Meta-analysis on the safety and efficacy of the enhanced recovery after surgery in distal pancreatectomy / 中华胰腺病杂志

Objective:The safety and effectiveness of the enhanced recovery after surgery (ERAS) in the treatment of distal pancreatectomy (DP) were evaluated by meta-analysis.Methods:Pancreatic body and tail resection, distal pancreatic resection, ERAS, rapid recovery after surgery, pancreatectomy, DP and ERAS were used as key words, and the network database such as Chinese journal full-text database, Wanfang data knowledge service platform, Weipu database, Chinese biomedical literature database, Pubmed, Embase, Cochrane library, Web of science, Sciencedirect and so on were searched. The retrospective literatures published from the database establishment to May 2022 were retrieved from the network database, and the papers were screened and the quality was evaluated according to the pre-set inclusion and exclusion criteria; and important data were extracted. The software Review Manager 5.4 was used for meta-analysis.Results:9 papers were finally included, and a total of 650 patients with DP were enrolled (311 in the ERAS group and 339 in the NO-ERAS group). Meta-anaysis showed that compared with NO-ERAS group, ERAS group could reduce intraoperative bleeding ( MD=-73.88, 95% CI -121.21--26.55, P=0.002), decrease the incidence of postoperative complications ( OR=0.48, 95% CI 0.32-0.72, P<0.001) and pulmonary complications ( OR=0.47, 95% CI 0.24-0.93, P=0.030), shorten the postoperative exhaust time (MD=-8.76, 95% CI -11.23--6.29, P<0.001), postoperative length of hospital stay ( MD=-2.65, 95% CI -3.06--2.07, P<0.001) and abdominal drainage tube removal time ( MD=-1.45, 95% CI -1.81--1.09, P<0.001). However, ERAS could not shorten the operative time ( MD=6.25, 95% CI -4.56-17.07, P=0.260), reduce the incidence of postoperative pancreatic fistula ( OR=0.92, 95% CI 0.53--1.60, P=0.780) and the re-admission rate within 30 days after surgery ( OR=1.00, 95% CI 0.47-2.11, P=0.990). Conclusions:ERAS is safe and effective for patients undergoing DP, because it can reduce intraoperative bleeding and postoperative complications, shorten postoperative hospital stay and postoperative abdominal drainage tube removal time.

Effects of neuropilin and tolloid-like 2 on proliferation, migration, cell cycle and apoptosis of gallbladder carcinoma cells and related mechanism / 中华肝胆外科杂志

Objective:To investigate the effects and molecular mechanism of neuropilin and tolloid-like 2 (NETO2) on proliferation, migration, cell cycle, and apoptosis in gallbladder cancer (GBC).Methods:The NETO2 mRNA and protein expression in GBC-SD, ZJU-0430, NOZ GBC cells were detected by quantitative real-time polymerase chain reaction and Western blot. NETO2 overexpression and knockdown stable cell lines were constructed by plasmid transfection. Cell counting kit-8 assay, colony formation assay, transwell assay, flow cytometry and WB assay were performed to evaluate proliferation, migration, cell cycle, apoptosis, epithelial-mesenchymal transition (EMT) and changes of phosphatidylinositol-3 kinase/protein kinase B (PI3K/Akt) signaling pathway.Results:GBC-SD and ZJU-0430 cells with NETO2 gene overexpression and NOZ cells with NETO2 gene knockdown were effectively constructed. NETO2 overexpression in gallbladder cancer cell lines significantly improved cell proliferation and migration, advanced cell cycle progression from G0/G1 to S phase, and inhibited cell apoptosis. In the ZJU-0430 and GBC-SD cells, the clone number increased from (78.5±9.2), (217.0±6.4) to (213.5±10.3), (296.3±9.3)( t=10.98, 6.51; P=0.008, 0.023); The number of migrating cells increased from (198.6±8.4), (233.3±11.0) to (382.7±12.4), (379.0±7.3) ( t=16.98, 16.85, both P<0.001); The total apoptosis rate reduced from (29.7±0.9)%, (35.6±1.1)% to (19.2±0.5)%, (29.1±0.4)% ( t=9.74, 9.05; both P<0.001); The expression of EMT related proteins such as N-cadherin, Vimentin, Snail, and Slug were upregulated, while E-cadherin expression was downregulated. Phosphorylated PI3K (p-PI3K) and Akt (p-Akt) protein expression were significantly increased (all P<0.05). In contrast, NETO2 knockdown had the opposite effect on all these parameters. Conclusion:NETO2 influences the EMT process by regulating the PI3K/Akt signaling pathway, thus promotes GBC cell proliferation, migration and cell cycle progression, and inhibits cancer cell apoptosis.

Analysis and prevention of heat-related diseases in beach volleyball events of the 19th Hangzhou Asian Games / 中华急诊医学杂志

Objective:To analyze the occurrence characteristics of heat-related diseases in the 19th Hangzhou Asian Games beach volleyball events, strengthen the ability of prevention and early identification of heat-related diseases, and provide reference for the holding of large-scale outdoor events in summer and reasonable allocation of medical resources.Methods:The medical insurance of heat-related diseases of relevant personnel in the beach volleyball competition from September 19 to September 28, 2023 was retrospectively analyzed, and the incidence of heat-related diseases in the personnel involved in Asia was analyzed.Results:During the beach volleyball competition in Ningbo Region of the Hangzhou Asian Games, a total of 103 people were provided with health services in the medical service field (61 people had mild discomfort due to excessive outdoor temperature; Other cold, minor injury, bandage 42 people); Medical services provided 44 times (4 referrals). Among them, 11 cases were sports injury and trauma (29.5%), 11 cases were heat stroke and other related symptoms (25%), 6 cases were sunburn (13.6%), 10 cases were oral diseases of five senses (22.8%), 4 cases were upper respiratory tract infection (9.1%).Conclusions:The holding of large-scale outdoor events in summer should focus on heat-related diseases, and it is necessary to effectively do the corresponding planning work in advance in terms of reasonable allocation of medical resources and targeted training of professionals.

The influence of HNF4G on the proliferation and migration of gallbladder cancer cells and the underlying mechanism / 肿瘤

Objective:To investigate the effect of hepatocyte nuclear factor 4 gamma(HNF4G)on the proliferation,migration,cell cycle and apoptosis of gallbladder cancer cells and the underlying molecular mechanisms. Methods:The expression levels of HNF4G mRNA and protein in gallbladder cancer cell lines(GBC-SD,NOZ and ZJU-0430)were examined by real-time fluorescence quantitative PCR and Western blotting,respectively.Stable HNF4G-silencing or overexpressing GBC-SD,NOZ and ZJU-0430 cell lines were established by lentiviral infection.Then,the effect of HNF4G silencing or overexpression on the proliferation,migration,cell cycle and apoptosis of gallbladder cancer cell lines were evaluated by CCK-8 assay,colony formation assay,Transwell assay and FCM assay.The effect of changes in HNF4G gene expression level on the expression levels of cell cycle associated proteins(Cyclin A2 and Cyclin B1),apoptotic proteins(Bax and Bcl-2),epithelial-mescenchymal transition associated proteins(E-cadherin,N-cadherin,vimentin,Snail and Slug)as well as ErbB2 and phosphorylated AKT in the ErbB2/PI3K/AKT signaling pathway was examined by Western blotting. Results:Real-time fluorescence quantitative PCR and Western blotting results demonstrated that the expression level of HNF4G mRNA and protein in NOZ cells was significantly lower than that in GBC-SD and ZJU-0430 cells(P＜0.001).The successful establishment of HNF4G-sliencing and HNF4G-overexpressing gallbladder cancer cell lines was verified by Western blotting analysis.Over expression of HNF4G could enhance the proliferation and migration of GBC-SD,NOZ and ZJU-0430 cells(P＜0.001),promote the transition of S-phase to G2/M-phase,and inhibit the apoptosis of these gallbladder cancer cell lines.Western blotting analysis showed that overexpression of HNF4G could increase the expression of Cyclin A2,Cyclin B1,Bcl-2,N-cadherin,Vimentin,Snail,Slug,ErbB2 and phosphorylated AKT,and decrease the expression of Bax and E-cadherin(P＜0.001).In contrast,HNF4G silencing could induce the opposite changes in the biological behaviors and protein expression in GBC-SD cells. Conclusion:HNF4G affects the proliferation and migration of gallbladder cancer cells by participating in the regulation of the epithelial-mescenchymal transition and ErbB2/PI3K/AKT signaling pathway.The influence of HNF4G on gallbladder cancer cells suggests that HNF4G may be a potential gene target for gallbladder cancer treatment.

Research advances in targeted therapy for gallbladder carcinoma / 临床肝胆病杂志

Gallbladder carcinoma （GBC） is a type of malignant tumor with an extremely poor prognosis， and at present， surgical operation is the most effective treatment method for this disease. Unfortunately， due to a lack of typical symptoms in the early stage， most patients have progressed to the advanced stage at the time of confirmed diagnosis and lost the opportunity for radical surgery. Among the currently available adjuvant treatments， targeted therapy has higher specificity and fewer side effects and has improved the prognosis of a variety of malignancies. With reference to the latest research advances in targeted therapy for GBC， this article reviews the current research status， potential targets， and targeted medications of targeted therapy for GBC， in order to provide a reference for the clinical treatment of GBC patients.