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Impact of open hepatectomy on postoperative bile leakage in patients with biliary tract cancer

World Journal of Gastrointestinal surgery 2024年第1期16卷 67-75页

作者： Gang Wu Wen-Ying Li Yu-Xing Gong Feng Lin Chen Sun general surgery department The Second Affiliated Hospital of Harbin Medical UniversityHarbin 150000Heilongjiang ProvinceChina

BACKGROUND Bile leakage is a common and serious complication of open hepatectomy for the treatment of biliary tract *** To evaluate the incidence,risk factors,and management of bile leakage after open hepatectomy in patients with biliary tract *** We retrospectively analyzed 120 patients who underwent open hepatectomy for biliary tract cancer from February 2018 to February *** leak was defined as bile drainage from the surgical site or drain or the presence of a biloma on *** incidence,severity,timing,location,and treatment of the bile leaks were *** risk factors for bile leakage were analyzed using univariate and multivariate logistic regression *** The incidence of bile leak was 16.7%(20/120),and most cases were grade A(75%,15/20)according to the International Study Group of Liver surgery *** median time of onset was 5 d(range,1-14 d),and the median duration was 7 d(range,2-28 d).The most common location of bile leakage was the cut surface of the liver(70%,14/20),followed by the anastomosis site(25%,5/20)and the cystic duct stump(5%,1/20).Most bile leaks were treated conservatively with drainage,antibiotics,and nutritional support(85%,17/20),whereas some required endoscopic retrograde cholangiopancreatography with stenting(10%,2/20)or percutaneous transhepatic cholangiography with drainage(5%,1/20).Risk factors for bile leakage include male sex,hepatocellular carcinoma,major hepatectomy,blood loss,and blood *** Bile leakage is a frequent complication of open hepatectomy for biliary tract ***,most cases are mild and can be conservatively *** sex,hepatocellular carcinoma,major hepatectomy,blood loss,and blood transfusion were associated with an increased risk of bile leak.

关键词： Open hepatectomy Bile leak Biliary tract cancer Risk factors Management Complication

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RBM25 depletion suppresses the growth of colon cancer cells through regulating alternative splicing of MNK2

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Science China Life Sciences 2024年第10期67卷 2186-2197页

作者： Lili Zhi Chaoqun Chen Ge Zhang Tian Huang Wenxia He Jinrui Zhang Dan Chen Jiayi Liu Jinyao Zhao Yangfan Qi Guiying Wang Wenjing Zhang Yang Wang Sino-US Research Center for Cancer Translational Medicine of the Second Affiliated Hospital of Dalian medical University & Institute of Cancer Stem Cell Dalian Medical University department of Immunology College of Basic Medical SciencesDalian Medical University Institute of Cancer Stem Cell Dalian Medical University department of Pathology the First Affiliated Hospital of Dalian Medical UniversityDalian Medical University department of general surgery the Second Hospital of Hebei Medical University The Second department of general surgery the Fourth Hospital of Hebei Medical University Hebei Key Laboratory of Etiology Tracing and Individualized Diagnosis and Treatment for Digestive System Carcinoma

Increasing evidence suggests that deregulated RNA splicing factors play critical roles in tumorigenesis; however, their specific involvement in colon cancer remains largely unknown. Here we report that the splicing factor RBM25 is overexpressed in colon cancer, and this increased expression correlates with a poor prognosis of patients with colon cancer. Functionally, RBM25 ablation suppresses the growth of colon cancer cells both in vitro and in vivo. Mechanistically, our transcriptome-wide analysis of splicing events revealed that RBM25 regulates a large number of cancer-related alternative splicing events across the human genome in colon cancer. Particularly, RBM25 regulates the splicing of MNK2 by interacting with the poly G rich region in exon 14a, thereby inhibiting the selection of the proximal 3'splice site(ss), resulting in the production of the oncogenic short isoform, MNK2b. Knockdown of RBM25 leads to an increase in the MNK2a isoform and a decrease in the MNK2b isoform. Importantly, re-expression of MNK2b or blocking the 3′ ss of the alternative exon 14a with ASO partially reverses the RBM25 knockdown mediated tumor suppression. Moreover, MNK2b levels were significantly increased in colon cancer tissues, which is positively correlated with the expression level of RBM25. Collectively, our findings uncover the critical role of RBM25 as a key splicing factor in colon cancer, suggesting its potential as a prognostic marker and therapeutic target.

关键词： RBM25 colon cancer alternative splicing MNK2

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Indication of conservative treatment by antibiotics for uncomplicated and complicated acute appendicitis

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World Journal of Gastrointestinal surgery 2024年第8期16卷 2538-2545页

作者： Yuichi Hosokawa Masato Moritani Yosuke Makuuchi Yuichi Nagakawa department of surgery Nishitokyo Central General HospitalTokyo 188-0014Japan department of Gastrointestinal and Pediatric surgery Tokyo Medical UniversityTokyo 166-0023Japan

BACKGROUND Acute appendicitis is one of the most common emergency abdominal disease,and recent studies have evaluated conservative treatment using antibiotics for uncomplicated *** the efficacy of conservative treatment for uncomplicated appendicitis is known,its efficacy for complicated appendicitis remains unknown,so are risk factors for the conservative treatment of *** our institution,conservative treatment has long been the first choice for most appendicitis cases,except for ***,this novel study inves-tigated the outcomes of conservative treatment for uncomplicated and compli-cated acute appendicitis and the risk factors associated with conservative *** significant and independent predictors of resistance to conservative treatment were body temperature≥37.3°C,appendicolith and Douglas sinus fluid visible on computed tomography(CT).The rate of resistance to conservative treatment was 66.7%(6/9)for patients with the above three factors,22.9%(8/35)for patients with two factors(appendicolith and body temperature≥37.3°C),16.7%(2/12)for patients with two factors(Douglas sinus fluid and appendicolith)and 11.1%(1/9)for patients with two factors(Douglas sinus fluid and body temperature≥37.3°C).CONCLUSION A temperature≥37.3°C,appendicolith and Douglas sinus fluid on CT might be clinical risk factors of resistance to conservative treatment for acute appendicitis.

关键词： Acute appendicitis Conservative treatment Antibiotics Appendicolith Uncomplicated appendicitis

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Bile acids inhibit ferroptosis sensitivity through activating farnesoid X receptor in gastric cancer cells

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World Journal of Gastroenterology 2024年第5期30卷 485-498页

作者： Chu-Xuan Liu Ying Gao Xiu-Fang Xu Xin Jin Yun Zhang Qian Xu Huan-Xin Ding Bing-Jun Li Fang-Ke Du Lin-Chuan Li Ming-Wei Zhong Jian-Kang Zhu Guang-Yong Zhang department of general surgery Shandong Provincial Qianfoshan HospitalShandong UniversityJinan 250014Shandong ProvinceChina department of general surgery Linyi People's HospitalLinyi 276034Shandong ProvinceChina department of Nursing Huantai TCM HospitalZibo 256400Shandong ProvinceChina Center for Translational medical Research The First Affiliated Hospital of Shandong First Medical UniversityJinan 250014Shandong ProvinceChina department of general surgery The First Affiliated Hospital of Shandong First Medical UniversityJinan 250014Shandong ProvinceChina

BACKGROUND Gastric cancer(GC)is associated with high mortality *** acids(BAs)reflux is a well-known risk factor for GC,but the specific mechanism remains *** GC development in both humans and animals,BAs serve as signaling molecules that induce metabolic *** confers additional cancer phenotypes,including ferroptosis *** is a novel mode of cell death characterized by lipid peroxidation that contributes universally to malignant ***,it is not fully defined if BAs can influence GC progression by modulating *** To reveal the mechanism of BAs regulation in ferroptosis of GC *** In this study,we treated GC cells with various stimuli and evaluated the effect of BAs on the sensitivity to *** used gain and loss of function assays to examine the impacts of farnesoid X receptor(FXR)and BTB and CNC homology 1(BACH1)overexpression and knockdown to obtain further insights into the molecular mechanism *** Our data suggested that BAs could reverse erastin-induced ferroptosis in GC *** effect correlated with increased glutathione(GSH)concentrations,a reduced GSH to oxidized GSH ratio,and higher GSH peroxidase 4(GPX4)expression ***,we confirmed that BAs exerted these effects by activating FXR,which markedly increased the expression of GSH synthetase and ***,BACH1 was detected as an essential intermediate molecule in the promotion of GSH synthesis by BAs and ***,our results suggested that FXR could significantly promote GC cell proliferation,which may be closely related to its anti-ferroptosis *** This study revealed for the first time that BAs could inhibit ferroptosis sensitivity through the FXR-BACH1-GSHGPX4 axis in GC *** work provided new insights into the mechanism associated with BA-mediated promotion of GC and may help identify potential therapeutic targets for GC patients with BAs reflux.

关键词： Gastric cancer Ferroptosis Bile acids Chenodeoxycholic acid Farnesoid X receptor Glutathione

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Th17/Treg balance and macrophage polarization ratio in lower extremity arteriosclerosis obliterans

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Asian Pacific Journal of Tropical Biomedicine 2024年第3期14卷 127-136,I0006-I0009页

作者： Zhen-Zhen Li Min Liu Xiong-Hui He Zhen-Dong Liu Zhan-Xiang Xiao Hao Qian You-Fei Qi Cun-Chuan Wang department of Metabolic and Bariatric surgery The First Affiliated Hospital of Jinan UniversityGuangzhouGuangdong Province510632China department of Vascular surgery Hainan General HospitalHainan Affiliated Hospital of Hainan Medical UniversityHaikouHainan Province570311China department of Physical Examination Hainan General HospitalHainan Affiliated Hospital of Hainan Medical UniversityHaikouHainan Province570311China department of Gastrointestinal surgery Hainan General HospitalHainan Affiliated Hospital of Hainan Medical UniversityHaikouHainan Province570311China

Objective:To explore the balance of peripheral blood T helper 17 cells/regulatory T cell(Th17/Treg)ratio and the polarization ratio of M1 and M2 macrophages in lower extremity arteriosclerosis obliterans(ASO).Methods:A rat model of lower extremity ASO was established,and blood samples from patients with lower extremity ASO before and after surgery were *** was used to detect interleukin 6(IL-6),IL-10,and ***-time RCR and Western blot analyses were used to detect Foxp3,IL-6,IL-10,and IL-17 ***,flow cytometry was applied to detect the Th17/Treg ratio and M1/M2 ***:Compared with the control group,the iliac artery wall of ASO rats showed significant hyperplasia,and the concentrations of cholesterol and triglyceride were significantly increased(Psurgery(such as percutaneous transluminal angioplasty and arterial stenting),all these changes were significantly improved(Psurgery can effectively improve the balance of Th17/Treg,and reduce the ratio of M1/M2,and the expression of inflammatory factors.

关键词： Lower extremity arteriosclerosis Regulatory T cells Regulatory B cells Inflammatory factors M1 macrophages M2 macrophages

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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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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

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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

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The efficacy of vitamin E in preventing arthrofibrosis after joint replacement

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Animal Models and Experimental Medicine 2024年第2期7卷 145-155页

作者： Yingfang Fan Jean Yuh Sashank Lekkala Mehmet D.Asik Andrew Thomson Madeline McCanne Mark A.Randolph Antonia F.Chen Ebru Oral Harris Orthopaedic Laboratory Department of Orthopaedic SurgeryMassachusetts General HospitalBostonMassachusettsUSA department of Orthopaedic surgery Harvard Medical SchoolBostonMassachusettsUSA department of surgery Harvard Medical SchoolBostonMassachusettsUSA department of Orthopaedic surgery Brigham and Women's HospitalBostonMassachusettsUSA

Background:Arthrofibrosis is a joint disorder characterized by excessive scar formation in the joint *** E is an antioxidant with potential anti-fibroblastic *** aim of this study was to establish an arthrofibrosis rat model after joint replacement and assess the effects of vitamin E supplementation on joint ***:We simulated knee replacement in 16 male Sprague–Dawley *** immobilized the surgical leg with a suture in full *** control groups were killed at 2 and 12 weeks(n=5 per group),and the test group was supplemented daily with vitamin E(0.2 mg/mL)in their drinking water for 12 weeks(n=6).We performed histological staining to investigate the presence and severity of *** staining andα2-macroglobulin(α2M)enzyme-linked immunosorbent assay(ELISA)were used to assess local and systemic *** weight bearing(total internal reflection)and range of motion(ROM)were collected for functional ***:The ROM and weight-bearing symmetry decreased after the procedure and recovered slowly with still significant deficit at the end of the study for both *** analysis confirmed fibrosis in both lateral and posterior periarticular *** E supplementation showed a moderate anti-inflammatory effect on the local and systemic *** vitamin E group exhibited significant improvement in ROM and weight-bearing symmetry at day 84 compared to the control ***:This model is viable for simulating arthrofibrosis after joint *** E may benefit postsurgical arthrofibrosis,and further studies are needed for dosing requirements.

关键词： arthrofibrosis range of motion total knee arthroplasty vitamin E

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Predictors of complications after prophylactic ileostomy reversal for rectal cancer:A retrospective study

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World Journal of Gastrointestinal surgery 2024年第5期16卷 1354-1362页

作者： Quan Lv Xin-Peng Shu Dong Peng Si-Qi Li Zheng Xiang department of Gastrointestinal surgery The First Affiliated Hospital of Chongqing Medical UniversityChongqing 400016China Chongqing Key Laboratory of department of general surgery The First Affiliated Hospital of Chongqing Medical UniversityChongqing 400016China

BACKGROUND Previous studies have analyzed the risk factors for complications after ileostomy reversal for rectal cancer(RC),but there were significant differences in the reported risk factors for complications after stoma *** studies have analyzed the risk factors for stoma-related complications and overall postoperative com-plications *** To analyze the risk factors for overall complications and stoma-related complications after ileostomy reversal for patients with *** This was a retrospective study of 439 patients who underwent ileostomy reversal at a clinical center and were followed up between September 2012 and September *** variables are expressed as the mean±SD and were analyzed with independent-sample t tests,while frequency variables are expressed as n(%),and theχ2 test or Fisher’s exact test was *** and multivariate logistic regression analyses were used to identify predictors of overall complications and stoma-related *** The overall complication rate after ileostomy reversal was 11.4%.Patients with lower preoperative albumin concentration(Psurgery to ileostomy reversal(Psurgery to ileostomy reversal(P<0.01,OR=1.140,95%CI:1.038-1.252)were independent risk factors for stoma-related compl

关键词： Ileostomy Reversal Risk factors Complications Rectal cancer

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