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Graphene nanoplatelets (GNPs) reinforced 2024Al alloy was successfully fabricated by ultrasonic vibration dispersion. The microstructure and mechanical properties of the 2024Al-GNPs composites with various GNPs concentrations (0.5–1.1 wt%) were analyzed. The strengthening mechanism and the interface bonding between the GNPs and Al matrix were investigated. When the content of added GNPs was 0.8 wt%, the tensile strength, yield strength and microhardness of the composites reached 236 MPa, 184.4 MPa and 122.4 HV, respectively, corresponding to enhancements by 30%, 43.3% and 31.6% compared to those of the matrix. The interface was clean under the ultrasonic vibration, and brittle Al 4 C 3 phase was not formed on the interface. The good interface bonding and the improvement of GNPs dispersion enabled GNPs to provide effective strengthening for the composites. • Ultrasonic and magnetic stirring treatments can disperse and protect the structure of GNPs. • Ultrasonic vibrations effectively disperse graphene and form a good interface between GNPs and Al matrix. • The pull-out and Load transfer of graphene further increases the mechanical properties of the composites. [ABSTRACT FROM AUTHOR]

As an emerging 3D printing technique, melt electrospinning writing (MEW) has been used to fabricate scaffolds with controllable structure and good mechanical strength for bone regeneration. However, how to further improve MEW scaffolds with nanoscale extracellular matrix (ECM) mimic structure and bioactivity is still challenging. In this study, we proposed a simple composite process by combining MEW and solution electrospinning (SE) to fabricate a micro/nano hierarchical scaffold for bone tissue engineering. The morphological results confirmed the hierarchical structure with both well-defined MEW microfibrous grid structure and SE random nanofiber morphology. The addition of gelatin nanofibers turned the scaffolds to be hydrophilic, and led to a slight enhancement of mechanical strength. Compared with PCL MEW scaffolds, higher cell adhesion efficiency, improved cell proliferation and higher osteoinductive ability were achieved for the MEW/SE composite scaffolds. Finally, multilayer composite scaffolds were fabricated by alternately stacking of MEW layer and SE layer and used to assess the effect on cell ingrowth in the scaffolds. The results showed that gelatin nanofibers did not inhibit cell penetration, but promoted the three-dimensional growth of bone cells. Thus, the strategy of the combined use of MEW and SE is a potential method to fabricate micro/nano hierarchical scaffolds to improve bone regeneration. [Display omitted] • PCL/gelatin hierarchical scaffolds were fabricated by melt electrospinning writing (MEW) and solution electrospinning (SE). • Improved cell adhesion and proliferation and osteoinductive ability were achieved for the MEW/SE composite scaffolds. • Nanofibers in multilayer hierarchical scaffolds did not inhibit cell penetration, but promoted the 3D growth of osteocytes. [ABSTRACT FROM AUTHOR]

Due to the breathable and soft nature, leather has been selected as flexible material to produce comfortable shoes. However, due to the intimate contact between leather surface and foot skin, bacteria growth and rapid colonization on leather surface can lead to biofilm formation which will bring potential risk of foot infection. Especially for those patients with diabetic foot, such foot infection can be life threatening. In this work, a composite coating was facilely fabricated onto leather surface via the layer-by-layer assembly of positively charged chitosan (CS) and negatively charged gallic acid modified silver nanoparticles (GA@AgNPs), with subsequent immobilization on leather by chemical cross-linking. Such cross-linked CS/GA@AgNPs coated leather exhibited efficiently antibacterial activities against Escherichia coli ( E. coli ) and Staphylococcus aureus ( S. aureus ) through a “kill-release” strategy, which was mainly attributed to the synergistic effect of contact-killing of CS layer, Ag + ions release and bacterial repelling of anionic GA@AgNPs layer. Furthermore, the stability of the composite coating on leather surface was investigated, and the results revealed that the cross-linking could enhance the durably antibacterial activities of leather against laundering and mechanical abrasion. Therefore, based on the efficiently and durably antibacterial properties, such cross-linked CS/GA@AgNPs layers coated leather is a promising candidate for producing leather shoes for diabetic patients. [ABSTRACT FROM AUTHOR]

In this study, a WO 3 /g-C 3 N 4 composite photocatalyst was synthesized via a hydrothermal method and characterized for its potential application in photocatalytic H2 generation from PET degradation. XRD analysis revealed that the hexagonal WO 3 crystal structure was achieved after 10 h of hydrothermal time, with particles of suitable size for uniform loading on the g-C 3 N 4 surface. SEM images showed the successful loading of WO 3 nanorods onto the g-C3N4 surface, significantly increasing the specific surface area. FTIR and UV–vis diffuse reflectance spectroscopy confirmed the formation of a Z-type heterojunction between WO 3 and g-C 3 N 4. Photoluminescence measurements indicated a reduced rate of electron-hole pair recombination in the composite. The 30% WO 3 /g-C 3 N 4 composite demonstrated a high H 2 evolution rate of 14.21 mM and excellent stability in PET solution under visible light irradiation. 1H NMR and EPR spectroscopy analyses revealed the degradation of PET into small molecular compounds and the generation of active radicals, including ·O 2 −, during the reaction. Overall, the WO 3 /g-C 3 N 4 composite exhibited promising potential for photocatalytic H 2 production and PET degradation. [Display omitted] • C 3 N 4 /WO 3 photocatalyst were successfully synthesiszed • Photocatalytic removal of microplastics from water activated by visible light. • The by-products from microplastics degradation are considered to have low toxicity. • Degradation efficiency and applied system limitations are proposed. [ABSTRACT FROM AUTHOR]

• The fibrous membrane with hierarchical structure was fabricated by sequential electrospinning. • The trilayered fibrous membrane had high filtration efficiency and low pressure drop. • The fibrous membrane exhibited antibacterial activity and biodegradability. • The trilayered fibrous membrane possessed directional water transport performance. Particulate matters (PMs) pollution and bacteria severely affect human health. Fibrous filters have shown great potential in intercepting PMs and bacteria. However, developing a novel respirator material endowed with multi-functions, such as efficient filtration, antibacterial activity, directional moisture transport and biodegradability is still challenging. Herein, a multifunctional air filtration membrane with hierarchical structure was fabricated by sequentially electrospinning poly (ε-caprolactone) (PCL) fibrous membrane, PCL/gelatin fibrous membrane and PCL/gelatin/ε-poly (L-lysine) (ε-PL) fibrous membrane. The fabricated trilayered fibrous membrane exhibited high PM filtration efficiency and a low pressure drop. Moreover, the fibrous membrane possessed excellent antibacterial activity due to the incorporation of ε-PL. In addition, the trilayered fibrous membrane provided directional water transport performance by the combination of hydrophobic fibrous layer and hydrophilic fibrous layer, thus improving the comfort of the wearer. Importantly, benefiting from the biodegradability property of PCL, gelatin and ε-PL, the fibrous membrane was biodegradable, which could decrease the burden on the environment. The fabricated trilayered fibrous membrane not only shows promising potential as a highly efficient, antibacterial, moisture-wicking and biodegradable air filtration membrane, but also offers a versatile strategy to design a multifunctional face mask. [ABSTRACT FROM AUTHOR]

Objectives The assessment of acute pancreatitis severity on admission currently remains a challenge to clinicians. A single, rapid biochemical marker would be preferable to clinical and radiological scoring systems. The aim of this study was to undertake a meta-analysis on the value of carboxypeptidase-B activation peptide (CAPAP) in predicting severity of acute pancreatitis on admission. Methods Major databases and trial registries were searched to identify all relevant studies from January 1998 to March 2015. Pooled sensitivity, specificity and the diagnostic odds ratios (DOR) with 95% confidence interval (CI) were calculated for each study and were compared to other biomarkers, if included, within the same study. Summary receiver-operating curves (ROC) were conducted and the area under the curve (AUC) was evaluated. Results In total, six studies were included. At the time of admission, the AUC of serum CAPAP for predicting severity of acute pancreatitis was 0.86 with pooled sensitivity, specificity and DOR of 0.90, 0.70 and 19.08, respectively. When serum CAPAP was compared with urinary CAPAP, the AUC, pooled sensitivity, specificity and DOR were 0.69 vs 0.88, 0.90 vs 0.81, 0.68 vs. 0.77 and 17.96 vs. 18.58, respectively. Similarly, the AUC, pooled sensitivity, specificity and DOR of serum CAPAP vs maximal serum C-reactive protein within the first 3 days of admission were found to be 0.97 vs. 0.82, 0.92 vs. 0.88, 0.81 vs 0.68 and 37.90 vs. 18.80, respectively. Conclusions Both serum and urinary CAPAP have the potential to act as a stratification marker on admission in predicting severity of acute pancreatitis. [ABSTRACT FROM AUTHOR]

The TiO 2 nanoparticles-coated CNTs (TiO 2 @CNTs) were used as reinforcement to fabricate the 7075-TiO 2 @CNTs composites via ultrasonic-assisted casting, then the composites were adopted T6 treatment. The microstructures and wear performance were investigated in detail. The TiO 2 @CNTs could promote the refinement of α-Al grains, reducing the average size by 60.7%. With the addition of 1.0 wt% TiO 2 @CNTs and introduced T6 treatment, the wear rates have maximally decreased by 48.2% and 69.2%, respectively. The self-lubrication and refinement strengthening effect of CNTs improved the wear resistance, and the strong interfacial bonding between nanoscale MgZn 2 precipitates and α-Al further enhanced the tribological properties. The effects of vertical load and sliding velocity on tribological morphology of T6 treatment composites were investigated, demonstrating that with the increase of vertical load, the wear rate and micro-crack tendency increased. Meantime, with the increase of sliding velocity, both the wear rate and the surface roughness showed a decreasing and then increasing trend. The main wear regime was abrasive wear combined with slight oxidation at lower velocities, while delamination wear combined with severe oxidation at higher velocities. • The TiO 2 @CNTs could promote the refinement of α-Al grains, reducing the average size by 60.7%. • The self-lubrication and refinement strengthening effect of CNTs improved the wear resistance. • The strong interfacial bonding between nanoscale MgZn 2 precipitates and α-Al further improved the tribological properties. • The wear rate and micro-crack tendency on the worn surface increased with the increase of vertical load. • The wear rate and the surface roughness showed a decreasing and then increasing trend with the increase of sliding velocity. [ABSTRACT FROM AUTHOR]

Photoacoustic (PA) remote sensing (PARS) microscopy represents a significant advancement by eliminating the need for traditional acoustic coupling media in PA microscopy (PAM), thereby broadening its potential applications. However, current PARS microscopy setups predominantly rely on free-space optical components, which can be cumbersome to implement and limit the scope of imaging applications. In this study, we develop an all-fiber miniature non-contact PA probe based on PARS microscopy, utilizing a 532-nm excitation wavelength, and showcase its effectiveness in in vivo vascular imaging. Our approach integrates various fiber-optic components, including a wavelength division multiplexer, a mode field adaptor, a fiber lens, and an optical circulator, to streamline the implementation of the PARS microscopy system. Additionally, we have successfully developed a miniature PA probe with a diameter of 4 mm. The efficacy of our imaging setup is demonstrated through in vivo imaging of mouse brain vessels. By introducing this all-fiber miniature PA probe, our work may open up new opportunities for non-contact PAM applications.

Background: To improve perioperative frailty status in patients undergoing laparoscopic colorectal cancer surgery (LCCS), we explored a new intensive prehabilitation program that combines prehabilitation exercises with standard enhanced recovery after surgery (ERAS) and explored its impact., Methods: We conducted a prospective randomized controlled trial. Between April 2021 to August 2021, patients undergoing elective LCCS were randomized into the standardized ERAS (S-ERAS) group or ERAS based on prehabilitation (group PR-ERAS). Patients in the PR-ERAS group undergoing prehabilitation exercises in the perioperative period in addition to standard enhanced recovery after surgery. We explored the effects of this prehabilitation protocol on frailty, short-term quality of recovery (QoR), psychological status, postoperative functional capacity, postoperative outcomes, and pain., Results: In total, 125 patients were evaluated, and 95 eligible patients were enrolled and randomly allocated to the S-ERAS (n = 45) and PR-ERAS (n = 50) groups. The Fried score was higher in the PR-ERAS group on postoperative day (7 (2(2,3) vs. 3(2,4), P = 0.012). The QoR-9 was higher in the PR-ERAS group than in the S-ERAS group on the 1st, 2nd, 3rd, and 7th postoperative days. The PR-ERAS group had an earlier time to first ambulation (P < 0.050) and time to first flatus (P < 0.050)., Conclusion: Prehabilitation exercises can improve postoperative frailty and accelerate recovery in patients undergoing LCCS but may not improve surgical safety. Therefore, better and more targeted prehabilitation recovery protocols should be explored., Clinical Trial Registration: www.clinicaltrials.org , identifier NCT04964856., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Yang, Yuan, Liu, Tang, He, Chen, Xiong, Huang and Qian.)

Background: Sleep traits have been linked to diseases; particularly, their impact on cancer has received increasing attention. This study aimed to investigate whether sleep traits have a causal relationship with colorectal cancer (CRC) using two-sample Mendelian randomization (TSMR)., Methods: Genetic instrumental variables (IVs) for seven sleep traits (sleep duration, ease of getting up in the morning, morning chronotype, daytime napping, insomnia symptoms, snoring, and daytime dozing) were selected from pooled data from published genome-wide association studies (GSWSs). Two-sample multivariate Mendelian randomization (MR) analyses were conducted to assess the causal association between sleep traits and CRC. Reverse MR analyses were performed to determine the causal relationship between CRC and sleep traits. Inverse variance weighted (IVW), MR-Egger, and weighted medians were calculated for all MR analyses., Results: The multivariable MR (MVMR) analysis found that appropriate sleep duration [odds ratio (OR) =0.989; 95% confidence interval (CI): 0.980, 0.999; P=0.04] and ease of getting up in the morning (OR =0.990; 95% CI: 0.980, 1.000; P=0.04) were protective factors for CRC. Snoring (OR =1.021; 95% CI: 1.002, 1.041; P=0.03) was associated with the risk of CRC. Ease of getting up in the morning (OR =0.990; 95% CI: 0.983, 0.997; P=0.003) was associated with reduced risk of colon cancer. Morning chronotype (OR =1.004; 95% CI: 1.000, 1.007; P=0.04) was associated with the risk of colon cancer. Insomnia symptoms (OR =0.995; 95% CI: 0.990, 0.999; P=0.03) were a protective factor for rectal cancer. There was no evidence found for a causal association between other sleep traits and CRC, colon, or rectal cancer., Conclusions: Proper sleep duration and ease of getting up in the morning may be protective factors against CRC, and snoring may increase the risk of CRC., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jgo.amegroups.com/article/view/10.21037/jgo-24-11/coif). The authors have no conflicts of interest to declare., (2024 Journal of Gastrointestinal Oncology. All rights reserved.)

Purpose: Currently, there is no consensus regarding whether super-elderly (aged > 80 years) patients are suitable candidates for laparoscopic surgery. This study aimed to analyse the short-term outcomes and oncological prognosis of laparoscopic gastrectomy in super-elderly patients with gastric cancer (GC)., Methods: Following PRISMA and AMSTAR-2 guidelines, we searched the Web of Science, Embase, Cochrane Library, and Pubmed databases from inception until May 2024 and performed a meta-analysis. All published studies exploring the surgical outcomes and oncological prognosis of laparoscopic versus open gastrectomy in super-elderly patients with GC were reviewed. Statistical analyses were performed using RevMan 5.3., Results: A total of 1,085 studies were retrieved, eight of which were included in the meta-analysis, comprising 807 patients > 80 years of age with GC. The meta-analysis showed that compared with open gastrectomy, patients with GC > 80 years old who underwent laparoscopic gastrectomy had a longer operative time (weighted mean difference [WMD] = 30.48, p < 0.001), less intraoperative blood loss (WMD = -166.96, P < 0.001), shorter postoperative exhaust time (WMD =-0.83, p < 0.001), shorter length of stay (WMD = -0.78, p < 0.001), fewer overall complications (Odds ratio [OR] = 0.54, p = 0.003), higher 5-year overall survival rate (OR = 1.66, p = 0.03) and disease-specific survival rate (OR = 3.23, p < 0.001). Furthermore, laparoscopic gastrectomy did not significantly affect the number of lymph node dissections, the rate of D2 radical gastrectomy, major postoperative complications, or postoperative pneumonia., Conclusions: Compared to open gastrectomy, patients with GC aged > 80 years who underwent laparoscopic gastrectomy may have better short-term outcomes. Age should not be a contraindication for minimally invasive surgery., (© 2024. The Author(s), under exclusive licence to Federación de Sociedades Españolas de Oncología (FESEO).)

Introduction: Patients with pancreatic ductal adenocarcinoma (PDAC) remain a poor prognosis despite the development of chemotherapy. Although programmed cell death 1 (PD-1) blockade has shown great efficacy in various solid tumours, its application in treating PDAC is limited. Recent studies have indicated that chemotherapy or stereotactic body radiotherapy (SBRT) may improve the antitumour effect of PD-1 blockade in patients with PDAC. The objective of this study is to evaluate the efficacy and safety of combined therapy comprising PD-1 blockade, gemcitabine plus nab-paclitaxel chemotherapy and SBRT for patients with metastatic PDAC., Methods and Analysis: This is a multicentre, single-arm, prospective phase II clinical trial. Forty-three patients diagnosed with metastatic PDAC will be enrolled. The eligible patients will be intravenously administered 1000 mg/m 2 gemcitabine and 125 mg/m 2 nab-paclitaxel on days 1 and 8 of the 21-day cycle. Serplulimab (200 mg) will be administered intravenously on day 1 of the 21-day cycle. Furthermore, during the second cycle, the patients will undergo SBRT with doses of 33 Gy in five fractions for primary lesions or doses of 24 Gy in three fractions for metastases. The primary endpoint is the 6-month progression-free survival (PFS) rate. The secondary endpoints overall survival, PFS, overall response rate, disease control rate, time to progression, duration of response, duration of disease control and safety. Moreover, this trial seeks to investigate biomarkers such as circulating tumour DNA and circulating hybrid cells in patients diagnosed with metastatic PDAC., Ethics and Dissemination: The study was approved by the Ethics Committee on Biomedical Research, West China Hospital of Sichuan University. The study results will be presented at international conferences and published in a peer-reviewed journal., Trial Registration Number: ChiCTR2300073237., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

The lack of fat in yogurt can lead to alterations in taste and whey separation, reducing consumer acceptance. In this study, the feasibility of enhancing the quality of skim milk yogurt through a combination of transglutaminase (TG) and protein-glutaminase (PG) was investigated. The combination of TG and PG resulted in simultaneous cross-linking and deamidated of casein micelles, with PG deamidation taking priority over TG cross-linking, leading to higher solubility and lower turbidity of milk proteins compared with TG alone. When 0.06 U/mL TG and 0.03 U/mL PG were added, firmness and viscosity indexes significantly increased by 38.26 and 78.59%, respectively as compared with the control. Microscopic images revealed increased cross-linking with casein and filling of cavities by smaller sub-micelles in the combination of TG and PG treatment. Furthermore, the combination of TG and PG resolved issues of rough taste and whey separation, leading to improved overall liking. This study highlights the benefits of using both enzymes in dairy production and has important implication for future research., (© 2024, The Authors. Published by Elsevier Inc. on behalf of the American Dairy Science Association®. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).)

Scandium oxide (Sc 2 O 3 ) has a wide range of applications in metallurgy, chemical industry, electronics and many other high-tech fields. However, most Sc 2 O 3 materials exist in the powder or bulk form, while nanostructured Sc 2 O 3 has rarely been reported as there is a lack of a common method to control its dimensionality, hindering the understanding of new properties and potential applications of nano-Sc 2 O 3 materials. In this paper, we establish a procedure to synthesize a two-dimensional (2D) Sc 2 O 3 -covalent organic framework (COF) composite film where the crystal size of Sc 2 O 3 domains is as small as ∼3 nm. The composite film is prepared by a Schiff base condensation reaction at the sharp n -pentane/water interface using a combination of surfactant-monolayer-assisted interfacial synthesis and laminar assembly polymerization methods. Then the conditions of nucleation and uniform film formation of the 2D Sc 2 O 3 /COF are explored further. Meanwhile, an atomic force microscopy indentation test shows that the material has a high Young's modulus of 89.1 ± 3.8 GPa, which is much higher than those of the majority of reported 2D polymer materials. We further extended this synthesis method to the preparation of Yb 2 O 3 (ytterbium oxide) and/or Er 2 O 3 (erbium oxide)-incorporated 2D COF composite films, verifying the universality of this strategy. This work provides an opportunity to vary the dimensionality of many kinds of metal oxides and explore the potential applications of low-dimensional Sc 2 O 3 materials.

Background: Protective ileostomy can effectively prevent severe anastomotic leakage after rectal cancer surgery; however, the optimal timing for ileostomy closure during adjuvant chemotherapy remains unclear. This study aimed to explore the safety and long-term outcomes of early ileostomy closure during adjuvant chemotherapy., Method: Patients who underwent laparoscopic rectal cancer surgery combined with protective ileostomy and adjuvant chemotherapy between April 2017 and April 2021 were retrospectively evaluated. Patients were divided into an early closure group during chemotherapy (group A) and a late closure group after chemotherapy (group B)., Results: A total of 215 patients were included in this study, with 115 in group A and 100 in group B. There were no significant differences in demographic and clinical characteristics between the two groups. In group A, durations of stoma status ( p < 0.001) and low anterior resection syndrome (LARS) ( p < 0.001) were shorter, and rectal stenosis ( p =0.036) and stoma-related complications ( p =0.007), especially stoma stenosis ( p =0.041), were less common. However, compliance with chemotherapy was worse ( p =0.009). There were no significant differences in operative time, postoperative hospital stay, postoperative complications, incidence and severity of LARS, disease-free survival, or overall survival between groups., Conclusion: Early ileostomy closure can effectively reduce the duration of stoma status, duration of LARS, rectal stenosis, and stoma-related complications while not affecting surgical complications and oncological outcomes. Ileostomy closure should not be delayed because of adjuvant chemotherapy. However, follow-up should be strengthened to increase compliance and integrity with chemotherapy., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2024 Fan He et al.)

The electrocatalytic hydrogen evolution reaction (HER) is an efficient approach to convert sustainable energy sources into clean energy carriers, H 2 . Although various transition metal sulfides (TMSs) have been reported as promising alternatives to precious metal-based catalysts, the top catalyst among TMSs remains unclear as there is a dearth of high-quality studies that provide a 'fair' comparison of the performance of these TMSs synthesized and tested under the same conditions. In this work, layered transition metal sulfides (MS 2 : MoS 2 , WS 2 , VS 2 ) and non-layered transition metal sulfides (M x S y : FeS 2 , CoS x , NiS) were obtained by a straightforward hydrothermal method, and thus a comprehensive platform was established for the comparison of the intrinsic activity of these materials in the HER. Experimental results demonstrate that layered MS 2 exhibits better performance than non-layered M x S y in acidic electrolytes, while CoS x and NiS can catalyze hydrogen evolution more effectively under alkaline conditions due to structural reconfiguration. MoS 2 shows the best HER performance in both acidic and alkaline electrolytes, particularly in 1 M KOH solution. This work provides guidance for the optimal design of transition metal electrocatalysts, and structural engineering strategies can be used to further enhance their catalytic activity.

High-capacity anodes, especially silicon, suffer from huge volume fluctuations and electrode material pulverization during lithiation/delithiation. An accessible solution to this issue is to construct nano-silicon anodes with optimized particle size and a conductive matrix. In this work, we introduce a novel strategy for the in situ , rapid synthesis of ultra-small silicon nanoparticles uniformly embedded within carbonized nanosheets (us-Si/C) through swift high-temperature thermal radiative heating of sizable silicon nanoparticles (SiNPs). The us-Si/C anode shows ample capability to accommodate volume fluctuations during the lithiation/delithiation processes. The as-prepared anode exhibits a specific capacity of 920 mA h g -1 after 1000 cycles at a current density of 2 A g -1 , indicating the advantages of the well-tailored structure. Additionally, the us-Si/C electrode can maintain an areal capacity of approximately 1.55 mA h cm -2 after 200 cycles at a high loading of 3.66 mg cm -2 . Moreover, it presents practical applicability when assembled into LFP (lithium iron phosphate)//us-Si/C full cells. This preparation method presents great promise for achieving roll-to-roll manufacturing for practical applications due to its simplicity and efficiency.

Background: Laparoscopic right hemicolectomy is a standard treatment modality for right colon cancer. However, performing intracorporeal anastomosis (IA) for totally laparoscopic right hemicolectomy (TLRH) remains a challenge for some surgeons. To simplify IA in TLRH we used self-pulling and latter transection (SPLT) reconstruction in TLRH, and compared this procedure with overlap IA and laparoscopy-assisted right hemicolectomy (LARH) in order to evaluate its safety and effectiveness., Methods: Patients with right colon cancer who underwent SPLT-TLRH, TLRH with overlap IA or LARH between July 2019 and June 2023 were evaluated retrospectively. Basic information, oncological features, perioperative outcomes, and postoperative complications were compared between groups., Results: In total, 188 patients with right colon cancer that underwent SPLT-TLRH (n = 60), TLRH(n=21) or LARH (n = 107) were included in the study. No patient required conversion to open surgery. The operation time in SPLT-TLRH group was significantly shorter than that in TLRH group (P<0.05). Compared with LARH group, SPLT-TLRH group had significantly longer distal margins, shorter skin incisions (P < 0.001), time to first flatus, time to first defecation, and postoperative hospital stays (P<0.05)., Conclusion: We introduced SPLT to TLRH. The SPLT-TLRH group demonstrated better short-term outcomes. Therefore, we believe that SPLT reconstruction is effective and safe in TLRH for right colon cancer, and can simplify reconstruction., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Yang, He, Tang, Chen, Xiong, Zou, Woraikat, Qian and Li.)

Radical resection of rectal cancer is a safe and effective treatment, but there remain several complications related to anastomosis. We aimed to assess the risk factors and incidence of rectal anastomotic stenosis (AS) after rectal cancer resection. We conducted a systematic review and meta-analysis after searching PubMed, Embase, Web of Science, and Medline databases from inception until May 2023. Data are reported as the combined odds ratio (OR) for categorical variables and the weighted mean difference (WMD) for continuous variables. Six hundred and fifty-nine studies were retrieved, nine (3031 patients) of which were included in the meta-analysis. Young age (WMD = -3.09, P = 0.0002), male sex (OR = 1.53, P = 0.0002), smoking (OR = 1.54, P = 0.009), radiotherapy (OR = 2.34, P = 0.0002), protective stoma (OR = 2.88, P = 0.007), intersphincteric resection surgery (OR = 6.28, P = 0.05), anastomotic fistula (OR = 3.72, P = 0.003), and anastomotic distance (WMD = -3.11, P = 0.0006) were identified as factors that increased the risk of AS, while staple (OR = 0.39, P < 0.001) was a protective factor. The incidence of AS after rectal cancer resection was approximately 17% (95% CI: 13%-21%). We identified eight risk factors and one protective factor associated with AS after rectal cancer resection. These factors may be combined in future studies to develop a more comprehensive and accurate prediction model related to AS after rectal cancer resection., Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interest., (Copyright © 2023 Asian Surgical Association and Taiwan Robotic Surgery Association. Published by Elsevier B.V. All rights reserved.)

In this Letter, we present an experimental demonstration of downstream signaling in a 16 × 50 Gbit/s coherent passive optical network (CPON) using the code and space division multiplexing (CDM-SDM) approach. We realize optical SDM through the utilization of a 4-core weakly coupled multicore fiber (WC-MCF), enhancing the total available optical launch power at the optical line terminal (OLT). This enhancement significantly improves the power budget for CPONs that connect with a large number of optical network units (ONUs). At the second stage of the CPON, four CDM-assigned ONUs are connected to individual cores of the WC-MCF, thereby supporting the connectivity of up to 16 ONUs. Through experiments, we have noted substantial disparities in the downstream signaling performance among individual CDM-assigned ONUs, particularly as the capacity is increased to 800 Gbit/s. To address this issue, we have employed an innovative approach by leveraging space-time coding techniques to manipulate the CDM tributaries, to achieve a balanced reception performance for all ONUs within the CPON. We believe that the proposed CDM-SDM CPON scheme, complemented by the advanced DSP flow chart, holds significant promise for future PON systems characterized by substantial capacity and extensive connectivity.

Postoperative pancreatic fistula (POPF) is a severe complication after distal pancreatectomy (DP); however, it is unclear how to effectively reduce the incidence. The purpose of this meta-analysis is to determine whether reinforced stapling reduces POPF after DP. From February 2007 to April 2023, a comprehensive search of electronic data and references was conducted in PubMed/Medline, Embase, Web of Science, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews. In this study, the perioperative outcomes were evaluated for the reinforced stapler (RS) group and the standard stapler (SS) group in DP using Review Manager Software. Using fixed- or random-effects models, pooled odds ratios (ORs) and mean differences (MDs) with 95% confidence intervals (CIs) were calculated. In total, three randomized clinical trials (RCTs) with 425 patients and five observational clinical studies (OCS) with 318 patients were included. In pooled meta-analyses from RCTs, there was no difference between the two groups in the incidence of POPF (OR = 0.79; 95% CI [0.47,1.35]; P = 0.39), intraoperative blood loss (MD = 10.66; 95% CI [- 28.83,50.16]; P = 0.6), operative time (MD = 9.88; 95% CI [- 8.92,28.67]; P = 0.3), major morbidity (OR = 1.12; 95% CI [0.67,1.90]; P = 0.66), reoperation (OR = 0.97; 95% CI [0.41,2.32]; P = 0.95), readmission (OR = 0.99; 95% CI [0.57,1.72]; P = 0.97) or hospital stay (MD = - 0.95; 95% CI [- 5.22,3.31]; P = 0.66). However, the results of POPF and readmission were favorable for RS in the OCS group., (© 2023. Italian Society of Surgery (SIC).)

Background: Systemic chemotherapy is the primary treatment in patients with locally advanced or metastatic pancreatic ductal adenocarcinoma (PDAC). More effective treatment options are highly awaited. The aim of this study was to evaluate the toxicity and feasibility of gemcitabine/nab-paclitaxel/S-1 (GAS) chemotherapy on a 21-day cycle in patients with locally advanced or metastatic PDAC, determine the dose-limiting toxicity (DLT) and the maximum tolerated dose (MTD) of S-1 in this regimen, and explore preliminary efficacy., Methods: Eligible patients with locally advanced or metastatic PDAC received GAS chemotherapy on a 21-day cycle. Fixed-dose nab-paclitaxel (125 mg/m2) and gemcitabine (1000 mg/m2) were given intravenously on days 1 and 8. Different doses of S-1 were given orally twice daily from day 1 to day 14 in a 3+3 dose escalation design. According to patients` body surface area, the dose-escalation design was as follows: patients with a body surface area of 1.25-1.5 m2 received S-1 40 mg/day initially and the dose was increased to 60 mg or 80 mg. Patients with a body surface area of more than 1.5 m2 received S-1 60 mg/day initially and the dose was increased to 80 mg or 100 mg. The primary endpoints were to evaluate the toxicity and determine the DLT and MTD of S-1. The secondary endpoint was to evaluate efficacy, including best objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), and overall survival (OS). adverse events (AEs) were evaluated according to the NCI-CTCAE 5.0. Tumor response was assessed using the RECIST 1.1., Results: A total of 21 eligible patients were included. Due to the infrequence of patients with a body surface area of 1.25-1.5 m2, only 2 patients were included in cohort of S-1 40 mg. The dose-escalation for patients in this group failed to be enrolled completely. For patients with a body surface area of more than 1.5 m2, 3 DLTs in 7 patients were detected at cohort of S-1 100 mg (grade 3 thrombocytopenia with hemorrhage, grade 3 rash, and grade 3 mucositis/stomatitis). S-1 80 mg/day (body surface area: >1.5 m2) was considered to be the MTD in GAS chemotherapy on a 21-day cycle. No grade 4 AEs or treatment-related deaths were observed. The most commonly occurring hematologic AE of any grade was anemia (38.1%). The most frequent nonhematologic AEs of any grade were peripheral neuropathy (38.1%), dyspepsia (23.8%), constipation (23.8%), and alopecia (23.8%). Response assessment showed that the best ORR was 36.8% (7 of 19 patients) and the DCR was 94.7% (18 of 19 patients). The median PFS was 5.3 (95% CI, 4.6 to 6.0) months and the median OS was 10.3 (95% CI, 8.1 to 12.5) months., Conclusion: GAS chemotherapy (21-day cycle) with nab-paclitaxel 125 mg/m2, gemcitabine 1000 mg/m2, and S-1 80 mg/day (body surface area: >1.5 m2) was found to have acceptable toxicity and significant clinical control in patients with locally advanced or metastatic PDAC. We conclude that further trials with this combination are warranted. (Trial Identifier: ChiCTR1900027833 [chictr.org])., (© The Author(s) 2022. Published by Oxford University Press.)

Background: The COVID-19 pandemic is affecting the mental and emotional well-being of patients, family members, and health care workers. Patients in the isolation ward may have psychological problems due to long-term hospitalization, the development of the epidemic, and the inability to see their families. A medical assistive robot (MAR), acting as an intermediary of communication, can be deployed to address these mental pressures., Objective: CareDo, a MAR with telepresence and teleoperation functions, was developed in this work for remote health care. The aim of this study was to investigate its practical performance in the isolation ward during the pandemic., Methods: Two systems were integrated into the CareDo robot. For the telepresence system, a web real-time communications solution is used for the multiuser chat system and a convolutional neural network is used for expression recognition. For the teleoperation system, an incremental motion mapping method is used for operating the robot remotely. A clinical trial of this system was conducted at First Affiliated Hospital, Zhejiang University., Results: During the clinical trials, tasks such as video chatting, emotion detection, and medical supplies delivery were performed via the CareDo robot. Seven voice commands were set for performing system wakeup, video chatting, and system exiting. Durations from 1 to 3 seconds of common commands were set to improve voice command detection. The facial expression was recorded 152 times for a patient in 1 day for the psychological intervention. The recognition accuracy reached 95% and 92.8% for happy and neutral expressions, respectively., Conclusions: Patients and health care workers can use this MAR in the isolation ward for telehealth care during the COVID-19 pandemic. This can be a useful approach to break the chains of virus transmission and can also be an effective way to conduct remote psychological intervention., (©Ruohan Wang, Honghao Lv, Zhangli Lu, Xiaoyan Huang, Haiteng Wu, Junjie Xiong, Geng Yang. Originally published in JMIR Human Factors (https://humanfactors.jmir.org), 20.04.2023.)

The no-touch isolation technique has been widely used in cancer surgery as a strategy to prevent cancer cells from spreading; however, it is difficult to apply in laparoscopic pancreaticoduodenectomy (LPD). Here, we describe an orthotopic resection surgical technique that applies a no-touch principle for LPD and can help with the in situ resection of tumors. In implementing this surgical strategy, Kocher's maneuver was not performed first. Instead, after the exploration of the abdominal cavity, the distal stomach and the pancreatic neck were transected. Then, the dissection of the uncinate process of the pancreas, the duodenum, and the superior mesenteric vein and artery is carried out via an inferior infracolic approach. Finally, the pancreatic head and duodenum were removed in situ. Among the 41 patients who underwent this technique, two (4.9%) required conversion to open surgery due to uncontrolled bleeding. The average operative time was 335 min (248-1055 min). The mean estimated blood loss was 300 mL (50-1250 mL). Two patients (4.9%) underwent combined PV resection and reconstruction; six patients (14.6%) required a blood transfusion; two patients (4.9%) suffered from postoperative bleeding; two patients (4.9%) suffered from Grade B pancreatic fistulas; one patient (2.4%) suffered from bile leakage; and three patients (7.3%) suffered from abdominal fluid collection. No patients died during the perioperative period. Therefore, orthotopic LPD using an inferior infracolic approach is safe and feasible for patients with malignant pancreatic head and periampullary tumors. However, further investigations are required to elucidate its oncological benefits.

An exact modal decomposition method plays an important role in revealing the modal characteristics of a few-mode fiber, and it is widely used in various applications ranging from imaging to telecommunications. Here, ptychography technology is successfully used to achieve modal decomposition of a few-mode fiber. In our method, the complex amplitude information of the test fiber can be recovered by ptychography, and then the amplitude weight of each eigenmode and the relative phase between different eigenmodes can be easily calculated by modal orthogonal projection operations. In addition, we also propose a simple and effective method to realize coordinate alignment. Numerical simulations and optical experiments validate the reliability and feasibility of the approach.

Ordered mesoporous manganese oxides (MnO x ) were synthesized using the modified inverse micelle method. The crystal structure and surface morphology were characterized by X-ray diffraction (XRD), scanning electron microscopy (SEM) and transmission electron microscopy (TEM). The element content and changes in surface valence of catalysts were analyzed by X-ray photoelectron spectroscopy (XPS). The MnO x were used to activate peroxymonosulfate (PMS) to degrade tetracycline hydrochloride (TCH). The catalytic activity of MnO x was enhanced at a calcination temperature of 350 °C (MM-3). The degradation efficiency of TCH in MM-3/PMS system was 87.89% in 180 min. Appropriate dosages of catalyst and PMS improve the degradation efficiency of TCH. This system showed a wide range of pH application (3-9). In the presence of coexisting ions and humic acid, the degradation efficiency of TCH was still above 80%. The results of free radical capture experiment and electron paramagnetic resonance (EPR) test proved that the system activates PMS to produce three types of free radicals: SO 4 - , OH and 1 O 2 . Therefore, MM-3 is a promising catalyst for the degradation of TCH in practical wastewater treatment., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Many strategies have been adopted to engineer bone-ligament interface, which is of great value to both the tissue regeneration and the mechanism understanding underlying interface regeneration. However, how to recapitulate the complexity and heterogeneity of the native bone-ligament interface including the structural, cellular and mechanical gradients is still challenging. In this work, a bioinspired grid-crimp micropattern fabricated by melt electrospinning writing (MEW) was proposed to mimic the native structure of bone-ligament interface. The printing strategy of crimped fiber micropattern was developed and the processing parameters were optimized, which were used to mimic the crimp structure of the collagen fibrils in ligament. The guidance effect of the crimp angle and fiber spacing on the orientation of fibroblasts was studied, and both of them showed different levels of cell alignment effect. MEW grid micropatterns with different fiber spacings were fabricated as bone region. Both the alkaline phosphatase activity and calcium mineralization results demonstrated the higher osteoinductive ability of the MEW grid structures, especially for that with smaller fiber spacing. The combined grid-crimp micropatterns were applied for the co-culture of fibroblasts and osteoblasts. The results showed that more cells were observed to migrate into the in-between interface region for the pattern with smaller fiber spacing, suggested the faster migration speed of cells. Finally, a cylindrical triphasic scaffold was successfully generated by rolling the grid-crimp micropatterns up, showing both structural and mechanical similarity to the native bone-ligament interface. In summary, the proposed strategy is reliable to fabricate grid-crimp triphasic micropatterns with controllable structural parameters to mimic the native bone-to-ligament structure, and the generated 3D scaffold shows great potential for the further bone-ligament interface tissue engineering., (© 2022 IOP Publishing Ltd.)

Background: The relationship between N6-methyladenosine (m 6 A) RNA methylation regulators and the tumor immune microenvironment has been extensively studied. Nevertheless, the potential function of m 6 A regulators in the tumor immune landscape of pancreatic ductal adenocarcinoma (PDAC) remains to be fully elucidated., Methods: Here, we systematically evaluated the expression of 19 m 6 A regulators in PDAC patients from The Cancer Genome Atlas (TCGA) and the Gene Expression Omnibus (GEO) database. Utilizing consensus clustering, the PDAC patients were segmented into two subgroups according to the expression of 19 m 6 A regulators. A prognostic risk signature of 5 m 6 A methylation regulators ( ALKBH5 , IGF2BP2 , IGF2BP3 , LRPPRC , and KIAA1429 ) was then built, and the PDAC patients were divided into high-risk and low-risk groups. Subsequently, differences in independent prognostic parameters, risk score distribution, survival, and cluster analysis between high-risk and low-risk groups were analyzed., Results: We found two subgroups with dramatically different immune landscapes and prognoses. Subsequently, differences in independent prognostic parameters, risk score distribution, survival, and cluster analysis between the high-risk and low-risk groups were found. Moreover, these gene signatures displayed good discriminative performances in the GEO datasets. We also found that the risk score was positively correlated with the tumor mutation burden (TMB), and the TMB value was higher in the high-risk scoring group. The low-risk scoring group was linked by a stronger response to anti-programmed cell death ligand 1 (anti-PD-L1) immunotherapy and clinical advantages in the immunotherapeutic advanced urothelial cancer (IMvigor210) cohort. Ultimately, we found that these 5 m 6 A regulators had a fatal regulatory role on the tumor immune microenvironment in PDAC patients., Conclusions: The construction signature based on the m 6 A regulators may be crucial regulators of the tumor immune microenvironment in PDAC, providing a new approach to improving the immunotherapy strategy for PDAC patients., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://gs.amegroups.com/article/view/10.21037/gs-21-859/coif). The authors have no conflicts of interest to declare., (2022 Gland Surgery. All rights reserved.)

Traditional foam hydraulic fracturing fluids used guar cross-linking technology. However, major production problems, such as high friction and difficulty to accurately control the cross-linking time, have influenced the large-scale application of cross-linked guar foam fracturing fluids. In this study, we developed a novel non-cross-linked foam fracturing fluid using a series of polymers synthesized with acrylamide and hexadecyl trimethylallyl ammonium chloride as monomers and improved the stability of foam by forming structures in solution through association. The results showed that the hydrophobic groups were the key factors that affect the foam stability, and the hydrolysis degree had a significant effect on the elasticity of the polymer solution. The model association polymer with 0.75% hydrophobic group content and 56% hydrolytic degree was optimal. The stability of our proposed foam was comparable to that of the cross-linked guar gum foam. The adsorption of associating polymers on the gas and water interface resulted in a high-stability foam. Our study demonstrates a new avenue to develop high-stability foams to satisfy the current hydraulic fracturing scheme., Competing Interests: The authors declare no competing financial interest., (© 2021 The Authors. Published by American Chemical Society.)

The alternating current poling (ACP) method has been become more and more popular recently because of its advantages of being low cost, time saving and highly efficient. Few ACP studies have focused on relaxor-PT crystals with a high coercive field and high Curie temperature or the effects of ACP on intrinsic and extrinsic contributions. The effects of the electric field, frequency, and number of cycles of ACP on the piezoelectric and dielectric properties of 〈001〉-oriented Pb(In 0.5 Nb 0.5 )O 3 -PbTiO 3 ferroelectric crystals were studied. The dielectric permittivity ε 33 T / ε 0 and piezoelectric coefficient d 33 of an ACP sample are 3070 and 1400 pC N -1 , respectively, which are 14% and 18% larger than those of a DCP sample. Rayleigh analysis reveals that both intrinsic and extrinsic contributions are enhanced after ACP. The poling electric field, frequency and cycle number can influence the intrinsic and extrinsic contributions. The intrinsic contribution is significantly affected by the poling electric field, and cycle number, but it is not very sensitive to frequency, while the poling electric field, frequency and cycle number are very important for the extrinsic contribution. This work demonstrates that the uniform domain patterns are a critical factor for the enhancement of the piezoelectric properties., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

Postoperative pancreatic fistula (POPF) is the most serious complication after pancreaticoduodenectomy (PD). Recently, Blumgart anastomosis (BA) has been found to have some advantages in terms of decreasing POPF compared with other pancreaticojejunostomy (PJ) using either the duct-to-mucosa or invagination approach. Therefore, the aim of this study was to examine the safety and effectiveness of BA versus non-Blumgart anastomosis after PD. The PubMed, EMBASE, Web of Science and the Cochrane Central Library were systematically searched for studies published from January 2000 to March 2020. One RCT and ten retrospective comparative studies were included with 2412 patients, of whom 1155 (47.9%) underwent BA and 1257 (52.1%) underwent non-Blumgart anastomosis. BA was associated with significantly lower rates of grade B/C POPF (OR 0.38, 0.22 to 0.65; P = 0.004) than non-Blumgart anastomosis. Additionally, in the subgroup analysis, the grade B/C POPF was also reduced in BA group than the Kakita anastomosis group. There was no significant difference regarding grade B/C POPF in terms of soft pancreatic texture between the BA and non-Blumgart anastomosis groups. In conclusion, BA after PD was associated with a decreased risk of grade B/C POPF. Therefore, BA seems to be a valuable PJ to reduce POPF comparing with non-Blumgart anastomosis.

Pancreatic ductal adenocarcinoma (PDAC) displays a highly aggressive malignancy and is considered to be an incurable and rapidly lethal disease. MicroRNAs (miRNAs) are small non-coding RNAs of approximately nucleotides that regulate several aspects of tumors pathogenesis, including migration, invasion, metastasis and epithelial-mesenchymal transition. We have found that miR-107 was significantly high expression in PDAC tissues and cells. High miR-107 expression is associated with poor clinicopathological parameters and prognosis in PDAC patients. Deregulated expression of miR-107 in PDAC cells (AsPC-1 and Panc-1) is sufficient to reduce cell migration and invasion, and to induce upregulation of epithelial markers (β-catenin, ZO-1 and E-cadherin) and a decrease of mesenchymal marker expression (ZEB-1 and vimentin). We also found that the caveolin-1, PTEN and p-Akt expression are modulated by miR-107 in PDAC cells. Moreover, our study clearly demonstrated that deregulated expression of miR-107 inhibited cell migration and invasion and EMT by up-regulation of caveolin-1 and PTEN, and inhibition of PI3K/Akt signaling in PDAC cells. Our study suggested that miR‑107 expression might both be a useful indicator of the metastatic potential and provided a new potential therapeutic target in PDAC., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Background: Total pancreatectomy (TP) is considered a viable option in some selected patients with pancreatic ductaladenocarcinoma (PDAC). The aim of this study was to compare the clinical outcomes between TP and pancreaticoduodenectomy (PD) in patients with PDAC., Materials and Methods: A total of 375 patients were selected from our center's database in China and classified into two groups: the PD group (n = 325) and the TP group (n = 50). A matched-pair analysis of the patients was conducted with a ratio of 1:1. Univariate and multivariate survival analyses were performed for overall survival., Results: Overall morbidity was lower in the PD group than in the TP group (31.4% vs 52%, respectively, P = 0.004). However, no significant difference was observed in major morbidity between the two groups (24.9% vs 30%, P = 0.455). The rates of 5-year overall (P = 0.043) and disease-free (P = 0.037) survival were significantly higher in the PD group. Furthermore, the univariate and multivariate analyses revealed that adjuvant chemotherapy (HR = 0.684, 95%CI = 0.545-0.860, P = 0.001) and margin resection status (HR = 1.666, 95%CI = 1.196-2.321, P = 0.003) were significant prognostic factors. After the matched-pair analysis, there were no significant differences between the two groups regarding postoperative complications and overall survival. However, the matched PD group had greater estimated blood loss (P = 0.037) and blood transfusion (56% vs 36%, P = 0.045)., Conclusion: From our study, the postoperative outcomes and survival time of TP are similar to those of matched PD. It seems reasonable to suggest that TP can be considered as safe, feasible, and efficacious as PD for patients with PDAC., (Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.)

Rationale: Phyllodes tumors (PT) of the breast are rare neoplasm originating from fibroepithelial component. To our knowledge, our report is the first reported case of PT in 2 sisters., Patient Concerns: We presented 2 cases of PT of the breast involving in 2 sisters. On physical examination of the younger sister, a firm mass measuring approximately 3 cm in diameter was identified in upper inner quadrant of the right breast. Physical examination of the elder sister revealed a 3 cm lump in upper outer quadrant of the left breast., Diagnoses: Histopathology of the younger sister revealed a malignant PT. The elder sister was diagnosed with borderline PT., Interventions: The younger sister with malignant PT underwent right mastectomy. The elder sister with borderline PT was scheduled for wide resection of the mass in the left breast., Outcomes: After a follow-up of 23 months, no local or distant recurrence was observed., Lessons: Our cases indicate that genetic factor may contribute to the risk of PT of the breast. Markers such as p53 and Ki-67 may have some correlation with PT malignancy.

Rationale: The image-guided iodine-125 seed implantation has been widely used for a variety of tumors, including prostatic cancer, pulmonary cancer, hepatocellular carcinoma and pancreatic cancer. However, the clinical value of iodine-125 seed implantation for the treatment of pancreatic metastasis from hepatocellular carcinoma has not been reported. We presented the first case with ultrasound-guided iodine-125 seed implantation for this disease., Patient Concerns: We presented the case of a 48-year-old man patient with primary hepatocellular carcinoma and pancreatic metastasis who was managed with ultrasound-guided iodine-125 seeds implantation., Diagnoses: She was diagnosed with synchronous pancreatic metastases from hepatocellular carcinoma., Interventions: Puncture biopsy and ultrasound-guided iodine-125 seeds implantation., Outcomes: The hepatic and pancreatic tumors were obviously reduced after 15 months. Moreover, the liver function test was mildly abnormal in glutamic-oxalacetic transaminase and glutamic-pyruvic transaminase., Lessons: The image-guided iodine-125 seeds implantation was an important therapeutic approache to unresectable hepatocellular carcinoma with pancreatic metastasis. However, more related cases should be reported for further evaluating the value of the way.