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Development and validation of a machine learning-based early prediction model for massive intraoperative bleeding in patients with primary hepatic malignancies

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World Journal of Gastrointestinal Oncology 2024年第1期16卷 90-101页

作者： Jin Li Yu-Ming Jia Zhi-Lei Zhang Cheng-Yu Liu Zhan-Wu Jiang Zhi-Wei Hao Li Peng department of Hepatological surgery The Fourth Hospital of Hebei Medical UniversityShijiazhuang 050011Hebei ProvinceChina department of General surgery II Baoding First Central HospitalBaoding 071000Hebei ProvinceChina

BACKGROUND Surgical resection remains the primary treatment for hepatic malignancies,and intraoperative bleeding is associated with a significantly increased risk of ***,accurate prediction of intraoperative bleeding risk in patients with hepatic malignancies is essential to preventing bleeding in advance and providing safer and more effective *** To develop a predictive model for intraoperative bleeding in primary hepatic malignancy patients for improving surgical planning and *** The retrospective analysis enrolled patients diagnosed with primary hepatic malignancies who underwent surgery at the Hepatobiliary surgery department of the Fourth Hospital of Hebei Medical University between 2010 and *** regression analysis was performed to identify potential risk factors for intraoperative bleeding.A prediction model was developed using Python programming language,and its accuracy was evaluated using receiver operating characteristic(ROC)curve *** Among 406 primary liver cancer patients,16.0%(65/406)suffered massive intraoperative *** regression analysis identified four variables as associated with intraoperative bleeding in these patients:ascites[odds ratio(OR):22.839;P<0.05],history of alcohol consumption(OR:2.950;P<0.015),TNM staging(OR:2.441;P<0.001),and albumin-bilirubin score(OR:2.361;P<0.001).These variables were used to construct the prediction *** 406 patients were randomly assigned to a training set(70%)and a prediction set(30%).The area under the ROC curve values for the model’s ability to predict intraoperative bleeding were 0.844 in the training set and 0.80 in the prediction *** The developed and validated model predicts significant intraoperative blood loss in primary hepatic malignancies using four preoperative clinical factors by considering four preoperative clinical factors:ascites,history of alcohol consumption,TNM staging,and albumin-bilirubin ***

关键词： Primary liver cancer Intraoperative bleeding Machine learning Model

Effects of microenvironment and biological behavior on the paracrine function of stem cells

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Genes & Diseases 2024年第1期11卷 135-147页

作者： Zhixin Xue Yunjun Liao Ye Li The department of Plastic and Cosmetic surgery Nanfang HospitalSouthern Medical UniversityGuangzhouGuangdong 510515China

Mesenchymal stem cells(MSCs),the most well-studied cell type in the field of stem cell therapy,have multi-lineage differentiation and self-renewal ***-based thera-pies have been used to treat diverse diseases because of their ability to potently repair tissue and locally restore *** increasing body of evidence demonstrates that paracrine func-tion is central to the effects of MsC-based *** factors,cytokines,chemokines,extracellular matrix components,and extracellular vehicles all contribute to the beneficial ef-fects of MSCs on tissue regeneration and *** paracrine substances secreted by MSCs change depending on the tissue microenvironment and biological *** this review,we discuss the bioactive substances secreted by MsCs depending on the microenvironment and biological behavior and their regulatory mechanisms,which explain their potential to treat human diseases,to provide new ideas for further research and clinical cell-free therapy.

关键词： Bioactive behavior Mesenchymal stem cells Microenvironment Paracrine Secretome

Honokiol Prevents Intestinal Barrier Dysfunction in Mice with Severe Acute Pancreatitis and Inhibits JAK/STAT1 Pathway and Acetylation of HMGB1

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Chinese Journal of Integrative Medicine 2024年第6期30卷 534-542页

作者： LI Jie CHEN Ya-feng GAO Lei LI Yi-jie FENG Dian-xu department of General surgery Putuo HospitalShanghai University of Traditional Chinese MedicineShanghai200062China

Objective To investigate the effect of honokiol(HON)and the role of high-mobility group protein B1(HMGB1)on the pathogenesis of severe acute pancreatitis(SAP).Methods Thirty mice were numbered according to weight,and randomly divided into 5 groups using a random number table,including control,SAP,SAP and normal saline(SAP+NS),SAP and ethyl pyruvate(SAP+EP),or SAP+HON groups,6 mice in each *** of pancreas,intestine,and blood were collected 12 h after SAP model induction for examination of pathologic changes,immune function alterations by enzyme linked immunosorbent assay(ELISA),and Western *** vitro experiments,macrophages were divided into 5 groups,the control,lipopolysaccharide(LPS),LPS+DMSO(DMSO),LPS+anti-HMGB1 monoclonal antibody(mAb),and LPS+HON *** tight connection level was determined by transmission electron microscopy and fluorescein *** location and acetylation of HMGB1 were measured by Western ***,pyridone 6 and silencing signal transducer and activator of the transcription 1(siSTAT1)combined with honokiol were added to determine whether the Janus kinase(JAK)/STAT1 participated in the regulation of honokiol on *** protein expression levels of HMGB1,JAK,and STAT1 were detected using Western *** Mice with SAP had inflammatory injury in the pancreas,bleeding of intestinal tissues,and cells with disrupted *** in the SAP+HON group had significantly fewer pathological *** with SAP also had significant increases in the serum levels of amylase,lipase,HMGB1,tumor necrosis factor-α,interleukin-6,diamine oxidase,endotoxin-1,and *** in the SAP+HON group did not show these abnormalities(P<0.01).Studies of Caco-2 cells indicated that LPS increased the levels of occludin and claudin-1 as well as tight junction permeability,decreased the levels of junctional adhesion molecule C,and elevated intercellular permeability(P<0.01).HON treatment blocked these *** of

关键词： severe acute pancreatitis intestinal barrier dysfunction honokiol high-mobility group protein B1 Januskinase signal transducerand activatorof transcription1

Liver transplantation as an alternative for the treatment of neuroendocrine liver metastasis: Appraisal of the current evidence

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Hepatobiliary & Pancreatic Diseases International 2024年第2期23卷 146-153页

作者： Philip C.Muller Matthias Pfister Dilmurodjon Eshmuminov Kuno Lehmann department of surgery and Transplantation University Hospital ZurichRämistrasse 100Zurich CH-8091Switzerland

Background:Liver transplantation(LT)for neuroendocrine liver metastases(NELM)is still in *** comparing LT with liver resection(LR)for NELM are scarce,as patient selection is heterogeneous and experience is *** goal of this review was to provide a critical analysis of the evidence on LT versus LR in the treatment of *** sources:A scoping literature search on LT and LR for NELM was performed with PubMed,including English articles up to March ***:International guidelines recommend LR for NELM in resectable,well-differentiated tumors in the absence of extrahepatic metastatic disease with superior results of LR compared to systemic or liver-directed *** liver surgery has extended resectability criteria whilst entailing increased perioperative risk and short disease-free *** highly selected patients(based on the Milan criteria)with unresectable NELM,oncologic results of LT are *** factors include tumor biology(G1/G2)and burden,waiting time for LT,patient age and extrahepatic *** on low-level evi-dence,LT for low-grade NELM within the Milan criteria resulted in improved disease-free survival and overall survival compared to *** benefits of LT were lost in patients beyond the Milan ***:With adherence to strict selection criteria especially tumor biology,LT for NELM is becoming a valuable option providing oncologic benefits compared to *** evidence suggests even stricter selection criteria with regard to tumor biology.

关键词： Liver transplantation Neuroendocrine liver metastases Liver resection Selection criteria Tumor biology

Safflower Yellow Inhibits Progression of Hepatocellular Carcinoma by Modulating Immunological Tolerance via FAK Pathway

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Chinese Journal of Integrative Medicine 2024年第4期30卷 339-347页

作者： JI Hua-feng YANG Zi-qiang HAN Jun-jun LI He-fang JIN Zhao-qing CHEN Wei-qing CHEN Fei-hua GONG Mou-chun department of General surgery First People's Hospital of Hangzhou Lin'an DistrictHangzhou(311300)China

Objective To explore the anti-tumor effect of safflower yellow(SY)against hepatocellular carcinoma(HCC)and the underlying potential *** An in vitro model was established by mixing Luc-Hepa1-6 cells and CD3^(+)CD8^(+)T cells,followed by adding programmed cell death protein 1(PD-1)antibody(Anti-mPD-1)with or without *** apoptosis was detected by flow cytometry and the level of inflammatory cytokines was determined by enzyme-linked immunosorbent *** protein levels of programmed cell death 1 ligand 1(PD-L1),chemokine ligand(CCL5),C-X-C motif chemokine ligand 10(CXCL10)were measured by Western *** in situ animal model was established in mice followed by treatment with anti-mPD-1 with or without *** imaging was monitored with an AniView 100 imaging *** establish the FAK-overexpressed Luc-Hepa1-6 cells,cells were transfected with adenovirus containing pcDNA3.1-FAK for 48 *** The fluorescence intensity,apoptotic rate,release of inflammatory cytokines,and CCL5/CXCL10 secretion were dramatically facilitated by anti-mPD-1(P<0.01),accompanied by an inactivation of PD-1/PD-L1 axis,which were extremely further enhanced by SY(P<0.05 or P<0.01).Increased fluorescence intensity,elevated percentage of CD3+CD8+T cells,facilitated release of inflammatory cytokines,inactivated PD-1/PD-L1 axis,and increased CCL5/CXCL10 secretion were observed in Anti-mPD-1 treated mice(P<0.01),which were markedly enhanced by SY(P<0.05 or P<0.01).Furthermore,the enhanced effects of SY on inhibiting tumor cell growth,facilitating apoptosis and inflammatory cytokine releasing,suppressing the PD-1/PD-L1 axis,and inducing the CCL5/CXCL10 secretion in Anti-mPD-1 treated mixture of Luc-Hepa1-6 cells and CD3+CD8+T cells were abolished by FAK overexpression(P<0.01).Conclusion SY inhibited the progression of HCC by mediating immunological tolerance through inhibiting FAK.

关键词： hepatocellular carcinoma safflower yellow Chinese medicine tumor microenvironment programmed cell death protein 1 focal adhesion kinase

Stercoral perforation of the cecum:A case report

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World Journal of Gastrointestinal surgery 2024年第4期16卷 1189-1194页

作者： Hung-Chun Yu Ta-Wei Pu Jung-Cheng Kang Chao-Yang Chen Je-Ming Hu Ruei-Yu Su department of surgery Taichung Armed Forces General HospitalTaichung 411228Taiwan department of surgery Tri-Service General HospitalNational Defense Medical CenterTaipei 11490Taiwan Division of Colon and Rectal surgery Department of SurgeryTri-Service General Hospital Songshan BranchNational Defense Medical CenterTaipei 105Taiwan Division of Colon and Rectal surgery Department of SurgeryTaiwan Adventist HospitalTaipei 105Taiwan Division of Colon and Rectal surgery Department of SurgeryTri-Service General HospitalNational Defense Medical CenterTaipei 114Taiwan department of Pathology Tri-Service General HospitalNational Defense Medical CenterTaipei 105Taiwan department of Pathology and Laboratory Medicine Taoyuan Armed Forces General HospitalTaoyuan 325Taiwan

BACKGROUND With less than 90 reported cases to date,stercoral perforation of the colon is a rare *** ulceration is thought to occur due to ischemic pressure necrosis of the bowel wall,which is caused by the presence of a stercoraceous *** underscore this urgent surgical situation concerning clinical presentation,surgical treatment,and results,we present the case of a 66-year-old man with a stercoral *** SUMMARY A 66-year-old man with a history of hypertension,hyperlipidemia,and gout presented at the emergency department with lower abdominal pain and a low-grade fever lasting for a few *** computed tomography indicated a suspected bezoar(approximately 7.6 cm)in the dilated cecum,accompanied by pericolic fat stranding,mild proximal dilatation of the ileum,pneumoperitoneum,and minimal ***,feculent peritonitis with isolated cecal perforation were ***,a right hemicolectomy with peritoneal lavage was performed.A histopathological examination supported the intraoperative *** In stercoral perforations,a diagnosis should be diligently pursued,especially in older adults,and prompt surgical intervention should be implemented.

关键词： Acute abdomen Colectomy Peritoneal lavage Pneumoperitoneum Bezoars Case report

Efficacy of ginseng-based Renshenguben oral solution for cancer-related fatigue among patients with advanced-stage hepatocellular carcinoma:A prospective multicenter cohort study

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Hepatobiliary & Pancreatic Diseases International 2024年第3期23卷 249-256页

作者： Ming-Da Wang Chen Yuan Ke-Chun Wang Nan-Ya Wang Ying-Jian Liang Hong Zhu Xiang-Min Tong Tian Yang department of Hepatobiliary and Pancreatic surgery General Surgery CenterFirst Hospital of Jilin UniversityChangchun 130021China department of Hepatobiliary surgery Eastern Hepatobiliary Surgery HospitalSecond Military Medical University(Naval Medical University)Shanghai 200438China department of Clinical Laboratory Laboratory Medicine CenterZhejiang Provincial People’s HospitalHangzhou Medical CollegeHangzhou 310000China department of Hepatobiliary surgery First Affiliated Hospital of Harbin Medical UniversityHarbin 150007China department of Medical Oncology First Affiliated Hospital of Soochow UniversitySuzhou 215006China fdepartment of Central Laboratory Affiliated Hangzhou First People’s HospitalWestlake University School of MedicineHangzhou 310006China

Background:Cancer-related fatigue(CRF)is a common and debilitating symptom experienced by patients with advanced-stage cancer,especially those undergoing antitumor *** study aimed to evaluate the efficacy and safety of Renshenguben(RSGB)oral solution,a ginseng-based traditional Chinese medicine,in alleviating CRF in patients with advanced hepatocellular carcinoma(HCC)receiving antitumor ***:In this prospective,open-label,controlled,multicenter study,patients with advanced HCC at BCLC stage C and a brief fatigue inventory(BFI)score of≥4 were *** were assigned to the RSGB group(RSGB,10 mL twice daily)or the control group(with supportive care).Primary and secondary endpoints were the change in multidimensional fatigue inventory(MFI)score,and BFI and functional assessment of cancer therapy-hepatobiliary(FACT-Hep)scores at weeks 4 and 8 after *** events(AEs)and toxicities were ***:A total of 409 participants were enrolled,with 206 assigned to the RSGB *** week 4,there was a trend towards improvement,but the differences were not statistically *** week 8,the RSGB group exhibited a significantly lower MFI score(P<0.05)compared to the control group,indicating improved fatigue ***,the RSGB group showed significantly greater decrease in BFI and FACT-Hep scores at week 8(P<0.05).Subgroup analyses among patients receiving various antitumor treatments showed similar *** linear regression analyses revealed that the RSGB group experienced a significantly substantial decrease in MFI,BFI,and FACT-Hep scores at week *** serious drug-related AEs or toxicities were ***:RSGB oral solution effectively reduced CRF in patients with advanced HCC undergoing antitumor therapy over an eight-week period,with no discernible *** findings support the potential of RSGB oral solution as an adjunctive treatment for managing CRF in this patient population.

关键词： Cancer-related fatigue Hepatocellular carcinoma Renshenguben oral solution Efficacy Safety Ginseng

Relationship between Helicobacter pylori infection and colorectal polyp/colorectal cancer

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World Journal of Gastrointestinal surgery 2024年第4期16卷 1008-1016页

作者： Ying Liu Ding-Quan Yang Jun-Nan Jiang Yan Jiao department of General surgery The Affiliated Hospital to Changchun University of Chinese MedicineChangchun 130021Jilin ProvinceChina department of Gastrointestinal and Colorectal surgery China-Japan Union Hospital of Jilin UniversityChangchun 130033Jilin ProvinceChina department of Hepatobiliary and Pancreatic surgery General Surgery CenterThe First Hospital of Jilin UniversityChangchun 130021Jilin ProvinceChina

Helicobacter pylori(***)plays an important role in the development of gastric cancer,although its association to colorectal polyp(CP)or colorectal cancer(CRC)is *** this issue of World Journal of Gastrointestinal surgery,Zhang et al investigated the risk factors for *** infection after colon polyp ***,the researchers used R software to create a prediction model for *** infection based on their *** editorial gives an overview of the association between *** and CP/CRC,including the clinical significance of *** as an independent risk factor for CP/CRC,the underlying processes of ***-associated carcinogenesis,and the possible risk factors and identification of ***.

关键词： Helicobacter pylori Colorectal polyp Colorectal cancer Risk factor

Surgically treating a rare and asymptomatic intraductal papillary neoplasm of the bile duct:A case report

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World Journal of Clinical Cases 2024年第2期12卷 367-373页

作者： Shen-Zhen Zhu Zhao-Feng Gao Xiao-Rong Liu Xiao-Guang Wang Fei Chen department of General surgery Jiaxing Second HospitalJiaxing 314000Zhejiang ProvinceChina department of Hepatobiliary surgery Jiaxing Second HospitalJiaxing 314000Zhejiang ProvinceChina

BACKGROUND Intraductal papillary neoplasms of the bile duct(IPNBs)are rare and characterized by papillary growth within the bile duct *** is similar to obstructive biliary *** this report,we present an unexpected case of asymptomatic IPNB and consolidate our findings with the relevant literature to augment our understanding of this *** relevant literature contributes to a more comprehensive understanding of the *** SUMMARY A 66-year-old Chinese male patient was admitted to our hospital for surgical intervention after gallstones were discovered during a routine physical *** imaging revealed a lesion on the left side of the liver,which raised the suspicion of IPNB.A laparoscopic left hemihepatectomy was performed,and subsequent histopathological examination confirmed the diagnosis of *** the 3-mo postoperative follow-up,the patient reported good recovery and no *** can manifest both latently and *** surgical resection is the most effective treatment for *** Hepatic and biliary masses,should be considered to diagnose *** surgery and vigilant follow-up are crucial in determining prognosis.

关键词： Intraductal papillary neoplasm of the bile duct Tumor Surgical treatment Prognosis Case report