constant modulus algorithm (CMA) and direct-detection least mean square (DD-LMS) equalization. The results indicate that the J-DBN equalizer has better bit error rate (BER) performance in receiver sensitivity. In addition, the computational complexity of the J-DBN-based equalizer can be approximately 46% lower than that of conventional equalizers with similar performance. To our knowledge, this is the first time that a novel joint DBN equalizer has been proposed based on classical algorithms. It is a promising scheme to meet the demands of future fiber–wireless integration communication for low power consumption, low cost, and high capacity. [ABSTRACT FROM AUTHOR]

Stereochemical quality control for pharmaceutical drug substance intermediates is a daunting task, especially considering the need to separate multiple stereoisomers simultaneously with low ppm level sensitivity. To address these challenges, we have successfully implemented chiral column screening, and developed an ultrasensitive liquid chromatography–mass spectrometry (LC‐MS) method to separate four stereoisomers including the API intermediate, its enantiomer, and two other diastereomers. Parameters such as mobile phase additives, MS fragmentor, and column temperature were optimized to achieve the desired selectivity and sensitivity. The method enabled stereoisomer detection with high sensitivity (2 ppm LOD and 5 ppm LOQ), good linearity, and desired spike recovery, and it has been successfully applied for stereoisomer quantitation in multiple large‐scale batches and demonstrated chiral quality control of the drug substance intermediate. [ABSTRACT FROM AUTHOR]

Acid catalyzes a higher-dilution condensation reaction of 2,6-bis(hydroxymethyl)-p-substituted-phenols synthesizing oxacalix(3)arene macrocycles with an yield of 12-32%. Conversion of these macrocycles into their sodium or potassium salts helps in their isolation. Metal-binding studies show that presence of base is essential for binding between oxacalix(3) arenes and alkali metals. Sodium and potassium ions exhibit higher affinity toward oxacalix(3) arenes than lithium ions.

Short Summary: This was a prospective study of 535 diabetes patients who underwent metabolic surgery (n = 112) and medical treatment (n = 423). Metabolic surgery decreased both office systolic blood pressure (SBP) and diastolic blood pressure (DBP) and also significantly reduced ambulatory SBP (132 ± 2 vs. 119 ± 1 mmHg, p < 0.0001). Moreover, the rate of achieving the target SBP of 130 and 140 mmHg was also significantly higher in the surgery group. The defined daily dose of antihypertensive medication was significantly decreased in after surgery. Furthermore, metabolic surgery markedly improved the risks of atherosclerotic cardiovascular disease. In conclusion, metabolic surgery can effectively achieve the BP target and improve multiple metabolic dysfunction in type 2 diabetes mellitus patients with hypertension. Aims: The effect of metabolic surgery compared with that of conventional therapy on target blood pressure (BP)and defined daily dose (DDD) of antihypertensive drugs in type 2 diabetes (T2DM) patients with hypertension remains unclear. This study aimed to investigate the differences in target BP and DDD between metabolic surgery and conventional treatment in T2DM patients with hypertension. Materials and methods: This was a prospective study of 535 diabetes patients who underwent metabolic surgery (n = 112) and medical treatment (n = 423). Changes in the target BP from baseline to every follow‐up were analysed. Results: Metabolic surgery decreased both office systolic and diastolic BP (DBP) and also significantly reduced ambulatory systolic BP (SBP; 132 ± 2 vs. 119 ± 1 mmHg, p < 0.0001), but not DBP (78 ± 1 vs. 76 ± 1 mmHg, p = 0.177). Patients maintained their SBP at <120 mmHg after 2 years (50% vs. 1.9%, p < 0.0001). Moreover, the rate of achieving the target SBP of 130 and 140 mmHg was also significantly higher in the surgery group, and this started from the initial 6 months after commencing treatment to the end of follow‐up. The dosage (DDD: 1.44 ± 0.65 vs. 0.32 ± 0.05, p < 0.001) of antihypertensive medication was significantly decreased after metabolic surgery. Furthermore, metabolic surgery, but not medical treatment, markedly improved the risks of atherosclerotic cardiovascular disease. Conclusions: Metabolic surgery can effectively achieve the BP target and reduce the usage of antihypertensive medications as well as improve multiple metabolic dysfunction in T2DM patients with hypertension. This study provides an alternative approach to antagonize the metabolic related hypertension. [ABSTRACT FROM AUTHOR]

Background Total mesorectum excision (TME) is considered the standard surgical procedure for rectal-cancer treatment. Transanal TME (taTME) is a new procedure to treat low rectal cancer. Some published studies have proven that taTME can provide a better-quality resected specimen in low-rectal-cancer patients in comparison to the transabdominal procedure, yet long-term outcomes must be investigated. We designed this non-inferiority trial (TaLaR trial) to compare short-term and long-term outcomes between taTME and laparoscopic TME (lapTME) for rectal cancer. Methods The TaLaR trial is a phase III open-labeled multicenter randomized–controlled trial. Patients who are diagnosed with rectal cancer with no more than T3N2 stage, and with the tumor location below the peritoneal reflection by magnetic resonance imaging scan, digital rectal examination, or colonoscopy, qualify for this study. After calculating, a total of 1,114 patients (557 per group) will be randomly allocated to either the taTME or the lapTME group. Primary endpoints are the 3-year disease-free survival (DFS) rate and the 5-year overall survival (OS) rate. Secondary endpoints include specimen quality, perioperative results, pelvic and anal function, and quality of life. Discussion The TaLaR trial is expected to clarify whether taTME can achieve comparable oncological outcomes, as well as improve specimen quality and recovery conditions in rectal-cancer patients compared with lapTME. [ABSTRACT FROM AUTHOR]

Background: Idiopathic megacolon (IMC) is an uncommon disease in adults. To date, only a few laparoscopic experiences and functional outcomes of IMC have been reported. This study was to retrospectively analyse our 12 year surgical experience and functional outcomes in adult patients with IMC. Methods: A 12‐year retrospective study from October 2006 to November 2018 was performed for patients with IMC who underwent surgical interventions. Patients who underwent laparoscopic‐assisted colectomy and Duhamel procedure with ileorectal or colorectal anastomosis were collected. Clinical data of surgery and functional outcomes were analysed. Results: A total of 13 patients who underwent surgical interventions were included in the study. Seven patients underwent laparoscopic total colectomy with ileorectal anastomosis (Duhamel procedure), one patient underwent laparoscopic total colectomy with end ileostomy because of acute intestinal obstruction, while five other patients underwent laparoscopic segmental colectomy with colorectal anastomosis (Duhamel procedure). The mean operative time was 181.6 min (range 150–246). The mean estimated blood loss was 75.6 ml (range 40–200). The mean postoperative hospital stay was 8.2 days (range 6–13). There was no conversion to an open procedure and no surgical mortality. Postoperative diarrhoea was the most prominent complaint during the early period after total colectomy. All patients showed adaptation to the defaecation frequency 3–6 months postoperatively, and had a good quality of life in long‐term follow‐up. Conclusion: Laparoscopic‐assisted colectomy with Duhamel procedure is a safe and efficient technique for IMC in adults. The scope of colon resection and the type of anastomosis should be individually selected. [ABSTRACT FROM AUTHOR]