This prospective, randomized study compared the outcomes of hand-assisted laparoscopic surgery (HALS) with open surgery for the resection of rectal cancer. The main outcome measures were procedure time, blood loss, post-operative pain, time to oral intake, return of bowel function, length of hospital stay, morbidity and functional recovery. Patients in each group were similar with regard to general status, procedure types and the histopathological features of tumours. Procedure times were significantly longer with HALS versus open surgery. Analgesic requirements, surgical blood loss, time to first passing flatus, time to first oral fluids and post-operative hospital stay length were all significantly shorter in the HALS group. At a median follow-up of 16.3 months, local recurrence of tumour was not observed in either group. In this study, the HALS approach for curative resection of rectal cancer was safe and effective and may offer several potential advantages to patients in their post-operative recovery.

Most common D + T + CAPOX regimen related TEAEs were G1/2: anemia, thrombocytopenia, fatigue, diarrhea, nausea each in 3 pts. No related G3/4 toxicities; overall four G5 events; 1 related event pulmonary embolism. mITT analysis included 22 pts. Preliminary ORR in response evaluable (RE) mITT was 68% (13 PR, 6 SD, 1 NE, 2 pending first scan) and DCR 100%. In RE DKK1 high pts (n¼7) there was an ORR of 100% (6 PR, 1 NE) compared with DKK1 low pts (n¼9) ORR of 56% (5 PR, 4 SD). Median DoR and PFS were not reached.Conclusions: D + T + CAPOX was well tolerated and has encouraging early activity as first line treatment for advanced GEA (unselected for PD-L1), with a preliminary ORR of 68% and DCR of 100%. Higher ORR in biomarker RE population: DKK1 high compared with DKK1 low (ORR 100% vs 56%). Updated ORR, DoR, PFS and PD-L1 expression will be reported.Clinical trial identification: NCT04363801.

Multistage fatigue tests were conducted on the single-edge-notch tension specimens of Ni-based superalloy GH4169. Fatigue crack growth data at different stages were recorded with the surface replica technique. Continuum damage mechanics incorporating critical distance theory was used to evaluate fatigue crack initiation life. Then, small and long fatigue crack grow rates were modeled using Shyam's model and modified Paris law, respectively. Finally, the multistage fatigue model deriving from the above theories was proposed to predict total fatigue life of GH4169. Fatigue life prediction results show that the proposed multistage fatigue model has high accuracy for GH4169.

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