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0 ± 8.3 vs. 23.6 ± 17.8, P = 0.04), as was the length of hospital stay (30.1 ± 6.3 vs. 36.8 ± 16.7, P = 0.017). Furthermore, when the defect size was ≥ 4 mm, the time to clinical success, hospital stay, and hospital cost in the experimental group were lower than those in the control group (P  less then  0.05). Placement of a new gastrointestinal decompression tube is a safe treatment. When the defect size is ≥ 4 mm, the time to clinical success, length of hospital stay, and hospital cost can be reduced.

Despite widespread adoption and technological advances in laparoscopic liver resection (LLR), conversion to laparotomy can still occur unexpectedly. Several studies have explored risk factors of open conversion (OC). However, most of these studies were conducted before 2018 and included all patients who underwent surgery at an early stage after starting LLR. The purpose of this study was to analyze the incidence and risk factors of OC in patients within the past 5years (2017-2021).

Patients who underwent LLR at Samsung Medical Center from January 2017 to December 2021 were investigated. The incidence and causes of OC were investigated and risk factors associated with OC were also analyzed.

A total of, 1951 patients were investigated. OC was observed in 34 patients (1.74%). The percentage of previous surgeries (50% vs. 25.5%, P < 0.001), history of hepatectomy (23.5% vs. 5.4%, P = 0.002), multi-focal disease (29.4% vs. 13.9%, P = 0.037), and posterosuperior (PS) location (64.7% vs. 39%, P = 0.004) were higher in the OC group. The most common cause of OC was adhesion (44.1%). In the analysis of risk factors associated with OC, PS location (OR 2.79, P = 0.007) and maximum tumor size (OR 0.92, P = 0.037) were statistically significant factors in multivariate analysis.

The updated incidence of OC was 1.74%. The main cause of OC was adhesion. In addition, PS location and smaller tumor size were risk factors associated with OC.

The updated incidence of OC was 1.74%. The main cause of OC was adhesion. In addition, PS location and smaller tumor size were risk factors associated with OC.

Delayed gastric conduit emptying can occur after esophagectomy and has been shown to be associated with increased risk for postoperative complications. Application of a standardized clinical protocol after esophagectomy including an upper gastrointestinal contrast study has the potential to improve postoperative outcomes.

Prospective cohort including all patients operated with esophagectomy at two high-volume centers for esophageal surgery. The standardized clinical protocol included an upper gastrointestinal contrast study on day 2 or 3 after surgery. All images were compiled and evaluated for the purpose of the study. Clinical data was collected in IRB approved institutional databases at the participating centers.

The study included 119 patients treated with esophagectomy of whom 112 (94.1%) completed an upper gastrointestinal contrast study. The results showed that 8 (7.1%) patients had radiological delayed gastric conduit emptying defined as no emptying of contrast through the pylorus. Partial condual contrast studies can be used to assess the level of emptying of the gastric conduit after esophagectomy. Application of upper gastrointestinal contrast study in the ERAS guidelines-driven standardized clinical pathway after esophagectomy has the potential to improve postoperative outcomes.

Although international guidelines recommend not fixing the mesh in almost all cases of laparoendoscopic repairs, in case of large direct hernias (M3) mesh fixation is recommended to reduce recurrence risk. Despite lack of high-quality evidence, the recommendation was upgraded to strong by expert panel. The authors conducted a research experiment to verify the hypothesis that it is possible to preserve the mesh in the operating field in large direct hernias (M3) without the need to use fixing materials.

The authors conducted an experiment with scientists from Universities of Technology in a model that reflects the conditions in the groin area. By simulating conditions of the highest possible intra-abdominal pressure, they examined the mesh behavior within the groin and its ability to dislocate under the forces generated by this pressure. The experiment involved six spatial implants and one flat macroporous mesh.

Heavyweight spatial meshes and lightweight spatial-individualized meshes showed no tendency t biophysics. Clinical trials confirming the results in vivo will allow to supplement or amend the guidelines for the treatment of large inguinal hernias.

To date, no prospective study has compared the safety and efficacy of band-assisted endoscopic mucosal resection (BA-EMR) with those of endoscopic dissection (ESD) for the treatment of submucosal tumors (SMTs) in the gastric fundus. We aimed to compare the safety and efficacy of BA-EMR with those of ESD for SMTs ≤ 1.5cm in the gastric fundus.

In total, 62 patients with SMTs ≤ 1.5cm in the gastric fundus underwent band ligation; the lesions that could be completely ligated were excised using a snare, while others were removed by ESD.

Of 62 patients, 42 had their lesions completely ligated by the band and underwent BA-EMR, while 20 had lesions that could not be completely ligated and underwent ESD. The average tumor size was 0.94 ± 0.16 and 1.30 ± 0.16cm in the BA-EMR and ESD groups, respectively. Compared with ESD, BA-EMR had significantly fewer complications and a significantly shorter mean operating time and hospital stay.

BA-EMR is a safe and effective method for small SMTs in the gastric fundus, but is only suitable for SMTs < 1.2cm. For small SMTs (< 1.2cm) in the gastric fundus, BA-EMR may simplify the treatment procedure, shorten the operation time, and reduce complications.

BA-EMR is a safe and effective method for small SMTs in the gastric fundus, but is only suitable for SMTs  less then  1.2 cm. For small SMTs ( less then  1.2 cm) in the gastric fundus, BA-EMR may simplify the treatment procedure, shorten the operation time, and reduce complications.

Esophageal endoscopic submucosal dissection (ESD) is the gold standard for the treatment of precancerous lesions or superficial esophageal cancers. Vorinostat This procedure is currently performed by expert endoscopists only, and poorly standardized. We aimed to assess the technical results and outcomes of a "tunnel + clip" strategy for esophageal ESD procedures performed by less experienced operators for the treatment of superficial neoplasms.

All consecutive esophageal ESDs performed with the "tunnel + clip" technique for patients with early esophageal cancer in 3 centers were enrolled. Procedural characteristics, clinical outcomes, and complications were recorded.

Among 195 esophageal ESD procedures performed, early adenocarcinomas or high-grade dysplasia complicating Barrett's esophagus were predominant (132/195, 67.7%) compared with early squamous cell carcinomas (63/195, 32.3%). The en bloc, R0 and curative resection rates were 100% (195/195), 78.5% (153/195) and 67.2% (131/195), respectively. The mean rate of ESD was 29.7 mm

/min. One (0.5%) perprocedural perforation and 7 (3.6%) postprocedural bleedings occurred, all managed endoscopically. No delayed perforation occurred. Overall, 31 patients (31/195; 15.9%) of patients developed stenosis.

The "tunnel + clip" strategy is safe, and allows to achieve high en bloc, R0 and curative resection rates. This standardized procedure could be used by physicians with little experience and might help spreading esophageal ESD in Western countries.

The "tunnel + clip" strategy is safe, and allows to achieve high en bloc, R0 and curative resection rates. This standardized procedure could be used by physicians with little experience and might help spreading esophageal ESD in Western countries.Common thyroid diseases are hyperthyroidism, hypothyroidism, thyroiditis, thyroid tumor and so on. Baidu is currently the most widely used online search tool in China, has developed an internet search trends collection and analysis tool called the Baidu Index. The aim of the present study was to understand the trend and characteristics of public's online attention to thyroid diseases, and to explore the value of Baidu Index in monitoring online retrieval behavior of thyroid-related information. Taking the period from January 1, 2011 to December 31, 2019 as the time range into consideration, we used the big data analysis tool of Baidu Index and took "thyroid nodules", "thyroid cancer", "thyroiditis" "hyperthyroidism" and "hypothyroidism" as the keywords, the data of "search index" and "media index" were recorded on a weekly basis, and all information were aggregated into quarterly and annual to generate the final data which was carried out for secondary analysis. Pearson correlation analysis was used to analyze the correlation between the search index of keywords and the year. One-way Analysis of Variance was used to analyze the differences between search index and media index. Among the five keywords, thyroid nodule search index had the highest growth rate (640%), followed by thyroid cancer (298%). The media's attention to thyroid diseases had been declining year by year. Unlike the public's attention, the media index of hyperthyroidism was significantly higher than other keywords. Over the past nine years, the public's attention to thyroid-related diseases has been increasing gradually. Baidu Index is an effective tool to track the health information query behavior of Chinese internet users, which can provide a cost-effective supplement to traditional monitoring system.Microbial consortia exhibit spatial patterning across diverse environments. Since probing the self-organization of natural microbial communities is limited by their inherent complexity, synthetic models have emerged as attractive alternatives. In this study, we develop novel frameworks of bacterial communication and explore the emergent spatiotemporal organization of microbes. Specifically, we built quorum sensing-mediated models of microbial growth that are utilized to characterize the dynamics of communities from arbitrary initial configurations and establish the effectiveness of our communication strategies in coupling the growth rates of microbes. Our simulations indicate that the behavior of quorum sensing-coupled consortia can be most effectively modulated by the rates of secretion of acyl homoserine lactones. Such a mechanism of control enables the construction of desired relative populations of constituent species in spatially organized populations. Our models accurately recapitulate previous experiments that have investigated pattern formation in synthetic multi-cellular systems. Additionally, our software tool enables the easy implementation and analysis of our frameworks for a variety of initial configurations and simplifies the development of sophisticated gene circuits facilitating distributed computing. Overall, we demonstrate the potential of spatial organization as a tunable parameter in synthetic biology by introducing a communication paradigm based on the location and strength of coupling of microbial strains.