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Clinical characteristics and risk factors of post-operative intestinal flora disorder following laparoscopic colonic surgery:A propensityscore-matching analysis

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World Journal of Gastrointestinal surgery 2024年第5期16卷 1259-1270页

作者： Gan-Bin Li Chen-Tong Wang Xiao Zhang Xiao-Yuan Qiu Wei-Jie Chen Jun-Yang Lu Lai Xu Bin Wu YiXiao Guo-Le Lin Department of general surgery Peking Union Medical College HospitalPeking Union Medical CollegeBeijing 100730China

BACKGROUND Intestinal flora disorder(IFD)poses a significant challenge after laparoscopic colonic surgery,and no standard criteria exists for its diagnosis and *** To analyze the clinical features and risk factors of *** Patients with colon cancer receiving laparoscopic surgery were included using propensity-score-matching(PSM)*** on the occurrence of IFD,patients were categorized into IFD and non-IFD *** clinical characteristics and treatment approaches for patients with IFD were *** regression analysis was performed to identify the risk factors of *** The IFD incidence after laparoscopic surgery was 9.0%(97 of 1073 patients).After PSM,97 and 194 patients were identified in the IFD and non-IFD groups,*** most common symptoms of IFD were diarrhea and abdominal,typically occurring on post-operative days 3 and *** patients were managed conservatively,including modulation of the intestinal flora(90.7%),oral/intravenous application of vancomycin(74.2%),and insertion of a gastric/ileus tube for decompression(23.7%).Multivariate regression analysis identified that preoperative intestinal obstruction[odds ratio(OR)=2.79,95%CI:1.04–7.47,P=0.041]and post-operative antibiotics(OR=8.57,95%CI:3.31–23.49,P<0.001)were independent risk factors for IFD,whereas pre-operative parenteral nutrition(OR=0.12,95%CI:0.06–0.26,P<0.001)emerged as a protective *** A stepwise approach of probiotics,vancomycin,and decompression could be an alternative treatment for *** attention is warranted post-operatively for patients with pre-operative obstruction or early use of antibiotics.

关键词： Colon cancer,Laparoscopy Intestinal flora disorder Clinical characteristics Risk factors

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Percutaneous transhepatic stenting for acute superior mesenteric vein stenosis after pancreaticoduodenectomy with portal vein reconstruction:A case report

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World Journal of Gastrointestinal surgery 2024年第4期16卷 1195-1202页

作者： Chen Lin Zi-Yan Wang Liang-Bo Dong Zhi-Wei Wang Ze-Hui Li Wei-Bin Wang Department of general surgery Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China Department of general surgery Peking Union Medical College HospitalBeijing 100730China Interventional Section Department of RadiologyPeking Union Medical College HospitalChinese Academy of Medical Science and Peking Union Medical CollegeBeijing 100730China

BACKGROUND Percutaneous transhepatic stent placement has become a common strategy for the postoperative treatment of portal vein(PV)/superior mesenteric veins(SMV)stenosis/*** has been widely used after liver transplantation surgery;however,reports on stent placement for acute PV/SMV stenosis after pancreatic surgery within postoperative 3 d are *** SUMMARY Herein,we reported a case of intestinal edema and SMV stenosis 2 d after pancreatic *** patient was successfully treated using stent *** the stenosis resolved after stent placement,complications,including bleeding,pancreatic fistula,bile leakage,and infection,made the treatment highly *** use of anticoagulants was adjusted multiple times to prevent venous thromboembolism and the risk of *** careful treatment,the patient stabilized,and stent placement effectively managed postoperative PV/SMV *** Stent placement is effective and feasible for treating acute PV/SMV stenosis after pancreatic surgery even within postoperative 3 d.

关键词： Pancreaticoduodenectomy Portal vein reconstruction Portal vein stenosis Portal vein stent Case report

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Pan-immune-inflammation value as a prognostic biomarker for colon cancer and its variation by primary tumor location

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World Journal of Gastroenterology 2024年第33期30卷 3823-3836页

作者： Qian-Yu Wang Wen-Tao Zhong Yi Xiao Guo-Le Lin Jun-Yang Lu Lai Xu Guan-Nan Zhang Jun-Feng Du Bin Wu Department of general surgery Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China medical Department of general surgery The First Medical CenterChinese PLA General HospitalBeijing 100853China

BACKGROUND A growing body of research indicates significant differences between left-sided colon cancers(LCC)and right-sided colon cancers(RCC).Pan-immune-inflammation value(PIV)is a systemic immune response marker that can predict the prognosis of patients with colon ***,the specific distinction between PIV of LCC and RCC remains *** To investigate the prognostic and clinical significance of PIV in LCC and RCC *** This multicenter retrospective cohort study included 1510 patients with colon cancer,comprising 801 with LCC and 709 with *** used generalized lifting regression analysis to evaluate the relative impact of PIV on disease-free survival(DFS)in these ***-Meier analysis,as well as univariate and multivariate analyses,were used to examine the risk factors for *** correlation between PIV and the clinical characteristics was statistically analyzed in these *** A total of 1510 patients{872 female patients(58%);median age 63 years[interquartile ranges(IQR):54-71];patients with LCC 801(53%);median follow-up 44.17 months(IQR 29.67-62.32)}were *** was significantly higher in patients with RCC[median(IQR):214.34(121.78-386.72)vs 175.87(111.92-286.84),P227.84)was associated with worse DFS in LCC[PIV-high:Adjusted hazard ratio(aHR)=2.39;95%confidence interval:1.70-3.38;P<0.001]but not in RCC(PIV-high:aHR=0.72;95%confidence interval:0.48-1.08;P=0.114).CONCLUSION These findings suggest that PIV may predict recurrence in patients with LCC but not RCC,underscoring the importance of tumor location when using PIV as a colon cancer biomarker.

关键词： Colon cancer Left-sided colon cancer Right-sided colon cancer Pan-immune-inflammation value Systemic inflammatory biomarkers Prognosis

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CD87-targeted BiTE and CAR-T cells potently inhibit invasive nonfunctional pituitary adenomas

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Science China(Life Sciences) 2024年第10期67卷 2169-2185页

作者： Yuan Ren Xinjie Bao Ming Feng Bing Xing Wei Lian Yong Yao Renzhi Wang Department of Neurosurgery Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China

Recently,bispecific T-cell engagers(BiTEs)and chimeric antigen receptor-modified T cells(CAR-Ts)have been shown to have high therapeutic efficacy in hematological ***87 is highly expressed in solid tumors with an oncogenic *** assess their cytotoxic effects on invasive nonfunctioning pituitary adenomas(iNFPAs),we first examined CD87 expression and its effects on the metabolism of iNFPA *** generated CD87-specific BiTE and CAR/IL-12 T cells,and their cytotoxic effects on iNFPAs cells and in mouse models were ***87 had high expression in i NFPA tissue and cell samples but was undetected in noncancerous brain ***87×CD3 BiTE and CD87 CAR/IL-12 T-cells showed antigenic specificity and exerted satisfactory cytotoxic effects,decreasing tumor cell proliferation in vitro and reducing existing tumors in experimental ***,the above findings suggest that CD87 is a promising target for the immunotherapeutic management of iNFPAs using anti-CD87 BiTE and CD87-specific CAR/IL-12 T cells.

关键词： CD87 chimeric antigen receptor T cells invasive non-functional pituitary adenomas bispecific T cell engager Warburg effect

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Innovative integration of lung ultrasound and wearable monitoring for predicting pulmonary complications in colorectal surgery:A prospective study

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World Journal of Gastrointestinal surgery 2024年第8期16卷 2649-2661页

作者： Chen Lin Pei-Pei Wang Zi-Yan Wang Guo-Ru Lan Kai-Wen Xu Chun-Hua Yu Bin Wu Department of general surgery Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China School of Medicine Tsinghua UniversityBeijing 100084China Department of Anesthesiology Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China Department of Clinical Laboratory Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China

BACKGROUND Postoperative pulmonary complications(PPCs)are common in patients who undergo colorectal *** have focused on how to accurately diagnose and reduce the incidence of *** ultrasound has been proven to be useful in preoperative monitoring and postoperative care after cardiopulmonary ***,lung ultrasound has not been studied in abdominal surgeries and has not been used with wearable devices to evaluate the influence of postoperative ambulation on the incidence of *** To investigate the relationship between lung ultrasound scores,PPCs,and postoperative physical activity levels in patients who underwent colorectal *** In this prospective observational study conducted from November 1,2019 to August 1,2020,patients who underwent colorectal surgery underwent daily bedside ultrasonography from the day before surgery to postoperative day(POD)*** ultrasound scores and PPCs were recorded and analyzed to investigate their *** bracelets measured the daily movement distance for 5 days post-surgery,and the correlation between postoperative activity levels and lung ultrasound scores was *** Thirteen cases of PPCs was observed in the cohort of 101 *** mean(standard deviation)peak lung ultrasound score was 5.32(2.52).Patients with a lung ultrasound score of≥6 constituted the high-risk ***-risk lung ultrasound scores were associated with an increased incidence of PPCs after colorectal surgery(logistic regression coefficient,1.715;odds ratio,5.556).Postoperative movement distance was negatively associated with the lung ultrasound scores[Spearman’s rank correlation coefficient(r),-0.356,Psurgery.

关键词： Colorectal cancer Pulmonary complications Lung ultrasound Wearable devices Respiratory exercises

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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 ***,evidence on the circumstances under which corticosteroid therapy(CST)for AIP improves or worsens DM is *** study aimed to demonstrate and identify predictors of DM control under the influence of ***: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 *** 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 *** the 52 patients with DM,CST was administered in 48 *** 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 ***:Patients with diffuse pancreatic swelling and pancreatic body/tail involvement in pancreatitis tended to be complicated with cDM at AIP *** 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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Clinical manifestations and spermatogenesis outcomes in Chinese patients with congenital hypogonadotropic hypogonadism caused by inherited or de novo FGFR1 mutations

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Asian Journal of Andrology 2024年第4期26卷 426-432页

作者： Yu-Fan Yang Hai-Lu Ma Xi Wang Min Nie Jiang-Feng Mao Xue-Yan Wu Department of Endocrinology Peking Union Medical College HospitalChinese Academy of Medical SciencesPeking Union Medical CollegeBeijing 100730China.

Fibroblast growth factor receptor 1(FGFR1)mutations are associated with congenital hypogonadotropic hypogonadism(CHH)through inheritance or spontaneous *** detected FGFR1 mutations in a Chinese cohort of 210 CHH patients at peking union medical college hospital(beijing,China)using next-generation and Sanger *** assessed missense variant pathogenicity using six bioinformatics tools and compared clinical features and treatment outcomes between inherited and de novo mutation *** 19 patients with FGFR1 mutations,three were recurrent,and 16 were novel *** of the novel mutations were likely pathogenic according to the American college of medical Genetics and Genomics(ACMG)guidelines,with the prevalent P366L *** majority of FGFR1 mutations was inherited(57.9%),with frameshift mutations exclusive to the de novo mutation *** inherited mutation group had a lower incidence of cryptorchidism,short stature,and skeletal *** the inherited mutation group,luteinizing hormone(LH)levels were 0.5 IU l−1,follicle-stimulating hormone(FSH)levels were 1.0 IU l−1,and testosterone levels were 1.3 nmol l−*** contrast,the de novo group had LH levels of 0.2 IU l−1,FSH levels of 0.5 IU l−1,and testosterone levels of 0.9 nmol l−1,indicating milder hypothalamus–pituitary–gonadal axis(HPGA)functional deficiency in the inherited *** inherited mutation group showed a tendency toward higher spermatogenesis *** conclusion,this study underscores the predominance of inherited FGFR1 mutations and their association with milder HPGA dysfunction compared to de novo mutations,contributing to our understanding of the genetic and clinical aspects of FGFR1 mutations.

关键词： congenital hypogonadotropic hypogonadism de novo FGFR1 inherited

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Targeted metabolomics reveals the aberrant energy status in diabetic peripheral neuropathy and the neuroprotective mechanism of traditional Chinese medicine JinMaiTong

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Journal of Pharmaceutical Analysis 2024年第2期14卷 225-243页

作者： Bingjia Zhao Qian Zhang Yiqian He Weifang Cao Wei Song Xiaochun Liang Department of Traditional Chinese Medicine Peking Union Medical College HospitalPeking Union Medical CollegeChinese Academy of Medical SciencesBeijing100730China Institute of Basic Medicine Sciences Chinese Academy of Medical SciencesBeijing100005China medical Research Center Peking Union Medical College HospitalPeking Union Medical CollegeChinese Academy of Medical SciencesBeijing100730China

Diabetic peripheral neuropathy (DPN) is a common and devastating complication of diabetes, for which effective therapies are currently lacking. Disturbed energy status plays a crucial role in DPN pathogenesis. However, the integrated profile of energy metabolism, especially the central carbohydrate metabolism, remains unclear in DPN. Here, we developed a metabolomics approach by targeting 56 metabolites using high-performance ion chromatography-tandem mass spectrometry (HPIC-MS/MS) to illustrate the integrative characteristics of central carbohydrate metabolism in patients with DPN and streptozotocin-induced DPN rats. Furthermore, JinMaiTong (JMT), a traditional Chinese medicine (TCM) formula, was found to be effective for DPN, improving the peripheral neurological function and alleviating the neuropathology of DPN rats even after demyelination and axonal degeneration. JMT ameliorated DPN by regulating the aberrant energy balance and mitochondrial functions, including excessive glycolysis restoration, tricarboxylic acid cycle improvement, and increased adenosine triphosphate (ATP) generation. Bioenergetic profile was aberrant in cultured rat Schwann cells under high-glucose conditions, which was remarkably corrected by JMT treatment. In-vivo and in-vitro studies revealed that these effects of JMT were mainly attributed to the activation of adenosine monophosphate (AMP)-activated protein kinase (AMPK) and downstream peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1α). Our results expand the therapeutic framework for DPN and suggest the integrative modulation of energy metabolism using TCMs, such as JMT, as an effective strategy for its treatment.

关键词： Diabetic peripheral neuropathy JinMaiTong Energy metabolism Targeted metabolomics Adenosine monophosphate-activated protein kinase

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Long-term prognosis and its associated predictive factors in patients with eosinophilic gastroenteritis

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World Journal of Gastroenterology 2024年第2期30卷 146-157页

作者： Kai-Wen Li Ge-Chong Ruan Shuang Liu Tian-Ming Xu Ye Ma Wei-Xun Zhou Wei Liu Peng-Yu Zhao Zhi-Rong Du Ji Li Jing-Nan Li Department of Gastroenterology Chinese Academy of Medical Sciences and Peking Union Medical College HospitalBeijing 100730China Department of Allergy Chinese Academy of Medical Sciences and Peking Union Medical College HospitalBeijing 100730China Department of Pathology Chinese Academy of Medical Sciences and Peking Union Medical College HospitalBeijing 100730China Department of Radiology Chinese Academy of Medical Sciences and Peking Union Medical College HospitalBeijing 100730China Affairs Office Chinese Academy of Medical Sciences and Peking Union Medical College Hospital(West campus)Beijing 100032China

BACKGROUND Eosinophilic gastroenteritis(EGE)is a chronic recurrent disease with abnormal eosinophilic infiltration in the gastrointestinal *** remain the most common treatment ***,disease relapse and glucocorticoid dependence remain notable *** date,few studies have illuminated the prognosis of EGE and risk factors for disease *** To describe the clinical characteristics of EGE and possible predictive factors for disease relapse based on long-term *** This was a retrospective cohort study of 55 patients diagnosed with EGE admitted to one medical center between 2013 and *** records were collected and ***-Meier curves and log-rank tests were conducted to reveal the risk factors for long-term relapse-free survival(RFS).RESULTS EGE showed a median onset age of 38 years and a slight female predominance(56.4%).The main clinical symptoms were abdominal pain(89.1%),diarrhea(61.8%),nausea(52.7%),distension(49.1%)and vomiting(47.3%).Forty-three(78.2%)patients received glucocorticoid treatment,and compared with patients without glucocorticoid treatments,they were more likely to have elevated serum immunoglobin E(IgE)(86.8%vs 50.0%,P=0.022)and descending duodenal involvement(62.8%vs 27.3%,P=0.046)at *** a median follow-up of 67 mo,all patients survived,and 56.4%had at least one *** variables at baseline might have been associated with the overall RFS rate,including age at diagnosis24 kg/m^(2)(HR 0.3922,95%CI:0.1916-0.8027,P=0.014),disease duration from symptom onset to diagnosis>3.5 mo(HR 2.4725,95%CI:1.220-5.0110,P=0.011),vomiting(HR 3.1259,95%CI:1.5246-6.4093,P=0.001),total serum IgE>300 KU/L at diagnosis(HR 0.2773,95%CI:0.1204-0.6384,P=0.022)and glucocorticoid treatment(HR 6.1434,95%CI:2.8446-13.2676,P=0.003).CONCLUSION In patients with EGE,younger onset age,longer disease c

关键词： Eosinophilic gastroenteritis Prognosis Relapse Glucocorticoid Glucocorticoid dependence

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Dysregulated N6-methyladenosine modification in peripheral immune cells contributes to the pathogenesis of amyotrophic lateral sclerosis

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Frontiers of Medicine 2024年第2期18卷 285-302页

作者： Di He Xunzhe Yang Liyang Liu Dongchao Shen Qing Liu Mingsheng Liu Xue Zhang Liying Cui Department of Neurology Peking Union Medical College Hospital(PUMCH)Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing100730China medical Doctor Program Chinese Academy of Medical Science and Peking Union Medical CollegeBeijing100730China McKusick-Zhang Center for Genetic Medicine State Key Laboratory of Medical Molecular BiologyInstitute of Basic Medical Sciences Chinese Academy of Medical SciencesSchool of Basic MedicinePeking Union Medical CollegeBeijing100730China Neuroscience Center Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing100730China

Amyotrophic lateral sclerosis(ALS)is a progressive neurogenerative disorder with uncertain *** evidence implicates N6-methyladenosine(m6A)modification in ALS *** RNA immunoprecipitation sequencing(MeRIP-seq)and liquid chromatography–mass spectrometry were utilized for m6A profiling in peripheral immune cells and serum proteome analysis,respectively,in patients with ALS(n=16)and controls(n=6).The single-cell transcriptomic dataset(GSE174332)of primary motor cortex was further analyzed to illuminate the biological implications of differentially methylated genes and cell communication *** of peripheral immune cells revealed extensive RNA hypermethylation,highlighting candidate genes with differential m6A modification and expression,including C-X3-C motif chemokine receptor 1(CX3CR1).In RAW264.7 macrophages,disrupted CX3CR1 signaling affected chemotaxis,potentially influencing immune cell migration in *** proteome analysis demonstrated the role of dysregulated immune cell migration in *** type-specific expression variations of these genes in the central nervous system(CNS),particularly microglia,were *** communication between neurons and glial cells was selectively altered in ALS *** integrated approach underscores m6A dysregulation in immune cells as a potential ALS contributor.

关键词： amyotrophic lateral sclerosis N^(6)-methyladenosine epi-transcriptome proteome single cell RNA sequencing analysis CX3CR1

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