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World Journal of Gastrointestinal Oncology 2024年第5期16卷 2219-2224页

作者： Wen-Tao Zhong Yuan Lv Qian-Yu Wang Ran An Gang Chen Jun-Feng Du The Second School of Clinical Medicine Southern Medical UniversityGuangzhou 510515Guangdong ProvinceChina Department of general Surgery The 7^(th)Medical Center of PLA General HospitalBeijing 100700China Department of Pathology The 7^(th)Medical Center of PLA General HospitalBeijing 100700China

BACKGROUND According to the latest report,colorectal cancer is still one of the most prevalent cancers,with the third highest incidence and mortality *** of advanced rectal cancer with distant metastases is usually unsatisfactory,especially for mismatch repair proficient(pMMR)rectal cancer,which leads to poor prognosis and *** SUMMARY We report a case of a pMMR rectal adenocarcinoma with metastases of multiple lymph nodes,including the left supraclavicular lymph node,before treatment in a 70-year-old *** received full courses of chemoradiotherapy(CRT)followed by 4 cycles of programmed death 1 inhibitor Tislelizumab,and a pathologic complete response(pCR)was achieved,and the lesion of the left supraclavicular lymph node also *** pMMR advanced rectal cancer with preserved intact distant metastatic lymph nodes may benefit from full-course CRT combined with immunotherapy.

关键词： Rectal cancer Metastasis Chemoradiotherapy Immunotherapy Prognosis Case report

Understanding autoimmune pancreatitis: Clinical features, management challenges, and association with malignancies

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World Journal of Gastroenterology 2024年第15期30卷 2091-2095页

作者： Grigorios Christodoulidis Marina Nektaria Kouliou Konstantinos Eleftherios Koumarelas Department of general Surgery University Hospital of LarissaUniversity of ThessalyLarissa 41110Greece

In this editorial we comment on the article by Jaber et *** pancreatitis(AIP)represents a distinct form of pancreatitis,categorized into AIP-1 and AIP-2,characterized by obstructive jaundice,lymphoplasmacytic infiltrate,and ***-1,associated with elevated immunoglobulin G4(IgG4)levels,exhibits higher relapse rates,affecting older males,while AIP-2 is less common and linked to inflammatory bowel *** is considered a manifestation of IgG4-related systemic disease,sharing characteristic histological *** are the primary treatment,with emerging biomarkers like interferon alpha and *** poses an increased risk of various malignancies,and the assoc-iation with pancreatic cancer is *** is reserved for severe cases,necessitating careful evaluation due to diagnostic *** patients may have concurrent PanINs but display favorable long-term outcomes compared to pancreatic cancer *** diagnostic assessment,including biopsy and steroid response,is crucial for informed surgical decisions in AIP.

关键词： Autoimmune pancreatitis Immunoglobulin G4-related disease Pancreatic cancer Surgery

Cryptococcus splenic abscess in primary biliary cholangitis: a case report

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World Journal of Emergency Medicine 2024年第4期15卷 319-321页

作者： Yuxin Dong Qing Tang Lijun Wang Songtao Shou Department of Emergency Medicine Tianjin Medical University General HospitalTianjin 300052China

Chronic liver diseases,including primary biliary cholangitis(PBC),are recognized as immunosuppressive conditions due to the impaired functionality of hepatic sinusoidal Kupffer cells.[1]PBC is specifically characterized by cholangitis and progressive liver pathology,which may eventually lead to *** compromised liver function and reduced efficacy of Kupffer cells in patients with PBC weaken their cell-mediated immune responses,increasing their susceptibility to opportunistic pathogens such as Cryptococcus.[2]Cryptococcosis is an infectious disease caused by pathogenic encapsulated yeasts of the genus Cryptococcus,which is distributed worldwide and exhibits diverse clinical presentations.[3]Most case reports on cryptococcal infections are associated with HIV infection or other conditions that compromise the immune system.[4]Case reports related to primary biliary cholangitis are ***,this case report underscores a rare cryptococcal infection in a patient with primary biliary cholangitis,emphasizing the need to consider opportunistic infections in those with compromised liver function and immune dysregulation.

关键词： cholangitis impaired diseases

Establishment and evaluation of a prognostic model for patients with unresectable gastric cancer liver metastases

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World Journal of Clinical Cases 2024年第13期12卷 2182-2193页

作者： Zheng-Yao Chang Wen-Xing Gao Yue Zhang Wen Zhao Di Wu Lin Chen Department of general Surgery The First Medical Center of Chinese PLA General HospitalBeijing 100853China Department of Endocrinology The First Medical Center of Chinese PLA General HospitalBeijing 100853China School of Medicine Nankai UniversityTianjin 300071China

BACKGROUND Liver metastases(LM)is the primary factor contributing to unfavorable outcomes in patients diagnosed with gastric cancer(GC).The objective of this study is to analyze significant prognostic risk factors for patients with GCLM and develop a reliable nomogram model that can accurately predict individualized prognosis,thereby enhancing the ability to evaluate patient *** To analyze prognostic risk factors for GCLM and develop a reliable nomogram model to accurately predict individualized prognosis,thereby enhancing patient outcome *** Retrospective analysis was conducted on clinical data pertaining to GCLM(type III),admitted to the Department of general Surgery across multiple centers of the Chinese PLA general hospital from January 2010 to January *** dataset was divided into a development cohort and validation cohort in a ratio of 2:*** the development cohort,we utilized univariate and multivariate Cox regression analyses to identify independent risk factors associated with overall survival in GCLM ***,we established a prediction model based on these findings and evaluated its performance using receiver operator characteristic curve analysis,calibration curves,and clinical decision curves.A nomogram was created to visually represent the prediction model,which was then externally validated using the validation *** A total of 372 patients were included in this study,comprising 248 individuals in the development cohort and 124 individuals in the validation *** on Cox analysis results,our final prediction model incorporated five independent risk factors including albumin levels,primary tumor size,presence of extrahepatic metastases,surgical treatment status,and chemotherapy *** 1-,3-,and 5-years Area Under the Curve values in the development cohort are 0.753,0.859,and 0.909,respectively;whereas in the validation cohort,they are observed to be 0.772,0.848,and ***,th

关键词： Gastric cancer Liver metastases Nomogram Prognostic model Survival analysis

3D laparoscopy and fluorescence imaging can improve surgical precision for hepatectomy

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Hepatobiliary Surgery and Nutrition 2024年第3期13卷 544-547页

作者： Joshua Sheng Hao Lim Vishal G.Shelat Department of general Surgery Tan Tock Seng HospitalSingaporeSingapore

Laparoscopic hepatectomy for the treatment of hepatocellular carcinoma(HCC)has been shown to have superior short-term and comparable long-term outcomes compared with open hepatectomy in experienced centres(1).Short-term advantages include small incisions,reduced post-operative pain,faster recovery,reduced blood loss and lower risk of complications(2).However,the loss of tactile sensation makes it challenging to accurately locate lesions and define tumour margins.

关键词： 3D laparoscopy hepatocellular carcinoma(HCC) indocyanine green dye(ICG dye) liver resection

Heterochronous multiple primary prostate cancer and lymphoma:A case report

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World Journal of Clinical Cases 2024年第7期12卷 1333-1338页

作者： Jin-Long Liang Yu-Qing Bu Li-Li Peng Hong-Zhen Zhang Department of Oncology Hebei General HospitalShijiazhuang 050051Hebei ProvinceChina

BACKGROUND Multiple primary malignant tumors(MPMTs)are rare type of cancer,especially when solid tumors are the first and lymphoma is the second primary *** report a patient with heterochronous MPMTs consisting of prostate cancer and rectal diffuse large B-cell lymphoma(DLBCL).CASE SUMMARY We report a 77-year-old male patient diagnosed with prostate cancer who was treated with radiation therapy and one year of endocrine therapy with bicalutamide(50 mg per day)and an extended-release implant of goserelin(1/28 d).Seven years later,rectal DLBCL with lung metastases was *** Although rare,the possibility of prostate cancer combined with a double primary cancer of DLBCL can provide a deeper understanding.

关键词： Multiple primary malignant tumors Radiation therapy Diffuse large B-cell lymphoma Prostate cancer Non-Hodgkin lymphoma Case report

Feasibility and safety of minimally invasive multivisceral resection for T4b rectal cancer:A 9-year review

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World Journal of Gastrointestinal Surgery 2024年第3期16卷 777-789页

作者： Kai Siang Chan Biquan Liu Ming Ngan Aloysius Tan Kwang Yeong How Kar Yong Wong Department of general Surgery Tan Tock Seng HospitalSingapore 308433Singapore

BACKGROUND Colorectal cancer is the third most common cancer and the second highest cause of cancer-related mortality *** 5%-10%of patients are diagnosed with locally advanced rectal cancer(LARC)on *** LARC invading into other structures(i.e.T4b),multivisceral resection(MVR)and/or pelvic ex-enteration(PE)remains the only potential curative surgical *** and/or PE is a major and complex surgery with high post-operative *** invasive surgery(MIS)has been shown to improve short-term post-operative outcomes in other gastrointestinal malignancies,but there is little evi-dence on its use in MVR,especially so for robotic *** is a single-center retrospective cohort study from 1st January 2015 to 31st March *** criteria were patients diagnosed with cT4b rectal cancer and underwent MVR,or stage 4 disease with resectable systemic ***-tients who underwent curative MVR for locally recurrent rectal cancer,or me-tachronous rectal cancer were also *** criteria were patients with systemic metastases with non-resectable *** patients planned for elective surgery were enrolled into the standard enhanced recovery after surgery pathway with standard peri-operative management for colorectal *** sur-gery was defined based on technical difficulty of surgery(*** PE,bladder-sparing prostatectomy,pelvic lymph node dissection or need for flap creation).Our primary outcomes were the margin status,and complication ***-gorical values were described as percentages and analysed by the chi-square *** variables were expressed as median(range)and analysed by Mann-Whitney U *** overall survival(OS)and recurrence-free survival(RFS)were analysed using Kaplan-Meier estimates with life table ***-rank test was performed to determine statistical significance between cumulative *** significance was defined as P<*** estimates with li

关键词： Laparoscopy Minimally invasive surgical procedures Multivisceral resection Pelvic Exenteration Rectal neoplasms Robotic surgical procedures

Is tumor necrosis factor-α monoclonal therapy with proactive therapeutic drug monitoring optimized for inflammatory bowel disease? Network meta-analysis

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World Journal of Gastrointestinal Surgery 2024年第2期16卷 571-584页

作者： Fang-Yuan Zheng Kai-Si Yang Wen-Cheng Min Xin-Zhu Li Yu Xing Shuai Wang Ying-Shi Zhang Qing-Chun Zhao Teaching hospital of Shenyang Pharmaceutical University General Hospital of Northern Theater CommandShenyang 110016Liaoning ProvinceChina

BACKGROUND The efficacy and safety of anti-tumor necrosis factor-α(TNF-α)monoclonal antibody therapy[adalimumab(ADA)and infliximab(IFX)]with therapeutic drug monitoring(TDM),which has been proposed for inflammatory bowel disease(IBD)patients,are still *** To determine the efficacy and safety of anti-TNF-αmonoclonal antibody therapy with proactive TDM in patients with IBD and to determine which subtype of IBD patients is most suitable for proactive TDM *** As of July 2023,we searched for randomized controlled trials(RCTs)and observa-tional studies in PubMed,Embase,and the Cochrane Library to compare anti-TNF-αmonoclonal antibody therapy with proactive TDM with therapy with reactive TDM or empiric *** and network meta-analyses were used to determine the IBD patient subtype that achieved clinical remission and to determine the need for *** This systematic review and meta-analysis yielded 13 studies after exclusion,and the baseline indicators were *** found a significant increase in the number of patients who achieved clinical remission in the ADA[odds ratio(OR)=1.416,95%confidence interval(CI):1.196-1.676]and RCT(OR=1.393,95%CI:1.182-1.641)subgroups and a significant decrease in the number of patients who needed surgery in the proactive vs reactive(OR=0.237,95%CI:0.101-0.558)and IFX+ADA(OR=0.137,95%CI:0.032-0.588)subgroups,and the overall risk of adverse events was reduced(OR=0.579,95%CI:0.391-0.858)according to the pairwise ***,the network meta-analysis results suggested that patients with IBD treated with ADA(OR=1.39,95%CI:1.19-1.63)were more likely to undergo TDM,especially in comparison with patients with reactive TDM(OR=1.38,95%CI:1.07-1.77).CONCLUSION Proactive TDM is more suitable for IBD patients treated with ADA and has obvious advantages over reactive *** recommend proactive TDM in IBD patients who are treated with ADA.

关键词： Inflammatory bowel disease Therapeutic drug monitoring Adalimumab Infliximab Network meta-analysis

Early sodium bicarbonate therapy for critically ill patients with septic shock and acute moderate metabolic acidosis

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Emergency and Critical Care Medicine 2024年第3期4卷 101-102页

作者： Sai Huang Yaojun Peng Xuan Zhang Yuan Yao Cong Feng Department of Hematology Fifth Medical Center of Chinese PLA General HospitalBeijingChina National Clinical Research Center of Geriatric Diseases Chinese PLA General HospitalBeijingChina Department of Emergency First Medical Center of Chinese PLA General HospitalBeijingChina hospital Management Institute Medical innovation research departmentChinese PLA General HospitalBeijingChina Department of general Medicine Hainan Hospital of General Hospital of People’s Liberation ArmyBeijingChina State Key Laboratory of Kidney Diseases National Clinical Research Center of Kidney DiseasesGeneral Hospital of People’s Liberation ArmyBeijingChina.

To the editor:In recent decades,septic shock has continued to be a life-threatening health problem around the world.^([1])Meanwhile,metabolic acidosis(MA)is also well known in critically ill patients,and even moderate metabolic acidosis(MMA)is associated with higher mortality than sepsis.^([2])Although the administration of sodium bicarbonate(SB)is widely used in sepsis shock with MA in the intensive care unit(ICU),its clinical efficacy is not well *** the 2021 update of the Surviving Sepsis Campaign guidelines,Evans et al.

关键词： critically editor continued

Growth hormone improves insulin resistance in visceral adipose tissue after duodenal-jejunal bypass by regulating adiponectin secretion

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World Journal of Diabetes 2024年第6期15卷 1340-1352页

作者： Zi-Tian Liu Guang-Wei Yang Xiang Zhao Shuo-Hui Dong Yang Jiao Zheng Ge Ao Yu Xi-Qiang Zhang Xin-Zhen Xu Zhi-Qiang Cheng Xiang Zhang Ke-Xin Wang Department of general Surgery Qilu Hospital of Shandong UniversityJinan 250012Shandong ProvinceChina Department of general Surgery Shandong University of Qilu Hospital(Qingdao)Qingdao 266000Shandong ProvinceChina

BACKGROUND The mechanism of improvement of type 2 diabetes after duodenal-jejunal bypass(DJB)surgery is not *** To study the morphological and functional changes in adipose tissue after DJB and explore the potential mechanisms contributing to postoperative insulin sensitivity improvement of adipose tissue in a diabetic male rat *** DJB and sham surgery was performed in a-high-fat-diet/streptozotocin-induced diabetic rat *** adipose tissue was weighed and observed under *** inguinal fat to represent subcutaneous adipose tissue(SAT)and mesangial fat to represent visceral adipose ***-sequencing was utilized to evaluate gene expression alterations *** hematoxylin and eosin staining,reverse transcription-quantitative polymerase chain reaction,western blot,and enzyme-linked immunosorbent assay were used to study the *** resistance was evaluated by *** After DJB,whole body blood glucose metabolism and insulin sensitivity in adipose tissue *** cell volume in both visceral adipose tissue(VAT)and SAT *** to SAT,VAT showed more significantly functional alterations after DJB and KEGG analysis indicated growth hormone(GH)pathway and downstream adiponectin secretion were involved in metabolic *** circulating GH and adiponectin levels and GH receptor and adiponectin levels in VAT *** experiment showed that GH stimulated adiponectin secretion and improve insulin *** GH improves insulin resistance in VAT in male diabetic rats after receiving DJB,possibly by increasing adiponectin secretion.

关键词： Growth hormone Insulin resistance Bariatric surgery Adipose tissue Adiponectin