Intrahepatic cholangiocarcinoma is the second most common intrahepatic primary liver tumor after hepatocellular carcinoma (HCC).Epidemiological study suggests a strong correlation between HBV infection and ICC development.This review focused on the potential mechanisms of HBV-induced ICC and gives a primary summary of suggested hypothesis,which included:(1) HBV infection of liver stem/progenitor cells will indirectly lead to HBV infection of intrahepatic biliary epithelial cells and lead to the development of ICC; (2) the changed microenvironment of intrahepatic biliary epithelial cells by HBV infection eventually results in carcinogenesis ; (3) the HBV infection of hepatic sten/progenitor cell can transform into tumor-like stem cells and ultimately differentiate into ICC-like tumor cells.

Objective:To analyze the correlation between the muscle thickness (MT) and echo intensity (EI) of the medial head of gastrocnemius and muscle mass, strength and functional parameters, and to evaluate the diagnostic efficacy of MT and EI for decreased muscle mass.Methods:Fifty-two subjects who visited the Department of Ultrasound Medicine of the Second Affiliated Hospital of Fujian Medical University from March to December 2021 were collected.MT of the medial head of gastrocnemius was measured by two-dimensional ultrasound, and EI values in the region of interest were analyzed using Image J software. Twenty of the subjects were selected to assess the intra-observer and inter-observer agreements in measuring MT and EI values using the intraclass correlation coefficient (ICC) and Altman-Bland analysis was performed. The subjects were divided into healthy control group (30 cases) and decreased muscle mass group (22 cases) according to 2019 Asian Sarcopenia Working Group (AWGS) diagnostic criteria, the differences in MT and EI values between the two groups were compared, and the correlation between MT, EI values and muscle mass, strength, function were analyzed using Pearson correlation analysis. The diagnostic cutoff values of MT and EI values for decreased muscle mass were obtained using ROC curves, and the diagnostic efficacy was compared.Results:①The ICC of MT and EI in medial head of gastrocnemius detected by the same physician and different physicians were greater than 0.97, and the retest reliability was good. ②Compared with the healthy control group, the MT value in medial head of gastrocnemius decreased and the EI value increased in the decreased muscle mass group ( t=4.759, -3.789; all P<0.001). ③The MT value in medial head of gastrocnemius was positively correlated with appendicular skeletal muscle mass (ASM), appendicular skeletal muscle mass index (ASMI), lower limb skeletal muscle mass (LLSM), grip strength, and gait speed ( r=0.579, 0.568, 0.585, 0.495, 0.415; all P<0.001), of which, the correlation with LLSM was the best; ④EI in medial head of gastrocnemius was negatively correlated with ASM and ASMI, LLSM, grip strength, and gait speed, ( r=-0.583, -0.591, -0.590, -0.537, -0.455; all P<0.001), and among which the correlation with ASMI was the best. ⑤The medial head of gastrocnemius MT and EI were 14.33 mm and 58.85 for predicting decreased muscle mass, respectively, and there was no significant difference in the diagnostic performance of the two for decreased muscle mass ( Z=0.734 3, P>0.05). Conclusions:The MT and EI values of the medial head of gastrocnemius can accurately assess muscle mass and can be used in the evaluation of patients with decreased muscle mass.

Objective:To investigate the application value of porcine small intestinal sub-mucosa (SIS) acellular matrix mesh in laparoscopic inguinal hernia repair (LIHR).Methods:The prospective multicenter randomized controlled single-blind non-inferiority-type study was conducted. The clinical data of 216 patients who underwent LIHR in 4 medical centers, including Beijing Chaoyang Hospital of Capital Medical University et al, from April 2021 to August 2022 were selected. Patients were divided into two groups using a central randomization system. Patients in the experimental group were implanted domestic SIS mesh, and patients in the control group were implanted imported mesh of similar material origin. The baseline characteristics of enrolled patients were evaluated using the full analysis set, and the effectiveness indicators were evaluated using the protocol set. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the ttest. Measurement data with skewed distribution were represented as M(range), and comparison between groups was conducted using the Wilcoxon rank sum test. Count data were expressed as absolute numbers and/or percentages, and comparison between groups was conducted using the chi-square test or Fisher exact probability. If the lower limit of 95% confidence interval( CI) of the difference in effective rates between the experimental group and the control group was greater than the non-inferiority cut-off value of ?10%, the experimental group was considered non-inferior to the control group. Results:(1) Situations of the enrolled patients. A total of 216 patients were selected for eligibility, with 46 patients dropping out due to violation of the trial protocol, and the remaining 170 patients were included in the full analysis set. Nine patients were dislodged due to loss to follow-up, and 161 patients completed follow-up. One case in the experimental group was excluded due to violating the inclusion and exclusion criteria, while the remaining 160 patients were included in the protocol set (80 cases in the experimental group and 80 cases in the control group). There was no significant difference in the gender, age, body mass index (BMI), surgical method, Gilbert type of hernia, volume of intraoperative blood loss, operation time of patients between the experimental group and the control group ( P>0.05), confounding bias ensured comparability. (2) Study endpoints. ① Primary study endpoint. During the postoperative 6 month of follow-up, none of patient in the experimental group or the control group had hernia recurrence, with the recurrence rate as 0. Results of non-inferiority test showed that the difference of hernia recurrence between the two groups was 0 (95% CI as ?4.58% to 4.58%), with the lower limit of ?4.58% greater than the non-inferiority cut-off value of ?10%, which fulfilled the non-inferiority hypothesis. ② Secondary study endpoints. Cases with plasmapheresis during the follow-up were 18 in the experimental group and 29 in the control group, respectively, showing no significant difference between the two groups ( χ2=3.65, P>0.05). There were 4 cases with postoperative pain and 1 case with postoperative malaise in the experimental group, and there were 8 cases with postoperative pain and 0 case with postoperative malaise in the control group, showing no signifi-cant difference in the above indicators between the two groups ( P>0.05). None of patient in the experimental group or the control group had incision infection, enterocutaneous fistula, intestinal obstruction, intestinal canal injury, allergy and rejection, testicular inflammation and/or atrophy, or any other complication. Conclusion:Compared with imported mesh of similar material origin, domestic porcine SIS mesh is safe and effective in LIHR.