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Predictive value of preoperative routine examination for the prognosis of patients with pT2N0M0 or pT3N0M0 colorectal cancer

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World Journal of Gastrointestinal Oncology 2024年第6期16卷 2429-2438页

作者： Peng-Fei Jing Jin Chen en-da yu Chao-yu Miao Department of Colorectal Surgery Changhai HospitalSecond Military Medical University/Naval Medical UniversityShanghai 200433China Department of endocrinology and Metabolism Changhai HospitalSecond Military Medical University/Naval Medical UniversityShanghai 200433China Department of Pharmacology Second Military Medical University/Naval Medical UniversityShanghai 200433China

BACKGROUND In recent years,the incidence of colorectal cancer(CRC)has been increasing.With the popularization of endoscopic technology,a number of early CRC has been diagnosed.However,despite current treatment methods,some patients with early CRC still experience postoperative recurrence and metastasis.AIM To search for indicators associated with early CRC recurrence and metastasis to identify high-risk populations.METHODS A total of 513 patients with pT2N0M0 or pT3N0M0 CRC were retrospectively enrolled in this study.Results of blood routine test,liver and kidney function tests and tumor markers were collected before surgery.Patients were followed up through disease-specific database and telephone interviews.Tumor recurrence,metastasis or death were used as the end point of study to find the risk factors and predictive value related to early CRC recurrence and metastasis.RESULTS We comprehensively compared the predictive value of preoperative blood routine,blood biochemistry and tumor markers for disease-free survival(DFS)and overall survival(OS)of CRC.Cox multivariate analysis demonstrated that low platelet count was significantly associated with poor DFS[hazard ratio(HR)=0.995,95% confidence interval(CI):0.991-0.999,P=0.015],while serum carcinoembryonic antigen(CEA)level(HR=1.008,95%CI:1.001-1.016,P=0.027)and serum total cholesterol level(HR=1.538,95%CI:1.026-2.305,P=0.037)were independent risk factors for OS.The cutoff value of serum CEA level for predicting OS was 2.74 ng/mL.Although the OS of CRC patients with serum CEA higher than the cutoff value was worse than those with lower CEA level,the difference between the two groups was not statistically significant(P=0.075).CONCLUSION For patients with T2N0M0 or T3N0M0 CRC,preoperative platelet count was a protective factor for DFS,while serum CEA level was an independent risk factor for OS.Given that these measures are easier to detect and more acceptable to patients,they may have broader applications.

关键词： Colorectal cancer Platelet count Serum carcinoembryonic antigen Total cholesterol level Overall survival Disease-free survival

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Recurrent sigmoid volvulus relieved by transanal ileus tube implantation

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Gastroenterology Report 2022年第1期10卷 641-643页

作者： Zi-Ye Zhao Qian-Wen Zhang Cheng-Long Wang en-da yu Jun-Jie Xing Department of Colorectal Surgery Changhai HospitalShanghaiP.R.China Department of Radiology Changhai HospitalShanghaiP.R.China Department of Gastroenterology Xiamen University Affiliated Chenggong Hospital(Chinese PLA 73rd Army Corps Hospital)XiamenFujianP.R.China

Introduction Sigmoid volvulus(SV)is a main cause of colonic mechanical obstruction.The sigmoid colon has a long and narrow mesentery that is the anatomical basis for the volvulus.The anti-mesenteric border of the sigmoid colon elongates -20%more than the mesenteric border when it is inflated and this provides the driving force that initiates and sustains the volvulus,often resulting in a counterclockwise rotation to form a closed-loop obstruction[1].Colonoscopic decompression and detorsion is the first-line treatment for SV[2].

关键词： torsion narrow driving

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Re-recognition of BMPR1A-related polyposis:beyond juvenile polyposis and hereditary mixed polyposis syndrome

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Gastroenterology Report 2023年第1期11卷 209-215页

作者： Zi-Ye Zhao Ye Lei Zhao-Ming Wang Huan Han Jun-Jie Xing Xiao-Dong Xu Xian-Hua Gao Wei Zhang en-da yu Department of Colorectal Surgery and Hereditary Colorectal Cancer Registry Changhai HospitalShanghaiP.R.China Department of General Surgery Eastern Theater Naval Hospital of Chinese PLAZhoushanZhejiangP.R.China Department of Pathology Changhai HospitalShanghaiP.R.China

Background Bone morphogenetic protein receptor type 1A(BMPR1A)is responsible for two individual Mendelian diseases:juvenile polyposis syndrome and hereditary mixed polyposis syndrome 2,which have overlapping phenotypes.This study aimed to elucidate whether these two syndromes are just two subtypes of a single syndrome rather than two isolated syndromes.Methods We sequenced the BMPR1A gene in 186 patients with polyposis and colorectal cancer,and evaluated the clinicopathological features and phenotypes of the probands and their available relatives with BMPR1A mutations.Results BMPR1A germline mutations were found in six probands and their three available relatives.The numbers of frameshift,nonsense,splice-site,andmissensemutations were one,one,two,and two,respectively;two of the sixmutations were novel.Typical juvenile polyps were found in only three patients.Two patients had colorectal cancer rather than any polyps.Conclusions Diseases in BMPR1A germline mutation carriers vary from mixed polyposis to sole colorectal cancer,and typical juvenile polyps do not always occur in these carriers.The variety of phenotypes reflected the features of BMPR1Amutation carriers,which should be recognized as a spectrum of one syndrome.Genetic testing may be a good approach to identifying BMPR1A-related syndromes.

关键词： BMPR1A gene juvenile polyposis syndrome hereditary mixed polyposis syndrome hamartoma polyposis

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Pouchitis

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World Journal of Gastroenterology 2007年第42期13卷 5598-5604页

作者： en-da yu Zhuo Shao Bo Shen Department of Colorectal Surgery Shanghai Changhai Hospital Shanghai 200438 China Department of Biliary Surgery Eastern Hepatobiliary Hospital Shanghai 200438 China Digestive Disease Center Cleveland Clinic ClevelandOH 44195 United States

While restorative proctocolectomy with ileal pouch-anal anastomosis has significantly improved the quality of life in patients with underlying ulcerative colitis who require surgery,complications can occur.Pouchitis as the most common long-term complication represents a spectrum of disease processes ranging from acute,antibiotic-responsive type to chronic antibiotic-refractory entity.Accurate diagnosis using a combined assessment of symptoms,endoscopy and histology and the stratification of clinical phenotypes is important for treatment and prognosis the disease.The majority of patients respond favorably to antibiotic therapy.However,management of chronic antibiotic-refractory pouchitis remains a challenge.

关键词：肠炎肠阻塞发病机理保健食品

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Research progress on the molecular biological characteristics of colorectal laterally spreading tumor

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Journal of Hainan Medical University 2018年第4期24卷 151-154页

作者： Liang-Liang Zhu en-da yu Traditional Chinese Medicine Hospital of Shijingshan District Beijing 100043China The Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine Shanghai 201999China

Colorectal laterally spreading tumor (LST) is a flat protuberant lesion originating from the colorectal mucosa, which is mainly charactherized by lateral superficial diffusion, and rarely vertically invades the deep wall of the intestine. LST is closely related to the occurrence and development of colorectal cancer, but its pathological morphology and molecular mechanism are different from those of general adenoma, and it has some particularity. At present, the related research on LST in China has just started, but we find that its incidence is not low. Therefore, the research progress of epidemiology, molecular biology as well as clinical diagnosis and treatment of this disease is reviewed.

关键词： Colorectal laterally spreading tumor Molecular biology Colorectal cancer

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Preoperative carcinoembryonic antibody is predictive of distant metastasis in pathologically T1 colorectal cancer after radical surgery

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World Journal of Gastroenterology 2013年第3期19卷 389-393页

作者： Zheng Lou Rong-Gui Meng Wei Zhang en-da yu Chuan-Gang Fu Department of Colorectal Surgery Changhai Hospital

AIM:To identify the predictors of distant metastasis in pathologically T1(pT1)colorectal cancer(CRC)after radical resection. METHODS:Variables including age,gender,preoperative carcinoembryonic antibody(CEA)level,tumor location,tumor size,lymph node status,and histological grade were recorded.Patients with and without metastasis were compared with regard to age,gender,CEA level and pathologic tumor characteristics using the independent t test orχ 2 test,as appropriate.Risk factors were determined by logistic regression analysis. RESULTS:Metastasis occurred in 6(3.8%)of the 159 patients during a median follow-up of 67.0(46.5%) mo.The rates of distant metastasis in patients with pT1 cancer of the colon and rectum were 6.7%and 2.9%, respectively(Pen male and female patients with T1 CRC were 6.25%and 1.27%,respectively(Pent site of distant metastasis was the liver. Age(P=0.522),gender(P=0.980),tumor location(P =0.330),tumor size(P=0.786),histological grade(P =0.509),and high serum CEA level(P=0.262)were not prognostic factors for lymph node metastasis.Univariate analysis revealed that age(P=0.231),gender(P =0.137),tumor location(P=0.386),and tumor size (P=0.514)were not risk factors for distant metastasis after radical resection for T1 colorectal cancer.Postoperative metastasis was only significantly correlated with high preoperative serum CEA level(P=0.001).Using multivariate logistic regression analysis,high preoperative serum CEA level(P=0.004;odds ratio 15.341; 95%CI 2.371-99.275)was an independent predictor for postoperative distant metastasis. CONCLUSION:The preoperative increased serum CEA level is a predictive risk factor for distant metastasis in CRC patients after radical resection.Adjuvant chemotherapy may be necessary in such patients,even if they have pT1 colorectal cancer.

关键词： Colorectal cancer Risk factor Metastasis Pathologically T1 Carcinoembryonic antigen

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Appropriate treatment of acute sigmoid volvulus in the emergency setting

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World Journal of Gastroenterology 2013年第30期19卷 4979-4983页

作者： Zheng Lou en-da yu Wei Zhang Rong-Gui Meng Li-Qiang Hao Chuan-Gang Fu Department of Colorectal Surgery Changhai Hospital

AIM:To investigate an appropriate strategy for the treatment of patients with acute sigmoid volvulus in the emergency setting.METHODS:A retrospective review of 28 patients with acute sigmoid volvulus treated in the Department of Colorectal Surgery,Changhai Hospital,Shanghai from January 2001 to July 2012 was performed.Following the diagnosis of acute sigmoid volvulus,an initial colonoscopic approach was adopted if there was no evidence of diffuse peritonitis.RESULTS:Of the 28 patients with acute sigmoid volvulus,19(67.9%)were male and 9(32.1%)were female.Their mean age was 63.1 ± 22.9 years(range,21-93 years).Six(21.4%)patients had a history of abdominal surgery,and 17(60.7%)patients had a history of constipation.Abdominal radiography or computed tomography was performed in all patients.Colonoscopic detorsion was performed in all 28 patients with a success rate of 92.8%(26/28).Emergency surgery was required in the other two patients.Of the 26 successfully treated patients,seven(26.9%)had recurrent volvulus.CONCLUSION:Colonoscopy is the primary emergency treatment of choice in uncomplicated acute sigmoid volvulus.Emergency surgery is only for patients in whom nonoperative treatment is unsuccessful,or in those with peritonitis.

关键词： Sigmoid colon Volvulus Emergency Colonoscopy

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Near real-time gravitational wave data analysis of the massive black hole binary with TianQin

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Science China(Physics,Mechanics & Astronomy) 2024年第7期67卷 175-186页

作者： Hong-yu Chen Xiang-yu Lyu en-Kun Li Yi-Ming Hu MOE Key Laboratory of TianQin Mission TianQin Research Center for Gravitational Physics&School of Physics and AstronomyFrontiers Science Center for TianQinGravitational Wave Research Center of CNSASun Yat-sen University(Zhuhai Campus)Zhuhai 519082China

Space-borne gravitational wave(GW)detectors can detect the merger of massive black holes.The early warning and localization of GW events before merging can be used to inform electromagnetic telescopes and conduct multimessenger observations.However,this requires real-time data transmission and analysis capabilities.The geocentric orbit of the space-borne GW detector Tian Qin makes it possible to conduct real-time data transmission.In this study,we develop a search and localization pipeline for massive black hole binaries(MBHBs)with Tian Qin under both regular and real-time data transmission modes.We demonstrate that,with real-time data transmission,MBHBs can be accurately localized on the fly.With the approaching merger,each analysis can be finished in only 40 min.For an MBHB system at a distance of 1 Gpc,if we receive data every hour,then we can pinpoint its location to within less than 1 deg^(2)on the final day before the merger.

关键词： gravitational wave detectors and experiments black holes data analysis algorithms and implementation data management

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Molecular mechanism of Xuebijing in treating pyogenic liver abscess complicated with sepsis

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World Journal of Emergency Medicine 2024年第1期15卷 35-40页

作者： Wei Zhou Maiying Fan Xiang Li Fang yu en Zhou Xiaotong Han Department of Emergency Medicine the First Affi liated Hospital of Hunan Normal University/Hunan Provincial People’s HospitalChangsha 410005China Department of Otolaryngology-head and Neck Surgery the First Affi liated Hospital of Hunan Normal University/Hunan Provincial People’s HospitalChangsha 410005China

BACKGROUND:Xuebijing(XBJ)can alleviate the inflammatory response,improve organ function,and shorten the intensive care unit(ICU)stay in patients with pyogenic liver abscess(PLA)complicated with sepsis,but the molecular mechanisms have not been elucidated.This study aimed to explore the molecular mechanism of XBJ in treating PLA complicated with sepsis using a network pharmacology approach.METHODS:The active ingredients and targets of XBJ were retrieved from the ETCM database.Potential targets related to PLA and sepsis were retrieved from the GeneCards,PharmGKB,DisGenet,Online Mendelian Inheritance in Man(OMIM),Therapeutic Targets database(TTD),and DrugBank databases.The targets of PLA complicated with sepsis were mapped to the targets of XBJ to identify potential treatment targets.Protein-protein interaction networks were analyzed using the STRING database.Potential treatment targets were imported into the Metascape platform for Gene Ontology(GO)functional enrichment and Kyoto encyclopedia of Genes and Genomes(KEGG)pathway enrichment analyses.Molecular docking was performed to validate the interactions between active ingredients and core targets.RESULTS:XBJ was found to have 54 potential treatment targets for PLA complicated with sepsis.Interleukin-1β(IL-1β),interleukin-6(IL-6),and tumor necrosis factor(TNF)were identifi ed as core targets.KEGG enrichment analysis revealed important pathways,including the interleukin-17(IL-17)signaling pathway,the TNF signaling pathway,the nuclear factor-kappa B(NF-κB)signaling pathway,and the Toll-like receptor(TLR)signaling pathway.Molecular docking experiments indicated stable binding between XBJ active ingredients and core targets.CONCLUSION:XBJ may exert therapeutic eff ects on PLA complicated with sepsis by modulating signaling pathways,such as the IL-17,TNF,NF-κB,and TLR pathways,and targeting IL-1β,IL-6,and TNF.

关键词： Xuebijing injection Pyogenic liver abscess Sepsis

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Factors influencing willingness to participate in ophthalmic clinical trials and strategies for effective recruitment

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International Journal of Ophthalmology(english edition) 2024年第1期17卷 157-163页

作者： Jia-en Liang Meng-Yin Liang en-en Zhang yu-Ying Peng Ling-Ling Chen Jia-yu Deng Ting Lin Jun Fu Jia-Ni Zhang Shao-Li Li Fei Li Hui-Ming Xaio Wen-Min Huang yu-Hong Liu State Key Laboratory of Ophthalmology Zhongshan Ophthalmic CenterSun Yat-sen UniversityGuangdong Provincial Key Laboratory of Ophthalmology and Visual ScienceGuangdong Provincial Clinical Research Center for Ocular DiseasesGuangzhou 510060Guangdong ProvinceChina

AIM:To explore the factors influencing individuals’willingness to participate in ophthalmic clinical trials.METHODS:A questionnaire survey was conducted from January to April 2021 among patients and their family members at Zhongshan Ophthalmic Center,Sun Yat-sen University,in Guangzhou,China.The survey gathered data on respondents’willingness,demographic and socioeconomic profiles,as well as their reasons and concerns regarding engagement in clinical trials.RESULTS:Of the 1078 residents surveyed(mean age 31.2±13.1y;65.8%females)in Guangzhou,749(69.5%)expressed a willingness to participate in future ophthalmic clinical trials.Specific characteristics associated with greater willingness included a younger age,lower annual income,higher education,prior participation experience,previous ophthalmic treatment,and a better understanding of clinical trials.With the exception of age,these characteristics were significantly linked to a higher willingness.The primary barrier to participation,expressed by 64.8%of those willing and 54.4%of those unwilling,was“Uncertain efficacy”.In terms of motivations,the willing group ranked“Better therapeutic benefits”(35.0%),“Professional monitoring”(34.3%),and“Trust in healthcare professionals”(33.1%)as their top three reasons,whereas the unwilling participants indicated“Full comprehension of the protocol”(46.2%)as the key facilitator.CONCLUSION:This study reveals a substantial willingness to participate in ophthalmic clinical trials and demonstrates the predictive role of demographic and socioeconomic factors.Variations in motivators and concerns between willing and unwilling participants highlight the significance of tailored recruitment strategies.Importantly,the need for and trust in healthcare professionals stand out as powerful motivations,underscoring the importance of enhancing physician-patient relationships,adopting patient-centered communication approaches,and addressing individualized needs to improve accrual rates.

关键词： participation willingness recruitment strategy ophthalmic clinical trial

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