Background: The coronavirus disease 2019 (COVID-19) pandemic disrupted healthcare and worsened quality of life (QOL). Advanced esophageal cancer is often accompanied by malnutrition and poor QOL; chemoradiotherapy (CRT) remains the mainstay of treatment.We evaluated nutrition and QOL pre- and post-CRT immediately before and during the pandemic. Methods: Patients with esophageal cancer who underwent neoadjuvant or definitive CRT between April 2019 and December 2020 were enrolled. Disease severity, treatment timing, and outcomes were compared for cohorts treated pre-COVID-19 and during COVID-19. Nutritional status was measured with the Patient-Generated Subjective Global Assessment (PG-SGA). QOL was measured with the Mandarin Chinese version of the European Organization for Research and Treatment of Cancer core questionnaire (EORTC QLQ-C30) and the esophageal site-specific module (QLQ-OES18). In the pandemic cohort, pre-/post-CRT paired analyses were performed. Results: Eighty-four patients were enrolled. The median diagnosis to treatment interval lengthened during COVID-19 (17.8 days vs. 24.2 days, p=0.04). Among the patients treated during the COVID-19 pandemic, nutritional status improved significantly following CRT (p=0.003). In the EORTC QLQ-C30, post-CRT scores for global health status (p<0.01) and emotional functioning (p<0.01) showed significant improvement. Additionally, symptom scores, including fatigue (p=0.02) and nausea and vomiting (p=0.02), decreased. However, financial difficulties worsened after CRT (p=0.02). In the EORTC QLQ-OES18, post-CRT symptom scores for eating (p<0.01), reflux (p=0.03), and pain (p<0.01) showed significant improvement. Conclusion Despite COVID-19-related delays, CRT enhanced nutrition, global health, and symptom control in esophageal cancer, although financial burdens increased. Integrating socioeconomic support with oncologic care is vital during health crises.

Objective:To compare the perioperative outcomes of laparoscopic duodenal-preserving pancreatic head resection(LDPPHR) with laparoscopic pancreaticoduodenectomy(LPD) in the treatment of borderline and benign diseases of the pancreatic head.Methods:This is a retrospective cohort study. Perioperative data from 87 patients with non-malignant pancreatic head diseases who underwent LDPPHR or LPD were retrospectively collected in the Department of Biliary-Pancreatic Surgery,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology from January 2020 to December 2022. There were 49 male and 38 female patients with an age ( M(IQR)) of 57.0(16.5) years (range: 20 to 75 years). Forty patients underwent LDPPHR and 47 patients underwent LPD. Quantitative data following a normal distribution were compared using Student′s t-test, while quantitative data not following a normal distribution were compared using the Mann-Whitney U test. Comparisons of categorical or ordinal variables were made using χ2 test or Fisher′s exact test. Logistic regression analysis was used to estimate the risk factors associated with the rate of complications. Results:There were no statistically significant differences between the LDPPHR group and the LPD group in terms of reoperation rate,total hospital stay duration,postoperative hospital stay duration,90-day mortality rate,30-day and 90-day readmission rates,and 2-year tumor recurrence rate (all P>0.05). The complication rate was higher in the LDPPHR group compared to the LPD group (80.0%(32/40) vs. 51.1%(24/47), χ2=7.89, P=0.005),but there was no difference in the rate of Clavien-Dindo classification of surgical complications ≥Ⅲ between the two groups (10.0%(4/40) vs. 12.8%(6/47), χ2<0.01, P=0.947). Additionally,the rate of delayed gastric emptying (DGE) was higher in the LDPPHR group compared to the LPD group ( χ2=10.79, P=0.001),but there was no statistically significant difference in the rate of B,C grade DGE between the two groups ( χ2=0.48, P=0.487). There were no statistically significant differences in the rates of postoperative pancreatic fistula,bile leakage,post-pancreatectomy hemorrhage,intra-abdominal infection,and pulmonary infection between the two groups (all P>0.05). The results of the univariate logistic regression analysis showed that LDPPHR (compared to LPD, OR=3.83, 95% CI: 1.46 to 10.04, Z=2.73, P=0.006) and preoperative biliary stent placement (compared to non-use of biliary stent, OR=5.30, 95% CI: 1.13 to 25.00, Z=2.11, P=0.035) were risk factors for the complication rate,but neither was an independent risk factor for complication rate (all P>0.05). Conclusion:The preliminary results suggest that LDPPHR can achieve perioperative safety and effectiveness comparable to LPD.

Objective:To compare the perioperative outcomes of laparoscopic duodenal-preserving pancreatic head resection(LDPPHR) with laparoscopic pancreaticoduodenectomy(LPD) in the treatment of borderline and benign diseases of the pancreatic head.Methods:This is a retrospective cohort study. Perioperative data from 87 patients with non-malignant pancreatic head diseases who underwent LDPPHR or LPD were retrospectively collected in the Department of Biliary-Pancreatic Surgery,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology from January 2020 to December 2022. There were 49 male and 38 female patients with an age ( M(IQR)) of 57.0(16.5) years (range: 20 to 75 years). Forty patients underwent LDPPHR and 47 patients underwent LPD. Quantitative data following a normal distribution were compared using Student′s t-test, while quantitative data not following a normal distribution were compared using the Mann-Whitney U test. Comparisons of categorical or ordinal variables were made using χ2 test or Fisher′s exact test. Logistic regression analysis was used to estimate the risk factors associated with the rate of complications. Results:There were no statistically significant differences between the LDPPHR group and the LPD group in terms of reoperation rate,total hospital stay duration,postoperative hospital stay duration,90-day mortality rate,30-day and 90-day readmission rates,and 2-year tumor recurrence rate (all P>0.05). The complication rate was higher in the LDPPHR group compared to the LPD group (80.0%(32/40) vs. 51.1%(24/47), χ2=7.89, P=0.005),but there was no difference in the rate of Clavien-Dindo classification of surgical complications ≥Ⅲ between the two groups (10.0%(4/40) vs. 12.8%(6/47), χ2<0.01, P=0.947). Additionally,the rate of delayed gastric emptying (DGE) was higher in the LDPPHR group compared to the LPD group ( χ2=10.79, P=0.001),but there was no statistically significant difference in the rate of B,C grade DGE between the two groups ( χ2=0.48, P=0.487). There were no statistically significant differences in the rates of postoperative pancreatic fistula,bile leakage,post-pancreatectomy hemorrhage,intra-abdominal infection,and pulmonary infection between the two groups (all P>0.05). The results of the univariate logistic regression analysis showed that LDPPHR (compared to LPD, OR=3.83, 95% CI: 1.46 to 10.04, Z=2.73, P=0.006) and preoperative biliary stent placement (compared to non-use of biliary stent, OR=5.30, 95% CI: 1.13 to 25.00, Z=2.11, P=0.035) were risk factors for the complication rate,but neither was an independent risk factor for complication rate (all P>0.05). Conclusion:The preliminary results suggest that LDPPHR can achieve perioperative safety and effectiveness comparable to LPD.

Acute cholecystitis and several gallbladder stone-related conditions, such as impacted common bile duct stones, cholangitis, and biliary pancreatitis, are common medical conditions in daily practice. An early cholecystectomy or drainage procedure with delayed cholecystectomy is the current standard of treatment based on published clinical guidelines. Cirrhosis is not only a condition of chronically impaired hepatic function but also has systemic effects in patients. In cirrhotic individuals, several predisposing factors, including changes in the bile acid composition, increased nucleation of bile, and decreased motility of the gallbladder, contribute to the formation of biliary stones and the possibility of symptomatic cholelithiasis, which is an indication for surgical treatment. In addition to these predisposing factors for cholelithiasis, systemic effects and local anatomic consequences related to cirrhosis lead to anesthesiologic risks and perioperative complications in cirrhotic patients. Therefore, the treatment of the aforementioned biliary conditions in cirrhotic patients has become a challenging issue. In this review, we focus on cholecystectomy for cirrhotic patients and summarize the surgical indications, risk stratification, surgical procedures, and surgical outcomes specific to cirrhotic patients with symptomatic cholelithiasis.

Acute cholecystitis and several gallbladder stone-related conditions, such as impacted common bile duct stones, cholangitis, and biliary pancreatitis, are common medical conditions in daily practice. An early cholecystectomy or drainage procedure with delayed cholecystectomy is the current standard of treatment based on published clinical guidelines. Cirrhosis is not only a condition of chronically impaired hepatic function but also has systemic effects in patients. In cirrhotic individuals, several predisposing factors, including changes in the bile acid composition, increased nucleation of bile, and decreased motility of the gallbladder, contribute to the formation of biliary stones and the possibility of symptomatic cholelithiasis, which is an indication for surgical treatment. In addition to these predisposing factors for cholelithiasis, systemic effects and local anatomic consequences related to cirrhosis lead to anesthesiologic risks and perioperative complications in cirrhotic patients. Therefore, the treatment of the aforementioned biliary conditions in cirrhotic patients has become a challenging issue. In this review, we focus on cholecystectomy for cirrhotic patients and summarize the surgical indications, risk stratification, surgical procedures, and surgical outcomes specific to cirrhotic patients with symptomatic cholelithiasis.

OBJECTIVE: To investigate the effect of miR-133b on cardiomyocyte apoptosis induced by myocardial ischemia-reperfusion (I/R) and explore the mechanism. METHODS: Thirty-six adult SD rats were randomized into sham-operated group, I/R group, AdmiR-NC group and AdmiR-133b group, and rat models of myocardial I/R were established in the latter 3 groups with myocardial injections of saline or recombinant adenoviruses in the left ventricle. The expression of MiR-133b was detected using RT-qPCR, and cardiac function of the rats was determined using FDP 1 HRV and BRS analysis system. Serum CK-MB and cTnI levels were determined by ELISA, myocardial injury was evaluated with HE staining, cardiomocyte apoptosis was detected by flow cytometry, and ROS content was determined using a DCFH-DA probe. In the in vitro experiment, H9C2 myocardial cells with hypoxia/reoxygenation (H/R) treatment were transfected with Mir-NC or MiR-133b mimic, and the cellular expression of MiR-133b, cell apoptosis, and ROS content were determined. Dual luciferase reporter assay was performed to verify the targeting relationship between miR-133b and YES1. The effects of pc-YES1 or miR-133b mimic transfection on YES1 expression, apoptosis, and ROS content in H9C2 cells were evaluated. RESULTS: Compared with those in I/R group, miR-133b expression was obviously up-regulated, LVEDP, cTnI and CK-MB levels were significantly decreased, and LVSP, +dp/dt, -dp/dt, HR and CF levels were increased in admiR-133b group ( CONCLUSIONS miR-133b can inhibit I/R-induced myocardial cell apoptosis and ROS accumulation by targeting YES1 to reduce myocardial I/R injury in rats.
Animals ; Apoptosis ; MicroRNAs/genetics* ; Myocardial Reperfusion Injury ; Myocytes, Cardiac ; Rats ; Rats, Sprague-Dawley ; Reactive Oxygen Species

Objective To investigate the relationship between negative acute phase proteins and chronic urticaria (CU).Methods Fifty patients with CU were enrolled into this study,and divided into three grades,i.e.,mild (grade 1),moderate (grade 2) and severe (grade 3) according to symptoms.Twenty-eight health checkup examinees served as the control group.Immunoturbidimetry was performed to determine serum levels of prealbumin (PA) and transferrin (TRF).Enzyme-linked immunosorbent assay was conducted to measure serum levels of insulinlike growth factor-1 (IGF-1) and tumor necrosis factor-α (TNF-α).Statistical analysis was carried out to assess differences in these indices between these two groups,the relationship among these indices and between these indices and disease severity.Results Compared with the control group,the patients with CU showed reduced serum levels of PA ((229.99 ± 54.16) vs.(272.06 ± 36.42) mg/L,t =3.667,P ＜ 0.05) and IGF-1 ((177.23 ± 46.48) vs.(239.88 ± 45.16) μg/L,t =5.748,P＜ 0.05),but higher serum levels of TNF-α ((25.39 ± 11.01) vs.(14.13 ± 6.12) ng/L,t =4.989,P＜ 0.05),and similar serum levels of TRF ((2.48 ± 0.49) vs.(2.48 ± 0.25) g/L,P＞ 0.05).The serum level of PA showed a significant negative correlation with that of TNF-α (r =-0.312,P ＜ 0.05),as well as with disease severity (r =-0.635,P ＜ 0.01),whereas the serum level of TNF-α showed a significant positive correlation with disease severity (r =0.409,P ＜ 0.01),and no statistical correlation was found between the remaining indices (all P ＞ 0.05) in the patients with CU.Conclusions Serum levels of some negative acute phase proteins decrease and negatively correlate with disease severity in patients with CU.Acute phase response may be involved in the occurrence of CU.

Objective To evaluate the relationship of acute-phase response and coagulation/fibrinolysis with chronic urticaria (CU).Methods Fifty-three patients with CU and twenty-five healthy human controls were enrolled in this study.Venous blood samples were collected from all of these subjects.Then,enzyme-linked immunosorbent assay was carried out to measure the serum levels of interleukin-6 (IL-6) and amyloid protein A (AA),and immunoturbidimetry to determine the levels of serum high sensitive C-reactive protein (Hs-CRP) and plasma D-dimer.The patients with CU were classified into three groups according to the severity of clinical symptoms.The levels of serum IL-6 and plasma D-dimer were given in mean ± standard deviation,and those of serum AA and Hs-CRP in mean (25th percentile,75th percentile).Rank sum test and t test were performed to compare these parameters between the patients and controls,and Spearman rank correlation analysis was conducted to study the relationship among these parameters as well as between these parameters and symptom severity in these patients.Results The levels of serum IL-6,serum AA and plasma D-dimer were (10.70 ± 4.94) ng/L,4.92 (8.22,12.51) μg/L,and (222.32 ± 163.69) μg/L respectively in the patients with CU,significantly higher than those in the healthy controls ((7.49 ± 3.41) ng/L,2.11 (1.21,2.83) μg/L,(104.72 ± 43.12) μg/L,respectively,all P＜ 0.05),while no significant differences were observed between the patients and controls in the level of serum HsCRP (0.30 (0.10,1.40) mg/L vs.0.30 (0.10,0.55) mg/L,P ＞ 0.05).In patients with CU,the levels of serum IL-6 were unrelated to those of serum Hs-CRP,serum AA,or plasma D-dimer (all P ＞ 0.05),whereas a positive correlation was observed between the levels of serum Hs-CRP and AA (r =0.67,P ＜ 0.01),serum Hs-CRP and plasma D-dimer (r =0.49,P ＜ 0.01),serum AA and plasma D-dimer (r =0.38,P ＜ 0.01).Further more,the levels of serum Hs-CRP,AA and plasma D-dimer were significantly correlated with symptom severity in patients with CU (r =0.63,0.62,0.47,respectively,all P ＜ 0.01).Conclusions Acute-phase response coexists with the activation of coagulation system in patients with CU,suggesting a potential association between acute-phase response and coagulation system activation.