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This research dealt with a novel method of fabricating green composites with biodegradable poly (lactic acid) (PLA) and natural hemp fiber. The new preparation method was that hemp fibers were firstly blending-spun with a small amount of PLA fibers to form compound fiber pellets, and then the traditional twin-screw extruding and injection-molding method were applied for preparing the composites containing 10–40 wt% hemp fibers with PLA pellets and compound fiber pellets. This method was very effective to control the feeding and dispersing of fibers uniformly in the matrix thus much powerful for improving the mechanical properties. The tensile strength and modulus were improved by 39 and 92 %, respectively without a significant decrease in elongation at break, and the corresponding flexural strength and modulus of composites were also improved by 62 and 90 %, respectively, when the hemp fiber content was 40 wt%. The impact strength of composite with 20 wt% hemp fiber was improved nearly 68 % compared with the neat PLA. The application of the silane coupling agent promoted further the mechanical properties of composites attributed to the improvement of interaction between fiber and resin matrix.

Background The population of Aging cancer survivors in the United States has surged to over 16.9 million. Research on the relationship between statin usage and post-cancer survival rates remains limited. Aims This study aims to investigate the association between statin use and various causes of mortality among aging cancer survivors. Methods We analyzed NHANES data from 1999 to 2018, Statin usage, both hydrophilic and lipophilic, was derived from NHANES prescription records. We utilized Cox proportional hazards models to associate statin utilization with mortality, differentiating causes of death according to statin type and patterns of use. Results Within a cohort of 2,968 participants, statin usage was categorized into non-users (1,738), hydrophilic statin users (216), and lipophilic statin users (982). Compared to those who did not use statins, individuals prescribed hydrophilic statins did not show a reduced risk of all-cause mortality (adjusted hazard ratio [HR] 1.01; 95% confidence interval [CI] 0.72–1.41; P  = 0.960), as outlined in Model 3. In contrast, the group receiving lipophilic statins exhibited a notable decrease in all-cause mortality risk (adjusted HR, 0.77; P  = 0.003). Nonetheless, both hydrophilic and lipophilic statins were effective in diminishing the risk associated with cancer from its onset until death, with hydrophilic statins showing a greater level of efficacy. Discussion The potential of statins to reduce cancer-related mortality may provide avenues for targeted clinical interventions and management strategies. Conclusions Our study reveals that the use of lipophilic statins is significantly associated with lower all-cause and cancer-cause mortality risks among aging cancer survivors.

This study aimed to evaluate the association between the triglyceride-glucose (TyG) index and high-sensitivity C-reactive protein-to-albumin ratio (hsCAR) and the prognosis of patients with STEMI and hypertension. A total of 699 patients diagnosed with STEMI and hypertension were included in this study database. Compared to the low TyG index group (< 7.8), the high TyG index group (≥ 7.8) was associated with an increased risk of MACE (HR 2.09, 95% CI = 1.58–2.77; P  < 0.001). Similarly, a higher hsCAR (≥ 0.15) was linked to an increased risk of MACE (HR 1.46, 95% CI = 1.12–1.90; P  = 0.005). Subsequently, we categorized the population into four groups based on the defined cutoff points. Compared to the low TyG–low hsCAR subgroup, the other three subgroups demonstrated an elevated risk of MACE. Among patients treated with PCSK9 and SGLT2 inhibitors, the combined effect of the TyG index and hsCAR on MACE was attenuated. Finally, The combined TyG index and hsCAR model exhibited optimal performance (AUC = 0.71, 95% CI = 0.67–0.75; P  < 0.001). This study demonstrates that the TyG index and hsCAR provide strong combined predictive power. The synergistic utilization offers a comprehensive approach to cardiovascular risk assessment.

Background This study looked into how predictive in ST-segment elevation myocardial infarction (STEMI) is the high-sensitivity C-reactive protein-to-albumin ratio (hsCAR) as well as glycated hemoglobin to high-density lipoprotein cholesterol (HbA1c/HDL-c) ratio. Methods This retrospective cohort research was carried out on 1,177 patients having STEMI who were given percutaneous coronary intervention (PCI). For major adverse cardiovascular events (MACE), the independent and combined predictive values of the HbA1c/HDL-c ratio (threshold ≥ 6.61) and hsCAR (threshold ≥ 0.18) were assessed. MACE was an amalgamation of death from all causes, ischemia-induced revascularization, myocardial infarction not leading to death, heart failure hospitalization, and cerebrovascular events. The team used Cox regression models, causal mediation examination, and receiver operating characteristic curves to assess prognostic performance and mechanistic pathways, and compared them with the Global Registry of Acute Coronary Events (GRACE) risk score. Results The interquartile range for follow-up was 79 to 672 days, with 461 median days. A raised HbA1c/HDL-c ratio (≥ 6.61) and hsCAR (≥ 0.18) independently predicted MACE, with 1.51 (95% confidence interval [CI]: 1.26–1.81; P  < 0.001) as well as 1.84 (95% CI: 1.53–2.21; P  = 0.005) hazard ratios (HRs), respectively. Combined use enhanced risk stratification, with the high HbA1c/HDL-c–high hsCAR group showing the highest risk (adjusted HR 2.19, 95% CI: 1.67–2.87; P  < 0.001). Causal mediation examination revealed that coronary lesion complexity partially mediated these associations; the SYNergy between PCI with TAXUS and Cardiac Surgery (SYNTAX) and the residual SYNTAX scores were responsible for accounting for 24.2%/17.7% of the hsCAR effect and 16.8%/25.2% of the HbA1c/HDL-c ratio effect, respectively. Compared with the individual markers or the GRACE risk score, the combined biomarker model demonstrated superior discriminatory capacity (area under the curve = 0.63, 95% CI = 0.60–0.66; P  < 0.001), with significant improvement in integrated discrimination. Conclusion The integration of HbA1c/HDL-c and hsCAR can significantly improve risk stratification in patients with STEMI, outperforming traditional scoring systems and assisting in the precise management of individuals at risk.

PurposeTo determine whether sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) should be the optimal choice in patients stratified by diabetes duration and body mass index (BMI) level.MethodsClassification tree analysis was performed to identify the influential factors for surgical procedure selection in real setting. Meta-analyses stratified by influential factors were conducted to compare the complete diabetes remission rates between SG and RYGB. The cost-effectiveness analysis was performed when results from meta-analysis remain uncertain.ResultsAmong 3198 bariatric procedures in China, 824 (73%) SGs and 191 (17%) RYGBs were performed in patients with T2DM. Diabetes duration with a cutoff value of 5 years and BMI level with 35.5 kg/m2 were identified as the influential factors. For patients with diabetes duration > 5 years, RYGB showed a significant higher complete diabetes remission rate than SG at 1 year: 0.52 (95% confidence interval (CI): 0.46–0.58) versus 0.36 (95% CI: 0.30–0.42). For patients with diabetes duration ≤ 5 years and BMI ≥ 35.5 kg/m2, there was no significant difference between 2 procedures: 0.57 (95% CI: 0.43–0.71) for SG versus 0.66 (95% CI: 0.62–0.70) for RYGB. The cost-effectiveness ratios of SG and RYGB were 244.58 and 276.97 dollars per QALY, respectively.ConclusionsFor patients with diabetes duration > 5 years, RYGB was the optimal choice with regard to achieving complete diabetes remission at 1 year after surgery. However, for patients with diabetes duration ≤ 5 years and BMI ≥ 35.5 kg/m2, SG appeared to provide a cost-effective choice.

Introduction: At present, the main treatment of gastric cancer is surgical resection combined with radiotherapy and chemotherapy, the most important part of which is radical gastrectomy. Laparoscopic radical gastrectomy for advanced gastric cancer is difficult to operate, and whether it can achieve the same curative effect with the laparotomy is still controversial. Materials and Methods: This study retrospectively analysed the clinical data of 269 gastric cancer patients surgically treated by our medical team from May 2011 to December 2015 for comparative analysis of the clinical efficacy of laparoscopic-assisted radical gastrectomy and traditional open radical gastrectomy. Results: The laparoscopic surgery group had longer duration of surgery, less intra-operative blood loss, shorter post-operative exhaust time, shorter post-operative hospital stay and shorter timing of drain removal. The average number of harvested lymph nodes in the laparoscopic surgery group was 22.9 ± 9.5 per case. And in the laparotomy group the average number was 23.3 ± 9.9 per case. The difference had no statistical significance. With the increase of the number of laparoscopic surgical procedures, the amount of intra-operative blood loss gradually decreases, and the duration of surgery is gradually reduced. Conclusion: Laparoscopic radical gastrectomy is superior to open surgery in the aspects of intra-operative blood loss, post-operative exhaust time, post-operative hospital stay and timing of drain removal. With the number of laparoscopic radical gastrectomy cases increased, the duration of surgery is shortened and the amount of intra-operative blood loss will decrease.

Given the role of gastrointestinal reconstruction, we investigated whether Roux-en-Y gastrointestinal reconstruction (RYGR) and Billroth I reconstruction (B1R) can improve glucose in nonobese type 2 diabetes mellitus patients. Seventy-six nonobese type 2 diabetes mellitus patients underwent open subtotal gastrectomy with RYGR and B1R between January 2005 and January 2010 in our hospital. Besides demographic data, preoperative weight, glucose, hemoglobin A1c, ghrelin, and glucagon-like peptide 1 were determined. As defined previously, 2 of 35 patients with RYGR were cured, 5 patients were controlled, and 10 patients were improved; similarly, 2 of 41 patients with B1R were controlled, and 3 patients improved 12 months after surgery. The fasting glucose and hemoglobin A1c decreased more significantly in RYGR patients (P < .05). Moreover, a higher fasting plasma GLP-1 level in RYGR patients and lower ghrelin in B1R patients were noted after surgery (P < .05). RYGR shows a more effective amelioration in nonobese type 2 diabetes mellitus patients.

Terahertz spectroscopy was used to qualitatively and quantitatively analyze four samples (three brands) of trehalose produced in China and other countries. The results show that the main characteristic peak was greatly affected by concentration, and the optimal detection concentration of trehalose was determined to be 25%–55% by transmission scanning. There were six significant characteristic absorption peaks in the trehalose spectrum, meaning that terahertz spectroscopy can be used for qualitative analysis, analogous to infrared spectroscopy. Moreover, the terahertz spectrum can effectively distinguish the three isomers of trehalose, whereas infrared spectroscopy cannot. Thus, it was found that the current commercially available trehalose is the α,α‐isomer. Quantitative analysis of the three brands of trehalose using terahertz spectroscopy matched the purity trends found by high‐performance liquid chromatography analysis, with the order of purity from highest to lowest being TREHA, Pioneer, and Huiyang. The actual quantitative values did differ between the two detection methods, but the variation in the values from the same sample obtained by the two detection methods was less than 5%, confirming that terahertz spectroscopy is very suitable for the rapid and relative quantitative detection of trehalose. The terahertz spectrum can significantly distinguish the three isomers of trehalose but infrared spectroscopy not. The fluctuation of the values from the same sample obtained by terahertz and HPLC methods was less than 5%. Therefore, terahertz is very suitable for qualitative and rapid crude quantitative detection of trehalose.

Background Ileal transposition (IT) can effectively resolve obesity and improve type 2 diabetes. IT is associated with increased glucagon-like peptide 1 secretion. The mechanisms mediating the effects of IT on obesity and diabetes remain undefined. Given the role of pro-opiomelanocortin neurons in energy balance, we sought to determine its potential role in these processes. Methods Twenty non-obese diabetic Goto–Kakizaki rats underwent either IT or sham operation. Various measures including food intake, body weight, fasting plasma glucose, glucagon-like peptide 1 level, activated pro-opiomelanocortin neuron number, and pro-opiomelanocortin mRNA expression were evaluated. Results The IT group demonstrated significantly improved plasma glucose homeostasis with increased glucagon-like peptide 1 secretion. The IT group ate less and demonstrated reduced body weight gain over time. These effects were also associated with increased central neuronal activity with increased pro-opiomelanocortin and derivative gene expression in the hypothalamus and increased protein expression in the pituitary gland. Conclusions More pro-opiomelanocortin neurons in the hypothalamus of diabetes rats were activated after ileal transposition. These data suggest a potential important role for pro-opiomelanocortin neurons in the resolution of diabetes after IT.