Objective: To explore the application value of rapid rehabilitation concept in patients with extrahepatic bile duct stones under laparoscopy during perioperative period. Methods: 90 patients with extrahepatic bile duc...Objective: To explore the application value of rapid rehabilitation concept in patients with extrahepatic bile duct stones under laparoscopy during perioperative period. Methods: 90 patients with extrahepatic bile duct stones treated in our hospital from January 2022 to February 2023 were selected as the research object and randomly divided into the study group and the control group. The control group was given routine care, and the observation group was given rapid surgical rehabilitation care. The postoperative anal exhaust time, first meal time, early activity time, pain time, abdominal drainage tube removal time, hospitalization time and complication rate were compared between the two groups. The independent sample T test was used for the measurement data, and the x<sup>2</sup> test was used for the counting data, and the difference was statistically significant (P Results: The postoperative anal exhaust time, first meal time, early activity time, pain time, abdominal drainage tube removal time and hospitalization time in the study group were shorter than those in the control group (all P Conclusion: The concept of rapid rehabilitation can significantly improve the perioperative nursing effect of patients with extrahepatic bile duct stones and accelerate their rehabilitation, which is worth improving and popularizing.展开更多
BACKGROUND Surgical resection remains the primary treatment for hepatic malignancies,and intraoperative bleeding is associated with a significantly increased risk of death.Therefore,accurate prediction of intraoperati...BACKGROUND Surgical resection remains the primary treatment for hepatic malignancies,and intraoperative bleeding is associated with a significantly increased risk of death.Therefore,accurate prediction of intraoperative bleeding risk in patients with hepatic malignancies is essential to preventing bleeding in advance and providing safer and more effective treatment.AIM To develop a predictive model for intraoperative bleeding in primary hepatic malignancy patients for improving surgical planning and outcomes.METHODS The retrospective analysis enrolled patients diagnosed with primary hepatic malignancies who underwent surgery at the Hepatobiliary Surgery Department of the Fourth Hospital of Hebei Medical University between 2010 and 2020.Logistic regression analysis was performed to identify potential risk factors for intraoperative bleeding.A prediction model was developed using Python programming language,and its accuracy was evaluated using receiver operating characteristic(ROC)curve analysis.RESULTS Among 406 primary liver cancer patients,16.0%(65/406)suffered massive intraoperative bleeding.Logistic regression analysis identified four variables as associated with intraoperative bleeding in these patients:ascites[odds ratio(OR):22.839;P<0.05],history of alcohol consumption(OR:2.950;P<0.015),TNM staging(OR:2.441;P<0.001),and albumin-bilirubin score(OR:2.361;P<0.001).These variables were used to construct the prediction model.The 406 patients were randomly assigned to a training set(70%)and a prediction set(30%).The area under the ROC curve values for the model’s ability to predict intraoperative bleeding were 0.844 in the training set and 0.80 in the prediction set.CONCLUSION The developed and validated model predicts significant intraoperative blood loss in primary hepatic malignancies using four preoperative clinical factors by considering four preoperative clinical factors:ascites,history of alcohol consumption,TNM staging,and albumin-bilirubin score.Consequently,this model holds promise for enhancing individualised surgical planning.展开更多
Portal hypertension is a group of syndrome characterized by splenic hyperfunction, esophageal and gastric varices and ascites caused by abnormal portal vein hemodynamics. Among them, upper gastrointestinal bleeding ca...Portal hypertension is a group of syndrome characterized by splenic hyperfunction, esophageal and gastric varices and ascites caused by abnormal portal vein hemodynamics. Among them, upper gastrointestinal bleeding caused by esophageal and gastric varices is the most dangerous complication, which often threatens the lives of patients. After half a century of development, the treatment of portal hypertension is divided into two categories: medical drug therapy, endoscopic therapy and surgical treatment. With the understanding of portal hypertension and the continuous development of medical technology, the surgical operation of portal hypertension has also been greatly improved, reducing postoperative complications and improving the quality of life of patients after operation. However, at present, there is no surgical method that can completely cure portal hypertension. This article reviews the progress of surgical treatment of portal hypertension in recent years, in order to provide reference for the surgical treatment of portal hypertension.展开更多
Objective:To explore the effect of nursing intervention based on Caprini risk assessment scale for venous thromboembolism(VTE)in perioperative patients with liver cancer.Methods:A total of 128 hepatocellular cancer(HC...Objective:To explore the effect of nursing intervention based on Caprini risk assessment scale for venous thromboembolism(VTE)in perioperative patients with liver cancer.Methods:A total of 128 hepatocellular cancer(HCC)patients who were hospitalized in our department from January 2021 to March 2022 and met the research criteria were selected.According to odd and even numbers in the order of inclusion,64 cases were divided into two groups:a control group and an observation group.The control group received routine nursing intervention during perioperative period,while the observation group received nursing intervention based on Caprini risk assessment scale for VTE.The incidence of VTE and complications were compared between the two groups.Results:The incidence of VTE and postoperative complications in the observation group were lower than those in the control group(P<0.05).Conclusion:Nursing intervention based on Caprini risk assessment scale for VTE can reduce the incidence of perioperative deep vein thrombosis and complications in patients with liver cancer;thus,it is worthy of clinical application.展开更多
Objective:To explore the application effect of“Internet+”nursing in patients discharged from hospital after liver cancer operation.Methods:A total of 90 patients who underwent hepatocellular carcinoma resection in S...Objective:To explore the application effect of“Internet+”nursing in patients discharged from hospital after liver cancer operation.Methods:A total of 90 patients who underwent hepatocellular carcinoma resection in Shaanxi Provincial People’s Hospital from November 2019 to August 2020 were divided into an observation group(n=45)and a control group(n=45)randomly by drawing lots.The control group received routine discharge health guidance while the observation group underwent an“Internet+”nursing through hospital Internet information platforms,online consultation,and so on.Patients of both groups returned to the hospital one month after discharge and filled in the questionnaire.The incidence of adverse reactions,quality of life,and level of hope were compared between the two groups 1 month after discharge.Results:The incidence of adverse reactions in the observation group was significantly lower than that of the control group,and the difference was statistically significant(P<0.05).The quality of life and level of hope of patients in the observation group were significantly higher than those in control group and the difference was statistically significant(P<0.05).Conclusion:“Internet+”nursing service plays a positive role in improving the patients’about their disease and their quality of life after discharge from hospital after liver cancer operation,which is worthy of popularization in clinical practice.展开更多
BACKGROUND Our study investigated the role of FAM53B in regulating macrophage M2 polarization and its potential mechanisms in promoting pancreatic ductal adenocarcinoma(PDAC)metastasis.AIM To further investigate the r...BACKGROUND Our study investigated the role of FAM53B in regulating macrophage M2 polarization and its potential mechanisms in promoting pancreatic ductal adenocarcinoma(PDAC)metastasis.AIM To further investigate the role of FAM53B in regulating macrophage M2 polarization and its potential mechanism in promoting PDAC metastasis.Our goal is to determine how FAM53B affects macrophage M2 polarization and to define its underlying mechanism in PDAC metastasis.METHODS Cell culture and various experiments,including protein analysis,immunohisto-chemistry,and animal model experiments,were conducted.We compared FAM53B expression between PDAC tissues and healthy tissues and assessed the correlation of FAM53B expression with clinical features.Our study analyzed the role of FAM53B in macrophage M2 polarization in vitro by examining the expression of relevant markers.Finally,we used a murine model to study the role of FAM53B in PDAC metastasis and analyzed the potential underlying mechanisms.RESULTS Our research showed that there was a significant increase in FAM53B levels in PDAC tissues,which was linked to adverse tumor features.Experimental findings indicated that FAM53B can enhance macrophage M2 polarization,leading to increased anti-inflammatory factor release.The results from the mouse model further supported the role of FAM53B in PDAC metastasis,as blocking FAM53B prevented tumor cell invasion and metastasis.CONCLUSION FAM53B promotes PDAC metastasis by regulating macrophage M2 polarization.This discovery could lead to the development of new strategies for treating PDAC.For example,interfering with the FAM53B signaling pathway may prevent cancer spread.Our research findings also provide important information for expanding our understanding of PDAC pathogenesis.展开更多
BACKGROUND Regarding the incidence of malignant tumors in China,the incidence of liver cancer ranks fourth,second only to lung,gastric,and esophageal cancers.The case fatality rate ranks third after lung and cervical ...BACKGROUND Regarding the incidence of malignant tumors in China,the incidence of liver cancer ranks fourth,second only to lung,gastric,and esophageal cancers.The case fatality rate ranks third after lung and cervical cancer.In a previous study,the whole-process management model was applied to patients with breast cancer,which effectively reduced their negative emotions and improved treatment adherence and nursing satisfaction.METHODS In this single-center,randomized,controlled study,60 randomly selected patients with liver cancer who had been admitted to our hospital from January 2021 to January 2022 were randomly divided into an observation group(n=30),who received whole-process case management on the basis of routine nursing mea-sures,and a control group(n=30),who were given routine nursing measures.We compared differences between the two groups in terms of anxiety,depression,the level of hope,self-care ability,symptom distress,sleep quality,and quality of life.RESULTS Post-intervention,Hamilton anxiety scale,Hamilton depression scale,memory symptom assessment scale,and Pittsburgh sleep quality index scores in both groups were lower than those pre-intervention,and the observation group had lower scores than the control group(P<0.05).Herth hope index,self-care ability assessment scale-revision in Chinese,and quality of life measurement scale for patients with liver cancer scores in both groups were higher than those pre-intervention,with higher scores in the observation group compared with the control group(P<0.05).CONCLUSION Whole-process case management can effectively reduce anxiety and depression in patients with liver cancer,alleviate symptoms and problems,and improve the level of hope,self-care ability,sleep quality,and quality of life,as well as provide feasible nursing alternatives for patients with liver cancer.展开更多
BACKGROUND Liver cancer is one of the most common malignant tumors,and ranks as the fourth leading cause of cancer death worldwide.Microvascular invasion(MVI)is considered one of the most important factors for recurre...BACKGROUND Liver cancer is one of the most common malignant tumors,and ranks as the fourth leading cause of cancer death worldwide.Microvascular invasion(MVI)is considered one of the most important factors for recurrence and poor prognosis of liver cancer.Thus,accurately identifying MVI before surgery is of great importance in making treatment strategies and predicting the prognosis of patients with hepatocellular carcinoma(HCC).Radiomics as an emerging field,aims to utilize artificial intelligence software to develop methods that may contribute to cancer diagnosis,treatment improvement and evaluation,and better prediction.AIM To investigate the predictive value of computed tomography radiomics for MVI in solitary HCC≤5 cm.METHODS A total of 185 HCC patients,including 122 MVI negative and 63 MVI positive patients,were retrospectively analyzed.All patients were randomly assigned to the training group(n=124)and validation group(n=61).A total of 1351 radiomic features were extracted based on three-dimensional images.The diagnostic performance of the radiomics model was verified in the validation group,and the Delong test was applied to compare the radiomics and MVIrelated imaging features(two-trait predictor of venous invasion and radiogenomic invasion).RESULTS A total of ten radiomics features were finally obtained after screening 1531 features.According to the weighting coefficient that corresponded to the features,the radiomics score(RS)calculation formula was obtained,and the RS score of each patient was calculated.The radiomics model exhibited a better correction and identification ability in the training and validation groups[area under the curve:0.72(95%confidence interval:0.58-0.86)and 0.74(95%confidence interval:0.66-0.83),respectively].Its prediction performance was significantly higher than that of the image features(P<0.05).CONCLUSION Computed tomography radiomics has certain predictive value for MVI in solitary HCC≤5 cm,and the predictive ability is higher than that of image features.展开更多
BACKGROUND Surgical resection is the preferred method for patients with complex liver cancer.But the tumor is in a special position,the surgery is highly risky,postoperative complications can easily occur,and the prog...BACKGROUND Surgical resection is the preferred method for patients with complex liver cancer.But the tumor is in a special position,the surgery is highly risky,postoperative complications can easily occur,and the prognosis is not ideal.AIM To investigate the effectiveness of surgical resection for complex liver cancer and its influencing factors.METHODS Fifty-seven patients who had complicated liver cancer and underwent surgical resection at our hospital from August 2015 to August 2016 were enrolled in this study.All patients were followed for three years,and their postoperative complications,survival,and factors that impacted their survival were analyzed.RESULTS The total incidence of postoperative complications was 45.61%,and the incidence of pleural effusion was the highest at 28.07%.There were no correlations between the 2-year and 3-year survival rates and sex,age,and HbsAg of the patients(P>0.05).In terms of pathological parameters,the 2-year and 3-year survival rates were significantly different according to the presence of a tumor capsule,degree of liver cirrhosis,satellite or focal lesions,hepatic vein thrombosis,portal vein tumor thrombus,and intraoperative blood loss(P<0.05).CONCLUSION be affected by factors such as the presence of a tumor capsule,cirrhosis degree,satellite or focal lesions,hepatic vein embolization,portal vein tumor thrombus,and intraoperative blood loss.Therefore,these factors should be controlled and prevented during surgery to help improve patient survival after surgery.展开更多
Liver is the most common metastasis target organ in the late stage of colorectal cancer. More than 50% of colorectal cancer patients will have simultaneous or heterochronous liver metastasis. The survival time of pati...Liver is the most common metastasis target organ in the late stage of colorectal cancer. More than 50% of colorectal cancer patients will have simultaneous or heterochronous liver metastasis. The survival time of patients with colorectal cancer and liver metastasis (CRLM) is short;not all patients can get radical resection of liver metastasis. For this part of patients, microwave ablation technology has been proved to be one of the effective methods for the treatment of liver metastasis. Laparoscopic B-ultrasound ablation also highlights a lot of minimally invasive advantages;this paper reviews the relevant literature of PubMed database, Wanfang database and CNKI database, in order to provide the treatment basis for clinical application of microwave ablation technology under laparoscopic B-ultrasound in the treatment of CRLM. The results showed that the safety and effectiveness of microwave ablation for liver metastases under the location of B-ultrasonic laparoscopy were confirmed, and patients with liver metastases of colorectal cancer who could not be resected could choose this treatment.展开更多
BACKGROUND Adenomyomatous hyperplasia of the distal common bile duct(CBD)is very rare,with only scarce case reports in the literature.Diagnosis is usually based on imaging findings,and endoscopic biopsy is very diffic...BACKGROUND Adenomyomatous hyperplasia of the distal common bile duct(CBD)is very rare,with only scarce case reports in the literature.Diagnosis is usually based on imaging findings,and endoscopic biopsy is very difficult before operation.It is believed that adenomyomatous hyperplasia has little or no risk of malignant transformation.CASE SUMMARY A 68-year-old woman with abdominal pain in the right upper quadrant was referred to our hospital.Abdominal ultrasonography in the emergency ward revealed acute cholecystitis and dilated CBD.Laboratory findings showed elevated levels of transaminases,phosphatase,andγ-glutamyltranspeptidase.Pharmaceutical treatment for 3 d did not relieve the symptoms.Magnetic resonance cholangiopancreatography(MRCP)and computed tomography(CT)showed proximal bile duct dilatation but could not identify the cause.Endoscopic ultrasonography(EUS)demonstrated a mixed echogenic mass in the distal CBD.During surgery,a firm mass was found in the distal CBD and the Whipple procedure was performed with the initial concern of malignancy.Histology showed diffuse adenomyomatous hyperplasia.CONCLUSION EUS may be a useful choice to diagnose adenomyoma of the distal CBD before operation,especially in patients with ambiguous MRCP/CT findings.展开更多
Objective The aim of the study was to investigate the correlation between the hemoglobin-to-red cell distribution width ratio(HRR)and all-cause mortality in patients with malignant tumors and sepsis.Methods All patien...Objective The aim of the study was to investigate the correlation between the hemoglobin-to-red cell distribution width ratio(HRR)and all-cause mortality in patients with malignant tumors and sepsis.Methods All patients who met the inclusion criteria of the Medical Information Mart for Intensive Care(MIMIC)-Ⅳwere selected and divided into four groups according to the quartile range of HRR distribution.Kaplan-Meier(K-M)analysis was used to plot the 28-day survival curve,and the log-rank test was used to compare the prognosis in each HRR group.A Cox proportional hazards regression model was used to evaluate the prognosis of HRR as both a continuous and categorical variable,and a restricted cubic spline was used to study the effect of HRR,as a continuous variable,on the mortality in patients with malignant tumors and sepsis.Interaction and subgroup analyses were performed to evaluate the consistency of correlations.Results A total of 3926 patients were included in the study,including 934 patients in the HRR≤4.97 group,988 patients in the 4.97<HRR≤6.26 group,1005 patients in the 6.26<HRR≤7.84 group,and 999 patients in the HRR≥7.84 group.According to the K-M analysis,the 28-day survival rate was the lowest in the HRR≤4.97 group(59.53%),and there were significant differences in survival rates among different HRR levels(P<0.001).The Cox proportional hazards regression model found that after adjusting for various potential confounding factors,HRR was negatively correlated with 28-day and 365-day mortality,and the risk of death in the HRR≥7.84 group was significantly lower than that in the HRR≤4.97 group(P=0.030 and P=0.008,respectively).The restricted cubic spline plot revealed a linear and negative relationship between the HRR and the 28-day and 365-day mortality rates.Subgroup analysis revealed an interaction between HRR,blood urea nitrogen,and SAPS II scores(P=0.010 and P=0.048,respectively).Conclusion Low HRR is an independent risk factor for all-cause mortality in patients with malignant tumors and sepsis and could be used as a prognostic indicator for these patients.展开更多
BACKGROUND The most effective treatment for advanced cirrhosis and portal hypertension is liver transplantation(LT).However,splenomegaly and hypersplenism can persist even after LT in patients with massive splenomegal...BACKGROUND The most effective treatment for advanced cirrhosis and portal hypertension is liver transplantation(LT).However,splenomegaly and hypersplenism can persist even after LT in patients with massive splenomegaly.AIM To examine the feasibility of performing partial splenectomy during LT in patients with advanced cirrhosis combined with severe splenomegaly and hypersplenism.METHODS Between October 2015 and February 2019,762 orthotopic LTs were performed for patients with end-stage liver diseases in Tianjin First Center Hospital.Eighty-four cases had advanced cirrhosis combined with severe splenomegaly and hypersplenism.Among these patients,41 received partial splenectomy during LT(PSLT group),and 43 received only LT(LT group).Patient characteristics,intraoperative parameters,and postoperative outcomes were retrospectively analyzed and compared between the two groups.RESULTS The incidence of postoperative hypersplenism(2/41,4.8%)and recurrent ascites(1/41,2.4%)in the PSLT group was significantly lower than that in the LT group(22/43,51.2%;8/43,18.6%,respectively).Seventeen patients(17/43,39.5%)in the LT group required two-stage splenic embolization,and further splenectomy was required in 6 of them.The operation time and intraoperative blood loss in the PSLT group(8.6±1.3 h;640.8±347.3 mL)were relatively increased compared with the LT group(6.8±0.9 h;349.4±116.1 mL).The incidence of postoperative bleeding,pulmonary infection,thrombosis and splenic arterial steal syndrome in the PSLT group was not different to that in the LT group,respectively.CONCLUSION Simultaneous PSLT is an effective treatment and should be performed in patients with advanced cirrhosis combined with severe splenomegaly and hypersplenism to prevent postoperative persistent hypersplenism.展开更多
文摘Objective: To explore the application value of rapid rehabilitation concept in patients with extrahepatic bile duct stones under laparoscopy during perioperative period. Methods: 90 patients with extrahepatic bile duct stones treated in our hospital from January 2022 to February 2023 were selected as the research object and randomly divided into the study group and the control group. The control group was given routine care, and the observation group was given rapid surgical rehabilitation care. The postoperative anal exhaust time, first meal time, early activity time, pain time, abdominal drainage tube removal time, hospitalization time and complication rate were compared between the two groups. The independent sample T test was used for the measurement data, and the x<sup>2</sup> test was used for the counting data, and the difference was statistically significant (P Results: The postoperative anal exhaust time, first meal time, early activity time, pain time, abdominal drainage tube removal time and hospitalization time in the study group were shorter than those in the control group (all P Conclusion: The concept of rapid rehabilitation can significantly improve the perioperative nursing effect of patients with extrahepatic bile duct stones and accelerate their rehabilitation, which is worth improving and popularizing.
文摘BACKGROUND Surgical resection remains the primary treatment for hepatic malignancies,and intraoperative bleeding is associated with a significantly increased risk of death.Therefore,accurate prediction of intraoperative bleeding risk in patients with hepatic malignancies is essential to preventing bleeding in advance and providing safer and more effective treatment.AIM To develop a predictive model for intraoperative bleeding in primary hepatic malignancy patients for improving surgical planning and outcomes.METHODS The retrospective analysis enrolled patients diagnosed with primary hepatic malignancies who underwent surgery at the Hepatobiliary Surgery Department of the Fourth Hospital of Hebei Medical University between 2010 and 2020.Logistic regression analysis was performed to identify potential risk factors for intraoperative bleeding.A prediction model was developed using Python programming language,and its accuracy was evaluated using receiver operating characteristic(ROC)curve analysis.RESULTS Among 406 primary liver cancer patients,16.0%(65/406)suffered massive intraoperative bleeding.Logistic regression analysis identified four variables as associated with intraoperative bleeding in these patients:ascites[odds ratio(OR):22.839;P<0.05],history of alcohol consumption(OR:2.950;P<0.015),TNM staging(OR:2.441;P<0.001),and albumin-bilirubin score(OR:2.361;P<0.001).These variables were used to construct the prediction model.The 406 patients were randomly assigned to a training set(70%)and a prediction set(30%).The area under the ROC curve values for the model’s ability to predict intraoperative bleeding were 0.844 in the training set and 0.80 in the prediction set.CONCLUSION The developed and validated model predicts significant intraoperative blood loss in primary hepatic malignancies using four preoperative clinical factors by considering four preoperative clinical factors:ascites,history of alcohol consumption,TNM staging,and albumin-bilirubin score.Consequently,this model holds promise for enhancing individualised surgical planning.
文摘Portal hypertension is a group of syndrome characterized by splenic hyperfunction, esophageal and gastric varices and ascites caused by abnormal portal vein hemodynamics. Among them, upper gastrointestinal bleeding caused by esophageal and gastric varices is the most dangerous complication, which often threatens the lives of patients. After half a century of development, the treatment of portal hypertension is divided into two categories: medical drug therapy, endoscopic therapy and surgical treatment. With the understanding of portal hypertension and the continuous development of medical technology, the surgical operation of portal hypertension has also been greatly improved, reducing postoperative complications and improving the quality of life of patients after operation. However, at present, there is no surgical method that can completely cure portal hypertension. This article reviews the progress of surgical treatment of portal hypertension in recent years, in order to provide reference for the surgical treatment of portal hypertension.
文摘Objective:To explore the effect of nursing intervention based on Caprini risk assessment scale for venous thromboembolism(VTE)in perioperative patients with liver cancer.Methods:A total of 128 hepatocellular cancer(HCC)patients who were hospitalized in our department from January 2021 to March 2022 and met the research criteria were selected.According to odd and even numbers in the order of inclusion,64 cases were divided into two groups:a control group and an observation group.The control group received routine nursing intervention during perioperative period,while the observation group received nursing intervention based on Caprini risk assessment scale for VTE.The incidence of VTE and complications were compared between the two groups.Results:The incidence of VTE and postoperative complications in the observation group were lower than those in the control group(P<0.05).Conclusion:Nursing intervention based on Caprini risk assessment scale for VTE can reduce the incidence of perioperative deep vein thrombosis and complications in patients with liver cancer;thus,it is worthy of clinical application.
文摘Objective:To explore the application effect of“Internet+”nursing in patients discharged from hospital after liver cancer operation.Methods:A total of 90 patients who underwent hepatocellular carcinoma resection in Shaanxi Provincial People’s Hospital from November 2019 to August 2020 were divided into an observation group(n=45)and a control group(n=45)randomly by drawing lots.The control group received routine discharge health guidance while the observation group underwent an“Internet+”nursing through hospital Internet information platforms,online consultation,and so on.Patients of both groups returned to the hospital one month after discharge and filled in the questionnaire.The incidence of adverse reactions,quality of life,and level of hope were compared between the two groups 1 month after discharge.Results:The incidence of adverse reactions in the observation group was significantly lower than that of the control group,and the difference was statistically significant(P<0.05).The quality of life and level of hope of patients in the observation group were significantly higher than those in control group and the difference was statistically significant(P<0.05).Conclusion:“Internet+”nursing service plays a positive role in improving the patients’about their disease and their quality of life after discharge from hospital after liver cancer operation,which is worthy of popularization in clinical practice.
文摘BACKGROUND Our study investigated the role of FAM53B in regulating macrophage M2 polarization and its potential mechanisms in promoting pancreatic ductal adenocarcinoma(PDAC)metastasis.AIM To further investigate the role of FAM53B in regulating macrophage M2 polarization and its potential mechanism in promoting PDAC metastasis.Our goal is to determine how FAM53B affects macrophage M2 polarization and to define its underlying mechanism in PDAC metastasis.METHODS Cell culture and various experiments,including protein analysis,immunohisto-chemistry,and animal model experiments,were conducted.We compared FAM53B expression between PDAC tissues and healthy tissues and assessed the correlation of FAM53B expression with clinical features.Our study analyzed the role of FAM53B in macrophage M2 polarization in vitro by examining the expression of relevant markers.Finally,we used a murine model to study the role of FAM53B in PDAC metastasis and analyzed the potential underlying mechanisms.RESULTS Our research showed that there was a significant increase in FAM53B levels in PDAC tissues,which was linked to adverse tumor features.Experimental findings indicated that FAM53B can enhance macrophage M2 polarization,leading to increased anti-inflammatory factor release.The results from the mouse model further supported the role of FAM53B in PDAC metastasis,as blocking FAM53B prevented tumor cell invasion and metastasis.CONCLUSION FAM53B promotes PDAC metastasis by regulating macrophage M2 polarization.This discovery could lead to the development of new strategies for treating PDAC.For example,interfering with the FAM53B signaling pathway may prevent cancer spread.Our research findings also provide important information for expanding our understanding of PDAC pathogenesis.
基金This study protocol was approved by the General Hospital of the Yangtze River Shipping,and all the families have voluntarily participated in the study and have signed informed consent forms.
文摘BACKGROUND Regarding the incidence of malignant tumors in China,the incidence of liver cancer ranks fourth,second only to lung,gastric,and esophageal cancers.The case fatality rate ranks third after lung and cervical cancer.In a previous study,the whole-process management model was applied to patients with breast cancer,which effectively reduced their negative emotions and improved treatment adherence and nursing satisfaction.METHODS In this single-center,randomized,controlled study,60 randomly selected patients with liver cancer who had been admitted to our hospital from January 2021 to January 2022 were randomly divided into an observation group(n=30),who received whole-process case management on the basis of routine nursing mea-sures,and a control group(n=30),who were given routine nursing measures.We compared differences between the two groups in terms of anxiety,depression,the level of hope,self-care ability,symptom distress,sleep quality,and quality of life.RESULTS Post-intervention,Hamilton anxiety scale,Hamilton depression scale,memory symptom assessment scale,and Pittsburgh sleep quality index scores in both groups were lower than those pre-intervention,and the observation group had lower scores than the control group(P<0.05).Herth hope index,self-care ability assessment scale-revision in Chinese,and quality of life measurement scale for patients with liver cancer scores in both groups were higher than those pre-intervention,with higher scores in the observation group compared with the control group(P<0.05).CONCLUSION Whole-process case management can effectively reduce anxiety and depression in patients with liver cancer,alleviate symptoms and problems,and improve the level of hope,self-care ability,sleep quality,and quality of life,as well as provide feasible nursing alternatives for patients with liver cancer.
基金Scientific Research Program of Hunan Provincial Health Commission,China,No.B2019072Changsha Science and Technology Project,China,No.kq1907062.
文摘BACKGROUND Liver cancer is one of the most common malignant tumors,and ranks as the fourth leading cause of cancer death worldwide.Microvascular invasion(MVI)is considered one of the most important factors for recurrence and poor prognosis of liver cancer.Thus,accurately identifying MVI before surgery is of great importance in making treatment strategies and predicting the prognosis of patients with hepatocellular carcinoma(HCC).Radiomics as an emerging field,aims to utilize artificial intelligence software to develop methods that may contribute to cancer diagnosis,treatment improvement and evaluation,and better prediction.AIM To investigate the predictive value of computed tomography radiomics for MVI in solitary HCC≤5 cm.METHODS A total of 185 HCC patients,including 122 MVI negative and 63 MVI positive patients,were retrospectively analyzed.All patients were randomly assigned to the training group(n=124)and validation group(n=61).A total of 1351 radiomic features were extracted based on three-dimensional images.The diagnostic performance of the radiomics model was verified in the validation group,and the Delong test was applied to compare the radiomics and MVIrelated imaging features(two-trait predictor of venous invasion and radiogenomic invasion).RESULTS A total of ten radiomics features were finally obtained after screening 1531 features.According to the weighting coefficient that corresponded to the features,the radiomics score(RS)calculation formula was obtained,and the RS score of each patient was calculated.The radiomics model exhibited a better correction and identification ability in the training and validation groups[area under the curve:0.72(95%confidence interval:0.58-0.86)and 0.74(95%confidence interval:0.66-0.83),respectively].Its prediction performance was significantly higher than that of the image features(P<0.05).CONCLUSION Computed tomography radiomics has certain predictive value for MVI in solitary HCC≤5 cm,and the predictive ability is higher than that of image features.
文摘BACKGROUND Surgical resection is the preferred method for patients with complex liver cancer.But the tumor is in a special position,the surgery is highly risky,postoperative complications can easily occur,and the prognosis is not ideal.AIM To investigate the effectiveness of surgical resection for complex liver cancer and its influencing factors.METHODS Fifty-seven patients who had complicated liver cancer and underwent surgical resection at our hospital from August 2015 to August 2016 were enrolled in this study.All patients were followed for three years,and their postoperative complications,survival,and factors that impacted their survival were analyzed.RESULTS The total incidence of postoperative complications was 45.61%,and the incidence of pleural effusion was the highest at 28.07%.There were no correlations between the 2-year and 3-year survival rates and sex,age,and HbsAg of the patients(P>0.05).In terms of pathological parameters,the 2-year and 3-year survival rates were significantly different according to the presence of a tumor capsule,degree of liver cirrhosis,satellite or focal lesions,hepatic vein thrombosis,portal vein tumor thrombus,and intraoperative blood loss(P<0.05).CONCLUSION be affected by factors such as the presence of a tumor capsule,cirrhosis degree,satellite or focal lesions,hepatic vein embolization,portal vein tumor thrombus,and intraoperative blood loss.Therefore,these factors should be controlled and prevented during surgery to help improve patient survival after surgery.
文摘Liver is the most common metastasis target organ in the late stage of colorectal cancer. More than 50% of colorectal cancer patients will have simultaneous or heterochronous liver metastasis. The survival time of patients with colorectal cancer and liver metastasis (CRLM) is short;not all patients can get radical resection of liver metastasis. For this part of patients, microwave ablation technology has been proved to be one of the effective methods for the treatment of liver metastasis. Laparoscopic B-ultrasound ablation also highlights a lot of minimally invasive advantages;this paper reviews the relevant literature of PubMed database, Wanfang database and CNKI database, in order to provide the treatment basis for clinical application of microwave ablation technology under laparoscopic B-ultrasound in the treatment of CRLM. The results showed that the safety and effectiveness of microwave ablation for liver metastases under the location of B-ultrasonic laparoscopy were confirmed, and patients with liver metastases of colorectal cancer who could not be resected could choose this treatment.
基金Supported by The Program for Diagnostic and Therapeutic Technique of Clinically Important Disease in Suzhou,No.LCZX201707Program for GUSU Medicine Talents,No.GSWS2019012
文摘BACKGROUND Adenomyomatous hyperplasia of the distal common bile duct(CBD)is very rare,with only scarce case reports in the literature.Diagnosis is usually based on imaging findings,and endoscopic biopsy is very difficult before operation.It is believed that adenomyomatous hyperplasia has little or no risk of malignant transformation.CASE SUMMARY A 68-year-old woman with abdominal pain in the right upper quadrant was referred to our hospital.Abdominal ultrasonography in the emergency ward revealed acute cholecystitis and dilated CBD.Laboratory findings showed elevated levels of transaminases,phosphatase,andγ-glutamyltranspeptidase.Pharmaceutical treatment for 3 d did not relieve the symptoms.Magnetic resonance cholangiopancreatography(MRCP)and computed tomography(CT)showed proximal bile duct dilatation but could not identify the cause.Endoscopic ultrasonography(EUS)demonstrated a mixed echogenic mass in the distal CBD.During surgery,a firm mass was found in the distal CBD and the Whipple procedure was performed with the initial concern of malignancy.Histology showed diffuse adenomyomatous hyperplasia.CONCLUSION EUS may be a useful choice to diagnose adenomyoma of the distal CBD before operation,especially in patients with ambiguous MRCP/CT findings.
文摘Objective The aim of the study was to investigate the correlation between the hemoglobin-to-red cell distribution width ratio(HRR)and all-cause mortality in patients with malignant tumors and sepsis.Methods All patients who met the inclusion criteria of the Medical Information Mart for Intensive Care(MIMIC)-Ⅳwere selected and divided into four groups according to the quartile range of HRR distribution.Kaplan-Meier(K-M)analysis was used to plot the 28-day survival curve,and the log-rank test was used to compare the prognosis in each HRR group.A Cox proportional hazards regression model was used to evaluate the prognosis of HRR as both a continuous and categorical variable,and a restricted cubic spline was used to study the effect of HRR,as a continuous variable,on the mortality in patients with malignant tumors and sepsis.Interaction and subgroup analyses were performed to evaluate the consistency of correlations.Results A total of 3926 patients were included in the study,including 934 patients in the HRR≤4.97 group,988 patients in the 4.97<HRR≤6.26 group,1005 patients in the 6.26<HRR≤7.84 group,and 999 patients in the HRR≥7.84 group.According to the K-M analysis,the 28-day survival rate was the lowest in the HRR≤4.97 group(59.53%),and there were significant differences in survival rates among different HRR levels(P<0.001).The Cox proportional hazards regression model found that after adjusting for various potential confounding factors,HRR was negatively correlated with 28-day and 365-day mortality,and the risk of death in the HRR≥7.84 group was significantly lower than that in the HRR≤4.97 group(P=0.030 and P=0.008,respectively).The restricted cubic spline plot revealed a linear and negative relationship between the HRR and the 28-day and 365-day mortality rates.Subgroup analysis revealed an interaction between HRR,blood urea nitrogen,and SAPS II scores(P=0.010 and P=0.048,respectively).Conclusion Low HRR is an independent risk factor for all-cause mortality in patients with malignant tumors and sepsis and could be used as a prognostic indicator for these patients.
基金National Natural Science Foundation of China,No.81870444Tianjin Natural Science Foundation,No.19JCQNJC10300Spring Bud Plan of Tianjin First Central Hospital,No.TFCHCL201801.
文摘BACKGROUND The most effective treatment for advanced cirrhosis and portal hypertension is liver transplantation(LT).However,splenomegaly and hypersplenism can persist even after LT in patients with massive splenomegaly.AIM To examine the feasibility of performing partial splenectomy during LT in patients with advanced cirrhosis combined with severe splenomegaly and hypersplenism.METHODS Between October 2015 and February 2019,762 orthotopic LTs were performed for patients with end-stage liver diseases in Tianjin First Center Hospital.Eighty-four cases had advanced cirrhosis combined with severe splenomegaly and hypersplenism.Among these patients,41 received partial splenectomy during LT(PSLT group),and 43 received only LT(LT group).Patient characteristics,intraoperative parameters,and postoperative outcomes were retrospectively analyzed and compared between the two groups.RESULTS The incidence of postoperative hypersplenism(2/41,4.8%)and recurrent ascites(1/41,2.4%)in the PSLT group was significantly lower than that in the LT group(22/43,51.2%;8/43,18.6%,respectively).Seventeen patients(17/43,39.5%)in the LT group required two-stage splenic embolization,and further splenectomy was required in 6 of them.The operation time and intraoperative blood loss in the PSLT group(8.6±1.3 h;640.8±347.3 mL)were relatively increased compared with the LT group(6.8±0.9 h;349.4±116.1 mL).The incidence of postoperative bleeding,pulmonary infection,thrombosis and splenic arterial steal syndrome in the PSLT group was not different to that in the LT group,respectively.CONCLUSION Simultaneous PSLT is an effective treatment and should be performed in patients with advanced cirrhosis combined with severe splenomegaly and hypersplenism to prevent postoperative persistent hypersplenism.
