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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 *** 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 ***: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 *** 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 *** C-index,receiver operating characteristic(ROC)curve and calibration curve were used to evaluate the predictive power of the nomogram model for gallstone ***: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 *** results showed that the C-index of the nomogram model was 0.692,suggesting it was valuable to predict gallstone ***,the calibration curve showed good consistency between the predicted probability and actual ***:The nomogram model for

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

Beyond surgery:Overcoming postoperative depression in cancer patients

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World Journal of Psychiatry 2024年第7期14卷 1140-1142页

作者： Shao-Ming Song Xiao Wang Hong-Mei Yue Rong Liu The First School of Clinical Medicine Lanzhou UniversityLanzhou 730000Gansu ProvinceChina Faculty of hepato-pancreato-biliary surgery The First Medical Center of PLA General HospitalBeijing 100853China

Depression is a common occurrence among cancer patients,and it significantly impacts their clinical outcomes and quality of life,with a high incidence during anti-tumor treatment or after *** association between surgery and depression is the result of the interaction of various factors,including physio-logical,psychological,and social factors,all of which are intertwined and make patients susceptible to depression after surgical *** depression has a significant negative impact on many aspects of cancer patients,and it requires timely identification and intervention to improve the overall outcome.

关键词： Depression surgery Tumor Anti-tumor therapy

Post-operative morbidity after neoadjuvant chemotherapy and resection for gallbladder cancer: A national surgical quality improvement program analysis

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World Journal of Gastrointestinal surgery 2024年第1期16卷 95-102页

作者： Minha Kim Stephanie Stroever Krist Aploks Alexander Ostapenko Xiang Da Dong Ramanathan Seshadri Department of General surgery Danbury HospitalDanburyCT 06810United States Department of Research and Innovation Nuvance HealthDanburyCT 06810United States Division of Surgical Oncology/hepato-pancreato-biliary surgery Danbury HospitalDanburyCT 06810United States

BACKGROUND Gallbladder cancer is the most common malignancy of the biliary ***-adjuvant chemotherapy(NACT)has improved overall survival by enabling R0 ***,there is no consensus of guidelines for neoadjuvant therapy in gallbladder *** investigations continue to analyze the regimen and benefit of NACT for ongoing care of gallbladder cancer patients,we examined American College of Surgeons National Surgical Quality Improvement Program(NSQIP)database to determine if there was higher morbidity among the neo-adjuvant group within the 30-day post-operative *** hypothesized patients who underwent NACT were more likely to have higher post-operative *** To investigate the 30-day post-operative morbidity outcomes between patients who received NACT and underwent surgery and patients who only had *** A retrospective analysis of the targeted hepatectomy NSQIP data between 2015 and 2019 was performed to determine if NACT in gallbladder cancer increased the risk for post-operative morbidity(bile leak,infection rate,rate of converting to open surgery,etc.)compared to the group who only had *** calculate the odds ratio for the primary and secondary outcomes,a crude logistic regression was *** Of the 452 patients,52 patients received NACT prior to *** were no statistically significant differences in the odds of morbidity between the two groups,including bile leak[odds ratio(OR),0.69;95%confidence interval(95%CI):0.16-2.10;P=0.55],superficial wound infection(OR,0.58;95%CI:0.03-3.02;P=0.61),and organ space wound infection(OR,0.63;95%CI:0.18-1.63;P=0.61).CONCLUSION There was no significant difference in the risk of 30-day post-operative morbidity between the NACT and surgery group and the surgery only group.

关键词： Gallbladder cancer Neoadjuvant chemotherapy Radical cholecystectomy National surgery Quality Improvement Program Postoperative outcome

Role of ablation therapy in conjunction with surgical resection for neuroendocrine tumors involving the liver

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World Journal of Gastrointestinal surgery 2024年第3期16卷 768-776页

作者： Alexander Ostapenko Stephanie Stroever Lud Eyasu Minha Kim Krist Aploks Xiang Da Dong Ramanathan Seshadri Department of General surgery Danbury HospitalDanburyCT 06810United States Department of Research and Innovation Nuvance HealthDanburyCT 06810United States Division of Surgical Oncology/hepato-pancreato-biliary surgery Danbury HospitalDanburyCT 06810United States

BACKGROUND Resection of hepatic metastasis from neuroendocrine tumors(NETs)improves quality of life and prolongs 5-year *** can be utilized with surgery to achieve complete *** several studies report long-term out-comes for patients undergoing ablation,none have explored perioperative effects of ablation in patients with metastatic *** To determine if intra-operative ablation during hepatectomy increases risk of ad-verse outcomes such as surgical site infections(SSIs),bleeding,and bile *** A retrospective analysis of the hepatectomy National Surgical Quality Impro-vement Program database from 2015-2019 was performed to determine the odds of SSIs,bile leaks,or bleeding in patients undergoing intraoperative ablation when compared to hepatectomy *** Of the 966 patients included in the study,298(30.9%)underwent ablation during *** were 78(11.7%)patients with SSIs in the hepatectomy alone group and 39(13.1%)patients with a SSIs in the hepatectomy with ablation *** leak occurred in 41(6.2%)and 14(4.8%)patients in the two groups,respec-tively;bleeding occurred in 117(17.5%)and 33(11.1%),*** con-trolling for confounding variables,ablation did not increase risk of SSI(P=0.63),bile leak(P=0.34)or bleeding(P=0.07)when compared to patients undergoing resection alone on multivariate *** Intraoperative ablation with hepatic resection for NETs is safe in the perioperative period without significant increased risk of infection,bleeding,or bile *** should utilize this modality when appropriate to a-chieve optimal disease control and outcomes.

关键词： Hepatectomy Neuroendocrine tumor Ablation Bile leaks Bleeding Surgical site infections

Autophagy in hepatic progenitor cells modulates exosomal miRNAs to inhibit liver fibrosis in schistosomiasis

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Frontiers of Medicine 2024年第3期18卷 538-557页

作者： Yue Yuan Jiaxuan Li Xun Lu Min Chen Huifang Liang Xiao-ping Chen Xin Long Bixiang Zhang Song Gong Xiaowei Huang Jianping Zhao Qian Chen Division of Gastroenterology Department of Internal Medicine at Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430030China Hepatic surgery center Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430030China Hubei Key Laboratory of hepato–pancreato–biliary Diseases Wuhan430030China Department of Trauma surgery Tongji Trauma CenterTongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430030China

Schistosoma infection is one of the major causes of liver *** roles of hepatic progenitor cells(HPCs)in the pathogenesis of liver fibrosis have been ***,the precise mechanism underlying the role of HPCs in liver fibrosis in schistosomiasis remains *** study examined how autophagy in HPCs affects schistosomiasis-induced liver fibrosis by modulating exosomal *** activation of HPCs was verified by immunohistochemistry(IHC)and immunofluorescence(IF)staining in fibrotic liver from patients and mice with Schistosoma japonicum *** coculturing HPCs with hepatic stellate cells(HSCs)and assessing the autophagy level in HPCs by proteomic analysis and in vitro phenotypic assays,we found that impaired autophagy degradation in these activated HPCs was mediated by lysosomal *** autophagy by the autophagy inhibitor chloroquine(CQ)significantly diminished liver fibrosis and granuloma formation in ***-infected ***-secreted extracellular vehicles(EVs)were further isolated and studied by miRNA ***-1306-3p,miR-493-3p,and miR-34a-5p were identified,and their distribution into EVs was inhibited due to impaired autophagy in HPCs,which contributed to suppressing HSC *** conclusion,we showed that the altered autophagy process upon HPC activation may prevent liver fibrosis by modulating exosomal miRNA release and inhibiting HSC activation in *** the autophagy degradation process may be a therapeutic strategy for liver fibrosis during Schistosoma infection.

关键词： schistosomiasis hepatic progenitor cell autophagy extracellular vesicle fibrosis miRNA

Routine utilization of machine perfusion in liver transplantation:Ready for prime time?

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World Journal of Gastroenterology 2024年第11期30卷 1488-1493页

作者： Alessandro Parente Keyue Sun Philipp Dutkowski AM James Shapiro Andrea Schlegel Department of surgery Division of TransplantationUniversity of Alberta HospitalEdmonton T6G 2B7Canada Immunity and Inflammation Lerner Research InstituteClevelandOH 44195United States Swiss hepato-pancreato-biliary center Department of Visceral and Transplantation SurgeryUniversity Hospital ZurichZurich 8091Switzerland Immunity and Inflammation Digestive Disease and Surgery InstituteClevelandOH 44195United States

The last decade has been notable for increasing high-quality research and dramatic improvement in outcomes with dynamic liver *** evidence from numerous randomized controlled trials has been pooled by meta-analyses,providing the highest available evidence on the protective effect of machine perfusion(MP)over static cold storage in liver transplantation(LT).Based on a protective effect with less complications and improved graft survival,the field has seen a paradigm shift in organ *** editorial focuses on the role of MP in LT and how it could become the new“gold standard”.Strong collaborative efforts are needed to explore its effects on long-term outcomes.

关键词： Liver transplantation Machine perfusion Viability assessment Hypothermic oxygenated perfusion Normothermic machine perfusion

Comprehensive review of hepatocellular carcinoma with portal vein tumor thrombus:State of art and future perspectives

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hepatobiliary & Pancreatic Diseases International 2024年第3期23卷 221-227页

作者： Paschalis Gavriilidis Timothy M Pawlik Daniel Azoulay Department of surgery Colchester General HospitalTurner RoadColchester CO45JLUK Department of surgery The Ohio State Wexner Medical CenterJames Comprehensive Cancer CenterColumbusOHUSA Department of hepato-biliary and Liver Transplantation surgery Paul Brousse University HospitalParis-Saclay UniversityVillejuif 94800France

Background:Despite advances in the diagnosis of patients with hepatocellular carcinoma(HCC),70%-80%of patients are diagnosed with advanced stage *** vein tumor thrombus(PVTT)is among the most ominous signs of advanced stage disease and has been associated with poor survival if *** sources:A systematic search of MEDLINE(PubMed),Embase,Cochrane Library and Database for Systematic Reviews(CDSR),Google Scholar,and National Institute for Health and Clinical Excellence(NICE)databases until December 2022 was conducted using free text and MeSH terms:hepatocellular carcinoma,portal vein tumor thrombus,portal vein thrombosis,vascular invasion,liver and/or hepatic resection,liver transplantation,and systematic ***:centers of surgical excellence have reported promising results related to the individualized surgical management of portal thrombus versus arterial chemoembolization or systemic *** elements to the individualized surgical management of HCC and portal thrombus include precise classification of the portal vein tumor thrombus,accurate identification of the subgroups of patients who may benefit from resection,as well as meticulous surgical *** review addressed five specific areas:(a)formation of PVTT;(b)classifications of PVTT;(c)controversies related to clinical guidelines;(d)surgical treatments versus non-surgical approaches;and(e)characterization of surgical techniques correlated with classifications of ***:Current evidence from Chinese and Japanese high-volume centers demonstrated that patients with HCC and associated PVTT can be managed with surgical resection with acceptable results.

关键词： Hepatectomy Liver surgery Liver neoplasms Portal vein tumor thrombus

Efficacy comparison of fruquintinib,regorafenib monotherapy or plus programmed death-1 inhibitors for microsatellite stable metastatic colorectal cancer

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World Journal of Gastrointestinal Oncology 2024年第6期16卷 2449-2462页

作者： Tian-Qi An Hui Qiu Quan-Bo Zhou Hong Zong Shuang Hu Yu-Gui Lian Rui-Hua Zhao Department of Oncology The First Affiliated Hospital of Zhengzhou UniversityZhengzhou 450000Henan ProvinceChina Department of hepato-pancreato-biliary surgery Peking University Cancer Hospital and InstituteBeijing 100000China Department of Colorectal surgery The First Affiliated Hospital of Zhengzhou UniversityZhengzhou 450000Henan ProvinceChina

BACKGROUND Regorafenib(R)and fruquintinib(F)are the standard third-line regimens for colorectal cancer(CRC)according to the National Comprehensive Cancer Network guidelines,but both have limited *** phase 2 trials have indicated that R or F combined with immune checkpoint inhibitors can reverse immunosuppression and achieve promising efficacy for microsatellite stable or proficient mismatch repair(MSS/pMMR)*** to the lack of studies comparing the efficacy between F,R,F plus programmed death-1(PD-1)inhibitor,and R plus PD-1 inhibitors(RP),it is still unclear whether the combination therapy is more effective than *** To provide critical evidence for selecting the appropriate drugs for MSS/pMMR metastatic CRC(mCRC)patients in clinical *** A total of 2639 CRC patients were enrolled from January 2018 to September 2022 in our hospital,and 313 MSS/pMMR mCRC patients were finally *** A total of 313 eligible patients were divided into F(n=70),R(n=67),F plus PD-1 inhibitor(FP)(n=95)and RP(n=81)*** key clinical characteristics were well balanced among the *** median progression-free survival(PFS)of the F,R,FP,and RP groups was 3.5 months,3.6 months,4.9 months,and 3.0 months,*** median overall survival(OS)was 14.6 months,15.7 months,16.7 months,and 14.1 *** FP regimen had an improved disease control rate(DCR)(P=0.044)and 6-month PFS(P=0.014)and exhibited a better trend in PFS(P=0.057)compared with F,and it was also significantly better in PFS than RP(P=0.030).RP did not confer a significant survival benefit;instead,the R group had a trend toward greater benefit with OS(P=0.080)compared with *** significant differences were observed between the R and F groups in PFS or OS(P>0.05).CONCLUSION FP is superior to F in achieving 6-month PFS and DCR,while RP is not better than *** has an improved PFS and 6-month PFS compared with RP,but F and R had similar clinical ***,FP may be a

关键词： Colorectal cancer Fruquintinib Regorafenib Programmed death-1 inhibitor Real-world

Safety,immunogenicity and protective effect of sequential vaccination with inactivated and recombinant protein COVID-19 vaccine in the elderly:a prospective longitudinal study

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Signal Transduction and Targeted Therapy 2024年第6期9卷 2738-2747页

作者： Hong-Hong Liu Yunbo Xie Bao-Peng Yang Huan-Yue Wen Peng-Hui Yang Jin-E Lu Yan Liu Xi Chen Meng-Meng Qu Yang Zhang Wei-Guo Hong Yong-Gang Li Junliang Fu Fu-Sheng Wang Out-patient Department of Day Diagnosis and Treatment The Fifth Medical Center of Chinese PLA General HospitalBeijing 100039China Senior Department of Infectious Diseases The Fifth Medical Center of Chinese PLA General HospitalNational Clinical Research Center for Infectious DiseasesBeijing 100039China Chinese PLA Medical School Chinese PLA General HospitalBeijing 100039China Hunyuan County People’s Hospital Datong 037499 Shanxi ProvinceChina Faculty of hepato-pancreato-biliary surgery Institute of Hepatobiliary SurgeryThe First Medical CenterChinese PLA General HospitalBeijing 100853China

The safety and efficacy of COVID-19 vaccines in the elderly,a high-risk group for severe COVID-19 infection,have not been fully *** clarify these issues,this prospective study followed up 157 elderly and 73 young participants for 16 months and compared the safety,immunogenicity,and efficacy of two doses of the inactivated vaccine BBIBP-CorV followed by a booster dose of the recombinant protein vaccine *** results showed that this vaccination protocol was safe and tolerable in the *** administering two doses of the BBIBP-CorV,the positivity rates and titers of neutralizing and anti-RBD antibodies in the elderly were significantly lower than those in the young *** the ZF2001 booster dose,the antibody-positive rates in the elderly were comparable to those in the young;however,the antibody titers remained ***,age,and underlying diseases were independently associated with vaccine immunogenicity in elderly *** pseudovirus neutralization assay showed that,compared with those after receiving two doses of BBIBP-CorV priming,some participants obtained immunological protection against BA.5 and BF.7 after receiving the ZF2001 *** infection symptoms last longer in the infected elderly and pre-infection antibody titers were negatively associated with the severity of post-infection *** antibody levels in the elderly increased significantly after breakthrough infection but were still lower than those in the *** data suggest that multiple booster vaccinations at short intervals to maintain high antibody levels may be an effective strategy for protecting the elderly against COVID-19.

关键词： vaccination vaccine doses