Background: and Purpose Ruptured intracranial aneurysms (RIA) are associated with a mortality rate of up to 40% in the Chinese population, highlighting the critical need for targeted treatment interventions for at-risk individuals. Although the impact of aldehyde dehydrogenase 2 (ALDH2) gene mutations on susceptibility to intracranial aneurysms (IA) is well documented, the potential connection between ALDH2 rs671 single-nucleotide polymorphism (SNP) and RIA remains unexplored. Given the increased prevalence of ALDH2 gene mutations among Chinese Han individuals, it is clinically relevant to investigate the link between ALDH2 rs671 SNP and IA rupture. Methods: A prospective study was conducted on 546 patients diagnosed with IA to investigate the association between ALDH2 rs671 SNP and the risk of IA rupture. Results: The ALDH2 rs671 SNP (ALDH2*2) was significantly more prevalent in patients with unruptured IA (UIA) than in those with RIA (32.56% vs. 18.58%, P=0.004). Multivariate logistic regression analysis revealed that people with the ALDH2 mutation (ALDH2*1/*2 and ALDH2*2/*2 gene type) had a significantly reduced odds ratio (OR=0.49; 95% confidence level [CI] 0.27–0.88; P=0.018) for RIAs. Age-specific subgroup analysis indicated that the ALDH2 mutation provided a stronger protective effect in individuals aged 60 years and above with IA compared to those under 60 years old (OR=0.38 vs. OR=0.52, both P<0.05). Conclusion The incidence of RIA was significantly higher in individuals with a normal ALDH2 gene (ALDH2*1/*1) than in those with an ALDH2 rs671 SNP (ALDH2*1/*2 or ALDH2*2/*2). ALDH2 rs671 SNP may serve as a protective factor against RIA in the Chinese Han population.

Background: and Purpose Ruptured intracranial aneurysms (RIA) are associated with a mortality rate of up to 40% in the Chinese population, highlighting the critical need for targeted treatment interventions for at-risk individuals. Although the impact of aldehyde dehydrogenase 2 (ALDH2) gene mutations on susceptibility to intracranial aneurysms (IA) is well documented, the potential connection between ALDH2 rs671 single-nucleotide polymorphism (SNP) and RIA remains unexplored. Given the increased prevalence of ALDH2 gene mutations among Chinese Han individuals, it is clinically relevant to investigate the link between ALDH2 rs671 SNP and IA rupture. Methods: A prospective study was conducted on 546 patients diagnosed with IA to investigate the association between ALDH2 rs671 SNP and the risk of IA rupture. Results: The ALDH2 rs671 SNP (ALDH2*2) was significantly more prevalent in patients with unruptured IA (UIA) than in those with RIA (32.56% vs. 18.58%, P=0.004). Multivariate logistic regression analysis revealed that people with the ALDH2 mutation (ALDH2*1/*2 and ALDH2*2/*2 gene type) had a significantly reduced odds ratio (OR=0.49; 95% confidence level [CI] 0.27–0.88; P=0.018) for RIAs. Age-specific subgroup analysis indicated that the ALDH2 mutation provided a stronger protective effect in individuals aged 60 years and above with IA compared to those under 60 years old (OR=0.38 vs. OR=0.52, both P<0.05). Conclusion The incidence of RIA was significantly higher in individuals with a normal ALDH2 gene (ALDH2*1/*1) than in those with an ALDH2 rs671 SNP (ALDH2*1/*2 or ALDH2*2/*2). ALDH2 rs671 SNP may serve as a protective factor against RIA in the Chinese Han population.

Background: and Purpose Ruptured intracranial aneurysms (RIA) are associated with a mortality rate of up to 40% in the Chinese population, highlighting the critical need for targeted treatment interventions for at-risk individuals. Although the impact of aldehyde dehydrogenase 2 (ALDH2) gene mutations on susceptibility to intracranial aneurysms (IA) is well documented, the potential connection between ALDH2 rs671 single-nucleotide polymorphism (SNP) and RIA remains unexplored. Given the increased prevalence of ALDH2 gene mutations among Chinese Han individuals, it is clinically relevant to investigate the link between ALDH2 rs671 SNP and IA rupture. Methods: A prospective study was conducted on 546 patients diagnosed with IA to investigate the association between ALDH2 rs671 SNP and the risk of IA rupture. Results: The ALDH2 rs671 SNP (ALDH2*2) was significantly more prevalent in patients with unruptured IA (UIA) than in those with RIA (32.56% vs. 18.58%, P=0.004). Multivariate logistic regression analysis revealed that people with the ALDH2 mutation (ALDH2*1/*2 and ALDH2*2/*2 gene type) had a significantly reduced odds ratio (OR=0.49; 95% confidence level [CI] 0.27–0.88; P=0.018) for RIAs. Age-specific subgroup analysis indicated that the ALDH2 mutation provided a stronger protective effect in individuals aged 60 years and above with IA compared to those under 60 years old (OR=0.38 vs. OR=0.52, both P<0.05). Conclusion The incidence of RIA was significantly higher in individuals with a normal ALDH2 gene (ALDH2*1/*1) than in those with an ALDH2 rs671 SNP (ALDH2*1/*2 or ALDH2*2/*2). ALDH2 rs671 SNP may serve as a protective factor against RIA in the Chinese Han population.

Objective:To explore the influencing factors of early death (within 3 months) in adult glioma patients, and to construct a risk prediction model.Methods:Retrospective analysis was performed on the clinical data of 228 adult glioma patients admitted to the 909th Hospital (Dongnan Hospital of Xiamen University) from June 2020 to June 2024. Patients were divided into a death group ( n=32) and a survival group ( n=196) based on whether death occurred within 3 months, and the clinical data between the two groups were compared. Multivariate logistic regression was used to analyze the influencing factors of death within 3 months, a logistic regression prediction model was constructed, and receiver operator characteristic (ROC) curve was plotted to analyze the predictive value of the model. Results:There were no statistically significant differences between the two groups in age, gender, hypertension, diabetes, tumor location, tumor involvement, neurological impairment, maximum tumor diameter, chemotherapy, or radiotherapy (all P>0.05). The death group showed higher proportions of cerebral herniation ( χ2=20.74, P<0.001), hospital admission Karnofsky performance status (KPS) score ≤70 ( χ2=26.66, P<0.001), tumor grade Ⅲ-Ⅳ ( χ2=28.70, P<0.001), MGMT promoter unmethylation ( χ2=10.25, P=0.001), IDH wild-type ( χ2=6.18, P=0.013), and incomplete tumor resection ( χ2=10.37, P=0.001) compared with the survival group. Multivariate analysis revealed that cerebral herniation ( OR=19.78, 95% CI: 5.33-73.41, P<0.001), hospital admission KPS score ≤70 ( OR=19.64, 95% CI: 5.54-69.59, P<0.001), tumor grade Ⅲ-Ⅳ ( OR=9.40, 95% CI: 3.02-29.27, P<0.001), MGMT promoter unmethylation ( OR=4.28, 95% CI: 1.18-15.54, P=0.027), and incomplete tumor resection ( OR=9.50, 95% CI: 2.72-33.23, P<0.001) were independent risk factors for early death in glioma patients. The risk prediction model for early death in glioma patients constructed based on these indicators was logit ( P) =-18.04+2.96×cerebral herniation (with=1, without=0) +2.98×hospital admission KPS score (≤70=1, >70=0) +2.24×tumor grade (Ⅲ-Ⅳ=1, Ⅰ-Ⅱ=0) +1.45×MGMT promoter methylation (no=1, yes=0) +2.25×complete tumor resection (no=1, yes=0). ROC curve analysis demonstrated that this model had predictive value for early death in glioma patients, with an area under the curve of 0.920 (95% CI: 0.868-0.972), a sensitivity of 0.842, and a specificity of 0.906. Conclusions:Cerebral herniation, hospital admission KPS score ≤70, tumor grade Ⅲ-Ⅳ, MGMT promoter unmethylation, and incomplete tumor resection are independent risk factors for early death in adult glioma patients. The risk prediction model constructed based on these indicators has good predictive value.

Objective:To investigate the effect of cancer nodules on postoperative liver metastasis in patients undergoing radical resection of colorectal cancer.Methods:The clinicopathological data of 196 patients undergoing radical operation for colorectal cancer admitted to the Dongnan Hospital of Xiamen University from January 2019 to June 2020 were retrospectively analyzed. According to the pathological results, they were divided into cancer nodule group and non-cancer nodule group. Time and the number of liver metastasis during the follow-up period were analyzed. The relationship between cancer nodules and clinicopathological features was analyzed, and the influencing factors of postoperative liver metastasis in patients with colorectal cancer were analyzed by univariate and logistic multivaiate analysis. The receiver operator characteristic (ROC) curve was drawn to analyze the predictive effect of cancer nodule diameter on postoperative liver metastasis of colorectal cancer.Results:There were 50 patients accompanied by cancer nodules in 196 patients with colorectal cancer, the incidence rate was 25.5%, the diameter of cancer nodules was 0.4-1.8 cm, the median diameter was 1.0 cm, and there were 46 patients with liver metastasis, the incidence rate was 23.5%. There were statistically significant differences in carbohydrate antigen CA19-9 ( χ2=7.55, P=0.006), maximum tumor diameter ( χ2=12.23, P<0.001), T stage ( χ2=15.79, P<0.001), vascular thrombus ( χ2=12.79, P<0.001), lymph node metastasis ( χ2=16.18, P<0.001) between the cancer nodule group and the non-cancer nodule group. Univariate analysis showed that CA19-9 ( χ2=7.40, P=0.007), maximum tumor diameter ( χ2=8.23, P=0.004), T stage ( χ2=4.58, P=0.032), vascular cancer thrombus ( χ2=12.97, P<0.001), lymph node metastasis ( χ2=3.96, P=0.047), cancer nodules ( χ2=67.60, P<0.001), cancer nodule diameter ( t=4.28, P<0.001), and the number of cancer nodules ( χ2=68.77, P<0.001) were all influential factors for postoperative liver metastasis in colorectal cancer patients. Multivariate analysis showed that stage T 3-4 ( OR=4.62, 95% CI: 1.51-7.35, P=0.003), vascular cancer thrombus ( OR=5.42, 95% CI: 1.75-12.85, P<0.001), accompanied by cancer nodules ( OR=18.54, 95% CI: 7.45-39.73, P<0.001), the diameter of cancer nodules ( OR=13.20, 95% CI: 4.74-29.64, P<0.001), number of nodules [one cancer nodule ( OR=9.11, 95% CI: 2.24-27.34, P<0.001), two cancer nodules ( OR=6.36, 95% CI: 1.38-9.08, P<0.001) and three cancer nodules ( OR=5.00, 95% CI: 1.98-8.84, P<0.001) ] were independent influencing factors for postoperative liver metastasis in patients with colorectal cancer. ROC curve analysis showed that the best threshold of the diameter of cancer nodules for predicting liver metastasis was 1.1 cm [area under the curve (AUC) =0.764, 95% CI: 0.632-0.896, P=0.002). The incidence of liver metastasis in patients with cancer nodules diameter≥1.1 cm was 95.65% (22/23), higher than that in patients with cancer nodules diameter<1.1 cm (40.74%, 11/27), with a statistically significant difference ( χ2=16.69, P<0.001) . Conclusion:Patients with colorectal cancer with cancer nodules≥1.1 cm in diameter should be vigilant against postoperative liver metastasis.

OBJECTIVE: To investigate the long-term outcome of laparoscope-assisted transanal total mesorectal excision (taTME) for rectal cancer. METHODS: Clinicopathological data of 29 patients with mid-low rectal cancer undergoing laparoscope-assisted taTME at Department of Gastrointestinal Surgery, the First Affiliated Hospital of Guangzhou Medical University from May 2010 to December 2015 were collected for the retrospective case-series study. All the operations were performed with transabdominal and transanal procedure simultaneously or sequentially. Perioperative presentations, pathological examinations, and oncologic outcomes were retrospectively analyzed. Long-term recurrence, metastasis and survival were assessed during follow-up. Outpatient clinic and telephone survey were used for follow-up. The follow-up time ended in December 2018. The overall survival (OS) rate and disease-free survival (DFS) rate were calculated by the Kaplan-Meier method. RESULTS: The average intra-operative blood loss was (75.9±9.5) ml (range,20 to 200). The average operating time was (223.6±4.1) minutes (range, 165 to 280). The average number of harvested lymph node was 22.3±2.0. The average length of pathological specimen was (13.1±0.6) cm. The average distal resection margin was (2.9±0.2) cm. 89.7% (26/29) of specimens was complete and 10.3% (3/29) near complete. Two cases (6.9%) had positive cutting circumferential margin. Median follow-up was 56 (range, 22 to 91) months. Local recurrence rate, distant metastasis rate, 3-year OS rate, 3-year DFS rate, 5-year OS rate, 5-year DFS rate were 10.3% (3/29), 20.7%(6/29), 96.6%, 83.2%, 87.6% and 79.6%, respectively. No incisional hernia or adhesive intestinal obstruction was found. CONCLUSION Long-term outcomes of mid-low rectal cancer patients undergoing laparoscope-assisted taTME are satisfactory.
Humans ; Laparoscopes ; Neoplasm Recurrence, Local ; Rectal Neoplasms ; surgery ; Rectum ; Retrospective Studies ; Transanal Endoscopic Surgery

Objective:To systematic review the relationships between the expression of osteopontin (OPN) and esophageal squamous cell carcinoma and its clinicopathologic feature with meta-analyses.Methods: The published studies in the PubMed, the Cochrane Library, EMbase, CBM, CNKI, VIP and WanFang databases were searched, at the time, the documents retrospective method was adopted, and then a series researches about the relationships between the expression of OPN and esophageal squamous cell carcinoma and its clinicopathologic feature were collected. The Jan., 2017 was the deadline of search. The study arranged two researcher to screen documents as the standards of inclusion and exclusion, and extract data and evaluate the quality of methodology for these included documents. The RevMan 5.2 was applied to analyze these data in this Meta analysis.Results: A total of 12 case control studies were included, which included 782 cases of esophageal squamous cell carcinoma in case group and 700 persons in control group. The results of Meta analysis showed the OR of the expression of OPN between cases group and control group was 52.71, and its 95% confidence interval (CI) was 17.95-154.79. Besides, the OR of the expression of OPN between clinical Ⅰ-Ⅱ stage group and clinical Ⅲ-Ⅳ stage group was 0.20, and its 95% (CI) was 0.07-0.60. The OR of the expression of OPN between group with lymph node metastasis and group without lymph node metastasis was 6.37, and its CI was 3.64-11.15. The OR of the expression of OPN between T1+T2 group and T3+T4 group was 0.31, and its 95% (CI) was 0.15-0.64. The differences of the expression of OPN among various group had statistically significant.Conclusion:Current evidence indicates that the expression level of OPN is significantly correlated with esophageal squamous cell carcinoma and its clinicopathologic features. Due to the limited quantity of documents and quality of included studies, above conclusions need to be verified by conducting more high quality studies.

ObjectiveTo discuss the more aesthetic and minimally invasive surgical approach of endoscopic thyroidectomy.Methods50 cases of endoscopic thyroidectomy via breast areola-axillary approach were retrospectively analyzed.Among these cases,12 received unilateral partial lobectomy,30 received unilateral total lobectomy and 8 received bilateral partial lobectomy.Results Endoscopic thyroidectomy was completed in all the patients.The intraoperative blood loss was ( 12.77 ± 20.12 ) ml.The operation time was (67.00 ± 21.28 )min.The postoperative hospital stay was (3.77 ± 0.50)days.Hoarseness occurred in 2 cases.All the 50 cases were followed up from 1 to 6 months and no other complication occurred.ConclusionEndoscopic thyroidectomy via breast areola-axillary approach is more aesthetic and minimally invasive; however,the operator needs an adaptive process for a better surgical view angle.

Objective To assess the value of CT in the detection of spontaneous rupture of hepatocarcinoma as well as to assess CT finging of hepatocarcinoma rupture.Methods Clinical manifestation and CT findings of spontaneous rupture of hepatocarcinoma in 22 cases proved surgically and pathologically were reviewed. CT characters of variable pathological changes of ruptured hepatocarcinoma and its relationship to the rupture of hepatocarcinoma were also analyzed. The analysis involved the status of liver cirrhosis, ascites, intrahepatic locations of the tumor, extent of extrahepatic protrusion and central necrosis of the tumor.Results All ruptured tumours were located at the periphery of the liver, 12 cases had a protruding contour. The maximum diameter of tumours ranged from 2 to 16 cm. Discontinuity of the hepatic surface was seen in 16 cases,necrosis of core was seen in 12 cases. 3 cases with non-ruptured masses also showed contrast medium flow over the perihepatic border during the arterial phase. 2 cases showed a haematoma with attenuated rim inside the mass, but rupture was found during surgery. 1 case show detached broken bits drifting in mass ascites. In 5 cases, CT images during the arterial phase showed a non-enhancing low attenuating lesion with focal discontinuity and peripheral rim enhancement. Conclusion The accuracy of CT diagnosis of spontaneous rupture of hepatocarcinoma is very high. Moreover, CT is a necessary imaging modality in diagnosis of ruptured hepatocarcinoma suspected by clinical findings.

Objective To study the MRI characteristics of osteoblastoma and to discuss its diagnostic value. Methods Nine patients with osteoblastoma proved by pathology were examined with T_2WI, nonenhanced T_1WI and Gd-DTPA enhanced T_1WI MR imaging before operation MR finding were analyzed. Results Of nine patients, tumor originated from spine in five patients, from skull in three patients and from pelvis in one patient. Of these patients, benign osteoblastoma were in six patients and malignant were in three patients. On MRI, the tumor was an expanded osteolytic lesion, osteoid production formation was low or equal signal intensity on T_1WI and medial or high signal intensity on T_2WI. MRI showed low signal intensity of the calcification or ossification in osteoblastoma on T_2WI, and low or equal signal intensity on T_1WI. The ossified ring of tumor was low signal intensity on both T_1- and T_2WI. The adjacent soft tissue masses were showed on MRI. All patients given gadolinium showed enhancement within the osteoid production and the adjacent soft tissue mass, and no enhancement with ossification and calcification, cystoid and the ossified ring on MRI. The boundary of malignant osteoblastoma was obscure, and adjacent tissue could be invaded.Conclusion MR imaging can show all the characteristics of osteoblastoma well . It is of important value in diagnosis, operative orientation and staging of osteoblastoma, especially for the lesion originated from spine and skull.