Objective:To analyze the predictive value of the preoperative lymphocyte-to-monocyte ratio (LMR) for the postoperative prognosis of distal cholangiocarcinoma.Methods:Clinical data of 197 patients with distal cholangiocarcinoma undergoing radical surgery at Beijing Chaoyang Hospital Affiliated to Capital Medical University from January 2011 to December 2023 were retrospectively analyzed, including 118 males and 79 females, aged (65.1±10.2) years. Patients were randomly divided into the training set ( n=137) and the test set ( n=60) in a ratio of 7∶3. The training set is used to construct the nomogram, and the test set is used to evaluate the nomogram. Multivariate analysis of the influencing factors of long-term survival after surgery for distal cholangiocarcinoma was conducted using Lasso regression and Cox regression. And based on the results of multiple factors, a nomogram for predicting the postoperative prognosis of distal cholangiocarcinoma was constructed. The receiver operating characteristic (ROC) curve, conformance index, calibration curve and decision curve were used to analyze and evaluate the predictive efficacy of the model. Results:Lasso regression screening showed that smoking history, preoperative LMR, preoperative total bilirubin, preoperative carbohydrate antigen (CA) 19-9, intraoperative blood loss, tumor differentiation degree, T staging of tumor, portal vein system invasion, nerve invasion and lymph node metastasis were risk factors affecting the long-term survival after surgery (all P<0.05). Multivariate Cox regression analysis showed that preoperative LMR, CA19-9, T staging of tumor, portal vein system invasion and lymph node metastasis were the influencing factors for long-term survival after surgery for distal cholangiocarcinoma. Based on the above factors, a nomogram for predicting the postoperative prognosis of distal cholangiocarcinoma was constructed. The areas under the ROC curves of this nomogram for predicting 3-year postoperative survival in the training set and the test set were 0.806 (95% CI: 0.719-0.893) and 0.811 (95% CI: 0.696-0.927), respectively. The consistency indices of the training set and the test set were 0.730 (95% CI: 0.678-0.783) and 0.714 (95% CI: 0.637-0.790), respectively. The calibration curves of the model in the training set and test set shows that the model fits well in both sets. The decision curve analysis (DCA) shows that the model has good clinical predictive efficacy in both sets. When the threshold range in the training set is between 10% and 84% and in the test set is between 18% and 82%, the model can bring benefits in predicting postoperative prognosis. Conclusion:The preoperative LMR level is one of the influencing factors for the postoperative prognosis of patients after surgery for distal cholangiocarcinoma. LMR-based model can effectively predict postoperative prognosis of patients with distal cholangiocarcinoma.

Objective:The SARS-CoV-2 has a high natural mutation rate, and dynamic monitoring of virus variants remains a key focus in current COVID-19 prevention and control efforts.Methods:In this study, a sensitive and rapid method for detecting SARS-CoV-2 omicron variant nucleic acid was established based on the BMD-PCR technology.Results:This method showed good specificity, and had no cross-reactivity with 11 common viruses transmitted via the respiratory and gastrointestinal tracts, and the limit of detection is 555 copies/ml. Compared with SARS-CoV-2 whole-genome sequencing result, among 50 samples with original Ct values ≤32 tested for the Omicron variant, 49 samples tested positive for the N679K mutation site using BMD-PCR Omicron variant detection, achieving a concordance rate of 98.00%. For 30 samples JN.1 lineage, 29 samples tested positive for the K356T mutation site using BMD-PCR JN.1 lineage detection, with a concordance rate of 96.67%. For 10 samples with original SARS-CoV-2 detection Ct values between 35 and 32, 7 samples tested positive for the N679K mutation site using BMD-PCR Omicron variant detection, Resultsing in a detection rate of 70.00%. For samples with SARS-CoV-2 nucleic acid detection Ct values>35, the detection rate for the N679K mutation site in the BMD-PCR Omicron variant was 20.00%.Conclusions:This method can serve as a high-throughput supplementary approach for the preliminary identification of SARS-CoV-2 variant genotypes.

Objective:To evaluate the value of HALP index on postoperative survival of patients with distal cholangiocarcinoma.Methods:A retrospective analysis was performed on 165 patients with distal cholangiocarcinoma who underwent surgery at Beijing Chaoyang Hospital, Capital Medical University from Jan 2011 to Dec 2022. Hemoglobin, albumin, lymphocyte count, and platelet count were recorded within one week before surgery, and hemoglobin×albumin×lymphocyte count/platelet count (HALP) was calculated. The receiver operating characteristic curve was drawn to determine the optimal cutoff value for predicting postoperative survival. According to the cutoff value, the patients were divided into high HALP group and low HALP group, and the prognosis of different groups was compared. Multivariate COX regression analysis was used to construct a prediction model for variables with statistically significant differences.Results:The median overall survival (OS) for the entire cohort was 29 months, with cumulative 1-, 3-, and 5-year survival rates of 78.2%, 38.8%, and 30.4%, respectively. The low-HALP group (median OS: 22 months) had significantly inferior survival compared to the high-HALP group (median OS: 37 months), with 1-, 3-, and 5-year survival rates of 70.1%,31.4%,22.8% vs. 89.7%,45.3%,38.1% ( χ2=7.695, P=0.006). Conclusion:The HALP index calculated from the patient's preoperative indicators can be used to predict the overall survival of patients with distal cholangiocarcinoma.

Objective:To investigate the correlation between lymphocyte-monocyte ratio (LMR) and long-term prognosis after distal cholangiocarcinoma.Methods:A retrospective case-control study was conducted to analyze the clinical data of 186 patients with distal cholangiocarcinoma who underwent radical pancreaticoduodenectomy at Beijing Chaoyang Hospital Affiliated to Capital Medical University from January 2013 to December 2023. Among them, there were 109 males and 77 females, with an age of (65.4±9.4) years, ranging from 29 to 85 years. The data of preoperative peripheral blood routine examination of the patients were collected, and the patients were divided into a high LMR group(LMR>2.98, n=100) and a low LMR group(LMR≤2.98, n=86). The preoperative, intraoperative and postoperative clinical characteristics of the two groups were compared. Measurement data with normal distribution were expressed as mean±standard deviation ( ± s), and t-test was used for inter-group comparison. Measurement data with non-normal distribution were expressed as M( Q1, Q3), and Mann-Whitney U test was used for inter-group comparison. Chi-square test was used for inter-group comparison of count data. The Cox proportional hazards regression model was used for univariate and multivariate prognostic analysis, and the Kaplan-Meier estimation method was used to create survival curves to analyze and evaluate the influencing factors of long-term prognosis after distal cholangiocarcinoma surgery. Results:Univariate analysis results showed that gender, age, BMI, history of diabetes, carcinoembryonic antigen; operation duration, intraoperative blood loss; resection margin status, degree of tumor cell differentiation, and presence of postoperative complications had no statistically significant differences in their impact on the prognosis of patients after distal cholangiocarcinoma surgery( P>0.05). In contrast, LMR, neutrophilto-lymphocyte ratio, platelet-lymphocyte ratio, albumin, total bilirubin, carbohydrate antigen 199, intraoperative blood transfusion, tumor diameter, and lymph node metastasis showed statistically significant differences in their influence on the postoperative prognosis of distal cholangiocarcinoma patients( P<0.05). Multivariate analysis results indicated that LMR≤2.98( HR=1.776, 95% CI: 1.153-2.736), CA19-9>37 U/mL( HR=1.521, 95% CI: 1.025-2.259), and lymph node metastasis( HR=1.601, 95% CI: 1.106-2.318) were independent risk factors affecting patient prognosis( P<0.05). The 1-, 3-, and 5-year cumulative survival rates in the high LMR group were 91%, 40%, and 20% respectively, while those in the low LMR group were 58.1%, 15.1%, and 8.1% respectively, with a statistically significant difference( P<0.05). Conclusion:Preoperative LMR for distal cholangiocarcinoma can suggest a long-term prognosis, and a low LMR value suggests a poor prognosis.

Objective:To analyze the predictive value of the preoperative lymphocyte-to-monocyte ratio (LMR) for the postoperative prognosis of distal cholangiocarcinoma.Methods:Clinical data of 197 patients with distal cholangiocarcinoma undergoing radical surgery at Beijing Chaoyang Hospital Affiliated to Capital Medical University from January 2011 to December 2023 were retrospectively analyzed, including 118 males and 79 females, aged (65.1±10.2) years. Patients were randomly divided into the training set ( n=137) and the test set ( n=60) in a ratio of 7∶3. The training set is used to construct the nomogram, and the test set is used to evaluate the nomogram. Multivariate analysis of the influencing factors of long-term survival after surgery for distal cholangiocarcinoma was conducted using Lasso regression and Cox regression. And based on the results of multiple factors, a nomogram for predicting the postoperative prognosis of distal cholangiocarcinoma was constructed. The receiver operating characteristic (ROC) curve, conformance index, calibration curve and decision curve were used to analyze and evaluate the predictive efficacy of the model. Results:Lasso regression screening showed that smoking history, preoperative LMR, preoperative total bilirubin, preoperative carbohydrate antigen (CA) 19-9, intraoperative blood loss, tumor differentiation degree, T staging of tumor, portal vein system invasion, nerve invasion and lymph node metastasis were risk factors affecting the long-term survival after surgery (all P<0.05). Multivariate Cox regression analysis showed that preoperative LMR, CA19-9, T staging of tumor, portal vein system invasion and lymph node metastasis were the influencing factors for long-term survival after surgery for distal cholangiocarcinoma. Based on the above factors, a nomogram for predicting the postoperative prognosis of distal cholangiocarcinoma was constructed. The areas under the ROC curves of this nomogram for predicting 3-year postoperative survival in the training set and the test set were 0.806 (95% CI: 0.719-0.893) and 0.811 (95% CI: 0.696-0.927), respectively. The consistency indices of the training set and the test set were 0.730 (95% CI: 0.678-0.783) and 0.714 (95% CI: 0.637-0.790), respectively. The calibration curves of the model in the training set and test set shows that the model fits well in both sets. The decision curve analysis (DCA) shows that the model has good clinical predictive efficacy in both sets. When the threshold range in the training set is between 10% and 84% and in the test set is between 18% and 82%, the model can bring benefits in predicting postoperative prognosis. Conclusion:The preoperative LMR level is one of the influencing factors for the postoperative prognosis of patients after surgery for distal cholangiocarcinoma. LMR-based model can effectively predict postoperative prognosis of patients with distal cholangiocarcinoma.

Objective:The SARS-CoV-2 has a high natural mutation rate, and dynamic monitoring of virus variants remains a key focus in current COVID-19 prevention and control efforts.Methods:In this study, a sensitive and rapid method for detecting SARS-CoV-2 omicron variant nucleic acid was established based on the BMD-PCR technology.Results:This method showed good specificity, and had no cross-reactivity with 11 common viruses transmitted via the respiratory and gastrointestinal tracts, and the limit of detection is 555 copies/ml. Compared with SARS-CoV-2 whole-genome sequencing result, among 50 samples with original Ct values ≤32 tested for the Omicron variant, 49 samples tested positive for the N679K mutation site using BMD-PCR Omicron variant detection, achieving a concordance rate of 98.00%. For 30 samples JN.1 lineage, 29 samples tested positive for the K356T mutation site using BMD-PCR JN.1 lineage detection, with a concordance rate of 96.67%. For 10 samples with original SARS-CoV-2 detection Ct values between 35 and 32, 7 samples tested positive for the N679K mutation site using BMD-PCR Omicron variant detection, Resultsing in a detection rate of 70.00%. For samples with SARS-CoV-2 nucleic acid detection Ct values>35, the detection rate for the N679K mutation site in the BMD-PCR Omicron variant was 20.00%.Conclusions:This method can serve as a high-throughput supplementary approach for the preliminary identification of SARS-CoV-2 variant genotypes.

Objective:To evaluate the value of HALP index on postoperative survival of patients with distal cholangiocarcinoma.Methods:A retrospective analysis was performed on 165 patients with distal cholangiocarcinoma who underwent surgery at Beijing Chaoyang Hospital, Capital Medical University from Jan 2011 to Dec 2022. Hemoglobin, albumin, lymphocyte count, and platelet count were recorded within one week before surgery, and hemoglobin×albumin×lymphocyte count/platelet count (HALP) was calculated. The receiver operating characteristic curve was drawn to determine the optimal cutoff value for predicting postoperative survival. According to the cutoff value, the patients were divided into high HALP group and low HALP group, and the prognosis of different groups was compared. Multivariate COX regression analysis was used to construct a prediction model for variables with statistically significant differences.Results:The median overall survival (OS) for the entire cohort was 29 months, with cumulative 1-, 3-, and 5-year survival rates of 78.2%, 38.8%, and 30.4%, respectively. The low-HALP group (median OS: 22 months) had significantly inferior survival compared to the high-HALP group (median OS: 37 months), with 1-, 3-, and 5-year survival rates of 70.1%,31.4%,22.8% vs. 89.7%,45.3%,38.1% ( χ2=7.695, P=0.006). Conclusion:The HALP index calculated from the patient's preoperative indicators can be used to predict the overall survival of patients with distal cholangiocarcinoma.

Objective:To investigate the effect of cholesterol-modified prognostic nutritional index (cPNI) on postoperative long-term prognosis of the borderline resectable pancreatic cancer (BRPC).Methods:Clinical data of 173 patients with BRPC admitted to the Department of Hepatobiliary and Pancreaticosplenic Surgery, Beijing Chaoyang Hospital, Capital Medical University from January 2011 to September 2023 were retrospectively analyzed, including 90 males and 83 females, aged (61.7±9.8) years. The receiver operating curve (ROC) of preoperative cPNI predicting 1-year postoperative survival was drawn and the optimal cut-off value in predicting 1-year survival was 77.36. Patients were divided into low cPNI ( n=83, cPNI≤77.36) and high cPNI group ( n=90, cPNI>77.36). Kaplan-Meier method was used for survival analysis, log-rank test was used for univariate analysis, and Cox proportion hazard model was used for multivariate analysis to reveal the effect of cPNI on postoperative long-term survival in patients with BRPC. Results:The cumulative survival rates at 1, 2 and 3 years after surgery in low cPNI group and high cPNI group were 70.6%, 40.3%, 21.8%, and 48.3%, 21.5%, 9.5%, respectively ( χ2=8.49, P=0.004). Univariate analysis showed that preoperative cPNI, length of portal vein invasion, tumor differentiation degree, tumor TNM stage, tumor diameter, lymph node metastasis, and postoperative chemotherapy were correlated with long-term survival of BRPC patients (all P<0.05). Multivariate analysis showed that BRPC patients with preoperative cPNI >77.36 ( HR=1.452, 95% CI: 1.026-2.053, P=0.035) had a increased risk of postoperative death, while patients with length of portal venous invasion >3.0 cm, poorer tumor differentiation, lymph node metastasis and no postoperative chemotherapy had an increased risk of postoperative death. Conclusion:Preoperative cPNI >77.36 is a risk factor for long-term survival in BRPC patients.

Objective:To explore the composition of oral microbiome in patients of long-term survival after liver transplantation, and compare the diversity and distribution of oral microbiome in liver transplant patients with or without liver cancer.Methods:This is a cross-sectional study. Clinical data of 20 patients of long-term survival after liver transplantation from Beijing Chaoyang Hospital Affiliated to Capital Medical University from July 2023 to October 2023 were continuously collected, including 13 males and 7 females, aged 55 (48, 60) years. There were eight patients with hepatocellular carcinoma (HCC) undergoing liver transplantation and 12 non-HCC liver transplant patients. Oral microbiome was analyzed by 16S rDNA gene sequencing, and the diversity analysis and LEfSe analysis were performed.Results:The top ten groups of bacteria in the HCC and non-HCC liver transplant patients were both Bacteroidota, Firmicutes, Proteobacteria, Actinobacteria, Fusobacteriota, Patescibacteria, Campylobacterota, Cyanobacteria, spirochaetota, and Aenigmarchaeota. The top ten genus levels of bacteria in the HCC and non-HCC liver transplant patients were both Haemophilus, Porphyromonas, Gemella, Fusobacterium, Actinomyces, Prevotella, Rothia, Streptococcus, Neisseria. By LEfSe analysis, we found the enrichment of Flavobacteriales, Flavobacteriaceae, Capnocytophaga, Mogibacterium_timidum, Capnocytophaga_leadbetteri, Campylobacter_showae in the HCC group, while the enrichment of Veillonella_atypica, Prevotella_histicola in the non-HCC group.Conclusion:The main microbiome was similar between HCC and non-HCC liver transplant patients, but there were also some differences in microbiome communities.

Portal vein thrombosis is one of the common complications of liver cirrhosis. The incidence of portal vein thrombosis is increased with the progression of diseases. The incidence and progression of portal vein thrombosis are associated with multiple factors. The indications of anticoagulant therapy remain to be investigated. At present, portal vein thrombosis is no longer considered as a contraindication for liver transplantation. Nevertheless, complicated portal vein thrombosis will increase perioperative risk of liver transplantation. How to restore the blood flow of portal vein system is a challenge for surgical decision-making in clinical practice. Rational preoperative typing, surgical planning and portal vein reconstruction are the keys to ensure favorable long-term prognosis of liver transplant recipients. In this article, epidemiological status, risk factors, typing and identification of portal vein thrombosis, preoperative and intraoperative management of portal vein thrombosis in liver transplantation, and the impact of portal vein thrombosis on the outcomes of liver transplantation were reviewed, aiming to provide reference for perioperative management of portal vein thrombosis throughout liver transplantation.