Notes

Cocultured porcine granulosa cellular material react to excessive non-esterified fatty acids during in vitro readiness.
mption in China.
Whether proximal gastrectomy (PG) can be applied to patients with proximal advanced gastric cancer (AGC) remains controversial. We aimed to explore the oncological safety of PG for proximal AGC in this study.

452 patients undergoing surgery for proximal AGC in the Affiliated Cancer Hospital of Nanjing Medical University were enrolled in this study. 329 patients with AGC were finally analyzed, of which 254 patients underwent total gastrectomy (TG) and 75 patients underwent PG. We used propensity score-matched (PSM) analysis to reduce biases.

After PSM, 67 patients with proximal AGC were included in the PG group and TG group, respectively. The estimated 5-year OS rates for TG and PG group after PSM were 64.3% and 74.9%, respectively, and no significant difference in OS existed between the two groups (p=0.275). Multivariate analysis showed that PG was not an independent prognostic factor. Incidence of metastasis in No.5 or 6 lymph node (LN) station was significantly higher in the patients with pathological T4 and Borrmann III tumors (9.9% and 10.6%) than those with pathological T2/3 and Borrmann I/II tumors (2.2% and 3.3%). No metastasis was observed in No.5 or 6 LN station in patients with pathological T2/3 tumors or Borrmann I/II tumors when tumor size was ≤4cm.

PG is a reasonable choice for patients with selected proximal AGC, especially for those with tumors of size ≤4cm, Borrmann type I/II, and pathological T2/3. Future prospective randomized trials should be conducted first in patients with these specific proximal tumors.
PG is a reasonable choice for patients with selected proximal AGC, especially for those with tumors of size ≤4 cm, Borrmann type I/II, and pathological T2/3. Future prospective randomized trials should be conducted first in patients with these specific proximal tumors.
Cervical lymph node (CLN) metastasis (CLNM) can be found in some patients with CLN-negative (cN0) papillary thyroid microcarcinoma (PTMC), while the risk factors are still unknown. This study aimed to examine the risk factors of CLNM in patients with cN0 PTMC, contributing to screening cN0 PTMC patients with high risk in CLNM for preventive CLN dissection (CLND).

This retrospective study included consecutive patients pathologically diagnosed with cN0 PTMC and who underwent surgery at the General Surgery Department of China-Japan Friendship Hospital between 07/2016 and 01/2020. The patients were grouped according to whether CLNM was present. Factors associated with CLNM were analyzed, and a risk prediction model was established in logistic regression analysis, and their predictive power was evaluated by receiver operating characteristic curves (ROC).

Finally, 171 patients were included; among them, 71 (41.5%) had CLNM. There were 32 males and 139 females. The multivariable analysis showed that males (OR=5.619, 95%CI 2.186-14.446; P<0.001), age ≤45 years (OR=2.982, 95%CI 1.446-6.151; P=0.003), adjacent to dorsal membrane (OR=3.022, 95%CI 1.430-6.387; P=0.004), and irregular borders (OR=4.332, 95%CI 1.104-17.000; P=0.036) were independent risk factors of CLNM. The risk prediction model composed of the four risk factors showed a relatively high AUC, at 0.760. When the cut-off was 0.38, the sensitivity was 67.6%, and the specificity was 73.0%.

Male sex, age ≤45 years, adjacent to dorsal membranes, and irregular borders are independent risk factors for CLNM in patients with cN0 PTMC. This might help identify cN0 PTMC patients needing preventive CLND.
Male sex, age ≤45 years, adjacent to dorsal membranes, and irregular borders are independent risk factors for CLNM in patients with cN0 PTMC. click here This might help identify cN0 PTMC patients needing preventive CLND.The liver is the most common metastasis site of gastrointestinal stromal tumours (GISTs). However, primary hepatic gastrointestinal stromal tumours (PHGISTs) are also reported, which is no more than 40 cases to date. PHGISTs are mostly misdiagnosed preoperatively due to the lack of specific symptoms and imaging features. It majorly attributes to vague characteristics on CT or MRI, which PHGISTs almost meet the imaging diagnosis criteria of hepatocellular carcinoma (HCC) or hepatapostema. Here we reported an educational case series of PHGISTs with misleading medical histories and imaging features. Case 1 The patient has a history of Hepatitis B, which lead to the misuse of The Liver Imaging and Reporting Data System (LI-RADS) classification on CT. The hepatic occupying lesion was estimated as LR-5 which meant the definite diagnosis of HCC. Unexpectedly, the postoperative pathology demonstrates PHGISTs; Case 2 Another patient, who manifested hepatalgia and fever, was misdiagnosed as hepatapostema according to CT, which lead to the operation of ultrasound-guided percutaneous catheter drainage. Case 3 A female farmer living in a schistosomiasis-infested area was hospitalized for an asymptomatic hepatic mass. Diagnosis of HCC was considered for high-risk factors and radiography features. Postoperative did verify the existence of old eggs of schistosomiasis, but the tumour was confirmed as PHGISTs.
Currently, the early diagnosis of second primary cancers (SPCs) after gastric cancer (GC) remains a thorny problem. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been demonstrated to participate in the development of GC. Thus, we investigated diagnostic values of NLR and PLR in SPCs after GC.

78 patients with SPCs after GC, 99 patients with single GC and 107 healthy controls were retrospectively analyzed between 2011 and 2021. We detected their hematological parameters, plotted receiver operating characteristic curves of NLR, PLR, carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) alone or in combination for SPCs, and compared area under the curve (AUC).

SPC patients had higher levels of NLR, PLR, CEA and CA19-9 than other groups, and all indicators increased synchronically with GC progression. Compared with single GC patients, SPC patients had higher NLR levels in each TNM stage and higher PLR levels in stage II-IV. Moreover, NLR and PLR levels in stage I of SPC patients were significantly higher than those in stage IV of single GC patients. The diagnostic efficiency of NLR (AUC=0.845) and PLR (AUC=0.796) was significantly higher than that of CEA (AUC=0.672) and CA19-9 (AUC=0.655) in SPCs. Pairwise combination had superior diagnostic performance for SPCs, with the largest being NLR combined with PLR (AUC=0.881).

Clinically, existing diagnostic methods can be combined with NLR and PLR in early diagnosing SPCs after GC.
Clinically, existing diagnostic methods can be combined with NLR and PLR in early diagnosing SPCs after GC.
The objective of the clinical trial is to determine whether our novel multimodal approach can improve the anastomotic leakage (AL) in patients undergoing low anterior resection (LAR) for rectal cancer.

From September 2019 to December 2020, a total of 33 patients who underwent LAR in our hospital were divided to receive a defunctioning stoma (DS) or multi-modal approach. The multi-modal approach consists of three intraoperative preventive measures (pelvic floor peritoneum closure, transanal drainage tube and abdominal drains) combined with a standardised pathway for early detection and active management of AL. The short-term indicators observed postoperatively were as follows (1) incidence of AL; (2) additional operation time after LAR; (3) ileostomy complications; (4) postoperative hospital stay; (5) mortality. Long-term endpoints comprise (1) Wexner incontinence scale; (2) anorectal manometry measurements.

No significant difference was observed in the rates of postoperative AL between both groups (P>0.05). Remarkable divergences in the ileostomy complications, Wexner score, and manometric evaluation were not noted between the groups (P>0.05). Both the maximal resting pressure and maximal squeezing pressure at 6 month were significantly decreased relative to the values noted before treatment (P<0.001).

In conclusion, the multi-modal approach achieves the same effect as DS in the prevention and management of AL during LRA with shorter operation time, meanwhile overcomes the adverse impact brought by DS. Therefore, our multiinterventional program may be used to replace the DS procedure during LRA.
In conclusion, the multi-modal approach achieves the same effect as DS in the prevention and management of AL during LRA with shorter operation time, meanwhile overcomes the adverse impact brought by DS. Therefore, our multiinterventional program may be used to replace the DS procedure during LRA.Endoscopic ultrasound-guided drainage (EUSD) and percutaneous drainage (PD) have reportedly been used for postoperative pancreatic fluid collection (PFC). However, there is limited evidence regarding safety and efficacy in a comparison of EUSD and PD for postoperative PFC. We conducted a search of the databases PubMed, Embase, Web of Science, the Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov, to August 2020. Studies comparing EUSD and PD for postoperative PFC were included. The outcomes included technical success, clinical success, adverse events, and recurrence of PFC.We included a total of 6 studies involving 247 patients in the current study. There was no significant difference between EUSD and PD in terms of technical success (odds ratio [OR] = 0.95; 95% confidence interval [CI] 0.29-3.12; p = 0.94) and clinical success (OR = 1.36; 95% CI 0.68-2.72; p = 0.39). PFC recurrence and adverse events were similar between the two groups (OR = 1.82; 95% CI 0.75-4.37; p = 0.18 and OR = 0.78; 95% CI 0.31-1.92; p = 0.58, respectively).This meta-analysis confirmed that EUSD has comparable safety and efficacy to PD for postoperative PFC. Additional high-quality studies are required in the future.
Roux-en-Y gastric bypass (RYGB) is considered the gold standard procedure for bariatric surgery that leads to sustained weight loss and amelioration of obesity-related comorbidities.

To verify long-term efficacy and safety and to investigate the influence of early weight loss on post-RYGB long-term weight maintenance in obese Chinese with body mass index (BMI)<35kg/m
.

All patients were followed up for evaluating the variations in their BMI, percentage of excess weight loss (%EWL), and total body percentage weight loss (%TWL). Linear regression models were applied to evaluate the effects of early weight loss on successful weight maintenance. Optimal cutoff values were analyzed via plotting the receiver operative characteristic (ROC) curve.

In the current study, 143 patients were recruited. Preoperative BMI and weight were recorded as 32.24 (29.39-33.12) kg/m
, and 88.90±9.52kg, respectively. At 1, 3, and 5 years, successful weight loss i.e., greater than 25% TWL was attained by 46.85%, 37.76%, and 37.06% of patients, respectively. The obtained data revealed that %TWL at 0.5 years was considerably associated with %TWL for up to 5 years (P-value <0.001). Based on the ROC curve, %TWL of 24.39% at 0.5 years best predicted effective weight loss at 5 years (sensitivity 71.70%, specificity 82.22%).

RYGB is a safe and effective approach for weight loss and %TWL at 6 months might be used for predicting weight maintenance up to 5 years post-RYGB in obese Chinese with a BMI <35kg/m
.
RYGB is a safe and effective approach for weight loss and %TWL at 6 months might be used for predicting weight maintenance up to 5 years post-RYGB in obese Chinese with a BMI less then 35 kg/m2.
My Website: https://www.selleckchem.com/products/acetosyringone.html