Objective:To systematically evaluate the molecular characteristics and prognostic value of ammonia death-related genes in hepatocellular carcinoma(HCC).Methods:Consensus unsupervised clustering was used to identify ammonia death-related molecular subtypes in HCC samples.Weighted gene co-expression network analysis(WGCNA)was applied to identify gene modules associated with ammonia death.Support vector machine(SVM)and LASSO algorithms were used to screen four hub genes,and a risk score system was constructed based on a LASSO-Cox regression model.The association between the risk model and patient survival,tumor microenvironment,and re-sponse to immunotherapy was further analyzed.Results:Consensus clustering identified two distinct ammonia death-related molecular subtypes(P<0.05).The constructed risk score model showed good predictive performance for overall survival in HCC patients and was closely associated with immune infiltration characteristics of the tumor microenviron-ment and immunotherapy responsiveness(P<0.05).Conclusion:The ammonia death-related risk score model may serve as a novel prognostic biomarker for HCC and provide potential guidance for immunotherapy strategies.

Objective:To explore the potential prognostic value of the HAMP(hepcidin)gene in gastric adenocarci-noma and its correlation with immune infiltration in gastric cancer.Methods:This study systematically analyzed the ex-pression characteristics of the HAMP gene using bioinformatics approaches based on mRNA data from 448 gastric ad-enocarcinoma tissues and non-tumor tissues in the TCGA database.Firstly,the cBioPortal platform was employed to analyze the genetic variation features of the HAMP gene,and the LinkedOmics database was used to evaluate the corre-lation between its methylation status and expression levels.Kaplan-Meier survival analysis with log-rank test was per-formed to assess the relationship between HAMP expression levels and patient prognosis.Furthermore,by integrating TIMER2.0 and TISIDB databases,we systematically evaluated the correlation between HAMP expression and immune-related genes as well as immune cell infiltration.Gene Set Enrichment Analysis(GSEA)was conducted to investigate HAMP-associated signaling pathway characteristics.Finally,STRING and Gepia databases were utilized to construct a protein-protein interaction network of HAMP and identify core interacting genes,comprehensively evaluating the role of HAMP in immune infiltration in gastric adenocarcinoma.Results:The expression level of HAMP was significantly higher in gastric adenocarcinoma tissues compared to normal tissues(P<0.01),and its elevated expression was strongly associ-ated with poor patient prognosis,manifested by significantly shorter overall survival(OS),progression-free survival(PFS),and post-progression survival(PPS)(all P<0.05).Genomic analysis revealed that HAMP mutations in gastric cancer were predominantly amplification-type,and its methylation level showed a positive correlation with mRNA expression(r=0.14,P<0.001).Immunological analysis demonstrated that high HAMP expression was significantly correlated with multiple key immune checkpoint molecules(PD-1:rho=0.274;PD-L1:rho=0.211;CTLA-4:rho=0.199,all P<0.001)and immune cell infiltration(dendritic cells:r=0.548;macrophages:r=0.414;neutrophils:r=0.374,all P<0.001).Pathway enrichment analy-sis indicated that the high HAMP expression group was significantly enriched in immune-related pathways including anti-gen presentation and NK cell-mediated cytotoxicity.Furthermore,protein-protein interaction network analysis identified core interacting genes such as TREM2 and TYROBP,suggesting that HAMP may participate in tumor immune regulation through specific molecular networks.Conclusion:HAMP is highly expressed in gastric cancer,and its high expression significantly reduces the survival time of gastric adenocarcinoma patients,demonstrating prognostic value.HAMP ex-pression is positively correlated with most immune-related genes in STAD and significantly associated with the abun-dance of multiple immune cell infiltration levels,serving as an independent prognostic factor related to immune infiltration.

Objective:To investigate the feasibility of daily laparoscopic appendectomy for acute appendicitis in college students and establish a predictive model of the nomogram.Methods:A prospective analysis was performed on 82 college students with acute appendicitis who were admitted to hospital continuously from December 2023 to De-cember 2024.All patients received laparoscopic appendectomy and accelerated rehabilitation surgical measures combin-ing traditional Chinese and Western medicine,and were divided into two groups according to whether the daytime op-eration mode was achieved.Multivariate Logistic regression analysis was used to screen the independent influencing factors for achieving the day surgery model,and the prediction model was constructed,evaluated and verified.Results:Of the 82 patients,46(56%)achieved the daytime operation mode,the mean length of hospitalization was(41.37±6.33)h,and no serious complications were observed 30 days after surgery.The independent influencing factors for achieving this model were CRP≤13.9 mg/L,abdominal pain time≤22 h,appendix diameter≤10 mm,no drainage tube placed,and postoperative VAS score≤2.5(all P<0.05).The area under the curve of the prediction model was 0.905(95%CI:0.845～0.966),and the calibration chart indicated that the predicted probability of the model was in good agreement with the ac-tual probability,and the decision curve showed good clinical benefit.Conclusion:It is safe and feasible for college stu-dents to receive day surgery mode of laparoscopic appendectomy.The created nomogram model has good predictive ability,which can identify eligible patients as early as possible,and take timely intervention measures to improve the achievement rate.

Objective:To investigate the impacts of preoperative regional arterial infusion chemotherapy(PRAC)combined with laparoscopic surgery on the efficacy,safety,immune function,and serum levels of matrix metallopro-teinase-7(MMP-7)and human cartilage glycoprotein(YKL-40)in patients with colorectal cancer.Methods:This study retrospectively selected 164 patients with colorectal cancer(January 2014 to December 2016)as the research subjects.Patients who underwent conventional treatment and laparoscopic surgery were included into control group(81 cases);patients undergoing PRAC+laparoscopic surgery were included into observation group(83 cases).The clinical efficacy,stress response indicators,immune function related indicators,changes in serum MMP-7 and YKL-40 levels,and occurrence of adverse reactions in two groups were observed before treatment(T0)and after 4 cycles of chemotherapy(T1).Results:At T1,the total effective rate of observation group(85.54%)was greatly higher than that of control group(67.90%)(P<0.05).The levels of cortisol(Cor),neutrophile granulocyte(NE),white blood cell count(WBC),and interleukin(IL)-6 were prominently increased in both groups(P<0.05),but the levels of these indicators in observation group were greatly lower than those in control group(P<0.05).The levels of IgM and IgA in both groups were greatly reduced(P<0.05),but the levels of IgM and IgA in observation group were prominently higher than those in control group(P<0.05).The levels of MMP-7 and YKL-40 decreased in both groups(P<0.05),and the level in observation group was prominently lower than that in control group(P<0.05).There was no significant difference in the overall incidence of adverse reactions and 5-year survival rate between control group and observation group(P>0.05).Conclusion:The combination of PRAC and laparoscopic surgery has prominent healing effects and certain safety in patients with colorectal cancer.It can effectively improve immune function,reduce serum MMP-7 and YKL-40 levels.

Objective:The current study was designed to elucidate the expression pattern,prognosis value,im-mune characteristics and potential molecular mechanisms of HDGF in HCC.Methods:Clinical and gene expression data of the TCGA-LIHC cohort were collected.The Kaplan-Meier method,time-dependent receiver operating charac-teristic(ROC)curves and Cox regression analysis were used to analyze the prognostic value of HDGF.The expression level difference of HDGF was analyzed using the R package DESeq2.Gene ontology,KEGG and GSEA analyses were used to determine the biological function of HDGF in HCC development.The SsGSEA method were used to analyze the immune infiltrates of HCC.Human methylation 450 data and level 3 HTSeq-FPKM data from TCGA-LIHC were used to analyze the effects of DNA methylation level on HDGF expression.Results:Our results indicated that HDGF was over-expressed in HCC and correlated with historical grade and AFP levels(P<0.001).HDGF expression level is an indepen-dent risk factor for overall survival in patients with HCC(P=0.008).The functional and immune analysis indicated that HDGF is closely related to tumor-immune microenvironment and immune infiltration,especially Cytotoxic cells,pDC and Th2 cells(P<0.001).In addition,high HDGF expression in HCC was associated with demethylation of its promoter region(P<0.05).Conclusion:Our results demonstrated that HDGF independently predicts unfavorable prognosis and regu-lates the immune microenvironment of HCC,suggesting HDGF as a potential immunotherapeutic target for HCC.

Objective:It is of great significance to analyze the expression characteristics of immune-related genes in pancreatic cancer and their relationship with prognosis,construct and verify a reliable prognostic model,and explore prognostic methods of pancreatic cancer from the perspective of immune microenvironment.Methods:GSEA enrich-ment analysis of differentially expressed genes in pancreatic cancer was performed to identify key immune-related pathways and genes.The genes involved in the immune pathway were screened through the STRING database and combined with univariate Cox regression and LASSO regression analysis.Three key genes,RIPK2,IRAK2 and CXCL11,were finally identified to construct the prognostic model.The accuracy of the model was evaluated using ROC curves and calibration curves,and verified in an independent verification set(GSE57495).At the same time,the expression pat-terns of key genes in the immune microenvironment were analyzed by single-cell RNA sequencing,and the expression levels of these genes were verified in pancreatic cancer cell lines by RT-qPCR.Results:The expressions of RIPK2,IRAK2 and CXCL11 in pancreatic cancer cell lines were higher than those in normal pancreatic cancer cells(P<0.05).The model based on these three genes divided the patients into a high-risk group(n=87)and a low-risk group(n=89),and the difference in survival time between the high-risk group and the low-risk group was statistically significant(P<0.001).Risk score was correlated with G stage,N stage and tumor residue(P<0.01).Single-cell analysis showed that the ex-pression of these genes was highest in tumor-associated macrophages(mean>0.5)and correlated with regulatory T cells and macrophage infiltration(P<0.05).Multivariate analysis showed that risk score was correlated with overall sur-vival after adjusting for clinical factors(P=0.0014).Conclusion:Based on three key immune-related genes(RIPK2,IRAK2 and CXCL11),we successfully constructed a model to accurately predict the prognosis of pancreatic cancer pa-tients,revealing the important role of these genes in the tumor immune microenvironment,and providing new insights and theoretical basis for pancreatic cancer prognosis assessment and immunotherapy research.

Objective:To investigate the expression of LINC01088 in breast cancer and its effects on cell prolifera-tion,migration,and invasion.Methods:GEPIA and bc-GenExMiner were used to analyze the correlation between LINC01088 expression levels and clinical characteristics as well as prognosis.The expression of LINC01088 in MCF10A and MDA-MB-231,BT-549,MCF7 were detected by Real-time PCR.The effect of LINC01088 on the biological func-tion of breast cancer cells was examined by overexpressing LINC01088 in breast cancer cells.Cell proliferation was as-sessed using the Incucyte assay,while cell migration and invasion were evaluated using Transwell assays.Western blot-ting was employed to detect the expression of proteins associated with cell proliferation and metastasis.Results:LINC01088 expression was significantly lower in breast cancer tissues compared to normal breast tissues(P<0.05).Data from the bc-GenExMiner database revealed higher LINC01088 expression in HER2 positive patients(P<0.0001),corre-lating with longer overall survival(P=0.0006)and disease-free survival(P=0.0002).The mRNA expression level of LINC01088 in normal breast epithelial cell line was higher than that in breast cancer cell lines(P<0.05).Overexpression of LINC01088 significantly reduced proliferation,migration,and invasion in three breast cancer cell lines(P<0.01).Addi-tionally,LINC01088 upregulated p21 and p27(P<0.01),while downregulating Snail,Slug,PI3K,and phosphorylated Akt(P<0.05).Conclusion:LINC01088 expression was significantly reduced in human breast cancer.In vitro,LINC01088 in-hibited the proliferation,migration,and invasion of breast cancer cells.This effect may be attributed to its role in sup-pressing the PI3K-AKT pathway and epithelial-mesenchymal transition.

Objective:To compare the safety,short-term and long-term efficacy of laparoscopic radical antero-grade modular pancreatic-splenic resection(L-RAMPS)and open radical anterograde modular pancreatic-splenic resec-tion(RAMPS)in the treatment of distal pancreatic cancer,providing clinical evidence for the development of minimally in-vasive surgery for distal pancreatic cancer.Methods:Clinical and follow-up data of patients with distal pancreatic can-cer who underwent surgical treatment at Department of Liver Transplantation and Hepatobiliary Surgery,Shandong Pro-vincial Hospital Affiliated to Shandong First Medical University,between January 2019 and October 2021 were retro-spectively collected.Patients were divided into a L-RAMPS group(n=70)and a RAMPS group(n=36)based on the sur-gical approach.Propensity score matching(PSM)was applied in a 1:1 ratio to compare short-term and long-term out-comes between the two groups.Results:After PSM,L-RAMPS group has the advantage of less estimated blood loss(50 mL vs 180 mL,P=0.002)and a shorter postoperative length of stay(6 d vs 8 d,P<0.001).No statistically significant differences were observed in long-term survival and postoperative complication rates between these two groups(P>0.05).Univariate and multivariate analyses identified preoperative serum CA19-9 levels,peritumoral tissue infiltration,perineural invasion,and lymph node metastasis as independent risk factors for early postoperative tumor recurrence.Conclusion:This study has demonstrated that L-RAMPS for patients with distal pancreatic cancer has the advantage of less estimated blood loss and a shorter postoperative length of stay.The short-term and long-term efficacy of L-RAMPS is comparable to that of RAMPS.L-RAMPS is a safe and effective surgical method for patients with distal pan-creatic cancer.

Objective:To analyze the expression of serum lysyl oxidase like protein 4(LOXL4)and protein tyrosine phosphatase non receptor type 3(PTPN3)in patients with colorectal cancer and their relationship with postoperative liver metastasis.Methods:Totally 137 patients with colorectal cancer who visited Qingdao Central Hospital,University of Health and Rehabilitation Science from April 2017 to December 2019 were recruited as the cancer group.Complying with whether liver metastasis occurred during the follow-up period of 5 years,the patients were classified into the liver metastasis group(27 cases)and the non liver metastasis group(110 cases).Another 137 healthy individuals who underwent physical check ups were recruited as the control group.The qRT-PCR method was used to detect the ex-pression levels of serum LOXL4 and PTPN3 mRNAs.The serum LOXL4 and PTPN3 mRNAs were compared under dif-ferent clinical pathological data,and the pathological data of liver metastasis group and non liver metastasis group were compared.Cox regression analysis was used to explore the influencing factors of postoperative liver metastasis in pa-tients with colorectal cancer.ROC curve was used to explore the predictive value of serum LOXL4 and PTPN3 for postoperative liver metastasis in patients with colorectal cancer.Results:Compared with the control group,the can-cer group had higher levels of serum LOXL4 and PTPN3 mRNAs expression(P<0.05).Compared with patients with medium to high differentiation,infiltration depth≤1/2 muscle layer,and TNM stage I-II,patients with low differentia-tion,infiltration depth>1/2 muscle layer,and TNM stage III had higher levels of serum LOXL4 and PTPN3 mRNAs ex-pression(P<0.05).Compared with the non liver metastasis group,the liver metastasis group had higher levels of se-rum LOXL4 and PTPN3 mRNAs expression(P<0.05).High expression of serum LOXL4 and PTPN3 mRNAs were risk factors for liver metastasis after colorectal cancer surgery(P<0.05).Compared with the single prediction of serum LOXL4 and PTPN3 mRNAs,the AUC of serum LOXL4 combined with PTPN3 in predicting postoperative liver metasta-sis in colorectal cancer patients was higher(P<0.05).Conclusion:Serum LOXL4 and PTPN3 mRNAs expression lev-els are abnormally elevated in patients with colorectal cancer,which is related to the deterioration of pathological data such as differentiation degree,infiltration depth,and TNM staging.Elevated serum LOXL4 and PTPN3 mRNAs expres-sion levels may increase the risk of postoperative liver metastasis in patients,and the combination has higher predic-tive value for postoperative liver metastasis.

Objective:To identify risk factors for mortality in patients with cirrhosis and portal hypertension compli-cated by esophagogastric variceal bleeding(EVB)after transjugular intrahepatic portosystemic shunt(TIPS),and to estab-lish a prediction model.Methods:Clinical data of 80 patients who underwent TIPS from March 2022 to March 2024 were retrospectively analyzed.Based on 28-day outcomes,patients were divided into survival(n=65)and death(n=15)groups.Univariate and multivariate logistic regression analyses were used to determine independent predictors,and the model's calibration and discrimination were assessed by the Hosmer-Lemeshow test and ROC curve.Results:Inde-pendent risk factors for death included Child-pugh score(OR=2.653),MELD score(OR=1.924),bleeding volume(OR=1.754),portal vein thrombosis(OR=3.247),and hepatic encephalopathy(OR=2.834).The model demonstrated good cali-bration(Hosmer-Lemeshow χ2=7.142,P=0.521)and discrimination,with an AUC of 0.873(95%CI:0.773-0.939),sensi-tivity of 83.3%,and specificity of 87.7%.Conclusion:Child-pugh score,MELD score,bleeding volume,portal vein thrombosis,and hepatic encephalopathy are independent predictors of post-TIPS mortality in cirrhotic patients with EVB.Emergency TIPS carries higher mortality risk than elective TIPS.The proposed model shows strong predictive perfor-mance and may aid in individualized prognosis assessment and therapeutic decision-making.