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Comparison of long-term quality of life between Billroth-I and Roux-en-Y anastomosis after distal gastrectomy for gastric cancer: a randomized controlled trial

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Chinese Medical Journal 2023年第9期136卷 1074-1081页

作者： Kun Yang Weihan Zhang Zehua Chen Xiaolong Chen Kai Liu Linyong Zhao jiankun hu Department of General Surgery&Laboratory of Gastric Cancer State Key Laboratory of Biotherapy/Collaborative Innovation Center of Biotherapy and Cancer CenterWest China HospitalSichuan UniversityChengduSichuan 610041China Gastric Cancer Center West China HospitalSichuan UniversityChengduSichuan 610041China

Background:The results of studies comparing Billroth-I(B-I)with Roux-en-Y(R-Y)reconstruction on the quality of life(QoL)are still inconsistent.The aim of this trial was to compare the long-term QoL of B-I with R-Y anastomosis after curative distal gastrectomy for gastric cancer.Methods:A total of 140 patients undergoing curative distal gastrectomy with D2 lymphadenectomy in West China Hospital,Sichuan University from May 2011 to May 2014 were randomly assigned to the B-I group(N=70)and R-Y group(N=70).The follow-up time points were 1,3,6,9,12,24,36,48,and 60 months after the operation.The final follow-up time was May 2019.The clinicopathological features,operative safety,postoperative recovery,long-term survival as well as QoL were compared,among which QoL score was the primary outcome.An intention-to-treat analysis was applied.Results:The baseline characteristics were comparable between the two groups.There were no statistically significant differences in terms of postoperative morbidity and mortality rates,and postoperative recovery between the two groups.Less estimated blood loss and shorter surgical duration were found in the B-I group.There were no statistically significant differences in 5-year overall survival(79%[55/70]of the B-I group vs.80%[56/70]of the R-Y group,P=0.966)and recurrence-free survival rates(79%[55/70]of the B-I group vs.78%[55/70]of the R-Y group,P=0.979)between the two groups.The scores of the global health status of the R-Y group were higher than those of the B-I group with statistically significant differences(postoperative 1 year:85.4±13.1 vs.88.8±16.1,P=0.033;postoperative 3 year:87.3±15.2 vs.92.8±11.3,P=0.028;postoperative 5 year:90.9±13.7 vs.96.4±5.6,P=0.010),and the reflux(postoperative 3 year:8.8±12.9 vs.2.8±5.3,P=0.001;postoperative 5 year:5.1±9.8 vs.1.8±4.7,P=0.033)and epigastric pain(postoperative 1 year:11.8±12.7 vs.6.1±8.8,P=0.008;postoperative 3 year:9.4±10.6 vs.4.6±7.9,P=0.006;postoperative 5 year:6.0±8.9 vs.2.7±4.6,P=0.022)were milder in the R-Y group than those of the B-

关键词： Gastric cancer Distal gastrectomy Digestive tract reconstruction Billroth-I anastomosis Roux-en-Y anastomosis Quality of life

Eco-friendly biodegradable polyurethane based coating for antibacterial and antifouling performance

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Chinese Journal of Chemical Engineering 2023年第2期54卷 80-88页

作者： Abid Ali Bilal Ul Amin Wenwu Yu Taijiang Gui Weiwei Cong Kai Zhang Zheming Tong jiankun hu Xiaoli Zhan Qinghua Zhang College of Chemical and Biological Engineering Provincial Key Laboratory of Advanced Chemical Engineering Manufacture TechnologyZhejiang UniversityHangzhou 310027China Institute of Mold Technology Changzhou Vocational Institute of Mechatronic TechnologyChangzhou 213164China State Key Laboratory of Marine Coatings Marine Chemical Research Institute Co.LtdQingdao 266072China Quzhou Research Institute Zhejiang UniversityQuzhou 324000China

Biofouling, which comprises the absorption of proteins and the adhesion of bacteria to the surface of living entities, is a severe concern for the maritime sector since it ultimately leads to hydrodynamic drag,resulting in a higher increase in fuel consumption. As a result, polymer resins are crucial in the marine sector for anti-biofouling coatings. In this work, the poly(caprolactone-ethylene glycol-caprolactone)-p olyurethane(PECL-PU) are prepared through ε-caprolactone(CL), poly(ethylene glycol)(PEG), 4,4'-methylene bis(cyclohexyl isocyanate) and 1,4 butanediol. Our study demonstrate that the PECL-PU copolymer degraded in artificial seawater(5.21%), enzymatic solution(12.63%), and seawater(13.75%)due to the presence of PEG segments in the laboratory-based test under static condition. Because the addition of PEG segments are increased the polymer's amorphous area and decreased the crystallization of the polycaprolactone(PCL) in the copolymer, as demonstrated by differential scanning calorimetry, X-ray diffraction, and water contact angle studies. Therefore, the hydrolysis rates of PECL-PU were higher than the caprolactone-co-polyurethane(CL-PU). The antifouling test showed that PECL-PU3 copolymer had about 90.29% protein resistance, 85.2% Escherichia coli(E. coli) reduction and 94.61% marine diatom Navicula incerta reduction comparison to the control. We have developed an eco-friendly and inexpensive promising degradable polyurethane for reduction of bacterial biofilm, which can preserve the formation of biofouling on marine coating under practical sea conditions.

关键词： Caprolactone PEG segments Biodegradable polyurethane Biofouling Hydrolytic degradation

ELANE:an emerging lane to selective anticancer therapy

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Signal Transduction and Targeted Therapy 2021年第11期6卷 3155-3156页

作者： Boqiang Peng jiankun hu Xianghui Fu Laboratory of Gastric Cancer and Department of Gastrointestinal Surgery State Key Laboratory of Biotherapy and Cancer CenterWest China HospitalSichuan University and Collaborative Innovation Center of BiotherapyChengduSichuanChina Division of Endocrinology and Metabolism State Key Laboratory of Biotherapy and Cancer CenterWest China HospitalSichuan University and Collaborative Innovation Center of BiotherapyChengduSichuanChina

Recently,Cui et al.1 revealed that neutrophil elastase(ELANE)can selectively kill a wide range of cancer cells while sparing proximal non-cancer cells and significantly attenuate tumorigenesis,suggesting a promising s... 详细信息

关键词： cancer proximal

模拟虚拟技术在外科医师腹腔镜培训中的实践经验

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中华消化外科杂志 2024年第4期23卷 561-565页

作者：胡建昆刘凯彭柏强四川大学华西医院普外科胃癌中心&胃癌研究室成都610041 四川大学华西临床医学院成都610041

随着微创外科的发展和普及应用,腹腔镜技术已成为当代外科医师不可或缺的核心技能之一.随着人工智能和医工融合技术的发展、创新,基于模拟和虚拟现实技术的外科模拟医学亦得到迅速推广和应用,同时也为腹腔镜外科医师的培训提供全新、有... 详细信息

随着微创外科的发展和普及应用,腹腔镜技术已成为当代外科医师不可或缺的核心技能之一.随着人工智能和医工融合技术的发展、创新,基于模拟和虚拟现实技术的外科模拟医学亦得到迅速推广和应用,同时也为腹腔镜外科医师的培训提供全新、有效的手段和平台.笔者单位前期系统性整合腹腔镜模拟虚拟技术,牵头开展腹腔镜虚拟模拟技术在专科医师实践技能考试中应用的实证研究,制定腹腔镜培训理论和操作实践课程、常态化开展基于模拟虚拟系统的腹腔镜培训,制定并构建腹腔镜外科医师分阶段渐进式的培训体系.笔者查阅相关文献,并结合团队实践,介绍和论述腹腔镜模拟虚拟系统在外科住院医师培训中的探索与实践,以期推动我国腹腔镜培训的标准化、规范化和同质化.

关键词：模拟技术虚拟技术培训考核规范化腹腔镜检查

食管胃结合部腺癌外科治疗中国专家共识(2024年版)解读

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中华胃肠外科杂志 2024年第2期27卷 127-131页

作者：刘凯朱云峰杨玉赏陈龙奇胡建昆四川大学华西医院普通外科胃癌中心&胃癌研究室成都610041 四川大学华西临床医学院成都610041 四川大学华西医院胸外科成都610041

食管胃结合部腺癌(AEG)由于解剖位置的特殊性,其定义、分期及治疗策略存在诸多分歧与争议。2018年9月,我国发布了首部《食管胃结合部腺癌外科治疗中国专家共识(2018年版)》,积极推动了胸外科和普通外科医师AEG外科治疗策略的规范性和一... 详细信息

食管胃结合部腺癌(AEG)由于解剖位置的特殊性,其定义、分期及治疗策略存在诸多分歧与争议。2018年9月,我国发布了首部《食管胃结合部腺癌外科治疗中国专家共识(2018年版)》,积极推动了胸外科和普通外科医师AEG外科治疗策略的规范性和一致性。5年来,多项AEG临床研究结果的呈现,为AEG的外科治疗关键环节策略的选择提供了新的临床证据。因此,为进一步提升我国AEG外科临床实践的诊疗水平,在中国医师协会内镜医师分会腹腔镜外科专业组、国际食管疾病学会中国分会(CSDE)、中国食管胃结合部腺癌研究协作组、中国抗癌协会胃癌专委会和中华医学会肿瘤分会胃肠肿瘤学组的共同牵头和组织下,由25名胃肠外科专家和24名胸外科专家组成2024版食管胃结合部腺癌外科治疗中国专家共识编审专家组进行讨论修订,主要基于近5年来高级别临床研究证据完成共识的更新。最终形成了29项AEG外科治疗相关的推荐陈述,并提出了5项尚待探索的外科问题。本文主要针对修订后的共识推荐陈述进行解读。

关键词：食管胃结合部腺癌外科专家共识解读

Comparison of survival outcomes between transthoracic and transabdominal surgical approaches in patients with Siewert-Ⅱ/Ⅲesophagogastric junction adenocarcinoma:a single-institution retrospective cohort study

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Chinese Journal of Cancer Research 2016年第4期28卷 413-422页

作者： Weihan Zhang Xinzu Chen Kai Liu Kun Yang Xiaolong Chen Ying Zhao Yongfan Zhao Jiaping Chen Longqi Chen jiankun hu Department of Gastrointestinal Surgery West China HospitalSichuan UniversityChengdu 610041China Institute of Gastric Cancer State Key Laboratory of BiotherapyWest China HospitalSichuan UniversityChengdu 610041China Department of Discipline Construction West China HospitalSichuan UniversityChengdu 610041China Department of Thoracic Surgery West China HospitalSichuan UniversityChengdu 610041China

Objective： To compare the survival outcomes of transabdominal （TA） and transthoracic （TT） surgical approaches in patients with Siewert-II/III esophagogastric junction adenocarcinoma. Methods： This retrospective study was conducted in patients with Siewert-II/III esophagogastric junction adenocarcinoma who underwent either TT or TA operations in the West China Hospital between January 2006 and December 2009. Results： A total of 308 patients （109 in the TT and 199 in the TA groups） were included in this study with a follow-up rate of 87.3%. The median （P25, P75） number of harvested perigastric lymph nodes was 8 （5, 10） in the TT group and 23 （16, 34） in the TA group （P〈0.001）, and the number of positive perigastric lymph nodes was 2 （0, 5） in the TT group and 3 （1, 8） in the TA group （P〈0.004）. The 5-year overall survival （OS） rate was 36% in the TT group and 51% in the TA group （P=0.005）. Subgroup analysis by Siewert classification showed that 5-year OS rates for patients with Siewert II tumors were 38% and 48% in TT and TA groups, respectively （P=0.134）, whereas the 5-year OS rate for patients with Siewert III tumors was significantly lower in the TT group than that in the TA group （33% vs. 53%; P=0.010）. Multivariate analysis indicated that N2 and N3 stages, RI/R2 resection and a TT surgical approach were prognostic factors for poor OS. Conclusions： Improved perigastric lymph node dissection may be the main reason for better survival outcomes observed with a TA gastrectomy approach than with TT gastrectomy for Siewert III tumor patients.

关键词： Siewert classification adenocarcinoma of esophagogastric junction transthoracic transabdominal prognosis

局部进展期胃腺癌患者接受根治性切除术联合紫杉醇腹腔热灌注化疗的安全性研究

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中华胃肠外科杂志 2024年第5期27卷 471-477页

作者：梅嘉鑫赵林勇张维汉刘凯陈小龙杨昆胡建昆四川大学华西医院普通外科、胃癌中心&胃癌研究室生物治疗全国重点实验室成都610041

目的探究局部进展期胃癌患者接受根治性切除术联合紫杉醇腹腔热灌注化疗(HIPEC)的安全性。方法本研究为回顾性队列研究,收集2019年7月至2021年4月期间于四川大学华西医院胃肠外科收治的467例局部进展期胃腺癌患者的临床病理资料,其中根... 详细信息

目的探究局部进展期胃癌患者接受根治性切除术联合紫杉醇腹腔热灌注化疗(HIPEC)的安全性。方法本研究为回顾性队列研究,收集2019年7月至2021年4月期间于四川大学华西医院胃肠外科收治的467例局部进展期胃腺癌患者的临床病理资料,其中根治切除术+紫杉醇HIPEC 151例(手术+HIPEC组),仅接受根治性切除术316例(单纯手术组)。按照美国卫生与公众服务部公布的常见不良事件评价标准(CTCAE 5.0)对纳入患者的围手术期不良反应事件的发生情况进行评价。根据腹腔热灌注化疗次数对HIPEC组患者进行亚组分析,通过χ^(2)检验对不同亚组的不良事件发生率进行差异分析。并通过logistic模型分析局部进展期胃腺癌患者接受根治性切除术联合紫杉醇HIPEC发生不良事件的独立危险因素。结果手术+HIPEC组中,男性113例(74.8%),女性38例(25.2%);中位年龄为64(55,68)岁;术后接受1次、2次和3次紫杉醇HIPEC的患者分别有18例(11.9%)、79例(52.3%)和54例(35.8%),中位肿瘤最大径为5.0(3.6,6.5)cm。单纯手术组中,男性244例(77.2%),女性72例(22.8%);中位年龄为63(54,68)岁,中位肿瘤最大径为4.0(3.0,5.5)cm。手术+HIPEC组中,共有112例(74.2%)患者在围手术期内出现了198例次2级及以上不良事件,其中以术后低白蛋白血症的发生次数最多(85例,56.3%),其次是术后贫血(50例,33.1%)。与单纯手术组相比,手术+HIPEC组患者中术后低白蛋白血症[56.3%(85/151)比37.7%(119/316),χ^(2)=14.420,P0.05)。结论根治性切除术后行紫杉醇HIPEC会增加局部进展期胃癌患者术后低白蛋白血症、贫血以及术后腹痛腹胀的发生风险,但增加HIPEC次数并未显著升高其相关不良事件的发生风险。本研究未发现紫杉醇HIPEC相关不良事件的独立危险因素。

关键词：胃肿瘤,局部进展期腹腔热灌注化疗紫杉醇安全性

Synthesis and characterization of caprolactone based polyurethane with degradable and antifouling performance

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Chinese Journal of Chemical Engineering 2021年第6期34卷 299-306页

作者： Abid Ali Lina Song jiankun hu Jingxian Jiang Qingqing Rao Muhammad Shoaib Shah Fahad Yongjie Cai Xiaoli Zhan Fengqiu Chen Qinghua Zhang College of Chemical and Biological Engineering Zhejiang Provincial Key Laboratory of Advanced Chemical EngineeringManufacture TechnologyZhejiang UniversityHangzhou 310027China Ningbo Research Institute Zhejiang UniversityNingbo 315100China

In this work,a degradable polyurethane composed of caprolactone(CL)and L-Lactide(LLA)as soft segments,and 4,40-methylenebis(cyclohexyl isocyanate)(H12 MDI)and polytetramethylene ether glycol(PTMEG)as hard segments,was prepared.Hydrolytic degradation experiment revealed that the degradable polyurethane(PU)could be degraded in artificial seawater.It also showed that caprolactone-copolyurethane(CL-PU)copolymer with higher crystallinity degraded much slower in artificial seawater.However,the introduction of LLA resulted in an increase in the hydrophilicity and reduction in the crystallinity of degradable PU,as demonstrated by the contact angle analysis.The result of the scanning electron microscope showed that the surface of degradable PU renewed under static condition.Moreover,degradable PU was able to be used as a carrier,and it controlled the release rate of 4,5-dichloro-2-octyl-isothiazolone(DCOIT).The anti-diatom(Navicula incerta)test demonstrated that the(caprolactone-co-L-lactide)-co-polyurethane 4(CL/LAx-PU4)with DCOIT contents prevented the adhesion of diatom Navicula incerta(88.37%reduction)due to their self-polishing and the release of antifoulants.Therefore,the degradable PU consisted of CL,LLA,and DCOIT could be a durable resin with good antifouling activity for the application in the marine anti-biofouling field.

关键词： Antifoulant 4 5-dicholoro-2-octyl-isothiazolone Degradable polyurethane L-Lactide Caprolactone

Nicotinamide N-methyltransferase and liver diseases

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Genes & Diseases 2023年第5期10卷 1883-1893页

作者： Guangyu Liang Ying Li Yan Lin Xiao Yang jiankun Yang Shaobo hu Anding Liu Experimental Medicine Center Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubei 430030China Department of Hepatobiliary Surgery Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubei 430022China

Cellular metabolism-induced epigenetic regulation is essential for the maintenance of cellular homeostasis.Nicotinamide N-methyltransferase(NNMT)is emerging as a key point of intersection between cellular metabolism and epigenetic regulation and has a central role in various physiological and pathological processes.NNMT catalyzes the methylation of nicotinamide(NAM)using the universal methyl donor S-adenosyl methionine(SAM)to yield S-adeno-syl-L-homocysteine(SAH)and N1-methylnicotinamide(MNAM),directly linking methylation balance with nicotinamide adenosine dinucleotide(NAD+)contents.NNMT acts on either the SAM-methylation balance or both NAD+metabolism,depending on the tissue involved or pathological settings where metabolic demand is increased.Under physiological conditions,the liver act as an essential metabolic organ with abundant NNMT expression,while NNMT hepatic function is not mediated by its methyltransferase activity due to other major methyltransferases such as glycine N-methyltransferase(GNMT)in the liver.However,hepatic NNMT,as well as its metabolite is improperly regulated and linked to the worse pathological states in liver diseases,including alcoholic liver disease,non-alcoholic fatty liver disease(NAFLD),liver cirrhosis,and hepatocellular carcinoma(HCC),suggesting a potential role in the process of liver diseases.In this review,we summarize how NNMT regulates cell methylation balance and NAD metabolism,and extensively outline the current knowledge concerning the functions of NNMT in hepatic metabolism including glucose,lipid and energy,with a specific focus on the contribution of NNMT to the pathophysiology of liver-related diseases.NNMT is involved in the development and progression of liver diseases.Understanding the complex NNMT regulatory network and its effects on pathogenesis could provide new therapeutic strategies in the context of liver diseases.

关键词： Epigenetics Liver diseases Metabolism Nicotinamide N-methyltransferase Non-alcoholic fatty liver disease