1.Hepatitis B virus reactivation in hepatocellular carcinoma patients after microwave ablation
Wen LU ; Qingmin FAN ; Panpan WU ; Zhongqi XU ; Yun XU ; Guojun QIAN
Chinese Journal of Hepatobiliary Surgery 2015;21(5):297-300
Objective To investigate the risk factors of hepatitis B virus (HBV) reactivation after microwave ablation (MWA) and its prevention.Methods 72 patients who met the inclusion criteria were enrolled into the study.30 patients were in the control group and 42 patients in the prophylactic antivirus group.Results 8.3% (6/72) patients developed HBV reactivation.A high HBV DNA load and no prophylactic antivirus therapy were independent risk factors of viral reactivation.Conclusion Prophylactic antivirus therapy can prevent HBV reactivation.
2.Associations of cholecystectomy with the risk of colorectal cancer: a Mendelian randomization study.
Lanlan CHEN ; Zhongqi FAN ; Xiaodong SUN ; Wei QIU ; Wentao MU ; Kaiyuan CHAI ; Yannan CAO ; Guangyi WANG ; Guoyue LV
Chinese Medical Journal 2023;136(7):840-847
BACKGROUND:
Cholecystectomy is a standard surgery for patients suffering from gallbladder diseases, while the causal effects of cholecystectomy on colorectal cancer (CRC) and other complications are still unknown.
METHODS:
We obtained genetic variants associated with cholecystectomy at a genome-wide significant level ( P value <5 × 10 -8 ) as instrumental variables (IVs) and performed Mendelian randomization (MR) to identify the complications of cholecystectomy. Furthermore, the cholelithiasis was also treated as the exposure to compare its causal effects to those of cholecystectomy, and multivariable MR analysis was carried out to judge whether the effect of cholecystectomy was independent of cholelithiasis. The study was reported based on Strengthening the Reporting of Observational Studies in Epidemiology Using Mendelian Randomization guidelines.
RESULTS:
The selected IVs explained 1.76% variance of cholecystectomy. Our MR analysis suggested that cholecystectomy cannot elevate the risk of CRC (odds ratio [OR] =1.543, 95% confidence interval [CI]: 0.607-3.924). Also, it was not significant in either colon or rectum cancer. Intriguingly, cholecystectomy might decrease the risk of Crohn's disease (OR = 0.078, 95% CI: 0.016-0.368) and coronary heart disease (OR = 0.352, 95% CI: 0.164-0.756). However, it might increase the risk of irritable bowel syndrome (IBS) (OR = 7.573, 95% CI: 1.096-52.318). Cholelithiasis could increase the risk of CRC in the largest population (OR = 1.041, 95% CI: 1.010-1.073). The multivariable MR analysis suggested that genetic liability to cholelithiasis could increase the risk of CRC in the largest population (OR = 1.061, 95% CI: 1.002-1.125) after adjustment of cholecystectomy.
CONCLUSIONS
The study indicated that cholecystectomy might not increase the risk of CRC, but such a conclusion needs further proving by clinical equivalence. Additionally, it might increase the risk of IBS, which should be paid attention to in clinical practice.
Humans
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Mendelian Randomization Analysis
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Irritable Bowel Syndrome
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Colorectal Neoplasms/genetics*
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Cholelithiasis/complications*
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Cholecystectomy/adverse effects*
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Genome-Wide Association Study
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Polymorphism, Single Nucleotide
3. Mechanism of immune inflammation after severe trauma and progress in clinical intervention
Cong CHEN ; Fan WU ; Maoxin QIN ; Zhongqi LIU ; Chengzhou CAI ; Sheng WANG ; Ruolan LIN ; Yan YAN ; Yi LI ; Minghua LIU
Chinese Journal of Trauma 2019;35(10):953-960
The pathophysiological process of immune inflammatory response after severe trauma is extremely complex, especially manifested in the dynamic changes. In the physiological response state, the inflammatory and anti-inflammatory conditions are in a dynamic balance. The immune inflammatory response is relatively stable, avoiding excessive inflammatory reactions or immunosuppression and reducing further damage to the body. In the pathological response state, the dynamic balance between inflammatory and anti-inflammatory is broken, and it can also lead to persistent inflammatory-immunosuppression-catabolism syndrome (PICS). As a result, it increases serious complications such as uncontrolled inflammatory reactions, sepsis, multiple organ dysfunction syndrome (MODS), and multiple organ failure (MOF). Current researches on post-traumatic immune inflammatory response have also expanded to the genetic level, indicating that the over-expression of genes and the generation and increase of immune response media are likely to be the key reasons for the disorder of immune inflammatory response. The author reviews the research progress of immune inflammatory response mechanism and related clinical intervention after severe trauma, in order to summarize the previous research results and explore the future research direction.