Pub Date : 2024-09-05DOI: 10.1097/JS9.0000000000002068
Chien-Hui Wu, Te-Wei Ho, Ching-Hsuan Chen, Kuo-Liong Chien, Yu-Wen Tien
Background: Endoscopic ultrasound-guided aspiration or biopsy allows preoperative confirmation of malignancy but is not necessary for resectable pancreatic cancer. Preoperative biopsy may induce pancreatitis, making surgery difficult and complex. Therefore, we performed a retrospective study to evaluate the association between preoperative endoscopic ultrasound-guided biopsy and surgical outcomes in patients with resectable pancreatic head tumors.
Materials and methods: A prospectively enrolled cohort from a single high-volume pancreatic center was analyzed. Between 2007 and 2019, a total of 518 patients with resectable pancreatic head tumors underwent pancreaticoduodenectomy. This analysis was performed to determine the association of preoperative endoscopic ultrasound-guided biopsy with operating time and major complications.
Results: In 518 patients who received pancreaticoduodenectomy, 164 patients (31.6%) underwent preoperative endoscopic ultrasound-guided biopsy. Endoscopic ultrasound-guided biopsy increased surgical time (46.9 min, confidence interval: 25.1-68.8, P-value <0.05) without increasing complications (odds ratio: 0.53, confidence interval: 0.31-1.29, P-value=0.29).
Conclusion: Preoperative endoscopic ultrasound-guided biopsy for pancreatic head tumors may increase operative time but is not associated with an increased risk of mortality and complications.
{"title":"Preoperative endoscopic ultrasound-guided biopsy for resectable pancreatic head tumors increases operative time but not complications - a single center cohort study.","authors":"Chien-Hui Wu, Te-Wei Ho, Ching-Hsuan Chen, Kuo-Liong Chien, Yu-Wen Tien","doi":"10.1097/JS9.0000000000002068","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002068","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic ultrasound-guided aspiration or biopsy allows preoperative confirmation of malignancy but is not necessary for resectable pancreatic cancer. Preoperative biopsy may induce pancreatitis, making surgery difficult and complex. Therefore, we performed a retrospective study to evaluate the association between preoperative endoscopic ultrasound-guided biopsy and surgical outcomes in patients with resectable pancreatic head tumors.</p><p><strong>Materials and methods: </strong>A prospectively enrolled cohort from a single high-volume pancreatic center was analyzed. Between 2007 and 2019, a total of 518 patients with resectable pancreatic head tumors underwent pancreaticoduodenectomy. This analysis was performed to determine the association of preoperative endoscopic ultrasound-guided biopsy with operating time and major complications.</p><p><strong>Results: </strong>In 518 patients who received pancreaticoduodenectomy, 164 patients (31.6%) underwent preoperative endoscopic ultrasound-guided biopsy. Endoscopic ultrasound-guided biopsy increased surgical time (46.9 min, confidence interval: 25.1-68.8, P-value <0.05) without increasing complications (odds ratio: 0.53, confidence interval: 0.31-1.29, P-value=0.29).</p><p><strong>Conclusion: </strong>Preoperative endoscopic ultrasound-guided biopsy for pancreatic head tumors may increase operative time but is not associated with an increased risk of mortality and complications.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":null,"pages":null},"PeriodicalIF":12.5,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-05DOI: 10.1097/JS9.0000000000002074
Ming Ma, Jun Zeng, Mengli Zhu, Hui Li, Tao Lin, Hao Yang, Xin Wei, Turun Song
Background: Human umbilical cord mesenchymal stem cells derived extracellular vesicles (HUMSC-EVs) have drawn much interest in kidney transplantation, mainly because of their renoprotection by alleviating cell injury and stimulating tissue repair. Cellular senescence has been proven to play a dual regulatory role in kidney ischemia-reperfusion injury (IRI), and the regulation of HUMSC-EVs on tubular epithelial cell senescence may be a potential therapeutic target.
Materials and methods: In vitro, the hypoxia-reoxygenation of human kidney-2 cells was used to simulate kidney IRI, and the regulation of HUMSC-EVs on human kidney-2 cells was detected. Transcriptome sequencing of human kidney-2 cells was used to explore the potential regulatory mechanism. In vivo, adult male mice were divided into five groups: control group, IRI group, HUMSC-EVs treatment group, senolytics treatment group (dasatinib + quercetin), and combined treatments group (HUMSC-EVs and senolytics). Kidney function, senescent features of tubular epithelial cells, acute kidney injury, and chronic interstitial fibrosis in mice were detected to explore the renoprotection effects of HUMSC-EVs.
Results: Kidney IRI significantly up-regulated expressions of LaminB1, p53, p21, p16, senescence-associated beta-galactosidase, and apoptosis of tubular epithelial cells. In the mouse kidney IRI model, kidney subcapsular injection of HUMSC-EVs significantly improved kidney function, reducing the senescent features of tubular epithelial cells and alleviating acute kidney injury and chronic interstitial fibrosis. HUMSC-EVs mainly achieved renoprotection by regulating Bax/Bcl-2-dependent apoptosis during acute kidney injury and mostly reduced tubular atrophy and kidney interstitial fibrosis by regulating Ras-pERK-Ets1-p53 pathway-dependent cell senescence. Oral administration of senolytics also alleviated kidney injury induced by IRI, while the combined treatments of HUMSC-EVs and senolytics had better renoprotection effects.
Conclusions: The combination of HUMSC-EVs and senolytics alleviated acute kidney injury and chronic interstitial fibrosis by dynamic regulation of cell senescence and apoptosis, which provides a therapeutic potential strategy for organ preservation and tissue repair in kidney transplantation.
{"title":"Human umbilical cord mesenchymal stem cells derived extracellular vesicles ameliorate kidney ischemia-reperfusion injury by suppression of senescent tubular epithelial cells - Experimental Study.","authors":"Ming Ma, Jun Zeng, Mengli Zhu, Hui Li, Tao Lin, Hao Yang, Xin Wei, Turun Song","doi":"10.1097/JS9.0000000000002074","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002074","url":null,"abstract":"<p><strong>Background: </strong>Human umbilical cord mesenchymal stem cells derived extracellular vesicles (HUMSC-EVs) have drawn much interest in kidney transplantation, mainly because of their renoprotection by alleviating cell injury and stimulating tissue repair. Cellular senescence has been proven to play a dual regulatory role in kidney ischemia-reperfusion injury (IRI), and the regulation of HUMSC-EVs on tubular epithelial cell senescence may be a potential therapeutic target.</p><p><strong>Materials and methods: </strong>In vitro, the hypoxia-reoxygenation of human kidney-2 cells was used to simulate kidney IRI, and the regulation of HUMSC-EVs on human kidney-2 cells was detected. Transcriptome sequencing of human kidney-2 cells was used to explore the potential regulatory mechanism. In vivo, adult male mice were divided into five groups: control group, IRI group, HUMSC-EVs treatment group, senolytics treatment group (dasatinib + quercetin), and combined treatments group (HUMSC-EVs and senolytics). Kidney function, senescent features of tubular epithelial cells, acute kidney injury, and chronic interstitial fibrosis in mice were detected to explore the renoprotection effects of HUMSC-EVs.</p><p><strong>Results: </strong>Kidney IRI significantly up-regulated expressions of LaminB1, p53, p21, p16, senescence-associated beta-galactosidase, and apoptosis of tubular epithelial cells. In the mouse kidney IRI model, kidney subcapsular injection of HUMSC-EVs significantly improved kidney function, reducing the senescent features of tubular epithelial cells and alleviating acute kidney injury and chronic interstitial fibrosis. HUMSC-EVs mainly achieved renoprotection by regulating Bax/Bcl-2-dependent apoptosis during acute kidney injury and mostly reduced tubular atrophy and kidney interstitial fibrosis by regulating Ras-pERK-Ets1-p53 pathway-dependent cell senescence. Oral administration of senolytics also alleviated kidney injury induced by IRI, while the combined treatments of HUMSC-EVs and senolytics had better renoprotection effects.</p><p><strong>Conclusions: </strong>The combination of HUMSC-EVs and senolytics alleviated acute kidney injury and chronic interstitial fibrosis by dynamic regulation of cell senescence and apoptosis, which provides a therapeutic potential strategy for organ preservation and tissue repair in kidney transplantation.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":null,"pages":null},"PeriodicalIF":12.5,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-05DOI: 10.1097/JS9.0000000000002067
Jianye Yang, Leilei Qin, Chen Zhao, Hai Wang, Cheng Chen, Tao Zhang, Bo Zhu, Li Wei, Xudong Su, Yujian Li, Ning Hu, Wei Huang
Preoperative diagnosis of periprosthetic joint infection (PJI) is critical to guide treatment options and improve patient outcomes. In this letter, we discuss results from our experiences with a novel nomogram diagnosis model based on serum and synovial fluid indicators for the preoperative diagnosis of PJI. The results showed that the novel nomogram diagnosis model can distinguish PJI from aseptic loosening before the operation. And it is also a useful candidate for the selection of the timing of current secondary revision.
{"title":"Diagnosis of periprosthesis joint infection and selection of replantation timing: A novel nomogram diagnosis model.","authors":"Jianye Yang, Leilei Qin, Chen Zhao, Hai Wang, Cheng Chen, Tao Zhang, Bo Zhu, Li Wei, Xudong Su, Yujian Li, Ning Hu, Wei Huang","doi":"10.1097/JS9.0000000000002067","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002067","url":null,"abstract":"<p><p>Preoperative diagnosis of periprosthetic joint infection (PJI) is critical to guide treatment options and improve patient outcomes. In this letter, we discuss results from our experiences with a novel nomogram diagnosis model based on serum and synovial fluid indicators for the preoperative diagnosis of PJI. The results showed that the novel nomogram diagnosis model can distinguish PJI from aseptic loosening before the operation. And it is also a useful candidate for the selection of the timing of current secondary revision.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":null,"pages":null},"PeriodicalIF":12.5,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-05DOI: 10.1097/JS9.0000000000002069
Pei-Hsin Hsiung, Ho-Yin Huang, Wei-Yu Chen, Yur-Ren Kuo, Ying-Chi Lin
Background: Free flap construction enhances quality of life for head and neck cancer (HNC) patients; however, complications, such as thrombosis and hematoma, threaten flap survival. This study aimed to identify factors influencing flap failure, thrombosis, and hematoma.
Methods: A retrospective nested case-control study was conducted on HNC patients who underwent free flap reconstruction at a tertiary medical center between January 2019 and January 2022. All patients received antithrombotic prophylaxis consisting of prostaglandin E1, dextran, aspirin, and dipyridamole. Risk factors were analyzed using multivariate logistic regression.
Results: Among 548 flaps analyzed, flap failure, thrombosis, and hematoma rates were 4.74%, 3.83%, and 9.65%, respectively. Risk factors for flap failure included thrombosis (OR 86.42, 95% CI 15.73-474.89), smoking (OR 49.44, 95% CI 1.28->1000), posteromedial thigh (PMT) flap usage (OR 14.05, 95% CI 2.48-79.54), hematoma (OR 9.68, 95% CI 2.35-39.79), and younger age (OR 0.93, 95% CI 0.87-0.99). Thrombosis risk factors included PMT usage (OR 11.45, 95% CI 2.60-50.38) and anastomosis with the superior thyroid vein (SThV) as the recipient vein after multiple reconstructions (OR 7.91, 95% CI 2.06-30.39). Hematoma risk factors included fibula osteocutaneous flap usage (OR 9.22, 95% CI 2.71-31.42), double-flap usage (OR 8.88, 95% CI 1.80-43.81), liver cirrhosis (OR 6.28, 95% CI 1.44-27.47), and postsurgery hypertension (OR 2.77, 95% CI 1.39-5.50), whereas ipsilateral recurrence (OR 0.14, 95% CI 0.03-0.73) and using the external jugular vein (EJV) as the recipient vein (OR 0.22, 95% CI 0.08-0.61) were protective factors.
Conclusion: Thrombosis poses a greater risk than hematoma for flap failure. Utilization of the PMT flap and the SThV markedly increased the risk of thrombosis and flap failure. These findings highlight the importance of antithrombotic prophylaxis and the selection of flaps and recipient veins in recurrent HNC patients.
背景:游离皮瓣可提高头颈癌(HNC)患者的生活质量,但血栓和血肿等并发症威胁着皮瓣的存活。本研究旨在确定影响皮瓣失败、血栓形成和血肿的因素:方法:对2019年1月至2022年1月期间在一家三级医疗中心接受游离皮瓣重建术的HNC患者进行了一项回顾性巢式病例对照研究。所有患者均接受了抗血栓预防治疗,包括前列腺素 E1、右旋糖酐、阿司匹林和双嘧达莫。使用多变量逻辑回归分析了风险因素:在分析的 548 个皮瓣中,皮瓣失败率、血栓形成率和血肿形成率分别为 4.74%、3.83% 和 9.65%。皮瓣失败的风险因素包括血栓形成(OR 86.42,95% CI 15.73-474.89)、吸烟(OR 49.44,95% CI 1.28->1000)、使用大腿后内侧(PMT)皮瓣(OR 14.05,95% CI 2.48-79.54)、血肿(OR 9.68,95% CI 2.35-39.79)和年龄较小(OR 0.93,95% CI 0.87-0.99)。血栓风险因素包括使用 PMT(OR 11.45,95% CI 2.60-50.38)和多次重建后以甲状腺上静脉(STHV)作为受体静脉进行吻合(OR 7.91,95% CI 2.06-30.39)。血肿风险因素包括使用腓骨骨皮瓣(OR 9.22,95% CI 2.71-31.42)、使用双瓣(OR 8.88,95% CI 1.80-43.81)、肝硬化(OR 6.28,95% CI 1.44-27.47)和术后高血压(OR 2.77,95% CI 1.39-5.50),而同侧复发(OR 0.14,95% CI 0.03-0.73)和使用颈外静脉(EJV)作为受体静脉(OR 0.22,95% CI 0.08-0.61)是保护因素:结论:与血肿相比,血栓形成对皮瓣失败的风险更大。结论:血栓形成比血肿更容易导致皮瓣失败。使用PMT皮瓣和SThV明显增加了血栓形成和皮瓣失败的风险。这些发现强调了抗血栓预防以及选择皮瓣和受体静脉对复发性 HNC 患者的重要性。
{"title":"Cumulative risk factors for flap failure, thrombosis, and hematoma in free flap reconstruction for head and neck cancer: a retrospective nested case-control study.","authors":"Pei-Hsin Hsiung, Ho-Yin Huang, Wei-Yu Chen, Yur-Ren Kuo, Ying-Chi Lin","doi":"10.1097/JS9.0000000000002069","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002069","url":null,"abstract":"<p><strong>Background: </strong>Free flap construction enhances quality of life for head and neck cancer (HNC) patients; however, complications, such as thrombosis and hematoma, threaten flap survival. This study aimed to identify factors influencing flap failure, thrombosis, and hematoma.</p><p><strong>Methods: </strong>A retrospective nested case-control study was conducted on HNC patients who underwent free flap reconstruction at a tertiary medical center between January 2019 and January 2022. All patients received antithrombotic prophylaxis consisting of prostaglandin E1, dextran, aspirin, and dipyridamole. Risk factors were analyzed using multivariate logistic regression.</p><p><strong>Results: </strong>Among 548 flaps analyzed, flap failure, thrombosis, and hematoma rates were 4.74%, 3.83%, and 9.65%, respectively. Risk factors for flap failure included thrombosis (OR 86.42, 95% CI 15.73-474.89), smoking (OR 49.44, 95% CI 1.28->1000), posteromedial thigh (PMT) flap usage (OR 14.05, 95% CI 2.48-79.54), hematoma (OR 9.68, 95% CI 2.35-39.79), and younger age (OR 0.93, 95% CI 0.87-0.99). Thrombosis risk factors included PMT usage (OR 11.45, 95% CI 2.60-50.38) and anastomosis with the superior thyroid vein (SThV) as the recipient vein after multiple reconstructions (OR 7.91, 95% CI 2.06-30.39). Hematoma risk factors included fibula osteocutaneous flap usage (OR 9.22, 95% CI 2.71-31.42), double-flap usage (OR 8.88, 95% CI 1.80-43.81), liver cirrhosis (OR 6.28, 95% CI 1.44-27.47), and postsurgery hypertension (OR 2.77, 95% CI 1.39-5.50), whereas ipsilateral recurrence (OR 0.14, 95% CI 0.03-0.73) and using the external jugular vein (EJV) as the recipient vein (OR 0.22, 95% CI 0.08-0.61) were protective factors.</p><p><strong>Conclusion: </strong>Thrombosis poses a greater risk than hematoma for flap failure. Utilization of the PMT flap and the SThV markedly increased the risk of thrombosis and flap failure. These findings highlight the importance of antithrombotic prophylaxis and the selection of flaps and recipient veins in recurrent HNC patients.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":null,"pages":null},"PeriodicalIF":12.5,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-05DOI: 10.1097/JS9.0000000000002076
Yue Kang, Yujing Guan, Shenglong Li
Articular cartilage damage is predominantly caused by trauma, osteoarthritis (OA), and other pathological conditions. The limited intrinsic capacity of cartilage tissue to self-repair necessitates timely intervention following acute injuries to prevent accelerated degeneration, leading to the development of planar arthritis or even osteoarthritis. Unfortunately, current therapies for articular cartilage damage are inadequate in effectively replacing or regenerating compromised cartilage due to the absence of suitable tissue-engineered artificial matrices. However, there is promise in utilizing hydrogels, a category of biomaterials characterized by their elasticity, smooth surfaces, and high water content, for cartilage regeneration. Recent advancements in hydrogel engineering have focused on improving their bioactive and physicochemical properties, encompassing innovative composition designs, dynamic modulation, and intricate architectures. This review provides a comprehensive analysis of hydrogels for articular cartilage repair, focusing on their innovative design, clinical applications, and future research directions. By integrating insights from lastest research studies and clinical trials, the review offers a unique perspective on the translation of hydrogels for articular cartilage repair, underscoring their potential as promising therapeutic agents.
{"title":"Innovative hydrogel solutions for articular cartilage regeneration: a comprehensive review.","authors":"Yue Kang, Yujing Guan, Shenglong Li","doi":"10.1097/JS9.0000000000002076","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002076","url":null,"abstract":"<p><p>Articular cartilage damage is predominantly caused by trauma, osteoarthritis (OA), and other pathological conditions. The limited intrinsic capacity of cartilage tissue to self-repair necessitates timely intervention following acute injuries to prevent accelerated degeneration, leading to the development of planar arthritis or even osteoarthritis. Unfortunately, current therapies for articular cartilage damage are inadequate in effectively replacing or regenerating compromised cartilage due to the absence of suitable tissue-engineered artificial matrices. However, there is promise in utilizing hydrogels, a category of biomaterials characterized by their elasticity, smooth surfaces, and high water content, for cartilage regeneration. Recent advancements in hydrogel engineering have focused on improving their bioactive and physicochemical properties, encompassing innovative composition designs, dynamic modulation, and intricate architectures. This review provides a comprehensive analysis of hydrogels for articular cartilage repair, focusing on their innovative design, clinical applications, and future research directions. By integrating insights from lastest research studies and clinical trials, the review offers a unique perspective on the translation of hydrogels for articular cartilage repair, underscoring their potential as promising therapeutic agents.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":null,"pages":null},"PeriodicalIF":12.5,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-05DOI: 10.1097/JS9.0000000000002082
P Thamarai, S Karishma, R Kamalesh, Alan Shaji, A Saravanan, Shabana Bibi, A S Vickram, Hitesh Chopra, Rimah Abdullah Saleem, Khalaf F Alsharif, Abdulrahman Theyab, Mohamed Kamel, Mariam K Alamoudi, Ajoy Kumer, Shivani Chopra, Mohamed M Abdel-Daim
Stem cell therapy has emerged as a promising approach for regenerative medicine, offering potential treatments for a wide range of diseases and injuries. Although stem cell therapy has great promise, several obstacles have prevented its broad clinical adoption. The effectiveness of therapy has been inhibited by problems such as ineffective stem cell differentiation, low post-transplantation survival rates, and restricted control over stem cell behaviour. Furthermore, the implementation of stem cell therapies is further complicated by the possibility of immunological rejection and cancer. Innovative strategies that provide precise control over stem cell characteristics and maximize their therapeutic potential are desperately needed to overcome these obstacles. Recent studies have shown that the effectiveness of stem cell treatments can be greatly increased by nanoscale advances. By establishing an ideal microenvironment and precisely offering growth factors, nanomaterials such as nanoparticles, nanocomposites, and quantum dots have been demonstrated to improve stem cell differentiation and proliferation. This article provides an overview of the recent trends and applications of nanoscale innovations in the context of stem cell therapy. The recent development of precision medicine has been facilitated by the incorporation of nanotechnology into stem cell therapy. The ability to manipulate stem cells at the nanoscale offers unprecedented control over their behavior and function, opening up exciting possibilities for personalized and highly effective therapeutic interventions. This review paper highlights the recent trends and applications of nanotechnology in advancing stem cell therapy, showcasing its potential to revolutionize regenerative medicine.
{"title":"Current advancements in nanotechnology for stem cells.","authors":"P Thamarai, S Karishma, R Kamalesh, Alan Shaji, A Saravanan, Shabana Bibi, A S Vickram, Hitesh Chopra, Rimah Abdullah Saleem, Khalaf F Alsharif, Abdulrahman Theyab, Mohamed Kamel, Mariam K Alamoudi, Ajoy Kumer, Shivani Chopra, Mohamed M Abdel-Daim","doi":"10.1097/JS9.0000000000002082","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002082","url":null,"abstract":"<p><p>Stem cell therapy has emerged as a promising approach for regenerative medicine, offering potential treatments for a wide range of diseases and injuries. Although stem cell therapy has great promise, several obstacles have prevented its broad clinical adoption. The effectiveness of therapy has been inhibited by problems such as ineffective stem cell differentiation, low post-transplantation survival rates, and restricted control over stem cell behaviour. Furthermore, the implementation of stem cell therapies is further complicated by the possibility of immunological rejection and cancer. Innovative strategies that provide precise control over stem cell characteristics and maximize their therapeutic potential are desperately needed to overcome these obstacles. Recent studies have shown that the effectiveness of stem cell treatments can be greatly increased by nanoscale advances. By establishing an ideal microenvironment and precisely offering growth factors, nanomaterials such as nanoparticles, nanocomposites, and quantum dots have been demonstrated to improve stem cell differentiation and proliferation. This article provides an overview of the recent trends and applications of nanoscale innovations in the context of stem cell therapy. The recent development of precision medicine has been facilitated by the incorporation of nanotechnology into stem cell therapy. The ability to manipulate stem cells at the nanoscale offers unprecedented control over their behavior and function, opening up exciting possibilities for personalized and highly effective therapeutic interventions. This review paper highlights the recent trends and applications of nanotechnology in advancing stem cell therapy, showcasing its potential to revolutionize regenerative medicine.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":null,"pages":null},"PeriodicalIF":12.5,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-04DOI: 10.1097/JS9.0000000000002014
Piotr Dudek, Maciej Kocon, Jacek Kowalczewski
{"title":"Short-Term outcomes of a novel salvage procedure for Non-Reducible patella dislocation Post-Revision total knee arthroplasty: A 1- to 4-year Follow-Up preliminary study.","authors":"Piotr Dudek, Maciej Kocon, Jacek Kowalczewski","doi":"10.1097/JS9.0000000000002014","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002014","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":null,"pages":null},"PeriodicalIF":12.5,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objectives: To compare the value of tumor stroma ratio (TSR) and radiomic signature from baseline MRI for stratifying the risk of distant metastases (DM) in patients with locally advanced rectal cancer (LARC).
Materials and methods: Data from 302 patients with LARC who underwent neoadjuvant chemoradiotherapy and total mesorectal excision in our hospital between 2015 and 2018 were retrospectively reviewed, and the patients were randomly allocated into the training and validation cohorts in a ratio of 7:3. Patients were followed-up for more than 3 years postoperatively with metachronous DM as the endpoint. Independent risk factors for DM-free survival (DMFS) were analyzed using Cox regression. The TSR of endoscopic biopsy specimens was scored automatically. Totally 1229 radiomic features of each tumor were extracted from baseline MRI, and the Radscore was calculated.
Results: The median follow-up time was 54.3 (51.6-57.1) months, and the 3-year DMFS was 83.8%. The best cutoff value of the TSR to distinguish patient's DM risk was 0.477 (Sen=70.8%, Sep=78%, P<0.001). Increased TSR (HR=3.072, P=0.006) and Radscore (HR=719.231, P=0.023), advanced MR-evaluated T stage (HR=2.660, P=0.023) and ypN (HR=2.362, P=0.028) stage were independent risk factors for DMFS. The area under the curve of the combined model was significantly higher than that of the radiomic model (P=0.013) but without significant advantage over the TSR model (P=0.086).
Conclusion: TSR of colonoscopic biopsies can independently stratify DM risk in patients with LARC. The TSR model is the most convenient and efficient method for DM risk stratification in LARC.
研究目的比较肿瘤基质比(TSR)和基线MRI的放射学特征对局部晚期直肠癌(LARC)患者远处转移(DM)风险的分层价值:回顾性审查了2015年至2018年间在我院接受新辅助化放疗和全直肠系膜切除术的302例LARC患者的数据,并按7:3的比例将患者随机分配到训练组和验证组。患者术后随访3年以上,以代谢性DM为终点。采用Cox回归分析了无DM生存率(DMFS)的独立危险因素。内镜活检标本的 TSR 自动评分。从基线磁共振成像中提取了每个肿瘤的1229个放射学特征,并计算了Radscore:中位随访时间为 54.3(51.6-57.1)个月,3 年 DMFS 为 83.8%。区分患者 DM 风险的 TSR 最佳临界值为 0.477(Sen=70.8%,Sep=78%,PConclusion):结肠镜活检的 TSR 可以对 LARC 患者的 DM 风险进行独立分层。TSR 模型是对 LARC 患者进行 DM 风险分层的最便捷、最有效的方法。
{"title":"Role of microenvironment characteristics and MRI radiomics in the risk stratification of distant metastases in rectal cancer: A diagnostic study.","authors":"Qing Zhao, Hongxia Zhong, Xu Guan, Lijuan Wan, Xinming Zhao, Shuangmei Zou, Hongmei Zhang","doi":"10.1097/JS9.0000000000001916","DOIUrl":"https://doi.org/10.1097/JS9.0000000000001916","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the value of tumor stroma ratio (TSR) and radiomic signature from baseline MRI for stratifying the risk of distant metastases (DM) in patients with locally advanced rectal cancer (LARC).</p><p><strong>Materials and methods: </strong>Data from 302 patients with LARC who underwent neoadjuvant chemoradiotherapy and total mesorectal excision in our hospital between 2015 and 2018 were retrospectively reviewed, and the patients were randomly allocated into the training and validation cohorts in a ratio of 7:3. Patients were followed-up for more than 3 years postoperatively with metachronous DM as the endpoint. Independent risk factors for DM-free survival (DMFS) were analyzed using Cox regression. The TSR of endoscopic biopsy specimens was scored automatically. Totally 1229 radiomic features of each tumor were extracted from baseline MRI, and the Radscore was calculated.</p><p><strong>Results: </strong>The median follow-up time was 54.3 (51.6-57.1) months, and the 3-year DMFS was 83.8%. The best cutoff value of the TSR to distinguish patient's DM risk was 0.477 (Sen=70.8%, Sep=78%, P<0.001). Increased TSR (HR=3.072, P=0.006) and Radscore (HR=719.231, P=0.023), advanced MR-evaluated T stage (HR=2.660, P=0.023) and ypN (HR=2.362, P=0.028) stage were independent risk factors for DMFS. The area under the curve of the combined model was significantly higher than that of the radiomic model (P=0.013) but without significant advantage over the TSR model (P=0.086).</p><p><strong>Conclusion: </strong>TSR of colonoscopic biopsies can independently stratify DM risk in patients with LARC. The TSR model is the most convenient and efficient method for DM risk stratification in LARC.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":null,"pages":null},"PeriodicalIF":12.5,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-04DOI: 10.1097/JS9.0000000000002070
Fei Li, Jiayu Liang, Xin Wei
Background: Clear cell renal cell carcinoma (ccRCC) represents the predominant and remarkably diverse form of renal cell carcinoma. The involvement of the Castor zinc finger 1 (CASZ1) gene in adverse prognostic outcomes has been observed across different cancer types. Nevertheless, the specific altered activities and associated multi-omics characteristics of CASZ1 in ccRCC remain unelucidated.
Method: In order to explore the expression of CASZ1, evaluate its prognostic significance, and aid in the therapeutic decision-making process for patients with ccRCC, the The Cancer Genome Atlas(TCGA), Gene expression omnibus (GEO), and The Human Protein Atlas (HPA) databases were utilized to gather data on clinicopathological data, prognostic information, genomic, methylomic and immunomic data. Additionally, the Genomics of drug sensitivity in cancer (GDSC) database provided information on drug sensitivity.
Results: CASZ1 expression was found to be significantly reduced in ccRCC and was associated with unfavorable pathological characteristics and a bleak prognosis. Diminished CASZ1 mRNA levels were notably correlated with heightened cytosine-phosphate-guanine (CpG) methylation , indicating a poorer prognosis for patients with increased methylation. Examination of RNA-seq data from TCGA indicated that the CASZ1-high expression subgroup displayed heightened immune cell infiltration and increased expression of immune checkpoint markers, potentially suggesting a more favorable response to immunotherapy. Furthermore, data from the GDSC database indicated that the CASZ1-low expression subgroup might exhibit greater sensitivity to anti-angiogenetic treatments, such as Sunitinib and Axitinib.
Conclusions: These results indicate that CASZ1 may function as a biomarker for distinguishing various tumor microenvironment phenotypes, predicting prognosis, and assisting in treatment decisions for individuals with ccRCC.
{"title":"Epigenetic modification of Castor zinc finger 1 (CASZ1) is associated with tumor microenvironments and prognosis of clear cell renal cell carcinoma.","authors":"Fei Li, Jiayu Liang, Xin Wei","doi":"10.1097/JS9.0000000000002070","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002070","url":null,"abstract":"<p><strong>Background: </strong>Clear cell renal cell carcinoma (ccRCC) represents the predominant and remarkably diverse form of renal cell carcinoma. The involvement of the Castor zinc finger 1 (CASZ1) gene in adverse prognostic outcomes has been observed across different cancer types. Nevertheless, the specific altered activities and associated multi-omics characteristics of CASZ1 in ccRCC remain unelucidated.</p><p><strong>Method: </strong>In order to explore the expression of CASZ1, evaluate its prognostic significance, and aid in the therapeutic decision-making process for patients with ccRCC, the The Cancer Genome Atlas(TCGA), Gene expression omnibus (GEO), and The Human Protein Atlas (HPA) databases were utilized to gather data on clinicopathological data, prognostic information, genomic, methylomic and immunomic data. Additionally, the Genomics of drug sensitivity in cancer (GDSC) database provided information on drug sensitivity.</p><p><strong>Results: </strong>CASZ1 expression was found to be significantly reduced in ccRCC and was associated with unfavorable pathological characteristics and a bleak prognosis. Diminished CASZ1 mRNA levels were notably correlated with heightened cytosine-phosphate-guanine (CpG) methylation , indicating a poorer prognosis for patients with increased methylation. Examination of RNA-seq data from TCGA indicated that the CASZ1-high expression subgroup displayed heightened immune cell infiltration and increased expression of immune checkpoint markers, potentially suggesting a more favorable response to immunotherapy. Furthermore, data from the GDSC database indicated that the CASZ1-low expression subgroup might exhibit greater sensitivity to anti-angiogenetic treatments, such as Sunitinib and Axitinib.</p><p><strong>Conclusions: </strong>These results indicate that CASZ1 may function as a biomarker for distinguishing various tumor microenvironment phenotypes, predicting prognosis, and assisting in treatment decisions for individuals with ccRCC.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":null,"pages":null},"PeriodicalIF":12.5,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Gastroesophageal reflux disease (GERD) is a prevalent condition that manifests a spectrum of symptoms, including gastroesophageal-related cough (GERC). Anti-reflux procedures have been employed to alleviate these symptoms, yet their efficacy varies. This systematic review and meta-analysis aim to evaluate the improvement in gastroesophageal-related cough and other reflux symptoms following anti-reflux procedures.
Methods: A systematic review was performed by searching PubMed, Embase, and Cochrane Library. All observational studies reporting the improvement of GERC and other reflux symptoms after the anti-reflux procedures. Data were extracted and pooled using a random effects model to assess the overall effect size and heterogeneity between studies. We found that anti-reflux surgery has some clear benefits for common reflux-related symptoms.
Results: Fifty-nine eligible studies with 7431 patients with GERD were included in this study. The pooled cough remission rate was 80.0% (95%CI 75.4-84.2) and the mean time of follow up was 35.8 months. Anti-reflux surgery significantly improved overall reflux-related symptom scores (all P<0.001). We also assessed the rate of remission of other reflux symptoms. The pooled heartburn remission rate was 87.7% (95%CI 82.3-92.2) and the pooled regurgitation remission rate was 91.2%(95%CI 87.8-94.1).
Conclusion: Anti-reflux procedures significantly improve gastroesophageal-related cough and other reflux symptoms. These findings support the use of anti-reflux procedures as a viable treatment option for patients with GERD symptoms. Further research is needed to identify predictors of success and to optimize patient selection for anti-reflux procedures.
{"title":"Efficacy and safety of anti-reflux surgery in gastroesophageal-related cough: a systematic review and meta-analysis.","authors":"Yuheng Liu, Junfeng Huang, Shuxin Zhong, Ziwen Zheng, Zhixing Xu, Dongda Zhou, Shuojia Xie, Zikai Lin, Shiyue Li, Ruchong Chen","doi":"10.1097/JS9.0000000000001998","DOIUrl":"https://doi.org/10.1097/JS9.0000000000001998","url":null,"abstract":"<p><strong>Background: </strong>Gastroesophageal reflux disease (GERD) is a prevalent condition that manifests a spectrum of symptoms, including gastroesophageal-related cough (GERC). Anti-reflux procedures have been employed to alleviate these symptoms, yet their efficacy varies. This systematic review and meta-analysis aim to evaluate the improvement in gastroesophageal-related cough and other reflux symptoms following anti-reflux procedures.</p><p><strong>Methods: </strong>A systematic review was performed by searching PubMed, Embase, and Cochrane Library. All observational studies reporting the improvement of GERC and other reflux symptoms after the anti-reflux procedures. Data were extracted and pooled using a random effects model to assess the overall effect size and heterogeneity between studies. We found that anti-reflux surgery has some clear benefits for common reflux-related symptoms.</p><p><strong>Results: </strong>Fifty-nine eligible studies with 7431 patients with GERD were included in this study. The pooled cough remission rate was 80.0% (95%CI 75.4-84.2) and the mean time of follow up was 35.8 months. Anti-reflux surgery significantly improved overall reflux-related symptom scores (all P<0.001). We also assessed the rate of remission of other reflux symptoms. The pooled heartburn remission rate was 87.7% (95%CI 82.3-92.2) and the pooled regurgitation remission rate was 91.2%(95%CI 87.8-94.1).</p><p><strong>Conclusion: </strong>Anti-reflux procedures significantly improve gastroesophageal-related cough and other reflux symptoms. These findings support the use of anti-reflux procedures as a viable treatment option for patients with GERD symptoms. Further research is needed to identify predictors of success and to optimize patient selection for anti-reflux procedures.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":null,"pages":null},"PeriodicalIF":12.5,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}