Objective:To investigate the impact of para-tumoral micro-metastasis(PTMM) and other clinicopathological characteristics on the prognosis of patients with intrahepatic cholangiocarcinoma (ICC).Methods:This is a retrospective cohort study. Clinical data from 137 ICC patients who underwent radical resection at the Hepatobiliary Surgery Center, Department of General Surgery, Huashan Hospital, Fudan University, between January 2017 and December 2022 were analyzed retrospectively. The cohort included 91 males and 46 females, with age ( M(IQR)) of 63 (13) years (range: 32 to 82 years). Kaplan-Meier curves were used to estimate median survival times, while Log-rank tests assessed differences in overall survival (OS) and recurrence-free survival (RFS). Univariate and multivariate Cox regression models were employed to identify factors associated with OS and RFS. Results:The median OS for all 137 ICC patients was 34 months, with 1-, 2-, and 3-year OS rates of 90.7%, 69.4%, and 39.5%, respectively. The results of univariate and multivariate Cox analysis showed that Child-Pugh grade, CA19-9, carcinoembryonic antigen, and PTMM were independent prognostic factors for OS in ICC patients after radical resection (all P<0.05), Child-Pugh grade, maximum tumor diameter, whether lymph node metastasis, and PTMM were independent prognostic factors for RFS in radical resection in ICC patients (all P<0.05). PTMM-positive patients had a median OS of 21 months and median RFS of 12 months, whereas PTMM-negative patients exhibited a median OS exceeding 60 months and median RFS of 36 months. Log-rank tests demonstrated statistically significant differences in OS and RFS between PTMM-positive and PTMM-negative patients ( P<0.01 and P=0.001, respectively). Conclusion:Preliminary findings suggest that PTMM holds significant prognostic value in evaluating outcomes for ICC patients undergoing curative resection.

Objective:To explore the effects of mHealth-based home exercise rehabilitation on lower limb muscle strength and quality of life in liver cancer surgery patients after discharge from the hospital.Method:One hundred cases of hepatocellular carcinoma patients who underwent surgery in two tertiary hospi-tals from June 2022 to August 2023 were selected,including 50 cases in the control group and 50 cases in the intervention group.The patients were instructed to carry out home exercise for 3 weeks respectively.The control group was given a home rehabilitation exercise manual,while the intervention group developed mHealth-based exercise rehabilitation based on this exercise prescription.The muscle strength and quality of life levels of the two groups were compared after the intervention.Result:Patients with mHealth-based exercise rehabilitation had significantly higher lower limb muscle strength than the control group after 3 weeks of intervention(P<0.05).The fatigue and nausea,and vomiting symp-toms in the quality of life domains were significantly improved compared with the control group(P<0.05).Conclusion:Home-based exercise rehabilitation based on mHealth can effectively improve lower limb muscle strength,fatigue,and nausea and vomiting symptoms in patients discharged from the hospital after surgery for hepatocellular carcinoma.It is an effective way to improve the rehabilitation of patients discharged from the hospital for hepatocellular carcinoma.

Objective:To construct a management program for postoperative home exercise rehabilitation in patients undergoing liver cancer surgery, and to provide guidance for improving home exercise capacity after liver cancer surgery.Methods:A mixed study design was used to summarize the best evidence for a postoperative home exercise rehabilitation program for patients with liver cancer based on a literature review from January to June 2022, and the first draft of a postoperative home exercise rehabilitation program for liver cancer patients was formed after discussion in the research team, and discussed in an expert validation meeting, and the first draft of the program was revised and improved according to the expert′s opinion in combination with clinical practice.Results:This study included 14 articles, including 4 clinical guidelines, 3 systematic evaluations, 2 randomized controlled studies, 3 class experimental research and 2 expert consensuses. And 22 pieces of evidence were included in the summary of evidence, including the principle of exercise, supervision of exercise, type of exercise, time and frequency of exercise, and intensity of exercise. A total of 10 experts participated in the expert validation meeting, with 6 males and 4 females, aged (53.31 ± 10.23) years, with an expert authority coefficient of 0.944, and the final home exercise rehabilitation program for postoperative patients with liver cancer was formed to include six aspects, including pre-exercise assessment, warm-up exercise, whole-body exercise, stretching exercise, organizing exercise, and exercise detection and follow-up.Conclusions:The home exercise rehabilitation program for postoperative liver cancer surgery patients is scientific, practical and feasible, and it is a systematic, standardized and safe exercise management model, which can be used for home guidance of postoperative exercise rehabilitation for liver cancer patients.

Objective:To explore the effects of mHealth-based home exercise rehabilitation on lower limb muscle strength and quality of life in liver cancer surgery patients after discharge from the hospital.Method:One hundred cases of hepatocellular carcinoma patients who underwent surgery in two tertiary hospi-tals from June 2022 to August 2023 were selected,including 50 cases in the control group and 50 cases in the intervention group.The patients were instructed to carry out home exercise for 3 weeks respectively.The control group was given a home rehabilitation exercise manual,while the intervention group developed mHealth-based exercise rehabilitation based on this exercise prescription.The muscle strength and quality of life levels of the two groups were compared after the intervention.Result:Patients with mHealth-based exercise rehabilitation had significantly higher lower limb muscle strength than the control group after 3 weeks of intervention(P<0.05).The fatigue and nausea,and vomiting symp-toms in the quality of life domains were significantly improved compared with the control group(P<0.05).Conclusion:Home-based exercise rehabilitation based on mHealth can effectively improve lower limb muscle strength,fatigue,and nausea and vomiting symptoms in patients discharged from the hospital after surgery for hepatocellular carcinoma.It is an effective way to improve the rehabilitation of patients discharged from the hospital for hepatocellular carcinoma.

Objective:To construct a management program for postoperative home exercise rehabilitation in patients undergoing liver cancer surgery, and to provide guidance for improving home exercise capacity after liver cancer surgery.Methods:A mixed study design was used to summarize the best evidence for a postoperative home exercise rehabilitation program for patients with liver cancer based on a literature review from January to June 2022, and the first draft of a postoperative home exercise rehabilitation program for liver cancer patients was formed after discussion in the research team, and discussed in an expert validation meeting, and the first draft of the program was revised and improved according to the expert′s opinion in combination with clinical practice.Results:This study included 14 articles, including 4 clinical guidelines, 3 systematic evaluations, 2 randomized controlled studies, 3 class experimental research and 2 expert consensuses. And 22 pieces of evidence were included in the summary of evidence, including the principle of exercise, supervision of exercise, type of exercise, time and frequency of exercise, and intensity of exercise. A total of 10 experts participated in the expert validation meeting, with 6 males and 4 females, aged (53.31 ± 10.23) years, with an expert authority coefficient of 0.944, and the final home exercise rehabilitation program for postoperative patients with liver cancer was formed to include six aspects, including pre-exercise assessment, warm-up exercise, whole-body exercise, stretching exercise, organizing exercise, and exercise detection and follow-up.Conclusions:The home exercise rehabilitation program for postoperative liver cancer surgery patients is scientific, practical and feasible, and it is a systematic, standardized and safe exercise management model, which can be used for home guidance of postoperative exercise rehabilitation for liver cancer patients.

Objective:To investigate the impact of para-tumoral micro-metastasis(PTMM) and other clinicopathological characteristics on the prognosis of patients with intrahepatic cholangiocarcinoma (ICC).Methods:This is a retrospective cohort study. Clinical data from 137 ICC patients who underwent radical resection at the Hepatobiliary Surgery Center, Department of General Surgery, Huashan Hospital, Fudan University, between January 2017 and December 2022 were analyzed retrospectively. The cohort included 91 males and 46 females, with age ( M(IQR)) of 63 (13) years (range: 32 to 82 years). Kaplan-Meier curves were used to estimate median survival times, while Log-rank tests assessed differences in overall survival (OS) and recurrence-free survival (RFS). Univariate and multivariate Cox regression models were employed to identify factors associated with OS and RFS. Results:The median OS for all 137 ICC patients was 34 months, with 1-, 2-, and 3-year OS rates of 90.7%, 69.4%, and 39.5%, respectively. The results of univariate and multivariate Cox analysis showed that Child-Pugh grade, CA19-9, carcinoembryonic antigen, and PTMM were independent prognostic factors for OS in ICC patients after radical resection (all P<0.05), Child-Pugh grade, maximum tumor diameter, whether lymph node metastasis, and PTMM were independent prognostic factors for RFS in radical resection in ICC patients (all P<0.05). PTMM-positive patients had a median OS of 21 months and median RFS of 12 months, whereas PTMM-negative patients exhibited a median OS exceeding 60 months and median RFS of 36 months. Log-rank tests demonstrated statistically significant differences in OS and RFS between PTMM-positive and PTMM-negative patients ( P<0.01 and P=0.001, respectively). Conclusion:Preliminary findings suggest that PTMM holds significant prognostic value in evaluating outcomes for ICC patients undergoing curative resection.

The LIM domains proteins are of significance proteins of human tumors. LMO3, a member of LIM-only subclass of LIM proteins, participates in the occurrence and development in many kinds of tumors, including neuroblastoma, meningioma, lung cancer and hepatocellular carcinoma, etc. LMO3 functions as interacting with neuronal transcription factor, HUA enhancer 2, interacting with upstream gene and inhibits its transcriptional activity or directly interacting with gene signaling. As an incomparable role in processes of tumors, LMO3 contributes to huge opportunities for therapeutic targeting for the future of the field.This article focuses on the molecular mechanism of LMO3 in the process of tumor development and metastasis, and reviews its recent progress.

Aerobic glycolysis,which is also termed as Warburg effect,is one of the most common and profound biochemical phenotypes of tumor ceils.Several oncogenes and tumor suppressors genes have been implicated in aerobic glycolysis.MicroRNAs can control this metabolic switch by regulating oncogenes and tumor suppressors genes in a post-transcriptional way.A deeper understanding of the mechanisms and pathways by which miRNAs regulate the aerobic glycolysis will hopefully lead to a new therapeutic strategy for malignant cancer.

Liquid therapy is a vital method of perioperative treatment.Choosing correct kinds of transfusion and reasonable therapy strategies can significantly reduce the perioperative complications and shorten days in hospital and improve the critical patients prognosis.The historical development of perioperative liquid therapy is a forward process,which is about crystalloids vs.cilloid,dry vs.wet,and other controversial problems continuing to be summarized,explored and discussed.In this process,there are some specific perioperative treatment strategies with the physician having a deeper cognitive,such as goal-directed therapy,early goal directed therapy and fast track surgery which have significant clinical curative effect.This article summarizes the advance of perioperative liquid therapy.

Objective To observe the effect of combined treatment with rhTRAIL(recombinant human TNF-related apoptosis inducing ligand) and selective Cox-2 inhibitor Celecoxib on gallbladder carcinoma in vitro and to explore the possible mechanism of the effect. Methods Western blot analysis was used to detect the expression of c-FLIP and death receptors after treatment by Celecoxib. Apoptosis of gallbladder cell line SGC-996 after the combined treatment with Celecoxib and rhTRAIL was detected in three ways: (1) phase microscopy of the cells, (2) detection of effector caspase-3 and caspase-7 activity, and (3) determination of the proportion of apoptotic cells labeled by Annexin V-PI flow cytometric analysis using CELLQUEST software. Results Celecoxib down-regulated the expression of c-FLIPs and up-regulated the expression of DR5 in a dose- and time-dependent mode on cell line SGC-996. Apoptotic levels in the combined treatment group in cell line SGC-996 were significantly higher than those in the single drug treatment group and control group. Conclusion Celecoxib markedly sensitized rhTRAIL-induced apoptosis through the down-regulation of c-FLIPs and up-regulation of DR5 in gallbladder carcinoma cell line SGC-996.