Application of AI on cholangiocarcinoma.

Cholangiocarcinoma, classified as intrahepatic, perihilar, and extrahepatic, is considered a deadly malignancy of the hepatobiliary system. Most cases of cholangiocarcinoma are asymptomatic. Therefore, early detection of cholangiocarcinoma is significant but still challenging. The routine screening of a tumor lacks specificity and accuracy. With the application of AI, high-risk patients can be easily found by analyzing their clinical characteristics, serum biomarkers, and medical images. Moreover, AI can be used to predict the prognosis including recurrence risk and metastasis. Although they have some limitations, AI algorithms will still significantly improve many aspects of cholangiocarcinoma in the medical field with the development of computing power and technology.

Impact of preoperative type 2 diabetes mellitus on the outcomes of patients with gastric cancer following gastrectomy: Analysis of 834 patients using propensity score matching.

The purpose of the current study was to compare the outcomes of patients with gastric cancer (GC) between the type 2 diabetes mellitus (T2DM) group and the non-T2DM group. The PubMed, Embase and Cochrane Library databases were searched from inception to March 8, 2022, to identify propensity score matching (PSM) studies that analyzed the effect of T2DM on the outcomes of patients with GC. Total complications, overall survival (OS), disease-free survival (DFS) and cancer-specific survival (CSS) were compared between the T2DM group and the non-T2DM group. A total of four PSM studies with 834 patients were included in the current study. There were 311 and 523 patients in the T2DM group and the non-T2DM group, respectively. Baseline characteristics of the two groups were adjusted with PSM in all the four studies, however, no significant difference was found in baseline characteristics (P>0.05). DFS was significantly worse in the T2DM group compared with that in the non-T2DM group [hazard ratio (HR), 1.45; 95% confidence interval (CI), 1.10-1.90; P=0.007)]. However, after pooling up the data, there was no significant difference between the T2DM group and the non-T2DM group in terms of OS (HR, 1.41; 95% CI, 0.92-2.16; P=0.11), CSS (HR, 1.29; 95% CI, 0.92-1.81; P=0.14) and total complications (odds ratio, 1.01; 95% CI, 0.64-1.60; P=0.95). Patients with GC and T2DM are associated with poor DFS. However, there were no significant differences between the T2DM group and the non-T2DM group in terms of OS, CSS and total complications.

The Effect of Surgical Approach on Clinical Outcomes in 535 Patients with Remnant Gastric Cancer.

Purpose: This study aimed to evaluate the effect of laparoscopic gastrectomy (LG) and open gastrectomy (OG) on clinical outcomes in patients with remnant gastric cancer (RGC). Materials and Methods: The databases of PubMed, EMBASE, and Cochrane Library were used to search for eligible studies from inception to April 1st, 2023. Hazard ratios (HRs), mean difference (MD), odds ratios (OR), and 95% confidence intervals (CIs) were pooled up to analyze. The Newcastle-Ottawa Scale (NOS) scores were used to evaluate the quality of the included studies. This study was performed with RevMan 5.3 (The Cochrane Collaboration, London, United Kingdom) software. Results: A total of 11 studies involving 535 RGC patients were included in this study. In terms of basic information, we found that the OG group had a higher American Society of Anesthesiologists (ASA) grade (≥2) (OR = 0.24, I2 = 54%, 95% CI = 0.08-0.71, P = .01) than the LG group. In terms of postoperative outcomes, we found that the LG group had longer operative time (MD = 33.95, I2 = 58%, 95% CI = 15.05-52.85, P < .01), shorter postoperative hospital stay (MD = 5.08, I2 = 84%, 95% CI = -9.74 to -0.42, P = .03), shorter length of incision (MD = -7.15, I2 = 94%, 95% CI = -10.99 to -3.31, P < .01), earlier food intake (MD = -3.09, I2 = 76%, 95% CI = -4.84 to -1.35, P < .01), and earlier time to first flatus (MD = -0.84, I2 = 0%, 95% CI = -1.09 to -0.59, P < .01). We found that there was no statistically significant difference in overall survival (HR = 0.96, I2 = 0%, 95% CI = 0.48-1.93, P = .92) between the LG group and the OG group. Conclusion: LG for RGC patients had longer surgical time, shorter postoperative hospital stay, shorter length of incision, earlier food intake, and earlier time to first flatus.

Experimental Study of External Flame Evolution and Temperature Characteristics after a Methane Explosion in a Rectangular Chamber.

A series of methane-vented explosions were experimentally investigated in a 4.5 m3 rectangular chamber at P0 = 100 kPa and T0 = 298 K, and the effects of ignition positions and vent areas on the external flame and temperature characteristics were studied. The results indicate that the vent area and ignition position significantly affect external flame and temperature changes. The external flame is portioned into three stages: an external explosion, a violent flame jet with a blue flame, and a yellow flame venting. The temperature peak first rises and then reduces with increasing distance. Rear ignition produces the largest flame lengths and highest temperature, while front ignition leads to the shortest flame and smallest temperature peak. The maximum flame diameter occurs at central ignition. As vent areas increase, the coupling effect of the pressure wave and the internal flame front weakens and the diameter and peak of the high-temperature peak increase. These results can offer scientific guidance for designing disaster prevention measures and evaluating explosion accidents in buildings.

Are High Levels of Microsatellite Instability and Microsatellite Stability Identical in DNA Mismatch Repair-Deficient Colorectal Cancer Patients?

Purpose: The purpose of the current study was to determine whether there is a difference between high levels of microsatellite instability (MSI-H) and microsatellite stability (MSS) in DNA mismatch repair-deficient (DMMR) colorectal cancer (CRC) patients. Methods: A total of 452 CRC patients with DMMR from December, 2014, to April, 2021, in our hospital were selected retrospectively. However, only 105 patients underwent Sanger or next-generation-sequencing (NGS) to confirm their microsatellite status. Ultimately, 55 MSI-H patients and 20 MSS patients with intact medical record information were included in this study. Results: The MSS group was associated with a higher mutation rate in the KRAS gene (P=0.011). Meanwhile, MSI-H was related to colon cancer (P < 0.01). However, no significant differences in other clinical characteristics were observed between the two groups of patients. There was no significant difference between the MSI-H and MSS groups in terms of overall survival (OS) (P=0.398) and disease-free survival (DFS) (P=0.307). Conclusion: The MSI-H status was associated with colon cancer and a lower mutation rate of the KRAS gene in DMMR patients. In CRC-DMMR patients, the MSS group exhibited better OS and DFS than the MSI-H group, although these differences were not statistically significant. Accordingly, in clinical practice, we should not confuse these two types of patients.

Mechanochemically synthesized zeolitic imidazolate framework-8 as sorbent for dispersive solid-phase extraction of benzophenone-type ultraviolet filters in aqueous samples.

Benzophenone-type ultraviolet filters (BP-UVFs) are a group of emerging contaminants, which found in various environmental aqueous samples raising potential risks for public health concern and could bioaccumulate in the food chain. This study describes a simple and "green" method to rapidly analyze five BP-UVFs that are frequently found in surface water and in seawater samples. Dispersive solid-phase extraction (DSPE) using a zeolitic imidazolate framework­8 (ZIF-8) as the sorbent was applied to efficiently extract the BP-UVFs from aqueous samples, and they were then detected and quantified by UHPLC-electrospray ionization (+)-quadrupole time-of-flight mass spectrometry (UHPLC-ESI (+)-QTOF-MS). The ZIF-8 sorbent was synthesized by a green one-step mechanochemical process using water-assisted grinding and a stoichiometric reaction. The Box-Behnken Design coupled with the response surface method was applied to optimize the main DSPE extraction factors. The developed method was fully validated, showing low limits of quantification (LOQs; 0.3-20 ng L-1), satisfactory mean spiked recoveries (72-105%), and a high level of precision (3-9%). A preliminary analysis of the surface water and seawater samples revealed that 2-hydroxy-4-methoxybenzophenone (BP-3) was the most common BP-UVF present in our aquatic environment, likely due to its widespread applications and slow rate of degradation.

Genetic Characteristics of Resectable Colorectal Cancer with Pulmonary Metastasis.

The lung is the most common extra-abdominal metastasis site of colorectal cancer (CRC). This study aimed to investigate the genetic variation of pulmonary metastases (PM) and primary tumors in resectable CRC. The clinical data of 410 patients with PM after CRC surgery and 33 paraffin-embedded tissue samples from January 2012 to July 2019 in our hospital were collected retrospectively. Next, 450-panel gene detection technologies based on next-generation sequencing (NGS) were used to analyze the changes in the gene map and the overall variation in cancer-related genes in PM and primary tumors. After quality control, 19 samples were included in the final gene analysis. The results showed that APC (89.5%), TP53 (89.5%), and KRAS (53%) were the most common mutations in PM and primary tumors, but the gene amplification variation was enriched in primary tumors (4.6% vs. 11.4%). KRAS G12D was the most common site variation of the KRAS gene in both PM and primary tumors of CRC. There was no hotspot mutation in the TP53 locus in CRC, and the TP53 mutation in the PM was consistent with that in the primary lesion. The microsatellite instability (MSI) levels of 10 patients were MSS. The mean tumor mutation burden (TMB) of the primary tumor (5.3 muts·Mb-1) was slightly higher than that of metastasis (5.0 muts·Mb-1). In our institution, the genetic characteristics of resectable PM from CRC may be highly consistent with those of the primary tumor.

Endoscopic incision of rectal diverticulum: A case report.

A 70-year-old woman with a rectal diverticulum presented with anal pendant expansion and difficulty in defecation for more than 1 year. The patient was diagnosed with a rectal diverticulum by pelvic enhanced magnetic resonance imaging (MRI), computerized tomography (CT), rectal angiography, and colonoscopy. The endoscopic diverticulum incision procedure (EDIP) was implemented with this patient. At the 4-month follow-up, anal pendant expansion and difficulty in defecation were significantly relieved. Furthermore, colonoscopy proved that there were no vestigial feces in the diverticulum.