Component separation repair of incisional hernia: evolution of practice and review of long-term outcomes in a single center

PURPOSE

To review the long-term outcomes of complex abdominal wall reconstruction using anterior and posterior component separation (CS) techniques in our center.

METHODS

This was a descriptive analytical study. Analysis of data from a prospectively collected database of patients who had undergone Component Separation (CS) repair of incisional hernias was performed. Two techniques were used. Anterior component separation (ACS) and posterior component separation with transversus abdominis release (PCS/TAR). Follow-up was clinical review at 6 weeks, 6 months, and 12 months with direct access telephone review thereafter. Long-term outcome data was obtained from electronic records and based on either clinical or CT assessment. Minimum physical follow-up was 6 months for all patients.

RESULTS

89 patients with large incisional hernias underwent CS repair. 29 patients had ACS while 60 underwent PCS/TAR. Mean follow-up was 60 months (range 6-140 months) in the ACS group and 20 months (range 6-72 months) in the PCS group. Twenty-five patients (28%) had simultaneous major procedures including 21 intestinal anastomoses. Twenty-six (29%) of patients had associated stomas. Twenty-seven (30.3%) of the patients had undergone previous hernia repairs. Seromas occurred in 24 (26.97%) patients. Wound infections were more common after ACS. There have been 10 (11.2%) recurrences to date.

CONCLUSION

Component separation repair techniques result in good long-term outcomes with acceptable complication rates. They can be performed simultaneously with gastrointestinal procedures with low morbidity. Appropriate patient selection and use of appropriate mesh are important.

The Impact of Prone Ventilation on Hypoxemia Following Extracorporeal Cardiac Surgery: A Meta Analysis

Objective

To systematically assess the impact of prone position ventilation on hypoxemia in patients following extracorporeal cardiac surgery and to establish a reference for further clinical investigation into effective post-surgery mechanical ventilation positions.

Methods

A meta-analysis was conducted through extensive database searches, focusing on randomized controlled trials of cardiopulmonary bypass in hypoxic patients meeting specific inclusion and exclusion criteria. A total of 8 papers involving 442 patients were finally included in this study.

Results

The meta-analysis revealed that the oxygenation index was significantly higher in the prone position ventilation group compared to the supine position ventilation group [MD=51.24, 95% CI (46.14, 56.35), P < .001]. The partial pressure of oxygen in prone patients was also significantly higher than in supine patients [MD=-2.96, 95% CI (1.78, 4.14), P < .001]. Regarding oxygen saturation, blood oxygen saturation in the prone position group surpassed that in the supine position group, showing a statistically significant difference [MD=4.81, 95% CI (3.83, 5.79), P < .001]. Additionally, patients ventilated in the prone position exhibited a shorter duration of mechanical ventilation compared to those in the supine position, with a statistically significant difference [MD=-57.31, 95% CI (-66.57, -48.06), P < .001].

Conclusions

In the absence of significant hemodynamic changes, prone position ventilation significantly enhances the oxygenation index and reduces the duration of mechanical ventilation in patients undergoing extracorporeal circulation surgery. However, the observed heterogeneity across studies may be attributed to variations in breathing styles, respiratory techniques, and physiological parameters among different patient groups.

Mettl3‑mediated m6A RNA methylation regulates osteolysis induced by titanium particles

Peri‑prosthetic osteolysis (PPO) induced by wear particles is considered the primary cause of titanium prosthesis failure and revision surgery. The specific molecular mechanisms involve titanium particles inducing multiple intracellular pathways, which impact disease prevention and the targeted therapy of PPO. Notably, N6‑methyladenosine (m6A) serves critical roles in epigenetic regulation, particularly in bone metabolism and inflammatory responses. Thus, the present study aimed to determine the role of RNA methylation in titanium particle‑induced osteolysis. Results of reverse transcription‑quantitative PCR (RT‑qPCR), western blotting, ELISA and RNA dot blot assays revealed that titanium particles induced osteogenic inhibition and proinflammatory responses, accompanied by the reduced expression of methyltransferase‑like (Mettl) 3, a key component of m6A methyltransferase. Specific lentiviruses vectors were employed for Mettl3 knockdown and overexpression experiments. RT‑qPCR, western blotting and ELISA revealed that the knockdown of Mettl3 induced osteogenic inhibition and proinflammatory responses comparable with that induced by titanium particle, while Mettl3 overexpression attenuated titanium particle‑induced cellular reactions. Methylated RNA immunoprecipitation‑qPCR results revealed that titanium particles mediated the methylation of two inhibitory molecules, namely Smad7 and SMAD specific E3 ubiquitin protein ligase 1, via Mettl3 in bone morphogenetic protein signaling, leading to osteogenic inhibition. Furthermore, titanium particles induced activation of the nucleotide binding oligomerization domain 1 signaling pathway through methylation regulation, and the subsequent activation of the MAPK and NF‑κB pathways. Collectively, the results of the present study indicated that titanium particles utilized Mettl3 as an upstream regulatory molecule to induce osteogenic inhibition and inflammatory responses. Thus, the present study may provide novel insights into potential therapeutic targets for aseptic loosening in titanium prostheses.

Uncertainties and opportunities in delivering environmentally sustainable surgery: the surgeons' view

Surgery is a carbon-heavy activity and creates a high volume of waste. Surgical teams around the world want to deliver more environmentally sustainable surgery but are unsure what to do and how to create change. There are many interventions available, but resources and time are limited. Capital investment into healthcare and engagement of senior management are challenging. However, frontline teams can change behaviours and drive wider change. Patients have a voice here too, as they would like to ensure their surgery does not harm their local community but are concerned about the effects on them when changes are made. Environmentally sustainable surgery is at the start of its journey. Surgeons need to rapidly upskill their generic knowledge base, identify which measures they can implement locally and take part in national research programmes. Surgical teams in the NHS have the chance to create a world-leading programme that can bring change to hospitals around the world. This article provides an overview of how surgeons see the surgical team being involved in environmentally sustainable surgery.

Prognostic model of ER-positive, HER2-negative breast cancer predicted by clinically relevant indicators

PURPOSE

To study the clinicopathological variables connected with disease-free survival (DFS) as well as overall survival (OS) in patients who are ER-positive or HER2-negative and to propose nomograms for predicting individual risk.

METHODS

In this investigation, we examined 585 (development cohort) and 291 (external validation) ER-positive, HER2-negative breast cancer patients from January 2010 to January 2014. From January 2010 to December 2014, we retrospectively reviewed and analyzed 291 (external validation) and 585 (development cohort) HER2-negative, ER-positive breast cancer patients. Cox regression analysis, both multivariate and univariate, confirmed the independence indicators for OS and DFS.

RESULTS

Using cox regression analysis, both multivariate and univariate, the following variables were combined to predict the DFS of development cohort: pathological stage (HR = 1.391; 95% CI = 1.043-1.855; P value = 0.025), luminal parting (HR = 1.836; 95% CI = 1.142-2.952; P value = .012), and clinical stage (HR = 1.879; 95% CI = 1.102-3.203; P value = 0.021). Endocrine therapy (HR = 3.655; 95% CI = 1.084-12.324; P value = 0.037) and clinical stage (HR = 6.792; 95% CI = 1.672-28.345; P value = 0.009) were chosen as predictors of OS. Furthermore, we generated RS-OS and RS-DFS. According to the findings of Kaplan-Meier curves, patients who are classified as having a low risk have considerably longer DFS and OS durations than patients who are classified as having a high risk.

CONCLUSION

To generate nomograms that predicted DFS and OS, independent predictors of DFS in ER-positive/HER2-negative breast cancer patients were chosen. The nomograms successfully stratified patients into prognostic categories and worked well in both internal validation and external validation.

Comprehensive Need as a Mediator Between Psychological Stress and Quality of Life Among Caregivers of Patients With Cancer

BACKGROUND

Caregivers of patients with cancer are susceptible to profound psychological distress and low quality of life owing to the substantial demands of caregiving. The comprehensive needs of caregivers are closely linked to their quality of life. However, little is known about the relationship between these factors.

OBJECTIVE

This study aimed to determine whether comprehensive needs mediate the relationships between psychological stress and quality of life in caregivers of patients with cancer.

METHODS

A cross-sectional design was used to recruit 382 participants through convenience sampling. Psychological stress, comprehensive needs, and quality of life were measured using a questionnaire.

RESULTS

Psychological stress was associated with higher comprehensive needs (r = 0.30, P < .01) and lower quality of life (r = -0.20, P < .01). Comprehensive needs were negatively associated with quality of life (r = -0.28, P < .01). Mediation analysis findings revealed that both the indirect effect of psychological stress on quality of life via comprehensive needs (β = -0.10; P < .001) and its direct effect on quality of life (β = -0.16; P < .01) were statistically significant, suggesting a partial mediatory effect of comprehensive needs between psychological stress and quality of life.

CONCLUSIONS

Our findings suggest that reducing psychological stress can improve quality of life by promoting satisfaction with comprehensive needs.

IMPLICATIONS FOR PRACTICE

Interventions that help reduce psychological stress and meet the comprehensive needs of caregivers of patients with cancer can improve their quality of life.

Candidate Regulatory Genes for Hindlimb Development in the Embryos of the Chinese Alligator (Alligator sinensis)

Crocodilians, which are a kind of animal secondary adaptation to an aquatic environment, their hindlimb can provide the power needed to engage in various life activities, even in low-oxygen water environments. The development of limbs is an important aspect of animal growth and development, as it is closely linked to body movement, support, heat production, and other critical functions. For the Chinese alligator, the hindlimb is one of the main sources of power, and its development and differentiation will directly influence the survival ability in the wild. Furthermore, a better understanding of the hindlimb developmental process will provide data support for the comparative evolutionary and functional genomics of crocodilians. In this study, the expression levels of genes related to hindlimb development in the Chinese alligator embryos during fetal development (on days 29, 35, 41, and 46) were investigated through transcriptome analysis. A total of 1675 differentially expressed genes (DEGs) at different stages were identified by using limma software. These DEGs were then analyzed using weighted correlation network analysis (WGCNA), and 4 gene expression modules and 20 hub genes were identified that were associated with the development of hindlimbs in the Chinese alligator at different periods. The results of GO enrichment and hub gene expression showed that the hindlimb development of the Chinese alligator embryos involves the development of the embryonic structure, nervous system, and hindlimb muscle in the early stage (H29) and the development of metabolic capacity occurs in the later stage (H46). Additionally, the enrichment results showed that the AMPK signaling pathway, calcium signaling pathway, HIF-1 signaling pathway, and neuroactive ligand-receptor interaction are involved in the development of the hindlimb of the Chinese alligator. Among these, the HIF-1 signaling pathway and neuroactive ligand-receptor interaction may be related to the adaptation of Chinese alligators to low-oxygen environments. Additionally, five DEGs (CAV1, IRS2, LDHA, LDB3, and MYL3) were randomly selected for qRT-PCR to verify the transcriptome results. It is expected that further research on these genes will help us to better understand the process of embryonic hindlimb development in the Chinese alligator.

Enantioselective SN 2 Alkylation of Homoenolates by N-Heterocyclic Carbene Catalysis

The functionalization of the β-carbon of enals with electrophiles is a signature umpolung reactivity of N-heterocyclic carbene (NHC) derived homoenolates. However, only a limited number of electrophiles are shown to be compatible, with most of them being π-electrophiles. In this study, the successful enantioselective β-alkylation of homoenolates is reported using Csp3 electrophiles through an SN 2 strategy. The protocol shows a broad scope regarding alkyl electrophiles, delivering good yields, and excellent enantioselectivities (up to 99% ee). It enables the installation of drug-like structural motifs in either enals or alkylating agents, demonstrating its potential as a valuable tool for late-stage modification. Furthermore, a concise synthetic route is presented to chiral pyrroloindoline-type skeletons. Preliminary mechanistic studies support a direct SN 2 mechanism.

Generation of a FLNA knockout hESC line (WAe009-A-P) to model cardiac valvular dysplasia using CRISPR/Cas9

The FLNA gene encodes the cytoskeletal protein filamin A which plays a key role in the structure and function of the cardiac valves. Truncating FLNA mutations are associated with cardiac valvular dysplasia. To further understand the exact role of FLNA in this disease, we have generated a human FLNA knockout cell line from H9 using CRISPR/Cas9 technology in this study. This cell line WAe009-A-P has a 2 bp deletion in the exon 2 of FLNA gene which resulted in a frameshift in the translation of FLNA and no FLNA protein was detected in this cell line. Moreover, WAe009-A-P also expressed pluripotency markers, had a normal female karyotype (46XX) and maintained the ability to differentiate into the three germ layers in vitro.

The association between circulatory, local pancreatic PCSK9 and type 2 diabetes mellitus: The effects of antidiabetic drugs on PCSK9

Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a potent modulator of cholesterol metabolism and plays a crucial role in the normal functioning of pancreatic islets and the progression of diabetes. Islet autocrine PCSK9 deficiency can lead to the enrichment of low-density lipoprotein (LDL) receptor (LDLR) and excessive LDL cholesterol (LDL-C) uptake, subsequently impairing the insulin secretion in β-cells. Circulatory PCSK9 levels are primarily attributed to hepatocyte secretion. Notably, anti-PCSK9 strategies proposed for individuals with hypercholesterolemia chiefly target liver-derived PCSK9; however, these anti-PCSK9 strategies have been associated with the risk of new-onset diabetes mellitus (NODM). In the current review, we highlight a new direction in PCSK9 inhibition therapy strategies: screening candidates for anti-PCSK9 from the drugs used in type 2 diabetes mellitus (T2DM) treatment. We explored the association between circulating, local pancreatic PCSK9 and T2DM, as well as the relationship between PCSK9 monoclonal antibodies and NODM. We discussed the emergence of artificial and natural drugs in recent years, exhibiting dual benefits of antidiabetic activity and PCSK9 reduction, confirming that the diverse effects of these drugs may potentially impact the progression of diabetes and associated disorders, thereby introducing novel avenues and methodologies to enhance disease prognosis.

RHO OF PLANT proteins are essential for pollen germination in Arabidopsis

Pollen germination is a process of polarity establishment, through which a single and unique growth axis is established. Although most of the intracellular activities associated with pollen germination are controlled by RHO OF PLANTs (ROPs) and increased ROP activation accompanies pollen germination, a critical role of ROPs in this process has not yet been demonstrated. Here, by genomic editing of all 4 Arabidopsis (Arabidopsis thaliana) ROPs that are preferentially expressed in pollen, we showed that ROPs are essential for polarity establishment during pollen germination. We further identified and characterized 2 ROP effectors in pollen germination (REGs) through genome-wide interactor screening, boundary of ROP domain (BDR) members BDR8 and BDR9, whose functional loss also resulted in no pollen germination. BDR8 and BDR9 were distributed in the cytosol and the vegetative nucleus of mature pollen grains but redistributed to the plasma membrane (PM) of the germination site and to the apical PM of growing pollen tubes. We demonstrated that the PM redistribution of BDR8 and BDR9 during pollen germination relies on ROPs but not vice versa. Furthermore, enhanced expression of BDR8 partially restored germination of rop1 pollen but had no effects on that of the quadruple rop pollen, supporting their genetic epistasis. Results presented here demonstrate an ROP signaling route essential for pollen germination, which supports evolutionarily conserved roles of Rho GTPases in polarity establishment.

Effects of remote ischemic preconditioning on coronary blood flow and microcirculation

This study aimed to determine the effect of short-term remote ischemic preconditioning (RIPC) on coronary blood flow and microcirculation function using the quantitative flow ratio (QFR) and index of microcirculatory resistance (IMR). We randomly divided 129 patients undergoing coronary angiography (CAG) into RIPC and control groups. Following the first CAG, we randomly divided the patients further into the unilateral upper limb and lower limb groups for four cycles of ischemia/reperfusion circulation; subsequently, we performed the second CAG. During each CAG, contrast-flow QFR (cQFR), fixed-flow QFR (fQFR), and IMR (in patients with cardiac syndrome X) were calculated and compared. We measured 253 coronary arteries in 129 patients. Compared to the control group, the average cQFR of the RIPC group increased significantly after RIPC. Additionally, 23 patients with cardiac syndrome X (IMR > 30) were included in this study. Compared to the control group, IMR and the difference between cQFR and fQFR (cQFR-fQFR) both decreased significantly after receiving RIPC. The application of RIPC can increase coronary blood flow and improve coronary microcirculation function.

DNMT3B activates FGFR3-mediated endoplasmic reticulum stress by regulating PTPN2 promoter methylation to promote the development of atherosclerosis

Endoplasmic reticulum (ER) stress is closely associated with atherosclerosis (AS). Nevertheless, the regulatory mechanism of ER stress in endothelial cells during AS progression is unclear. Here, the role and regulatory mechanism of DNA (cytosine-5-)- methyltransferase 3 beta (DNMT3B) in ER stress during AS progression were investigated. ApoE^-/- mice were fed with high fat diet to construct AS model in vivo. HE and Masson staining were performed to analyze histopathological changes and collagen deposition. HUVECs stimulated by ox-LDL were used as AS cellular model. Cell apoptosis was examined using flow cytometry. DCFH-DA staining was performed to examine ROS level. The levels of pro-inflammatory cytokines were assessed using ELISA. In addition, MSP was employed to detect PTPN2 promoter methylation level. Our results revealed that DNMT3B and FGFR3 were significantly upregulated in AS patient tissues, whereas PTPN2 was downregulated. PTPN2 overexpression attenuate ox-LDL-induced ER stress, inflammation and apoptosis in HUVECs and ameliorated AS symptoms in vivo. PTPN2 could suppress FGFR3 expression in ox-LDL-treated HUVECs, and FGFR3 knockdown inhibited ER stress to attenuate ox-LDL-induced endothelial cell apoptosis. DNMT3B could negatively regulate PTPN2 expression and positively FGFR2 expression in ox-LDL-treated HUVECs; DNMT3B activated FGFR2 expression by increasing PTPN2 promoter methylation level. DNMT3B downregulation repressed ox-LDL-induced ER stress, inflammation and cell apoptosis in endothelial cells, which was reversed by PTPN2 silencing. DNMT3B activated FGFR3-mediated ER stress by increasing PTPN2 promoter methylation level and suppressed its expression, thereby boosting ER stress to facilitate AS progression.

G-protein couple receptor (GPER1) plays an important role during ovarian folliculogenesis and early development of the Chinese Alligator

The critical role of the G protein-coupled receptor 1 (GPER1), a member of the seven-transmembrane G protein-coupled receptor family, in the functional regulation of oocytes accumulated abundant theories in the early research on model animals. However, the full-length cDNA encoding GPER1 and its role in the folliculogenesis has not been illustrated in crocodilians. 0.5, 3, and 12 months old Alligator sinensis cDNA samples were used to clone the full-length cDNA encoding GPER1. Immunolocalization and quantitative analysis were performed using Immunofluorescence technique, RT-PCR and Western blot. Simultaneously, studies on GPER1's promoter deletion and cis-acting transcriptional regulation mechanism were conducted. Immunolocalization staining for the germline marker DDX4 and GPER1 demonstrated that DDX4-positive oocytes were clustered tightly together within the nests, whereas scarcely any detectable GPER1 was present in the oocytes nest in Stage I. After that, occasionally GPER1-positive immunosignal was observed in oocytes and somatic cells additional with the primordial follicles, and it was mainly located at the granulosa cells or thecal cells within the early PFs in the Stage III. The single mutation of the putative SP1 motif, double mutating of Ets/SP1 and SP1/CRE binding sites all depressed promoter activities. This result will help to investigate the role of GPER1 in the early folliculogenesis of A. sinensis.

Discovery and Structure-Based Design of Inhibitors of the WD Repeat-Containing Protein 5 (WDR5)-MYC Interaction

WDR5 is a critical chromatin cofactor of MYC. WDR5 interacts with MYC through the WBM pocket and is hypothesized to anchor MYC to chromatin through its WIN site. Blocking the interaction of WDR5 and MYC impairs the recruitment of MYC to its target genes and disrupts the oncogenic function of MYC in cancer development, thus providing a promising strategy for the treatment of MYC-dysregulated cancers. Here, we describe the discovery of novel WDR5 WBM pocket antagonists containing a 1-phenyl dihydropyridazinone 3-carboxamide core that was identified from high-throughput screening and subsequent structure-based design. The leading compounds showed sub-micromolar inhibition in the biochemical assay. Among them, compound 12 can disrupt WDR5-MYC interaction in cells and reduce MYC target gene expression. Our work provides useful probes to study WDR5-MYC interaction and its function in cancers, which can also be used as the starting point for further optimization toward drug-like small molecules.

Canonical Rab5 GTPases are essential for pollen tube growth through style in Arabidopsis

Pollen tubes have dynamic tubular vacuoles. Functional loss of AP-3, a regulator of one vacuolar trafficking route, reduces pollen tube growth. However, the role of canonical Rab5 GTPases that are responsible for two other vacuolar trafficking routes in Arabidopsis pollen tubes is obscure. By using genomic editing, confocal microscopy, pollen tube growth assays, and transmission electron microscopy, we demonstrate that functional loss of canonical Rab5s in Arabidopsis, RHA1 and ARA7, causes the failure of pollen tubes to grow through style and thus impairs male transmission. Functional loss of canonical Rab5s compromises vacuolar trafficking of tonoplast proteins, vacuolar biogenesis, and turgor regulation. However, rha1;ara7 pollen tubes are comparable to those of wild-type in growing through narrow passages by microfluidic assays. We demonstrate that functional loss of canonical Rab5s compromises endocytic and secretory trafficking at the plasma membrane (PM), whereas the targeting of PM-associated ATPases is largely unaffected. Despite that, rha1;ara7 pollen tubes contain a reduced cytosolic pH and disrupted actin microfilaments, correlating with the mis-targeting of vacuolar ATPases (VHA). These results imply a key role of vacuoles in maintaining cytoplasmic proton homeostasis and in pollen tube penetrative growth through style.

Evaluation of early liquid drinking after radical gastrectomy in gastric cancer: a Chinese multicenter propensity score matching analysis

Background

Enhanced recovery after surgery is used in gastrointestinal surgery. This study aimed to access the effects of early liquid drinking (ELD) on gastrointestinal function recovery in patients with gastric cancer (GC) who underwent radical gastrectomy, as high-quality evidence on the outcomes of ELD after gastrectomy is currently lacking.

Methods

Clinicopathological data of patients with GC from 11 centers were retrospectively analysed. Clinical outcomes were investigated in 555 patients, including 225 who started drinking liquid within 48 h (ELD group) of surgery and 330 who started drinking liquid after flatus resumption (traditional liquid drinking [TLD] group). Propensity score matching (PSM) analysis was performed using a match ratio of 1:1 and 201 patients were selected from each group for the analysis. Primary outcome was time to first passage of flatus. Secondary outcomes included time to first defecation, post-operative hospitalization days, occurrence of short-term post-operative complications, and hospitalization costs.

Results

After PSM, baseline characteristics were not significantly different between the two groups. The time to first flatus (2.72 ± 1.08 vs 3.36 ± 1.39 days), first defecation (4.34 ± 1.85 vs 4.77 ± 1.61 days), and post-operative hospital stay (8.27 ± 4.02 vs 12.94 ± 4.43 days) were shorter in the ELD group than in the TLD group (all P < 0.05). The ELD group had lower hospitalization costs than the TLD group ([7.83 ± 2.44 vs 8.78 ± 3.41] × 10⁴ RMB, P = 0.041). No significant differences were observed in the incidence of post-operative complications.

Conclusions

Compared with TLD, post-operative ELD could promote rapid recovery of gastrointestinal function and reduce hospitalization costs; moreover, ELD does not increase the risk of post-operative complications.

Optimal postoperative surveillance strategies for cancer survivors with gastric neuroendocrine carcinoma based on individual risk: a multicenter real-world cohort study

BACKGROUND

The best follow-up strategy for cancer survivors after treatment should balance the effectiveness and cost of disease detection while detecting recurrence as early as possible. Due to the low incidence of gastric neuroendocrine carcinoma and mixed adenoneuroendocrine carcinoma [G-(MA)NEC], high-level evidence-based follow-up strategies is limited. Currently, there is a lack of consensus among clinical practice guidelines regarding the appropriate follow-up strategies for patients with resectable G-(MA)NEC.

MATERIALS AND METHODS

The study included patients diagnosed with G-(MA)NEC from 21 centers in China. The random forest survival model simulated the monthly probability of recurrence to establish an optimal surveillance schedule maximizing the power of detecting recurrence at each follow-up. The power and cost-effectiveness were compared with the National Comprehensive Cancer Network, European Neuroendocrine Tumor Society, and European Society for Medical Oncology Guidelines.

RESULTS

A total of 801 patients with G-(MA)NEC were included. The patients were stratified into four distinct risk groups utilizing the modified TNM staging system. The study cohort comprised 106 (13.2%), 120 (15.0%), 379 (47.3%), and 196 cases (24.5%) for modified groups IIA, IIB, IIIA, and IIIB, respectively. Based on the monthly probability of disease recurrence, the authors established four distinct follow-up strategies for each risk group. The total number of follow-ups 5 years after surgery in the four groups was 12, 12, 13, and 13 times, respectively. The risk-based follow-up strategies demonstrated improved detection efficiency compared to existing clinical guidelines. Further Markov decision-analytic models verified that the risk-based follow-up strategies were better and more cost-effective than the control strategy recommended by the guidelines.

CONCLUSIONS

This study developed four different monitoring strategies based on individualized risks for patients with G-(MA)NEC, which may improve the detection power at each visit and were more economical, effective. Even though our results are limited by the biases related to the retrospective study design, we believe that, in the absence of a randomized clinical trial, our findings should be considered when recommending follow-up strategies for G-(MA)NEC.

Validation of the 7-Item Domain-General Gambling Harm Scale (DGHS-7)

Introduction

Gambling can cause negative consequences affecting finances, work/study, physical and mental health, relationships, law abidingness, and the community. Although existing measures enable investigations of gambling harms, there is still a need for a brief measure covering the full range of gambling related harms.

Methods

We validated a 7-item domain-general harm scale (DGHS-7) using data from a cross-sectional survey of United Kingdom residents reporting gambling within the last 12 months (n = 2558, 62.4% women, mean age 40.1 years (SD = 12.5)). The DGHS-7 was investigated in terms of factor structure, measurement invariance, and convergent validity with a comprehensive 72-item checklist of gambling harm, the Short Gambling Harms Screen (SGHS), and the Problem Gambling Severity Index (PGSI). Discriminative validity was checked against the Personal Wellbeing Index (PWI). Internal consistency was also calculated.

Results

Confirmatory factor analysis supported a one-factor solution (χ² = 136.991, df = 14, χ²/df = 9.785, p <.001, CFI = 0.999, RMSEA = 0.059, 90% CI [0.050, 0.068]). Measurement invariance was supported for gender and binary categorization of age and income (ΔCFI = 0.001). The DGHS-7 correlated strongly with the 72-item checklist (r_s = 0.824), the SGHS (r_s = 0.793), the PGSI (r_s = 0.768), and moderately with the PWI (r_s = -0.303). Cronbach's alpha = 0.91 and ordinal alpha = 0.96 indicated good internal consistency.

Conclusions

Psychometric support was found for a brief measure covering all recognized domains of gambling harm. The DGHS-7 is useful for researchers needing a generic and short measure for epidemiological and other studies calling for short scales.

Mindfulness-based stress reduction combined with early cardiac rehabilitation improves negative mood states and cardiac function in patients with acute myocardial infarction assisted with an intra-aortic balloon pump: a randomized controlled trial

Objective

To investigate the clinical effects of mindfulness-based stress reduction (MBSR) intervention combined with early cardiac rehabilitation (CR) on patients with acute myocardial infarction (AMI) assisted with an intra-aortic balloon pump (IABP).

Methods

A total of 100 AMI patients with IABP assistance due to hemodynamic instability at Wuhan Asia Heart Hospital were enrolled in the study. The participants were divided into two groups using the random number table method (n = 50 each group). Patients receiving routine CR were assigned to the CR control group, while patients receiving MBSR plus CR were assigned to the MBSR intervention group. The intervention was performed twice a day until the removal of the IABP (5-7 days). Each patient's level of anxiety/depression and negative mood state were evaluated before and after intervention using the self-rating anxiety scale (SAS), self-rating depression scale (SDS), and profiles of mood state scale (POMS). The results of the control and intervention groups were compared. IABP-related complications and left ventricular ejection fraction (LVEF), measured with echocardiography, were also assessed and compared between the two groups.

Results

The SAS, SDS, and POMS scores were lower in the MBSR intervention group than in the CR control group (P < 0.05). There were also less IABP-related complications in the MBSR intervention group. LVEF was significantly improved in both groups, but the degree of LVEF improvement was more significant in the MBSR intervention group than in the CR control group (P < 0.05).

Conclusions

MBSR combined with early CR intervention can assist in alleviating anxiety, depression, and other negative mood states, reduce IABP-related complications, and further improve cardiac function in AMI patients with IABP assistance.

Spatial-temporal patterns of high-temperature and drought during the maize growing season under current and future climate changes in Northeast China

BACKGROUND

Under the background of global warming, the intensity and frequency of extreme meteorological events in the maize growing season in Northeast China are increasing. In order to clarify the occurrence characteristics of extreme meteorological events in Northeast China, this study focused on three extreme agrometeorological events, i.e., high temperatures, drought, and the compound events of high-temperature and drought during the maize growing season (May to September), impacting maize production in Northeast China.

RESULTS

Based on historical (1981-2017) and future (2021-2060) climate data, we analyzed the spatial-temporal patterns of these three events with different intensities in Northeast China. The results indicated that slight high temperatures and moderate and severe droughts occurred more frequently in the study area during the historical period. The frequency of the different grades of the compound events of high-temperature and drought will exhibit an increasing trend in the future, as will the frequency of the compound events of high-temperature and drought. This is particularly evident in the northwest of the study area.

CONCLUSION

The compound events of high-temperature and drought mainly occurred in late July and early August, encompassing the flowering stage of early-, middle-, and late-maturing maize varieties. It is important to identify the area and time of major extreme weather events to implement the necessary preventive measures. This article is protected by copyright. All rights reserved.

A p-orbital honeycomb-Kagome lattice realized in a two-dimensional metal-organic framework

The experimental realization of p-orbital systems is desirable because p-orbital lattices have been proposed theoretically to host strongly correlated electrons that exhibit exotic quantum phases. Here, we synthesize a two-dimensional Fe-coordinated bimolecular metal-organic framework which constitutes a honeycomb lattice of 1,4,5,8,9,12-hexaazatriphenylene molecules and a Kagome lattice of 5,15-di(4-pyridyl)-10,20-diphenylporphyrin molecules on a Au(111) substrate. Density-functional theory calculations show that the framework features multiple well-separated spin-polarized Kagome bands, namely Dirac cone bands and Chern flat bands, near the Fermi level. Using tight-binding modelling, we reveal that these bands are originated from two effects: the low-lying molecular orbitals that exhibit p-orbital characteristics and the honeycomb-Kagome lattice. This study demonstrates that p-orbital Kagome bands can be realized in metal-organic frameworks by using molecules with molecular orbitals of p-orbital like symmetry.

Pan-Cancer Analysis of Prognostic and Immune Infiltrates for the TMEM65, Especially for the Breast Cancer

Introduction

Transmembrane protein 65 (TMEM65) is an inner mitochondrial membrane protein, which played important role in mediating autophagy, smooth muscle contraction, protein glycosylation, and immune response. In recent years, the interest had risen for exploring the function of the TMEM genes in the cancer fields. As a consequence, in our pan-cancer research of the TMEM65, we explored the function of the gene in kinds of database and tried to apply the finding in the clinical practice.

Methods

In this research, we provide a comprehensive investigation of TMEM65 expression in a pan-cancer manner containing 33 cancer types. We evaluated the association of TMEM65 with the prognosis, immune infiltration, drug sensitivity analysis, GSVA enrichment analysis, TMB, MSI, NEO, and hotspot mechanisms.

Results

TMEM65 was abnormally expressed in 24 types of cancers and showed correlation with the OS for 6 cancers and PFI for 9 cancers and kpI for 3 types. Moreover, the TME score, CD8 T effector, and immune checkpoint scoring systems showed a close correlation with the TMEM65. Moreover, TMEM65 was strongly correlated with some of the most common tumor-related genes and certain pathways (TGF beta signaling, TNFA signaling, hypoxia, pyroptosis, DNA repairing, autophagy, ferroptosis, and other related genes). Additionally, the TMEM65 showed correlations with the tumor mutational burden (TMB), microsatellite instability (MSI), NEO, and drug sensitivity. Finally, we confirmed several pathways by the GSEA and GSVA for the TMEM65 at the breast cancer aspects. Nomogram prediction model was also established for the breast tumors based on the TMEM65 level and other variables.

Conclusion

Above all, the TMEM65 played important roles in predicting the prognosis of the cancers and correlated with the tumor immunity in the pan-cancer analysis.

Mechanism of Resistance to the WDR5 Inhibitor in MLL-Rearranged Leukemia

Drug resistance is a major problem often limiting the long-term effectiveness of targeted cancer therapeutics. Resistance can be acquired through mutations or amplification of the primary drug targets or activation of bypass signaling pathways. Considering the multifaceted function of WDR5 in human malignancies, WDR5 has emerged as an attractive drug target for the discovery of small-molecule inhibitors. In this study, we investigated if cancer cells might develop resistance to a highly potent WDR5 inhibitor. We established a drug-adapted cancer cell line and discovered that WDR5^P173L mutation occurs in the resistant cells, which confers resistance by preventing target engagement of the inhibitor. This work elucidated the WDR5 inhibitor's potential resistance mechanism in a preclinical study as a reference for future study in the clinical stage.

Microbial community structure dynamics of invasive bullfrog with meningitis-like infectious disease

Meningitis-like infectious disease (MID) (also known as frog cataract and torticollis) is a disease prone to occur in amphibians and reptiles. It is highly contagious and has a high mortality rate. In this study, we sampled and sequenced microbiomes from oral and intestinal samples of five normal and five diseased bullfrogs. The analysis found that the richness, uniformity, and abundance of the microbial community of the diseased bullfrogs were significantly higher than those of the normal bullfrogs in both the oral cavity and the gut. In the diseased group, the abundance of Elizabethkingia significantly increased and that of Lactococcus significantly decreased. It showed that the structure of the microbial community had changed a lot in diseased frogs. After the pathogenic bacteria infected the body, it might be make the decline in the immune function of the body declined, and resulting in some conditional pathogenic bacteria in the water body further infecting the body. As a result, the richness and composition of the microbial community significantly changed. This study can provide a theoretical basis for the control of MID of bullfrogs.

Experimental study of the dielectric properties of energy-containing materials at variable temperatures

Due to the inherent material characteristics of fireworks and negligent safety management, safety accidents have occurred in recent years, resulting in significant personal and property losses. Therefore, the status inspection of fireworks and other energy-containing materials is a hot issue in the field of energy-containing materials production, storage, transportation, and application. The dielectric constant is a parameter used to characterize the interaction between materials and electromagnetic waves. The methods of obtaining this parameter in the microwave band are not only numerous but also fast and easy. Thus, the real-time status of energy-containing materials can be monitored by monitoring their dielectric properties. Usually, temperature variation has an important effect on the state of energy-containing materials, and the accumulation of temperature can directly cause energy-containing materials to burn or even explode. Based on the above background, this paper proposes a method for testing the dielectric properties of energy-containing materials under variable temperature conditions based on the resonant cavity perturbation theory, which provides important theoretical support for testing the state of energy-containing materials under variable temperatures. Based on the constructed test system, the law of the variation of the dielectric constant of black powder with temperature was obtained, and the theoretical analysis of the test results was carried out. Experimental results show that the temperature change will induce chemical changes in the black powder material, specifically in its dielectric properties, and the magnitude of the changes is large, which is very conducive to real-time monitoring of the black powder state. The system and method developed in this paper can be used to obtain the high-temperature evolution of the dielectric properties of other types of energy-containing materials and provide technical support for the safe production, storage, and application of various types of energy-containing materials.

Loss of Wdr5 attenuates MLL-rearranged leukemogenesis by suppressing Myc targets

WD repeat domain 5 (WDR5) is a prominent target for pharmacological inhibition in cancer through its scaffolding role with various oncogenic partners such as MLL and MYC. WDR5-related drug discovery efforts center on blocking these binding interfaces or degradation have been devoted to developing small-molecule inhibitors or degraders of WDR5 for cancer treatment. Nevertheless, the precise role of WDR5 in these cancer cells has not been well elucidated genetically. Here, by using an MLL-AF9 murine leukemia model, we found that genetically deletion of Wdr5 impairs cell growth and colony forming ability of MLL-AF9 leukemia cells in vitro or ex vivo and attenuates the leukemogenesis in vivo as well, which acts through direct regulation of ribosomal genes. Pharmacological inhibition of Wdr5 recapitulates genetic study results in the same model. In conclusion, our current study demonstrated the first genetic evidence for the indispensable role of Wdr5 in MLL-r leukemogenesis in vivo, which supports therapeutically targeting WDR5 in MLL-rearranged leukemia by strengthening its disease linkage genetically and deepening insights into its mechanism of action.

Discovery of Potent Small-Molecule Inhibitors of WDR5-MYC Interaction

WD repeat domain 5 (WDR5) is a member of the WD40-repeat protein family that plays a critical role in multiple processes. It is also a prominent target for pharmacological inhibition in diseases such as cancer, aging, and neurodegenerative disorders. Interactions between WDR5 and various partners are essential for sustaining its function. Most drug discovery efforts center on the WIN (WDR5 interaction motif) site of WDR5 that is responsible for the recruitment of WDR5 to chromatin. Here, we describe the discovery of novel WDR5 inhibitors for the other WBM (WDR5 binding motif) pocket on this scaffold protein, to disrupt WDR5 interaction with its binding partner MYC by high-throughput biochemical screening, subsequent molecule optimization, and biological assessment. These new WDR5 inhibitors provide useful probes for future investigations of WDR5 and an avenue for targeting WDR5 as a therapeutic strategy.

Signaling network controlling ROP-mediated tip growth in Arabidopsis and beyond

Cell polarity operates across a broad range of spatial and temporal scales and is essential for specific biological functions of polarized cells. Tip growth is a special type of polarization in which a single and unique polarization site is established and maintained, as for the growth of root hairs and pollen tubes in plants. Extensive studies in past decades have demonstrated that the spatiotemporal localization and activity of Rho of Plants (ROPs), the only class of Rho GTPases in plants, are critical for tip growth. ROPs are switched on or off by different factors to initiate dynamic intracellular activities, leading to tip growth. Recent studies have also uncovered several feedback modules for ROP signaling. In this review, we summarize recent progress on ROP signaling in tip growth, focusing on molecular mechanisms that underlie the dynamic distribution and activity of ROPs in Arabidopsis. We also highlight feedback modules that control ROP-mediated tip growth and provide a perspective for building a complex ROP signaling network. Finally, we provide an evolutionary perspective for ROP-mediated tip growth in Physcomitrella patens and during plant-rhizobia interaction.

Addition of Alcohols onto Electron Deficient Heteroarenium Salts: A Reversible Covalent Bonding Process under Basic Condition

The reversible addition of benzyl alcohol onto heteroarenium salts under basic conditions was studied. The fine-tuning of the arenium nature and substituents allowed the discovery of a range of pyrimidinium substrates that can undergo C6-selective alcohol addition. Cross-over experiments were also performed to confirm the addition-elimination equilibrium under basic conditions.

On-surface synthesis and spontaneous segregation of conjugated tetraphenylethylene macrocycles

Creating conjugated macrocycles has attracted extensive research interest because their unique chemical and physical properties, such as conformational flexibility, intrinsic inner cavities and aromaticity/antiaromaticity, make these systems appealing building blocks for functional supramolecular materials. Here, we report the synthesis of four-, six- and eight-membered tetraphenylethylene (TPE)-based macrocycles on Ag(111) via on-surface Ullmann coupling reactions. The as-synthesized macrocycles are spontaneously segregated on the surface and self-assemble as large-area two-dimensional mono-component supramolecular crystals, as characterized by scanning tunneling microscopy (STM). We propose that the synthesis benefits from the conformational flexibility of the TPE backbone in distinctive multi-step reaction pathways. This study opens up opportunities for exploring the photophysical properties of TPE-based macrocycles.

Characteristics of sludge-based pyrolysis biochar and its application of enhancing denitrification

A modified biochar for enhanced denitrification was developed through a facile pyrolysis method using sewage sludge as raw material and melamine as nitrogen source. Through electrochemical analysis, sludge-based pyrolysis biochar (SPBC) has superior electrical conductivity and poor redox activity. SPBC can increase the electron transfer through the geoconductor mechanism. The effect and the mechanism of SPBC on denitrification were studied. The nitrate treatment efficiency increased with the increase of SPBC dosage. From the perspective of molecular biology, the activities of NAR and NIR enzymes, the degradation efficiency of glucose and the ETSA of bacteria were all promoted with the increase of SPBC, thereby promoting the removal of NO₃^-. In addition, SPBC had a certain screening effect on microbial communities, and biodiversity decreased with the increase of SPBC dosage. Although the biodiversity decreased, the relative abundance of microorganisms conducive to denitrification increased with the increase of SPBC dosage. The transformation strategy of SPBC proposed in this paper provides a technical solution for sludge recycling and application for strengthening denitrification.

Diffusion Tensor Imaging Analysis Along the Perivascular Space Index in Primary Parkinson's Disease Patients With and Without Freezing of Gait

Parkinson's disease (PD) is a common neurodegeneration disease associated with the abnormal deposition and spread of misfolded proteins (α-synuclein and Tau protein), which progressively damages the glymphatic system. This research intended to investigate the activity of the glymphatic system in PD individuals with freezing of gait (PD-FOG) and PD patients without it (PD-nFOG), as well as their relationship to the clinical neural scale. Diffusion tensor imaging (DTI) was performed in 28 PD-FOG individuals, 31 PD-nFOG individuals, and 34 healthy controls (HC). The DTI analysis along the perivascular space (DTI-ALPS) index was computed after post-processing of DTI images, representing brain glymphatic functions. The DTI-ALPS index was assessed for the association with the clinical variables. Compared to the HC group, the DTI-ALPS index of both PD-FOG and PD-nFOG patients was significantly decreased; however, no notable difference was found between the PD-FOG and PD-nFOG group. In addition, the DTI-ALPS index of PD-nFOG patients were positively correlated with disease duration, Unified Parkinson's Disease Rating-III Right (UPDRS-III R), UPDRS-III TOTAL, UPDRS-IV. Taken together, these findings highlighted the weakening of function of the glymphatic system in PD individuals, which is associated with motor symptoms and treatment complications. We speculate that treatment aimed at enhancing the flow and clearance of the glymphatic system may alleviate clinical symptoms of PD.

Giant nonlinear Hall effect in twisted bilayer WSe2

The recently discovered nonlinear Hall effect (NHE) in a few non-interacting systems provides a novel mechanism for generating second harmonic electrical Hall signals under time-reversal-symmetric conditions. Here, we introduce a new approach to engineering NHE by using twisted moiré structures. We found that the twisted WSe2 bilayer exhibited a NHE when the Fermi level was tuned to the moiré flat bands. When the first moiré band was half-filled, the nonlinear Hall signal exhibited a sharp peak with a generation efficiency that was at least two orders of magnitude greater than those obtained in previous experiments. We discuss the possible origins of the diverging generation efficiency in twisted WSe2 based on resistivity measurements, such as moiré interface induced correlation effects and mass-diverging type continuous Mott transition. This study demonstrates not only how interaction effects can combine with Berry curvature dipoles to produce novel quantum phenomena, but also the potential of NHE measurements as a new tool for studying quantum criticality.

Measurement of complex permittivity of liquids in the frequency range 100-1000 MHz by using a re-entrant cavity

For many liquid materials and biological media, their complex permittivity varies with frequency in the P-band (100-1000 MHz). In this paper, a re-entrant coaxial cavity resonance test system with intensive multi-frequency points testing capability is designed for the P-band to realize the test of the complex permittivity of P-band materials. For this system, a test algorithm has been written, and on the basis of this system, a perturbation block has been designed, using stepper motors to control the up and down movement of the perturbation block to achieve frequency tunability of the cavity, enabling more P-band frequency test data to be obtained. The experimental results show that the system is suitable for testing the electrical parameters of P-band biological media and liquid materials and for testing solid materials in aerospace, electromagnetic shielding, and other fields where there is a great demand for P-band testing.

Phospholipid peroxidation inhibits autophagy via stimulating the delipidation of oxidized LC3-PE

Phospholipid peroxidation of polyunsaturated fatty acids at the bis-allylic position drives ferroptosis. Here we identify a novel role for phospholipid peroxidation in the inhibition of autophagy. Using in vitro and in vivo models, we report that phospholipid peroxidation induced by glutathione peroxidase-4 inhibition and arachidonate 15-lipoxygenase overexpression leads to overload of peroxidized phospholipids and culminate in inhibition of autophagy. Functional and lipidomics analysis further demonstrated that inhibition of autophagy was associated with an increase of peroxidized phosphatidylethanolamine (PE) conjugated LC3. We further demonstrate that autophagy inhibition occurred due to preferential cleavage of peroxidized LC3-PE by ATG4B to yield delipidated LC3. Mouse models of phospholipid peroxidation and autophagy additionally supported a role for peroxidized PE in autophagy inhibition. Our results agree with the recognized role of endoplasmic reticulum as the primary source for autophagosomal membranes. In summary, our studies demonstrated that phospholipid peroxidation inhibited autophagy via stimulating the ATG4B-mediated delipidation of peroxidized LC3-PE.

Permittivity measurement of the substrate by using the corrected differential phase method and quick-press test fixture

Permittivity is critical for analyzing electromagnetic propagation in the substrate. The differential phase method is desirable to measure the permittivity of the substrate. The actual measurement is usually required to be started at a low frequency to avoid the S₂₁-phase ambiguity problem. To get rid of this problem, the unwrapped S₂₁-phase is calculated accurately at any measurement frequency range. In the classical method of calculating the real permittivity from the effective permittivity, the calculation error increases gradually with increasing frequency, especially in an ultra-wide frequency range. To effectively reduce the error, the ratio of the calculated and real permittivity is used in the permittivity correction, which is a function with respect to frequency, dimension, and permittivity of the microstrip line. A two-step fitting process is proposed to reduce the dimension of the ratio function from three-dimension to two-dimension. Furthermore, a quick-press test fixture is designed for a more convenient measurement, which is characterized by no soldering requirement and ultra-wide frequency range. Compared with the stripline resonant method, in the proposed method, the maximum deviations of the four substrates are 0.035, -0.04, 0.07, and 0.13, in the frequency range of 1-40 GHz.

Risk factors of central area lymph nodes metastasis for guiding optimal right colon cancer surgery: A retrospective multicenter study.. [DOI: 10.21203/rs.3.rs-1991182/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0]

Background: D3 or CME lymphadenectomy for right colon cancer (RCC) with lymph nodes metastasis (LNM) is strongly recommended but the anatomical landmark remains controversial. Central LNM predicted poor prognosis in RCC and determined the extent of lymphadenectomy. Methods: Data for 1712 RCC patients treated with D3/CME lymphadenectomy were reviewed. These patients had been treated in 9 centers. A total of 1023 RCC patients were enrolled in the derivation cohort while 689 patients were enrolled in the validation cohort. Results: The overall central LNM incidence was 12.58% (215/1712). In the derivation cohort, univariate and multivariate cox regression analyses revealed that preoperative N staging based on CT scan (OR=7.85, 95% CI, 4.53-14.51, p<0.001), tumor differentiation (OR=0.53, 95% CI, 0.33-0.86, p=0.01) and intraoperative view of tumor movability (OR=0.53, 95% CI, 0.33-0.86, p=0.02) were significant independent factors. Areas under receiver-operating characteristic curves (AUC) for assessing central LNM in the derivation and validation cohorts were 0.802 and 0.750, respectively. The risk-scoring system for patients with RCC was also established. A score of 0 points was the optimal cut-off value for central LNM. Compared to patients in the low-risk group, patients in the high-risk group exhibited worse overall survival outcomes (p<0.001).Conclusions: The established model can be used for preoperative assessment of the risk of central LNM in RCC patients, and for determining the landmark for D3/CME lymphadenectomy, therefore might contribute to decreased therapeutic complications and improved clinical outcomes.

Simple Design of a Porous Solar Evaporator for Salt-Free Desalination and Rapid Evaporation

Solar-driven interfacial evaporation is considered to be one of the promising and efficient ways of producing clean water in recent years. However, it remains a challenge to develop solar evaporation devices with high solar evaporation rates and salt-free blocking properties. Here, a porous solar evaporator with directed water transport and salt-free desalination through excellent photothermal conversion and purposefully guided migration of the salt solution was developed. The designed porous photothermal sponge with the synergistic effect of MXene and polypyrrole can achieve evaporation rates of 1.47 and 2.27 kg m^-2 h^-1, respectively, in the capillary model and siphon model water-transporting solar evaporation devices. More interestingly, the designed zigzag-shaped device with an evaporation rate of 2.45 kg m^-2 h^-1 was achieved. In addition, the evaporator can operate stably under 9 h in the siphon model solar evaporation device and achieves the effect of salt-free desalination. The above design provides a good strategy for solar-powered desalination applications.

Asymptomatic mesh infection 6 years after laparoscopic totally extraperitoneal inguinal hernia repair: A rare case report

This report aims to discuss a case of asymptomatic mesh infection 6 years after laparoscopic totally extraperitoneal (TEP) inguinal hernia repair and to reveal that the risk of mesh infection may occur after a long period of this surgery. This report is also intended to suggest surgeons pay more attention to the follow‐up of such patients and to be aware of the possibility of mesh infection to assist in early diagnosis and treatment. A 63‐year‐old male patient, who underwent TEP inguinal hernia repair 6 years ago for right inguinal hernia, fell down accidentally 2 weeks ago. Enhanced computed tomography(CT) showed right lower abdomen cystic lesions, so he underwent laparoscopic surgery during which abscess caused by delayed mesh infection was found. After removing the mesh and abscess, he was discharged. The risk of mesh infection after TEP inguinal hernia repair is low, but it can last for more than 6 years and can even be asymptomatic as long as the mesh remains in the body.

Synthesis of Single-Layer Two-Dimensional Metal-Organic Frameworks M3 (HAT)2 (M=Ni, Fe, Co, HAT=1,4,5,8,9,12-hexaazatriphenylene) Using an On-Surface Reaction

1,4,5,8,9,12-Hexaazatriphenylene (HAT) is one of the smallest polyheterocyclic aromatic building blocks for forming conjugated metal-organic frameworks (cMOFs). However, the strong inter-molecular steric hindrance impedes the growth of HAT-based cMOFs. Here we employ on-surface synthesis to grow single-layer two-dimensional cMOFs of M₃ (HAT)₂ (M=Ni, Fe, Co). Using scanning tunnelling microscopy and density-functional theory (DFT) analysis, we resolve that the frameworks comprise a hexagonal lattice of HAT molecules and a Kagome lattice of metal atoms. The DFT analysis indicates that Ni, Co and Fe carry a magnetic moment of 1.1, 2.5, and 3.7 μB, respectively. We anticipate that the small π-conjugated core of HAT and strong bidentate chelating coordination give rise to appealing electronic and magnetic properties.