[Comparison of percutaneous mechanical thrombectomy and surgical thrombectomy in the treatment of acute arteriovenous graft thrombosis].

Objective: To compare the efficacy between percutaneous mechanical thrombectomy and surgical thrombectomy in the treatment of acute arteriovenous graft thrombosis (AVG). Methods: The clinical data of acute thrombosis AVG patients treated in the Department of Vascular Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University from January 2020 to December 2021 were retrospectively analyzed. Patients were divided into percutaneous mechanical thrombectomy group and surgical thrombectomy group according to treatment methods. Baseline information, technical success rate, complication rate, and 24-month primary and secondary patency rates of the two groups were analyzed. Results: A total of 130 patients aged (54.1±14.2) years were enrolled in the study, including 66 males and 64 females. There were 78 patients in the percutaneous mechanical thrombectomy group and 52 patients in surgical thrombectomy group. No statistically significant differences in gender, age, comorbidities, and lesion characteristics between the two groups were detected (all P>0.05). The technical success rate in the mechanical thrombectomy group was 98.7% (77/78), and the complication rate was 5.1% (4/78), while the technical success rate in the surgical thrombectomy group was 94.2% (49/52), and the complication rate was 9.6% (5/52). There were no statistically significant differences in the technical success rate and complication rate between the two groups (all P>0.05). The average operation time of mechanical thrombectomy was significantly shorter than that of surgical thrombectomy [(62.8±13.9) min vs (77.0±17.6) min, P<0.001]. The Kaplan-Meier survival analysis indicated the primary patency rates of the mechanical thrombectomy group at 12 and 24 months after thrombectomy were 62.8% and 38.5%, respectively, while the primary patency rates of the surgical thrombectomy group at 12 and 24 months were 57.7% and 36.5%, respectively. There was no statistically significant difference in the primary patency rate between the two groups (P=0.641). The secondary patency rates of the mechanical thrombectomy group at 12 and 24 months were 98.7% and 94.9%, respectively, while the secondary patency rates of the surgical thrombectomy group at 12 and 24 months were 92.3% and 82.7%, respectively. The secondary patency rates of the mechanical thrombectomy group were higher than those of the surgical thrombectomy group (P=0.020). Conclusion: Mechanical thrombectomy is a safe and effective treatment for acute AVG thrombosis, with the advantages of shorter operation time and higher secondary patency rate compared with surgical thrombectomy.

[Imaging characteristics and diagnosis of primary middle mediastinal tumors].

Objectives: To investigate the proportion of different histological types and CT enhanced imaging features of primary middle mediastinal lesions in order to improve the understanding of these tumors and the accuracy of preoperative diagnosis. Methods: Retrospective analysis was conducted on 84 patients with primary middle mediastinal lesions and clear histological classifications diagnosed and treated at the Cancer Hospital, Chinese Academy of Medical Sciences from January 2012 to December 2022. Clinical, imaging, and pathological data were collected and classified according to tumor histological classifications. CT imaging manifestations such as tumor location, size, morphology, edge, boundary, internal components, enhancement characteristics, and surrounding tissue invasion were evaluated and recorded. Results: The histological types of the primary middle mediastinal lesions from the 84 patients included mesenchymal tumors, anterior intestinal cysts, giant lymph node hyperplasia, substernal goiter, neuroendocrine carcinoma, lymphohematopoietic system tumors, and mesothelioma, accounting for 28.6%, 27.4%, 14.3%, 3.6%, 11.9%, 9.5%, and 4.8%, respectively. Mesenchymal tumors included peripheral nerve sheath tumors, vascular tumors, adipogenic tumors, solitary fibrous tumors, and synovial sarcoma, accounting for 54.2%, 20.8%, 12.5%, 8.3%, and 4.2%, respectively. The above tumors had diverse imaging manifestations and specific imaging features. Mature fat were found in 3 cases of liposarcoma; Calcification was observed in 2 cases of thyroid nodules and 7 cases of giant lymph node hyperplasia; Enhanced scanning showed significant enhancement in 2 cases of solitary fibrous tumors, 3 cases of thyroid nodules, and 11 cases of giant lymph node hyperplasia; Mediastinal large lymph nodes was observed in 6 cases of lymphoma and 3 cases of mesothelioma; High invasiveness was observed in 4 cases of mesothelioma and 9 cases of neuroendocrine carcinoma. Conclusion: Mediastinal tumors have low incidence rate and rich histological types, and their imaging manifestations are diverse. Preoperative differential diagnosis can be made according to their specific imaging characteristics.

[Application value of laparoscopic double stapler firings and double stapling technique combined with rectal eversion and total extra-abdominal resection in the sphincter-preserving resection of low rectal cancer].

Objectives: To investigate the application value of laparoscopic double stapler firings and double stapling technique combined with rectal eversion and total extra-abdominal resection (LDER) in the anal preservation treatment of low rectal cancer. Methods: Inclusion criteria: (1) age was 18-70; (2) the distance of the lower tumor edge from the anal verge was 4-5 cm; (3) primary tumor with a diameter ≤3 cm; (4) preoperative staging of T1~2N1~2M0; (5) "difficult pelvis", defined as ischial tuberosity diameter<10 cm or body mass index>25 kg/m2; (6) patients with strong intention for sphincter preservation; (7) no preoperative treatment (e.g., chemotherapy, radiotherapy, molecular targeted therapy, or immunotherapy); (8) no lateral lymph node enlargement; (9) no previous anorectal surgery; (10) patients with good basic condition who could tolerate surgery. Exclusion criteria: (1) previously suffered from malignant tumors of the digestive tract or currently suffering from malignant tumors out of the digestive tract; (2) patients with preoperative anal dysfunction (Wexner score ≥ 10), or fecal incontinence. The specific surgical steps are as follows: the distal end of the rectum was dissected to the level of the interspace between internal and external sphincters of anal canal. Five centimeters proximal to the tumor, the mesorectum was ligated, and a liner stapler was used to transect the rectum. The distal rectum with the tumor were then everted and extracted through the anus. The rectum was transected 0.5-1.0 cm distal to the tumor with a linear stapler. Full thickness suture was used to reinforce the stump of the rectum, which was then brought back into the pelvic cavity. Finally, an end-to-end anastomosis between the colon and the rectum was performed. A retrospective descriptive study was performed of the clinical and pathological data of 12 patients with T1-T2 stage low rectal cancer treated with LDER at Henan Provincial People's Hospital from January 2020 to December 2022. Results: All 12 patients successfully completed LDER with sphincter preservation, without conversion to open surgery or changes in surgical approach. The median surgical time was 272 (155-320) minutes, with a median bleeding volume of 100 (50-200) mL. No protective stoma was performed, and all patients received R0 resection. The average hospital stay was 9 (7-15) days. There were no postoperative anastomotic leakage or perioperative deaths. All 12 patients received postoperative follow-up, with a median follow-up of 12 months (6-36 months) and a Wexner score of 8 (5-14) at 6 months postoperatively. There was no tumor recurrence or metastasis during the follow-up period. Conclusions: LDER is safe and effective for the treatment of low rectal cancer.

[Study on optimization of image processing parameters of pneumoconiosis by DR].

Objective: To explore the effect of different post-processing parameters of digital radiography (DR) on the quality of chest X-ray for pneumoconiosis diagnosis, and to provide suggestions on parameter setting suitable for this kind of DR machine. Methods: From January 1, 2022 to June 30, 2022, the chest films of 35 workers in the department of radiology of Hangzhou occupational disease prevention and treatment hospital were randomly selected and printed after setting different image post-processing parameters. The quality of chest film was evaluated by the measurement of optical densitometer and the combination of subjective and objective by professional physicians. Results: When the density is set to 2 and the contrast/detail contrast is 4.5, the optical density of each area of DR chest film meets the requirements of chest X-ray quality, and the qualified rate of physician quality evaluation is the highest. Conclusion: Reasonable setting of image post-processing parameters can improve the quality of chest radiograph.

CLIC1 knockout inhibits invasion and migration of gastric cancer by upregulating AMOT-p130 expression

Purpose To explore the regulatory relationship between Chloride intracellular channel 1 (CLIC1) and Angiomotin (AMOT)-p130, and reveal the role of AMOT-p130 in gastric cancer (GC). Methods Immunohistochemistry was performed to analyze the expression of CLIC1 and AMOT-p130 in GC tissues and adjacent tissues. The expression of AMOT-p130 upon CLIC1 silencing was analyzed using RT-PCR, western blot, and immunofluorescence in GC cells. Transwell and wound-healing assays were performed to detect migration and invasion in GC cells. The changes in EMT-related proteins were detected using western blot. Results Our study found that high CLIC1 expression was significantly associated with low AMOT-p130 expression in GC tissues. Silencing CLIC1 expression in MGC-803 cells (MGC-803 CLIC1 KO) and AGS cells (AGS CLIC1 KO) decreased the invasive and migratory abilities of tumor cells, which were induced by the upregulation of AMOT-p130. Subsequently, we demonstrated that AMOT-p130 inhibits the invasive and migratory abilities of GC cells by inhibiting epithelial–mesenchymal transition. Conclusions Our study suggests that AMOT-p130 could inhibit epithelial–mesenchymal transition in GC cells. CLIC1 may participate in the metastatic progression of GC by downregulating the expression of AMOT-p130 (AU)