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Machine learning identifies the risk of complications after laparoscopic radical gastrectomy for gastric cancer

World Journal of Gastroenterology 2024年第1期30卷 79-90页

作者： Qing-Qi Hong Su Yan Yong-Liang Zhao Lin Fan Li Yang Wen-Bin Zhang Hao Liu He-Xin Lin Jian Zhang Zhi-Jian Ye Xian Shen Li-Sheng Cai Guo-Wei Zhang Jia-Ming Zhu Gang Ji Jin-Ping Chen Wei Wang Zheng-Rong Li Jing-Tao Zhu Guo-Xin Li Jun You department of Gastrointestinal Oncology surgery The First Affiliated Hospital of Xiamen UniversitySchool of MedicineXiamen 361001Fujian ProvinceChina department of Gastrointestinal surgery Qinghai University Affiliated HospitalXining 810000Qinghai ProvinceChina department of General surgery and Center of Minimal Invasive Gastrointestinal surgery The First Hospital Affiliated to Army Medical UniversityChongqing 400038China department of General surgery The First Affiliated Hospital of Xi'an Jiaotong UniversityXi'an 710061Shaanxi ProvinceChina department of General surgery The First Affiliated Hospital of Nanjing Medical UniversityNanjing 210029Jiangsu ProvinceChina department of Gastrointestinal surgery The First Affiliated Hospital of Xinjiang Medical UniversityUrmuqi 830054Xinjiang Uygur Autonomous RegionChina department of General surgery Nanfang HospitalSouthern Medical UniversityGuangzhou 510515Guangdong ProvinceChina department of Gastrointestinal surgery Affiliated Hangzhou First People's HospitalZhejiang University School of MedicineHangzhou 310006Zhejiang ProvinceChina department of Gastrointestinal surgery Zhongshan Hospital of Xiamen UniversityXiamen 361004Fujian ProvinceChina department of surgery The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical UniversityWenzhou 325027Zhejiang ProvinceChina department of General surgery Unit 4 Zhangzhou Affiliated Hospital of Fujian Medical UniversityZhangzhou 363000Fujian ProvinceChina department of Gastrointestinal surgery The Second Affiliated Hospital of Xiamen Medical CollegeXiamen 361021Fujian ProvinceChina department of Gastrointestinal Nutrition and Hernia surgery The Second Hospital of Jilin UniversityChangchun 130041Jilin ProvinceChina department of Digestive Diseases Xijing HospitalAir Force Military Medical UniversityXi'an 710032Shaanxi ProvinceChina department of Gastrointestinal surgery Quanzhou First Hospital Affiliated to Fujian Medical UniversityQuanzhou 362002Fujian Provin

BACKGROUND Laparoscopic radical gastrectomy is widely used,and perioperative complications have become a highly concerned *** To develop a predictive model for complications in laparoscopic radical gastrectomy for gastric cancer to better predict the likelihood of complications in gastric cancer patients within 30 days after surgery,guide perioperative treatment strategies for gastric cancer patients,and prevent serious *** In total,998 patients who underwent laparoscopic radical gastrectomy for gastric cancer at 16 Chinese medical centers were included in the training group for the complication model,and 398 patients were included in the validation *** clinicopathological data and 30-d postoperative complications of gastric cancer patients were *** machine learning methods,lasso regression,random forest,and artificial neural networks,were used to construct postoperative complication prediction models for laparoscopic distal gastrectomy and laparoscopic total gastrectomy,and their prediction efficacy and accuracy were *** The constructed complication model,particularly the random forest model,could better predict serious complications in gastric cancer patients undergoing laparoscopic radical *** exhibited stable performance in external validation and is worthy of further promotion in more *** Using the risk factors identified in multicenter datasets,highly sensitive risk prediction models for complications following laparoscopic radical gastrectomy were *** hope to facilitate the diagnosis and treatment of preoperative and postoperative decision-making by using these models.

关键词： Gastric cancer Laparoscopic radical gastrectomy Postoperative complications Laparoscopic total gastrectomy

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Hepatocellular carcinoma presenting as an extrahepatic mass:A case report and review of literature

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World Journal of Gastrointestinal Oncology 2024年第5期16卷 2241-2252页

作者： Wei Kelly Wu Krutika Patel Chandrasekhar Padmanabhan Kamran Idrees department of surgery Vanderbilt University Medical CenterNashvilleTN 37232United States department of Pathology Microbiology and ImmunologyVanderbilt University Medical CenterNashvilleTN 37232United States Division of Surgical Oncology and Endocrine surgery Department of SurgeryVanderbilt University Medical CenterNashvilleTN 37232United States

BACKGROUND Hepatocellular carcinoma(HCC)is a primary liver tumor generally diagnosed based on radiographic *** disease is typically associated with increased tumor diameter,multifocality,and vascular *** report a case of a patient who presented with extrahepatic HCC metastasis to a portocaval lymph node with occult hepatic primary on computed tomography(CT).We review the literature for cases of extrahepatic HCC presentation without known hepatic lesions and discuss strategies to differentiate between metastatic and ectopic *** SUMMARY A 67-year-old male with remotely treated hepatis C was referred for evaluation of an enlarging portocaval,mixed cystic-solid *** CT evaluations demonstrated steatosis,but no cirrhosis or liver *** ultrasound demonstrated a normal-appearing pancreas,biliary tree,and *** needle aspiration yielded atypical *** differential diagnosis included duodenal or pancreatic cyst,lymphoproliferative cyst,stromal or mesenchymal lesions,nodal involvement from gastrointestinal or hematologic malignancy,or duodenal gastrointestinal stromal *** review by a multidisciplinary tumor board,the patient underwent open surgical resection of a 5.2 cm×5.5 cm retroperitoneal mass with pathology consistent with moderately-differentiated *** resonance imaging(MRI)subsequently demonstrated a 1.2 cm segment VIII hepatic lesion with late arterial enhancement,fatty sparing,and intrinsic T1 *** fetoprotein was 23.3 ng/*** patient was diagnosed with HCC with portocaval nodal ***:We surveyed the literature for HCC presenting as extrahepatic masses without history of concurrent or prior intrahepatic *** identified 18 cases of extrahepatic HCC ultimately found to represent metastatic lesions,and 30 cases of extrahepatic HCC found to be primary,ectopic *** Hepatocellular carcinoma can seldomly present with extrahepatic metastasis in the setting of

关键词： Extrahepatic Metastasis Portocaval Lymph node Case report

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Left ventricular thrombosis caused cerebral embolism during venoarterial extracorporeal membrane oxygenation support: A case report

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World Journal of Clinical Cases 2024年第5期12卷 973-979页

作者： Yao-Bang Bai Feng Zhao Zhen-Hua Wu Guo-Ning Shi Nan Jiang Intensive Care Unit Department of Cardiac SurgeryTianjin Chest HospitalTianjin 300222China department of Cardiac surgery Tianjin Chest HospitalTianjin 300222China

BACKGROUND Venoarterial(VA)extracorporeal membrane oxygenation(ECMO),an effective short-term circulatory support method for refractory cardiogenic shock,is widely ***,retrospective analyses have shown that VA-ECMO-assisted cases were associated with a relatively high mortality rate of approximately 60%.Embolization in important organs caused by complications of left ventricular thrombosis(LVT)during VA-ECMO is also an important *** the incidence of LVT during VA-ECMO is not high,the consequences of embolization are *** SUMMARY A 37-year-old female patient was admitted to hospital because of fever for 4 d and palpitations for 3 *** excluding the diagnosis of coronary heart disease,we established a diagnosis of“clinically explosive myocarditis”.The patient still had unstable hemodynamics after drug treatment supported by VA-ECMO,with heparin for *** day 4 of ECMO support,a left ventricular thro-mbus attached to the papillary muscle root of the mitral valve was found by transthoracic *** ventricular decompression was performed and ECMO was successfully removed,but the patient eventually died of multiple cerebral *** LVT with high mobility during VA-ECMO may cause embolism in important ***,a"wait and see"strategy should be avoided.

关键词： Venoarterial extracorporeal membrane oxygenation Left ventricular thrombosis Cerebral embolism Magnetic Resonance Imaging Therapy Case report

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Mirizzi syndrome:Problems and strategies

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Hepatobiliary & Pancreatic Diseases International 2024年第3期23卷 234-240页

作者： Jun Wu Shuang-Yong Cai Xu-Liang Chen Zhi-Tao Chen Shao-Hua Shi department of Hepatobiliary and Pancreatic surgery People’s Hospital of Jiulongpo DistrictChongqing 400050China department of Hepatobiliary and Pancreatic surgery Shulan(Hangzhou)Hospital Affiliated to Zhejiang Shuren University Shulan International Medical CollegeHangzhou 310003China

Mirizzi syndrome is a serious complication of gallstone *** is caused by the impacted stones in the gallbladder neck or cystic *** of the features of Mirizzi syndrome is severe inflammation or dense fibrosis at the Calot’s *** our clinical practice,bile duct,branches of right hepatic artery and right portal vein clinging to gallbladder infundibulum are often observed due to gallbladder infundibulum adhered to right hepatic *** intraoperative damage of branches of right hepatic artery occurs more easily than that of bile duct,all of which are hidden pitfalls for *** resonance cholangiopancreatography(MRCP)and endoscopic retrograde cholangiopancreatography(ERCP)are the preferable tools for the diagnosis of Mirizzi *** cholecystectomy in Mirizzi syndrome is easy to damage branches of right hepatic artery and bile duct due to gallbladder infundibulum adhered to right hepatic *** cholecystectomy is an easy,safe and definitive approach to Mirizzi *** combined with the application of ERCP,a laparoscopic management of Mirizzi syndrome by well-trained surgeons is feasible and *** objective of this review was to highlight its existing problems:(1)low preoperative diagnostic rate,(2)easy to damage bile duct and branches of right hepatic artery,and(3)high concomitant gallbladder ***,the review aimed to discuss the possible therapeutic strategies:(1)to enhance its preoperative recognition by imaging findings,and(2)to avoid potential pitfalls during surgery.

关键词： Mirizzi syndrome Bile duct injury Artery injury Surgical treatment Subtotal cholecystectomy

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Complementary comments on metastatic liver lesions with exceptional and rare cases

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World Journal of Gastroenterology 2024年第7期30卷 770-773页

作者： Kemal Bugra Memis Sonay Aydin department of radiology Erzincan Binali Yıldırım UniversityFaculty of MedicineErzincan 24000Turkey

Liver metastases can appear in different forms in magnetic resonance *** to popular belief,while radiologists report hypovascular or hypervascular metastatic lesions,exceptional examples may be detected in various *** aim of this article is to improve this review by presenting rare and atypical examples of liver metastasis,as well as cases that might potentially be misdiagnosed as metastases during the process of differential diagnosis.

关键词： Hepatic lesions Magnetic resonance imaging Liver metastases Echinococcus alveolaris Prostate adenocarcinoma Appendix neuroendocrine tumor

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Activatable fluorescent probes for imaging and diagnosis of rheumatoid arthritis

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Military Medical Research 2024年第2期11卷 287-307页

作者： Pan Luo Fu-Qiang Gao Wei Sun Jun-You Li Cheng Wang Qing-Yu Zhang Zhi-Zhuo Li Peng Xu department of Joint surgery Honghui HospitalXi'an Jiaotong UniversityXi'an 710054China department of Orthopedics China-Japan Friendship HospitalBeijing 100029China department of Orthopaedic surgery of the Perelman School of Medicine University of PennsylvaniaPhiladelphiaPA 19104USA School of Mechanical Engineering Sungkyunkwan UniversitySuwon 16419South Korea department of Orthopaedic surgery Peking University Third HospitalPeking UniversityBeijing 100191China department of Orthopedics Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinan 250021China State Key Laboratory of Pharmaceutical Biotechnology Division of Sports Medicine and Adult Reconstructive SurgeryDepartment of Orthopedic SurgeryNanjing Drum Tower Hospitalthe Affiliated Hospital of Nanjing University Medical SchoolNanjing 210008China

Rheumatoid arthritis(RA)is a systemic autoimmune disease that is primarily manifested as synovitis and polyarticular opacity and typically leads to serious joint damage and irreversible disability,thus adversely affecting locomotion ability and life ***,good prognosis heavily relies on the early diagnosis and effective therapeutic monitoring of *** fluorescent probes play vital roles in the detection and imaging of biomarkers for disease diagnosis and in vivo ***,we review the fluorescent probes developed for the detection and imaging of RA biomarkers,namely reactive oxygen/nitrogen species(hypochlorous acid,peroxynitrite,hydroxyl radical,nitroxyl),pH,and cysteine,and address the related challenges and prospects to inspire the design of novel fluorescent probes and the improvement of their performance in RA studies.

关键词： Rheumatoid arthritis Fluorescent probe Imaging Diagnosis Biomarker

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Predictive value of bilirubin and serum γ-glutamyltranspeptidase levels in type-2 diabetes mellitus patients with acute coronary syndrome

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World Journal of Diabetes 2024年第1期15卷 34-42页

作者： Jie Chen Wan-Chao Zhang Xiao-Qiang Tang Ruo-Han Yin Tao Wang Xiao-Yu Wei Chang-Jie Pan radiology department The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical UniversityChangzhou 213164Jiangsu ProvinceChina radiology department The People’s Hospital of WuQia CountyWuqia 845450Xinjiang Uygur Autonomous RegionChina

BACKGROUND Cardiovascular disease is a major complication of diabetes mellitus(DM).Type-2 DM(T2DM)is associated with an increased risk of cardiovascular events and mortality,while serum biomarkers may facilitate the prediction of these *** differential diagnosis of T2DM complicated with acute coronary syndrome(ACS)plays an important role in controlling disease progression and improving *** To investigate the correlation of serum bilirubin andγ-glutamyltranspeptidase(γ-GGT)with major adverse cardiovascular events(MACEs)in T2DM patients with *** The clinical data of inpatients from January 2022 to December 2022 were analyzed *** to different conditions,they were divided into the T2DM complicated with ACS group(T2DM+ACS,n=96),simple T2DM group(T2DM,n=85),and simple ACS group(ACS,n=90).The clinical data and laboratory indices were compared among the three groups,and the correlations of serum total bilirubin(TBIL)levels and serumγ-GGT levels with other indices were discussed.T2DM+ACS patients received a 90-day follow-up after discharge and were divided into event(n=15)and nonevent(n=81)groups according to the occurrence of MACEs;Univariate and multivariate analyses were further used to screen the independent influencing factors of MACEs in *** The T2DM+ACS group showed higherγ-GGT,total cholesterol,low-density lipoprotein cholesterol(LDL-C)and glycosylated hemoglobin(HbA1c)and lower TBIL and high-density lipoprotein cholesterol levels than the T2DM and ACS groups(P<0.05).Based on univariate analysis,the event and nonevent groups were significantly different in age(t=3.3612,P=0.0011),TBIL level(t=3.0742,P=0.0028),γ-GGT level(t=2.6887,P=0.0085),LDL-C level(t=2.0816,P=0.0401),HbA1c level(t=2.7862,P=0.0065)and left ventricular ejection fraction(LEVF)levels(t=3.2047,P=0.0018).Multivariate logistic regression analysis further identified that TBIL level and LEVF level were protective factor for MACEs,and age andγ-GGT

关键词： Acute coronary syndrome Type-2 diabetes mellitus Total bilirubin Major adverse cardiovascular events

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Epicardial adipose tissue in obesity with heart failure with preserved ejection fraction: Cardiovascular magnetic resonance biomarker study

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World Journal of Cardiology 2024年第3期16卷 149-160页

作者： Ju-Wei Shao Bing-Hua Chen Kamil Abu-Shaban Ahmad Baiyasi Lian-Ming Wu Jing Ma department of radiology The Affiliated Hospital of Yunnan UniversityKunming 650021Yunnan ProvinceChina department of radiology Ren Ji HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghai 200127China department of radiology University of Toledo College of MedicineToledoOH 43623United States department of radiology Wayne State University School of MedicineDetroitMI 48201United States department of Endocrinology Ren Ji HospitalShanghai Jiao Tong University School of MedicineShanghai 200127China

BACKGROUND Obesity has become a serious public health issue,significantly elevating the risk of various *** is a well-established contributor to Heart failure with preserved ejection fraction(HFpEF).Evaluating HFpEF in obesity is *** adipose tissue(EAT)has emerged as a valuable tool for validating prognostic biomarkers and guiding treatment ***,assessing EAT is of paramount *** magnetic resonance(CMR)imaging is acknowledged as the gold standard for analyzing cardiac function and *** hope to use CMR to assess EAT as a bioimaging marker to evaluate HFpEF in obese *** To assess the diagnostic utility of CMR for evaluating heart failure with preserved ejection fraction[HFpEF;left ventricular(LV)ejection fraction≥50%]by measuring the epicardial adipose tissue(EAT)volumes and EAT mass in obese *** Sixty-two obese patients were divided into two groups for a case-control study based on whether or not they had heart failure with *** two groups were defined as HFpEF+and HFpEF-.LV geometry,global systolic function,EAT volumes and EAT mass of all subjects were obtained using cine magnetic resonance *** Forty-five patients of HFpEF-group and seventeen patients of HFpEF+group were *** mass index(g/m2)of HFpEF+group was higher than HFpEF-group(P<0.05).In HFpEF+group,EAT volumes,EAT volume index,EAT mass,EAT mass index and the ratio of EAT/[left atrial(LA)left-right(LR)diameter]were higher compared to HFpEF-group(P<0.05).In multivariate analysis,Higher EAT/LA LR diameter ratio was associated with higher odds ratio of *** EAT/LA LR diameter ratio is highly associated with HFpEF in obese *** is plausible that there may be utility in CMR for assessing obese patients for HFpEF using EAT/LA LR diameter ratio as a diagnostic *** prospective studies,are needed to validate these proof-of-concept findings.

关键词： Heart failure with preserved ejection fraction Epicardial adipose tissue Obesity Cardiac magnetic resonance

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Pylorus-preserving gastrectomy for early gastric cancer

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World Journal of Gastrointestinal Oncology 2024年第3期16卷 653-658页

作者： Ke-Kang Sun Yong-You Wu department of Gastrointestinal surgery The Affiliated Kunshan Hospital to Jiangsu UniversitySuzhou 215300Jiangsu ProvinceChina department of Gastrointestinal surgery The Second Affiliated Hospital of Soochow UniversitySuzhou 215008Jiangsu ProvinceChina

Pylorus-preserving gastrectomy(PPG)has been widely accepted as a function-preserving gastrectomy for middle-third early gastric cancer(EGC)with a distal tumor border at least 4 cm proximal to the *** procedure essentially preserves the function of the pyloric sphincter,which requires to preserve the upper third of the stomach and a pyloric cuff at least 2.5 *** suprapyloric and infrapyloric vessels are usually preserved,as are the hepatic and pyloric branches of the vagus *** with distal gastrectomy,PPG has significant advantages in preventing dumping syndrome,body weight loss and bile reflux *** postoperative complications after PPG have reached an acceptable *** can be considered a safe,effective,and superior choice in EGC,and is expected to be extensively performed in the future.

关键词： Gastric cancer Pylorus-preserving gastrectomy Oncological safety Gastric stasis

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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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