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Where is the optimal plane to mobilize the anterior rectal wall in female patients undergoing total mesorectal excision?

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World Journal of Gastroenterology 2023年第19期29卷 2992-3002页

作者： Wei Jin Jun Yang Xin-Yu Li Wei-Cheng Wang wen-jian meng You Li Yi-Chao Liang Yi-Ming Zhou Xin-Dong Yang Yang-Yang Li Shao-Tang Li Department of Colorectal and Anal Surgery The First Affiliated Hospital of Wenzhou Medical UniversityWenzhou 325000Zhejiang ProvinceChina Department of Gastrointestinal Surgery The First Hospital of Quanzhou Affiliated to Fujian Medical UniversityQuanzhou 362002Fujian ProvinceChina Department of Gastrointestinal Surgery West China Hospital.Sichuan UniversityChengdu 610041Sichuan ProvinceChina Department of General Surgery Shanghai Jiao Tong University Medical School Affiliated RuijinShanghai 201800China Department of General Surgery Shengjing Hospital of China Medical UniversityShenyang 111300Liaoning ProvinceChina Department of General Surgery Huashan Hospital Fudan UniversityShanghai 201800China School of Basic Medicine Wenzhou Medical UniversityWenzhou 325000Zhejiang ProvinceChina Department of Pathology the First Affiliated Hospital of Wenzhou Medical UniversityWenzhou 325000Zhejiang ProvinceChina National Key Clinical Specialty(General Surgery) The First Affiliated Hospital of Wenzhou Medical UniversityWenzhou 325000Zhejiang ProvinceChina

BACKGROUND Since Heald proposed the total mesorectal excision(TME)procedure,the prognosis of patients with rectal cancer has been significantly improved.But Heald did not specifically describe the anterior surgical plane in female patients.And the surgical plane for mobilizing the anterior rectal wall during TME surgery in female patients remains controversial.AIM To investigate the anatomy of the female pelvis and identify the optimal plane for mobilizing the anterior rectal wall.METHODS We retrospectively collected surgical procedure videos and clinical data of female patients diagnosed with middle or low rectal cancer who underwent the TME procedure between January 2020 and October 2022 across six hospitals.The patients were divided into two groups based on the surgical approach used to mobilize the anterior rectal wall:The experimental group was to open the peritoneum at the lowest point of the peritonea reflection and enter the plane for mobilizing,while the control group was cut at 0.5-1 cm above the peritoneal reflection and enter another plan.Then,we compared the preoperative and postoperative information between the two groups.We also dissected and observed ten adult female pelvises to analyze the anatomic structure and compare the entry plane between the two approaches.Finally,we researched the pathological structure between the rectum and the vagina.RESULTS Finally,77 cases that met the criteria were included in our study.Our observations revealed that the experimental group underwent a smooth procedure,entering the plane amidst the mesorectal fascia and adventitia of the vagina,whereas the control group entered the plane between the vaginal adventitia and muscle layers.Compared to the control group,the experimental group showed a significant decrease in intraoperative bleeding[22.5(19.5-50)mL vs 17(5-20)mL,P=0.01],as well as a shorter duration of hospitalization[9(7-11.25)d vs 7(6-10)d,P=0.03].Through the examination of surgical videos and cadaveric studies,we discovered that Denonvilliers'fascia is a

关键词： Rectal cancer Procedure Female Rectal surgery specialty Fascia Laparoscopic

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Management and outcomes of surgical patients with intestinal Behçet’s disease and Crohn’s disease in southwest China

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World Journal of Clinical Cases 2021年第16期9卷 3858-3868页

作者： Li Zeng wen-jian meng Zhong-Hui wen Yi-Long Chen Yu-Fang Wang Cheng-Wei Tang Department of Gastroenterology West China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina Department of Gastrointestinal Surgery West China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina West China Biomedical Big Data Center West China Hospital/West China School of MedicineSichuan UniversityChengdu 610041Sichuan ProvinceChina

BACKGROUND Gastrointestinal involvement in Behçet's disease(GIBD)and Crohn’s disease(CD)are inflammatory diseases sharing a considerable number of similarities.However,different from CD,the operative and postoperative management of GIBD remains largely empirical because of the lack of comprehensive treatment guidelines.AIM To compare surgical patients with GIBD and those with CD in a medical center and identify notable clinical features and effective postoperative treatment for surgical patients with GIBD.METHODS We searched patients diagnosed with CD and GIBD who underwent operations for gastrointestinal complications from 2009 to 2015 at West China Hospital of Sichuan University.A total of 10 surgical patients with GIBD and 106 surgical patients with CD were recruited.Information including demographic data,medication,and operative and postoperative parameters were collected and analyzed.As the incidence of surgical GIBD is low,their detailed medical records were reviewed and compared to previous studies.Moreover,the prognoses of CD and GIBD were evaluated respectively between groups treated with biological and non-biological agents.RESULTS Indication for first surgery was often acute intestinal perforation for GIBDpatients (7/10 vs 0/106, P went reoperations. Theaverage period of postoperative recurrence was 7.87 mo in patients with Behçet'sdisease (BD) and 10.43 mo in patients with CD, whereas the mean duration fromfirst surgery to reoperation was 5.75 mo in BD patients and 18.04 mo in CDpatients. Surgical patients with GIBD more often used corticosteroids (6/10 vs7/106, P < 0.001) and thalidom

关键词： Gastrointestinal involvement in Behçet's disease Crohn’s disease Surgery Postoperative treatment Biological agents Real-world study

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Overexpression of connective tissue growth factor WISP-1 in Chinese primary rectal cancer patients

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World Journal of Gastroenterology 2007年第28期13卷 3878-3882页

作者： Chao Tian Zong-Guang Zhou wen-jian meng Xiao-Feng Sun Yong-Yang Yu Li Li Hong-Zhi Luo, Lie Yang Bin Zhou Jun Gu Department of Gastrointestinal Surgery and Division of Digestive Surgery and Organ-Microcirculation West China Hospital Sichuan University Chengdu 610041 Sichuan Province China Department of Oncology Institute of Biomedicine and Surgery University of Linkoping Linkoping Sweden Department of Gastrointestinal Surgery West China Hospital Sichuan University Chengdu 610041 Sichuan Province China

AIM: To clarify the expression change of Wnt-induced secreted protein-1 (WISP-1) in human rectal cancer and to determine whether it is correlated with invasion and metastasis of human rectal cancer. METHODS: Eighty-six paired samples of rectal cancer and surgically resected distant normal rectal tissue were collected and allocated into cancer group and control group respectively. WISP-1 mRNA was detected by relative quantitative real-time RT-PCR and WISP-1 protein was examined by immunohistochemical staining. RESULTS: WISP-1 gene overexpression was found in 65% (56/86) primary rectal cancers, 2-30 times that of the level in normal matched rectal tissues (P = 0.001). The mRNA expression level was correlated with Duke's staging, histological differentiation grade and lymph node status. The WISP-1 protein expression was in accordance with mRNA expression level. The positive degree of immunohistochemical staining in the cancer group (1.40 ± 0.35) was different from that in control group (1.04 ± 0.08, P < 0.001). Moreover, in cancer group the positive staining degree in high-level mRNA cancers (1.46 ± 0.37, n = 56) was higher than that in low-level mRNA (1.28 ± 0.28, n = 30, P = 0.018). CONCLUSION: Aberrant levels of WISP-1 expressionmay play a role in rectal tumorigenesis. WISP-1 may be used as a specific clinical diagnosis and prognosis marker in rectal cancer.

关键词：原发性直肠癌组织生长因子中国人 WISP-1 免疫组织学

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Novel mutations and sequence variants in exons 3-9 of human T Cell Factor-4 gene in sporadic rectal cancer patients stratified by microsatellite instability

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World Journal of Gastroenterology 2007年第27期13卷 3747-3751页

作者： wen-jian meng Ling Wang Chao Tian Yong-Yang Yu Bing Zhou Jun Gu Qing-Jie Xia Xiao-Feng Sun Yuan Li Rong Wang Xue-Lian Zheng Zong-Guang Zhou Department of Gastrointestinal Surgery West China Hospital Sichuan University Chengdu 610041 Sichuan Province China Division of Digestive Surgery and Organ-Microcirculation West China Hospital Sichuan University Chengdu 610041 Sichuan Province China Ophthalmologic Surgery Laboratory West China Hospital Sichuan University Chengdu 610041 Sichuan Province China National Key Laboratory of Biotherapy of West China Hospital Sichuan University Chengdu 610041 Sichuan Province China Department of Oncology Linkoping University Linkoping Sweden

AIM: To establish the role of human T Cell Factor-4 (hTCF-4) gene exons 3-9 mutation status in association with sporadic rectal cancer with microsatellite instability (MSI). METHODS: Microsatellite markers were genotyped in 93 sporadic rectal cancer patients. Eleven cases were found to be high-frequency MSI (MSI-H). Sequence analysis of the coding region of the exons 3-9 of hTCF-4 gene was carried out for the 11 MSI-H cases and 10 controls (5 microsatellite stability (MSS) cases and 5 cases with normal mucosa). The sequencing and MSI identification were used. RESULTS: Several novel mutations and variants were revealed. In exon 4, one is a 4-position continuous alteration which caused amino acid change from Q131T and S132I (391insA, 392 G > A, 393 A > G and 395delC) and another nucleotide deletion (395delC) is present in MSI-H cases (5/10 and 4/10, respectively) but completely absent in the controls.CONCLUSION: Novel mutations in exon 4 of hTCF-4 gene were revealed in this study, which might be o importance in the pathogenesis of sporadic rectal cance patients with MSI-H.

关键词：零星直肠癌突变分析序列变异体单发性肠癌

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Mucosa color and size may indicate malignant transformation of chicken skin mucosa-positive colorectal neoplastic polyps

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World Journal of Gastrointestinal Oncology 2024年第3期16卷 750-760页

作者： Ying-Jie Zhang meng-Xia Yuan Wu wen Fan Li Yi jian Chuan-Ming Zhang Ye Yang Feng-Lin Chen Department of Digestive Diseases Chengdu Second People’s HospitalChengdu 610000Sichuan ProvinceChina Graduate School Chengdu Medical CollegeChengdu 610000Sichuan ProvinceChina

BACKGROUND Lipid metabolism reprogramming is suspected to exist in pre-cancerous lesions,including colorectal adenoma.Screening colonoscopy frequently reveals chicken skin mucosa(CSM;white or yellow-white speckled mucosa)surrounding colo-rectal polyps,caused by macrophages engulfing and accumulating the lipids decomposed by colon cells or adjacent tumors.CSM-positive colorectal polyps are associated with various diseases;however,their prognosis varies greatly.Cold snare polypectomy is commonly used to resect lesions up to 10 to 15 mm in diameter without signs of submucosal invasion but is controversial for CSM-positive colorectal polyps.Improved imaging is required to diagnose and treat CSM-positive colorectal polyps.METHODS This retrospective cohort study included 177 patients with CSM-positive colorectal polyps diagnosed using endoscopy.All patient-related information was extracted from the Goldisc soft-clinic DICOM system or electronic medical record system.Based on the pathological results,patients were classified as non-neoplastic polyps(five juvenile polyps),neoplastic polyps,non-invasive high-grade neoplasia(NHGN),or submucosal invasive carcinoma(SM stage cancer).We analyzed and compared the clinical features,suspected risk factors for malignant transformation of neoplastic polyps,and early infiltration of sub-mucosal carcinoma.RESULTS The diameters of NHGN and SM polyps were much smaller than those of neoplastic polyps.Most NHGN polyps had a deeper red mucosal color.On logistic regression analyses,diameter and deeper red mucosal color were independent risk factors for malignant transformation of neoplastic polyps.Type 1 CSM was more common in high-grade intraepithelial neoplasia and SM;type 2 CSM was more common in neoplastic polyps.Logistic regression analyses revealed no significant differences in the malignant transformation of neoplastic polyps or early submucosal invasion of CSM-positive colorectal cancer.Changes in the CSM mucosa surrounding neoplastic polyps and submucosal invasion of colorectal ca

关键词： Chicken skin mucosa Colorectal cancer Colorectal polyps Endoscopic resection Malignant transformation White light endoscopy

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Observation of gapless corner modes of photonic crystal slabs in synthetic translation dimensions

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Photonics Research 2024年第3期12卷 444-455页

作者： wen-JIN ZHANG HAO-CHANG MO wen-JIE CHEN XIAO-DONG CHEN jian-wen DONG School of Physics&State Key Laboratory of Optoelectronic Materials and Technologies Sun Yat-sen UniversityGuangzhou 510275China

Second-order topological photonic crystals support localized corner modes that deviate from the conventional bulk-edge correspondence.However,the frequency shift of corner modes spanning the photonic band gap has not been experimentally reported.Here,we observe the gapless corner modes of photonic crystal slabs within a parameter space by considering translation as an additional synthetic dimension.These corner modes,protected by topological pumping in synthetic translation dimensions,are found to exist independently of the specific corner configuration.The gapless corner modes are experimentally imaged via the near-field scanning measurement and validated numerically by full-wave simulations.We propose a topological rainbow with gradient translation,demonstrating the ability to extract and separate specific frequency components of light into different spatial locations.Our work contributes to the advancement of topological photonics and provides valuable insights into the exploration of gapless corner modes in synthetic dimensions.

关键词： translation dimensions corner

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Early gastric cancer recurrence after endoscopic submucosal dissection:Not to be ignored!

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World Journal of Gastrointestinal Oncology 2024年第1期16卷 8-12页

作者： Yan Zeng jian Yang Jun-wen Zhang Department of Psychology The Second Affiliated Hospital of Chongqing Medical UniversityChongqing 400010China Department of Gastroenterology Changdu People's Hospital of XizangChangdu 854000Tibet Autonomous RegionChina Department of Gastroenterology The First Affiliated Hospital of Chongqing Medical UniversityChongqing 400016China

This editorial comments on the article“Efficacy of multi-slice spiral computed tomography in evaluating gastric cancer recurrence after endoscopic submucosal dissection”.We focus on the importance of paying more attention to postendoscopic submucosal dissection(ESD)gastric cancer recurrence in patients with early gastric cancer(EGC)and how to manage it effectively.ESD has been a wellknown treatment and the mainstay for EGC,with the advantages of less invasion and fewer complications when compared with traditional surgical procedures.Despite a lower local recurrence rate after ESD,the problem of postoperative recurrence in patients with EGC has become increasingly non-ignorable with the global popularization of ESD technology and the increasing number of post-ESD patients.

关键词： Early gastric cancer Recurrence Endoscopic submucosal dissection Postoperative Prediction

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Postoperative pneumocranium after endoscopic transnasal optic canal decompression

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International Journal of Ophthalmology(English edition) 2024年第5期17卷 973-975页

作者： Sheng-jian Lu Bo Yu wen-Can Wu The Eye Hospital School of Ophthalmology&OptometryWenzhou Medical UniversityWenzhou 325027Zhejiang ProvinceChina

Dear Editor,We present the first time,a case of a patient developed cerebrospinal fluid(CSF)leak and pneumocranium following optic canal decompression(OCD).INTRODUCTION Indirect traumatic optic neuropathy(ITON)impairs visual functions and quality of life.Endoscopic transnasal optic canal decompression(ETOCD)is one of the standard treatment strategies for the ITON.During the ETOCD,the optic nerve sheath are usually incised for sufficient decompression of optic nerve after removal of optic canal,which is associated with complications like CSF leakage,ophthalmic artery injury,and optic nerve injury[1].Generally,the mild CSF leak is common and can heal spontaneously using conventional treatment,the severe CSF leak requires surgical repair[2].

关键词： decompression nasal traumatic

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N-glycan biosignatures as a potential diagnostic biomarker for earlystage pancreatic cancer

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World Journal of Gastrointestinal Oncology 2024年第3期16卷 659-669页

作者： Yan-Rong wen Xia-wen Lin Yu-wen Zhou Lei Xu Jun-Li Zhang Cui-Ying Chen jian He Department of Nuclear Medicine Nanjing Drum Tower HospitalAffiliated Hospital of Medical SchoolNanjing UniversityNanjing 210008Jiangsu ProvinceChina Department of Research and Development Sysdiagno(Nanjing)Biotech Co.LtdNanjing 210008Jiangsu ProvinceChina

BACKGROUND Pancreatic ductal adenocarcinoma(PDAC)has a poor prognosis,with a 5-year survival rate of less than 10%,owing to its late-stage diagnosis.Early detection of pancreatic cancer(PC)can significantly increase survival rates.AIM To identify the serum biomarker signatures associated with early-stage PDAC by serum N-glycan analysis.METHODS An extensive patient cohort was used to determine a biomarker signature,in-cluding patients with PDAC that was well-defined at an early stage(stages I and II).The biomarker signature was derived from a case-control study using a case-cohort design consisting of 29 patients with stage I,22 with stage II,4 with stage III,16 with stage IV PDAC,and 88 controls.We used multiparametric analysis to identify early-stage PDAC N-glycan signatures and developed an N-glycan sig-nature-based diagnosis model called the“Glyco-model”.RESULTS The biomarker signature was created to discriminate samples derived from patients with PC from those of controls,with a receiver operating characteristic area under the curve of 0.86.In addition,the biomarker signature combined with cancer antigen 19-9 could discriminate patients with PDAC from controls,with a receiver operating characteristic area under the curve of 0.919.Glyco-model demonstrated favorable diagnostic performance in all stages of PC.The diagnostic sensitivity for stage I PDAC was 89.66%.Core Tip:This study employed a patient cohort to investigate the N-glycan signature of early-stage pancreatic cancer(PC).Serum N-glycans analysis was conducted to identify the serum biomarker signature associated with early-stage pancreatic ductal adenocarcinoma(PDAC),resulting in the identification of nine early-stage PDAC N-glycan signatures.Subsequently,utilizing these biosignatures,a diagnostic model named the“Glyco-model”was developed,demonstrating promising diagnostic performance across all stages of PC.The study revealed that the diagnostic sensitivity for stage I PDAC was determined to be 89.66%.Consequently,this diagnostic model exhibits potent

关键词： Glycomics N-glycans Biomarkers Pancreatic cancer Predictive modeling

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I-DCGAN and TOPSIS-IFP:A simulation generation model for radiographic flaw detection images in light alloy castings and an algorithm for quality evaluation of generated images

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China Foundry 2024年第3期21卷 239-247页

作者： Ming-jun Hou Hao Dong Xiao-yuan Ji wen-bing Zou Xiang-sheng Xia meng Li Ya-jun Yin Bao-hui Li Qiang Chen jian-xin Zhou State Key Laboratory of Materials Processing and Die&Mould Technology Huazhong University of Science and TechnologyWuhan 430074China Xinjiang Technology(jiangsu)Co. Ltd.Nantong 226100JiangsuChina Southwest Technique and Engineering Research Institute Chongqing 400039China Shanghai Spaceflight Precision Machinery Institute Shanghai 201600China

The intelligent detection technology driven by X-ray images and deep learning represents the forefront of advanced techniques and development trends in flaw detection and automated evaluation of light alloy castings.However,the efficacy of deep learning models hinges upon a substantial abundance of flaw samples.The existing research on X-ray image augmentation for flaw detection suffers from shortcomings such as poor diversity of flaw samples and low reliability of quality evaluation.To this end,a novel approach was put forward,which involves the creation of the Interpolation-Deep Convolutional Generative Adversarial Network(I-DCGAN)for flaw detection image generation and a comprehensive evaluation algorithm named TOPSIS-IFP.I-DCGAN enables the generation of high-resolution,diverse simulated images with multiple appearances,achieving an improvement in sample diversity and quality while maintaining a relatively lower computational complexity.TOPSIS-IFP facilitates multi-dimensional quality evaluation,including aspects such as diversity,authenticity,image distribution difference,and image distortion degree.The results indicate that the X-ray radiographic images of magnesium and aluminum alloy castings achieve optimal performance when trained up to the 800th and 600th epochs,respectively.The TOPSIS-IFP value reaches 78.7%and 73.8%similarity to the ideal solution,respectively.Compared to single index evaluation,the TOPSIS-IFP algorithm achieves higher-quality simulated images at the optimal training epoch.This approach successfully mitigates the issue of unreliable quality associated with single index evaluation.The image generation and comprehensive quality evaluation method developed in this paper provides a novel approach for image augmentation in flaw recognition,holding significant importance for enhancing the robustness of subsequent flaw recognition networks.

关键词： light alloy casting flaw detection image generator discriminator comprehensive evaluation index

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