The close relationship between gastric cancer (GC) and type 2 diabetes mellitus (T2DM) has garnered significant attention. On one hand, T2DM may play a role in the development and progression of GC, correlating with poor patient outcomes. On the other hand, after radical surgery for GC, T2DM can be effectively managed, potentially improving tumor prognosis. In recent years, bariatric and metabolic surgery (BMS) has revolutionized T2DM treatment for obese and overweight patients. Comparative analyses reveal similarities between surgical approaches for gastric cancer and BMS, leading to the emergence of the onco-metabolic surgery (OMS) concept, which suggests that radical tumor resection and T2DM remission in GC patients can be potentially achieved through a single procedure. However, there are notable differences between OMS and BMS, including target populations, surgical details, and perioperative management. Therefore, optimizing the application of the OMS concept in GC patients holds significant clinical importance. This article provides a review to facilitate the better implementation of this concept in practice.

The close relationship between gastric cancer (GC) and type 2 diabetes mellitus (T2DM) has garnered significant attention. On one hand, T2DM may play a role in the development and progression of GC, correlating with poor patient outcomes. On the other hand, after radical surgery for GC, T2DM can be effectively managed, potentially improving tumor prognosis. In recent years, bariatric and metabolic surgery (BMS) has revolutionized T2DM treatment for obese and overweight patients. Comparative analyses reveal similarities between surgical approaches for gastric cancer and BMS, leading to the emergence of the onco-metabolic surgery (OMS) concept, which suggests that radical tumor resection and T2DM remission in GC patients can be potentially achieved through a single procedure. However, there are notable differences between OMS and BMS, including target populations, surgical details, and perioperative management. Therefore, optimizing the application of the OMS concept in GC patients holds significant clinical importance. This article provides a review to facilitate the better implementation of this concept in practice.

Animals ; SARS-CoV-2 ; Antibodies, Neutralizing ; Macaca mulatta ; COVID-19/prevention & control* ; Antibodies, Viral ; Vaccines

Development of thoracolumbar vertebra (TLV) and rib primordium (RP) is a common evolutionary feature across vertebrates, although whole-organism analysis of the expression dynamics of TLV- and RP-related genes has been lacking. Here, we investigated the single-cell transcriptome landscape of thoracic vertebra (TV), lumbar vertebra (LV), and RP cells from a pig embryo at 27 days post-fertilization (dpf) and identified six cell types with distinct gene expression signatures. In-depth dissection of the gene expression dynamics and RNA velocity revealed a coupled process of osteogenesis and angiogenesis during TLV and RP development. Further analysis of cell type-specific and strand-specific expression uncovered the extremely high level of HOXA10 3'-UTR sequence specific to osteoblasts of LV cells, which may function as anti-HOXA10-antisense by counteracting the HOXA10-antisense effect to determine TLV transition. Thus, this work provides a valuable resource for understanding embryonic osteogenesis and angiogenesis underlying vertebrate TLV and RP development at the cell type-specific resolution, which serves as a comprehensive view on the transcriptional profile of animal embryo development.

Objective:To analyze and summarize the clinical features of pyogenic liver abscess (PLA) patients treated in 10 years, so as to provide evidence to improve current diagnosis and corresponding treatment strategies of PLA.Methods:The clinical symptoms, signs, laboratory and imaging findings, etiology and different treatments as well as corresponding efficacy and prognosis of PLA patients treated in Xiangya Hospital of Central South University during January 2010 to December 2019 were retrospectively analyzed.The chi-square was used to evaluate the differences of the categorical variables.Results:A total of 528 PLA cases were included in this study.Diabetes mellitus (46.8%, 247/528), biliary tract diseases (34.7%, 183/528) and previous hepatobiliary surgery history (19.7%, 104/528) were three most common risk factors leading to PLA. Fever (80.9%, 427/528), loss of appetite (53.6%, 283/528) and abdominal pain (51.9%, 274/528) were most common clinical manifestations. The accuracies of ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) were 95.5%(472/494), 97.0%(384/396), and 96.8%(92/95), respectively. The positive rate of pus culture (70.9%, 168/237) was higher than that of blood culture (20.0%, 42/210), and the difference was statistically significant ( χ2=115.746, P<0.01). The top three most common bacteria were Klebsiella pneumoniae (122 strains), Escherichia coli (29 strains) and Enterococcus faecium (10 strains). The drug resistance rate of Klebsiella pneumoniae to ampicillin was as high as 97.4%(112/115). The treatment programs included 200 cases of sole antibiotic treatments. Based on the antibiotic treatment, imaging guided percutaneous puncture therapy was the most commonly used treatment (45.6%, 241/528), included imaging guided percutaneous puncture and drainage (29.0%, 153/528) and imaging guided percutaneous catheterization (16.7%, 88/528). The surgical treatments included surgical catheter drainage (5.5%, 29/528) and surgical hepatectomy(11.0%, 58/528). The total number of cured cases was 495, and the cure rate was 93.8%. Conclusions:The common clinical manifestations of PLA are fever, loss of appetite, abdominal pain. Ultrasound is a routine and effective method to detect liver abscess. Klebsiella pneumoniae is the most common pathogen. Imaging guided percutaneous puncture is the most common treatment.

ObjectiveTo investigate the clinical significance of highly sensitive nucleic acid detection in precise antiviral therapy for patients with liver cirrhosis and its association with aminotransferase level. MethodsA total of 377 patients with hepatitis B cirrhosis who were hospitalized or attended the outpatient service from May 2013 to April 2019 were enrolled and tested by both domestic HBV DNA detection and highly sensitive Cobas HBV DNA detection. All patients underwent biochemical examination, four blood coagulation tests, routine blood test, and upper abdominal computed tomography or ultrasound. Sensitivity of different HBV DNA detection reagents was compared in liver cirrhosis patients with a low viral load, and the correlation between alanine aminotransferase (ALT) level and viral load was analyzed. The paired t-test was used for comparison of continuous data before and after treatment. The receiver operating characteristic (ROC) curve was used to screen out the optimal predictive values of ALT at different cut-off values of HBV DNA. ResultsAmong the 377 patients with hepatitis B cirrhosis, 215 tested positive and 162 tested negative by domestic HBV DNA, and among these 162 patients, 104 (64.2%) tested positive by Cobas HBV DNA detection, with a mean level of 267.5±42.3 IU/ml. After 24 weeks of antiviral therapy, the 104 patients with hepatitis B cirrhosis had significant improvements in viral replication level, ALT, and Child-Pugh score for liver function; HBV DNA decreased from 267.5±32.2 IU/ml before treatment to 59.6±7.7 IU/ml after treatment (t=3.486, P=0.002), ALT decreased from 871±10.8 U/L before treatment to 36.5±7.6 U/L after treatment (t=3.235, P=0.020), and the Child-Pugh score decreased from 6.5±0.7 before treatment to 5.7±0.5 after treatment (t=2.928, P=0.041). The ROC curve analysis of ALT in predicting HBV DNA decision point showed that an ALT level of 29 IU/L was the most sensitive cut-off value for predicting HBV DNA ＜20 IU/ml, with an area under the ROC curve of 0.904, a sensitivity of 1.0, and a specificity of 0.237. ConclusionPrecise detection helps to guarantee the precise clinical treatment of patients with hepatitis B cirrhosis and improve their treatment outcome and prognosis. An ALT level of 29 IU/L is a sensitive indicator for predicting patients with negative Cobas HBV DNA, so as to achieve individualized precise screening and treatment.

Objective To investigate the long term effect of stent implantation for severe carotid stenosis. Methods The clinical data of 66 patients with severe carotid artery stenosis who were hospitalized from January 2009 to December 2015 were retrospectively reviewed.40 patients underwent carotid artery stenosis stent implanta-tion(as study group)and 26 patients were treated with conventional drug theraphy(as control group).All patient were followed up for 36 months.and the quality of life of the patients was evaluated by SF-36 and the incidence of cerebrovascular events was recorded by following up.Results The quality of life score of the study group were sig-nificantly higher than those of the control group at 3 months,12 months,24 months and 36 months after operation (P<0.05);the incidence of cerebrovascular events after 12 months,24 months and 36 months in the study group was lower than in the control group,and the difference was significant(P<0.05).Conclusions There is obvious long-term effect of carotid artery stenting in the treatment of severe carotid stenosis,in which the quality of life can be effectively improved and the incidence of cerebrovascular events can be reduced in patients with carotid stenosis.

Objective To explore the effects of continuous renal replacement therapy (CRRT) on the changes of the respiration and blood circulation as well as peripheral blood cytokines levels in patients with severe acute pancreatitis(SAP) complicated with acute respiratory distress syndrome.Methods 48 SAP patients complicated with acute respiratory distress syndrome were divided into control group and CRRT treatment group according to the parallel control design principle.The control group was treated with routine way,and the CRRT treatment group was treated with CRRT on the basis of routine way.The clinical data and the levels of IL-6,IL-1β,TNF-α were compared between the two groups.Results The levels of IL-6,TNF-α were significantly lower in the CRRT treatment group than those in the control group in 12h [(147.72 ± 22.06) ng/L vs.(132.27 ± 18.03) ng/L,t =2.315,P＜0.05;(236.08 ±41.29) ng/L vs.(208.79±39.25)ng/L,t =2.406,P ＜0.05].The levels of IL-6,IL-1β,TNF-α were significantly lower in the CRRT treatment group than those in the control group in 24h [(136.57 ± 30.74) ng/L vs.(109.98 ± 35.83) ng/L,t =2.184,P ＜ 0.05;(35.76 ± 8.57) ng/L vs.(28.96 ±3,95) ng/L,t =2.237,P ＜0.05;(219.81 ±36.06) ng/L vs.(173.48 ±48.19) ng/L,t =2.206,P ＜0.05].The level of PaO2/FiO2 was significantly higher in the CRRT treatment group than that in the control group in 24h[(139.89 ±35,61) vs.(173.12 ±21.84),t =2.913,P ＜0.01].The levels of Ppeak,IL-1β were significantly lower in the CRRT treatment group than those in the control group in 48h [(28.96 ± 4.14) cmH2 O vs.(24.73 ± 8.52) cmH2 O,t =2.518,P ＜0.05;(29.87 ±5.12) ng/L vs.(23.57 ±3.91) ng/L,t =2.427,P ＜0.05].The levels of IL-6,TNF-αwere significantly lower in the CRRT treatment group than those in the control group in 48h [(117.60 ± 23.46) ng/L vs.(88.56 ± 13.02) ng/L,t =3.062,P ＜ 0.01;(205.25 ± 46.14) ng/L vs.(141.63 ± 33.80) ng/L,t =3.174,P ＜0.01].The level of PaO2/FiO2 was significantly higher in the CRRT treatment group than that in the control group in 48h [(148.07 ± 25.64) vs.(193.23 ± 29.60),t =2.983,P ＜ 0.01].There were no significant differences between the control group and CRRT treatment group in PaO2/FiO2,Ppeak,IL-6,IL-1β,TNF-α before treatment [(103.68±29.65) vs.(107.07 ±25.13),t =0.359,P ＞0.05;(34.62 ±7.36)cmH2O vs.(35.18 ±4.04)cmH2O,t =0.416,P ＞0.05;(152.61 ±31.53)ng/L vs (150.74 ±30.26) ng/L,t =0.668,P ＞0.05;(40.06 ±5.15) ng/L vs.(38.09 ±10.13) ng/L,t =0.819,P ＞0.05;(226.85 ±37.62) ng/L vs.(225.47 ±39.02) ng/L,t =0,702,P＞0.05].Conclusion CRRT can effectively reduce the plasma levels of IL-6,IL-1β,TNF-α in SAP patients complicated with acute respiratory distress syndrome,it has therapeutic effect on the respiration through changing the cytokines of SAP patients complicated with acute respiratory distress syndrome.