International journal of surgery最新文献

{"title":"Multi-omics dissection of high TWAS-active endothelial pathogenesis in pulmonary arterial hypertension: bridging single-cell heterogeneity, machine learning-driven biomarkers, and developmental reprogramming.","authors":"Zerong Li, Huayang Li, Wenmei Qiao, Siming Yu, Bin Fan, Ming Yang, Leyan Zhou, Fang Qiu, Zhongkai Wu, Jinping Wang","doi":"10.1097/JS9.0000000000003601","DOIUrl":"https://doi.org/10.1097/JS9.0000000000003601","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary Arterial Hypertension (PAH) is a leading cause of cardiovascular-related mortality worldwide. The emergence of single-cell RNA sequencing (scRNA-seq) has enhanced the ability to dissect cellular heterogeneity in PAH at a granular level. Transcriptome-wide association studies (TWAS) leverage expression quantitative trait loci (eQTL) and genome-wide association study (GWAS) data to identify novel susceptibility genes whose genetically predicted expression correlates with disease risk. However, no study has systematically integrated TWAS with scRNA-seq to unravel the pathogenesis of PAH at single-cell resolution.</p><p><strong>Methods: </strong>Using TWAS analysis, we identified a set of candidate genes genetically associated with PAH. We then evaluated the differential activity of these genes across PAH cell types at single-cell resolution using AUCell, Ucell, ssGSEA, and AddModuleScore algorithms. A subset of endothelial cells exhibiting elevated TWAS activity was identified via quartile-based stratification and designated as the high TWAS activity state (HTS) group. Multi-dimensional analyses, including observed-to-expected ratio (RO/E), CellChat, CytoTRACE, and scMetabolism, were employed to characterize the functional and communicative properties of HTS cells. Machine learning algorithms were integrated to identify signature genes of the HTS subpopulation, and a benchmarked random forest model was trained to predict HTS status. We performed immunohistochemistry and qRT-PCR validation of the signature genes (KLF2, RASIP1 and DEPP1) in PAH and control lung tissues to support their expression patterns.</p><p><strong>Results: </strong>We demonstrated that HTS endothelial cells are strongly associated with PAH pathogenesis, exhibiting significant tissue tropism, enhanced roles in intercellular communication, and a progenitor-like function in endothelial differentiation. Machine learning-based feature selection revealed three robust signature genes: KLF2, RASIP1, and DEPP1. These genes demonstrated exceptional predictive power for identifying HTS cells, suggesting their potential as drivers of endothelial dysfunction in PAH. The random forest model, benchmarked against multiple algorithms, achieved high accuracy in predicting PAH progression using these genes. Immunohistochemical analysis of pulmonary artery and qRT-PCR result of lung tissues addressed the elevated expression of KLF2, RASIP1 and DEPP1 in arterial wall post-PAH.</p><p><strong>Conclusion: </strong>This study elucidates endothelial cell heterogeneity in PAH and establishes the central role of HTS cells in disease progression, cellular crosstalk, and developmental reprogramming. Our findings bridge the gap between GWAS and scRNA-seq methodologies and provide a transformative framework for understanding PAH mechanisms.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":10.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251225","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}

{"title":"SPP1 in Notochord Cells Modulates Intervertebral Disc Degeneration Through CD44 Recognition by Macrophages Based on Single Cell Transcriptome Analysis.","authors":"Qiuwei Li, Peilin Jin, Chenhao Zhao, Renjie Zhang, Cailiang Shen","doi":"10.1097/JS9.0000000000003454","DOIUrl":"https://doi.org/10.1097/JS9.0000000000003454","url":null,"abstract":"<p><strong>Background: </strong>Intervertebral disc degeneration (IVDD) is a major cause of spinal disorders, often leading to chronic pain and mobility issues. Mechanical stress is a key factor in IVDD progression, but the underlying mechanisms remain unclear. In this study, we improved a rat intervertebral disc pressure model to explore how mechanical stress affects IVDD, focusing on notochord cell populations and their interactions in the degenerative process.</p><p><strong>Methods: </strong>We developed a custom pressure device for rats, validated using imaging techniques. Following pressure application, single-cell transcriptomics was employed to analyze dynamic changes in notochord cells in both surgical and sham groups. Gene expression profiles were analyzed for immune regulation, matrix metabolism, and intercellular signaling. We also studied the SPP1 signaling pathway and its interaction with CD44.Finally, we combined Mendelian randomization(MR) and human GEO sequencing data to support our results.</p><p><strong>Results: </strong>Pressure application resulted in significant structural damage and abnormal changes in matrix components, worsening over time. Single-cell analysis revealed differences in notochord cell populations between surgical and sham groups, with increased immune regulation and matrix metabolism activity. The SPP1-CD44 signaling pathway was activated in degenerated discs, especially in CD44-expressing cells, underscoring its role in matrix remodeling and inflammation.MR and human GEO sequencing data also support these ideas.</p><p><strong>Conclusion: </strong>This study provides insights into IVDD mechanisms, focusing on the role of the SPP1-CD44 pathway in disc degeneration. We suggest that targeting this pathway may offer potential therapeutic strategies for degenerative spinal diseases.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":10.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251297","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}

{"title":"Letter to the editor about'duration of surgical antibiotic prophylaxis and surgical site infection in orthopaedic surgery: a prospective cohort study'.","authors":"Jiayi Dou, Zhongcheng An, Tongfu Luo","doi":"10.1097/JS9.0000000000003535","DOIUrl":"https://doi.org/10.1097/JS9.0000000000003535","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":10.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251199","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}

{"title":"Risk factors for morbidity in both donor and recipient following minimally invasive donor hepatectomy: a systematic review.","authors":"Sang-Hoon Kim, Ki-Hun Kim, Surendran Sudhindran, Dieter C Broering","doi":"10.1097/JS9.0000000000003524","DOIUrl":"https://doi.org/10.1097/JS9.0000000000003524","url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive donor hepatectomy (MIDH), including laparoscopic, laparoscopic-assisted, and robotic donor hepatectomy, is an evolving technique in living donor liver transplantation, but its technical complexity presents potential risks for both donors and recipients. This study purposes to systematically review and identify key risk factors for donor and recipient morbidity after MIDH.</p><p><strong>Methods: </strong>A systematic search of electronic databases was performed to identify studies published between January 2001 and December 2024 that reported significant risk factors for donor and recipient complications after MIDH. Risk factors for overall or major complications, biliary complications (bile leak or biliary stricture), or open conversion were summarized using odds ratios or hazard ratios with 95% confidence intervals derived from multivariate analysis.</p><p><strong>Results: </strong>In total, eight studies reported significant risk factors for donor or recipient after MIDH. Risk factors for donor complications included unfavorable anatomical characteristics (short hepatic ducts, multiple hepatic ducts/arteries/veins, and large graft) and operative factors (increased operative time and blood loss). Conversion from laparoscopic to open was related to high BMI. Recipient risk factors included biliary variations, portal vein thrombosis, hepaticojejunostomy, prolonged operative time, massive transfusion, and high MELD scores. Robotic surgery was linked to favorable donor and recipient outcomes.</p><p><strong>Conclusion: </strong>Risk factors for donor and recipient morbidity after MIDH include anatomical, operative, procedural, donor, and recipient factors. Notably, biliary variation of graft is key contributor for both donor and recipient morbidity. Given the limited studies on risk factors, multicenter studies with larger sample sizes are essential to validate these findings.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":10.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251208","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}

{"title":"Letter to the editor comments on the manuscript entitled: surgical technique of laparoscopic mini-gastric bypass with obstructive stapleless pouch creation: a case series.","authors":"Galymjan Duysenov","doi":"10.1097/JS9.0000000000003155","DOIUrl":"https://doi.org/10.1097/JS9.0000000000003155","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":10.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251237","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}

{"title":"Letter to the editor:\"Deep learning-driven multi-hierarchical granularity integration for surgical scene understanding: experimental study\".","authors":"Zuomin Wang, Qinwei Liu, Wangdong Deng","doi":"10.1097/JS9.0000000000003532","DOIUrl":"https://doi.org/10.1097/JS9.0000000000003532","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":10.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251277","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}

{"title":"Comparison of safety and effectiveness between endoscopic ultrasound-guided and ultrasound-guided pancreatic biopsy in focal pancreatic disease: a multi-center, retrospective, propensity score analysis.","authors":"Weilu Chai, Qiang Lu, Dong Xu, Kai Li, Weina Wan, Li Yu, Ran Li, Tian'an Jiang","doi":"10.1097/JS9.0000000000003591","DOIUrl":"https://doi.org/10.1097/JS9.0000000000003591","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic ultrasound (EUS) and ultrasound (US) are the two primary imaging modalities used to guide pancreatic needle biopsy. This study aimed to compare the diagnostic performance and complications associated with EUS- and US-guided pancreatic biopsies.</p><p><strong>Methods: </strong>A total of 2517 consecutive patients who underwent 2583 cases of EUS- or US-guided pancreatic biopsy for focal pancreatic disease between January 2017 and December 2023 at seven university teaching hospitals were included. The endpoints evaluated were diagnostic inaccuracy, complications, and repeat biopsies for each method. The propensity score matching (PSM) method was used for the analysis.</p><p><strong>Results: </strong>For the entire cohort, diagnostic inaccuracies were observed in 7.0% of cases in the EUS-guided biopsy group compared to 3.5% in the US-guided biopsy group, representing a statistically significant difference (p = 0.001). The rates of major (p = 1.000) and minor complications (p = 0.309) were similar between the two groups. The rate of repeat biopsies was significantly higher in the EUS-guided biopsy group than in the US-guided biopsy group (5.0% vs. 2.8%, p = 0.024). However, after balancing lesion characteristics using PSM, no significant differences were observed between the EUS- and US-guided biopsies in diagnostic inaccuracy (7.2% vs. 8.5%, p = 0.600), major complications (0.5% vs. 0%, p = 0.499), minor complications (1.7% vs. 0.2%, p = 0.069), or repeat biopsy rate (5.5% vs. 6.5%, p = 0.656). Subgroup analysis revealed that among patients with exophytic and backward growth pancreatic lesions, both diagnostic inaccuracy (7.1% vs. 33.3%, p = 0.001) and the repeat biopsy rate (10.7% vs. 27.8%, p = 0.029) were significantly lower in the EUS-guided biopsy group compared to the US-guided biopsy group.</p><p><strong>Conclusions: </strong>This study confirmed that both EUS-guided and US-guided pancreatic biopsies are safe and effective for patients with focal pancreatic disease. After PSM, diagnostic inaccuracy, repeat biopsy and complication rates were similar, but EUS-guided biopsy was preferred for lesions with exophytic and backward growth morphology.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":10.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251248","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}

{"title":"Commentary: Unveiling the Prognostic Potential of C-Reactive Protein to Albumin Ratio in Valvular Heart Disease-A Step Toward Personalized Risk Stratification.","authors":"Yuru Fu, Yuanyuan Wang","doi":"10.1097/JS9.0000000000003542","DOIUrl":"https://doi.org/10.1097/JS9.0000000000003542","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":10.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251226","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}

{"title":"The twenty-year outcome of ascending aorta replacement and total arch replacement comparison in debakey type i acute aortic dissection.","authors":"Chun-Yang Huang, Chiao-Po Hsu, Ying-Ting Kuo","doi":"10.1097/JS9.0000000000003530","DOIUrl":"https://doi.org/10.1097/JS9.0000000000003530","url":null,"abstract":"<p><strong>Background: </strong>The mortality rate of acute DeBakey type I aortic dissection increases by 1% to 2% every hour after the first presentation if left untreated. However, the long-term outcomes of ascending aorta replacement (AR) versus total arch replacement (TAR) remain unclear. This study evaluated and compared the long-term outcomes between AR and TAR.</p><p><strong>Materials and methods: </strong>This retrospective study included 398 patients with acute DeBakey type I aortic dissection who underwent surgical repair between March 2002 and October 2024. Patient data were extracted from medical records, and patients were stratified into 2 groups (AR and TAR groups) according to surgical procedure. Inverse probability of treatment weighting was applied for further analysis.</p><p><strong>Results: </strong>Higher incidences of acute kidney injury (32.3% vs 20.6%, P = .029), new-onset stroke (9.5% vs 3.7%, P = .016), and bleeding (30.1% vs 16.2%, P = .007) and longer hospital stays (34.4 vs. 25.7 days, P = .042) were observed in the TAR group than in the AR group immediately postoperation. In long-term follow-up, no significant differences were observed between the groups regarding reintervention or mortality events. In addition, the risk of relative mortality associated with TAR was more apparent in patients older than 65 years.</p><p><strong>Conclusion: </strong>No significant differences were observed between TAR and AR in terms of 30-day mortality, reintervention events, aorta-related mortality, or overall mortality under the tear-oriented policy for acute DeBakey type I aortic dissection. Notably, older patients undergoing TAR had poorer overall survival outcomes than those undergoing AR did, particularly among patients older than 65 years.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":10.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251256","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}

{"title":"Feasibility of robotic liver resection compared with laparoscopic and open liver resection for hepatocellular carcinoma: a network meta-analysis.","authors":"Sang-Hoon Kim, Ki-Hun Kim, Hugo Pinto-Marques, João Santos Coelho","doi":"10.1097/JS9.0000000000003528","DOIUrl":"https://doi.org/10.1097/JS9.0000000000003528","url":null,"abstract":"<p><strong>Background: </strong>Robotic liver resection (RLR) has gained popularity in the treatment of hepatocellular carcinoma (HCC); however, its efficacy compared to laparoscopic liver resection (LLR) and open liver resection (OLR) remains unclear.</p><p><strong>Methods: </strong>Comprehensive literature search of electronic databases from January 2010 to December 2024 identified studies comparing RLR, LLR, or OLR. Operative, postoperative, and survival data were extracted, and pooled odd ratios or hazard ratios with 95% confidence intervals were calculated using a frequentist network meta-analysis including RLR, LLR and OLR.</p><p><strong>Results: </strong>A total of 69 studies, comprising 1 randomized controlled, 3 prospective, and 65 retrospective-matched studies, involving 13,257 patients were analyzed. This network meta-analysis showed that RLR had significantly lower blood loss than both OLR and LLR, with comparable operative time, RBC transfusion rates, Pringle maneuver use, Pringle time, and R1 resection rates. RLR showed similar rates of overall and major complications and hospital stay duration as LLR, with significant benefits over OLR. No significant differences in 90-day mortality were found among the three groups. For long-term outcomes, RLR showed no significant advantage over LLR or OLR in overall and recurrence-free survival, though it generally ranked higher with a greater P-score.</p><p><strong>Conclusions: </strong>This network meta-analysis suggests that RLR is a feasible surgical treatment option for HCC, offering perioperative and long-term outcomes comparable to LLR, with reduced postoperative morbidity and shorter hospital stays compared to OLR. However, further studies are needed to confirm RLR's efficacy due to its limited sample size.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":10.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251240","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}