Immune-related long noncoding RNA zinc finger protein 710-AS1-201 promotes the metastasis and invasion of gastric cancer cells.

BACKGROUND: Gastric cancer (GC) is a prevalent malignant tumor of the gastrointestinal system. ZNF710 is a transcription factor (TF), and zinc finger protein 710 (ZNF710)-AS1-201 is an immune-related long noncoding RNA (lncRNA) that is upregulated in GC cells. AIM: To assess the correlation between ZNF710-AS1-201 and immune microenvironment features and to investigate the roles of ZNF710-AS1-201 in the invasion and metastasis processes of GC cells. METHODS: We obtained data from The Cancer Genome Atlas and Wujin Hospital. We assessed cell growth, migration, invasion, and programmed cell death using cell counting kit-8, EdU, scratch, Transwell, and flow cytometry assays. Quantitative real-time polymerase chain reaction (qRT-PCR) was used to identify the potential downstream targets of ZNF710-AS1-201. RESULTS: In GC tissues with low ZNF710-AS1-201 expression, immunoassays detected significant infiltration of various antitumor immune cells, such as memory CD8 T cells and activated CD4 T cells. In the low-expression group, the half-maximal inhibitory concentrations (IC50s) of 5-fluorouracil, cisplatin, gemcitabine, and trametinib were lower, whereas the IC50s of dasatinib and vorinostat were higher. The malignant degree of GC was higher and the stage was later in the high-expression group. Additionally, patients with high expression of ZNF710-AS1-201 had lower overall survival and disease-free survival rates. In vitro, the overexpression of ZNF710-AS1-201 greatly enhanced growth, metastasis, and infiltration while suppressing cell death in HGC-27 cells. In contrast, the reduced expression of ZNF710-AS1-201 greatly hindered cell growth, enhanced apoptosis, and suppressed the metastasis and invasion of MKN-45 cells. The expression changes in ZNF710 were significant, but the corresponding changes in isocitrate dehydrogenase-2, Semaphorin 4B, ARHGAP10, RGMB, hsa-miR-93-5p, and ZNF710-AS1-202 were not consistent or statistically significant after overexpression or knockdown of ZNF710-AS1-201, as determined by qRT-PCR. CONCLUSION: Immune-related lncRNA ZNF710-AS1-201 facilitates the metastasis and invasion of GC cells. It appears that ZNF710-AS1-201 and ZNF710 have potential as effective targets for therapeutic intervention in GC. Nevertheless, it is still necessary to determine the specific targets of the ZNF710 TF.

Association of FHL5 and LPA genetic polymorphisms with diabetes mellitus risk: a case-control study.

BACKGROUND: China is one of the countries with the fastest growing prevalence of diabetes mellitus (DM) in the world. This study intended to investigate the association of single nucleotide polymorphisms (SNPs) of FHL5 and LPA with DM risk in the Chinese population. METHODS: This case-control study involved 1,420 Chinese individuals (710 DM patients and 710 controls). Four candidate loci (rs2252816/rs9373985 in FHL5 and rs3124784/rs7765781 in LPA) were successfully screened. The association of SNPs with DM risk was assessed by logistic regression analysis. Differences in clinical characteristics among subjects with different genotypes were analyzed by one-way analysis of variance. RESULTS: Overall analysis indicated that rs3124784 was associated with an increased risk of DM. Stratification analysis showed that rs3124784 significantly increased DM risk in different subgroups (male, non-smoking, non-drinking, and BMI > 24), while rs7765781 increased DM risk only in participants with BMI ≤ 24. Rs2252816 was associated with the course of DM. We also found that rs2252816 GG genotype and rs9373985 GG genotype were linked to the increased cystatin c in DM patients. CONCLUSION: The genetic polymorphisms of LPA may be associated with DM risk in the Chinese population, which will provide useful information for the prevention and diagnosis of DM.

Tailored machine learning for evaluating the long-term diabetes risk in older individuals: findings from the Irish Longitudinal Study on Ageing (TILDA).

OBJECTIVES: The prevalence of diabetes has increased globally, leading to a significant disease burden and financial cost. Early prediction is crucial to control its prevalence. DESIGN: A prospective cohort study. SETTING: National representative study on Irish. PARTICIPANTS: 8504 individuals aged 50 years or older were included. PRIMARY AND SECONDARY OUTCOME MEASURES: Surveys were conducted to collect over 40 000 variables related to social, financial, health, mental and family status. Feature selection was performed using logistic regression. Different machine/deep learning algorithms were trained, including distributed random forest, extremely randomised trees, a generalised linear model with regularisation, a gradient boosting machine and a deep neural network. These algorithms were integrated into a stacked ensemble to generate the best model. The model was tested using various metrics, such as the area under the curve (AUC), log loss, mean per classification error, mean square error (MSE) and root MSE (RMSE). The SHapley Additive exPlanations (SHAP) method was used to interpret the established model. RESULTS: After 2 years, 105 baseline features were identified as major contributors to diabetes risk, including sex, low-density lipoprotein cholesterol and cirrhosis. The best model achieved high accuracy, robustness and discrimination in predicting diabetes risk, with an AUC of 0.854, log loss of 0.187, mean per classification error of 0.267, RMSE of 0.229 and MSE of 0.052 in the independent test set. The model was also shown to be well calibrated. The SHAP algorithm provided insights into the decision-making process of the model. CONCLUSIONS: These findings could help physicians in the early identification of high-risk patients and implement targeted interventions to reduce diabetes incidence.

A comparison of the therapeutic outcomes between primary duct closure and T-tube drainage after laparoscopic common bile duct exploration: a single-centre retrospective study.

Introduction: In emergency surgery for acute obstruction of the common bile duct (CBD), primary duct closure (PC) of the CBD after laparoscopic common bile duct exploration (LCBDE) remains challenging. Aim: To explore the safety and effectiveness of this surgical method after LCBDE in patients with acute choledocholithiasis and discuss the feasibility of PC in the CBD. Material and methods: This retrospective study on surgical efficacy and safety involved 232 patients treated at The Third Affiliated Hospital of Soochow University between January 2015 and December 2019. These patients underwent LC + LCBDE for acute choledocholithiasis and were categorized into PC and T-tube drainage (TD) groups based on the method of closure of the CBD. The basic preoperative information, intraoperative situation, postoperative situation, and complications were analysed and compared between groups. Results: The baseline characteristics and preoperative information of patients between the 2 groups were balanced. Patients in the PC group had a shorter operation time (p < 0.001) and CBD suturing time (p < 0.001) than those in the TD group. In addition, compared with the TD group in postoperative situations, gastrointestinal recovery (p = 0.002), drainage removal (p < 0.001), and the length of postoperative hospital stay (p = 0.004) were markedly decreased in the PC group. In terms of intraoperative blood loss (p = 0.961), use of pipe washing (49.0 vs. 54.6%, p = 0.397), use of stone basket (50.0 vs. 42.3%, p = 0.243), use of electrohydraulic lithotripsy (1.0 vs. 3.1%, p = 0.525), postoperative liver function, and complications there was no significant difference between the PC and TD groups. No intraoperative transfusion and postoperative mortality occurred in either group. During 6 months of follow-up, only 1 patient showed biliary stricture in the PC group, and 2 and 4 patients in the PC and TD groups, respectively, showed residual stones. Conclusions: PC after LCBDE in acute choledocholithiasis patients displays better therapeutic outcomes than TD in some intraoperative and postoperative situations. PC of the CBD after LCBDE is a safe and effective therapeutic option in acute choledocholithiasis patients.

Identification and Analysis of Crucial Genes in H. pylori-Associated Gastric Cancer Using an Integrated Bioinformatics Approach.

Background: The relationship between H. pylori infection and gastric cancer (GC) has been widely studied, and H. pylori is considered as the main factor. Utilizing bioinformatics analysis, this study examined gene signatures related to progressing H. pylori-associated GC. Materials and Methods: The dataset GSE13195 was chosen to search for abnormally expressed genes in H. pylori-associated GC and normal tissues. The TCGA-STAD database was chosen to verify the expression of key genes in GC and normal tissues. Results: In GSE13195, a total of 332 differential expression genes (DEGs) were screened. The results of weighted gene co-expression network analysis showed that the light cyan, plum2, black, and magenta4 modules were associated with stages (T3, T2, and T4), while the orangered4, salmon2, pink, and navajowhite2 modules were correlated with lymph node metastasis (N3, N2, and N0). Based on the results of DEGs and hub genes, a total of 7 key genes (ADAM28, FCER1G, MRPL14, SOSTDC1, TYROBP, C1QC, and C3) were screened out. These gene mRNA levels were able to distinguish between normal and H. pylori-associated GC tissue using receiver operating characteristic curves. After transcriptional level verification and survival analysis, ADAM28 and C1QC were excluded. An immune infiltration study revealed that key genes were involved in regulating the infiltration levels of cells associated with innate immune response, antigen presentation process, humoral immune response, or Tcell-mediated immune response. In addition, drugs targeting FCER1G and TYROBP have been approved and are under investigation. Conclusion: Our study identified five key genes involved in H. pylori-associated GC tumorigenesis. Patients with higher levels of C3 expression had a poorer prognosis than those with lower levels. In addition, these key genes may serve as biomarkers and therapeutic targets for H. pylori-associated GC diagnosis, targeted therapy, and immunotherapy in the future.

Therapeutic efficacy of programmed spatial anatomy of the myopectineal orifice in total extraperitoneal hernioplasty: a retrospective study.

This study aimed to investigate the therapeutic efficacy of programmed spatial anatomy of myopectineal orifice technique in laparoscopic total extraperitoneal hernioplasty (TEP) surgery. A total of 121 adult male patients with unilateral inguinal hernias who underwent TEP in the Department of General Surgery, Wujin Hospital, affiliated with Jiangsu University, from January 2019 to December 2020 were selected. Patients were divided into the procedural (63 cases) and traditional groups (58 cases) according to the surgical methods adopted. The procedural group underwent programmed spatial anatomy of the myopectineal orifice combined with TEP, and the traditional group underwent traditional TEP. The perioperative evaluation indicators and postoperative complications were observed and compared between the two groups. Compared with the traditional group, the time of handling hernia, the intraoperative operation time, intraoperative blood loss, postoperative ambulation time, and postoperative hospital stay in the procedural group were significantly reduced (P < 0.05). The incidence of postoperative complications such as sensory nerve abnormalities and chronic pain was significantly decreased (P < 0.05), and the total incidence of complications in the procedural group was significantly lower than that in the traditional group (P < 0.05). While there was no significant difference in postoperative incision infection (P > 0.05). The programmed spatial anatomy of the myopectineal orifice can significantly improve the treatment outcome of TEP, significantly improve the patients' intraoperative and postoperative indicators, and reduce the incidence of postoperative complications. It is worthy of being promoted among young physicians and basic hospitals.

A new acidic microenvironment related lncRNA signature predicts the prognosis of liver cancer patients.

Background: The acidic microenvironment (AME), like hypoxia, inflammation, or immunoreaction, is a hallmark of the tumor microenvironment (TME). This work aimed to develop a prediction signature dependent on AME-associated lncRNAs in order to predict the prognosis of LC individuals. Methods: We downloaded RNA-seq information and the corresponding clinical and predictive data from The Cancer Genome Atlas (TCGA) dataset and conducted univariate and multivariate Cox regression analyses to identify AME-associated lncRNAs for the construction of a prediction signature The Kaplan-Meier technique was utilized to determine the overall survival (OS) rate of the high (H)-risk and low (L)-risk groups. Using gene set enrichment analysis (GSEA) the functional variations between the H- and L-risk groups were investigated. The association between the prediction signature and immunological state was investigated using single-sample GSEA (ssGSEA). Additionally, the association between the predicted signature and the therapeutic response of LC individuals was evaluated. Lastly, quantitative reverse transcription polymerase chain reaction (qRT-PCR) was performed to verify the risk model. Results: We generated a signature comprised of seven AME-associated lncRNAs (LINC01116, AC002511.2, LINC00426, ARHGAP31-AS1, LINC01060, TMCC1-AS1, AC012065.1). The H-risk group had a worse prognosis than the L- risk group. The AME-associated lncRNA signature might determine the prognosis of individuals with LC independently. The AME-related lncRNA signature shows a greater predictive effectiveness than clinic-pathological factors, with an area under the receiver operating characteristic (ROC) curve of 0.806%. When participants were categorized based on several clinico-pathological characteristics, the OS of high-risk individuals was shorter compared to low-risk patients. GSEA demonstrated that the metabolism of different acids and the PPAR signaling pathway are closely associated with low-risk individuals. The prognostic signature was substantially associated with the immunological status of LC individuals, as determined by ssGSEA. High risk individuals were more sensitive to some immunotherapies (including anti-TNFSF4 anti-SIRPA, anti-CD276 and anti-TNFSF15) and some conventional chemotherapy drugs (including lapatinib and paclitaxel). Finally, the expression levels of the seven lncRNAs comprising the signature were tested by qRT-PCR. Conclusions: A basis for the mechanism of AME-associated lncRNAs in LC is provided by the prediction signature, which also offers clinical therapeutic recommendations for LC individuals.

A novel difficulty scoring system of laparoscopic liver resection for liver tumor.

Objectives: To develop a novel difficulty scoring system (NDSS) to predict the surgical difficulty of laparoscopic hepatectomy. Patients and methods: A total of 138 patients with liver tumors performed liver resection (LLR) between March 2017 to June 2022 were selected from Affiliated Hospital of Jiangnan University and Wujin Hospital Affiliated with Jiangsu University.Patient demographics, laboratory tests, intraoperative variables, pathological characteristics were assessed. We also assessed the Child Pugh score and the DSS-B score. Results: Patients were divided into training and testing cohort according to their hospital. Patients in training cohort were divided into high and low difficult groups based on operation time, blood loss and conversion. Higher percentage of patients with malignant liver tumor (87.0% vs. 58.1%; P = 0.003) or history of hepatobiliary surgery (24.1% vs. 7.0%; P = 0.043) in high difficult group than in low difficult group. To improve the difficulty scoring system, we incorporated the history of hepatobiliary surgery and nature of the tumor. A novel difficulty scoring system was established. The results showed that the operation time (P < 0.001), blood loss (P < 0.001), ALT (P < 0.001) and AST (P = 0.001) were associated with the novel difficulty score significantly. Compared with DSS-B, the NDSS has a higher area under the receiver operating characteristic (AUROC) (0.838 vs. 0.814). The nomogram was established according to the NDSS. The AUROCs of the nomogram in training and testing cohort were 0.833 and 0.767. The calibration curves for the probability of adverse event showed optimal agreement between the probability as predicted by the nomogram and the actual probability. Conclusions: We developed a nomogram with the NDSS that can predict the difficulty of LLR. This system could more accurately reflect the difficulty of surgery and help liver surgeons to make the surgical plan and ensure the safety of the operation.

Identification of Key Genes in the HBV-Related HCC Immune Microenvironment Using Integrated Bioinformatics Analysis.

Purpose: Hepatocellular carcinoma (HCC) has poor prognosis and high mortality among gastrointestinal tumors because of its insidious onset and strong invasiveness. However, there was little understanding of their pathogenesis. The purpose of this study was to use bioinformatics analysis to identify genes associated with the immune microenvironment in HBV-related HCC and to develop new therapeutic targets to prevent and treat cancer. Methods: RNA-seq data of HBV-related HCC cases were downloaded from TCGA-LIHC database. ESTIMATE and Deseq2 algorithms were used to screen out differentially expressed genes (DEGs). WGCNA was used to construct gene coexpression networks. In key modules, functional enrichment analysis was performed. Protein-protein interaction (PPI) was used to screen hub genes, and survival analysis was conducted to assess their prognostic significance. Following, we search for key genes differentially expressed between cancerous and paracancerous tissues in GSE136247 and GSE121248 datasets. Reveal the potential links between key genes in immune infiltration by using TIMER. Finally, in TCGA-LIHC database, integration of key genes with clinical data were used to further validate their correlation with prognosis. Results: In the cohort of HBV-related HCC patients, immune/stromal/ESTIMATE scores were not significantly associated with patient prognosis. After bioinformatics analysis, screening out five key genes was significantly related to the prognosis of HBV-related HCC. Downregulation of SLAMF1 and TRAF3IP3 suggested poor prognosis and was related to a variety of immune cell infiltration. Furthermore, compared with adjacent nontumor tissues, TRAF3IP3 and SLAMF1 were highly expressed in tumor tissues and were linked to tumor recurrences. Conclusion: In conclusion, SLAMF1 and TRAF3IP3 were identified with higher expression in tumor tissues and associated with tumor recurrence. It will be a new research direction of tumor progress and treatment.

Construction of a Prognostic Immune-Related LncRNA Risk Model for Gastric Cancer.

Gastric cancer (GC) is one of the most common malignancies, and novel prognostic biomarkers for it are urgently required. This study is aimed at screening a group of immune-related lncRNAs (IRLs) in predicting the prognosis of GC patients. Genetic and clinical information from the 360 GC patients was included in this study. Eight IRLs in lncRNA-miRNA-mRNA network were screened out according to differential expression analysis. A novel risk score model with three IRLs (MIR4435-1HG, UCA1, and RP11-617F23.1) were identified, and patients were assigned to a high-risk group and a low-risk group. Patients in the low-risk group had a better prognosis. In addition, two nomograms were developed to predict the prognosis of GC. We evaluated the correlation between IRLs and the immune infiltration level of GC using TIMER. Furthermore, we verified that RP11-617F23.1 was significantly upregulated in human GC tissues compared with their adjacent tissues. And, patients with high RP11-617F23.1 expression in tumor tissues had poorer survival. In conclusion, we established a novel risk model based on IRLs for predicting the prognosis of GC. Meanwhile, a novel IRL, RP11-617F23.1, could serve as a predictor of prognosis for patients with GC.

Novel Hypoxia-Associated Gene Signature Depicts Tumor Immune Microenvironment and Predicts Prognosis of Colon Cancer Patients.

Hypoxia, a typical hallmark of numerous tumors, indicates poor infiltration of antitumor lymphocytes, as well as facilitates the development, progression, and drug resistance of malignant cells. Here, the present research was performed to identify novel hypoxia-related molecular markers and their correlation to the tumor immune microenvironment (TIME) in colon cancer. The expression of hypoxia-related gene signature was extracted from The Cancer Genome Atlas (TCGA) COAD cohort. Based on this signature, a risk score model was constructed using the Lasso regression model. Its discrimination ability and stability were validated in another independent cohort (GSE17536) from Gene Expression Omnibus (GEO) database. Moreover, molecular biology experiments (quantitative real-time PCR and multiple immunohistochemistry) were performed to validate the results of bioinformatics analyses. Three hub genes, including PPFIA4, SERPINE1, and STC2, were chosen to build the risk score model. All of these genes were increasingly expressed in the hypoxia subgroup (HS). Compared with the normoxia subgroup (NS), HS had worse pathological features (T, N, M, and stage) and overall survival (OS), more expression of immune checkpoint molecules, poorer infiltration of some pro-inflammation immune cells (CD4+ T cells and CD8+ T cells), and enriched infiltration of M0/M2 macrophages. After the risk model was proven to be valuable and stable, a nomogram was built based on this model and some clinicopathological factors. Moreover, it had been identified that three hub genes were all increasingly expressed in hypoxic conditions by quantitative real-time PCR (qPCR). The results of multiple immunohistochemistry (mIHC) also showed that higher expression of hub genes was associated with poorer infiltration of pro-inflammation immune cells (CD8+ T cells and M1 macrophages) and richer infiltration of anti-inflammation immune cells (Treg cells and M2 macrophages). In conclusion, the present study uncovered the relations among hypoxia, TIME, and clinicopathological features of colon cancer. It might provide new insight and a potential therapeutic target for immunotherapy.

Development of novel models for predicting mismatch repair protein deficiency and relevant disease-free survival in colorectal cancer patients.

PURPOSE: DNA mismatch repair (MMR) protein deficiency has attached more attention for its potential to be a biomarker of immunotherapy for colorectal cancer (CRC) patients. However, clinical models involving the expression status of MMR protein are rare. Herein, we sought to develop two clinical models (a diagnostic model for the prediction of MMR status and a prognostic model for the prediction of disease-free survival) for CRC patients. METHODS: A total of 582 CRC patients were finally included. There were 53 patients with deficient expression of MMR protein. The differences between the deficient MMR (dMMR) group and the proficient MMR (pMMR) group were analyzed. RESULTS: Compared to pMMR patients, those with dMMR status were younger and had better pathological features (depth of invasion, lymph node metastasis, distant metastasis, pathological stage, perineuronal invasion, and PLT level) and disease-free survival (DFS). The tumor location of the left colon, adenocarcinoma, and abnormal PLT level were identified as the independent predictors for pMMR. Based on these data, we developed the diagnostic model using Logistic regression analysis. It showed a satisfactory accuracy (AUC = 82.3% in the derivate set; AUC = 73.6% in the validation set). Furthermore, pMMR, poorer differentiation, perineuronal invasion, distant metastasis, lower hemoglobin level, and abnormal CEA level were established as the independent prognostic factors of poorer DFS. Based on them, a prognostic model with valuable performance (1-year AUC = 75.5%/3-year AUC = 76.9% in the derivate set; 1-year AUC = 72.3%/3-year AUC = 73.8% in the validation set) was developed. CONCLUSIONS: Our diagnostic and prognostic models could identify CRC patients at risk for pMMR protein expression and disease recurrence. It may contribute to improving the diagnosis and treatment of CRC patients at an individual level.

The efficacy and safety of dapagliflozin combined with oral hypoglycemic agents in patients with type 2 diabetes: a systematic review and meta-analysis.

BACKGROUND: There were reports that many patients with type 2 diabetes mellitus (T2DM) could not maintain the normal level of glycemic, who were treated with the antidiabetic agents. The sodium-glucose co-transporter-2 (SGLT2) inhibitors could improve patients' blood glucose level by inducing glycosuria, improving insulin sensitivity and the function of ß-cell and decreasing glucose toxicity. Which was unlike with other agents, indicating that the SGLT2 inhibitors might be effective alone or in combination with any other drugs. As a SGLT2 inhibitor, Dapagliflozin could be used in patients with T2DM. METHODS: Studies' identification were conducted with the literature search, and we searched studies published between 1950 and 2021 in PubMed, the Cochrane Library and Embase. A meta-analysis was performed using RevMan 5.3 software. Continuous data are presented as the means and standard deviations of differences in performance before and after active or control interventions. Adverse events were also assessed. RESULTS: Fifteen studies that provided individual data were included. Treatment with dapagliflozin was compared with treatment with placebo and resulted in a significantly greater change in HbA1c levels, fasting plasma glucose (FPG) and weight. In terms of the incidence of adverse drug reactions, the incidence of hypoglycemic events was not significantly different between the experimental and control groups. However, the incidences of genital infection and urinary tract infection were higher in the experimental group than in the control group. DISCUSSION: According to the available data, dapagliflozin combined with oral hypoglycemic agents can effectively reduce the level of HbA1c and body weight; however, it does not increase the incidence of hypoglycemia but can cause urinary tract infection and genital infection. Due to the limited literature included, the above conclusions need to be verified through more high-quality studies.

Transcriptome Profiling Reveals Molecular Changes during Flower Development between Male Sterile and Fertile Chinese Cabbage (Brassica rapa ssp. pekinensis) Lines.

Male sterility exists widely in flowering plants and is used as a fascinating tool by breeders for creating hybrid varieties. Herein, stamen samples from male sterile CCR20000 and male fertile CCR20001 lines during two developmental stages were employed to elucidate the molecular changes during flower development in fertile and sterile Chinese cabbage lines. RNA-seq revealed weak transcriptional activity in the sterile line, which may have led to the abnormal stamen development. The differentially expressed genes were enriched in plant hormone, carbon metabolism, and biosynthesis of amino acid pathways. Important genes with opposite patterns of regulation between the two lines have been associated with the male sterility trait. Members of the transcription factor families such as AP2, MYB, bHLH, and WRKY were highly active in the regulation of structural genes involved in pollen fertility. This study generated important genomic information to support the exploitation of the male sterility trait in Chinese cabbage breeding programs.

The comparation of short-term outcome between laparoscopic and open pancreaticoduodenectomy: a propensity score matching analysis.

Pancreaticoduodenectomy (PD) is one of the most complex and delicate operations in abdominal surgery. With the development of laparoscopic techniques, more and more pancreatic experts have become skilled in laparoscopic pancreaticoduodenectomy (LPD). However, the short-term efficacy of LPD compared to open pancreaticoduodenectomy (OPD) remains unclear. Here, we performed a propensity score matching study aiming to compare the short outcomes of patients who underwent LPD or OPD after the learning curve and established a risk model of pancreatic fistula. The data of 346 patients who had OPD or LPD from July 2015 to January 2020 were retrieved. After a 1:1 matching, 224 patients remained. The operation time was significantly longer (P = 0.001) but the amount of bleeding was significantly lower (P = 0.001) in the LPD group than in the OPD group. Patients in LPD group had fewer blood transfusions (P = 0.002) than those in OPD group. More lymph nodes (P < 0.001) were dissected in LPD group. The rate of grade B/C pancreatic fistula was significantly higher in the LPD group than in the OPD group (16.1% vs. 6.3%, P = 0.002). By multi variate Logistic regression analysis, we identified pancreatic tumor, malignancy and low body mass index were risk factors of Grade B/C pancreatic fistula after PD operation. Then, we developed a Grade B/C pancreatic fistula nomogram with the risk factors. The C-index of the nomogram was 0.836 (95% CI 0.762-0.910). In conclusion, LPD could be technically feasible, get less trauma and achieve similar short-term outcome as compared with OPD.

Comparison of diagnostic performance between convolutional neural networks and human endoscopists for diagnosis of colorectal polyp: A systematic review and meta-analysis.

Prospective randomized trials and observational studies have revealed that early detection, classification, and removal of neoplastic colorectal polyp (CP) significantly improve the prevention of colorectal cancer (CRC). The current effectiveness of the diagnostic performance of colonoscopy remains unsatisfactory with unstable accuracy. The convolutional neural networks (CNN) system based on artificial intelligence (AI) technology has demonstrated its potential to help endoscopists in increasing diagnostic accuracy. Nonetheless, several limitations of the CNN system and controversies exist on whether it provides a better diagnostic performance compared to human endoscopists. Therefore, this study sought to address this issue. Online databases (PubMed, Web of Science, Cochrane Library, and EMBASE) were used to search for studies conducted up to April 2020. Besides, the quality assessment of diagnostic accuracy scale-2 (QUADAS-2) was used to evaluate the quality of the enrolled studies. Moreover, publication bias was determined using the Deeks' funnel plot. In total, 13 studies were enrolled for this meta-analysis (ranged between 2016 and 2020). Consequently, the CNN system had a satisfactory diagnostic performance in the field of CP detection (sensitivity: 0.848 [95% CI: 0.692-0.932]; specificity: 0.965 [95% CI: 0.946-0.977]; and AUC: 0.98 [95% CI: 0.96-0.99]) and CP classification (sensitivity: 0.943 [95% CI: 0.927-0.955]; specificity: 0.894 [95% CI: 0.631-0.977]; and AUC: 0.95 [95% CI: 0.93-0.97]). In comparison with human endoscopists, the CNN system was comparable to the expert but significantly better than the non-expert in the field of CP classification (CNN vs. expert: RDOR: 1.03, P = 0.9654; non-expert vs. expert: RDOR: 0.29, P = 0.0559; non-expert vs. CNN: 0.18, P = 0.0342). Therefore, the CNN system exhibited a satisfactory diagnostic performance for CP and could be used as a potential clinical diagnostic tool during colonoscopy.

TGR5 Attenuated Liver Ischemia-Reperfusion Injury by Activating the Keap1-Nrf2 Signaling Pathway in Mice.

Hepatic ischemia/reperfusion injury (IRI) still remains an unavoidable problem in hepatectomy. The inflammatory response plays an important role in its pathogenesis. The plasma membrane-bound G protein-coupled bile acid receptor (TGR5), as one of G protein-coupled receptor (GPCR) families, has been proved to serve a protective role in several liver diseases. However, the exact function of TGR5 in modulating IRI remains obscure. We injected wild mice with a small interfering RNA of TGR5 (si-TGR5) or TGR5 agonist (INT-777) and established liver partial warm ischemia/reperfusion model. The results showed that knockdown of TGR5 significantly aggravated hepatic tissue injury, but treatment with INT-777 could reverse it, as evidenced by serum ALT and AST tests, liver histological injury, cytokines expressions, liver immunohistochemical analysis, and TUNEL staining. The apoptosis-associated proteins were evaluated after reperfusion. Moreover, we used primary bone marrow-derived macrophages (BMDMs) to establish hypoxia/reoxygenation (H/R) model to verify the anti-inflammation effect of TGR5. In in vivo experiments, we used TGR5-siRNA and TGR5 agonist (INT-777) to determine that TGR5 significantly attenuated liver damage after IRI through activating the Keap1-Nrf2 pathway. In addition, we found that overexpression of INT-777-activated TGR5 could reduce oxidative stress and inflammatory response in H/R-induced BMDMs through regulation of Keap1-Nef2 pathway during in vitro experiment. Importantly, these results were completely reversed in si-TGR5 BMDMs. In conclusion, the results indicated that TGR5 could effectively alleviated inflammation response via accelerating the activation of Keap1-Nrf2 signaling pathway during hepatic IRI, which may be meaningful in reducing related inflammatory molecules and adjusting inherent immunity.

Minimally Invasive Surgery of Primary Retroperitoneal Tumors from the Perspective of General Surgeons: 6 Years of Experience at a Single Institution.

Objective: This retrospective study aimed to present our surgical experience in patients with primary retroperitoneal tumors (PRTs) who underwent laparoscopic surgery and to compare the results with those of patients who underwent an open operation. Materials and Methods: We analyzed the medical data of patients who underwent retroperitoneal tumor resection through laparoscopic surgery or open operation between February 2014 and November 2019. Results: In total, 77 patients were enrolled. In total, 37 patients underwent open surgery and 40 patients underwent laparoscopic surgery. The tumor size in the open surgery group (10.2 ± 5.4 cm) was more significant than that in the laparoscopic surgery group (6.5 ± 3.1 cm) (P < .001). No difference was observed in operative time, blood loss, and transfusion between the two groups. Postoperative hospitalization in the open group (8.43 ± 2.77 days) was longer than that in the laparoscopic group (5.63 ± 2.16 days) (P < .001). The patients with PRTs in the IV area had minimal bleeding (16.67 ± 40.82 mL) and minimum postoperative hospitalization (3.83 ± 1.60 days). Conclusions: Laparoscopic resection of PRT is feasible in the selection of appropriate cases. The advantages are small trauma, light pain, quick recovery, and short hospital stay. It is especially suitable for benign PRTs with small size and cystic or small adhesion with vital organs or great vessels.

lncRNA ZNF667-AS1 (NR_036521.1) inhibits the progression of colorectal cancer via regulating ANK2/JAK2 expression.

Long noncoding RNAs (lncRNAs) participate in many biological processes by affecting gene expression at the posttranscriptional level. lncRNAs are dysregulated in colorectal cancer (CRC) and this dysregulation is closely related to tumorigenesis, metastasis, and prognosis. Although many lncRNAs have been identified in CRC, the relation between ZNF667 antisense RNA 1 (head to head; ZNF667-AS1, accession: NR_036521.1) and CRC remains unclear. In this study, a total of 2,218 differentially expressed genes and 428 differentially expressed lncRNAs were identified between tumor and pericarcinous tissues. They were mainly enriched in cancer pathways, chemokine signaling, phosphoinositide 3-kinase-protein kinase B signaling pathway, and others. Key lncRNAs, including ZNF667-AS1, and their corresponding genes, such as ankyrin 2 (ANK2), were downregulated in CRC tumor tissues. In addition, downregulated ZNF667-AS1 (NR_036521.1) expression is associated with poor prognosis and disease progression. Overexpression of ZNF667-AS1 (NR_036521.1) inhibited the proliferation, migration, and invasion of VOLO cells both in vitro and in vivo. Moreover, Janus kinase 2 (JAK2) and ANK2 were significantly down- and upregulated in the overexpressed ZNF667-AS1 VOLO cells compared to those in the negative-control group. Knockdown of ANK2 or overexpression of JAK2 significantly counteracted the inhibitory effects of overexpression of ZNF667-AS1 on LOVO cell proliferation and migration. Taken together, it is indicated in our research that ZNF667-AS1 interaction with ANK2/JAK2 maybe important in CRC progression. Overexpression of ZNF667-AS1 could inhibit the proliferation, migration, and invasion of CRC cells, which may be related with the high ANK2 and low JAK2 levels.