Purpose To investigate the clinicopathological significance of peritumoral retraction clefts(PRC)in esophageal squamous cell cancer(ESCC)and its correlation with prognosis.Methods 266 cases of esophageal squa-mous cell carcinoma were collected.Excluding the cases due to incomplete clinical data,cracks caused by the produc-tion process,and receiving preoperative adjuvant treatment,248 cases were finally counted.PRC was determined by the proportion of retraction clefts in the tumor volume of 10％.A retrospective analysis was conducted to explore the re-lationship between PRC and the clinicopathological features as well as prognosis of ESCC.Results Among 248 ESCC patients,114 cases had PRC,while 134 cases did not.Correlation analysis showed that PRC was closely related to his-tological grade,lymphatic invasion,lymph node metastasis,depth of tumor invasion and TNM stage of ESCC,and ES-CC patients with PRC were more likely to have lymphatic invasion and lymph node metastasis(P＜0.05).In patients without lymphatic invasion,the probability of nodal metastasis in patients with PRC was higher than those without PRC,and the difference was statistically significant(P＜0.001).Kaplan-Meier survival analysis showed that 5-year overall survival(P=0.001)and progression-free survival(P=0.002)in ESCC patients with PRC were significantly lower than those without PRC.Conclusion ESCC patients with PRC are more likely to have local invasiveness,lymphatic invasion and nodal metastasis,may predict the poor prognosis of ESCC patients.Patients with nodal metastasis are more common with PRC.

Purpose To investigate the clinicopathological significance of peritumoral retraction clefts(PRC)in esophageal squamous cell cancer(ESCC)and its correlation with prognosis.Methods 266 cases of esophageal squa-mous cell carcinoma were collected.Excluding the cases due to incomplete clinical data,cracks caused by the produc-tion process,and receiving preoperative adjuvant treatment,248 cases were finally counted.PRC was determined by the proportion of retraction clefts in the tumor volume of 10％.A retrospective analysis was conducted to explore the re-lationship between PRC and the clinicopathological features as well as prognosis of ESCC.Results Among 248 ESCC patients,114 cases had PRC,while 134 cases did not.Correlation analysis showed that PRC was closely related to his-tological grade,lymphatic invasion,lymph node metastasis,depth of tumor invasion and TNM stage of ESCC,and ES-CC patients with PRC were more likely to have lymphatic invasion and lymph node metastasis(P＜0.05).In patients without lymphatic invasion,the probability of nodal metastasis in patients with PRC was higher than those without PRC,and the difference was statistically significant(P＜0.001).Kaplan-Meier survival analysis showed that 5-year overall survival(P=0.001)and progression-free survival(P=0.002)in ESCC patients with PRC were significantly lower than those without PRC.Conclusion ESCC patients with PRC are more likely to have local invasiveness,lymphatic invasion and nodal metastasis,may predict the poor prognosis of ESCC patients.Patients with nodal metastasis are more common with PRC.

Objective To observe the value of 18F-prostate specific membrane antigen(PSMA)-1007 PET/MRI for diagnosing seminal vesicle invasion(SVI)of prostatic cancer(PCa).Methods Totally 92 male patients with PCa who underwent radical prostatectomy were retrospectively enrolled and divided into positive group(n=26)and negative group(n=66)based on postoperative pathology showed SVI or not.PET/MRI parameters,including maximum standard uptake value(SUVmax),minimum apparent diffusion coefficient(ADCmin),mean apparent diffusion coefficient(ADCmean),SUVmax/ADCmin,SUVmax/ADCmean,PSMA tumor volume(PSMA-TV)and total lesion PSMA(TL-PSMA)were compared between groups.The receiver operating characteristic curve was drawn,and the efficacy of each parameter for diagnosing SVI was analyzed.Results Among 92 cases of PCa,18F-PSMA-1007 PET/MRI showed 30 cases with SVI and 62 cases without SVI,with accuracy of 73.91％,sensitivity of 61.54％,specificity of 78.79％,positive predictive value of 53.33％and negative predictive value of 83.87％.Significant differences of ADCmin,PSMA-TV and TL-PSMA were found between groups(all P＜0.05).The area under the curve(AUC)of SUVmax,ADCmin,ADCmean,SUVmax/ADCmin,SUVmax/ADCmean,PSMA-TV and TL-PSMA for diagnosing SVI of PCa was 0.554,0.341,0.396,0.603,0.581,0.755 and 0.705,respectively.The AUC of PSMA-TV was higher than other parameters except for TL-PSMA,with sensitivity of 84.60％and specificity of 56.10％.Conclusion 18 F-PSMA-1007 PET/MRI was helpful for diagnosing SVI of PCa.

Objective To observe the value of 18F-prostate specific membrane antigen(PSMA)-1007 PET/MRI for diagnosing seminal vesicle invasion(SVI)of prostatic cancer(PCa).Methods Totally 92 male patients with PCa who underwent radical prostatectomy were retrospectively enrolled and divided into positive group(n=26)and negative group(n=66)based on postoperative pathology showed SVI or not.PET/MRI parameters,including maximum standard uptake value(SUVmax),minimum apparent diffusion coefficient(ADCmin),mean apparent diffusion coefficient(ADCmean),SUVmax/ADCmin,SUVmax/ADCmean,PSMA tumor volume(PSMA-TV)and total lesion PSMA(TL-PSMA)were compared between groups.The receiver operating characteristic curve was drawn,and the efficacy of each parameter for diagnosing SVI was analyzed.Results Among 92 cases of PCa,18F-PSMA-1007 PET/MRI showed 30 cases with SVI and 62 cases without SVI,with accuracy of 73.91％,sensitivity of 61.54％,specificity of 78.79％,positive predictive value of 53.33％and negative predictive value of 83.87％.Significant differences of ADCmin,PSMA-TV and TL-PSMA were found between groups(all P＜0.05).The area under the curve(AUC)of SUVmax,ADCmin,ADCmean,SUVmax/ADCmin,SUVmax/ADCmean,PSMA-TV and TL-PSMA for diagnosing SVI of PCa was 0.554,0.341,0.396,0.603,0.581,0.755 and 0.705,respectively.The AUC of PSMA-TV was higher than other parameters except for TL-PSMA,with sensitivity of 84.60％and specificity of 56.10％.Conclusion 18 F-PSMA-1007 PET/MRI was helpful for diagnosing SVI of PCa.

Objective To establish a finite element model of the hallux valgus foot and study the stress and displacement changes in the first and second rays of the hallux valgus under different tensile forces.Methods Foot CT images of a patient with hallux valgus were imported into Mimics to reconstruct a three-dimensional(3D)skeletal model of the foot.The 3-matic software was used to mesh the reconstructed model and generate the volume mesh.The optimized model was imported into ANSYS for finite element analysis.The relationship between the tensile forces and the stress/displacement of the first and second rays of the hallux valgus was verified by changing the size and direction of the tensile forces.Results Tensile forces of different magnitudes and directions were applied to the first proximal phalanx.When the force was less than 12 N,with an increase in tension,the displacement of the first phalange changed more significantly.For every 2 N increase in tension,the displacement increased by approximately 1 mm.When the force was greater than 12 N,with an increase in tension,the stress on the first phalange increased,whereas the displacement only changed slightly.In addition,when the magnitude of the force remained unchanged at 12 N and the direction of the force changed at intervals of 15°,the stress and stress distributions of the first and second rays changed with direction,and the displacement also changed accordingly.When the direction of the force was perpendicular to that of the second phalanx,the displacement of the first phalanx increased.Conclusions Finite element analysis technology can vividly and accurately analyze the stress and displacement changes of the first and second rays of hallux valgus under different tensile forces,and it lays a foundation for the design of hallux valgus orthoses.

Objective To compare the accuracy of the original-mirror alignment algorithm and a landmark-indepen-dent method in constructing the midsagittal plane(MSP)of the cone beam computed tomography in patients with facial deformities,so as to provide a theoretical basis for symmetric analysis.Methods The study was approved by the hospi-tal ethics committee.Cone beam computed tomography data of 30 patients with facial deformities were obtained,and the output was saved in DICOM format.The scan data were imported into Mimics 21.0;after segmentation,three-dimension-al(3D)skull models were reconstructed.Furthermore,the 3D scan data of skulls were transformed into mirror skull models using Geomagic Studio 2014 reverse engineering software.The MSP of each skull was generated using both the original-mirror alignment algorithm and the landmark-independent method.Original-mirror alignment algorithm:the original skull model and its mirror model were combined,and the new data to calculate the MSP(S1)of the original data in Geomagic Studio 2014 were obtained.Landmark-independent method:the following anatomical landmarks were deter-mined using Mimics 21.0:nasion(N),crista galli(CG),sella(S),basion(Ba),vomer(V),posterior nasal spine(PNS),in-cisive foramen(IF),and anterior nasal spine(ANS).The MSP(S2)of best fit was then found by minimizing the mean square distance of these eight anatomical landmarks to a plane in Geomagic Studio 2014.The results of the S1 and S2 models constructed using the original-mirror alignment algorithm and the landmark-independent method,respectively,were scored subjectively by five senior maxillofacial surgeons,and a paired t-test was performed for the two groups.The internal consistency analysis was performed based on secondary experiments to verify the repeatability of the expert evaluation method.Results The average scores of the S1 and S2 models were 65.73 and 75.90,respectively.The aver-age score of the model constructed using the landmark-independent method was significantly higher than that of the model constructed using the original-mirror alignment algorithm(P＜0.01).Furthermore,the results of the internal con-sistency analysis showed that the expert evaluation method had good reliability and validity.Conclusion In patients with facial deformities,the MSP constructed using the landmark-independent method is superior to that constructed us-ing the original-mirror alignment algorithm.This study provides a theoretical basis for maxillofacial symmetry analysis in clinical settings and is clinically feasible.

Objective To establish a simultaneous detection approach for 34 emerging contaminants(ECs)in tap water by liquid chromatography-tandem mass spectrometry(HPLC-MS/MS).Human health risk assessment was performed according to the detection results from 43 tap water samples.Methods Tap water samples were concentrated and extracted by solid phase extraction,and then blown to near dry by nitrogen at 40℃.The sample extracts were dissolved in methanol-water solution(95:5,VN)to 0.5 mL for analyzing.Agilent Jet Stream Electrospray Ionization(AJS ESI)and the multiple reaction monitoring(MRM)mode were performed for MS to acquire the data of 34 ECs.A database including precursor ion,product ion and retention times was established accordingly.Results The average linear correlation coefficients(r)of 34 kinds of ECs was 0.995 9.The limits of detection were 0.01～0.60 ng/L and the recoveries were between 60.7％and 119.8％.The intra-group precisions were between 0.05％～9.89％and the intra-day precisions were between 0.20％～14.40％for the spiked samples.The method was applied to analyze 43 tap water samples and a total of 15 ECs were detected.According to the results,the detection rate of caffeine was the highest(84％),and the concentration range was ND～74.42 ng/L.Among all the ECs detected,1,2,3-benzotriazole had the highest concentration(ND～361.15 ng/L),where detection rate was 44％.Humans may be exposed to these ECs by drinking the tap water.The human health risk assessments of 12 kinds of ECs were carried out,however,the estimated risk was negligible(risk quotient＜0.01).Conclusion The method is simple,highly sensitive and selective,and could meet the detection needs of ECs at trace level in tap water.There was no human health risk posed for ECs identified in 43 tap water samples analyzed by this method.

Objective Based on ultra-high-performance liquid chromatography-quadrupole time-of-flight tandem mass spectrometry(UPLC-QTOF-MS/MS),a nontarget screening strategy was adopted in analyzing and identifying emerging pollutants(EPs)in tap water across the country,and studying its spatial and temporal distribution characteristics.Methods After extracting tap water samples by solid phase extraction,mobile phases(0.1%aqueous formic acid and methanol solutions)was used to elute the sample on a C18 chromatographic column.The nontarget screening strategy was used to acquire the MS information in full scan mode.We extracted and analyzed the chromatographic and mass spectral peaks,then searched the spectral library to compare the exact mass numbers,and the secondary MS/MS spectra fragment ion information was compared one by one.Finally,the retention time and the mass spectrum data of candidate EPs were identified and analyzed with the data of standard samples.then quantified by the internal standard method.Results A total of 135 EPs were initially screened from tap water across the country and 24 with high chromatographic peak response were finally selected and verified by standard products,including 6 pharmaceuticals,13 pesticides,3 industrial compounds and 2 food additives.Nine of them showed detection rates of more than 60%,such as canrenone,medroxyprogesterone,hydrocortisone acetate,etc.The concentrations of detected pollutants range from ND 422.63 ng/L.And the four contaminants with higher average concentrations were canrenone,medroxyprogesterone,hydrocortisone acetate and tris(2-butoxyethyl)phosphate.Conclusion In this study,a nontarget strategy based on UPLC-QTOF-MS/MS was adopted to screen potential unknown pollutants with no-standards,and explored the overall contamination status of tap water samples.This contributed to more comprehensive understanding of the EPs distribution,and provided technical support for monitoring the EPs in tap water.

Objective:To compare the surgical efficacy and perioperative complications of total intracorporeal neobladder (ICNB) and extracorporeal neobladder (ECNB) reconstruction during robot-assisted radical cystectomy.Methods:We retrospectively reviewed our single-institutional, prospectively collected database for consecutive patients who underwent RARC with an ileum neobladder from January 2017 to June 2022. A total of 265 patients were collected, 158 in ICNB group and 107 in ECNB group. The two groups were matched 1∶1 according to gender, age, BMI, ASA score, NAC, history of abdominal surgery and tumor characteristics using propensity score matching (PSM) method. After PSM, operating time, estimated blood loss and perioperative complications were compared between ICNB and ECNB group. A total of 186 patients were paired (93 patients in each group). There were 91 males and 2 females in ICNB group. The median age of ICNB group was 64(55, 68) years; median BMI was 23.54(22.39, 25.39) kg/m 2; There were 91 cases with Clinical stage ≤T 2 stage and 15 cases with ASA score ≥3; 25 cases received neoadjuvant chemotherapy. There were 91 males and 2 females in ECNB group. The median age of ECNB group was 63(52, 67) years; median BMI was 23.31(20.76, 24.80) kg/m 2; There were 90 cases with Clinical stage ≤T 2 stage and 8 cases with ASA score ≥3; 12 cases received neoadjuvant chemotherapy. In the ECNB group, after completing the radical cystectomy and pelvic lymph node dissection with robot assistance, the traditional lower abdominal incision was used to pull the intestinal tube outside the body to complete the preparation of the new bladder and then restore it to the pelvic cavity for anastomosing, while in the ICNB group, the reconstruction of the new bladder in situ was always completed in the body cavity with robot assistance. The operative time, intraoperative blood loss and perioperative complications were compared between the two groups. Results:The median operative time in ICNB and ECNB groups was 302(261, 350) min and 337(285, 397) min, respectively ( P=0.003); median intraoperative blood loss was 300(225, 500) ml and 500(300, 650) ml, respectively ( P<0.01); perioperative blood transfusion rates were 4.3%(4/93) and 14.0%(13/93), respectively ( P=0.022); all the differences between the 2 groups were statistically significant. 90-d overall complications rate was significant lower in ICNB group (38.7% vs. 61.3%, P=0.002). There was no difference in 90-d major complications (8.6% vs. 16.1%, P=0.119). On multivariate logistic regression analysis, operating time( OR=1.004, 95% CI 1.000-1.007, P=0.040), surgical approach (ICNB/ECNB)( OR=2.248, 95% CI 1.220-4.141, P=0.009) and age( OR=1.036, 95% CI 1.002-1.072, P=0.037) were associated with 90-day overall complications. Operating time( OR=1.036, 95% CI 1.002-1.072, P=0.037), neoadjuvant chemotherapy( OR=0.198, 95% CI 0.059-0.663, P=0.009) and ASA score( OR=0.167, 95% CI 0.044-0.634, P=0.009) were associated with 90-day high-grade complications. Conclusion:Intracorporeal neobladder during robot-assisted radical cystectomy is safe and feasible. Compared with ECNB, ICNB significantly improved perioperative outcomes such as shorter operating time, fewer estimated blood loss and perioperative complications.

Objective:To compare the surgical efficacy and perioperative complications of total intracorporeal neobladder (ICNB) and extracorporeal neobladder (ECNB) reconstruction during robot-assisted radical cystectomy.Methods:We retrospectively reviewed our single-institutional, prospectively collected database for consecutive patients who underwent RARC with an ileum neobladder from January 2017 to June 2022. A total of 265 patients were collected, 158 in ICNB group and 107 in ECNB group. The two groups were matched 1∶1 according to gender, age, BMI, ASA score, NAC, history of abdominal surgery and tumor characteristics using propensity score matching (PSM) method. After PSM, operating time, estimated blood loss and perioperative complications were compared between ICNB and ECNB group. A total of 186 patients were paired (93 patients in each group). There were 91 males and 2 females in ICNB group. The median age of ICNB group was 64(55, 68) years; median BMI was 23.54(22.39, 25.39) kg/m 2; There were 91 cases with Clinical stage ≤T 2 stage and 15 cases with ASA score ≥3; 25 cases received neoadjuvant chemotherapy. There were 91 males and 2 females in ECNB group. The median age of ECNB group was 63(52, 67) years; median BMI was 23.31(20.76, 24.80) kg/m 2; There were 90 cases with Clinical stage ≤T 2 stage and 8 cases with ASA score ≥3; 12 cases received neoadjuvant chemotherapy. In the ECNB group, after completing the radical cystectomy and pelvic lymph node dissection with robot assistance, the traditional lower abdominal incision was used to pull the intestinal tube outside the body to complete the preparation of the new bladder and then restore it to the pelvic cavity for anastomosing, while in the ICNB group, the reconstruction of the new bladder in situ was always completed in the body cavity with robot assistance. The operative time, intraoperative blood loss and perioperative complications were compared between the two groups. Results:The median operative time in ICNB and ECNB groups was 302(261, 350) min and 337(285, 397) min, respectively ( P=0.003); median intraoperative blood loss was 300(225, 500) ml and 500(300, 650) ml, respectively ( P<0.01); perioperative blood transfusion rates were 4.3%(4/93) and 14.0%(13/93), respectively ( P=0.022); all the differences between the 2 groups were statistically significant. 90-d overall complications rate was significant lower in ICNB group (38.7% vs. 61.3%, P=0.002). There was no difference in 90-d major complications (8.6% vs. 16.1%, P=0.119). On multivariate logistic regression analysis, operating time( OR=1.004, 95% CI 1.000-1.007, P=0.040), surgical approach (ICNB/ECNB)( OR=2.248, 95% CI 1.220-4.141, P=0.009) and age( OR=1.036, 95% CI 1.002-1.072, P=0.037) were associated with 90-day overall complications. Operating time( OR=1.036, 95% CI 1.002-1.072, P=0.037), neoadjuvant chemotherapy( OR=0.198, 95% CI 0.059-0.663, P=0.009) and ASA score( OR=0.167, 95% CI 0.044-0.634, P=0.009) were associated with 90-day high-grade complications. Conclusion:Intracorporeal neobladder during robot-assisted radical cystectomy is safe and feasible. Compared with ECNB, ICNB significantly improved perioperative outcomes such as shorter operating time, fewer estimated blood loss and perioperative complications.