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Surgical Treatment of Osteonecrosis of the Femoral Head Using Minimally Invasive Surgical Drilling and Cancellous Grafting at Brazzaville University Hospital

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Open Journal of Orthopedics 2024年第2期14卷 122-132页

作者： Kevin Parfait Bienvenu Bouhelo-Pam Marius Monka Arnauld Sledje Wilfrid Bilongo Bouyou Regis Perry Massouama Paul Yèlai Ikounga Roger Bertrand Sah Mbou Armand Moyikoua department of Orthopaedic surgery and traumatology University Hospital of Brazzaville Brazzaville Republic of the Congo Faculty of Health Sciences Marien N’GOUABI University Brazzaville Republic of the Congo

Introduction: Osteonecrosis of the femoral head (ONTF) is a debilitating condition. Several treatments have been proposed with controversial results. The aim of our study was to evaluate treatment by surgical drilling coupled with in situ cancellous grafting. Materials and methods: Our study was a case-control study conducted at Brazzaville University Hospital from 1st January 2018 to 31 December 2023. It compared two groups of patients with ONTF: non-operated (13 patients, 20 hips) and operated (22 patients, 35 hips). We used the visual digital scale (VDS) for pain assessment, the Merle D’Aubigne-Postel (MDP) scoring system for clinical and functional assessment, and the evolution of necrosis. Results: The group of non-operated patients had a mean age of 35.69 ± 3.4 years, no improvement in pain with an EVN above seven at the last recoil and a mean global MDP score falling from 12.7 before offloading to 10.13 at one year. The group of patients operated on had a mean age of 37.86 ± 7.02 years, a significant reduction in pain (p = 0.00004) and a significantly increased MDP score (p = 0.0034). A comparison of the two groups of patients showed significant stabilization of the necrotic lesions in the operated patients (p = 0.00067), with better satisfaction in the same group. Conclusion: Surgical drilling combined with grafting in the treatment of early-stage ONTF has improved progress in our series. The technique is reproducible and less invasive. It has made it possible to delay unfavorable progression and, consequently, hip replacement surgery.

关键词： Hip Osteonecrosis of the Femoral Head Conservative Treatment Surgical Drilling Bone Grafting

Immune signature of small bowel adenocarcinoma and the role of tumor microenvironment

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World Journal of Gastroenterology 2024年第8期30卷 794-798页

作者： Grigorios Christodoulidis Marina Nektaria Kouliou Konstantinos Eleftherios Koumarelas department of General surgery University Hospital of LarissaLarissa 41110Greece

In this editorial we comment on the article published“Clinical significance of programmed cell death-ligand expression in small bowel adenocarcinoma is determined by the tumor microenvironment”.Small bowel adenocarcinoma(SBA)is a rare gastrointestinal neoplasm and despite the small intestine's significant surface area,SBA accounts for less than 3%of such *** detection is challenging and the reason arises from its asymptomatic nature,often leading to late-stage discovery and poor *** involves platinum-based chemotherapy with a 5-fluorouracil combination,but the lack of effective chemotherapy contributes to a generally poor *** are linked to genetic disorders and risk factors,including chronic inflammatory *** unique characteristics of the small bowel,such as rapid cell renewal and an active immune system,contributes to the rarity of these tumors as well as the high intratumoral infiltration of immune cells is associated with a favorable *** cell death-ligand 1(PD-L1)expression varies across different cancers,with potential discrepancies in its prognostic *** instability(MSI)in SBA is associated with a high tumor mutational burden,affecting the prognosis and response to *** presence of PD-L1 and programmed cell death 1,along with tumor-infiltrating lymphocytes,plays a crucial role in the complex microenvironment of SBA and contributes to a more favorable prognosis,especially in the context of high MSI *** tumor-infiltrating lymphocytes are identified as independent prognostic indicators and the association between MSI status and a favorable prognosis,emphasizes the importance of evaluating the immune status of tumors for treatment decisions.

关键词： Programmed cell death 1 Programmed cell death-ligand 1 Programmed death ligand Small bowel adenocarcinoma Tumor infiltrating lymphocytes Tumor microenvironment Microsatellite instability

Options and survival benefits of conversion therapy for unresectable hepatocellular carcinoma

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World Journal of Gastroenterology 2024年第18期30卷 2479-2481页

作者： Wong Hoi She Tan To Cheung department of surgery The University of Hong KongHong Kong 999077China

In the study by Wu et al,patients with unresectable hepatocellular carcinoma were subjected to transarterial chemoembolization(TACE)as a conversion therapy in order to render their tumors suitable for resection.A nomogram was devised and shown to be effective in predicting the survival of these *** of the results,however,is questionable since the study subjects consisted of patients who had resection after TACE while excluding patients with the same disease but not suitable for *** can be considered to be an option for conversion ***,markers for determining responses to a conversion therapy and for guiding the decision between TACE and sequential immunotherapy have been *** question of whether effective conversion therapy can truly enhance overall survival remains unanswered.

关键词： Conversion therapy Immunotherapy Liver resection Survival Transarterial chemoembolization Unresectable hepatocellular carcinoma

Revolutionizing gastric cancer treatment:The potential of immunotherapy

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World Journal of Gastroenterology 2024年第4期30卷 286-289页

作者： Grigorios Christodoulidis Konstantinos Eleftherios Koumarelas Marina Nektaria Kouliou department of General surgery University Hospital of LarissaLarissa 41110Greece

Gastric cancer,a prevalent malignancy worldwide,ranks sixth in terms of frequency and third in fatality,causing over a million new cases and 769000 annual *** in Eastern Europe and Eastern Asia,risk factors include family medical history,dietary habits,tobacco use,Helicobacter pylori,and Epstein-Barr virus ***,gastric cancer is often diagnosed at an advanced stage,leading to a grim prognosis,with a 5-year overall survival rate below 5%.Surgical intervention,particularly with D2 Lymphadenectomy,is the mainstay for early-stage cases but offers limited *** advanced cases,the National Comprehensive Cancer Network recommends chemotherapy,radiation,and targeted *** immunotherapy presents promise,especially for unresectable or metastatic cases,with strategies like immune checkpoint inhibitors,tumor vaccines,adoptive immunotherapy,and nonspecific *** this Editorial,with regards to the article“Advances and key focus areas in gastric cancer immunotherapy:A comprehensive scientometric and clinical trial review”,we address the advances in the field of immunotherapy in gastric cancer and its future prospects.

关键词： Immunotherapy Adaptive immunotherapy Tumor vaccines Chimeric antigen receptor therapy Tumor-infiltrating lymphocytes therapy Natural killer therapy Cytokine-induced killer therapy Engineered T cell receptor therapy Immune checkpoint inhibitors

Chronic active and atrophic gastritis as significant contributing factor to the development of gastric cystica profunda

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World Journal of Gastroenterology 2024年第17期30卷 2308-2310页

作者： Veronika Papp Pál Miheller department of surgery Transplantation and GastroenterologySemmelweis UniversityBudapest 1082Hungary

Gastric cystica profunda(GCP)is an uncommon but underestimated gastric *** precancerous potential determines its *** addition to previous mucosa injury due to operations,biopsy or polypectomy,chronic active and atrophic gastritis may also lead to the development of *** carefully examining the stomach and taking biopsy samples from the susceptible regions,the stage of atrophy can be *** atrophic gastritis is a risk factor for cancer evolvement and it can also contribute to GCPs *** frequently occur close to early gastric cancers(EGCs)or EGC can arise from the cystic *** resection is an effective and minimally invasive treat-ment in GCP.

关键词： Gastric cystica profunda Chronic active gastritis Atrophic gastritis Operative Link for Gastritis Assessment staging Early gastric cancer Endoscopic resection

Safety and efficacy of a programmed cell death 1 inhibitor combined with oxaliplatin plus S-1 in patients with Borrmann large type III and IV gastric cancers

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World Journal of Gastrointestinal Oncology 2024年第4期16卷 1281-1295页

作者： Zhe-Han Bao Can Hu Yan-Qiang Zhang Peng-Cheng Yu Yi Wang Zhi-Yuan Xu Huan-Ying Fu Xiang-Dong Cheng department of Interventional Radiology Zhejiang Cancer HospitalHangzhou 310004Zhejiang ProvinceChina department of Gastric surgery Zhejiang Cancer HospitalHangzhou 310022Zhejiang ProvinceChina department of Colonic surgery Jinhua Central HospitalJinhua 321000Zhejiang ProvinceChina department of Breast surgery Lin’an People’s HospitalHangzhou 311300Zhejiang ProvinceChina

BACKGROUND Gastric cancer(GC)is the fifth most common and the fourth most lethal malignant tumour in the *** patients are already in the advanced stage when they are diagnosed,which also leads to poor overall *** effect of posto-perative adjuvant chemotherapy for advanced GC is unsatisfactory with a high rate of distant metastasis and local *** To investigate the safety and efficacy of a programmed cell death 1(PD-1)inhibitor combined with oxaliplatin and S-1(SOX)in the treatment of Borrmann large type III and IV *** A retrospective analysis(IRB-2022-371)was performed on 89 patients with Borrmann large type III and IV GCs who received neoadjuvant therapy(NAT)from January 2020 to December *** to the different neoadjuvant treatment regimens,the patients were divided into the SOX group(61 patients)and the PD-1+SOX(P-SOX)group(28 patients).RESULTS The pathological response(tumor regression grade 0/1)in the P-SOX group was significantly higher than that in the SOX group(42.86%vs 18.03%,P=0.013).The incidence of ypN0 in the P-SOX group was higher than that in the SOX group(39.29%vs 19.67%,P=0.05).The use of PD-1 inhibitors was an independent factor affecting tumor regression ***,the use of PD-1 did not increase postoperative complications or the adverse effects of *** A PD-1 inhibitor combined with SOX could significantly improve the rate of tumour regression during NAT for patients with Borrmann large type III and IV GCs.

关键词： Neoadjuvant therapy Immunotherapy Gastric cancer Borrmann type Tumor regression grade

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

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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

Conditioned medium from human dental pulp stem cells treats spinal cord injury by inhibiting microglial pyroptosis

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Neural Regeneration Research 2024年第5期19卷 1105-1111页

作者： Tao Liu Ziqian Ma Liang Liu Yilun Pei Qichao Wu Songjie Xu Yadong Liu Nan Ding Yun Guan Yan Zhang Xueming Chen department of Orthopedic surgery Beijing Luhe HospitalCapital Medical UniversityBeijingChina department of Orthopedic surgery Beijing Chaoyang HospitalCapital Medical UniversityBeijingChina department of Stomatology Beijing Luhe HospitalCapital Medical UniversityBeijingChina department of Anesthesiology and Critical Care Medicine School of MedicineJohns Hopkins UniversityBaltimoreMDUSA department of Neurological surgery School of MedicineJohns Hopkins UniversityBaltimoreMDUSA

Human dental pulp stem cell transplantation has been shown to be an effective therapeutic strategy for spinal cord ***,whether the human dental pulp stem cell secretome can contribute to functional recovery after spinal cord injury remains *** the present study,we established a rat model of spinal cord injury based on impact injury from a dropped weight and then intraperitoneally injected the rats with conditioned medium from human dental pulp stem *** found that the conditioned medium effectively promoted the recovery of sensory and motor functions in rats with spinal cord injury,decreased expression of the microglial pyroptosis markers NLRP3,GSDMD,caspase-1,and interleukin-1β,promoted axonal and myelin regeneration,and inhibited the formation of glial *** addition,in a lipopolysaccharide-induced BV2 microglia model,conditioned medium from human dental pulp stem cells protected cells from pyroptosis by inhibiting the NLRP3/caspase-1/interleukin-1β*** results indicate that conditioned medium from human dental pulp stem cells can reduce microglial pyroptosis by inhibiting the NLRP3/caspase-1/interleukin-1βpathway,thereby promoting the recovery of neurological function after spinal cord ***,conditioned medium from human dental pulp stem cells may become an alternative therapy for spinal cord injury.

关键词： BV2 conditioned medium dental pulp stem cells GSDMD microglia neuroinflammation NLRP3 pyroptosis spinal cord injury

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