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Development and validation of a nomogram model for predicting the risk of gallstone recurrence after gallbladder-preserving surgery

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Hepatobiliary & Pancreatic Diseases International 2024年第3期23卷 288-292页

作者： Peng Liu Yong-Wei Chen Che Liu yin-tao wu Wen-Chao Zhao Jian-Yong Zhu Yang An Nian-Xin Xia Faculty of Hepato-Pancreato-Biliary Surgery the First Medical CenterChinese PLA General HospitalBeijing 100853China Institute of Hepatobiliary Surgery of Chinese PLA Beijing 100853China Key Laboratory of Digital Hepetobiliary Surgery of Chinese PLA Beijing 100853China

Background:The high incidence of gallstone recurrence was a major concern for laparoscopic gallbladderpreserving surgery.This study aimed to investigate the risk factors for gallstone recurrence after gallbladder-preserving surgery and to establish an individualized nomogram model to predict the risk of gallstone recurrence.Methods:The clinicopathological and follow-up data of 183 patients who were initially diagnosed with gallstones and treated with gallbladder-preserving surgery at our hospital from January 2012 to January 2019 were retrospectively collected.The independent predictive factors for gallstone recurrence following gallbladder-preserving surgery were identified by multivariate logistic regression analysis.A nomogram model for the prediction of gallstone recurrence was constructed based on the selected variables.The C-index,receiver operating characteristic(ROC)curve and calibration curve were used to evaluate the predictive power of the nomogram model for gallstone recurrence.Results:During the follow-up period,a total of 65 patients experienced gallstone recurrence,and the recurrence rate was 35.5%.Multivariate logistic regression analysis revealed that the course of gallstones>2 years[odds ratio(OR)=2.567,95%confidence interval(CI):1.270-5.187,P=0.009],symptomatic gallstones(OR=2.589,95%CI:1.059-6.329,P=0.037),multiple gallstones(OR=2.436,95%CI:1.133-5.237,P=0.023),history of acute cholecystitis(OR=2.778,95%CI:1.178-6.549,P=0.020)and a greasy diet(OR=2.319,95%CI:1.186-4.535,P=0.014)were independent risk factors for gallstone recurrence after gallbladder-preserving surgery.A nomogram model for predicting the recurrence of gallstones was established based on the above five variables.The results showed that the C-index of the nomogram model was 0.692,suggesting it was valuable to predict gallstone recurrence.Moreover,the calibration curve showed good consistency between the predicted probability and actual probability.Conclusions:The nomogram model for the prediction of gallstone recurrence might hel

关键词： Gallstone Gallbladder-preserving surgery Recurrence Risk factors Nomogram

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Impact of B-mode-ultrasound-guided transhepatic and transperitoneal cholecystostomy tube placement on laparoscopic cholecystectomy

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World Journal of Gastroenterology 2020年第36期26卷 5498-5507页

作者： Peng Liu Che Liu yin-tao wu Jian-Yong Zhu Wen-Chao Zhao Jing-Bo Li Hong Zhang ying-Xiang Yang Department of Hepatobiliary Surgery The Sixth Medical Center of People’s Liberation Army General HospitalBeijing 100048China

BACKGROUND B-mode-ultrasound-guided percutaneous cholecystostomy(PC)may be performed by a transhepatic or transperitoneal approach,called percutaneous transhepatic gallbladder drainage(PHGD)and percutaneous transperitoneal gallbladder drainage(PPGD),respectively.We compared the impact of PC related to the route of catheter placement on subsequent laparoscopic cholecystectomy(LC).AIM To compare the impact of PC related to the route of catheter placement on subsequent LC.METHODS We retrospectively studied 103 patients with acute calculous cholecystitis who underwent scheduled LC after PC between January 2010 and January 2019.Group I included 58 patients who underwent scheduled LC after PHGD.Group II included 45 patients who underwent scheduled LC after PPGD.Clinical outcomes were analyzed according to each group.RESULTS Baseline demographic characteristics did not differ significantly between both groups(P>0.05).Both PHGD and PPGD were able to quickly resolve cholecystitis sepsis.Group I showed significantly higher efficacy than group II in terms of lower pain score during puncture(3.1 vs 4.5;P=0.001)and at 12 h follow-up(1.5 vs 2.2;P=0.001),lower rate of fever within 24 h after PC(13.8%vs 42.2%;P=0.001),shorted operation duration(118.3 vs 139.6 min;P=0.001),lower amount of intraoperative bleeding(72.1 vs 109.4 mL;P=0.001)and shorter length of hospital stay(14.3 d vs 18.0 d;P=0.001).However,group II had significantly lower rate of local bleeding at the PC site(2.2%vs 20.7%;P=0.005)and lower rate of severe adhesion(33.5%vs 55.2%;P=0.048).No significant differences were noted between both groups regarding the conversion rate to laparotomy,rate of subtotal cholecystectomy,complications and pathology.CONCLUSION B-mode-ultrasound-guided PHGD is superior to PPGD followed by LC for treatment of acute calculous cholecystitis,with shorter operating time,minimal amount of intraoperative bleeding and short length of hospital stay.

关键词： Acute calculous cholecystitis Percutaneous transhepatic gallbladder drainage Percutaneous transperitoneal gallbladder drainage Laparoscopic cholecystectomy Bmode ultrasound Acute cholecystitis

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Rational surface charge engineering of haloalkane dehalogenase for boosting the enzymatic performance in organic solvent solutions

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Chinese Journal of Chemical Engineering 2024年第1期65卷 276-285页

作者： yin wu Yan Sun Department of Biochemical Engineering School of Chemical Engineering and Technology and Key Laboratory of Systems Bioengineering and Frontiers Science Center for Synthetic Biology(Ministry of Education)Tianjin UniversityTianjin 300350China

Biocatalysis in organic solvents(OSs)has numerous important applications,but native enzymes in OSs often exhibit limited catalytic performance.Herein,we proposed a computation-aided surface charge engineering strategy to improve the catalytic performance of haloalkane dehalogenase DhaA in OSs based on the energetic analysis of substrate binding to the DhaA surface.Several variants with enhanced OS resistance were obtained by replacing negative charged residues on the surface with positive charged residue(Arg).Particularly,a four-substitution variant E16R/E93R/E121R/E257R exhibited the best catalytic performance(five-fold improvement in OS resistance and seven-fold half-life increase in 40%(vol)dimethylsulfoxide).As a result,the overall catalytic performance of the variant could be at least 26 times higher than the wild-type DhaA.Fluorescence spectroscopy and molecular dynamics simulation studies revealed that the residue substitution mainly enhanced OS resistance from four aspects:(a)improved the overall structural stability,(b)increased the hydrophobicity of the local microenvironment around the catalytic triad,(c)enriched the hydrophobic substrate around the enzyme molecule,and(d)lowered the contact frequency between OS molecules and the catalytic triad.Our findings validate that computationaided surface charge engineering is an effective and ingenious rational strategy for tailoring enzyme performance in OSs.

关键词： Surface charge engineering Organic solvent resistance Molecular dynamics simulation Haloalkane dehalogenase

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Diabetes mellitus in patients with type 1 autoimmune pancreatitis at diagnosis and after corticosteroid therapy

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Hepatobiliary & Pancreatic Diseases International 2024年第4期23卷 393-398页

作者： Mei-Zi Li tao Guo Yun-Lu Feng Sheng-Yu Zhang Xiao-yin Bai Xi wu Kai Xu Ai-Ming Yang Department of Gastroenterology State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalPeking Union Medical College and Chinese Academy of Medical SciencesBeijing 100730China Department of Radiology Peking Union Medical College HospitalPeking Union Medical College and Chinese Academy of Medical SciencesBeijing 100730China

Background:A high prevalence of diabetes mellitus(DM)coexisting with autoimmune pancreatitis(AIP)is observed.However,evidence on the circumstances under which corticosteroid therapy(CST)for AIP improves or worsens DM is scarce.This study aimed to demonstrate and identify predictors of DM control under the influence of CST.Methods:Patients diagnosed with type 1 AIP were enrolled from a prospectively maintained cohort and were classified into three groups according to the chronology in which AIP and DM were diagnosed:pre-existing DM(pDM),concurrent DM(cDM),and non-DM(nDM).The responses of DM to CST were assessed when corticosteroid was ceased or tapered to a maintenance dose and classified as‘improvement’and‘non-improvement’(including‘no change’and‘exacerbation’).Results:Among 101 patients with type 1 AIP,52(51.5%)patients were complicated with DM at the time of AIP diagnosis,with 36 patients in the cDM group and 16 patients in the pDM group.The incidences of diffuse pancreatic swelling(72.2%)and pancreatic body/tail involvement(91.7%)were significantly higher in the cDM group than in both the pDM and nDM groups.Of the 52 patients with DM,CST was administered in 48 cases.Multivariate logistic analysis identified that elevated serum gamma-glutamyl transferase(GGT)level at AIP diagnosis[odds ratio(OR)=0.032,95%confidence interval(CI):0.003-0.412,P=0.008]and pancreatic atrophy after CST(OR=0.027,95%CI:0.003-0.295,P=0.003)were negatively associated with DM control improvement.Conclusions:Patients with diffuse pancreatic swelling and pancreatic body/tail involvement in pancreatitis tended to be complicated with cDM at AIP diagnosis.CST exerted a beneficial effect on the clinical course of DM in nearly half of the AIP patients complicated with DM at diagnosis,particularly in those without elevated serum GGT levels at diagnosis and who did not experience pancreatic atrophy after CST.

关键词： Type 1 autoimmune pancreatitis Diabetes mellitus Corticosteroid therapy Predictive factor Pancreatic atrophy

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Allergen degradation of bee pollen by lactic acid bacteria fermentation and its alleviatory effects on allergic reactions in BALB/c mice

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Food Science and Human Wellness 2024年第1期13卷 349-359页

作者： Shuting yin Qiangqiang Li Yuxiao tao Enning Zhou Kun Wang Wanwen Chen Xiangxin Li Liming wu Institute of Apicultural Research Chinese Academy of Agricultural SciencesBeijing 100093China Department of Animal Science McGill UniversityQuebec H9X 3V9Canada State Key Laboratory of Food Science and Technology School of Food Science and TechnologyJiangnan UniversityWuxi 214122China

Food allergy as a global health problem threatens food industry.Bee pollen(BP)is a typical food with allergenic potentials,although it performs various nutritional/pharmacological functions to humans.In this study,lactic acid bacteria(LAB)were used to ferment Brassica napus BP for alleviating its allergenicity.Four novel allergens(glutaredoxin,oleosin-B2,catalase and lipase)were identified with significant decreases in LAB-fermented BP(FBP)than natural BP by proteomics.Meanwhile,metabolomics analysis showed significant increases of 28 characteristic oligopeptides and amino acids in FBP versus BP,indicating the degradation of LAB on allergens.Moreover,FBP showed alleviatory effects in BALB/c mice,which relieved pathological symptoms and lowered production of allergic mediators.Microbial high-throughput sequencing analysis showed that FBP could regulate gut microbiota and metabolism to strengthen immunity,which were closely correlated with the alleviation of allergic reactivity.These findings could contribute to the development and utilization of hypoallergenic BP products.

关键词： Alleviatory effects Lactic acid bacteria fermentation Bee pollen allergen Gut microbiota Host metabolism

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Chemoselective and Living/Controlled Polymerization of Alkenyl Methacrylates by the Phosphonium Ylide/Organoaluminum Lewis Pairs

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Chinese Journal of Polymer Science 2024年第2期42卷 159-167,I0005页

作者： Zhi-Kang Chen wu-Chao Zhao Yi-Ling Zhao Cong-Lei Liu Liu-yin Jiang Yue-tao Zhang Hong-Ping Zhu State Key Laboratory of Physical Chemistry of Solid Surfaces College of Chemistry and Chemical EngineeringXiamen UniversityXiamen361005China State Key Laboratory of Supramolecular Structure and Materials College of ChemistryJilin UniversityChangchun130012China

Chemoselective,living/controlled polymerizations of allyl methacrylate(AMA) and vinyl methacrylate(VMA) with/without methyl methacrylate(MMA) by using the phosphonium ylide/organoaluminum based Lewis pairs(LPs) have been realized.The P-ylide-2/AIMe(BHT)_(2)(Pylide-2=Ph_(3)P=CHMe and BHT=2,6-iBu_(2)-4-MeC_(6)H_(2)O) was demonstrated to be superior by which homopolymers PAMAs(M_(n)=27.6-111.5kg/mol and ■=1.14-1.25) and PVMAs(M_(n)=28.4-78.4 kg/mol and ■=1.12-1.18) and block copolymers PMMA-b-PAMA,PAMA-b-PVMA,PAMA-bPMMA,PMMA-b-PAMA-b-PMMA,PAMA-b-PMMA-b-PAMA,and PAMA-b-PVMA-b-PAMA were synthesized.In the polymerizations,all of the monomers were reacted by the conjugated ester vinyl groups leaving intactly the nonconjugated acryloxy groups.The pendant acryloxy groups attached to the main chain enable further to post-functionalization by the AIBN-induced radical "thiol-ene" reaction using PhCH_(2)SH.The thiolether side group-containing polymers PAMA-SCH_(2)Ph and PAMA-SCH_(2)Ph-b-PMMA-b-PAMA-SCH_(2)Ph were thus prepared.

关键词： Phosphonium ylide Alkenyl methacrylate Chemoselectivity Living/controlled polymerization Post-functionalization

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Almost Periodic Type Group Actions on Compact Quantum Metric Spaces

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Acta Mathematica Sinica,English Series 2024年第2期40卷 568-594页

作者： Bo tao LONG Wei wu College of Mathematics MIIT Key Laboratory of Mathematical Modelling and High Performance Computing of Air VehiclesNanjing University of Aeronautics and AstronauticsNanjing 211106P.R.China School of Mathematical Sciences Shanghai Key Laboratory of Pure Mathematics and Mathematical PracticeEast China Normal UniversityShanghai 200241P.R.China

A compact quantum metric space is a complete order unit space A endowed with a Lipnorm L.We give some characterizations of almost periodic type group actions on a compact quantum metric space(A,L)by means of several kinds of subsets of A,its induced equicontinuous actions on several important subsets of the dual Banach space A*,and the Lip-norm L with its induced metric space structures on the state space S(A)of A.

关键词： Lip-norm compact quantum metric space Lipschitz isomorphism almost periodicity Arzela-Ascoli theorem metric set

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Immediate implantation of ultrafine fiber slow-release system based on cell electrospinning to induce osteogenesis of mesenchymal stem cells

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Regenerative Biomaterials 2024年第2期3卷 76-87页

作者： tao Lu Long Yang Zhuoyang Li yin Liu Shun'en Xu Chuan Ye Department of Orthopaedics The Affliated Hospital of Guizhou Medical UniversityGuiyang 550004China Department of Orthopaedics The First People's Hospital of GuiyangGuiyang 550004China Center for Tissue Engineering and Stem Cell Research Guizhou Medical UniversityGuiyang 550004China Department of Otolaryngology Head and Neck Surgery Xinqiao HospitalArmy Medical University(Third Military Medical University)Chongqing 400037China Department of Dental implant Stomatological Hospital of GuiyangGuiyang 550000China

This study presents the development and evaluation of a poly(3-hydroxybutyrate-co-4-hydroxybutyrate)(P34HB)ultrafine fiber slow-release system for in vivo osteogenic induction of human umbilical cord mesenchymal stem cells(HUCMSCs).Utilizing dual-nozzle and cell electrospinning techniques,the system encapsulates L-ascorbic acid-2-phosphate magnesium(AsP),βB-glycerophosphate sodium and dexamethasone(DEX)within the'fbers,ensuring sustained osteogenic differentiation.The scaffold's morphology,characterization,hydrophilicity,mechanical properties and cellular behavior were examined.Immediate subcutaneous implantation in rabbits was con-ducted to observe its ectopic osteogenic induction effect.Successfully fabricated P34HB ultrafine fiber slow-release sys-tem.Charact ization med.theuniform distribution of HUCMSCs and inducing components within the scaffold,with no chemical reactions affecting the active components.In vitro tests showcased a prolonged release of DEX and ASP,while biocompatibility assays highlighted the scaffold's suitability for cellular growth.Alizarin Red,type I collagen,and osteopontin(OPN)staining verifed the scaffold's potent osteogenic induction effect on HUCMsCs.Notably,immediate implantation into New Zealand White rabbits led to significant new bone formation within 8 weeks.These findings underscore the system's potential for immediate in vivo implantation without prior in vitro induction,marking a promising advancement in bone tissue engineering.

关键词： bone tissue engineering cell electrospinning in vivo induction immediate implantation biomaterials

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Predicting short-term major postoperative complications in intestinal resection for Crohn’s disease:A machine learning-based study

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World Journal of Gastrointestinal Surgery 2024年第3期16卷 717-730页

作者： Fang-tao Wang yin Lin Xiao-Qi Yuan Ren-Yuan Gao Xiao-Cai wu Wei-Wei Xu Tian-Qi wu Kai Xia Yi-Ran Jiao Lu yin Chun-Qiu Chen Diagnostic and Treatment Center for Refractory Diseases of Abdomen Surgery Shanghai Tenth People’s HospitalTongji University School of MedicineShanghai 200072China

BACKGROUND Due to the complexity and numerous comorbidities associated with Crohn’s disease(CD),the incidence of postoperative complications is high,significantly impacting the recovery and prognosis of patients.Consequently,additional stu-dies are required to precisely predict short-term major complications following intestinal resection(IR),aiding surgical decision-making and optimizing patient care.AIM To construct novel models based on machine learning(ML)to predict short-term major postoperative complications in patients with CD following IR.METHODS A retrospective analysis was performed on clinical data derived from a patient cohort that underwent IR for CD from January 2017 to December 2022.The study participants were randomly allocated to either a training cohort or a validation cohort.The logistic regression and random forest(RF)were applied to construct models in the training cohort,with model discrimination evaluated using the area under the curves(AUC).The validation cohort assessed the performance of the constructed models.RESULTS Out of the 259 patients encompassed in the study,5.0%encountered major postoperative complications(Clavien-Dindo≥III)within 30 d following IR for CD.The AUC for the logistic model was 0.916,significantly lower than the AUC of 0.965 for the RF model.The logistic model incorporated a preoperative CD activity index(CDAI)of≥220,a diminished preoperative serum albumin level,conversion to laparotomy surgery,and an extended operation time.A nomogram for the logistic model was plotted.Except for the surgical approach,the other three variables ranked among the top four important variables in the novel ML model.CONCLUSION Both the nomogram and RF exhibited good performance in predicting short-term major postoperative complic-ations in patients with CD,with the RF model showing more superiority.A preoperative CDAI of≥220,a di-minished preoperative serum albumin level,and an extended operation time might be the most crucial variables.The findings of this study can assist clinicians in

关键词： Crohn’s disease Postoperative complications Nomogram Random forest Intestinal resection

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LONP1 ameliorates liver injury and improves gluconeogenesis dysfunction in acute-on-chronic liver failure

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Chinese Medical Journal 2024年第2期137卷 190-199页

作者： Muchen wu Jing wu Kai Liu Minjie Jiang Fang Xie Xuehong yin Jushan wu Qinghua Meng Department of Liver Disease Beijing You-An HospitalCapital Medical UniversityBeijing 100069China Beijing Institute of Hepatology Beijing You-An HospitalCapital Medical UniversityBeijing 100069China Department of General Surgery Beijing You-An HospitalCapital Medical UniversityBeijing 100069China

Background:Acute-on-chronic liver failure(ACLF)is a severe liver disease with complex pathogenesis.Clinical hypoglycemia is common in patients with ACLF and often predicts a worse prognosis.Accumulating evidence suggests that glucose metabolic disturbance,especially gluconeogenesis dysfunction,plays a critical role in the disease progression of ACLF.Lon protease-1(LONP1)is a novel mediator of energy and glucose metabolism.However,whether gluconeogenesis is a potential mechanism through which LONP1 modulates ACLF remains unknown.Methods:In this study,we collected liver tissues from ACLF patients,established an ACLF mouse model with carbon tetrachloride(CCl 4),lipopolysaccharide(LPS),and D-galactose(D-gal),and constructed an in vitro hypoxia and hyperammonemia-triggered hepatocyte injury model.LONP1 overexpression and knockdown adenovirus were used to assess the protective effect of LONP1 on liver injury and gluconeogenesis regulation.Liver histopathology,biochemical index,mitochondrial morphology,cell viability and apoptosis,and the expression and activity of key gluconeogenic enzymes were detected to explore the underlying protective mechanisms of LONP1 in ACLF.Results:We found that LONP1 and the expressions of gluconeogenic enzymes were downregulated in clinical ACLF liver tissues.Furthermore,LONP1 overexpression remarkably attenuated liver injury,which was characterized by improved liver histopathological lesions and decreased serum alanine aminotransferase(ALT)and aspartate aminotransferase(AST)in ACLF mice.Moreover,mitochondrial morphology was improved upon overexpression of LONP1.Meanwhile,the expression and activity of the key gluconeogenic enzymes were restored by LONP1 overexpression.Similarly,the hepatoprotective effect was also observed in the hepatocyte injury model,as evidenced by improved cell viability,reduced cell apoptosis,and improved gluconeogenesis level and activity,while LONP1 knockdown worsened liver injury and gluconeogenesis disorders.Conclusion:We demonstrated that gluconeogenesis dysfunc

关键词： Acute-on-chronic liver failure Lon protease-1 Gluconeogenesis disturbance Mitochondrial dysfunction Metabolism

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