Application of the superior mesenteric artery-first approach in laparoscopic pancreatoduodenectomy: A literature review.

Background: Laparoscopic pancreaticoduodenectomy (LPD) is a complicated surgical procedure that has recently been performed safely. A superior mesenteric artery (SMA)-first approach can allow complete mesopancreas resection, maximizing surgical margins and R0 resection rates. Therefore, the SMA-first approach is recommended. This review is a literature summary of recent updates of the SMA approaches for LPD and informs clinical practice of the advantages of its various approach. Methods: A systematic literature search was performed on the PubMed (MEDLINE) database using truncated word searches and medical subject headings to identify all pertinent published studies. Results: After searching PubMed, 303 studies were identified and reviewed, of which 25 described the SMA-first approach, including the anterior, posterior, right, and left approaches, fully described in 5, 6, 13, and 6 articles, respectively. Conclusions: The SMA-first approach is the standard surgical technique for LPD. This review summarized each SMA-first approach's distinct advantages and indications.

MS-TCNet: An effective Transformer-CNN combined network using multi-scale feature learning for 3D medical image segmentation.

Medical image segmentation is a fundamental research problem in the field of medical image processing. Recently, the Transformer have achieved highly competitive performance in computer vision. Therefore, many methods combining Transformer with convolutional neural networks (CNNs) have emerged for segmenting medical images. However, these methods cannot effectively capture the multi-scale features in medical images, even though texture and contextual information embedded in the multi-scale features are extremely beneficial for segmentation. To alleviate this limitation, we propose a novel Transformer-CNN combined network using multi-scale feature learning for three-dimensional (3D) medical image segmentation, which is called MS-TCNet. The proposed model utilizes a shunted Transformer and CNN to construct an encoder and pyramid decoder, allowing six different scale levels of feature learning. It captures multi-scale features with refinement at each scale level. Additionally, we propose a novel lightweight multi-scale feature fusion (MSFF) module that can fully fuse the different-scale semantic features generated by the pyramid decoder for each segmentation class, resulting in a more accurate segmentation output. We conducted experiments on three widely used 3D medical image segmentation datasets. The experimental results indicated that our method outperformed state-of-the-art medical image segmentation methods, suggesting its effectiveness, robustness, and superiority. Meanwhile, our model has a smaller number of parameters and lower computational complexity than conventional 3D segmentation networks. The results confirmed that the model is capable of effective multi-scale feature learning and that the learned multi-scale features are useful for improving segmentation performance. We open-sourced our code, which can be found at https://github.com/AustinYuAo/MS-TCNet.

A transcriptome based molecular classification scheme for cholangiocarcinoma and subtype-derived prognostic biomarker.

Previous studies on the molecular classification of cholangiocarcinoma (CCA) focused on certain anatomical sites, and disregarded tissue contamination biases in transcriptomic profiles. We aim to provide universal molecular classification scheme and prognostic biomarker of CCAs across anatomical locations. Comprehensive bioinformatics analysis is performed on transcriptomic data from 438 CCA cases across various anatomical locations. After excluding CCA tumors showing normal tissue expression patterns, we identify two universal molecular subtypes across anatomical subtypes, explore the molecular, clinical, and microenvironmental features of each class. Subsequently, a 30-gene classifier and a biomarker (called "CORE-37") are developed to predict the molecular subtype of CCA and prognosis, respectively. Two subtypes display distinct molecular characteristics and survival outcomes. Key findings are validated in external cohorts regardless of the stage and anatomical location. Our study provides a CCA classification scheme that complements the conventional anatomy-based classification and presents a promising prognostic biomarker for clinical application.

Metabolism-related signalling pathways involved in the pathogenesis and development of metabolic dysfunction-associated steatotic liver disease.

Metabolic dysfunction-associated steatotic liver disease (MASLD) which formerly known as non-alcoholic fatty liver disease (NAFLD) is one of the causes of liver cirrhosis. Currently, a growing number of liver cirrhosis cases develop on the basis of MASLD, and the pathogenesis of MASLD remains unclear. This paper reviews the research progress on the involvement of different metabolism-related signalling pathways in the pathogenesis and development of MASLD.

Review of the Narrow-Banded Hawkmoth, Neogurelca montana (Rothschild & Jordan, 1915) (Lepidoptera: Sphingidae) in China, with Morphological and Phylogenetic Analysis.

Neogurelca montana (Rothschild & Jordan, 1915) is a species of the genus Neogurelca Hogenes & Treadaway, 1993, that was previously known from Sichuan, Yunnan, and Tibet, China. Recently, however, this species was also found in Beijing and Hebei. These populations differ from those in southwest China in body colour and the shape of the yellow patches of the hindwing-a paler body colour and triangular patches in the former and darker body colour and fan-like patches in the latter. Wing morphology, male and female genitalia, and molecular evidence (DNA barcodes) were analysed for the different localities of this species and three other Neogurelca species-N. hyas, N. himachala, and N. masuriensis. Our molecular data support the Beijing population of montana as a valid subspecies, which we describe as N. montana taihangensisssp. nov. Wing and genital morphology confirm the molecular conclusions. We also collected larvae of the new subspecies in the Beijing suburbs and describe its life history and larval hosts and compare them with those of N. himachala.

IFN-α induced systemic lupus erythematosus complicated with hemophagocytic lymphohistiocytosis: a case report and literature review.

Hemophagocytic lymphohistiocytosis (HLH) is a severe and life-threatening hyperinflammatory condition characterized by excessive activation of macrophages and T cells and resulted in multi-organ dysfunction. HLH can be a primary disease or secondary to infections, malignancy, and some autoimmune diseases, including adult-onset Still's disease (AOSD) and systemic lupus erythematosus (SLE). However, it is rare for HLH to occur as a secondary condition to drug-induced lupus erythematosus (DILE). In this report, we present a case of HLH as an unusual complication during SLE treatment in a 31-year-old male patient. The patient initially suffered from active chronic hepatitis B (CHB) and was treated with pegylated INFα-2b (Peg-INFα-2b), tenofovir disoproxil and lamivudine. After 19 months, CHB obtained biochemical and virological response with HBsAg positive to HBsAb. The patient developed fever, headache, and cytopenia after Peg-INFα-2b treatment for 33 months, and laboratory studies revealed that ANA and anti dsDNA were positive. He displayed 5 features meeting the HLH-2004 criteria for diagnosis including fever, pancytopenia, hyperferritinemia, high levels of soluble CD25, and hemophagocytosis on bone marrow biopsy. The patient was initiated with a combination treatment of intravenous methylprednisolone pulse therapy, oral cyclosporine, and etoposide (VP-16), which was followed by a course of oral prednisolone, intravenous cyclophosphamide pulse therapy, and entecavir with complete response. To our knowledge, this is the first report of IFN-α induced SLE complicating with HLH. Physicians should consider the potential autoimmune side effects of IFN-α therapy and be alert to insidious HLH in patients diagnosed with SLE.

Single-cell RNA sequencing highlights the role of PVR/PVRL2 in the immunosuppressive tumour microenvironment in hepatocellular carcinoma.

Introduction: The conflict between cancer cells and the host immune system shapes the immune tumour microenvironment (TME) in hepatocellular carcinoma (HCC). A deep understanding of the heterogeneity and intercellular communication network in the TME of HCC will provide promising strategies to orchestrate the immune system to target and eradicate cancers. Methods: Here, we performed single-cell RNA sequencing (scRNA-seq) and computational analysis of 35786 unselected single cells from 3 human HCC tumour and 3 matched adjacent samples to elucidate the heterogeneity and intercellular communication network of the TME. The specific lysis of HCC cell lines was examined in vitro using cytotoxicity assays. Granzyme B concentration in supernatants of cytotoxicity assays was measured by ELISA. Results: We found that VCAN+ tumour-associated macrophages (TAMs) might undergo M2-like polarization and differentiate in the tumour region. Regulatory dendritic cells (DCs) exhibited immune regulatory and tolerogenic phenotypes in the TME. Furthermore, we observed intensive potential intercellular crosstalk among C1QC+ TAMs, regulatory DCs, regulator T (Treg) cells, and exhausted CD8+ T cells that fostered an immunosuppressive niche in the HCC TME. Moreover, we identified that the TIGIT-PVR/PVRL2 axis provides a prominent coinhibitory signal in the immunosuppressive TME. In vitro, antibody blockade of PVR or PVRL2 on HCC cell lines or TIGIT blockade on immune cells increased immune cell-mediated lysis of tumour cell. This enhanced immune response is paralleled by the increased secretion of Granzyme B by immune cells. Discussion: Collectively, our study revealed the functional state, clinical significance, and intercellular communication of immunosuppressive cells in HCC at single-cell resolution. Moreover, PVR/PVRL2, interact with TIGIT act as prominent coinhibitory signals and might represent a promising, efficacious immunotherapy strategy in HCC.

New nomogram for predicting lymph node positivity in pancreatic head cancer.

Background: Pancreatic cancer is one of the most malignant cancers worldwide, and it mostly occurs in the head of the pancreas. Existing laparoscopic pancreaticoduodenectomy (LPD) surgical techniques have has undergone a learning curve, a wide variety of approaches for the treatment of pancreatic cancer have been proposed, and the operation has matured. At present, pancreatic head cancer has been gradually changing from "surgeons' evaluation of anatomical resection" to "biologically inappropriate resection". In this study, the risk of lymph node metastasis in pancreatic head cancer was predicted using common preoperative clinical indicators. Methods: The preoperative clinical data of 191 patients with pancreatic head cancer who received LPD in the First Affiliated Hospital of Jilin University from May 2016 to December 2021 were obtained. A univariate regression analysis study was conducted, and the indicators with a significance level of P<0.05 were included in the univariate logistic regression analysis into multivariate. Lastly, a nomogram was built based on age, tumor size, leucocyte,albumin(ALB), and lymphocytes/monocytes(LMR). The model with the highest resolution was selected by obtaining the area under a curve. The clinical net benefit of the prediction model was examined using decision curve analyses.Risk stratification was performed by combining preoperative CT scan with existing models. Results: Multivariate logistic regression analysis found age, tumor size, WBC, ALB, and LMR as five independent factors. A nomogram model was constructed based on the above indicators. The model was calibrated by validating the calibration curve within 1000 bootstrap resamples. The ROC curve achieved an AUC of 0.745(confidence interval of 95%: 0.673-0.816), thus indicating that the model had excellent discriminative skills. DCA suggested that the predictive model achieved a high net benefit in the nearly entire threshold probability range. Conclusions: This study has been the first to investigate a nomogram for preoperative prediction of lymphatic metastasis in pancreatic head cancer. The result suggests that age, ALB, tumor size, WBC, and LMR are independent risk factors for lymph node metastasis in pancreatic head cancer. This study may provide a novel perspective for the selection of appropriate continuous treatment regimens, the increase of the survival rate of patients with pancreatic head cancer, and the selection of appropriate neoadjuvant therapy patients.

Outcomes of laparoscopic pancreaticoduodenectomy using a modified technique：346 cases from a single center.

PURPOSE: To study the outcomes of laparoscopic pancreaticoduodenectomy (LPD) using a modified technique. METHODS: Our center used priority approach of uncinate process and artery in the pancreatectomy and duct to mucosa pancreaticojejunostomy with a single stitch in the pancreaticojejunostomy. Herein, we retrospectively reviewed 346 cases of LPD using modified techniques. Basic characteristics, preoperative outcomes, factors associated with unfavorable postoperative outcome, and mortality of patients undergoing LPD were collected and analyzed. RESULTS: The average operative time was 259.31 (35-425) min. The mean duration of pancreaticojejunostomy anastomosis was 31.97 (16-90) min. The mean intraoperative blood loss was 101.76 (0-1200) ml by estimation. Postoperative complications included 14 cases (4.1%) of bile leakage, 9 cases (2.6%) of delayed gastric emptying, 26 cases (7.5%) of postoperative bleeding, 34 cases (9.9%) of organ space infection, 17 cases (4.9%) of pulmonary infection, and 50 cases (14.5%) of POPF. Three factors including postoperative bleeding (OR = 3.502; P = 0.033), positive lymph node (OR = 3.296; P < 0.001), and postoperative chemotherapy (OR = 0.241; P = 0.008) were significantly associated with death of LPD. CONCLUSIONS: The modified technique for LPD presents safety and reliability. Postoperative bleeding and positive lymph node may be associated with worse overall survival, and postoperative chemotherapy may be associated with better overall survival.

Development of a nomogram for predicting the high-risk groups of solid-pseudopapillary neoplasms of the pancreas.

Background: Solid pseudopapillary neoplasms (SPNs) of the pancreas are indolent rare tumors with malignant potential. The risk factors associated with the malignant behavior of SPNs are still unclear. Methods: A retrospective analysis of patients with SPNs who underwent surgical treatment in the First Hospital of Jilin University from January 2010 to January 2022 was conducted. The clinical baseline data, pathology, imaging, and laboratory indicators of the patients were analyzed by univariate and multivariate logistic regression to identify the independent risk factors associated with the high-risk groups, and a predictive model was established in the form of a nomogram. Results: In multivariate analysis, clinical symptoms (P < 0.001), unclear tumor margins (P = 0.001), incomplete tumor capsules (P = 0.005), maximum tumor diameters ≥ 7.2 cm (P = 0.003), and prognostic nutritional index values < 47.45 (P = 0.007) were independent risk factor for SPNs with high-risk groups. A nomogram model was successfully established to predict high-risk groups of SPNs. The area under the receiver operating characteristic curve was 0.856. The calibration prediction curve was in good agreement with the standard curve. Conclusion: The nomogram model based on clinical symptoms, inflammatory markers, and imaging features had a high application value in the preoperative prediction of the high-risk groups of SPNs. A novel nomogram of the affiliated hospital of Jilin University-SPNs risk model was proposed for routine application to guide the patient counseling in clinical practice.

[Retracted] miR­365 targets ADAM10 and suppresses the cell growth and metastasis of hepatocellular carcinoma.

Following the publication of this paper, it was drawn to the Editors' attention by a concerned reader that certain of the colony formation assay data shown in Fig. 2C and the tumor images shown in Fig. 2E were similar to data appearing in different form in other articles by different authors. Owing to the fact that the contentious data in the above article had already been published elsewhere, or were already under consideration for publication, prior to its submission to Oncology Reports, the Editor has decided that this paper should be retracted from the Journal. After having been in contact with the authors, they agreed with the decision to retract the paper. The Editor apologizes to the readership for any inconvenience caused. [Oncology Reports 37: 1857­1864, 2017; DOI: 10.3892/or.2017.5423].

DAFLNet: Dual Asymmetric Feature Learning Network for COVID-19 Disease Diagnosis in X-Rays.

COVID-19 has become the largest public health event worldwide since its outbreak, and early detection is a prerequisite for effective treatment. Chest X-ray images have become an important basis for screening and monitoring the disease, and deep learning has shown great potential for this task. Many studies have proposed deep learning methods for automated diagnosis of COVID-19. Although these methods have achieved excellent performance in terms of detection, most have been evaluated using limited datasets and typically use a single deep learning network to extract features. To this end, the dual asymmetric feature learning network (DAFLNet) is proposed, which is divided into two modules, DAFFM and WDFM. DAFFM mainly comprises the backbone networks EfficientNetV2 and DenseNet for feature fusion. WDFM is mainly for weighted decision-level fusion and features a new pretrained network selection algorithm (PNSA) for determination of the optimal weights. Experiments on a large dataset were conducted using two schemes, DAFLNet-1 and DAFLNet-2, and both schemes outperformed eight state-of-the-art classification techniques in terms of classification performance. DAFLNet-1 achieved an average accuracy of up to 98.56% for the triple classification of COVID-19, pneumonia, and healthy images.

[Retracted] MicroRNA­744 inhibits migration and invasion of hepatocellular carcinoma cells by targeting SOX12.

Following the publication of this paper, it was drawn to the Editors' attention by a concerned reader that the cell migration assay data shown in Fig. 3B were strikingly similar to data that had appeared in different form in another article by different authors. Owing to the fact that the contentious data in the above article had already been published elsewhere prior to its submission to Oncology Reports, the Editor has decided that this paper should be retracted from the Journal. After having been in contact with the authors, they agreed with the decision to retract the paper. The Editor apologizes to the readership for any inconvenience caused. [Oncology Reports 40: 3585­3592, 2018; DOI: 10.3892/or.2018.6774].

A new species of Rhodambulyx Mell, 1939 (Lepidoptera: Sphingidae) from Southwest Chongqing, China.

A new species of the genus Rhodambulyx Mell, 1939, Rhodambulyx xinyuae sp. nov., is described from Simianshan Nature Reserve in Southwest Chongqing, China. This species is similar to R. davidi Mell, 1939 and R. kitchingi Brechlin, 2015 in habitus, but can be distinguished by a different wing pattern, male genitalia structure and DNA barcode sequence. In addition, Rhodambulyx namvui Eitschberger Nguyen, 2017 is removed from synonymy with R. kitchingi and synonymized instead with R. davidi, although whether it would be better treated as a subspecies of R. davidi requires further investigation.

[Retracted] Synergistic effects of co­expression plasmid­based ADAM10­specific siRNA and GRIM­19 on hepatocellular carcinoma in vitro and in vivo.

Following the publication of the above paper, it was drawn to the Editor's attention by a concerned reader that various data featured in several of the figures were strikingly similar to data appearing in different form in other articles by different authors. An independent enquiry was launched by the Editorial Office, which revealed that cell migration assay data featured in Fig. 5A and C of the above article had been included in another article written by different authors submitted for publication some 12 months previously. Owing to the fact that the contentious data in the above article were already under consideration for publication prior to its submission to Oncology Reports, the Editor has decided that this paper should be retracted from the Journal. After having been in contact with the authors, they agreed with the decision to retract the paper. The Editor apologizes to the readership for any inconvenience caused. [the original article was published in Oncology Reports 32: 2501-2510, 2014; DOI: 10.3892/or.2014.3503].

[Retracted] miR­222 regulates sorafenib resistance and enhance tumorigenicity in hepatocellular carcinoma.

Following the publication of this paper, it was drawn to the Editors' attention by a concerned reader that the flow cytometric data in Fig. 3A and western blotting data featured in Figs. 3C and 7 were strikingly similar to data appearing in different form in other articles that shared some of the same authors. Owing to the fact that the contentious data in the above article were already under consideration for publication, or had already been published, elsewhere prior to its submission to International Journal of Oncology, the Editor has decided that this paper should be retracted from the Journal. After having been in contact with the authors, they agreed with the decision to retract the paper. The Editor apologizes to the readership for any inconvenience caused. [the original article was published in International Journal of Oncology 45: 1537­1546, 2014; DOI: 10.3892/ijo.2014.2577].

Efficacy of radiofrequency ablation versus laparoscopic liver resection for hepatocellular carcinoma in China: a comprehensive meta-analysis.

INTRODUCTION: Hepatocellular carcinoma (HCC) has been the second leading cause of cancer-related death in China. Radiofrequency ablation is a relatively novel treatment that may improve the treatment of HCC. AIM: To evaluate and compare the efficacy and safety of radiofrequency ablation (RFA) versus laparoscopic liver resection (LLR) in the treatment of HCC. MATERIAL AND METHODS: We searched for relevant published studies in English (PubMed, Cochrane Library, EMBASE) and in Chinese (CBM, CNKI and Wanfang) from their inception until September 23, 2019. The quality of included studies was evaluated by the Newcastle-Ottawa Scale. RESULTS: A total of 19 retrospective studies including 2038 patients were eligible for the meta-analysis. The results of the meta-analysis demonstrated that LLR was superior to RFA in terms of 3-year overall survival rate (OR = 0.62), 1 to 3-year disease-free survival rates (OR = 0.57; OR = 0.41, respectively) and local recurrence rates (OR = 2.71). CONCLUSIONS: The meta-analysis demonstrates that laparoscopic liver resection should be preferred in tumors of size 3-5 cm, while for < 3 cm the long term results are equal.

The Impact of Aberrant Hepatic Artery on Resection Margin and Outcomes of Laparoscopic Pancreatoduodenectomy: A Single-Center Report.

BACKGROUND: Variations in the anatomy of the hepatic artery are common. This study was aimed at sharing our experience with identifying and protecting the aberrant hepatic artery (AHA) and discussing its impact on the resection margin and outcomes of laparoscopic pancreatoduodenectomy (LPD). METHODS: A total of 576 patients who underwent LPD between 2015 and 2020 were retrospectively selected and divided into AHA and no AHA groups for this study. The demographics of the patients, pathological features, surgical data, and postoperative complications were further compared and analyzed between the two groups. RESULTS: The AHA group included 127 patients (22.05%). No statistically significant differences were found between the AHA and no AHA groups in the intraoperative data, postoperative complications, and long-term survival with malignant tumor. There was also no significant difference in the R1 rate for pancreatic adenocarcinoma. CONCLUSIONS: AHA appears frequently; however, it does not change the incidence of perioperative adverse events following LPD or the long-term prognosis of malignant tumor. The preservation of AHA during surgery can be achieved with a well-planned approach and careful dissection.

Combining Gemcitabine-Loaded Macrophage-like Nanoparticles and Erlotinib for Pancreatic Cancer Therapy.

Pancreatic cancer is a lethal malignancy with a dismal prognosis. Gemcitabine is currently used to treat pancreatic cancer, but it is limited by significant toxicity. Clinical trials on the combination of gemcitabine and erlotinib reported unsatisfactory outcomes along with concerns of toxicity. The encapsulation of chemotherapy drugs in polylactic-co-glycolic acid (PLGA) nanoparticles (NPs) can alleviate toxicity through targeted delivery and sustained release. In addition, camouflaging the NPs with a macrophage membrane can evade the immune system and further improve tumor homing. We designed gemcitabine-loaded PLGA NPs with a macrophage membrane coating (MPGNPs) to reduce drug toxicity and increase the accumulation in the tumor. The combination of MPGNPs and erlotinib synergistically inhibited pancreatic cancer cell proliferation in vitro and in vivo by targeting the PI3K/AKT/mTOR and Ras/Raf/MEK/ERK signaling pathways. The MPGNPs were also able to evade phagocytosis and achieve passive targeting to the pancreatic tumors. The combination of MPGNPs and erlotinib showed synergistic anti-tumor efficacy in vitro and in vivo. This study provides a proof-of-concept for treating pancreatic cancer with a combination of MPGNPs and erlotinib.

Safety and Efficacy of Physical Thermal Ablation Combined Sorafenib for Hepatocellular Carcinoma: A Meta-analysis.

BACKGROUND AND AIMS: To compare the efficacy and safety of physical thermal ablation (PTA), including radiofrequency ablation (RFA) and microwave ablation (MWA), combined with sorafenib and physical thermal ablation alone for the control and treatment of hepatocellular carcinoma (HCC) according to the available literature. METHODS: Comprehensive searches were performed on PubMed, Embase, CNKI, the Cochrane Library, China Biomedical Literature Database (known as CBM), Weipu Journal, and Wanfang Database. Meta-analysis was performed using Revman 5.3 software. RESULTS: A total of 15 studies, consisting of 2,227 HCC patients, were selected and included in this meta-analysis. Compared with the RFA-alone group, the patients in the RFA+sorafenib group had longer 1-, 2-, and 3-year overall survival (all p<0.05), better overall efficacy (p<0.0001), longer radiofrequency interval (p<0.001), and lower 2-year recurrence rate (p=0.02). The 1-year overall survival (p=0.003) and overall efficacy (p=0.002) of the MWA+sorafenib group were also higher than those of the MWA-alone group. The incidences of adverse reactions in the RFA+sorafenib group, such as hand-foot skin reactions (p<0.001), diarrhea and constipation (p=0.0001), hypertension (p=0.009), and alopecia (p<0.001), were significantly higher than those in the RFA-alone group. CONCLUSIONS: RFA or MWA combined with sorafenib has produced a better therapeutic effect on HCC than physical thermal ablation alone; however, adverse reactions have been obvious. It is necessary to evaluate the safety of combination therapy, and pay close attention to the adverse reactions that develop in patients.