Microorganisms constitute an essential component in the indoor environment,which is closely related to hu-man health.However,there is limited evidence regarding the associations between indoor airborne microbiome and ...Microorganisms constitute an essential component in the indoor environment,which is closely related to hu-man health.However,there is limited evidence regarding the associations between indoor airborne microbiome and systemic inflammation,as well as whether this association is modified by indoor particulate matter and the underlying mechanisms.In this prospective repeated-measure study among 66 participants,indoor airborne mi-crobiome was characterized using amplicon sequencing and qPCR.Indoor fine particulate matter(PM_(2.5))and inhalable particulate matter(PM10)were measured.Systemic inflammatory biomarkers were assessed,including white blood cell(WBC),neutrophil(NEUT),monocyte,eosinophil counts,and their proportions.Targeted serum amino acid metabolomics were conducted to explore the underlying mechanisms.Linear mixed-effect models re-vealed that bacterial and fungal Simpson diversity were significantly associated with decreased WBC and NEUT.For example,for each interquartile range increase in the bacterial Simpson diversity,WBC and NEUT changed by-4.53%(95%CI:-8.25%,-0.66%)and-5.95%(95%CI:-11.3%,-0.27%),respectively.Notably,increased inflammatory risks of airborne microbial exposure were observed when indoor PM_(2.5) and PM10 levels were below the WHO air quality guidelines.Mediation analyses indicated that dopamine metabolism partially mediated the anti-inflammatory effects of fungal diversity exposure.Overall,our study indicated protection from a diverse indoor microbial environment on cardiovascular health and proposed an underlying mechanism through amino acid metabolism.Additionally,health risks associated with microbial exposure deserve more attention in con-texts of low indoor particulate matter pollution.Further research is necessary to fully disentangle the complex relationships between indoor microbiome,air pollutants,and human health.展开更多
Radiotherapy(RT)is considered a standard cancer treatment that directly kills tumor cells and promotes a systemic immune response.However,RT may also lead to tumor hypoxia,which further inhibits the antigen-presenting...Radiotherapy(RT)is considered a standard cancer treatment that directly kills tumor cells and promotes a systemic immune response.However,RT may also lead to tumor hypoxia,which further inhibits the antigen-presenting function of dendritic cells(DCs)and thereby weakens the systemic anti-tumor immune response induced by radiotherapy.In this study,the oxygen-loaded in situ gels carrying bacterial outer membrane(MOGel)were synthesized.As the gels slowly degraded,oxygen was gradually released to alleviate tumor hypoxia.The released bacterial outer membrane(OM)continuously activated DCs,enhancing their antigenpresenting capability.The results demonstrated that MOGel combined with RT induced the strongest tumor cell apoptosis in vitro and achieved a 80%tumor suppression rate in a colon cancer orthotopic model.Importantly,MOGel+RT induced an enhanced abscopal effect,and hypoxia and enhanced DCs activation contributed to the systemic immune response.Thus,OM-based oxygen gels may offer a novel strategy for enhancing the systemic immune response to RT.展开更多
Gastric ulcer(GU)represents a clinically significant manifestation of peptic ulcer disease,driven by a complex interplay of microbial,environmental,and immuneinflammatory factors.A recent cross-sectional study by Shen...Gastric ulcer(GU)represents a clinically significant manifestation of peptic ulcer disease,driven by a complex interplay of microbial,environmental,and immuneinflammatory factors.A recent cross-sectional study by Shen et al systematically evaluated six complete blood count-derived inflammatory indices:Neutrophil-tolymphocyte ratio,monocyte-to-lymphocyte ratio,platelet-to-lymphocyte ratio,systemic immune-inflammation index,systemic inflammatory response index(SIRI),and aggregate index of systemic inflammation and demonstrated their positive associations with GU prevalence,identifying SIRI as the strongest predictor.This editorial contextualizes these findings within the broader literature,clarifies that these indices reflect systemic rather than GU-specific inflammation,highlights methodological strengths and major limitations,and proposes a conceptual clinical algorithm for integrating SIRI into GU risk assessment.Future multicenter studies incorporating Helicobacter pylori infection,non-steroidal antiinflammatory drug exposure,and prospective design are essential to validate and translate these findings into clinical practice.展开更多
Neuroinflammation is a crucial factor in the progression of various diseases,ranging from immune-related conditions such as sepsis to neurodegenerative disorders such as Alzheimer’s disease(AD)(Ravichandran and Henek...Neuroinflammation is a crucial factor in the progression of various diseases,ranging from immune-related conditions such as sepsis to neurodegenerative disorders such as Alzheimer’s disease(AD)(Ravichandran and Heneka,2024).This perspective article,which draws on insights from diverse fields including neuroscience,immunology,and pathology,p rovides a critical analysis of ongoing research efforts in inflammasome biology,with specific emphasis on Nod-like receptor(NLR)and pyrin domain-containing protein 3(NLRP3).展开更多
Unresectable hepatocellular carcinoma(HCC)remains a global challenge,with limited effective treatment options for advanced-stage disease.The HIMALAYA trial(phase III randomized study that evaluated the STRIDE regimen)...Unresectable hepatocellular carcinoma(HCC)remains a global challenge,with limited effective treatment options for advanced-stage disease.The HIMALAYA trial(phase III randomized study that evaluated the STRIDE regimen)introduced the Single Tremelimumab Regular Interval Durvalumab(STRIDE)regimen,an immunotherapy-based approach that achieved a median overall survival(OS)of 16.43 months compared to 13.77 months with sorafenib.While statistically significant,this~2.7 months OS gain warrants scrutiny in light of STRIDE’s increased immune-related toxicity and cost.This commentary evaluates STRIDE’s impact within the broader landscape of first-line systemic therapy for unresectable HCC,alongside other regimens such as atezolizumab plus bevacizumab and nivolumab plus ipilimumab.We explore STRIDE’s mechanism of action,safety profile,modest progression-free survival(PFS)improvement,and implementation challenges,incorporating insights from 2023-2025 research.In addition,we discussed its limitations in non-viral HCC and Child-Pugh B patients,the role of emerging biomarkers,and the potential of radiation to enhance immunotherapy efficacy.As a dual immune checkpoint inhibitor(ICI)strategy,STRIDE offers an important advance that may not only extend survival but also open the door to future curative approaches.However,optimizing its use will require refined patient selection and further investigation of synergistic combination therapies.展开更多
Dear Editor,Systemic sclerosis(SSc)is an autoimmune connective tissue disease in which there are vascular abnormalities,inflammation,and fibrosis[1].These three characteristics primarily affect the skin and lungs.Of a...Dear Editor,Systemic sclerosis(SSc)is an autoimmune connective tissue disease in which there are vascular abnormalities,inflammation,and fibrosis[1].These three characteristics primarily affect the skin and lungs.Of all the autoimmune rheumatic diseases,SSc has the highest all-cause mortality rate,and the underlying pathogenic processes that mediate disease are still obscure,with wide diff erences in presentation and progression[2,3].展开更多
Some patients with systemic lupus erythematosus experience neuropsychiatric symptoms.Although magnetic resonance imaging can detect abnormal signals in the white matter of the brain,conventional methods often struggle...Some patients with systemic lupus erythematosus experience neuropsychiatric symptoms.Although magnetic resonance imaging can detect abnormal signals in the white matter of the brain,conventional methods often struggle to accurately capture microstructural changes.Various diffusion models have been used to study white matter in systemic lupus erythematosus;however,comparative analyses of their sensitivity and specificity for detecting microstructural changes remain insufficient.To address this,our team designed a diagnostic trial that used multimodal diffusion imaging techniques to observe white matter microstructural changes in patients with systemic lupus erythematosus who had neuropsychiatric symptoms,with an aim to identify key diagnostic biomarkers for these patients.Patients with active lupus who received treatment at the Department of Rheumatology and Immunology,The First Affiliated Hospital of China Medical University,from September 2023 to March 2024 were recruited.According to the standards of the American College of Rheumatology,patients with systemic lupus erythematosus who had neuropsychiatric symptoms were assigned to the systemic lupus erythematosus group,whereas those without neuropsychiatric symptoms were assigned to the non-systemic lupus erythematosus group.Additionally,healthy volunteers matched by region,sex,and age were recruited as controls.All three groups underwent the same diffusion magnetic resonance imaging examination protocol to compare differences in diffusion parameters.Advanced diffusion imaging models were able to sensitively detect microstructural changes in the white matter fibers of patients with systemic lupus erythematosus who had neuropsychiatric symptoms,with specific diffusion parameters showing significant abnormalities in key brain regions.In the left superior longitudinal fasciculus subregion and the right thalamic radiations of patients with systemic lupus erythematosus who had neuropsychiatric symptoms,we also identified abnormal diffusion characteristics that were clearly correlated with disease activity,suggesting that microstructural changes in these areas may reflect the dynamic process of neuroinflammatory damage.The present study addresses critical challenges in the diagnosis of systemic lupus erythematosus by identifying specific white matter imaging biomarkers and elucidating the association between microstructural damage and clinical manifestations.The main contributions of our study include:1)establishing axial regression probability parameters from mean apparent propagator magnetic resonance imaging as sensitive biomarkers for systemic lupus erythematosus,particularly in the third subregion of the left superior longitudinal fasciculus;2)demonstrating that multimodal diffusion imaging may be superior to conventional diffusion tensor imaging for detecting white matter microstructural abnormalities in patients with systemic lupus erythematosus;and 3)integrating tract-based spatial statistics with clinically relevant analyses to link imaging findings to pathological mechanisms.展开更多
Background We have developed a tridirectional regimen combining intraperitoneal,intravenous,and oral chemotherapy as a treatment for patients with advanced gastric cancer and individualized these chemotherapeutics acc...Background We have developed a tridirectional regimen combining intraperitoneal,intravenous,and oral chemotherapy as a treatment for patients with advanced gastric cancer and individualized these chemotherapeutics according to mRNA expression.This multicenter Phase Ⅲ umbrella study compared the efficacy and safety of individualized tridirectional intraperitoneal and systemic chemotherapy with that of standard systemic chemotherapy.Methods BRCA1/TOPO1 mRNA expression was examined in all enrolled patients.The patients were then randomized in a ratio of 3:1 to an individualized arm and a control arm.Patients in the control arm received systemic intravenous/oral chemotherapy,whereas those in the individualized arm received sensitive chemotherapeutics selected from oxaliplatin/cisplatin/docetaxel/irinotecan/S-1 according to their BRCA1/TOPO1 mRNA expression and received individualized tridirectional intraperitoneal/intravenous/oral chemotherapy.The primary endpoint was progressionfree survival and the secondary endpoints were response rate,overall survival,and safety.Results Overall,233 of 240 patients enrolled between August 2014 and December 2016 were included in the efficacy analysis.Baseline patient characteristics were balanced between the two arms.The objective response rate was 33.9%in the control arm and 49.1%in the individualized arm(P=0.039).In the control and individualized arms,median progression-free survival was 5.9 months and 8.0 months,respectively(hazard ratio 0.521,95%confidence interval 0.362-0.750,P=0.0005)and median overall survival was 13.5 months and 16.4 months,respectively(hazard ratio 0.684,95%confidence interval 0.474-0.988,P=0.0430).Both regimens were tolerable.Conclusion The primary analysis demonstrated the statistical superiority of this tridirectional individualized regimen and suggests that this regimen has clinical efficacy in patients with advanced gastric cancer.Trial registration Chinese Clinical Trial Registry(chictr.org.cn)Identifier:ChiCTR-IPR-15006201.展开更多
BACKGROUND Colorectal cancer,one of the most common malignancies,is primarily treated through surgery.With the widespread use of laparoscopy,gastrointestinal reconstruction remains a key area of research.The choice be...BACKGROUND Colorectal cancer,one of the most common malignancies,is primarily treated through surgery.With the widespread use of laparoscopy,gastrointestinal reconstruction remains a key area of research.The choice between intraperitoneal anastomosis(IA)and extraperitoneal anastomosis(EA)remains a subject of considerable debate.This study uses intraperitoneal isoperistaltic side-to-side anastomosis(IISSA)with hand-sewn closure of the common opening to evaluate its safety and short-term outcomes.It is hypothesized that this technique may offer better short-term outcomes than EA.AIM To investigate the safety and short-term outcomes of IISSA with hand-sewn closure of the common opening compared to EA.METHODS Patients who underwent laparoscopic radical colon cancer surgery between January 2018 and June 2022 at the First Affiliated Hospital of Xiamen University were retrospectively analyzed.Surgical,postoperative,and pathological features of the IA and EA groups were observed before and after propensity score matching.Patients with right-sided and left-sided colon cancer were separated,each further divided into IA and EA groups(R-IA vs R-EA for right-sided,L-IA vs L-EA for left-sided),for stratified analysis of the aforementioned indicators.RESULTS After propensity score matching,63 pairs were matched in each group.In surgical characteristics,the IA group exhibited less blood loss and shorter incisions than the EA group.Regarding postoperative recovery,the IA group showed earlier recovery of gastrointestinal function.Pathologically,the IA group had greater lymph node clearance.Relative to the R-EA group,the R-IA group experienced reduced blood loss,shorter assisted incisions,earlier recovery of gastrointestinal functions and greater lymph node dissection.When compared to the L-EA group,the L-IA group demonstrated earlier postoperative anal exhaust and defecation,along with a reduced length of hospitalization.Regarding postoperative complications,no statistically significant differences were found between the groups either after matching or in the stratified analyses.CONCLUSION Compared to EA,IISSA with hand-sewn closure of the common opening is a safe and feasible option for laparoscopic radical colon cancer surgery.展开更多
BACKGROUND The diagnosis of gastric carcinoma(GC)is essential for improving clinical outcomes.However,the biomarkers currently used for GC screening are not ideal.AIM To explore the diagnostic implications of the neut...BACKGROUND The diagnosis of gastric carcinoma(GC)is essential for improving clinical outcomes.However,the biomarkers currently used for GC screening are not ideal.AIM To explore the diagnostic implications of the neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),and systemic immune-inflammatory index(SII)for GC.METHODS The baseline data of 133 patients with GC and 134 patients with precancerous gastric conditions admitted between January 2022 and December 2023 were retrospectively analyzed.The information on peripheral blood platelet,neutrophil,and lymphocyte counts in each patient was collected,and the NLR,PLR,and SII levels of both groups were calculated.Additionally,multivariate logistic regression analysis was conducted,and the diagnostic implications of NLR,PLR,and SII in differentiating patients with precancerous gastric conditions,compared with those with GC,were analyzed through receiver operating characteristic(ROC)curves.RESULTS The data indicated that NLR,PLR,and SII had abnormally increased levels in the patients with GC.Gender and body mass index were risk factors for the occurrence of GC.ROC data revealed that the areas under the curve of three patients with precancerous gastric conditions,who were differentiated from those with GC,were 0.824,0.787,and 0.842,respectively.CONCLUSION NLR,PLR,and SII are all abnormally expressed in GC and have diagnostic implications,especially when used as joint indicators,in distinguishing patients with precancerous gastric conditions from those with GC.展开更多
Background Monoglycerides have emerged as a promising alternative to conventional practices due to their biolog-ical activities,including antimicrobial properties.However,few studies have assessed the efficacy of mono...Background Monoglycerides have emerged as a promising alternative to conventional practices due to their biolog-ical activities,including antimicrobial properties.However,few studies have assessed the efficacy of monoglyceride blend on weaned pigs and their impacts on performance,immune response,and gut health using a disease chal-lenge model.Therefore,this study aimed to investigate the effects of dietary monoglycerides of short-and medium-chain fatty acids on the immunity and gut health of weaned pigs experimentally infected with an enterotoxigenic Escherichia coli F18.Results Pigs supplemented with high-dose zinc oxide(ZNO)had greater(P<0.05)growth performance than other treatments,but no difference was observed in average daily feed intake between ZNO and monoglycerides groups during the post-challenge period.Pigs in ZNO and antibiotic groups had lower(P<0.05)severity of diarrhea than control,but the severity of diarrhea was not different between antibiotic and monoglycerides groups.Pigs fed with monoglycerides or ZNO had lower(P<0.05)serum haptoglobin on d 2 or 5 post-inoculation than control.Pigs in ZNO had greater(P<0.05)goblet cell numbers per villus,villus area and height,and villus height:crypt depth ratio(VH:CD)in duodenum on d 5 post-inoculation than pigs in other treatments.Pigs supplemented with monoglyc-erides,ZNO,or antibiotics had reduced(P<0.05)ileal crypt depth compared with control on d 5 post-inoculation,contributing to the increase(P=0.06)in VH:CD.Consistently,pigs in ZNO expressed the lowest(P<0.05)TNFa,IL6,IL10,IL12,IL1A,IL1B,and PTGS2 in ileal mucosa on d 5 post-inoculation,and no difference was observed in the expres-sion of those genes between ZNO and monoglycerides.Supplementation of ZNO and antibiotic had significant impacts on metabolic pathways in the serum compared with control,particularly on carbohydrate and amino acid metabolism,while limited impacts on serum metabolites were observed in monoglycerides group when compared with control.Conclusions The results suggest that supplementation of monoglyceride blend may enhance disease resist-ance of weaned pigs by alleviating the severity of diarrhea and mitigating intestinal and systemic inflammation,although the effectiveness may not be comparable to high-dose zinc oxide.展开更多
Background The emergence of antibiotic resistant microorganisms associated with conventional swine production practices has increased interest in acid-based compounds having antimicrobial properties and other biologic...Background The emergence of antibiotic resistant microorganisms associated with conventional swine production practices has increased interest in acid-based compounds having antimicrobial properties and other biological functions as nutritional interventions.Despite the interest in organic acids and monoglycerides,few studies have examined the effects of the combination of these acid-based additives in weaned pigs under disease challenge conditions.Therefore,this study aimed to investigate the effects of dietary supplementation with blend of organic acids and/or medium-chain fatty acid monoglycerides on intestinal health and systemic immunity of weaned pigs experimentally infected with an enterotoxigenic Escherichia coli(ETEC)F18 at 4-week of age.Results Dietary supplementation of organic acids,monoglycerides,or both organic acids and monoglycerides(combination)reduced(P<0.05)the diarrhea frequency of ETEC F18-infected pigs throughout the experimental period(d−7 to 21 post-inoculation).This is consistent with the reduced(P<0.05)proportion ofβ-hemolytic coliforms in feces observed for the organic acid and combination treatments on d 10 post-inoculation.Supplementation of organic acids,monoglycerides,or combination also reduced(P<0.05)bacterial translocation in mesenteric lymph nodes on d 21 post-inoculation.Pigs fed with monoglycerides or combination had lower(P<0.05)white blood cells on d 5 post-inoculation,and pigs fed the combination also had lower(P<0.05)lymphocytes than pigs in control group.Monoglyceride supplementation increased(P<0.05)white blood cells and neutrophils compared with control group on d 14 post-inoculation.However,supplementation with organic acid blend,monoglyceride blend,or combination did not affect growth performance in this experiment.Conclusions Supplementation with monoglycerides or organic acids alone or in combination improves the detrimental effects of ETEC F18 infection in weaned pigs,as indicated by reduced diarrhea,fecal shedding ofβ-hemolytic coliforms,and bacterial translocation,and thus enhancing disease resistance.Monoglycerides reduced the inflammatory response during peak infection,but their immunomodulatory and possible synergistic effects with organic acids need to be further investigated.展开更多
BACKGROUND Gastric cancer(GC)is the fifth most common cancer and the third leading cause of cancer-related deaths in China.Many patients with GC frequently experience symptoms related to the disease,including anorexia...BACKGROUND Gastric cancer(GC)is the fifth most common cancer and the third leading cause of cancer-related deaths in China.Many patients with GC frequently experience symptoms related to the disease,including anorexia,nausea,vomiting,and other discomforts,and often suffer from malnutrition,which in turn negatively affects perioperative safety,prognosis,and the effectiveness of adjuvant therapeutic measures.Consequently,some nutritional indicators such as nutritional risk index(NRI),prognostic nutritional index(PNI),and systemic immune-inflammatorynutritional index(SIINI)can be used as predictors of the prognosis of GC patients.AIM To examine the prognostic significance of PNI,NRI,and SIINI in postoperative patients with GC.METHODS A retrospective analysis was conducted on the clinical data of patients with GC who underwent surgical treatment at the Guangxi Medical University Cancer Hospital between January 2010 and December 2018.The area under the receiver operating characteristic(ROC)curve was assessed using ROC curve analysis,and the optimal cutoff values for NRI,PNI,and SIINI were identified using the You-Review-HTMLden index.Survival analysis was performed using the Kaplan-Meier method.In addition,univariate and multivariate analyses were conducted using the Cox proportional hazards regression model.RESULTS This study included a total of 803 patients.ROC curves were used to evaluate the prognostic ability of NRI,PNI,and SIINI.The results revealed that SIINI had superior predictive accuracy.Survival analysis indicated that patients with GC in the low SIINI group had a significantly better survival rate than those in the high SIINI group(P<0.05).Univariate analysis identified NRI[hazard ratio(HR)=0.68,95%confidence interval(CI):0.52-0.89,P=0.05],PNI(HR=0.60,95%CI:0.46-0.79,P<0.001),and SIINI(HR=2.10,95%CI:1.64-2.69,P<0.001)as prognostic risk factors for patients with GC.However,multifactorial analysis indicated that SIINI was an independent risk factor for the prognosis of patients with GC(HR=1.65,95%CI:1.26-2.16,P<0.001).CONCLUSION Analysis of clinical retrospective data revealed that SIINI is a valuable indicator for predicting the prognosis of patients with GC.Compared with NRI and PNI,SIINI may offer greater application for prognostic assessment.展开更多
Gastric cancer(GC)and gastroesophageal junction cancer(GEJC)represent a significant burden globally,with complications such as overt bleeding(OB)further exacerbating patient outcomes.A recent study by Yao et al evalua...Gastric cancer(GC)and gastroesophageal junction cancer(GEJC)represent a significant burden globally,with complications such as overt bleeding(OB)further exacerbating patient outcomes.A recent study by Yao et al evaluated the effectiveness and safety of systematic treatment in GC/GEJC patients presenting with OB.Using propensity score matching,the study balanced the comparison groups to investigate overall survival and treatment-related adverse events.The study's findings emphasize that systematic therapy can be safe and effective and contribute to the ongoing debate about the management of advanced GC/GEJC with OB,highlighting the complexities of treatment decisions in these high-risk patients.展开更多
Objective:The trial was designed to evaluate the efficacy of prophylactic hyperthermic intraperitoneal chemotherapy(HIPEC)with cisplatin for patients with locally advanced gastric cancer(LAGC).Methods:Between March 20...Objective:The trial was designed to evaluate the efficacy of prophylactic hyperthermic intraperitoneal chemotherapy(HIPEC)with cisplatin for patients with locally advanced gastric cancer(LAGC).Methods:Between March 2015 and November 2016,a phase Ⅱ clinical trial was performed.Fifty consecutive patients with LAGC were randomly assigned to two groups:the experimental group(radical gastrectomy+HIPEC with cisplatin+adjuvant chemotherapy)and the control group(radical gastrectomy+adjuvant chemotherapy).Survival rates were closely monitored.Results:The 5-year overall survival(OS)rate of all patients was 80.0%.The 5-year OS rate in the experimental group was lower than that in the control group,at 75.8%and 88.2%,respectively,with no statistical significance.In addition,5-year recurrence-free survival(RFS)rates of patients who underwent HIPEC or not were also 75.8%and 88.2%,respectively.In the multivariate analysis,only pT stage[risk ratio(RR)=7.079,P=0.018]was significantly associated with prognosis.The most common recurrence pattern was peritoneal recurrence in both groups.The experimental group had a lower incidence of peritoneal recurrence than the control group with no statistical significance.Conclusions:This trial clearly revealed that prophylactic HIPEC with cisplatin neither decrease the risk of peritoneal recurrence nor improve the prognosis of patients with LAGC.Thus,HIPEC with cisplatin is not recommended as a prophylactic treatment for peritoneal recurrence of LAGC after radical gastrectomy.展开更多
Cytoreductive surgery(CRS)and hyperthermic intraperitoneal chemotherapy(HIPEC)are complex surgical procedures that are often used to treat advanced cancers of the abdominal cavity with peritoneal metastasis.Although t...Cytoreductive surgery(CRS)and hyperthermic intraperitoneal chemotherapy(HIPEC)are complex surgical procedures that are often used to treat advanced cancers of the abdominal cavity with peritoneal metastasis.Although these treatments can be lifesaving,patients often experience a significant decrease in their overall quality of life(QoL),especially in the early stages of recovery,owing to the physical burden of surgery and the effects of chemotherapy.Many traditional QoL questionnaires have been used to measure CRS and HIPEC.However,these classical current QoL assessment tools often fail to capture the unique challenges faced by this population,including bowel dysfunction,stoma-related distress,and long-term survivorship issues.Therefore,additional parameters that assess bowel function and stoma opening status and especially patient-reported outcome measures would be useful in QoL measurements to provide a more detailed understanding of recovery and general well-being in these patients.展开更多
BACKGROUND Peritoneal metastases(PM)represent the most frequent and lethal form of dissemination in advanced gastric cancer(GC),with limited efficacy of systemic chemotherapy[median overall survival(OS):2-9 months].Ov...BACKGROUND Peritoneal metastases(PM)represent the most frequent and lethal form of dissemination in advanced gastric cancer(GC),with limited efficacy of systemic chemotherapy[median overall survival(OS):2-9 months].Over the past decades,hyperthermic intraperitoneal chemotherapy(HIPEC),often combined with cytoreductive surgery(CRS),has emerged as a locoregional strategy to improve peritoneal disease control.Retrospective studies have suggested promising survival benefits(median OS:18.8 months);however,conflicting results from prospective trials have limited its widespread adoption.This systematic review hypothesizes that selected patients with advanced or high-risk GC may benefit from HIPEC and evaluates whether such benefits have been confirmed in recent prospective evidence.AIM To evaluate the role and outcomes of HIPEC in advanced and high-risk GC through a systematic review of prospective trials.METHODS A systematic review of prospective randomized and controlled clinical trials(2010-2024)was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines.Studies were selected from PubMed,Cochrane,Scopus,and ClinicalTrials.gov.No geographical restrictions were applied in the search process.Eligible studies included patients with advanced GC(T3+,positive peritoneal cytology/PM)receiving HIPEC in either therapeutic or prophylactic settings.Exclusion criteria included retrospective studies,single-arm trials,and those lacking survival outcomes.Risk of bias was assessed using Risk of Bias 2.0 and Risk of Bias in Non-Randomized Studies of Interventions tools;sensitivity and heterogeneity analyses were also conducted.RESULTS Thirteen prospective studies(eight therapeutic,five prophylactic)were included.In therapeutic settings,CRS combined with HIPEC yielded a median OS of 11-24.9 months vs 4-6 months with systemic therapy alone.Completeness of cytoreduction(CC-0)was achieved in 67.3%of cases,and associated with improved disease-free survival.In prophylactic settings,HIPEC significantly reduced peritoneal recurrence,particularly in T4 tumors.Sensitivity analyses confirmed robustness of findings,though benefit was driven by a few key trials.Heterogeneity was moderate across studies;lack of standardized HIPEC protocols and patient selection criteria limited comparability.CONCLUSION HIPEC may improve survival and reduce recurrence in selected GC patients,particularly those with low peritoneal burden and CC-0 resection.Further standardization and prospective trials are needed.展开更多
BACKGROUND Prophylactic hyperthermic intraperitoneal chemotherapy(HIPEC)is one of the methods to prevent peritoneal metastasis of advanced gastric cancer(AGC).However,the prognosis of gastric cancer patients who recei...BACKGROUND Prophylactic hyperthermic intraperitoneal chemotherapy(HIPEC)is one of the methods to prevent peritoneal metastasis of advanced gastric cancer(AGC).However,the prognosis of gastric cancer patients who receive this treatment are different.AIM To investigate whether inflammation and nutritional indicators affect the pro-gnosis of AGC patients undergoing gastrectomy and prophylactic HIPEC,and to develop a novel inflammatory nutritional prognostic index(INPI).Additionally,we aimed to construct a nomogram model to visually predict the prognosis of these patients and provide more accurate guidance for clinical decision-making.METHODS Clinical data from 181 Locally AGC patients who underwent gastrectomy and prophylactic HIPEC treatment at The Affiliated Hospital of Qingdao University were retrospectively collected.Multicollinearity analysis and least absolute shrinkage and selection operator(LASSO)Cox regression were utilized to construct the INPI.Survival analyses were performed using the Kaplan-Meier method and log-rank test.Both univariate and multivariate Cox proportional hazards regression models were used to analyze independent prognostic factors,and a prognostic nomogram was generated.And the model was validated using the bootstrap method.RESULTS Clinical data from 181 locally AGC patients who underwent gastrectomy and prophylactic HIPEC treatment at The Affiliated Hospital of Qingdao University were retrospectively collected.Multicollinearity analysis and LASSO Cox regression were utilized to construct the INPI.Survival analyses were performed using the Kaplan-Meier method and log-rank test.Both univariate and multivariate Cox proportional hazards regression models were applied to analyze independent prognostic factors,and a prognostic nomogram was generated.And the model was validated using the bootstrap method.CONCLUSION Inflammation and nutrition indicators are associated with the prognosis of AGC patients undergoing gastrectomy and prophylactic HIPEC.The nomogram based on the INPI and clinical features supports personalized treatment strategies improving prognosis for AGC patients undergoing gastrectomy and prophylactic HIPEC.展开更多
Since its introduction in 1991,laparoscopic right colectomy has been the standard surgical treatment for benign and malignant right colon diseases.Extracorporeal anastomosis(ECA)is the most commonly used anastomotic t...Since its introduction in 1991,laparoscopic right colectomy has been the standard surgical treatment for benign and malignant right colon diseases.Extracorporeal anastomosis(ECA)is the most commonly used anastomotic technique.However,intracorporeal anastomosis(ICA)has emerged as a promising alternative because of its potential advantages.Recently,Wu et al provided compelling evidence supporting superiority of ICA over ECA,demonstrating reduced blood loss,smaller incisions,and faster postoperative recovery without increased complic-ations.Despite these benefits,ICA presents certain challenges such as longer operative times and technical difficulties.However,advances in minimally in-vasive surgery,including robot-assisted platforms,may facilitate broader adoption of ICA by addressing the technical limitations.Furthermore,meticulous surgical techniques and perioperative infection control strategies are essential for mitigating intra-abdominal infectious complications.Given the increasing adoption of ICA in minimally invasive right hemicolectomy,further studies,including multicenter randomized controlled trials,are necessary to confirm its oncological safety and establish standardized surgical protocols.Overall,ICA has the potential to become the preferred anastomotic approach in both laparoscopic and robotic colorectal surgeries.展开更多
Wen-lin Gong1,Chuang Sha2,Gang Du1,Zhong-gui Shan3,Zhong-quan Qi3,Su-fang Zhou1,Nuo Yang1,4,Yong-xiang Zhao1,4.First published:21 June 2017;10(5):454-460.DOI:10.1016/j.apjtm.2017.05.004 The authors would like to corre...Wen-lin Gong1,Chuang Sha2,Gang Du1,Zhong-gui Shan3,Zhong-quan Qi3,Su-fang Zhou1,Nuo Yang1,4,Yong-xiang Zhao1,4.First published:21 June 2017;10(5):454-460.DOI:10.1016/j.apjtm.2017.05.004 The authors would like to correct an error in Figure 3 in which the flow cytometric scattergram of CD4/CD44 for the control group was erroneously used for the scattergram of CD8/CD44 for the PVIDSC group.The correct scattergram of CD8/CD44 for the PVIDSC group is provided below.The error does not affect the conclusion of the study.The authors apologize for the error and the inconvenience it might have caused to readers.展开更多
基金supported by the National Key Research and Development Program of China(No.2022YFC3702704)the National Natural Science Foundation of China(Nos.22376005,22076006 and 82073506).
文摘Microorganisms constitute an essential component in the indoor environment,which is closely related to hu-man health.However,there is limited evidence regarding the associations between indoor airborne microbiome and systemic inflammation,as well as whether this association is modified by indoor particulate matter and the underlying mechanisms.In this prospective repeated-measure study among 66 participants,indoor airborne mi-crobiome was characterized using amplicon sequencing and qPCR.Indoor fine particulate matter(PM_(2.5))and inhalable particulate matter(PM10)were measured.Systemic inflammatory biomarkers were assessed,including white blood cell(WBC),neutrophil(NEUT),monocyte,eosinophil counts,and their proportions.Targeted serum amino acid metabolomics were conducted to explore the underlying mechanisms.Linear mixed-effect models re-vealed that bacterial and fungal Simpson diversity were significantly associated with decreased WBC and NEUT.For example,for each interquartile range increase in the bacterial Simpson diversity,WBC and NEUT changed by-4.53%(95%CI:-8.25%,-0.66%)and-5.95%(95%CI:-11.3%,-0.27%),respectively.Notably,increased inflammatory risks of airborne microbial exposure were observed when indoor PM_(2.5) and PM10 levels were below the WHO air quality guidelines.Mediation analyses indicated that dopamine metabolism partially mediated the anti-inflammatory effects of fungal diversity exposure.Overall,our study indicated protection from a diverse indoor microbial environment on cardiovascular health and proposed an underlying mechanism through amino acid metabolism.Additionally,health risks associated with microbial exposure deserve more attention in con-texts of low indoor particulate matter pollution.Further research is necessary to fully disentangle the complex relationships between indoor microbiome,air pollutants,and human health.
基金supported by the National Key R&D Program of China(2022YFC3401600)the National Natural Science Foun-dation of China(32530061 and 32171372)+1 种基金the Science and Technology Projects of Xizang Autonomous Region,China(XZ202202YD0029C)the Fundamental Research Funds for the Central Universities(KG202511)。
文摘Radiotherapy(RT)is considered a standard cancer treatment that directly kills tumor cells and promotes a systemic immune response.However,RT may also lead to tumor hypoxia,which further inhibits the antigen-presenting function of dendritic cells(DCs)and thereby weakens the systemic anti-tumor immune response induced by radiotherapy.In this study,the oxygen-loaded in situ gels carrying bacterial outer membrane(MOGel)were synthesized.As the gels slowly degraded,oxygen was gradually released to alleviate tumor hypoxia.The released bacterial outer membrane(OM)continuously activated DCs,enhancing their antigenpresenting capability.The results demonstrated that MOGel combined with RT induced the strongest tumor cell apoptosis in vitro and achieved a 80%tumor suppression rate in a colon cancer orthotopic model.Importantly,MOGel+RT induced an enhanced abscopal effect,and hypoxia and enhanced DCs activation contributed to the systemic immune response.Thus,OM-based oxygen gels may offer a novel strategy for enhancing the systemic immune response to RT.
基金Supported by the National Natural Science Foundation of China,No.82170406 and No.81970238.
文摘Gastric ulcer(GU)represents a clinically significant manifestation of peptic ulcer disease,driven by a complex interplay of microbial,environmental,and immuneinflammatory factors.A recent cross-sectional study by Shen et al systematically evaluated six complete blood count-derived inflammatory indices:Neutrophil-tolymphocyte ratio,monocyte-to-lymphocyte ratio,platelet-to-lymphocyte ratio,systemic immune-inflammation index,systemic inflammatory response index(SIRI),and aggregate index of systemic inflammation and demonstrated their positive associations with GU prevalence,identifying SIRI as the strongest predictor.This editorial contextualizes these findings within the broader literature,clarifies that these indices reflect systemic rather than GU-specific inflammation,highlights methodological strengths and major limitations,and proposes a conceptual clinical algorithm for integrating SIRI into GU risk assessment.Future multicenter studies incorporating Helicobacter pylori infection,non-steroidal antiinflammatory drug exposure,and prospective design are essential to validate and translate these findings into clinical practice.
基金supported by Texas Alzheimer’s Research and Care Consortium-TARCC 2022-26,The National Football League Players Association-NFLPA,NIH/NIA Grant 1R01 AG072491 to TB and FDP.
文摘Neuroinflammation is a crucial factor in the progression of various diseases,ranging from immune-related conditions such as sepsis to neurodegenerative disorders such as Alzheimer’s disease(AD)(Ravichandran and Heneka,2024).This perspective article,which draws on insights from diverse fields including neuroscience,immunology,and pathology,p rovides a critical analysis of ongoing research efforts in inflammasome biology,with specific emphasis on Nod-like receptor(NLR)and pyrin domain-containing protein 3(NLRP3).
文摘Unresectable hepatocellular carcinoma(HCC)remains a global challenge,with limited effective treatment options for advanced-stage disease.The HIMALAYA trial(phase III randomized study that evaluated the STRIDE regimen)introduced the Single Tremelimumab Regular Interval Durvalumab(STRIDE)regimen,an immunotherapy-based approach that achieved a median overall survival(OS)of 16.43 months compared to 13.77 months with sorafenib.While statistically significant,this~2.7 months OS gain warrants scrutiny in light of STRIDE’s increased immune-related toxicity and cost.This commentary evaluates STRIDE’s impact within the broader landscape of first-line systemic therapy for unresectable HCC,alongside other regimens such as atezolizumab plus bevacizumab and nivolumab plus ipilimumab.We explore STRIDE’s mechanism of action,safety profile,modest progression-free survival(PFS)improvement,and implementation challenges,incorporating insights from 2023-2025 research.In addition,we discussed its limitations in non-viral HCC and Child-Pugh B patients,the role of emerging biomarkers,and the potential of radiation to enhance immunotherapy efficacy.As a dual immune checkpoint inhibitor(ICI)strategy,STRIDE offers an important advance that may not only extend survival but also open the door to future curative approaches.However,optimizing its use will require refined patient selection and further investigation of synergistic combination therapies.
文摘Dear Editor,Systemic sclerosis(SSc)is an autoimmune connective tissue disease in which there are vascular abnormalities,inflammation,and fibrosis[1].These three characteristics primarily affect the skin and lungs.Of all the autoimmune rheumatic diseases,SSc has the highest all-cause mortality rate,and the underlying pathogenic processes that mediate disease are still obscure,with wide diff erences in presentation and progression[2,3].
基金supported by the National Natural Science Foundation Joint Fund,No.U22A20309(to PY)the Natural Science Foundation of LiaoningProvince,No.2023-MS-07(to HuL)the Unveiling Key Scientific and Technological Projects of Liaoning Province,No.2021JH1/10400051(to HuL).
文摘Some patients with systemic lupus erythematosus experience neuropsychiatric symptoms.Although magnetic resonance imaging can detect abnormal signals in the white matter of the brain,conventional methods often struggle to accurately capture microstructural changes.Various diffusion models have been used to study white matter in systemic lupus erythematosus;however,comparative analyses of their sensitivity and specificity for detecting microstructural changes remain insufficient.To address this,our team designed a diagnostic trial that used multimodal diffusion imaging techniques to observe white matter microstructural changes in patients with systemic lupus erythematosus who had neuropsychiatric symptoms,with an aim to identify key diagnostic biomarkers for these patients.Patients with active lupus who received treatment at the Department of Rheumatology and Immunology,The First Affiliated Hospital of China Medical University,from September 2023 to March 2024 were recruited.According to the standards of the American College of Rheumatology,patients with systemic lupus erythematosus who had neuropsychiatric symptoms were assigned to the systemic lupus erythematosus group,whereas those without neuropsychiatric symptoms were assigned to the non-systemic lupus erythematosus group.Additionally,healthy volunteers matched by region,sex,and age were recruited as controls.All three groups underwent the same diffusion magnetic resonance imaging examination protocol to compare differences in diffusion parameters.Advanced diffusion imaging models were able to sensitively detect microstructural changes in the white matter fibers of patients with systemic lupus erythematosus who had neuropsychiatric symptoms,with specific diffusion parameters showing significant abnormalities in key brain regions.In the left superior longitudinal fasciculus subregion and the right thalamic radiations of patients with systemic lupus erythematosus who had neuropsychiatric symptoms,we also identified abnormal diffusion characteristics that were clearly correlated with disease activity,suggesting that microstructural changes in these areas may reflect the dynamic process of neuroinflammatory damage.The present study addresses critical challenges in the diagnosis of systemic lupus erythematosus by identifying specific white matter imaging biomarkers and elucidating the association between microstructural damage and clinical manifestations.The main contributions of our study include:1)establishing axial regression probability parameters from mean apparent propagator magnetic resonance imaging as sensitive biomarkers for systemic lupus erythematosus,particularly in the third subregion of the left superior longitudinal fasciculus;2)demonstrating that multimodal diffusion imaging may be superior to conventional diffusion tensor imaging for detecting white matter microstructural abnormalities in patients with systemic lupus erythematosus;and 3)integrating tract-based spatial statistics with clinically relevant analyses to link imaging findings to pathological mechanisms.
基金funded by grants from the National Key Research and Development Program of China(grant numbers 2017YFC1308900 and SQ2018ZX090301)the National Natural Science Foundation of China(grant numbers 81370064 and 81672367).
文摘Background We have developed a tridirectional regimen combining intraperitoneal,intravenous,and oral chemotherapy as a treatment for patients with advanced gastric cancer and individualized these chemotherapeutics according to mRNA expression.This multicenter Phase Ⅲ umbrella study compared the efficacy and safety of individualized tridirectional intraperitoneal and systemic chemotherapy with that of standard systemic chemotherapy.Methods BRCA1/TOPO1 mRNA expression was examined in all enrolled patients.The patients were then randomized in a ratio of 3:1 to an individualized arm and a control arm.Patients in the control arm received systemic intravenous/oral chemotherapy,whereas those in the individualized arm received sensitive chemotherapeutics selected from oxaliplatin/cisplatin/docetaxel/irinotecan/S-1 according to their BRCA1/TOPO1 mRNA expression and received individualized tridirectional intraperitoneal/intravenous/oral chemotherapy.The primary endpoint was progressionfree survival and the secondary endpoints were response rate,overall survival,and safety.Results Overall,233 of 240 patients enrolled between August 2014 and December 2016 were included in the efficacy analysis.Baseline patient characteristics were balanced between the two arms.The objective response rate was 33.9%in the control arm and 49.1%in the individualized arm(P=0.039).In the control and individualized arms,median progression-free survival was 5.9 months and 8.0 months,respectively(hazard ratio 0.521,95%confidence interval 0.362-0.750,P=0.0005)and median overall survival was 13.5 months and 16.4 months,respectively(hazard ratio 0.684,95%confidence interval 0.474-0.988,P=0.0430).Both regimens were tolerable.Conclusion The primary analysis demonstrated the statistical superiority of this tridirectional individualized regimen and suggests that this regimen has clinical efficacy in patients with advanced gastric cancer.Trial registration Chinese Clinical Trial Registry(chictr.org.cn)Identifier:ChiCTR-IPR-15006201.
基金Bethune Charitable Foundation Project,No.HZB-20190528-10Natural Science Foundation of Fujian Province,No.2020J011230.
文摘BACKGROUND Colorectal cancer,one of the most common malignancies,is primarily treated through surgery.With the widespread use of laparoscopy,gastrointestinal reconstruction remains a key area of research.The choice between intraperitoneal anastomosis(IA)and extraperitoneal anastomosis(EA)remains a subject of considerable debate.This study uses intraperitoneal isoperistaltic side-to-side anastomosis(IISSA)with hand-sewn closure of the common opening to evaluate its safety and short-term outcomes.It is hypothesized that this technique may offer better short-term outcomes than EA.AIM To investigate the safety and short-term outcomes of IISSA with hand-sewn closure of the common opening compared to EA.METHODS Patients who underwent laparoscopic radical colon cancer surgery between January 2018 and June 2022 at the First Affiliated Hospital of Xiamen University were retrospectively analyzed.Surgical,postoperative,and pathological features of the IA and EA groups were observed before and after propensity score matching.Patients with right-sided and left-sided colon cancer were separated,each further divided into IA and EA groups(R-IA vs R-EA for right-sided,L-IA vs L-EA for left-sided),for stratified analysis of the aforementioned indicators.RESULTS After propensity score matching,63 pairs were matched in each group.In surgical characteristics,the IA group exhibited less blood loss and shorter incisions than the EA group.Regarding postoperative recovery,the IA group showed earlier recovery of gastrointestinal function.Pathologically,the IA group had greater lymph node clearance.Relative to the R-EA group,the R-IA group experienced reduced blood loss,shorter assisted incisions,earlier recovery of gastrointestinal functions and greater lymph node dissection.When compared to the L-EA group,the L-IA group demonstrated earlier postoperative anal exhaust and defecation,along with a reduced length of hospitalization.Regarding postoperative complications,no statistically significant differences were found between the groups either after matching or in the stratified analyses.CONCLUSION Compared to EA,IISSA with hand-sewn closure of the common opening is a safe and feasible option for laparoscopic radical colon cancer surgery.
文摘BACKGROUND The diagnosis of gastric carcinoma(GC)is essential for improving clinical outcomes.However,the biomarkers currently used for GC screening are not ideal.AIM To explore the diagnostic implications of the neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),and systemic immune-inflammatory index(SII)for GC.METHODS The baseline data of 133 patients with GC and 134 patients with precancerous gastric conditions admitted between January 2022 and December 2023 were retrospectively analyzed.The information on peripheral blood platelet,neutrophil,and lymphocyte counts in each patient was collected,and the NLR,PLR,and SII levels of both groups were calculated.Additionally,multivariate logistic regression analysis was conducted,and the diagnostic implications of NLR,PLR,and SII in differentiating patients with precancerous gastric conditions,compared with those with GC,were analyzed through receiver operating characteristic(ROC)curves.RESULTS The data indicated that NLR,PLR,and SII had abnormally increased levels in the patients with GC.Gender and body mass index were risk factors for the occurrence of GC.ROC data revealed that the areas under the curve of three patients with precancerous gastric conditions,who were differentiated from those with GC,were 0.824,0.787,and 0.842,respectively.CONCLUSION NLR,PLR,and SII are all abnormally expressed in GC and have diagnostic implications,especially when used as joint indicators,in distinguishing patients with precancerous gastric conditions from those with GC.
文摘Background Monoglycerides have emerged as a promising alternative to conventional practices due to their biolog-ical activities,including antimicrobial properties.However,few studies have assessed the efficacy of monoglyceride blend on weaned pigs and their impacts on performance,immune response,and gut health using a disease chal-lenge model.Therefore,this study aimed to investigate the effects of dietary monoglycerides of short-and medium-chain fatty acids on the immunity and gut health of weaned pigs experimentally infected with an enterotoxigenic Escherichia coli F18.Results Pigs supplemented with high-dose zinc oxide(ZNO)had greater(P<0.05)growth performance than other treatments,but no difference was observed in average daily feed intake between ZNO and monoglycerides groups during the post-challenge period.Pigs in ZNO and antibiotic groups had lower(P<0.05)severity of diarrhea than control,but the severity of diarrhea was not different between antibiotic and monoglycerides groups.Pigs fed with monoglycerides or ZNO had lower(P<0.05)serum haptoglobin on d 2 or 5 post-inoculation than control.Pigs in ZNO had greater(P<0.05)goblet cell numbers per villus,villus area and height,and villus height:crypt depth ratio(VH:CD)in duodenum on d 5 post-inoculation than pigs in other treatments.Pigs supplemented with monoglyc-erides,ZNO,or antibiotics had reduced(P<0.05)ileal crypt depth compared with control on d 5 post-inoculation,contributing to the increase(P=0.06)in VH:CD.Consistently,pigs in ZNO expressed the lowest(P<0.05)TNFa,IL6,IL10,IL12,IL1A,IL1B,and PTGS2 in ileal mucosa on d 5 post-inoculation,and no difference was observed in the expres-sion of those genes between ZNO and monoglycerides.Supplementation of ZNO and antibiotic had significant impacts on metabolic pathways in the serum compared with control,particularly on carbohydrate and amino acid metabolism,while limited impacts on serum metabolites were observed in monoglycerides group when compared with control.Conclusions The results suggest that supplementation of monoglyceride blend may enhance disease resist-ance of weaned pigs by alleviating the severity of diarrhea and mitigating intestinal and systemic inflammation,although the effectiveness may not be comparable to high-dose zinc oxide.
基金supported by Animal Nutrition,Eastman Chemical Company,Kingsport,TN,USA.
文摘Background The emergence of antibiotic resistant microorganisms associated with conventional swine production practices has increased interest in acid-based compounds having antimicrobial properties and other biological functions as nutritional interventions.Despite the interest in organic acids and monoglycerides,few studies have examined the effects of the combination of these acid-based additives in weaned pigs under disease challenge conditions.Therefore,this study aimed to investigate the effects of dietary supplementation with blend of organic acids and/or medium-chain fatty acid monoglycerides on intestinal health and systemic immunity of weaned pigs experimentally infected with an enterotoxigenic Escherichia coli(ETEC)F18 at 4-week of age.Results Dietary supplementation of organic acids,monoglycerides,or both organic acids and monoglycerides(combination)reduced(P<0.05)the diarrhea frequency of ETEC F18-infected pigs throughout the experimental period(d−7 to 21 post-inoculation).This is consistent with the reduced(P<0.05)proportion ofβ-hemolytic coliforms in feces observed for the organic acid and combination treatments on d 10 post-inoculation.Supplementation of organic acids,monoglycerides,or combination also reduced(P<0.05)bacterial translocation in mesenteric lymph nodes on d 21 post-inoculation.Pigs fed with monoglycerides or combination had lower(P<0.05)white blood cells on d 5 post-inoculation,and pigs fed the combination also had lower(P<0.05)lymphocytes than pigs in control group.Monoglyceride supplementation increased(P<0.05)white blood cells and neutrophils compared with control group on d 14 post-inoculation.However,supplementation with organic acid blend,monoglyceride blend,or combination did not affect growth performance in this experiment.Conclusions Supplementation with monoglycerides or organic acids alone or in combination improves the detrimental effects of ETEC F18 infection in weaned pigs,as indicated by reduced diarrhea,fecal shedding ofβ-hemolytic coliforms,and bacterial translocation,and thus enhancing disease resistance.Monoglycerides reduced the inflammatory response during peak infection,but their immunomodulatory and possible synergistic effects with organic acids need to be further investigated.
基金Supported by the Scientific Research Project of Hospital Pharmacy of Guangxi Pharmaceutical Association in 2022,No.GXYXH1-202202.
文摘BACKGROUND Gastric cancer(GC)is the fifth most common cancer and the third leading cause of cancer-related deaths in China.Many patients with GC frequently experience symptoms related to the disease,including anorexia,nausea,vomiting,and other discomforts,and often suffer from malnutrition,which in turn negatively affects perioperative safety,prognosis,and the effectiveness of adjuvant therapeutic measures.Consequently,some nutritional indicators such as nutritional risk index(NRI),prognostic nutritional index(PNI),and systemic immune-inflammatorynutritional index(SIINI)can be used as predictors of the prognosis of GC patients.AIM To examine the prognostic significance of PNI,NRI,and SIINI in postoperative patients with GC.METHODS A retrospective analysis was conducted on the clinical data of patients with GC who underwent surgical treatment at the Guangxi Medical University Cancer Hospital between January 2010 and December 2018.The area under the receiver operating characteristic(ROC)curve was assessed using ROC curve analysis,and the optimal cutoff values for NRI,PNI,and SIINI were identified using the You-Review-HTMLden index.Survival analysis was performed using the Kaplan-Meier method.In addition,univariate and multivariate analyses were conducted using the Cox proportional hazards regression model.RESULTS This study included a total of 803 patients.ROC curves were used to evaluate the prognostic ability of NRI,PNI,and SIINI.The results revealed that SIINI had superior predictive accuracy.Survival analysis indicated that patients with GC in the low SIINI group had a significantly better survival rate than those in the high SIINI group(P<0.05).Univariate analysis identified NRI[hazard ratio(HR)=0.68,95%confidence interval(CI):0.52-0.89,P=0.05],PNI(HR=0.60,95%CI:0.46-0.79,P<0.001),and SIINI(HR=2.10,95%CI:1.64-2.69,P<0.001)as prognostic risk factors for patients with GC.However,multifactorial analysis indicated that SIINI was an independent risk factor for the prognosis of patients with GC(HR=1.65,95%CI:1.26-2.16,P<0.001).CONCLUSION Analysis of clinical retrospective data revealed that SIINI is a valuable indicator for predicting the prognosis of patients with GC.Compared with NRI and PNI,SIINI may offer greater application for prognostic assessment.
文摘Gastric cancer(GC)and gastroesophageal junction cancer(GEJC)represent a significant burden globally,with complications such as overt bleeding(OB)further exacerbating patient outcomes.A recent study by Yao et al evaluated the effectiveness and safety of systematic treatment in GC/GEJC patients presenting with OB.Using propensity score matching,the study balanced the comparison groups to investigate overall survival and treatment-related adverse events.The study's findings emphasize that systematic therapy can be safe and effective and contribute to the ongoing debate about the management of advanced GC/GEJC with OB,highlighting the complexities of treatment decisions in these high-risk patients.
基金supported by the National Nature Science Foundation of China(No.81402308)Science Foundation of Peking University Cancer Hospital(No.2021-24)+2 种基金Natural Science Foundation of Beijing Municipal(No.7242020)Science Foundation of Peking University Cancer Hospital(No.BJCH2025GG04)the National Nature Science Foundation of China(No.82173151).
文摘Objective:The trial was designed to evaluate the efficacy of prophylactic hyperthermic intraperitoneal chemotherapy(HIPEC)with cisplatin for patients with locally advanced gastric cancer(LAGC).Methods:Between March 2015 and November 2016,a phase Ⅱ clinical trial was performed.Fifty consecutive patients with LAGC were randomly assigned to two groups:the experimental group(radical gastrectomy+HIPEC with cisplatin+adjuvant chemotherapy)and the control group(radical gastrectomy+adjuvant chemotherapy).Survival rates were closely monitored.Results:The 5-year overall survival(OS)rate of all patients was 80.0%.The 5-year OS rate in the experimental group was lower than that in the control group,at 75.8%and 88.2%,respectively,with no statistical significance.In addition,5-year recurrence-free survival(RFS)rates of patients who underwent HIPEC or not were also 75.8%and 88.2%,respectively.In the multivariate analysis,only pT stage[risk ratio(RR)=7.079,P=0.018]was significantly associated with prognosis.The most common recurrence pattern was peritoneal recurrence in both groups.The experimental group had a lower incidence of peritoneal recurrence than the control group with no statistical significance.Conclusions:This trial clearly revealed that prophylactic HIPEC with cisplatin neither decrease the risk of peritoneal recurrence nor improve the prognosis of patients with LAGC.Thus,HIPEC with cisplatin is not recommended as a prophylactic treatment for peritoneal recurrence of LAGC after radical gastrectomy.
文摘Cytoreductive surgery(CRS)and hyperthermic intraperitoneal chemotherapy(HIPEC)are complex surgical procedures that are often used to treat advanced cancers of the abdominal cavity with peritoneal metastasis.Although these treatments can be lifesaving,patients often experience a significant decrease in their overall quality of life(QoL),especially in the early stages of recovery,owing to the physical burden of surgery and the effects of chemotherapy.Many traditional QoL questionnaires have been used to measure CRS and HIPEC.However,these classical current QoL assessment tools often fail to capture the unique challenges faced by this population,including bowel dysfunction,stoma-related distress,and long-term survivorship issues.Therefore,additional parameters that assess bowel function and stoma opening status and especially patient-reported outcome measures would be useful in QoL measurements to provide a more detailed understanding of recovery and general well-being in these patients.
文摘BACKGROUND Peritoneal metastases(PM)represent the most frequent and lethal form of dissemination in advanced gastric cancer(GC),with limited efficacy of systemic chemotherapy[median overall survival(OS):2-9 months].Over the past decades,hyperthermic intraperitoneal chemotherapy(HIPEC),often combined with cytoreductive surgery(CRS),has emerged as a locoregional strategy to improve peritoneal disease control.Retrospective studies have suggested promising survival benefits(median OS:18.8 months);however,conflicting results from prospective trials have limited its widespread adoption.This systematic review hypothesizes that selected patients with advanced or high-risk GC may benefit from HIPEC and evaluates whether such benefits have been confirmed in recent prospective evidence.AIM To evaluate the role and outcomes of HIPEC in advanced and high-risk GC through a systematic review of prospective trials.METHODS A systematic review of prospective randomized and controlled clinical trials(2010-2024)was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines.Studies were selected from PubMed,Cochrane,Scopus,and ClinicalTrials.gov.No geographical restrictions were applied in the search process.Eligible studies included patients with advanced GC(T3+,positive peritoneal cytology/PM)receiving HIPEC in either therapeutic or prophylactic settings.Exclusion criteria included retrospective studies,single-arm trials,and those lacking survival outcomes.Risk of bias was assessed using Risk of Bias 2.0 and Risk of Bias in Non-Randomized Studies of Interventions tools;sensitivity and heterogeneity analyses were also conducted.RESULTS Thirteen prospective studies(eight therapeutic,five prophylactic)were included.In therapeutic settings,CRS combined with HIPEC yielded a median OS of 11-24.9 months vs 4-6 months with systemic therapy alone.Completeness of cytoreduction(CC-0)was achieved in 67.3%of cases,and associated with improved disease-free survival.In prophylactic settings,HIPEC significantly reduced peritoneal recurrence,particularly in T4 tumors.Sensitivity analyses confirmed robustness of findings,though benefit was driven by a few key trials.Heterogeneity was moderate across studies;lack of standardized HIPEC protocols and patient selection criteria limited comparability.CONCLUSION HIPEC may improve survival and reduce recurrence in selected GC patients,particularly those with low peritoneal burden and CC-0 resection.Further standardization and prospective trials are needed.
文摘BACKGROUND Prophylactic hyperthermic intraperitoneal chemotherapy(HIPEC)is one of the methods to prevent peritoneal metastasis of advanced gastric cancer(AGC).However,the prognosis of gastric cancer patients who receive this treatment are different.AIM To investigate whether inflammation and nutritional indicators affect the pro-gnosis of AGC patients undergoing gastrectomy and prophylactic HIPEC,and to develop a novel inflammatory nutritional prognostic index(INPI).Additionally,we aimed to construct a nomogram model to visually predict the prognosis of these patients and provide more accurate guidance for clinical decision-making.METHODS Clinical data from 181 Locally AGC patients who underwent gastrectomy and prophylactic HIPEC treatment at The Affiliated Hospital of Qingdao University were retrospectively collected.Multicollinearity analysis and least absolute shrinkage and selection operator(LASSO)Cox regression were utilized to construct the INPI.Survival analyses were performed using the Kaplan-Meier method and log-rank test.Both univariate and multivariate Cox proportional hazards regression models were used to analyze independent prognostic factors,and a prognostic nomogram was generated.And the model was validated using the bootstrap method.RESULTS Clinical data from 181 locally AGC patients who underwent gastrectomy and prophylactic HIPEC treatment at The Affiliated Hospital of Qingdao University were retrospectively collected.Multicollinearity analysis and LASSO Cox regression were utilized to construct the INPI.Survival analyses were performed using the Kaplan-Meier method and log-rank test.Both univariate and multivariate Cox proportional hazards regression models were applied to analyze independent prognostic factors,and a prognostic nomogram was generated.And the model was validated using the bootstrap method.CONCLUSION Inflammation and nutrition indicators are associated with the prognosis of AGC patients undergoing gastrectomy and prophylactic HIPEC.The nomogram based on the INPI and clinical features supports personalized treatment strategies improving prognosis for AGC patients undergoing gastrectomy and prophylactic HIPEC.
文摘Since its introduction in 1991,laparoscopic right colectomy has been the standard surgical treatment for benign and malignant right colon diseases.Extracorporeal anastomosis(ECA)is the most commonly used anastomotic technique.However,intracorporeal anastomosis(ICA)has emerged as a promising alternative because of its potential advantages.Recently,Wu et al provided compelling evidence supporting superiority of ICA over ECA,demonstrating reduced blood loss,smaller incisions,and faster postoperative recovery without increased complic-ations.Despite these benefits,ICA presents certain challenges such as longer operative times and technical difficulties.However,advances in minimally in-vasive surgery,including robot-assisted platforms,may facilitate broader adoption of ICA by addressing the technical limitations.Furthermore,meticulous surgical techniques and perioperative infection control strategies are essential for mitigating intra-abdominal infectious complications.Given the increasing adoption of ICA in minimally invasive right hemicolectomy,further studies,including multicenter randomized controlled trials,are necessary to confirm its oncological safety and establish standardized surgical protocols.Overall,ICA has the potential to become the preferred anastomotic approach in both laparoscopic and robotic colorectal surgeries.
文摘Wen-lin Gong1,Chuang Sha2,Gang Du1,Zhong-gui Shan3,Zhong-quan Qi3,Su-fang Zhou1,Nuo Yang1,4,Yong-xiang Zhao1,4.First published:21 June 2017;10(5):454-460.DOI:10.1016/j.apjtm.2017.05.004 The authors would like to correct an error in Figure 3 in which the flow cytometric scattergram of CD4/CD44 for the control group was erroneously used for the scattergram of CD8/CD44 for the PVIDSC group.The correct scattergram of CD8/CD44 for the PVIDSC group is provided below.The error does not affect the conclusion of the study.The authors apologize for the error and the inconvenience it might have caused to readers.
