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 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: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 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 predictive ability of Glypican-3 (GPC3) positive hepatocellular carcinoma based on the hepatobiliary specific contrast agent gadoxetate disodium enhancement of the liver imaging reporting and data system version 2018 (LI-RADS v2018) imaging features, and to assess the relevant clinical imaging features for postoperative recurrence in GPC3 positive HCC patients.Methods:This study was a cohort study. A total of 122 hepatocellular carcinoma patients who underwent gadoxetate disodium enhanced MRI examination with hepatic tumor resection in Henan Provincial People′s Hospital from January 2017 to December 2021 were retrospectively collected, including 96 GPC3 positive and 26 GPC3 negative patients. The imaging features defined by LI-RADS v2018 of HCC lesions were analyzed. Patients were followed up for 40 months to determine recurrence free survival (RFS). The logistic regression was used to analyze the risk factors of GPC3 positivity. An imaging model, and a clinical-imaging model which combined the patient′s alpha-fetoprotein levels were constructed. The efficacy of the model for predicting GPC3 positivity was assessed using receiver operating characteristic curves. Kaplan-Meier method was used to draw the survival curve, and the log-rank test was used to compare the RFS between GPC3 positive and negative patients. Risk factors affecting the recurrence of GPC3 positive HCC were assessed by Cox regression.Results:The results of logistic multivariate regression analysis confirmed that rim enhancement ( OR=5.685, 95% CI 1.229-26.287, P=0.026) and irregular tumor margin at hepatobiliary phase ( OR=4.431, 95% CI 1.684-11.663, P=0.003) were independent risk factors for GPC3 positive HCC. The area under the curve for predicting GPC3 positivity was 0.745 (95% CI 0.636-0.854) for the imaging model and 0.776 (95% CI 0.677-0.876) for the clinical-imaging model. The mean RFS in the GPC3 positive group was 22 months, and it was 32 months in the negative group. There was a statistically significant difference in RFS between the two groups ( χ2=5.15, P=0.023). The multivariate Cox regression analysis showed that the arterial rim enhancement ( HR=5.460, 95% CI 1.966-15.162, P=0.001), microvascular invasion ( HR=2.402, 95% CI 1.210-4.769, P=0.012), portal vein tumor thrombus ( HR=3.226, 95% CI 1.114-9.344, P=0.031) were independent risk factors for recurrence after hepatic tumor resection for GPC3-positive HCC. Conclusions:A model based on the LI-RADS v2018 imaging features of hepatobiliary specific contrast agent gadoxetate disodium enhancement can effectively predict GPC3 positive HCC. The arterial rim enhancement, microvascular invasion and portal vein tumor thrombus are independent risk factors for postoperative recurrence of GPC3 positive HCC.

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.

Objective:To evaluate superior mesenteric artery preferential approach in the borderline resectable pancreatic head cancer.Methods:The clinical and follow-up data of 90 patients with borderline resectable pancreatic head cancer who underwent radical pancreatoduodenectomy at Beijing Chaoyang Hospital,Capital Medical University from Jan 2015 to Dec 2021 were analyzed.Results:After exploring the superior mesenteric artery in the lower colon area to confirm the vascular invasion meet the resection criteria, the blood supply is cut off first, then the tumors were resected en bloc, with the invaded vessels resected and reconstructed or replaced. All 90 patients successfully completed the operation without perioperative death. Pathology established pancreatic ductal adenocarcinoma. The 1-year, 2-year, and 3-year disease-free survival rates of patients in the arterial priority approach group were 68.2%, 60.4%, and 54.3%, while the 1-year, 2-year, and 3-year disease-free survival rates of patients by conventional approach were 58.4%, 26.4%, and 11.7% ( P=0.001). Conclusion:The superior mesenteric artery preferential approach in the inferior colon region can prolong the survival time of patients after surgery, and reduce the recurrence.