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Single-incision vs three-incision laparoscopic cholecystectomy for complicated and uncomplicated acute cholecystitis

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World Journal of Gastroenterology 2013年第43期19卷 7743-7750页

作者： Shu-Hung Chuang Pai-Hsi Chen chih-Ming Chang chih-sheng lin Department of Biological Science and Technology National Chiao Tung University Department of Surgery Mackay Memorial HospitalHsin-Chu Branch College of Management Fu Jen Catholic University Department of Nursing Mackay Memorial HospitalHsin-Chu Branch

AIM:To compare the clinical outcome of single-incision laparoscopic cholecystectomy(SILC)and three-incision laparoscopic cholecystectomy(3ILC)for acute ***:From July 2009 to September 2012,136patients underwent SILC or 3ILC for acute cholecystitis at a tertiary referral *** experienced surgeon performed every procedure using 5 or 10 mm 30-degree laparoscopes,straight instruments,and conventional *** patients with perforated gallbladder and diffuse peritonitis and 23 patients with mild acute cholecystitis were *** remaining 108 patients were divided into complicated and uncomplicated groups according to pathologic *** demography,clinical data,operative results and complications were recorded and ***:Fifty patients with gangrenous cholecystitis,gallbladder empyema,or hydrops were classified as the complicated group,and 58 patients with acute cholecystitis were classified as the uncomplicated ***-three(46.0%)of the patients in the complicated group(n=50)and 39(67.2%)of the patients in the uncomplicated group(n=58)underwent SILC;all others underwent *** postoperative length of hospital stay(PLOS)was significantly shorter in the SILC subgroups than the 3ILC subgroups(3.5±1.1 d vs 4.6±1.3 d,P<0.01 in the complicated group;2.9±1.1 d vs 3.7±1.4 d,P<0.05 in the uncomplicated group).The maximum body temperature recorded at day 1 and at day 2 following the procedure was lower in the SILC subgroups,but the difference reached statistical significance only in the uncomplicated group(37.41±0.56℃vs 37.80±0.72℃,P<0.05 on postoperative day 1;37.10±0.43℃vs 37.57±0.54℃,P<0.01 on postoperative day 2).The operative time,estimated blood loss,postoperative narcotic use,total length of hospital stay,conversion rates,and complication rates were similar in both SILC and 3ILC *** complicated group had longer operative time(122.2±35.0 min vs 106.6±43.6 min,P<0.05),longer PLOS(4.1±1.3 d vs 3.2±1.2 d,P<0.

关键词： Single-incision laparoscopic cholecystectomy Single-incision laparoscopic surgery Laparoen doscopic single site surgery Cholecystectomy Acute cholecystitis Complicated cholecystitis Gangrenous cholecystitis

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Single-incision laparoscopic surgery for biliary tract disease

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World Journal of Gastroenterology 2016年第2期22卷 736-747页

作者： Shu-Hung Chuang chih-sheng lin Department of Surgery MacKay Memorial HospitalHsin-Chu BranchHsin-Chu 30071Taiwan Department of Healthcare Management Yuanpei University of Medical TechnologyHsin-Chu 30015Taiwan Department of Biological Science and Technology National Chiao Tung UniversityHsin-Chu 30068Taiwan

Single-incision laparoscopic surgery(SILS), or laparoendoscopic single-site surgery, has been employed in various fields to minimize traumatic effects over the last two decades. Single-incision laparoscopic cholecystectomy(SILC) has been the most frequently studied SILS to date. Hundreds of studies on SILC have failed to present conclusive results. Most randomized controlled trials(RCTs) have been small in scale and have been conducted under ideal operative conditions. The role of SILC in complicated scenarios remains uncertain. As common bile duct exploration(CBDE) methods have been used for more than one hundred years, laparoscopic CBDE(LCBDE) has emerged as an effective, demanding, and infrequent technique employed during the laparoscopic era. Likewise, laparoscopic biliary-enteric anastomosis is difficult to carry out, with only a few studies have been published on the approach. The application of SILS to CBDE and biliary-enteric anastomosis is extremely rare, and such innovative procedures are only carried out by a number of specialized groups across the globe. Herein we present a thorough and detailed analysis of SILC in terms of operative techniques, training and learning curves, safety and efficacy levels, recovery trends, and costs by reviewing RCTs conducted over the past three years and two recently updated meta-analyses. All existing literature on single-incision LCBDE and singleincision laparoscopic hepaticojejunostomy has been reviewed to describe these two demanding techniques.

关键词： Laparoendoscopic single-site surgery Laparoscopic cholecystectomy Laparoscopic commonbile duct exploration Laparoscopic hepaticojejunostomy Single-incision laparoscopic surgery

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The Security of Using Large Language Models:A Survey With Emphasis on ChatGPT

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IEEE/CAA Journal of Automatica Sinica 2025年第1期12卷 1-26页

作者： Wei Zhou Xiaogang Zhu Qing-Long Han lin Li Xiao Chen sheng Wen Yang Xiang the School of Science Computing and Engineering Technologies Swinburne University of Technology IEEE the School of Computer and Mathematical Sciences the University of Adelaide Adelaide the Faculty of Science and Engineering Southern Cross University the School of Information and Physical Sciences the University of Newcastle

ChatGPT is a powerful artificial intelligence(AI)language model that has demonstrated significant improvements in various natural language processing(NLP) tasks. However, like any technology, it presents potential security risks that need to be carefully evaluated and addressed. In this survey, we provide an overview of the current state of research on security of using ChatGPT, with aspects of bias, disinformation, ethics, misuse,attacks and privacy. We review and discuss the literature on these topics and highlight open research questions and future *** this survey, we aim to contribute to the academic discourse on AI security, enriching the understanding of potential risks and mitigations. We anticipate that this survey will be valuable for various stakeholders involved in AI development and usage, including AI researchers, developers, policy makers, and end-users.

关键词： Artificial intelligence (AI) ChatGPT large language models (LLMs) security

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Development and validation of a nomogram model for predicting overall survival in patients with gastric carcinoma

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World Journal of Gastrointestinal Oncology 2025年第2期17卷 132-143页

作者： Guan-Zhong Liang Xiao-sheng Li Zu-Hai Hu Qian-Jie Xu Fang Wu Xiang-lin Wu Hai-Ke Lei Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment Chongqing University Cancer HospitalChongqing 400030China Chongqing Cancer Multi-omics Big Data Application Engineering Research Center Chongqing University Cancer HospitalChongqing 400030China Department of Health Statistics School of Public HealthChongqing Medical UniversityChongqing 400016China Research Center for Medicine and Social Development School of Public HealthChongqing Medical UniversityChongqing 400016China The Research Center of Big Data Chongqing University Cancer HospitalChongqing 400030China

BACKGROUND The prevalence and mortality rates of gastric carcinoma are disproportionately elevated in China,with the disease's intricate and varied characteristics further amplifying its health *** forecasting of overall survival(OS)is of paramount importance for the clinical management of individuals afflicted with this *** To develop and validate a nomogram model that provides precise gastric cancer prevention and treatment guidance and more accurate survival outcome prediction for patients with gastric *** Data analysis was conducted on samples collected from hospitalized gastric cancer patients between 2018 and *** absolute shrinkage and selection operator,univariate,and multivariate Cox regression analyses were employed to identify independent prognostic factors.A nomogram model was developed to predict gastric cancer patient *** model's predictability and discriminative ability were evaluated via receiver operating characteristic *** evaluate the clinical utility of the model,Kaplan-Meier and decision curve analyses were *** A total of ten independent prognostic factors were identified,including body mass index,tumor-node-metastasis(TNM)stage,radiation,chemotherapy,surgery,albumin,globulin,neutrophil count,lactate dehydrogenase,and platelet-to-lymphocyte *** area under the curve(AUC)values for the 1-,3-,and 5-year survival prediction in the training set were 0.843,0.850,and 0.821,*** AUC values were 0.864,0.820,and 0.786 for the 1-,3-,and 5-year survival prediction in the validation set,*** model exhibited strong discriminative ability,with both the time AUC and time C-index exceeding *** with TNM staging,the model demonstrated superior clinical ***,a nomogram was developed via a web-based *** This study established and validated a novel nomogram model for predicting the OS of gastric cancer patients,which demonstrat

关键词： Gastric carcinoma Prediction Overall survival Nomogram Prospective

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CCHP-Type Micro-Grid Scheduling Optimization Based on Improved Multi-Objective Grey Wolf Optimizer

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Energy Engineering 2025年第3期122卷 1137-1151页

作者： Yu Zhang sheng Wang Fanming Zeng Yijie lin College of Mechanical and Control Engineering Guilin University of TechnologyGuilin541006China

With the development of renewable energy technologies such as photovoltaics and wind power,it has become a research hotspot to improve the consumption rate of new energy and reduce energy costs through algorithm *** reduce the operational costs of micro-grid systems and the energy abandonment rate of renewable energy,while simultaneously enhancing user satisfaction on the demand side,this paper introduces an improvedmultiobjective Grey Wolf Optimizer based on Cauchy *** proposed approach incorporates a Cauchy variation strategy during the optimizer’s search phase to expand its exploration range and minimize the likelihood of becoming trapped in local *** the same time,adoptingmultiple energy storage methods to improve the consumption rate of renewable ***,under different energy balance orders,themulti-objective particle swarmalgorithm,multi-objective grey wolf optimizer,and Cauchy’s variant of the improvedmulti-objective grey wolf optimizer are used for example simulation,solving the Pareto solution set of the model and *** analysis of the results reveals that,compared to the original optimizer,the improved optimizer decreases the daily cost by approximately 100 yuan,and reduces the energy abandonment rate to ***,it enhances user satisfaction and ensures the stable operation of the micro-grid.

关键词： Multi-objective optimization algorithm hybrid energy storage micro-grid CCHP

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Hsa-miR-214-3p inhibits breast cancer cell growth and improves the tumor immune microenvironment by downregulating B7H3

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Oncology Research 2025年第1期33卷 103-121页

作者： YAN LU KANG WANG YUANHONG PENG MENG CHEN lin ZHONG LUJI HUANG FU CHENG XINDAN sheng XIN YANG MANZHAO OUYANG GEORGE A.CAlin ZHIWEI HE China-America Cancer Research Institute Guangdong Medical UniversityDongguan523808China GCP Center Shunde HospitalSouthern Medical University(The First People’s Hospital of Shunde Foshan)Shunde528300China Department of Gastrointestinal Surgery Shunde HospitalSouthern Medical University(The First People’s Hospital of Shunde Foshan)Shunde528300China The Second School of Clinical Medicine Southern Medical UniversityGuangzhou510080China Department of Translational Molecular Pathology The University of Texas MD Anderson Cancer CenterHoustonTX 77030USA Department of Oncology Shunde HospitalSouthern Medical University(The First People’s Hospital of Shunde Foshan)Shunde528300China

Background:Immune checkpoint inhibitors play an important role in the treatment of solid tumors,but the currently used immune checkpoint inhibitors targeting programmed cell death-1(PD-1),programmed cell death ligand-1(PD-L1),and cytotoxic T-lymphocyte antigen-4(CTLA-4)show limited clinical efficacy in many breast cancers.B7H3 has been widely reported as an immunosuppressive molecule,but its immunological function in breast cancer patients remains ***:We analyzed the expression of B7H3 in breast cancer samples using data from the Cancer Genome Atlas Program(TCGA)and the Gene Expression Omnibus(GEO)*** were selected using the TarBase,miRTarBase,and miRBase *** regulatory role of the microRNA hsa-miR-214-3p on B7H3 was investigated through dual-luciferase reporter assays,which identified the specific action sites of *** expression levels of B7H3 and hsa-miR-214-3p in human breast cancer tissues and adjacent normal tissues were quantified using Western blotting and quantitative PCR(qPCR).In vitro experiments were performed to observe the effects of modulating the expression of B7H3 or hsa-miR-214-3p on breast cancer cell proliferation and ***,the regulatory impact of hsa-miR-214-3p on B7H3 was ***-linked immunosorbent assays(ELISA)and flow cytometry were employed to assess the effects of co-cultured breast cancer cells and normal human peripheral blood mononuclear cells(PBMCs)on immune cells and associated ***:In breast cancer tissues,the expression level of B7H3 is inversely correlated with that of hsa-miR-214-3p,as well as with the regulatory effects on breast cancercell ***-miR-214-3p was found to inhibit breast cancer cell growth by downregulating ***,our research identified,for the first time,two binding sites for hsa-miR-214-3p on the 3’UTR of B7H3,both of which exert similar effects ***-culture experiments revealed that hsamiR-214-3p

关键词： Breast cancer B7H3 Hsa-miR-214-3p Immunotherapy

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Flow behavior and dynamic softening mechanism of Pt−10Ir precious alloy

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Transactions of Nonferrous Metals Society of China 2025年第1期35卷 225-242页

作者： Xin-pei ZHANG Jun-jie HE lin PI Quan FU Wen-yan ZHOU Jun CHENG sheng-wen BAI Xuan ZHOU Yi LIU Yong MAO Materials Genome Institute School of Materials and EnergyYunnan UniversityKunming 650091China Kunming Precious Materials&Technology Co. Ltd.Yunnan Precious Metals Laboratory Co.Ltd.Sino-Platinum Metals Co.Ltd.Kunming 650106China Kunming Institute of Precious Metals Kunming 650106China State Key Laboratory of Advanced Technologies for Comprehensive Utilization of Platinum Metals Sino-Platinum Metals Co.Ltd.Kunming 650106China Shaanxi Key Laboratory of Biomedical Metal Materials Northwest Institute for Non-ferrous Metal ResearchXi’an 710016China College of Materials Science and Engineering Chongqing UniversityChongqing 400044China

The hot deformation behavior of Pt−10Ir alloy was studied under a wide range of deformation *** a low deformation temperature(950−1150℃),the softening mechanism is primarily dynamic *** addition,dynamic recrystallization by progressive lattice rotation near grain boundaries(DRX by LRGBs)and microshear bands assisted dynamic recrystallization(MSBs assisted DRX)coordinate the ***,it is difficult for the dynamic softening to offset the stain hardening due to a limited amount of DRXed *** a high deformation temperature(1250−1350℃),three main DRX mechanisms associated with strain rates occur:DRX by LRGBs,DRX by a homogeneous increase in misorientation(HIM)and geometric DRX(GDRX).With increasing strain,DRX by LRGBs is enhanced gradually under high strain rates;the“pinch-off”effect is enhanced at low strain rates,which was conducive to the formation of a uniform and fine microstructure.

关键词： platinum alloy hot deformation microstructure evolution dynamic recovery dynamic recrystallization

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Modified Pulsatilla decoction alleviates 5-fluorouracil-induced intestinal mucositis by modulating the TLR4/MyD88/NF-κB pathway and gut microbiota

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World Journal of Gastroenterology 2025年第7期31卷 110-129页

作者： Yi-Tong Qiu Xin-Yi Luo Ya-Feng Deng Xue Zheng Jian-Guo Qiu lin-sheng Zhang Xiao-Qi Huang Xue-Bao Zheng Hai-Yang Huang School of Pharmaceutical Sciences Guangzhou University of Chinese MedicineGuangzhou 525000Guangdong ProvinceChina Druggability Research Team Dongguan Institute of Guangzhou University of Chinese MedicineDongguan 523808Guangdong ProvinceChina Institute of Traditional Chinese Medicine Dongguan Hospital of Traditional Chinese MedicineDongguan 523000Guangdong ProvinceChina

BACKGROUND Modified Pulsatilla decoction(PD),a PD with licorice and ejiao,is a classic Traditional Chinese Medicine formula with significant efficacy in treating intestinal mucositis(IM)induced by tumor ***,its specific molecular and biological mechanisms remain *** To investigate the therapeutic effect and mechanism of modified PD in *** This study used an IM mouse model established using 5-fluorouracil injections to investigate the effects of the modified PD(3,6,and 12 g/kg)in *** primary chemical components of the modified PD were identified using liquid chromatography-mass *** weight loss,diarrhea scores,intestinal length,histopathological scores,and inflammatory cytokine levels were measured to evaluate the effects of the modified PD in *** on the TLR4/MyD88/NF-κB pathway were evaluated using western blot *** intestinal microbiota was characterized using Illumina NovaSeq *** The results showed that modified PD significantly improved weight loss and diarrhea and shortened the intestines in IM ***,modified PD suppressed the TLR4/MyD88/NF-κB pathway and downregulated the expression of reactive oxygen species,lipopolysaccharides,and pro-inflammatory cytokines(IL-1β,TNF-α,IFN-γ,IL-6,IL-8,and IL-17),while increasing the expression of the anti-inflammatory cytokine ***,modified PD protected the intestinal mucosal barrier by increasing the expression of tight junction proteins(occludin-1,claudin-1,and ZO-1)and ***,16S rDNA sequencing revealed that modified PD improved intestinal *** Our research offers new insights into the potential mechanism of modified PD in alleviating IM and provides experimental evidence supporting its pharmaceutical application in clinical IM treatment.

关键词： Modified Pulsatilla decoction Intestinal mucositis Oxidative stress Gut microbiota,TLR4/MyD88/NF-κB pathway Inflammatory response

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Pancreatic stent improves the success rate of needle-knife papillotomy in patients with difficult biliary cannulation

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World Journal of Gastroenterology 2025年第1期31卷 58-67页

作者： Mu-Hsien Lee Cheng-Hui lin Chi-Huan Wu Yung-Kuan Tsou Kai-Feng Sung sheng-Fu Wang Nai-Jen Liu Department of Gastroenterology and Hepatology Chang Gung Memorial Hospital and Chang Gung University College of MedicineTaoyuan 33305Taiwan School of Medicine Chang Gung UniversityTaoyuan 33305Taiwan

BACKGROUND Needle-knife precut papillotomy(NKP)is typically performed ***,it remains unclear whether pancreatic stent(PS)placement can improve the outcomes of *** To explore whether PS placement improves the success rate of NKP in patients with difficult biliary *** This single-center retrospective study included 190 patients who underwent NKP between January 2017 and December 2021 after failed conventional biliary *** cases with incidental pancreatic duct cannulation during conventional biliary cannulation,the decision for pre-NKP PS placement was made at the endoscopist's *** primary outcome was the difference in the NKP success rate between patients with and without PS placement;the secondary outcome was the adverse event *** Among the 190 participants,82 received pre-NKP PS(PS-NKP group)whereas 108 did not[freehand or freehand NKP(FH-NKP)group].Post-NKP selective biliary cannulation was successful in 167(87.9%)patients,and the PS-NKP had a significantly higher success rate than the FH-NKP group(93.9%vs 83.3%,P=0.027).The overall adverse event rates were 7.3%and 11.1%in the PS-NKP and FH-NKP groups,respectively(P=0.493).A periampullary diverticulum(PAD)and significant intraoperative bleeding during NKP were independently associated with NKP failure;however,a pre-NKP PS was the only predictor of NKP *** the 44 participants with PADs,the PS-NKP group had a non-significantly higher NKP success rate than the FH-NKP group(87.5%and 65%,respectively;P=0.076).CONCLUSION PS significantly improved the success rate of NKP in patients with difficult biliary cannulation.

关键词： Difficult biliary cannulation Endoscopic retrograde cholangiopancreatography Needle-knife papillotomy Pancreatic stent Selective biliary cannulation

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Research landmarks on the 60th anniversary of Epstein-Barr virus

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Science China(Life Sciences) 2025年第2期68卷 354-380页

作者： Lan-Yi Zhong Chu Xie Le-Le Zhang Yan-lin Yang Yuan-Tao Liu Ge-Xin Zhao Guo-Long Bu Xian-Shu Tian Zi-Ying Jiang Bo-Yu Yuan Peng-lin Li Pei-Huang Wu Wei-Hua Jia Christian Münz Benjamin E.Gewurz Qian Zhong Cong Sun Mu-sheng Zeng State Key Laboratory of Oncology in South China Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and TherapyGuangdong Provincial Clinical Research Center for CancerSun Yat-sen University Cancer CenterGuangzhou 510060China Viral Immunobiology Institute of Experimental ImmunologyUniversity of ZürichZürich 8092Switzerland Division of Infectious Diseases Department of MedicineBrigham and Women’s HospitalBoston MA 02115USA Department of Microbiology Harvard Medical SchoolBoston MA 02115USA Harvard Program in Virology Boston MA 02115USA Broad Institute of Harvard and MIT Cambridge MA 02142USA

Epstein-Barr virus(EBV),the first human oncovirus discovered in 1964,has become a focal point in virology,immunology,and oncology because of its unique biological characteristics and significant role in human *** we commemorate the 60th anniversary of EBV's discovery,it is an opportune moment to reflect on the major advancements in our understanding of this complex *** this review,we highlight key milestones in EBV research,including its virion structure and life cycle,interactions with the host immune system,association with EBV-associated diseases,and targeted intervention strategies.

关键词： Epstein-Barr virus oncovirus immune response epidemiology vaccines antibodies

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