Xiaochang People's Hospital

Gastrointestinal tumors are among the most common tumors worldwide and are currently the leading cause of cancer-related deaths. Gastrointestinal tumors affect the digestive system and include esophageal, liver, gastric, colorectal, and pancreatic cancers. Aerobic glycolysis is a widespread phenomenon among gastrointestinal tumor cells, which poses a major hazard to human health and life. Increasing evidence suggests that aerobic glycolysis can induce and promote the development of gastrointestinal tumors by rapidly providing large amounts of energy and altering the tumor microenvironment. Among them, glucose transporter proteins and key enzymes involved in glycolysis are expressed at higher levels during aerobic glycolysis, and the corresponding signaling pathways and transcription regulatory factors are activated, playing an important role in the occurrence and development of tumors. Additionally, evidence has indicated that aerobic glycolysis plays an essential role in inhibiting the development of immune cells, modifying the population of immune cells present in the surrounding tumor, and promoting the polarization of immune cells. Moreover, drugs and compounds that target essential enzymes and transcription factors associated with glycolysis are known to exhibit anticancer properties.

Enhanced recovery after surgery (ERAS) programs are increasingly applied in upper-GI surgery, yet evidence in gastrectomy remains evolving with minimally invasive and robotic techniques. We updated the randomized evidence base to re-estimate effects on recovery, complications, and costs. We systematically searched PubMed, Embase, Web of Science, and Cochrane CENTRAL (2018-2025) for parallel-group randomized controlled trials comparing full-pathway ERAS programs versus conventional care in adult patients undergoing gastrectomy for gastric cancer, in accordance with PRISMA for Abstracts guidance. Length of stay was the primary endpoint; secondary outcomes included time to gastrointestinal recovery, postoperative complications, readmission, mortality, and hospital costs. Random-effects meta-analysis was performed, and certainty of evidence was evaluated using GRADE. Twenty-seven trials (n = 3,274 patients) met eligibility criteria. ERAS significantly shortened length of stay and accelerated gastrointestinal recovery. Overall postoperative complications were numerically lower under ERAS and became statistically significant in prespecified sensitivity analyses excluding high-risk-of-bias or overlapping trials (risk ratio [RR] 0.73, 95% CI 0.56-0.96). Individual complications (pneumonia, surgical-site infection, anastomotic leak) and 30-day readmission did not show clear evidence of a difference. Mortality was rare in both groups. Certainty of evidence was generally low to moderate. ERAS in gastrectomy for gastric cancer may accelerate postoperative recovery and reduce costs without increasing complications or readmission. Standardized protocols and reporting are needed to enhance reliability and facilitate wider adoption.

Myocardial ischemia-reperfusion injury denotes the pathological damage resulting from the restoration of blood flow and oxygen supply following acute coronary artery occlusion. Myocardial ischemia-reperfusion injury is commonly seen in acute coronary syndromes and is an important factor in the development of ischemic cardiomyopathy, which severely affects the prognosis of coronary heart disease. The gut microbiota, a complex ecosystem with multifaceted functions, plays a crucial role in host health. Dysregulation of the gut microbiota exerts substantial effects on the onset and progression of cardiovascular diseases, including myocardial ischemia-reperfusion injury. This review elucidates the mechanisms underlying myocardial ischemia-reperfusion injury and the involvement of the gut microbiota in this process, encompassing aspects such as intestinal barrier integrity, microbial dysbiosis, inflammatory responses, oxidative stress, mitochondrial dysfunction, and metabolic alterations. Additionally, we investigate various interventions that modulate myocardial ischemia-reperfusion injury by influencing the gut microbiota. Maintaining a healthy intestinal barrier and a stable microbial ecology is paramount in preventing myocardial ischemia-reperfusion injury. High-fiber diets, probiotic consumption, short-chain fatty acids supplementation, and Traditional Chinese Medicine, can safeguard the heart against myocardial ischemia-reperfusion injury by regulating gut microbiota through diverse mechanisms. As the role of gut microbiota in myocardial ischemia-reperfusion injury continues to be investigated, it provides important therapeutic targets and drug development opportunities for the prevention and treatment of myocardial ischemia-reperfusion injury. However, further in-depth and comprehensive studies are required to fully realize these potentials.

Non-small-cell lung cancer (NSCLC) frequently harbors EGFR mutations, with the L858R and exon 19 deletions being the most prevalent. Rare EGFR exon 18 mutations, such as E709K, account for a small proportion but may significantly influence treatment response. The coexistence of E709K and L858R mutations presents unique therapeutic challenges and opportunities. This report describes a 64-year-old Chinese woman diagnosed with advanced lung adenocarcinoma harboring concurrent EGFR mutations (exon 18 p.E709K and exon 21 p.L858R). Initial treatment with osimertinib achieved partial response with a progression-free survival of 8 months, followed by disease progression. The patient was subsequently treated with afatinib, which showed transient efficacy but was discontinued due to poor tolerance. Combination therapies involving chemotherapy (paclitaxel-platinum and pemetrexed), bevacizumab, radiotherapy and the third-generation EGFR TKI amitinib were sequentially administered, resulting in sustained symptomatic relief and clinical benefit. Leptomeningeal metastasis was later managed with intrathecal pemetrexed and ongoing amitinib therapy. In conclusion, this case highlights the complex clinical course of NSCLC with dual EGFR mutations, including E709K. While first- and second-generation TKIs offer variable efficacy, third-generation TKIs like amitinib may provide a durable benefit in selected patients. Comprehensive genomic profiling and individualized therapeutic strategies are essential for optimizing outcomes, particularly in cases involving rare EGFR mutations.

Study DesignRetrospective cohort study.ObjectiveLimited clinical literature addresses potential differences in fusion features between Oblique lumbar interbody fusion (OLIF) and transforaminal lumbar interbody fusion (TLIF). We observed that in OLIF, there are many cases with the appearance of extra-vertebral bone bridges (EVB), a phenomenon distinct from traditional TLIF fusion. This study aims to compare fusion rates, cage subsidence, and fusion features among OLIF stand-alone (OLIF-SA), OLIF with posterior pedicle screw fixation (OLIF-PS), and TLIF.MethodsWe retrospectively analyzed 198 patients (311 levels) undergoing OLIF-SA, OLIF-PS, or TLIF from July 2017 to June 2021. We assessed patient-reported outcomes, cage subsidence, fusion rate, and fusion features on CT scans.ResultsThe study included 64 OLIF-SA patients (102 levels), 60 OLIF-PS patients (99 levels), and 74 TLIF patients (110 levels). Cage settling rates were 33.3% (OLIF-SA), 17.2% (OLIF-PS), and 32.8% (TLIF), with significant differences between OLIF-PS and TLIF (P < 0.05). Cage subsidence rates showed no significant difference: 11.8% (OLIF-SA), 9.1% (OLIF-PS), and 12.7% (TLIF) (P > 0.05). Fusion rates were 100% (OLIF-SA), 97.0% (OLIF-PS), and 96.4% (TLIF) (P = 0.167). Lateral fusion rates significantly differed: 49.0% (OLIF-SA), 30.3% (OLIF-PS), and 10.9% (TLIF) (P < 0.001). Preoperative osteophytes strongly promote lateral fusion (P < 0.001). VAS and ODI scores improved significantly post-surgery (P < 0.01).ConclusionsOLIF-SA, OLIF-PS, and TLIF surgeries show satisfactory results with comparable fusion rates. Notably, distinctive differences exist in fusion features between OLIF and TLIF surgeries, with lateral fusion more prevalent in OLIF, particularly in OLIF-SA surgeries.

Liposarcoma is a malignant tumor of adipocytic differentiation that rarely arises within the mediastinum. Most of the existing data available comes from scattered case reports and a few small series. A 51-year-old man was admitted with cough and sputum accompanied by fever. X-ray and CT showed a bulky anterior mediastinal mass that was initially misdiagnosed as a teratoma. PET/CT demonstrated a lesion on that location showing a small area of moderately intense uptake. After surgical excision, histopathological examination via hematoxylin and eosin first revealed the diagnosis of malignant undifferentiated tumors. The results of immunohistochemical evaluations were as follows: P63 (scattered +), VIMENTIN (giant cell +), CD68 (KPI; giant cell +), SMA (-), and Ki-67 (Li: 50%). Molecular pathology: MDM2 gene status (+) with amplification. The final histopathological diagnosis was dedifferentiated liposarcoma with osteosarcomatous differentiation. The patient underwent left mediastinal tumor resection, left upper lobe wedge resection and postoperative chemotherapy. Mediastinal recurrences and chest wall metastases occurred quickly before the second round of chemotherapy 2 months later. Four months after surgery, the patient died. This paper presents a case of dedifferentiated liposarcoma with osteosarcomatous differentiation in a rare location: the mediastinum. Correct diagnosis is of importance for appropriate choice of therapy. Clinicians should be aware of the presence of a dedifferentiated liposarcoma within a mass on the mediastinum and enhancing treatment and management strategies for affected patients.

Intracerebral hemorrhage and falls are common central nervous system injuries that seriously affect the quality of life of patients. Intracerebral hemorrhage can cause an increase in intracerebral pressure, affecting the circulation of brain tissue and cerebrospinal fluid, and even leading to the formation of cerebral herniation. However, falls can cause various neurological impairments such as consciousness disorders, limb movement disorders, and language impairments in patients. Therefore, it is crucial to evaluate the prognosis of patients with intracerebral hemorrhage and falls. Starting from the perspective of falls, through research on the data of fall patients in a certain hospital, it was found that the proportion of fall patients over the age of 50 was as high as 66.7%. As one ages, the damage caused by falls becomes more severe. Therefore, the prognosis evaluation and rehabilitation treatment of falls are increasingly important topics. In the rehabilitation treatment of patients with intracerebral hemorrhage, a univariate analysis of risk factors during the treatment period was conducted. Through analysis and comparison between the patient group and the rehabilitation group, significant differences in gender, history of hypertension, history of ischemic stroke, and collateral circulation (P<0.05) were found to indirectly or directly affect the stability of the patient's condition. A summary was made on the rehabilitation treatment of patients with intracerebral hemorrhage and falls, including rehabilitation treatment for acute symptoms, physical signs, consciousness status, etc., and recommendations were made for the prevention and improvement of complications.

ObjectiveIn this study, we investigated the impact of perioperative administration of Bifidobacterium triplex viable capsules on the serum levels of circulating miR-21-5p, miR-135-5p, and miR-155-5p in patients with colorectal cancer (CRC). The purpose of this study is to provide a foundation for future research on the use of Bifidobacterium triplex viable capsules to enhance postoperative recovery in patients with CRC.MethodsA total of 60 patients with primary CRC admitted to the Department of General Surgery at Shanxi Bethune Hospital between June 2020 and December 2020 were selected and randomly divided into two groups: 20 cases in the control group and 40 cases in the experimental group. The experimental group was administered oral Bifidobacterium triplex viable capsules during the perioperative period, while the control group was administered oral placebo. Before and after the perioperative period, the expression levels of miR-21-5p, miR-135-5p, and miR-155-5p were compared in the serum of both groups of patients. Furthermore, we established the prognostic value of these three miRNAs in CRC patients.ResultsAfter surgery, the expression levels of miR-21-5p, miR-135-5p, and miR-155-5p decreased in both groups of patients (P < 0.05). Significantly greater differences were observed between miR-21-5p and miR-135-5p (P < 0.001). Expression levels of serum miR-21-5p (P = 0.020) and miR-135-5p (P = 0.023) decreased significantly more in the experimental group than in the control group. The levels of the above three miRNAs after surgery did not correlate with 3-year OS (HR = 4.21; 95% CI 0.37–47.48; log-rank P = 0.20) or 3-year DFS (HR = 1.57; 95% CI 0.32–7.66; log-rank P = 0.55) in two groups.ConclusionRadical surgery reduces the levels of serum miR-21-5p, miR-135-5p, and miR-155-5p expression in patients with CRC. The use of Bifidobacterium triplex viable capsules assists in achieving quicker perioperative recovery from radical surgery in CRC patients, and this underlying mechanism may be associated with the regulation of serum miR-21-5p, miR-135-5p, and miR-155-5p expression levels.

Circular RNA (circRNA) was an important modulator and potential molecular target of nonsmall cell lung cancer (NSCLC). CircSATB2 was reported to be upregulated in NSCLC. However, the role and mechanism of circSATB2 in NSCLC progression remain to be illustrated. The RNA and protein expression was detected by quantitative real-time polymerase chain reaction, western blot, and immunohistochemistry assay. Cell counting kit-8, cell colony formation, and 5-ethynyl-2'-deoxyuridine assays were applied to assess cell growth. The migrated and invaded cells were examined by transwell assay. Flow cytometry was performed to measure apoptotic cells. The interaction among circSATB2, microRNA-150-5p (miR-150-5p), and tripartite motif-containing protein 66 (TRIM66) was identified by dual-luciferase reporter assay and RNA immunoprecipitation assay. An in vivo experiment was conducted to investigate the effect of circSATB2 on tumor growth. CircSATB2 expression was highly expressed in NSCLC tissues and cell lines. CircSATB2 and TRIM66 silencing both suppressed NSCLC cell growth, migration, and invasion whereas promoted NSCLC cell apoptosis. CircSATB2 acted as a molecular sponge for miR-150-5p, and miR-150-5p interacted with the 3' untranslated region (3'UTR) of TRIM66. Moreover, circSATB2 knockdown-induced effects were partly reversed by TRIM66 overexpression in NSCLC cells. Besides, cirSATB2 expression was negatively correlated with miR-150-5p level and positively correlated with TRIM66 level in NSCLC tumor tissues. CircSATB2 knockdown blocked xenograft tumor growth in vivo. In summary, this study verified that circSATB2 stimulated NSCLC cell malignant behaviors by miR-150-5p/TRIM66 pathway, providing a possible circRNA-targeted therapy for NSCLC.