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Platelets promote tumor growth and metastasis in several tumor types. Recent research has found platelets can extravasate and infiltrate into the tumor stroma and interact with the tumor microenvironment. The prognostic role of platelet infiltration in colorectal cancer (CRC) remains controversial. A pan-cancer survival analysis was performed to find the potential prognostic value of platelet infiltration in patients with cancer. A survival analysis and a nomogram prognostic model were established to further confirm the results with data from our center. The correlations between patient outcomes and tumor-infiltrating platelets (TIPs) were identified by immunohistochemical staining for CD42b. The prognostic accuracy and discriminative ability of the nomogram were determined by the concordance index (C-index) and a calibration curve. The pan-cancer survival analysis showed platelet infiltration can lead to a poor prognosis in patients with several types of cancers, including CRC. Platelet infiltration was associated with overall survival (OS) and disease-free survival (DFS) in both primary and validation cohorts. The C-index values of the nomogram for predicting OS and DFS were 0.774 and 0.769, respectively, which were higher than that of the TNM staging system alone. Our study found platelet infiltration has a potential prognostic value regarding postsurgical survival in CRC patients. The proposed nomogram resulted in a more accurate prognostic prediction for postsurgical CRC patients.

Recently, the global robust output regulation problem for a class of uncertain multi‐input multi‐output (MIMO) nonlinear systems which may not have well‐defined relative degree and are subject to a nonlinear exosystem has been studied based on a constructive nonlinear internal model. However, the proposed nonlinear internal model‐based control law is applicable to the case where the exogenous signals are reference input and/or measurable disturbance rather than unmeasurable disturbance. For this reason, this paper further studies the same control problem based on a general nonlinear internal model independent of the exogenous signal. It is shown that this control problem can be converted into a global robust stabilization problem of a more complicated MIMO nonlinear system with various uncertainties and well solved by a recursive state feedback controller design. Thus our approach applies to a broader class of output regulation problem of MIMO nonlinear systems.

Background The prognosis of patients with locally advanced gastric cancer with outlet obstruction is poor. Gastrectomy with curative intent is often initially impossible or difficult. Objective We report our experience of curative distal gastrectomy after laparoscopic gastrojejunostomy and fluorouracil, leucovorin, oxaliplatin, and docetaxel (FLOT) chemotherapy to examine the feasibility and safety of this modified strategy for locally advanced gastric cancer with outlet obstruction, initially deemed unresectable. Methods Between October 2017 and June 2019, 15 patients diagnosed with locally advanced gastric cancer with outlet obstruction sequentially underwent gastrojejunostomy, received four cycles of FLOT chemotherapy, and underwent laparoscopic distal gastrectomy with curative intent (R0 resection + D2 lymphadenectomy). Clinical data were retrospectively collected and analyzed. Results R0 resection was possible in 12/15 patients, laparoscopically in 11, and one conversion to laparotomy was necessary. There was no perioperative mortality in the 12 patients. Pathologic evaluation of the resected specimens revealed that complete tumor grade regression 1a (TRG1a), TRG1b, TRG2, and TRG3 occurred in 3, 2, 4, and 3 patients, respectively. Conclusion This case series showed that curative surgical resection was feasible as a staged approach for patients with locally advanced gastric cancer with outlet obstruction, after initial staged gastrojejunostomy and chemotherapy.

Aim Extralevator abdominoperineal resection) (ELAPR) is challenging “conventional” adbominoperineal resection (APR) yet the safety and efficacy of ELAPR is still under debate. We therefore developed a laparoscopic APR with transabdominal individualized levator transection (LAPR-TILT) approach and compared the outcome with a conventional laparoscopic APR (CLAPR). Method All eligible patients were entered a single center randomized controlled trial to compare CLAPR and LAPR-TILT. We assessed the first 185 patients, including operative findings, complications, histopathology and urogenital function. Results 93 patients in the CLAPR group and 92 patients in the APR-TILT group were included for analysis. The APR-TILT procedure took less time (137min [101-175] vs 146min [102-187], p=0.03), mainly owing to faster perineal dissection. APR-TILT resulted in reduced rate of bowel perforation (1.1% vs 8.6%, p=0.04), CRM positivity (1.1% vs 10.8%, P=0.01) and postoperative wound complications (5.4% vs 16.2%,p=0.02) as compared to the CLAPR procedure. At a median follow up of 19 months after surgery, 3 patients (3.2%) in the CLAPR group had tumor recurrence while no tumour recurrence occurred in the LAPR-TILT group. Patients underwent LAPR-TILT reported fewer urinary or sexual problems (LAPR-TILT vs CLAPR, 10.9% vs 24.7% and 17.4% vs 38.7% respectively). Conclusion Compared to CLAPR, LAPR-TILT achieved better pathological results for factors that are surrogate parameters for local recurrence. LAPR-TILT could also reduce the risk of urogenital dysfunction. This article is protected by copyright. All rights reserved.

Upon reduction and re-oxidization, the interface of a microtubular solid oxide fuel cell (MTSOFC) anode/electrolyte was structurally analyzed using a dual beam focused ion beam/scanning electron microscope (FIB/SEM) and scanning transmission electron microscopy combined with energy dispersive X-ray spectrometer (STEM-EDX). The bulk volume of the dense NiO phase dramatically contracted upon reduction, while the YSZ phases are completely unaffected. No cracks or particle detachment are observed either at the interface of the anode/electrolyte or in the anode backbone. Compared with the initial NiO state (as-prepared), the area of Ni phase contracts by 22.6%-83.7%, depending on the grain size.

BACKGROUND AND AIMS AG490, the specific inhibitor of JAK2/STAT3 signaling, has been shown to decrease portal pressure, splanchnic hyperdynamic circulation and liver fibrosis in cirrhotic rats. Nonselective betablockers such as propranolol are the only drugs recommended in the treatment of portal hypertension. The aim of this study was to explore the combinative effect of treatment with propranolol and AG490 on portal hypertension. METHODS Rats induced by common bile duct ligation were treated with vehicle, AG490, propranolol, or AG490 + propranolol for 2 weeks. Hemodynamics parameters were assessed. Expressions of phospho-STAT3 protein and its down-regulated cytokines in splanchnic organs were detected by ELISA or western blot. Lipopolysaccharide binding protein (LBP) and IL-6 were assessed by ELISA or western blot. Characterization of liver and mesentery was performed by histological analyses. RESULTS Highly expressed phospho-STAT3 protein in cirrhotic rats could successfully be inhibited by AG490 or AG490 + propranolol treatments but not by propranolol alone. Both AG490 and propranolol significantly reduced portal pressure and hyperdynamic splanchnic circulation, and combination of AG490 and propranolol achieved an additive effect than with either drug alone. AG490, alone or in combination with propranolol, inhibited liver fibrosis, splenomegaly and splanchnic angiogenesis. Increased markers of bacterial translocation (LBP and IL6) were greatly reduced by propranolol but not by AG490. CONCLUSIONS The combination of propranolol and AG490 caused a greater improvement of portal hypertension and might therefore offer a potentially promising therapy in the portal hypertension treatment.

Summary It is well known that multi-input, multi-output nature of nonlinear system and generalized exosystem have posed some challenges to output regulation theory. Recently, the global robust output regulation problem for a class of multivariable nonlinear system subject to a linear neutrally stable exosystem has been studied. It has been shown that a linear internal model-based state feedback control law can lead to the solution of previous problem. In this paper, we will further study the global robust output regulation problem of the system subject to a nonlinear exosystem. By utilizing nonlinear internal model design and decomposing the multi-input control problem into several single-input control problems, we will solve the problem by recursive control law design. The theoretical result is applied to the non-harmonic load torque disturbance rejection problem of a surface-mounted permanent magnet synchronous motor. Copyright © 2016 John Wiley & Sons, Ltd.