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The diagnostic value of tenascin-C in acute aortic syndrome

Journal of Geriatric Cardiology 2024年第3期21卷 359-368页

作者： Ming MA Wei CHEN Hai-Long CAO Jun PAN Qing ZHOU Xin-Long TANG Dong-Jin WANG department of Thoracic and Cardiovascular surgery Nanjing Drum Tower Hospital Clinical College of Nanjing Medical UniversityNanjingChina department of Thoracic and Cardiovascular surgery Nanjing Drum Tower HospitalAffiliated Hospital of Medical SchoolNanjing UniversityNanjingChina department of Thoracic surgery Kunshan Hospital of Traditional Chinese MedicineJiangsuChina

OBJECTIVES Misdiagnosis of acute aortic syndrome(AAS)significantly increases ***-C(TN-C)is an extracellular matrix glycoprotein related to cardiovascular *** elevation of TN-C in AAS and whether it can discriminate suddenonset of acute chest pain in Chinese remains *** We measured the plasma concentration of TN-C by ELISA in a cohort of 376 patients with chest or back *** to discriminate AAS from acute coronary syndrome(ACS)were compared and *** From October 2016 to September 2021,376 undiagnosed patients with chest or back pain were enrolled.166 of them were finally diagnosed as AAS,100 were ACS and 110 without cardiovascular diseases(NCV).TN-C was significantly elevated in AAS at 18.18 ng/mL(IQR:13.10–27.68)compared with 7.51 ng/mL(IQR:5.67–11.38)in ACS(P<0.001)and 3.68 ng/mL(IQR:2.50–5.29)in NCV(P<0.001).There was no significant difference in TN-C level among the subtypes of *** the 166 AAS patients,the peaked level of TN-C was at acute stage(P=0.012),then a slight of decrease was observed at subacute *** area under receiver operating characteristic curve for AAS patients versus NCV was 0.979(95%CI:0.964-0.994)for *** a cutoff level of 11.474 ng/mL,TN-C has a sensitivity of 76.0%,specificity of 85.5%,accuracy of 82.0%,positive predictive value(PPV)of 76.0%,negative predictive value(NPV)of 85.5%.Diagnostic performance of TN-C was superior to D-dimer and *** The concentration of serum TN-C in AAS patients was significantly higher than that in ACS patients and ***-C could be a new biomarker to distinguish AAS patients in the early stage after symptoms onset from other pain diseases.

关键词： acute cardiovascular elevated

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Abdominal cocoon syndrome-a rare culprit behind small bowel ischemia and obstruction:Three case reports

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World Journal of Gastrointestinal surgery 2024年第3期16卷 955-965页

作者： Witcha Vipudhamorn Tawan Juthasilaparut Pawit Sutharat Suwan Sanmee Ekkarin Supatrakul department of Colorectal surgery Chiang Mai UniversityChiang Mai 50200Thailand department of surgery Lampang HospitalLampang 52000Thailand

BACKGROUND Abdominal cocoon syndrome(ACS)represents a category within sclerosing encapsulating peritonitis,characterized by the encapsulation of internal organs with a fibrous,cocoon-like membrane of unknown origin,resulting in bowel obstruction and *** this condition before surgery poses a cha-llenge,often requiring confirmation during *** this context,we depict three instances of ACS:One linked to intestinal obstruction,the second exclu-sively manifesting as intestinal ischemia without any obstruction,and the final case involving a discrepancy between the radiologist and the *** SUMMARY Three male patients,aged 53,58,and 61 originating from Northern Thailand,arrived at our medical facility complaining of abdominal pain without any prior *** vital signs remained stable during the *** diagnosis of abdominal cocoon was confirmed through abdominal computed tomography(CT)before *** the first case,the CT scan revealed capsules around the small bowel loops,showing no enhancement,along with mesenteric congestion affecting both small and large bowel loops,without a clear *** second case showed intestinal obstruction due to an encapsulated capsule on the CT *** the final case,a patient presented with recurring abdominal ***,the radiologist suspected enteritis as the cause after the CT ***,a detailed review led the surgeon to suspect encapsulating peritoneal sclerosis(ACS)and subsequently perform *** surgical procedure involved complete removal of the encapsulating structure,resection of a portion of the small bowel,and end-to-end *** complications occurred during surgery,and the patients had a smooth recovery after surgery,eventually discharged in good *** histopathological examination of the fibrous membrane(cocoon)across all cases consistently revealed the presence of fibro-collagenous tissue,without any indications of *** Indivi

关键词： Sclerosing encapsulation peritonitis Abdominal cocoon Peritoneal Fibrosis Peritoneal encapsulation syndrome Intestinal obstruction surgery Case report

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Advancements in breath-based diagnostics for pancreatic cancer:Current insights and future perspectives

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World Journal of Gastrointestinal Oncology 2024年第6期16卷 2300-2303页

作者： Mesut Tez Eda Sahingoz Huseyin Fahri Martli department of surgery University of Health SciencesAnkara City HospitalAnkara 06800Türkiye department of General surgery Saglik Bilimleri UniversityAnkara 06100Turkiye department of General surgery Ankara City HospitalAnkara 06100Türkiye

Recent decades have seen a concerning surge in carcinogenic diseases,with cancer cases and deaths on the rise *** diagnostic methods are often invasive and time-consuming,highlighting the need for fast,accurate,and painless ***-invasive exhaled breath analysis emerges as a promising solution,with over 200 volatile organic compounds(VOCs)detected in exhaled air,showing potential as biomarkers for various diseases,including *** the lack of standardized methodologies,advancements in analytical instruments have expanded detection capabilities,reaching 3500 *** have identified specific VOC patterns associated with different cancers,offering hope for non-invasive *** such as gas chromatography-mass spectrometry and electronic noses show promise in distinguishing between healthy individuals and cancer ***,further research and standardization are needed to realize the full clinical potential of breath-based diagnostics,particularly in the early detection of challenging cancers like pancreatic cancer.

关键词： Pancreas Volatile organic compounds Diagnosis Cancer Breath

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Role of gut microbiota in Crohn’s disease pathogenesis:Insights from fecal microbiota transplantation in mouse model

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World Journal of Gastroenterology 2024年第31期30卷 3689-3704页

作者： Qiang Wu Lian-Wen Yuan Li-Chao Yang Ya-Wei Zhang Heng-Chang Yao Liang-Xin Peng Bao-Jia Yao Zhi-Xian Jiang Geriatric surgery of department of General surgery The Second Xiangya HospitalCentral South UniversityChangsha 410011Hunan ProvinceChina

BACKGROUND Inflammatory bowel disease,particularly Crohn’s disease(CD),has been associated with alterations in mesenteric adipose tissue(MAT)and the phenomenon termed“creeping fat”.Histopathological evaluations showed that MAT and intestinal tissues were significantly altered in patients with CD,with these tissues characterized by inflammation and *** To evaluate the complex interplay among MAT,creeping fat,inflammation,and gut microbiota in *** Intestinal tissue and MAT were collected from 12 patients with *** manifestations and protein expression levels were analyzed to determine lesion *** samples were collected from five recently treated CD patients and five control subjects and transplanted into *** intestinal and mesenteric lesions in these mice,as well as their systemic inflammatory status,were assessed and compared in mice transplanted with fecal samples from CD patients and control *** Pathological examination of MAT showed significant differences between CDaffected and unaffected colons,including significant differences in gut microbiota *** microbiota transplantation(FMT)from clinically healthy donors into mice with 2,4,6-trinitrobenzene sulfonic acid(TNBS)-induced CD ameliorated CD symptoms,whereas FMT from CD patients into these mice exacerbated CD ***,FMT influenced intestinal permeability,barrier function,and levels of proinflammatory factors and ***,FMT from CD patients intensified fibrotic changes in the colon tissues of mice with TNBS-induced *** Gut microbiota play a critical role in the histopathology of *** MAT and creeping fat may therefore have potential in the treatment of patients with CD.

关键词： Mesenteric adipose tissue Crohn’s disease Fecal microbiota transplantation Intestinal fibrosis Intestinal barrier

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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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Primary liver transplantation vs transplant after Kasai portoenterostomy in children with biliary atresia: A retrospective Brazilian single-center cohort

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World Journal of transplantation 2024年第1期14卷 112-119页

作者： Melina Utz Melere Valberto Sanha Marco Farina Carolina Soares da Silva Luiza Nader Cristine Trein Angelica Maria Lucchese Cristina Ferreira Antonio Nocchi Kalil Flavia Heinz Feier department of Hepatology and Liver transplantation Santa Casa de Porto AlegrePorto Alegre 90050170Brazil department of Hepato-biliary-pancreatic surgery and Liver transplantation Irmandade Santa Casa de Misericórdia de Porto AlegrePorto Alegre 90020-090Brazil department of Surgical Oncology Santa Rita Hospital/Santa Casa de Misericórdia de Porto AlegrePorto Alegre 90050-170Rio Grande do SulBrazil

BACKGROUND Biliary atresia(BA)is the most common indication for pediatric liver transplantation,although portoenterostomy is usually performed ***,due to the high failure rate of portoenterostomy,liver transplantation has been advocated as the primary procedure for patients with *** is still unclear if a previous portoenterostomy has a negative impact on liver transplantation *** To investigate the effect of prior portoenterostomy in infants un-dergoing liver transplantation for *** This was a retrospective cohort study of 42 pediatric patients with BA who underwent primary liver transplantation from 2013 to 2023 at a single tertiary center in *** with BA were divided into two groups:Those undergoing primary liver transplantation without portoenterostomy and those undergoing liver transplantation with prior *** variables were compared using the Student’s t-test or the Kruskal-Wallis test,and categorical variables were compared using theχ2 or Fisher’s exact test,as *** Cox regression analysis was performed to determine risk factors for portal vein *** and graft survival analyses were conducted with the Kaplan–Meier product-limit estimator,and patient subgroups were compared using the two-sided log-rank *** Forty-two patients were included in the study(25[60%]girls),23 undergoing liver transplantation without prior portoenterostomy,and 19 undergoing liver transplantation with prior *** with prior portoenterostomy were older(12 vs 8 months;P=0.02)at the time of liver transplantation and had lower Pediatric End-Stage Liver Disease scores(13.2 vs 21.4;P=0.01).The majority of the patients(35/42,83%)underwent livingdonor liver *** group of patients without prior portoenterostomy appeared to have a higher incidence of portal vein thrombosis(39 vs 11%),but this result did not reach statistical *** portoenterostomy

关键词： Hepatic portoenterostomy Biliary atresia Liver transplantation Patient outcome assessment Portal vein Survival

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Efficacy and safety of low-dose cyclophosphamide combined with lenvatinib, pembrolizumab and TACE for unresectable hepatocellular carcinoma:A single-center, prospective,single-arm clinical trial

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Chinese Journal of Cancer Research 2024年第2期36卷 114-123页

作者： Yupeng Ren Yuxuan Li Mingbo Cao Yongchang Tang Feng Yuan Gaoyuan Yang Zhiwei He Zheng Shi Xiaorui Su Zhicheng Yao Meihai Deng department of Hepatobiliary surgery the Third Affiliated HospitalSun Yat-sen UniversityGuangzhou 510630China department of General surgery Qilu HospitalShandong UniversityJinan 250012China department of Hepatobiliary surgery the First Affiliated Hospital of Guangzhou Medical UniversityGuangzhou 510120China department of Hepatobiliary and Pancreatic surgery the Third Affiliated HospitalSun Yat-sen UniversityGuangzhou 510630China

Objective: Unresectable hepatocellular carcinoma(uHCC) continues to pose effective treatment options. The objective of this study was to assess the efficacy and safety of combining low-dose cyclophosphamide with lenvatinib, pembrolizumab and transarterial chemoembolization(TACE) for the treatment of ***: From February 2022 to November 2023, a total of 40 patients diagnosed with uHCC were enrolled in this small-dose, single-center, single-arm, prospective study. They received a combined treatment of low-dose cyclophosphamide with lenvatinib, pembrolizumab, and TACE. Study endpoints included progression-free survival(PFS), objective response rate(ORR), and safety assessment. Tumor response was assessed using the modified Response Evaluation Criteria in Solid Tumors(mRECIST), while survival analysis was conducted through KaplanMeier curve analysis for overall survival(OS) and PFS. Adverse events(AEs) were evaluated according to the National Cancer Institute Common Terminology Criteria for Adverse Events(version 5.0).Results: A total of 34 patients were included in the study. The median follow-up duration was 11.2 [95% confidence interval(95% CI), 5.3-14.6] months, and the median PFS(mPFS) was 15.5(95% CI, 5.4-NA) *** OS(mOS) was not attained during the study period. The ORR was 55.9%, and the disease control rate(DCR) was 70.6%. AEs were reported in 27(79.4%) patients. The most frequently reported AEs(with an incidence rate >10%) included abnormal liver function(52.9%), abdominal pain(44.1%), abdominal distension and constipation(29.4%), hypertension(20.6%), leukopenia(17.6%), constipation(17.6%), ascites(14.7%), and insomnia(14.7%). Abnormal liver function(14.7%) had the most common grade 3 or higher ***: A combination of low-dose cyclophosphamide with lenvatinib, pembrolizumab, and TACE is safe and effective for u HCC, showcasing a promising therapeutic strategy for managing uHCC.

关键词： Hepatocellular carcinoma lenvatinib low-dose cyclophosphamide pembrolizumab transarterial chemoembolization

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Thrombotic microangiopathy after kidney transplantation: Expanding etiologic and pathogenetic spectra

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World Journal of transplantation 2024年第1期14卷 84-95页

作者： Muhammed Mubarak Amber Raza Rahma Rashid Fnu Sapna Shaheera Shakeel department of Histopathology Sindh Institute of Urology and TransplantationKarachi 74200SindhPakistan department of Nephrology Sindh Institute of Urology and TransplantationKarachi 74200SindhPakistan department of Pathology Montefiore Medical CenterThe University Hospital for Albert Einstein School of MedicineBronxNY 10461United States

Thrombotic microangiopathy(TMA)is an uncommon but serious complication that not only affects native kidneys but also transplanted *** review is specifically focused on post-transplant TMA(PT-TMA)involving kidney transplant *** reported prevalence in the latter population varies from 0.8%to 14%with adverse impacts on both graft and patient *** has many causes and associations,and the list of etiologic agents and associations is growing *** pathogenesis is equally varied and a variety of pathogenetic pathways lead to the development of microvascular injury as the final common ***-TMA is categorized in many ways in order to facilitate its ***,more than one causes are contributory in PT-TMA and it is often difficult to pinpoint one particular cause in an individual ***,the hallmark lesions are endothelial cell injury and intravascular thrombi affecting the *** diagnosis and classification of PT-TMA are imperative for optimal outcomes but are challenging for both clinicians and *** Banff classification has addressed this issue and has developed minimum diagnostic criteria for pathologic diagnosis of PT-TMA in the first *** of the condition is also challenging and still largely *** varies from simple maneuvers,such as plasmapheresis,drug withdrawal or modification,or dose reduction,to lifelong complement blockade,which is very expensive.A thorough understanding of the condition is imperative for an early diagnosis and quick treatment when the treatment is potentially *** review aims to increase the awareness of relevant stakeholders regarding this important,potentially treatable but under-recognized cause of kidney allograft dysfunction.

关键词： Thrombotic microangiopathy Microvascular injury Anemia Thrombocytopenia Kidney allograft failure

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GATIS score for predicting the prognosis of rectal neuroendocrine neoplasms:A Chinese multicenter study of 12-year experience

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World Journal of Gastroenterology 2024年第28期30卷 3403-3417页

作者： Xin-Yu Zeng Ming Zhong Guo-Le Lin Cheng-Guo Li Wei-Zhong Jiang Wei Zhang Li-Jian Xia Mao-Jun Di Hong-Xue Wu Xiao-Feng Liao Yue-Ming Sun Min-Hao Yu Kai-Xiong Tao Yong Li Rui Zhang Peng Zhang department of Gastrointestinal surgery Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430074Hubei ProvinceChina department of Gastrointestinal surgery Renji HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghai 200127China department of General surgery Peking Union Medical College HospitalPeking Union Medical CollegeBeijing 100730China department of Colorectal surgery Fujian Medical UniversityFuzhou 350401Fujian ProvinceChina department of Colorectal surgery Changhai HospitalShanghai 200433China department of Gastrointestinal surgery The First Affiliated Hospital of Shandong First Medical UniversityJinan 250118Shandong ProvinceChina department of Gastrointestinal surgery Taihe HospitalHubei University of MedicineShiyan 442099Hubei ProvinceChina department of Gastrointestinal surgery I Section Renmin Hospital of Wuhan UniversityWuhan 430060Hubei ProvinceChina department of General surgery Xiangyang Central HospitalAffiliated Hospital of Hubei University of Arts and ScienceXiangyang 441021Hubei ProvinceChina department of Colorectal surgery Jiangsu Province HospitalNanjing Medical UniversityNanjing 210029Jiangsu ProvinceChina department of Gastrointestinal surgery School of MedicineShanghai Jiao Tong UniversityShanghai 200127China department of General surgery Guangdong Provincial People’s HospitalGuangdong Academy of Medical SciencesGuangzhou 510080Guangdong ProvinceChina department of Colorectal surgery Liaoning Cancer HospitalShenyang 110042Liaoning ProvinceChina

BACKGROUND There is currently a shortage of accurate,efficient,and precise predictive instruments for rectal neuroendocrine neoplasms(NENs).AIM To develop a predictive model for individuals with rectal NENs(R-NENs)using data from a large *** Data from patients with primary R-NENs were retrospectively collected from 17 large-scale referral medical centers in *** forest and Cox proportional hazard models were used to identify the risk factors for overall survival and progression-free survival,and two nomograms were *** A total of 1408 patients with R-NENs were *** grade,T stage,tumor size,age,and a prognostic nutritional index were important risk factors for *** GATIS score was calculated based on these five *** overall survival prediction,the respective C-indexes in the training set were 0.915(95%confidence interval:0.866-0.964)for overall survival prediction and 0.908(95%confidence interval:0.872-0.944)for progression-free survival *** to decision curve analysis,net benefit of the GATIS score was higher than that of a single *** time-dependent area under the receiver operating characteristic curve showed that the predictive power of the GATIS score was higher than that of the TNM stage and pathological grade at all time *** The GATIS score had a good predictive effect on the prognosis of patients with R-NENs,with efficacy superior to that of the World Health Organization grade and TNM stage.

关键词： Rectal neuroendocrine neoplasm Nomogram Random forest Prognosis Overall survival Progression-free survival

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International standard of Traditional Chinese Medicine techniques: the operating specification for Traditional Chinese Medicine enema(2022)

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Journal of Traditional Chinese Medicine 2024年第5期44卷 1035-1043页

作者： YU Miao PEI Xiaohua department of General surgery Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University department of Chest and Breast surgery Beijing University of Chinese Medicine Xiamen Hospital

Chinese Medicine Enema is one of the external therapies in Traditional Chinese Medicine(TCM), which has been widely used clinically. The "International Standard of Traditional Chinese Medicine Techniques: The Operating Specifications for Chinese Medicine Enema is drawn up by the Beijing Hospital of Traditional Chinese Medicine affiliated to Capital Medical University and Beijing University of Chinese Medicine Xiamen Hospital in collaboration with domestic TCM universities and hospitals. The specification includes definition, operating process, points for attention and contraindications. It is targeted to provide reference for TCM providers at home and abroad with TCM background in clinical decision-making.

关键词： Chinese Medicine Enema international standard operating specifications traditional Chinese medical technology

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