Efficacy of Laparoscopic Left Hemihepatectomy Combined With Choledochoscopic Lithotomy for Complex Intrahepatic Bile Duct Stones and Its Impact on Postoperative Liver Function.

BACKGROUND: This study was designed to investigate the clinical efficacy of laparoscopic left hemihepatectomy combined with choledochoscopic lithotomy for patients with complex intrahepatic bile duct stones. MATERIALS AND METHODS: The clinical data of 97 patients with complex intrahepatic bile duct stones treated in our hospital between February 2019 and April 2022 were retrospectively collected. Patients were allocated into 2 groups based on their surgical approaches. In the control group, 46 patients underwent laparoscopic left hemihepatectomy, while in the combined group, 51 patients underwent laparoscopic left hemihepatectomy combined with choledochoscopic lithotomy. Parameters such as clinical efficacy, surgical indices, stress response markers (CRP, EP, COR), coagulation metrics (FIB, APTT, PT), liver function indicators (GGT, TBIL, ALT), complications, and quality of life were compared between the 2 groups. RESULTS: The combined group exhibited a significantly higher total effective rate compared with the control group (98.04% vs. 82.61%) (P<0.05). The operation duration of the combined group was longer than that of the control group. However, the duration for postoperative anal exhaustion, postoperative bed mobility, postoperative drainage, and hospital stay was shorter in the combined group than in the control group (P<0.05). CRP, EP, and COR concentrations were substantially elevated in both groups on the third postoperative day (P<0.05), but were lower in the combined group. Similarly, levels of FIB, APTT, and PT were markedly increased in both groups on the third postoperative day (P<0.05), but were lower in the combined group. On the seventh postoperative day, GGT, TBIL, and ALT were notably decreased in both groups, with the combined group exhibiting lower levels (P<0.05). The incidence of complications in the combined group was lower than that of the control group (5.88% vs. 19.57%) (P<0.05). At 3 months postoperatively, all GIQLI scores were markedly elevated in both groups, with superior scores observed in the combined group (P<0.05). CONCLUSION: The combined laparoscopy and choledochoscopy demonstrate a remarkable efficacy for complex intrahepatic bile duct stones, which significantly facilitate liver function recuperation, reduce stress reactions, reduce complications, enhance the quality of life, and exert a minimal impact on coagulation functions.

Development and verification of prognostic nomogram for ampullary carcinoma based on the SEER database.

Background: Ampullary carcinoma (AC) is a rare cancer of the digestive system that occurs in the ampulla at the junction of the bile duct and pancreatic duct. However, there is a lack of predictive models for overall survival (OS) and disease -specific survival (DSS) in AC. This study aimed to develop a prognostic nomogram for patients with AC using data from the Surveillance, Epidemiology, and End Results Program (SEER) database. Methods: Data from 891 patients between 2004 and 2019 were downloaded and extracted from the SEER database. They were randomly divided into the development group (70%) and the verification group (30%), and then univariate and multivariate Cox proportional hazards regression, respectively, was used to explore the possible risk factors of AC. The factors significantly related to OS and DSS were used to establish the nomogram, which was assessed via the concordance index (C-index), and calibration curve. An internal validation was conducted to test the accuracy and effectiveness of the nomogram. Kaplan-Meier calculation was used to predict the further OS and DSS status of these patients. Results: On multivariate Cox proportional hazards regression, the independent prognostic risk factors associated with OS were age, surgery, chemotherapy, regional node positive (RNP),extension range and distant metastasis with a moderate C-index of 0.731 (95% confidence interval (CI): 0.719-0.744) and 0.766 (95% CI: 0.747-0.785) in the development and verification groups, respectively. While, marital status, surgery, chemotherapy, regional node positive (RNP),extension range and distant metastasis were significantly linked to AC patients' DSS, which have a better C-index of 0.756 (95% confidence interval (CI): 0.741-0.770) and 0.781 (95% CI: 0.757-0.805) in the development and verification groups. Both the survival calibration curves of 3- and 5-year OS and DSS brought out a high consistency. Conclusion: Our study yielded a satisfactory nomogram showing the survival of AC patients, which may help clinicians to assess the situation of AC patients and implement further treatment.

circ-CFH promotes the development of HCC by regulating cell proliferation, apoptosis, migration, invasion, and glycolysis through the miR-377-3p/RNF38 axis.

Circular RNAs (circRNAs) have previously been confirmed to function as vital regulators in multiple human cancers, including hepatocellular carcinoma (HCC). This study aimed to clarify the role and underlying molecular mechanisms of circ-CFH in HCC. circ-CFH was overexpressed in HCC tissues and cells, and the downregulation of circ-CFH inhibited the development of HCC by repressing cell proliferation, migration, invasion, and glycolysis while enhancing apoptosis in vitro, as well as inhibited tumor growth in vivo. miR-377-3p was negatively regulated by circ-CFH, and silencing of miR-377-3p abolished circ-CFH knockdown-mediated effects on HCC cells. Moreover, overexpression of miR-377-3p could impede the HCC process by targeting RNF38. Mechanistically, the circ-CFH/miR-377-3p/RNF38 axis regulated the progression of HCC cells, which might provide new diagnostic markers for HCC.

Negative school experiences in early adolescence on depressive affect in middle adulthood.

This study takes a life course perspective to examine the long-term effect of negative school experiences during early adolescence on depressive affect in middle adulthood. The study uses a prospective longitudinal panel dataset that spanned nearly three decades with three waves: when respondents were at 7th grade (Time 1, mostly 12-13 years of age), young adulthood (Time 2, in their 20 s), and middle adulthood (Time 3, in their mid-30 s to early 40 s). The OLS regression models yielded results demonstrating that early negative school experiences were contemporaneously associated with depressive affect at Time 1, which endured through Time 2 and Time 3. Furthermore, independently of Time 1 control variables and the stability effects of depressive affect at Time 1 and Time 2, early negative school experiences still exerted a direct effect on depressive affect in middle adulthood. Ad hoc analysis demonstrated that this significant direct effect was mediated by the economic attainment of the respondents in middle adulthood net of the stability effects of depressive affect. Apparently, part of the influences of early negative school experiences on depressive affect in middle adulthood may be explained by its impeding economic attainment in adulthood, which in turn was associated with depressive affect.

School performance, peer association, psychological and behavioral adjustments: a comparison between Chinese adolescents with and without siblings.

We test theoretically informed hypotheses using survey reports of adolescents attending three middle schools in the outskirts of Fuzhou, Fujian, China. Results yielded by regression analyses are quite consistent with the hypothesized relationships, that is, Chinese singleton adolescents are more likely to anticipate going to college than non-singleton adolescents. Further, singletons are more associated with conventional peers and they report better adjustments both psychologically and behaviorally than non-singleton adolescents. Singletons and non-singletons, however, are not different in their self-reported performance in four school subjects, namely, Chinese, Math, English, and Political Studies. These results are discussed in light of the theoretical literature, especially related to attachment theory, resource dilution theory as well as confluence model.

Review of Research on the Role of Irisin in Tumors.

Irisin is a newly discovered exercise-induced cytokine, produced by the proteolytic hydrolysis of fibronectin type III domain-containing protein 5 (FNDC5). Irisin is widely distributed in the human body and is involved in the browning of white adipose tissue, improving insulin resistance, improving cognitive function, and regulating bone metabolism. Recent studies have shown that irisin concentration is elevated in a variety of tumor tissues as compared with that in normal tissues. However, irisin has different effects on the proliferation and apoptosis of tumor cells in breast cancer, lung cancer, and liver cancer through various mechanisms. Irisin plays an important role in the occurrence, development, and metastasis of different tumors, suggesting that irisin can be used as a potential target for tumor diagnosis and treatment. Therefore, studying the expression and function of irisin in tumors may be of great significance for the prevention and treatment of tumors. This article reviews the research progress on the role of irisin in tumors.

Mediating Mechanisms for the Intergenerational Transmission of Constructive Parenting: A Prospective Longitudinal Study.

Based on a prospective longitudinal panel data set that was collected at three developmental stages-early adolescence, young adulthood, and middle adulthood- this study investigates marital satisfaction and educational attainment as mediating mechanisms as well as gender's moderating effect for the intergenerational transmission of constructive parenting (N = 1,560). The results show that perceived satisfying experiences with parents during early adolescence are positively related to marital satisfaction and educational attainment in young adulthood, which, in turn, are positively related to individuals' utilization of constructive parenting in middle adulthood. The two mediating mechanisms account for most of the direct effect of the intergenerational transmission of constructive parenting. Furthermore, the mediating effect of marital relationship is stronger for current fathers than for mothers because of a stronger association between marital satisfaction and constructive parenting for men. The implications are discussed.