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Diagnostic significance of serum levels of serum amyloid A,procalcitonin,and high-mobility group box 1 in identifying necrotising enterocolitis in newborns

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World Journal of Gastrointestinal surgery 2024年第7期16卷 2003-2011页

作者： Li-Ming Guo Zhi-Hui Jiang Hong-Zhen Liu Lei Zhang department of General surgery Qingdao Women and Children’s HospitalQingdao 266000Shandong ProvinceChina department of pediatric surgery Children's Hospital Affiliated to Shandong UniversityJinan 250022Shandong ProvinceChina department of pediatric surgery Jinan Children's HospitalJinan 250022Shandong ProvinceChina department of pediatric surgery Qilu Hospital of Shandong University(Qingdao)Qingdao 260010Shandong ProvinceChina

BACKGROUND Necrotising enterocolitis(NEC)is a critical gastrointestinal emergency affecting premature and low-birth-weight neonates.Serum amyloid A(SAA),procalcitonin(PCT),and high-mobility group box 1(HMGB1)have emerged as potential biomarkers for NEC due to their roles in inflammatory response,tissue damage,and immune regulation.AIM To evaluate the diagnostic value of SAA,PCT,and HMGB1 in the context of NEC in newborns.METHODS The study retrospectively analysed the clinical data of 48 newborns diagnosed with NEC and 50 healthy newborns admitted to the hospital.Clinical,radiological,and laboratory findings,including serum SAA,PCT,and HMGB1 Levels,were collected,and specific detection methods were used.The diagnostic value of the biomarkers was evaluated through statistical analysis,which was performed using chi-square test,t-test,correlation analysis,and receiver operating characteristic(ROC)analysis.RESULTS The study demonstrated significantly elevated levels of serum SAA,PCT,and HMGB1 Levels in newborns diagnosed with NEC compared with healthy controls.The correlation analysis indicated strong positive correlations among serum SAA,PCT,and HMGB1 Levels and the presence of NEC.ROC analysis revealed promising sensitivity and specificity for serum SAA,PCT,and HMGB1 Levels as potential diagnostic markers.The combined model of the three biomarkers demonstrating an extremely high area under the curve(0.908).CONCLUSION The diagnostic value of serum SAA,PCT,and HMGB1 Levels in NEC was highlighted.These biomarkers potentially improve the early detection,risk stratification,and clinical management of critical conditions.The findings suggest that these biomarkers may aid in timely intervention and the enhancement of outcomes for neonates affected by NEC.

关键词： Serum amyloid A Procalcitonin High-mobility group box 1 Necrotising enterocolitis in newborns Serum biomarkers

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A Review of Type 1 and Type 2 Intraductal Papillary Neoplasms of the Bile Duct

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Current Medical Science 2024年第3期44卷 485-493页

作者： Xia-hui HUANG Tian-xiang CHEN Hong-liang LIU Ming-wen HUANG department of General surgery The Second Affiliated Hospital of Nanchang UniversityNanchang330006China

Intraductal papillary neoplasm of the bile duct(IPNB)is a heterogeneous disease similar to intraductal papillary mucinous neoplasm of the pancreas.These lesions have been recognized as one of the three major precancerous lesions in the biliary tract since 2010.In 2018,Japanese and Korean pathologists reached a consensus,classifying IPNBs into type l and type 2 IPNBs.IPNBs are more prevalent in male patients in East Asia and are closely related to diseases such as cholelithiasis and schistosomiasis.From a molecular genetic perspective,IPNBs exhibit early genetic variations,and different molecular pathways may be involved in the tumorigenesis of type 1 and type 2 IPNBs.The histological subtypes of IPNBs include gastric,intestinal,pancreaticobiliary,or oncocytic subtypes,but type 1 IPNBs typically exhibit more regular and well-organized histological features than type 2 IPNBs and are more commonly found in the intrahepatic bile ducts with abundant mucin.Due to the rarity of these lesions and the absence of specific clinical and laboratory features,imaging is crucial for the preoperative diagnosis of IPNB,with local bile duct dilation and growth along the bile ducts being the main imaging features.Surgical resection remains the optimal treatment for IPNBs,but negative bile duct margins and the removal of lymph nodes in the hepatic hilum significantly improve the postoperative survival rates for patients with IPNBs.

关键词： intraductal papillary neoplasm of the bile duct subclassification neoplasms precancerous tissue prognosis

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Tri-modal death distribution towards personalized management of intraductal papillary neoplasm of the bile duct patients:Every story has its own conclusion

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Hepatobiliary & Pancreatic Diseases International 2024年第3期23卷 313-316页

作者： Vor Luvira department of surgery Faculty of MedicineKhon Kaen UniversityKhon KaenThailand

The concept of intraductal papillary neoplasm of the bile duct(IPNB)has gained recognition as a discrete entity[1,2],possessing many features including multiplicity[3,4],mucin production[3],slow progression[3,5],various morphology[6,7],easy sloughing and seeding[8],and having unique risk factors[2,9-11].We have previously proposed a morphologic classification[6]and a progression model of IPNB[12].

关键词： neoplasm bile conclusion

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Comparison of various prediction models in the effect of laparoscopic sleeve gastrectomy on type 2 diabetes mellitus in the Chinese population 5 years after surgery

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Chinese Medical Journal 2024年第3期137卷 320-328页

作者： Chengyuan Yu Liang Wang Guangzhong Xu Guanyang Chen Qing Sang Qiqige Wuyun Zheng Wang Chenxu Tian Nengwei Zhang surgery Centre of Diabetes Mellitus Peking University Ninth School of Clinical MedicineBeijing 100038China department of surgery Beijing Shijitan HospitalCapital Medical UniversityBeijing 100038China

Background:The effect of bariatric surgery on type 2 diabetes mellitus(T2DM)control can be assessed based on predictive models of T2DM remission.Various models have been externally verified internationally.However,long-term validated results after laparoscopic sleeve gastrectomy(LSG)surgery are lacking.The best model for the Chinese population is also unknown.Methods:We retrospectively analyzed Chinese population data 5 years after LSG at Beijing Shijitan Hospital in China between March 2009 and December 2016.The independent t-test,Mann–Whitney U test,and chi-squared test were used to compare characteristics between T2DM remission and non-remission groups.We evaluated the predictive efficacy of each model for longterm T2DM remission after LSG by calculating the area under the curve(AUC),sensitivity,specificity,Youden index,positive predictive value(PPV),negative predictive value(NPV),and predicted-to-observed ratio,and performed calibration using Hosmer–Lemeshow test for 11 prediction models.Results:We enrolled 108 patients,including 44(40.7%)men,with a mean age of 35.5 years.The mean body mass index was 40.3±9.1 kg/m^(2),the percentage of excess weight loss(%EWL)was(75.9±30.4)%,and the percentage of total weight loss(%TWL)was(29.1±10.6)%.The mean glycated hemoglobin A1c(HbA1c)level was(7.3±1.8)%preoperatively and decreased to(5.9±1.0)%5 years after LSG.The 5-year postoperative complete and partial remission rates of T2DM were 50.9%[55/108]and 27.8%[30/108],respectively.Six models,i.e.,"ABCD",individualized metabolic surgery(IMS),advanced-DiaRem,DiaBetter,Dixon et al’s regression model,and Panunzi et al’s regression model,showed a good discrimination ability(all AUC>0.8).The"ABCD"(sensitivity,74%;specificity,80%;AUC,0.82[95%confidence interval[CI]:0.74–0.89]),IMS(sensitivity,78%;specificity,84%;AUC,0.82[95%CI:0.73–0.89]),and Panunzi et al’s regression models(sensitivity,78%;specificity,91%;AUC,0.86[95%CI:0.78–0.92])showed good discernibility.In the Hosmer–Lemeshow goodness-of-fit test,except for DiaRem(P<0.01),Di

关键词： Type 2 diabetes mellitus Risk prediction models External validation Sleeve gastrectomy Bariatric surgery

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Oncological features and prognosis of colorectal cancer in human immunodeficiency virus-positive patients: A retrospective study

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World Journal of Gastrointestinal surgery 2024年第1期16卷 29-39页

作者： Fu-Yu Yang Fan He De-Fei Chen Cheng-Lin Tang Saed Woraikat Yao Li Kun Qian department of Gastrointestinal surgery The First Affiliated Hospital of Chongqing Medical UniversityChongqing 400016China department of General surgery Chongqing Public Health Medical CenterChongqing 400036China

BACKGROUND Due to the prolonged life expectancy and increased risk of colorectal cancer(CRC)among patients with human immunodeficiency virus(HIV)infection,the prognosis and pathological features of CRC in HIV-positive patients require examination.AIM To compare the differences in oncological features,surgical safety,and prognosis between patients with and without HIV infection who have CRC at the same tumor stage and site.METHODS In this retrospective study,we collected data from HIV-positive and-negative patients who underwent radical resection for CRC.Using random stratified sampling,24 HIV-positive and 363 HIV-negative patients with colorectal adenocarcinoma after radical resection were selected.Using propensity score matching,we selected 72 patients,matched 1:2(HIV-positive:negative=24:48).Differences in basic characteristics,HIV acquisition,perioperative serological indicators,surgical safety,oncological features,and long-term prognosis were compared between the two groups.RESULTS Fewer patients with HIV infection underwent chemotherapy compared to patients without.HIV-positive patients had fewer preoperative and postoperative leukocytes,fewer preoperative lymphocytes,lower carcinoembryonic antigen levels,more intraoperative blood loss,more metastatic lymph nodes,higher node stage,higher tumor node metastasis stage,shorter overall survival,and shorter progression-free survival compared to patients who were HIV-negative.CONCLUSION Compared with CRC patients who are HIV-negative,patients with HIV infection have more metastatic lymph nodes and worse long-term survival after surgery.Standard treatment options for HIV-positive patients with CRC should be explored.

关键词： Colorectal cancer Human immunodeficiency virus Propensity score matching Oncological features Surgical safety Prognosis

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Outcome of percutaneous reconstruction of chronic lateral collateral ligament rupture

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Chinese Journal of Traumatology 2024年第1期27卷 58-62页

作者： Soliudeen Adebayo Arojuraye Ibrahim Abolaji Alabi Ibrahim Usman Mustapha department of Orthopaedics National Orthopaedic Hospital Dala-KanoNigeria department of surgery Bayero University KanoNigeria

Purpose:Many techniques have been described for the reconstruction of chronic lateral collateral ligament(LCL)rupture with different autograft options.The advantages of percutaneous LCL reconstruction include small incisions,minimal soft tissue disruption,less postoperative pain,and speedy rehabilitation and recovery.The aim of this study was to report the functional outcome of percutaneous LCL reconstruction and overall patient satisfaction in Africans.Methods:This prospective and interventional study involving 51 patients with chronic LCL rupture who had percutaneous LCL reconstruction using peroneus longus autograft was conducted between January 2021 and December 2022 in National Orthopaedic Hospital,Dala-Kano,Nigeria.The inclusion criteria were patients between the ages of 18 and 45 years with chronic isolated LCL and not more than 1 injury of knee ligament.Exclusion criteria were active infection,and multi-ligament knee injury requiring 2-staged surgery.The knee functions were assessed preoperatively,3 months,6 months,and 12 months postoperatively using the Lysholm scoring system.Patient satisfaction with the outcome of the treatment was assessed using a 5-point Likert scale.Relevant information was recorded into Microsoft Excel sheet and data was analyzed using SPSS version 23.0 for windows.The paired samples t-test was used to compare the clinical outcomes as continuous variables.Statistical significance was considered at psurgery was 7 months(ranging from 3 to 28 months).The mean follow-up period was(14.07±3.13)months.The mean preoperative and 1-year postoperative Lysholm scores were 44.33±12.97 and 97.96±1.23,respectively.Conclusion:Percutaneous LCL reconstruction using peroneus longus autograft significantly improves patient knee function and results in excellent patient satisfaction。

关键词： rupture ligament percutaneous

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Metformin and pancreatic neuroendocrine tumors:A systematic review and meta-analysis

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World Journal of Gastroenterology 2024年第7期30卷 759-769页

作者： Maja Cigrovski Berkovic Alessandro Coppola Vibor Sesa Anna Mrzljak Quirino Lai department for Sport and Exercise Medicine Faculty of Kinesiology University of ZagrebZagreb 10000Croatia department of surgery Sapienza University of RomeRome 00185Italy department of Gastroenterology and Hepatology Liver Transplant CenterUniversity Hospital Centre ZagrebZagreb 10000Croatia department of Medicine School of MedicineZagreb 10000Croatia General surgery and Organ Transplantation Unit Department of SurgerySapienza University of RomeRome 00018Italy

BACKGROUND Most patients with advanced pancreatic neuroendocrine tumors(pNETs)die due to tumor progression.Therefore,identifying new therapies with low toxicity and good tolerability to use concomitantly with the established pNET treatment is relevant.In this perspective,metformin is emerging as a molecule of interest.Retrospective studies have described metformin,a widely used agent for the treatment of patients with type 2 diabetes mellitus(T2DM),to be effective in modulating different tumor-related events,including cancer incidence,recurrence and survival by inhibiting mTOR phosphorylation.This systematic review evaluates the role of T2DM and metformin in the insurgence and post-treatment outcomes in patients with pNET.AIM To systematically analyze and summarize evidence related to the diagnostic and prognostic value of T2DM and metformin for predicting the insurgence and posttreatment outcomes of pNET.METHODS A systematic review of the published literature was undertaken,focusing on the role of T2DM and metformin in insurgence and prognosis of pNET,measured through outcomes of tumor-free survival(TFS),overall survival and progression free survival.RESULTS A total of 13 studies(5674 patients)were included in this review.Analysis of 809 pNET cases from five retrospective studies(low study heterogeneity with I^(2)=0%)confirms the correlation between T2DM and insurgence of pNET(OR=2.13,95%CI=1.56-4.55;P<0.001).The pooled data from 1174 pNET patients showed the correlation between T2DM and post-treatment TFS in pNET patients(hazard ratio=1.84,95%CI=0.78-2.90;P<0.001).The study heterogeneity was intermediate,with I^(2)=51%.A few studies limited the possibility of performing pooled analysis in the setting of metformin;therefore,results were heterogeneous,with no statistical relevance to the use of this drug in the diagnosis and prognosis of pNET.CONCLUSION T2DM represents a risk factor for the insurgence of pNET and is a significant predictor of poor post-treatment TFS of pNET patients.Unfortunately,a few studies wi

关键词： Pancreatic neuroendocrine tumors Type 2 diabetes mellitus Prognosis Treatment Metformin

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Aberrant LETM1 elevation dysregulates mitochondrial functions and energy metabolism and promotes lung metastasis in osteosarcoma

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Genes & Diseases 2024年第3期11卷 368-384页

作者： Yulu Shi Quan Kang Hong Zhou Xiaohan Yue Yang Bi Qing Luo Stem Cell Biology and Therapy Laboratory The Children's Hospital of Chongqing Medical UniversityNational Clinical Research Center for Child Health and DisordersMinistry of Education Key Laboratory of Child Development and DisordersChongqing Key Laboratory of PediatricsChongqing 400014China department of pediatric surgery The Children's Hospital of Chongqing Medical UniversityChongqing 400014China

Osteosarcoma is a differentiation-deficient disease,and despite the unique advan-tages and great potential of differentiation therapy,there are only a few known differentia-tion inducers,and little research has been done on their targets.Cell differentiation is associated with an increase in mitochondrial content and activity.The metabolism of some tu-mor cells is characterized by impaired oxidative phosphorylation,as well as up-regulation of aerobic glycolysis and pentose phosphate pathways.Leucine-containing zipper and EF-hand transmembrane protein 1(LETM1)is involved in the maintenance of mitochondrial morphology and is closely associated with tumorigenesis and progression,as well as cancer cell stemness.We found that MG63 and 143B osteosarcoma cells overexpress LETM1 and exhibit abnormalities in mitochondrial structure and function.Knockdown of LETM1 partially restored the mitochon-drial structure and function,inhibited the pentose phosphate pathway,promoted oxidative phosphorylation,and led to osteogenic differentiation.It also inhibited spheroid cell forma-tion,proliferation,migration,and invasion in an in vitro model.When LETM1 was knocked down in vivo,there was reduced tumor formation and lung metastasis.These data suggest that mitochondria are aberrant in LETM1-overexpressing osteosarcoma cells,and knockdown of LETM1 partially restores the mitochondrial structure and function,inhibits the pentose phosphate pathway,promotes oxidative phosphorylation,and increases osteogenic differentiation,thereby reducing malignant biological behavior of the cells.

关键词： Cancer metabolism Differentiation LETM1 Osteosarcoma Stemness

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Mucinous neoplasm of the appendix:A case report and review of literature

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World Journal of Gastrointestinal surgery 2024年第3期16卷 944-954页

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

BACKGROUND Appendiceal mucinous neoplasms(AMNs),although not classified as rare,are relatively uncommon tumors most often discovered incidentally during colorectal surgery.Accurate identification of AMNs is difficult due to non-specific sym-ptoms,overlapping tumor markers with other conditions,and the potential for misdiagnosis.This underscores the urgent need for precision in diagnosis to pre-vent severe complications.CASE SUMMARY This case report describes the unexpected discovery and treatment of a low-grade AMN(LAMN)in a 74-year-old man undergoing laparoscopic hemicolectomy for transverse colon adenocarcinoma(AC).Preoperatively,non-specific gastroin-testinal symptoms and elevated tumor markers masked the presence of AMN.The tumor,presumed to be an AMN peritoneal cyst intraoperatively,was con-firmed as LAMN through histopathological examination.The neoplasm exhibited mucin accumulation and a distinct immunohistochemical profile:Positive for Ho-meobox protein CDX-2,Cytokeratin 20,special AT-rich sequence-binding protein 2,and Mucin 2 but negative for cytokeratin 7 and Paired box gene 8.This profile aids in distinguishing appendiceal and ovarian mucinous tumors.Postoperative recovery was uncomplicated,and the patient initiated adjuvant chemotherapy for the colon AC.CONCLUSION This case highlights the diagnostic complexity of AMNs,emphasizing the need for vigilant identification to avert potential complications,such as pseudomyxoma peritonei.

关键词： Adenocarcinoma Appendiceal neoplasms Low-grade appendiceal mucinous neoplasm Peritoneal neoplasms Pseudomyxoma peritonei Case report

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Cellular angiofibroma arising from the rectocutaneous fistula in an adult: A case report

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World Journal of Clinical Cases 2024年第10期12卷 1778-1784页

作者： Hao-En Chen Yu-Yang Lu Ruei-Yu Su Hong-Hau Wang Chao-Yang Chen Je-Ming Hu Jung-Cheng Kang Kuan-Hsun Lin Ta-Wei Pu department of surgery Taichung Armed Forces General HospitalTaichung 411Taiwan department of surgery Tri-Service General HospitalNational Defense Medical CenterTaipei 114Taiwan department of pediatrics Tri-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 32551Taiwan department of Radiology Tri-Service General Hospital Songshan BranchNational Defense Medical CenterTaipei 105Taiwan Division of Colon and Rectal surgery Department of SurgeryTri-Service General HospitalNational Defense Medical CenterTaipei 114Taiwan Division of Colon and Rectal surgery Department of SurgeryTaiwan Adventist HospitalTaipei 105Taiwan Division of Thoracic surgery Department of SurgeryTri-Service General HospitalNational Defense Medical CenterTaipei 114Taiwan Division of Colon and Rectal surgery Department of SurgeryTri-Service General Hospital Songshan BranchNational Defense Medical CenterTaipei 105Taiwan

BACKGROUND Rectocutaneous fistulae are common.The infection originates within the anal glands and subsequently extends into adjacent regions,ultimately resulting in fistula development.Cellular angiofibroma(CAF),also known as an angiomy ofibroblastoma-like tumor,is a rare benign soft tissue neoplasm predominantly observed in the scrotum,perineum,and inguinal area in males and in the vulva in females.We describe the first documented case CAF that developed within a rectocutaneous fistula and manifested as a perineal mass.CASE SUMMARY In the outpatient setting,a 52-year-old male patient presented with a 2-year history of a growing perineal mass,accompanied by throbbing pain and minor scrotal abrasion.Physical examination revealed a soft,well-defined,non-tender mass at the left buttock that extended towards the perineum,without a visible opening.The initial assessment identified a soft tissue tumor,and the laboratory data were within normal ranges.Abdominal and pelvic computed tomography(CT)revealed swelling of the abscess cavity that was linked to a rectal cutaneous fistula,with a track-like lesion measuring 6 cm×0.7 cm in the left perineal region and attached to the left rectum.Rectoscope examination found no significant inner orifices.A left medial gluteal incision revealed a thick-walled mass,which was excised along with the extending tract,and curettage was performed.Histopathological examination confirmed CAF diagnosis.The patient achieved total resolution during follow-up assessments and did not require additional hospitalization.CONCLUSION CT imaging supports perineal lesion diagnosis and management.Perineal angiofibromas,even with a cutaneous fistula,can be excised transperineally.

关键词： Angiofibroma Perineal mass Rectocutaneous fistula Anorectal fistula Anal fistula Case report

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