BACKGROUND Cold-inducible RNA-binding protein(CIRP)is related to a family of stressinduced RNA-binding proteins.It is primarily found in the nucleus,where it regulates transcription.Under stress,CIRP translocates to t...BACKGROUND Cold-inducible RNA-binding protein(CIRP)is related to a family of stressinduced RNA-binding proteins.It is primarily found in the nucleus,where it regulates transcription.Under stress,CIRP translocates to the cytoplasm where it modulates translation;a subset is secreted as extracellular CIRP(eCIRP)which is a damage-associated molecular pattern(DAMP)molecule that stimulates the production of inflammatory mediators.Elevated blood eCIRP levels may foster immune tolerance and facilitate tumor growth.Increased CIRP levels have been noted in various malignancies including colorectal cancer(CRC).This study’s objective was to determine plasma eCIRP levels before and after minimally invasive colorectal resection(MICR)for CRC.AIM To assess plasma eCIRP levels prior to and following minimally invasive colorectal resection in the context of cancer pathology.METHODS MICR patients from an IRB-approved data/tissue bank for whom plasma samples were available were eligible.Plasma specimens were obtained preoperatively(preop)and at least 3 time’s postop[between postoperative day(POD)1-41];late samples were grouped into 7-day blocks and were considered separate time points.eCIRP levels were assessed via enzyme-linked immunosorbent assay(pg/mL)and results presented as mean±SD,analysis with Wilcoxon paired t-test.RESULTS A total of 83 CRC patients who underwent MICR[colon 66%,rectal 34%;laparoscopic-assisted(LA),70%;handassisted laparoscopic(HAL),30%]were studied.The mean preop eCIRP level was 896.8±757.0 pg/mL.Elevations in mean plasma levels(P=<0.001)were noted on POD1(2549±2632 pg/mL,n=83),POD3(1871±1362 pg/mL,n=77),POD7-13(1788±1403 pg/mL,n=57),POD14-20(1473±738.8 pg/mL,n=30),and POD21-27(1681±1375 pg/mL,n=21).No significant differences were noted at POD 28-41.Higher values were noted in the HAL’s(vs LA)group,however,there were more rectal cancers in the former.CONCLUSION Elevated plasma eCIRP levels persist for a month post MICR for CRC(change from baseline,77%-184%);highest values seen on POD1.The initial surge may be due to the acute inflammatory response while later elevations may be related to wound healing and remodeling.The higher levels noted in the HAL’s group(with greater IL and more rectal cases)suggest the extent of surgical trauma impacts eCIRP levels.Further investigations are needed.展开更多
Background： Pancreatectomies have been identified as procedures with an increased risk of readmission.In surgical patients, readmissions within 30 days of discharge are usually procedure-related. We sought to determi...Background： Pancreatectomies have been identified as procedures with an increased risk of readmission.In surgical patients, readmissions within 30 days of discharge are usually procedure-related. We sought to determine predictors of 30-day readmission following pancreatic resections in a large healthcare system.Methods： We retrospectively collected information from the records of 383 patients who underwent pancreaticresections from 2004–2013. To find the predictors of readmission in the 30 days after discharge,we performed a univariate screen of possible variables using the Fisher’s exact test for categorical variables and the Mann–Whitney U test for continuous variables. Multivariate analysis was used to determinethe independent factors.展开更多
Background:Traumatic pancreatic injuries are rare,and guidelines specifying management are controversial and difficult to apply in the acute clinical setting.Due to sparse data on these injuries,we carried out a retro...Background:Traumatic pancreatic injuries are rare,and guidelines specifying management are controversial and difficult to apply in the acute clinical setting.Due to sparse data on these injuries,we carried out a retrospective review to determine outcomes following surgical or non-surgical management of traumatic pancreatic injuries.We hypothesize a higher morbidity and mortality rate in patients treated surgically when compared to patients treated non-surgically.Methods:We performed a retrospective review of data from four trauma centers in New York from 1990–2014,comparing patients who had blunt traumatic pancreatic injuries who were managed operatively to those managed non-operatively.We compared continuous variables using the Mann-Whitney U test and categorical variables using the chi-square and Fisher’s exact tests.Univariate analysis was performed to determine the possible confounding factors associated with mortality in both treatment groups.Results:Twenty nine patients were managed operatively and 32 non-operatively.There was a significant difference between the operative and non-operative groups in median age(37.0 vs.16.2 years,P=0.016),grade of pancreatic injury(grade I;30.8 vs.85.2%,P value for all comparisons<0.0001),median injury severity score(ISS)(16.0 vs.4.0,P=0.002),blood transfusion(55.2 vs.15.6%,P=0.0012),other abdominal injuries(79.3 vs.38.7%,P=0.0014),pelvic fractures(17.2 vs.0.00%,P=0.020),intensive care unit(ICU)admission(86.2 vs.50.0%,P=0.003),median length of stay(LOS)(16.0 vs.4.0 days,P<0.0001),and mortality(27.6 vs.3.1%,P=0.010).Conclusions:Patients with traumatic pancreatic injuries treated operatively were more severely injured and suffered greater complications than those treated non-operatively.The greater morbidity and mortality associated with these patients warrants further study to determine optimal triage strategies and which subset of patients is likely to benefit from surgery.展开更多
文摘BACKGROUND Cold-inducible RNA-binding protein(CIRP)is related to a family of stressinduced RNA-binding proteins.It is primarily found in the nucleus,where it regulates transcription.Under stress,CIRP translocates to the cytoplasm where it modulates translation;a subset is secreted as extracellular CIRP(eCIRP)which is a damage-associated molecular pattern(DAMP)molecule that stimulates the production of inflammatory mediators.Elevated blood eCIRP levels may foster immune tolerance and facilitate tumor growth.Increased CIRP levels have been noted in various malignancies including colorectal cancer(CRC).This study’s objective was to determine plasma eCIRP levels before and after minimally invasive colorectal resection(MICR)for CRC.AIM To assess plasma eCIRP levels prior to and following minimally invasive colorectal resection in the context of cancer pathology.METHODS MICR patients from an IRB-approved data/tissue bank for whom plasma samples were available were eligible.Plasma specimens were obtained preoperatively(preop)and at least 3 time’s postop[between postoperative day(POD)1-41];late samples were grouped into 7-day blocks and were considered separate time points.eCIRP levels were assessed via enzyme-linked immunosorbent assay(pg/mL)and results presented as mean±SD,analysis with Wilcoxon paired t-test.RESULTS A total of 83 CRC patients who underwent MICR[colon 66%,rectal 34%;laparoscopic-assisted(LA),70%;handassisted laparoscopic(HAL),30%]were studied.The mean preop eCIRP level was 896.8±757.0 pg/mL.Elevations in mean plasma levels(P=<0.001)were noted on POD1(2549±2632 pg/mL,n=83),POD3(1871±1362 pg/mL,n=77),POD7-13(1788±1403 pg/mL,n=57),POD14-20(1473±738.8 pg/mL,n=30),and POD21-27(1681±1375 pg/mL,n=21).No significant differences were noted at POD 28-41.Higher values were noted in the HAL’s(vs LA)group,however,there were more rectal cancers in the former.CONCLUSION Elevated plasma eCIRP levels persist for a month post MICR for CRC(change from baseline,77%-184%);highest values seen on POD1.The initial surge may be due to the acute inflammatory response while later elevations may be related to wound healing and remodeling.The higher levels noted in the HAL’s group(with greater IL and more rectal cases)suggest the extent of surgical trauma impacts eCIRP levels.Further investigations are needed.
文摘Background： Pancreatectomies have been identified as procedures with an increased risk of readmission.In surgical patients, readmissions within 30 days of discharge are usually procedure-related. We sought to determine predictors of 30-day readmission following pancreatic resections in a large healthcare system.Methods： We retrospectively collected information from the records of 383 patients who underwent pancreaticresections from 2004–2013. To find the predictors of readmission in the 30 days after discharge,we performed a univariate screen of possible variables using the Fisher’s exact test for categorical variables and the Mann–Whitney U test for continuous variables. Multivariate analysis was used to determinethe independent factors.
文摘Background:Traumatic pancreatic injuries are rare,and guidelines specifying management are controversial and difficult to apply in the acute clinical setting.Due to sparse data on these injuries,we carried out a retrospective review to determine outcomes following surgical or non-surgical management of traumatic pancreatic injuries.We hypothesize a higher morbidity and mortality rate in patients treated surgically when compared to patients treated non-surgically.Methods:We performed a retrospective review of data from four trauma centers in New York from 1990–2014,comparing patients who had blunt traumatic pancreatic injuries who were managed operatively to those managed non-operatively.We compared continuous variables using the Mann-Whitney U test and categorical variables using the chi-square and Fisher’s exact tests.Univariate analysis was performed to determine the possible confounding factors associated with mortality in both treatment groups.Results:Twenty nine patients were managed operatively and 32 non-operatively.There was a significant difference between the operative and non-operative groups in median age(37.0 vs.16.2 years,P=0.016),grade of pancreatic injury(grade I;30.8 vs.85.2%,P value for all comparisons<0.0001),median injury severity score(ISS)(16.0 vs.4.0,P=0.002),blood transfusion(55.2 vs.15.6%,P=0.0012),other abdominal injuries(79.3 vs.38.7%,P=0.0014),pelvic fractures(17.2 vs.0.00%,P=0.020),intensive care unit(ICU)admission(86.2 vs.50.0%,P=0.003),median length of stay(LOS)(16.0 vs.4.0 days,P<0.0001),and mortality(27.6 vs.3.1%,P=0.010).Conclusions:Patients with traumatic pancreatic injuries treated operatively were more severely injured and suffered greater complications than those treated non-operatively.The greater morbidity and mortality associated with these patients warrants further study to determine optimal triage strategies and which subset of patients is likely to benefit from surgery.
