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Systematic Evaluation of Guidelines for the Diagnosis and Treatment of Hepatitis E Virus Infection

Journal of Clinical and Translational Hepatology 2024年第8期12卷 739-749页

作者： Ting Gu Cai-Ying Zheng Yan-Qin Deng Xiao-Feng Yang Wei-Min Bao Ying-Mei Tang Department of Gastroenterology Second Affiliated Hospital of Kunming Medical UniversityKunming Medical UniversityKunmingYunnanChina Second Affiliated Hospital of Kunming Medical University KunmingYunnanChina Department of colorectal Surgery The First People’s Hospital of Yunnan ProvinceKunmingYunnanChina

Background and Aims:The hepatitis E virus(HEV)is a zoonotic disease,and infection with HEV in humans primarily causes acute infections and can progress to chronic manifestation in immunocompromised *** the past decade,guidelines for diagnosing and treating HEV infection have been *** study aimed to systematically assess the quality of current guidelines for diagnosing and treating HEV infection,and we analyzed the differences in guideline quality and primary recommendations and explored possible reasons for these ***:Guidelines published between 2013 and 2022 were searched,and studies were identified using selection *** study assessed the quality of the included guidelines using the Appraisal of Guidelines for Research and Evaluation tool,extracted the primary recommendations in the guidelines,determined the highest level of evidence supporting the recommendations,and reclassified the evidence using the Oxford centre for Evidence-Based Medicine grading ***:Seven guidelines were included in the final *** quality of the guidelines varied *** discrepancies may have been caused by the lack of external experts,the failure to consider influencing factors in guideline application,and the lack of consideration of the public’s *** of the heterogeneity in primary recommendations revealed differences in algorithms for managing chronic HEV infection,the dosage of ribavirin,and a low level of evidence supporting the primary ***:Guideline quality and primary recommendations vary *** by guideline developers and researchers would facilitate updating and applying guidelines for diagnosing and treating HEV infection.

关键词： Hepatitis E virus Guidelines Diagnosis Treatment Systematic Evaluation

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Long-term outcomes after endoscopic removal of malignant colorectal polyps:Results from a 10-year cohort

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World Journal of Gastrointestinal Endoscopy 2024年第4期16卷 193-205页

作者： Anna Fábián Renáta Bor Béla Vasas Mónika Szűcs Tibor Tóth Zsófia Bősze Kata Judit Szántó Péter Bacsur Anita Bálint Bernadett Farkas Klaudia Farkas Ágnes Milassin Mariann Rutka Tamás Resál Tamás Molnár Zoltán Szepes Department of Internal Medicine University of SzegedSzent-Györgyi Albert Medical SchoolSzeged 6725Hungary Department of Pathology University of SzegedSzent-Györgyi Albert Medical SchoolSzeged 6725Hungary Department of Medical Physics and Medical Informatics University of SzegedSzent-Györgyi Albert Medical SchoolSzeged 6720Hungary USZ Translational colorectal Research Group Hungarian Centre of Excellence for Molecular MedicineSzeged 6725Hungary

BACKGROUND Choosing an optimal post-polypectomy management strategy of malignant colorectal polyps is challenging,and evidence regarding a surveillance-only strategy is *** To evaluate long-term outcomes after endoscopic removal of malignant colorectal *** A single-center retrospective cohort study was conducted to evaluate outcomes after endoscopic removal of malignant colorectal polyps between 2010 and *** disease rate and nodal metastases after secondary surgery and local and distant recurrence rate for those with at least 1 year of follow-up were *** rates for categorical variables and means for continuous variables with 95%confidence intervals were calculated,and Fisher’s exact test and Mann-Whitney test were *** risk factors of adverse outcomes were RESULTS In total,135 lesions(mean size:22.1 mm;location:42%rectal)from 129 patients(mean age:67.7 years;56%male)were *** proportion of pedunculated and non-pedunculated lesions was similar,with en bloc resection in 82%and 47%of lesions,*** differentiation,distance from resection margins,depth of submucosal invasion,lymphovascular invasion,and budding were reported at 89.6%,45.2%,58.5%,31.9%,and 25.2%,*** tumor was found in 10 patients,and nodal metastasis was found in 4 of 41 patients who underwent secondary surgical *** analysis identified piecemeal resection as a risk factor for residual malignancy(odds ratio:1.74;P=0.042).At least 1 year of follow-up was available for 117 lesions from 111 patients(mean follow-up period:5.59 years).Overall,54%,30%,30%,11%,and 16%of patients presented at the 1-year,3-year,5-year,7-year,and 9-10-year surveillance *** outcomes occurred in 9.0%(local recurrence and dissemination in 4 patients and 9 patients,respectively),with no difference between patients undergoing secondary surgery and surveillance *** Reporting of histological featur

关键词： Malignant colorectal polyps T1 tumor Endoscopic removal Outcomes Long-term Surveillance

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Knockdown of neuronal DAF-15/Raptor promotes healthy aging in ***

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Journal of Genetics and Genomics 2024年第5期51卷 507-516页

作者： Xiao Zang Qi Wang Hanxin Zhang Yiyan Zhang Zi Wang Zixing Wu Di Chen Model Animal Research Center of Medical School Nanjing UniversityNanjingJiangsu 210061China Zhejiang University-University of Edinburgh Institute School of MedicineZhejiang UniversityHainingZhejiang 314400China Department of colorectal Surgery The Second Affiliated HospitalZhejiang University School of MedicineHangzhouZhejiang 310058China

The highly conserved target of rapamycin(TOR)pathway plays an important role in aging across *** studies have established that inhibition of the TOR complex 1(TORC1)significantly extends lifespan in Caenorhabditis ***,it has not been clear whether TORC1 perturbation affects aging in a spatiotemporal ***,we apply the auxin-inducible degradation tool to knock down endogenous DAF-15,the *** ortholog of regulatory associated protein of TOR(Raptor),to characterize its roles in *** or tissue-specific inhibition of DAF-15 during development results in various growth defects,whereas neuron-specific knockdown of DAF-15 during adulthood significantly extends lifespan and *** neuronal DAF-15 deficiency-induced longevity requires the intestinal activities of DAF-16/FOXO and PHA-4/FOXA transcription factors,as well as the AAK-2/AMP-activated protein kinaseαcatalytic *** profiling reveals that the neuronal DAF-15 knockdown promotes the expression of genes involved in *** findings define the tissue-specific roles of TORC1 in healthy aging and highlight the importance of neuronal modulation of aging.

关键词： Aging targetof rapamycin DAF-15 DAF-16 C.elegans

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The Largest Chinese Cohort Study Indicates Homologous Recombination Pathway Gene Mutations as Another Major Genetic Risk Factor for colorectal Cancer with Heterogeneous Clinical Phenotypes

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Research 2024年第3期6卷 191-203页

作者： Yun Xu Kai Liu Cong Li Minghan Li Fangqi Liu Xiaoyan Zhou Menghong Sun Megha Ranganathan Liying Zhang Sheng Wang Xin Hu Ye Xu Department of colorectal Surgery Fudan University Shanghai Cancer CenterShanghaiP.R.China Department of Pathology Fudan University Shanghai Cancer CenterShanghaiP.R.China Department of Pathology Tissue BankFudan University Shanghai Cancer CenterShanghaiP.R.China Department of Medicine Memorial Sloan Kettering Cancer CenterNew YorkNYUSA Department of Pathology and Laboratory Medicine David Geffen School of MedicineUniversity of CaliforniaLos AngelesCAUSA Precision Cancer Medical Center Fudan University Shanghai Cancer CenterShanghaiP.R.China

While genetic factors were associated with over 30% of colorectal cancer (CRC) patients, mutations in CRC-susceptibility genes were identified in only 5% to 10% of these patients. Besides, previous studies on hereditary CRC were largely designed to analyze germline mutations in patients with single genetic high-risk factor, which limited understanding of the association between genotype and phenotypes. From January 2015 to December 2018, we retrospectively enrolled 2,181 patients from 8,270 consecutive CRC cases, covering 5 categories of genetic high-risk factors. Leukocyte genomic DNA was analyzed for germline mutations in cancer predisposition genes. The germline mutations under each category were detected and analyzed in association with CRC susceptibility, clinical phenotypes, and prognoses. A total of 462 pathogenic variants were detected in 19.3% of enrolled CRC patients. Mismatch repair gene mutation was identified in 9.1% of patients, most prevalent across all high-risk groups. Homologous recombination (HR) gene mutations were detected in 6.5% of cases, penetrated in early-onset and extra-colonic cancer risk groups. Mutations in HR genes, including BARD1, RAD50, and ATM, were found to increase CRC risk with odds ratios of 2.8-, 3.1-, and 3.1-fold, respectively. CRC patients with distinct germline mutations manifested heterogeneous phenotypes in clinicopathology and long-term prognoses. Thus, germline mutation screenings should be performed for CRC patients with any of those genetic risk factors. This study also reveals that HR gene mutations may be another major driver for increased CRC risk.

关键词： susceptibility category Major

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Occurrence and prevention of incisional hernia following laparoscopic colorectal surgery

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World Journal of Gastrointestinal Surgery 2024年第7期16卷 1973-1980页

作者： Xi-Wen Wu Ding-Quan Yang Ming-Wei Wang Yan Jiao The First Operating Room The First Hospital of Jilin UniversityChangchun 130021Jilin ProvinceChina Department of Gastrointestinal and colorectal Surgery China-Japan Union Hospital of Jilin UniversityChangchun 130033Jilin ProvinceChina Ministry of Health Key Laboratory of Radiobiology School of Public Health of Jilin UniversityChangchun 130000Jilin ProvinceChina Department of Hepatobiliary and Pancreatic Surgery General Surgery CenterThe First Hospital of Jilin UniversityChangchun 130021Jilin ProvinceChina

Among minimally invasive surgical procedures,colorectal surgery is associated with a notably higher incidence of incisional hernia(IH),ranging from 1.7% to 24.3%.This complication poses a significant burden on the healthcare system annually,necessitating urgent attention from *** a study published in the World Journal of Gastrointestinal Surgery,Fan et al compared the incidence of IH among 1614 patients who underwent laparoscopic colorectal surgery with different extraction site locations and evaluated the risk factors associated with its *** editorial analyzes the current risk factors for IH after laparoscopic colorectal surgery,emphasizing the impact of obesity,surgical site infection,and the choice of incision location on its ***,we summarize the currently available preventive measures for *** the low surgical repair rate and high recurrence rate associated with IH,prevention deserves greater research and attention compared to treatment.

关键词： Incisional hernia Laparoscopy colorectal surgery Risk factor Prevention

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Clinical application of eight-zone laparoscopic dissection strategy for rectal cancer:Experience and discussion

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World Journal of Gastroenterology 2024年第30期30卷 3574-3583页

作者： Chang Chen Xiang Zhang Xin Li Yan-Lei Wang Department of General Surgery Rongchang People's HospitalChongqing 250012China Department of colorectal Surgery Qilu HospitalShandong UniversityJinan 250012Shandong ProvinceChina Department of General Surgery Huantai Branch of Qilu Hospital of Shandong UniversityZibo 255000Shandong ProvinceChina

BACKGROUND The incidence of rectal cancer is increasing worldwide,and surgery remains the primary treatment *** the advent of total mesorectal excision(TME)technique,the probability of tumor recurrence post-surgery has significantly ***'focus has gradually shifted towards minimizing the impact of surgery on urinary and sexual *** these concerns,the optimal dissection of the rectal lateral ligaments and preservation of the pelvic floor neuro-vascular bundle have become *** explore the optimal surgical technique for TME and establish a standardized surgical protocol to minimize the impact on urinary and sexual functions,we propose the eight-zone dissection strategy for pelvic floor *** To compare the differences in surgical specimen integrity and postoperative quality of life satisfaction between the traditional pelvic floor dissection strategy and the innovative eight-zone dissection *** We analyzed the perioperative data of patients who underwent laparoscopic radical resection of rectal cancer at Qilu Hospital of Shandong University between January 1,2021 and December 1,*** study included a total of 218 patients undergoing laparoscopic radical surgery for rectal cancer,among whom 109 patients underwent traditional pelvic floor dissection strategy,and 109 patients received the eight-zone dissection *** There were no significant differences in general characteristics between the two *** in the eight-zone dissection group had higher postoperative specimen integrity(88.1%vs 78.0%,P=0.047).At the 3-month followup,patients in the eight-zone surgery group had better scores in urinary issues(6.8±3.3 vs 5.3±2.5,P=0.045)and male sexual desire(2.2±0.6 vs 2.5±0.5,P=0.047)compared to the traditional surgery strategy *** This study demonstrates that the eight-zone dissection strategy for laparoscopic lateral ligament dissection of rectal cancer is safe and ***

关键词： Eight-zone dissection strategy Rectal cancer Lateral ligament dissection Nerve injury Total mesorectal excision surgery

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Ultratough Yet Dynamic Crystalline Poly(thiourethane)Network Directly from Low Viscosity Precursors

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CCS Chemistry 2024年第3期6卷 682-692页

作者： Haijun Feng Yi Sheng Guancong Chen Binjie Jin Zizheng Fang Bo Yang Xiaorui Zhou Wenxuan Wu Tao Xie Ning Zheng State Key Laboratory of Chemical Engineering College of Chemical and Biological EngineeringZhejiang UniversityHangzhou 310058 Department of colorectal Surgery and Oncology Key Laboratory of Cancer Prevention and InterventionMinistry of EducationThe Second Affiliated HospitalZhejiang University School of MedicineHangzhou 310027

Thermosets based on direct curing of multifunctional monomers offer processing flexibility that thermoplastics cannot ***,this type of thermoset is typically amorphous since it is difficult to meet the stringent requirement of long-range molecular regularity for ***,we report here a crystallizable poly(thiourethane)thermoset synthesized directly from the curing of low-viscosity liquid precursors that does not employ any *** crystalline nature results in superior toughness,comparable to commercial high-density polyethylene,in sharp contrast to the brittleness of the typical,rigid,glassy thermoset *** that,the network polymer exhibits shape-memory behavior in which the crystalline transition is utilized for temporary shape fixing/recovery whereas the dynamic thiourethane bonds can be activated for bond exchange as a mechanism for complex shape *** with these combined features represent attractive options for demanding engineering applications due to their high performance and multifunctinality.

关键词： thermosets crystalline polymer thiourethane thermadapt

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Immunomodulation of adipose-derived mesenchymal stem cells on peripheral blood mononuclear cells in colorectal cancer patients with COVID-19

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World Journal of Gastrointestinal Oncology 2024年第5期16卷 2113-2122页

作者： Jun-Feng Wang Xiao-Xia Yang Jian Zhang Yan Zheng Fu-Qing Zhang Xiao-Feng Shi Yu-Liang Wang Department of colorectal Oncology Tianjin Medical University Cancer Institute and HospitalNational Clinical Research Center for CancerTianjin’s Clinical Research Center for CancerKey Laboratory of Cancer Prevention and TherapyTianjin 300060China Department of Neurology Tianjin First Center HospitalTianjin 300192China Prosthodontics Studio Tianjin Stomatological HospitalTianjin 300041China Department of Clinical Laboratory Medicine Tianjin Institute of UrologyThe Second Hospital of Tianjin Medical UniversityTianjin 300211China Department of Emergency Tianjin First Central HospitalTianjin 300192China

BACKGROUND Accumulating evidence has shown that adipose tissue-derived mesenchymal stem cells(ADSCs)are an effective therapeutic approach for managing coronavirus disease 2019(COVID-19);however,further elucidation is required to determine their underlying immunomodulatory effect on the mRNA expression of T helper cell-related transcription factors(TFs)and cytokine release in peripheral blood mononuclear cells(PBMCs).AIM To investigate the impact of ADSCs on the mRNA expression of TFs and cytokine release in PBMCs from colorectal cancer(CRC)patients with severe COVID-19(CRC^(+)patients).METHODS PBMCs from CRC^(+)patients(PBMCs-C+)and age-matched CRC patients(PBMCs-C)were stimulated and cultured in the presence/absence of *** mRNA levels of T-box TF TBX21(T-bet),GATA binding protein 3(GATA-3),RAR-related orphan receptor C(RORC),and forkhead box P3(FoxP3)in the PBMCs were determined by reverse transcriptase-polymerase chain *** supernatants were evaluated for levels of interferon gamma(IFN-γ),interleukin 4(IL-4),IL-17A,and transforming growth factor beta 1(TGF-β1)using an enzyme-linked immunosorbent *** Compared with PBMCs-C,PBMCs-C+exhibited higher mRNA levels of T-bet and RORC,and increased levels of IFN-γ and ***,a significant decrease in FoxP3 mRNA and TGF-β1,as well as an increase in Tbet/GATA-3,RORC/FoxP3,IFN-γ/IL-4,and IL-17A/TGF-β1 ratios were observed in PBMCs-C+.Furthermore,ADSCs significantly induced a functional regulatory T cell(Treg)subset,as evidenced by an increase in FoxP3 mRNA and TGF-β1 release *** was accompanied by a significant decrease in the mRNA levels of T-bet and RORC,release of IFN-γ and IL-17A,and T-bet/GATA-3,RORC/FoxP3,IFN-γ/IL-4,and IL-17A/TGF-β1 ratios,compared with the PBMCs-C+*** The present in vitro studies showed that ADSCs contributed to the immunosuppressive effects on PBMCs-C+,favoring Treg ***,ADSC-based cell therapy could be a beneficial approach for p

关键词： colorectal cancer COVID-19 Adipose-derived mesenchymal stem cells T helper cell Immunomodulation

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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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Preservation of superior rectal artery in laparoscopic colectomy:The best choice for slow transit constipation?

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World Journal of Gastrointestinal Surgery 2024年第7期16卷 2362-2364页

作者： Yi-Lei Liu Wei-Cheng Liu Department of Gastrointestinal Surgery Second Affiliated Hospital of Naval Medical University(Shanghai Changzheng Hospital)Shanghai 200003China Department of colorectal and Anal Surgery(Clinical Center for Pelvic Floor Surgery) Zhongnan Hospital of Wuhan UniversityWuhan 430071Hubei ProvinceChina

Laparoscopic colectomy with ileorectal anastomosis may be beneficial for patients with slow transit constipation who do not respond to conservative treatment,particularly if the superior rectal artery(SRA)is *** important concerns have been addressed in this *** is important to first go over the definition of surgical procedure as it is used in this ***,the current study lacked a control group that had SRA ***,it would be best to use a prospective,randomized controlled ***,a description of the mesenteric defect’s state following a laparoscopic colectomy is necessary.

关键词： Laparoscopic colectomy Slow transit constipation Ileorectal anastomosis Superior rectal artery Anastomotic leak

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