Background and Aims:The incidence of intrahepatic cholangiocarcinoma(ICC)has been increasing in recent years.Due to its insidious onset and low rate of early diagnosis,radical resection remains the only potential curative treatment.Lymph node metastasis is a major adverse prognostic factor in ICC,but the scope and therapeutic value of lymphadenectomy remain controversial.Previous studies suggest that patients with central ICC may derive greater survival benefit from lymphadenectomy than those with peripheral ICC.Preoperative assessment of lymph node status mainly relies on imaging,but its accuracy is limited.This study aimed to investigate the prognostic impact of lymphadenectomy in ICC patients at different anatomical sites to inform surgical decision-making.Methods:A retrospective analysis was conducted on 220 ICC patients who underwent radical resection at the 904th Hospital of the Joint Logistic Support Force of the PLA from May 2016 to May 2021.The cohort included 126 males and 94 females,with a mean age of(56.76±13.15)years.Patients were categorized into peripheral ICC(n=144)and central ICC(n=76)groups.Clinical characteristics,albumin-bilirubin(ALBI)grade,preoperative risk of lymph node metastasis,number of lymph nodes dissected,lymph node metastasis status,and postoperative survival outcomes were compared.Subgroup analyses were conducted to assess the prognostic value of the number of lymph nodes dissected under different risk stratifications.Results:Significant differences were observed between peripheral and central ICC in ALBI grade(x2=9.952,P=0.002),preoperative lymph node metastasis risk(x2=6.166,P=0.014),number of lymph nodes dissected(x2=4.167,P=0.042),and lymph node metastasis rate(x2=7.331,P=0.007).The 3-year overall survival(OS)rate was higher in peripheral ICC(31.94％)than in central ICC(15.79％)(x2=13.890,P＜0.001).Among central ICC patients,those with ≥6 lymph nodes dissected had better 3-year OS than those with＜6(16.89％vs.13.04％,x2=3.894,P=0.048).In the high-risk subgroup of central ICC,≥6 lymph nodes dissected was also associated with improved 3-year OS compared with＜6(15.62％vs.11.11％,x2=3.962,P=0.047).In contrast,the number of lymph node dissections had no significant prognostic impact in peripheral ICC or in patients classified as low risk.Conclusion:Patients with peripheral ICC had a better prognosis than those with central ICC.Adequate lymphadenectomy(≥6 nodes)improved survival and enhanced staging accuracy in central ICC patients at high risk of lymph node metastasis,highlighting the importance of preoperative risk assessment for optimizing surgical strategies.

Background and Aims:Radical resection is the only potentially curative treatment for intrahepatic cholangiocarcinoma(ICC),yet the high recurrence rate results in poor prognosis.In recent years,"textbook outcome"(TO)has been proposed as a comprehensive quality metric,but its association with prognosis remains unclear.This study aimed to analyze the risk factors influencing the achievement of TO after radical resection of ICC and to explore the relationship between TO and survival.Methods:A retrospective analysis was conducted on the clinical data of 180 ICC patients who underwent radical resection at the 904th Hospital of the Joint Logistic Support Force of the PLA between February 2018 and February 2023.Univariate and multivariate Logistic regression analyses were performed to identify risk factors associated with TO,and survival analysis was carried out using the Kaplan-Meier method and Log-rank test.Results:Of the 180 patients,66 achieved TO.Multivariate Logistic regression analysis indicated that preoperative total bilirubin＞22 μmol/L,preoperative CA19-9＞35 U/mL,maximum tumor diameter＞5 cm,poor tumor differentiation,microvascular invasion(MVI),and lymph node metastasis were independent risk factors for failing to achieve TO(all P＜0.05).Survival analysis demonstrated that patients who achieved TO had a significantly longer median survival compared with those who did not(36 months vs.16 months,P＜0.001).Conclusion:Preoperative total bilirubin＞22 μmol/L,preoperative CA19-9＞35 U/mL,maximum tumor diameter＞5 cm,poor tumor differentiation,MVI,and lymph node metastasis are independent risk factors for not achieving TO after radical resection of ICC.Patients who achieved TO exhibited markedly longer survival,suggesting that TO not only reflects perioperative treatment quality but also serves as an important prognostic indicator.Greater attention to these risk factors and optimization of perioperative management may improve the likelihood of achieving TO and enhance long-term outcomes.

Background and Aims:The incidence of intrahepatic cholangiocarcinoma(ICC)has been increasing in recent years.Due to its insidious onset and low rate of early diagnosis,radical resection remains the only potential curative treatment.Lymph node metastasis is a major adverse prognostic factor in ICC,but the scope and therapeutic value of lymphadenectomy remain controversial.Previous studies suggest that patients with central ICC may derive greater survival benefit from lymphadenectomy than those with peripheral ICC.Preoperative assessment of lymph node status mainly relies on imaging,but its accuracy is limited.This study aimed to investigate the prognostic impact of lymphadenectomy in ICC patients at different anatomical sites to inform surgical decision-making.Methods:A retrospective analysis was conducted on 220 ICC patients who underwent radical resection at the 904th Hospital of the Joint Logistic Support Force of the PLA from May 2016 to May 2021.The cohort included 126 males and 94 females,with a mean age of(56.76±13.15)years.Patients were categorized into peripheral ICC(n=144)and central ICC(n=76)groups.Clinical characteristics,albumin-bilirubin(ALBI)grade,preoperative risk of lymph node metastasis,number of lymph nodes dissected,lymph node metastasis status,and postoperative survival outcomes were compared.Subgroup analyses were conducted to assess the prognostic value of the number of lymph nodes dissected under different risk stratifications.Results:Significant differences were observed between peripheral and central ICC in ALBI grade(x2=9.952,P=0.002),preoperative lymph node metastasis risk(x2=6.166,P=0.014),number of lymph nodes dissected(x2=4.167,P=0.042),and lymph node metastasis rate(x2=7.331,P=0.007).The 3-year overall survival(OS)rate was higher in peripheral ICC(31.94％)than in central ICC(15.79％)(x2=13.890,P＜0.001).Among central ICC patients,those with ≥6 lymph nodes dissected had better 3-year OS than those with＜6(16.89％vs.13.04％,x2=3.894,P=0.048).In the high-risk subgroup of central ICC,≥6 lymph nodes dissected was also associated with improved 3-year OS compared with＜6(15.62％vs.11.11％,x2=3.962,P=0.047).In contrast,the number of lymph node dissections had no significant prognostic impact in peripheral ICC or in patients classified as low risk.Conclusion:Patients with peripheral ICC had a better prognosis than those with central ICC.Adequate lymphadenectomy(≥6 nodes)improved survival and enhanced staging accuracy in central ICC patients at high risk of lymph node metastasis,highlighting the importance of preoperative risk assessment for optimizing surgical strategies.

Background and Aims:Radical resection is the only potentially curative treatment for intrahepatic cholangiocarcinoma(ICC),yet the high recurrence rate results in poor prognosis.In recent years,"textbook outcome"(TO)has been proposed as a comprehensive quality metric,but its association with prognosis remains unclear.This study aimed to analyze the risk factors influencing the achievement of TO after radical resection of ICC and to explore the relationship between TO and survival.Methods:A retrospective analysis was conducted on the clinical data of 180 ICC patients who underwent radical resection at the 904th Hospital of the Joint Logistic Support Force of the PLA between February 2018 and February 2023.Univariate and multivariate Logistic regression analyses were performed to identify risk factors associated with TO,and survival analysis was carried out using the Kaplan-Meier method and Log-rank test.Results:Of the 180 patients,66 achieved TO.Multivariate Logistic regression analysis indicated that preoperative total bilirubin＞22 μmol/L,preoperative CA19-9＞35 U/mL,maximum tumor diameter＞5 cm,poor tumor differentiation,microvascular invasion(MVI),and lymph node metastasis were independent risk factors for failing to achieve TO(all P＜0.05).Survival analysis demonstrated that patients who achieved TO had a significantly longer median survival compared with those who did not(36 months vs.16 months,P＜0.001).Conclusion:Preoperative total bilirubin＞22 μmol/L,preoperative CA19-9＞35 U/mL,maximum tumor diameter＞5 cm,poor tumor differentiation,MVI,and lymph node metastasis are independent risk factors for not achieving TO after radical resection of ICC.Patients who achieved TO exhibited markedly longer survival,suggesting that TO not only reflects perioperative treatment quality but also serves as an important prognostic indicator.Greater attention to these risk factors and optimization of perioperative management may improve the likelihood of achieving TO and enhance long-term outcomes.

Objective:To study and compare the impact of lymph node metastasis and dissection on the prognosis of intrahepatic cholangiocarcinoma (ICC) patients at different anatomical locations, as well as the effect on prognosis.Methods:A retrospective analysis was conducted on the clinical data of 150 ICC patients who underwent radical surgical resection at the 904th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army from September 2017 to September 2020. Among them, 86 were males and 64 were females, with the age of (56.2±12.9) years. Differences in albumin-bilirubin (ALBI) grade, preoperative lymph node metastasis risk, number of lymph nodes dissected, lymph node metastasis, and postoperative survival between peripheral and central ICC patients were compared to analyze the impact of lymph node dissection on the prognosis of ICC patients at different locations.Results:There were statistically significant differences in ALBI grade, preoperative lymph node metastasis risk, the number of lymph nodes dissected, and lymph node metastasis between 98 cases of peripheral ICC and 52 cases of central ICC (all P<0.05). The 3-year overall survival rates for peripheral and central ICC patients were 30.6% and 15.4%, respectively, with a statistically significant difference ( χ2=8.46, P=0.004). Among central ICC patients, the 3-year overall survival rates for those with ≥6 lymph nodes dissected and <6 lymph nodes dissected were 16.7% and 12.5%, respectively, with a statistically significant difference ( χ2=3.96, P=0.046). In the high-risk central ICC patients with preoperative lymph node metastasis, the 3-year overall survival rate of ≥6 lymph nodes dissection ( n=22) and <6 lymph nodes dissection ( n=12) were 13.6% and 8.3%, respectively, with statistical significance ( χ2=5.55, P=0.019). Conclusions:The prognosis of peripheral ICC patients is better than that of central ICC patients. For central ICC patients with a high preoperative lymph node metastasis risk, adequate lymph node dissection can lead to a better prognosis.

Objective To evaluate the quality of life of patients with type 2 diabetes mellitus in Weifang City, Shandong Province and to explore its influencing factors. Methods A multistage stratified random sampling method was used to investigate patients in endocrine outpatient clinics in four medical institutions in Weifang from July to September 2022. The survey included general information, multi-dimensional evaluation of quality of life with the EQ-5D-5L scale, calculation of health utility values, and analysis of influencing factors using Tobit regression models. Results A total of 397 patients with type 2 diabetes were included in the present investigation, with health utility value of 0.82±0.21 points and visual analogue scale (VAS) score of 79.47±12.81 points. Pain or discomfort, anxiety or depression were more prominent in the study population. Age, diabetic complications, BMI, daily need for care, social support, and daily level of glycemic control were factors influencing health-related quality of life in patients with type 2 diabetes. Conclusion In the actual treatment of type 2 diabetes patients, an emphasis should be placed on protecting elderly type 2 diabetic patients, preventing and controlling the occurrence and development of diabetic complications, and improving daily blood glucose control to further improve the health-related quality of life of the population.

BACKGROUND AND OBJECTIVES: This study aims to explore the effects of a long non-coding RNA, LINC00525, on colorectal cancer (CRC) and its underlying molecular mechanisms. METHODS: The qPCR, MTT, colony formation, Western blotting, Luciferase reporter and biotin pull-down, shRNA knockdown and DNA fragmentation assays were performed in this study. RESULTS: High expressions of LINC00525 were associated with poor prognosis of CRC patients. LINC00525 knockdown decreased stemness properties and increased sensitivities to oxaliplatin. MiR-507 was a direct target of LINC00525 and overexpression of miR-507 significantly decreased abilities of tumorsphere formation and cell growth. Overexpression of miR-507 resulted in a decrease of expression of cancer stem cell markers and the increase of apoptosis rates. MiR-507 regulated the expression of ELK3. In addition, LINC00525 knockdown decreased the expression of ELK3. Restoration of ELK3 expression abrogated the effects of LINC00525 knockdown. LINC00525 could be served as prognostic marker of CRC. CONCLUSIONS: LINC00525 enhanced stemness properties and increased sensitivities of CRC cells to oxaliplatin by targeting miR-507/ELK3 axis.
Apoptosis ; Biotin ; Blotting, Western ; Colorectal Neoplasms ; DNA Fragmentation ; Humans ; Luciferases ; Neoplastic Stem Cells ; Prognosis ; RNA, Long Noncoding ; RNA, Small Interfering

Objective:To investigate the expressions of TGF-β1,survivin and caspase-3 in hepatolithiasis-associated intrahepatic cholangiocarcinoma(ICC)tissue and their clinical significance.Methods:The expressions of TGF-β1,survivin and caspase-3 in intrahepatic bile duct specimens from 52 patients with intrahepatic stones and concomitant ICC(tumor group)and 30 patients with intrahepatic stones and chronic inflammation(inflammation group)as well as 30 specimens of normal intrahepatic bile duct were determined by immunohistochemical staining.The relations of the three factors with the clinicopathologic characteristics and prognosis of ICC patients were analyzed.Results:In tumor group,inflammation group and normal group,the positive expression rates TGF-β1 and survivin presented a successively decreasing order,while the positive expression rates of caspase-3 showed a successively increasing order(all P<0.05);in ICC tissue,the expressions of TGF-β1 and survivin showed a positive correlation(r=0.917,P<0.01),and both had a negative correlation with that of caspase-3(r=-0.890,P<0.01;r=-0.894,P<0.01).the results of univariate and multivariate analyses showed that TGF-β1,survivin and caspase-3 were independent influential factors for the prognosis of patients with hepatolithiasis-associated ICC(all P<0.05);the survival rates of patients with positive TGF-β1 or survivin expression were significantly reduced compared with respective negative ones(χ2=13.192,P=0.001;χ2=10.536,P=0.002),and the survival rate of patients with positive caspase-3 expression was significantly higher than those with its negative expression(χ2=5.469,P=0.023).Conclusion:The expressions of TGF-β1,survivin and caspase-3 are abnormal in hepatolithiasis-associated ICC tissue,and they may probably be jointly involved in the occurrence and development of this condition.

Objective:To investigate the expressions of TGF-β1,survivin and caspase-3 in hepatolithiasis-associated intrahepatic cholangiocarcinoma(ICC)tissue and their clinical significance.Methods:The expressions of TGF-β1,survivin and caspase-3 in intrahepatic bile duct specimens from 52 patients with intrahepatic stones and concomitant ICC(tumor group)and 30 patients with intrahepatic stones and chronic inflammation(inflammation group)as well as 30 specimens of normal intrahepatic bile duct were determined by immunohistochemical staining.The relations of the three factors with the clinicopathologic characteristics and prognosis of ICC patients were analyzed.Results:In tumor group,inflammation group and normal group,the positive expression rates TGF-β1 and survivin presented a successively decreasing order,while the positive expression rates of caspase-3 showed a successively increasing order(all P<0.05);in ICC tissue,the expressions of TGF-β1 and survivin showed a positive correlation(r=0.917,P<0.01),and both had a negative correlation with that of caspase-3(r=-0.890,P<0.01;r=-0.894,P<0.01).the results of univariate and multivariate analyses showed that TGF-β1,survivin and caspase-3 were independent influential factors for the prognosis of patients with hepatolithiasis-associated ICC(all P<0.05);the survival rates of patients with positive TGF-β1 or survivin expression were significantly reduced compared with respective negative ones(χ2=13.192,P=0.001;χ2=10.536,P=0.002),and the survival rate of patients with positive caspase-3 expression was significantly higher than those with its negative expression(χ2=5.469,P=0.023).Conclusion:The expressions of TGF-β1,survivin and caspase-3 are abnormal in hepatolithiasis-associated ICC tissue,and they may probably be jointly involved in the occurrence and development of this condition.

The study of atrial fibrillation (AF) has been known as a hot topic of clinical concern. Body surface potential mapping (BSPM), a noninvasive electrical mapping technology, has been widely used in the study of AF. This study adopted 10 AF patients' preoperative and postoperative BSPM data (each patient's data contained 128 channels), and applied the autocorrelation function method to obtain the activation interval of the BSPM signals. The activation interval results were compared with that of manual counting method and the applicability of the autocorrelation function method was verified. Furthermore, we compared the autocorrelation function method with the commonly used fast Fourier transform (FFT) method. It was found that the autocorrelation function method was more accurate. Finally, to find a simple rule to predict the recurrence of atrial fibrillation, the autocorrelation function method was used to analyze the preoperative BSPM signals of 10 patients with persistent AF. Consequently, we found that if the patient's proportion of channels with dominant frequency larger than 2.5 Hz in the anterior left region is greater than the other three regions (the anterior right region, the posterior left region, and the posterior right region), he or she might have a higher possibility of AF recurrence. This study verified the rationality of the autocorrelation function method for rhythm analysis and concluded a simple rule of AF recurrence prediction based on this method.