BACKGROUND Preoperative nutritional assessment of cancer patients is important to reduce postoperative complications. Several studies have reported the Geriatric Nutritional Risk Index (GNRI) to be useful in assessing underlying diseases and long-term outcomes of hospitalized patients. The present study aimed to evaluate the impact of preoperative GNRI on short- and long-term outcomes in elderly gastric cancer patients who underwent laparoscopic gastrectomy. METHODS We retrospectively reviewed consecutive patients aged ≥ 65 years who underwent laparoscopy-assisted gastrectomy and had R0 resection for histologically confirmed gastric adenocarcinoma. The cutoff value for preoperative GNRI was determined to be 85.7 based on the incidence of postoperative complications. Patients were categorized into two groups low GNRI group and normal GNRI group. RESULTS Univariate analyses of the 303 patients revealed that the incidence of postoperative complications was significantly associated with the American Society of Antoperative complications and overall survival in elderly gastric cancer patients. It is a reliable and cost-effective prognostic indicator that should be routinely evaluated.BACKGROUND A difficulty scoring system (DSS) based on the extent of liver resection, tumor location, liver function, tumor size, and tumor proximity to major vessels was previously developed to assess the difficulty of laparoscopic liver resection (LLR). Recently, we proposed a modified DSS for patients who undergo LLR for intrahepatic duct (IHD) stones. In this study, we validated the modified DSS for LLR for IHD stones. METHODS We reviewed the clinical data of 121 patients who underwent LLR for IHD stones between July 2003 and November 2015 and validated the modified DSS in patients who underwent LLR according to their surgical outcomes. We divided the patients into subgroups according to their scores and compared the surgical outcomes, including hospital stay, operation time, blood loss, transfusion rate, and the postoperative complication rate and grade, among the subgroups of patients. RESULTS The DSS score ranged from 3 to 12 in LLR for IHD stones. The operation time (P  less then  0.001) significantly increased according to the DSS score. The median hospital stay after surgery (P = 0.024) and transfusion rate (P = 0.001) were significantly different among subgroups of patients divided by their difficulty scores. Lifirafenib cell line When we divided the patients into two groups based on the side of liver of resected, the operation time (P  less then  0.001), mean difficulty score (P  less then  0.001), and blood loss (P = 0.041) were greater in patients who underwent right liver resection. CONCLUSIONS The surgical difficulty varies among patients undergoing the same LLR procedure for IHD stones. The modified DSS for IHD stones can effectively predict the surgery outcomes and complications of LLR.BACKGROUND Different techniques for laparoscopic adrenalectomy have been proposed with the lateral transperitoneal approach and posterior retroperitoneal approach being the two more frequently minimally invasive surgeries in most of the clinics. There are no sufficient studies in which the results of lateral transperitoneal and posterior retroperitoneal approaches in synchronous bilateral laparoscopic adrenalectomy have been compared. In the current study, we aimed to report our multicenter results of the lateral transperitoneal and posterior retroperitoneal synchronous bilateral laparoscopic adrenalectomy experience in patients who had different bilateral adrenal pathologies and to compare the outcomes of these two different operative procedures. METHODS Between 2012 and 2018, a total of 52 patients with a mean age of 43.5 years underwent simultaneous bilateral laparoscopic adrenalectomy at 6 different centers. Twenty-seven and 25 patients underwent bilateral lateral transperitoneal and posterior retroperitoshows that shorter operative time and less bleeding can be achieved with posterior retroperitoneal approach in synchronous bilateral laparoscopic adrenalectomy. In our series, intraoperative and postoperative complication rates were similar between both surgical approaches.Urban growth has caused environmental problems around the world and profoundly altered the terrestrial carbon cycle, especially net primary productivity (NPP). Sustainable urban development requires a better understanding of the impacts of urban growth on ecosystems. We selected Guangzhou City to analyze the impacts of urban development processes and urban geographic changes on NPP, as well as the correlation between urbanization intensity and NPP, using a deep-learning urbanization characteristic index (UCI). The results showed that the NPP in the study area had clear spatial heterogeneity and declined overall from 2001 to 2013. Guangzhou's urbanization became more and more intense, the mean UCI increased significantly from 0.1293 in 2001 to 0.2879 in 2013, and urban geographic type was dominated by urban exurbs in 2001 and 2013 while urban fringe areas increased most significantly and about 2,320.24 km2 of urban exurbs were converted to urban fringes. There was a significant negative correlation between UCI and NPP in 2001 and 2013, implying that NPP had been negatively influenced by the increasing urban development intensity. The transition of urban exurbs to urban fringes was associated with the highest NPP losses, which was caused by cropland loss and built-up land expansion.A one-pot method based on cyclic voltammetric scan was used to fabricate a glassy carbon electrode modified with nanocomposites consisting of poly(thionine) and amino-functionalized graphene quantum dots (afGQDs). Under near-neutral conditions, the dye polymer was effectively oxidized by hydroxyl radicals (·OH) that were derived from the copper-catalyzed Fenton-like reaction, and the cathodic peak current on the modified electrode greatly increased. The reaction of Cu2+ with thiourea (TU) and the generation of a complex, CuTU2+, led to the decrease of Cu2+/Cu+ species, which inhibited the Fenton-like reaction and reduced the electrochemical response change. Due to a displacement reaction, the addition of Hg2+ into the H2O2-Cu2+-TU system resulted in the release of cuprous ions that benefited the Fenton-like reaction. Under the following optimal conditions 6 mg mL-1 afGQDs and the 25-cycle potential cycling for the fabrication of the modified electrode, pH 6.5, and the [Formula see text] ratio of 1.0, the increasing extent of the cathodic peak current exhibited a good linear response to the logarithm of the Hg2+ concentration in the range of 1 pM-1 μM with a detection limit of 0.