International journal of surgery最新文献

{"title":"An artificial intelligence-assisted comprehensive model for predicting lymph node metastasis in superficial esophageal squamous cell carcinoma: a diagnostic study.","authors":"Hao Zheng, Qi Zhang, Guangyao Ning, Yucheng Bai, Haibao Wang, Jie Fang, Huangqing Xu, Ningning Kang, Wei Ge, Huaguang Pan, Songping Xie, Renquan Zhang","doi":"10.1097/JS9.0000000000004969","DOIUrl":"https://doi.org/10.1097/JS9.0000000000004969","url":null,"abstract":"<p><strong>Background: </strong>Superficial esophageal squamous cell carcinoma (ESCC) is increasingly detected due to enhanced endoscopic surveillance, yet accurately predicting lymph node (LN) metastasis remains a challenge. This study aimed to construct a combined model integrating CT-based radiomic features and clinical risk factors to predict LN metastasis in superficial ESCC.</p><p><strong>Methods: </strong>We retrospectively analyzed 473 patients with superficial ESCC from two centers (403 in a training/internal validation cohort and 70 in an external validation cohort). Contrast-enhanced CT scans were used to extract radiomic features, which were input into a deep neural network (DNN) to develop a radiomics model. Univariate and multivariate logistic regression analyses identified clinical predictors, which were used to establish a clinical model. A combined nomogram integrating the radiomic score and selected clinical predictors was then constructed. Model performance was assessed in both internal and external validation cohorts using the area under the receiver operating characteristic curve (AUC), calibration plots, and decision curve analysis.</p><p><strong>Results: </strong>LN metastasis was present in 56 (13.9%) patients in the training/internal cohort and seven (10.0%) patients in the external cohort. In the training cohort, higher pathological T stage, poorer tumor differentiation, and larger tumor size were significantly associated with LN metastasis (all P < 0.05) and were independent predictors in multivariate analysis. The combined model achieved the highest predictive accuracy, with AUCs of 0.95 (95% CI: 0.91-0.99) in the training cohort, 0.93 (95% CI: 0.89-0.97) in the internal validation cohort, and 0.88 (95% CI: 0.83-0.92) in the external validation cohort.</p><p><strong>Conclusions: </strong>An integrated clinical-radiomics model offers effective prediction of LN metastasis in superficial ESCC, thereby potentially improving treatment decision-making and enabling personalized therapeutic strategies for patients with superficial ESCC.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":10.1,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147283729","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":"Comment on \"Artificial Intelligence for predicting post-excision recurrence and malignant progression in oral potentially malignant disorders: a retrospective cohort study\".","authors":"Jie Wang, Yan-Ling Zhang, Nan Zhuang","doi":"10.1097/JS9.0000000000004994","DOIUrl":"https://doi.org/10.1097/JS9.0000000000004994","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":10.1,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147283062","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: plasma proteomic markers predict risk for bowel resection in inflammatory bowel disease: a retrospective cohort study.","authors":"Chengting Zheng, Kehang Dai, Ping Chen","doi":"10.1097/JS9.0000000000004955","DOIUrl":"https://doi.org/10.1097/JS9.0000000000004955","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":10.1,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147276316","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":"Inflammatory indices and erectile dysfunction: several gaps that limit clinical translation.","authors":"Taotao Sun, Yipiao Liu, Penghui Yuan","doi":"10.1097/JS9.0000000000004996","DOIUrl":"https://doi.org/10.1097/JS9.0000000000004996","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":10.1,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147276318","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":"Melatonin attenuates oxidative stress-induced ferroptosis of nucleus pulposus cells and intervertebral disc degeneration via PI3K/AKT-mTOR pathway.","authors":"Zongyuan Deng, Lutong Wang, Tao Yu, Guoyan Liang, Zhengao Wang, Xingchen Zhao, Zhencong Zhang, Xiang Long, Xing Cheng, Feng-Juan Lyu, Peng Yu, Chengyun Ning, Yunbing Chang, Yongxiong Huang, Chong Chen","doi":"10.1097/JS9.0000000000004980","DOIUrl":"https://doi.org/10.1097/JS9.0000000000004980","url":null,"abstract":"<p><strong>Background: </strong>Intervertebral disc degeneration (IVDD) is a leading cause of low back pain and disability. Ferroptosis, an iron-dependent form of regulated cell death driven by oxidative stress, plays a critical role in IVDD pathogenesis. Melatonin, a neurohormone with antioxidative properties, has shown potential protective effects, but its precise mechanism of action remains unclear.</p><p><strong>Methods: </strong>This study integrated multi-omics analyses, human NP specimens, cultured human NP cells, and a rat IVDD model induced by tert-butyl hydroperoxide (TBHP). Ferroptosis, oxidative stress, mitochondrial injury, and ECM metabolism were evaluated using histological staining, flow cytometry, ELISA, immunofluorescence, and western blotting. The involvement of melatonin receptors and PI3K/AKT-mTOR signaling was examined using pharmacological activation/blockade. Computational structural modeling was additionally employed to assess interactions between mTOR and ferroptosis-related proteins.</p><p><strong>Results: </strong>Melatonin significantly inhibited TBHP-induced ferroptosis in NP cells by restoring GSH levels, reducing Fe2⁺ accumulation and ROS generation, preserving mitochondrial morphology, and upregulating SLC7A11 and GPX4. Melatonin also ameliorated ECM metabolic imbalance by increasing collagen II, aggrecan, and osteonectin, while suppressing MMP-9 and ADAMTS5. These protective effects were abolished by MT1/MT2 receptor antagonism or AKT phosphorylation inhibition, indicating pathway dependence. In vivo, melatonin attenuated disc degeneration, reduced apoptosis, restored ECM components, and normalized ferroptosis-related markers. Multi-omics datasets and structural modeling further supported that melatonin regulates ferroptosis through MT1/2-mediated activation of the PI3K/AKT-mTOR axis.</p><p><strong>Conclusions: </strong>Melatonin mitigates IVDD by suppressing ferroptosis and preserving ECM homeostasis through melatonergic receptor (MT1/MT2)-dependent activation of the PI3K/AKT-mTOR pathway. Notably, clinical and protein-level evidence suggests that MT1 may represent the predominant therapeutic target, supporting melatonin as a promising, low-toxicity candidate for delaying IVDD progression.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":10.1,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147276331","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":"Adebrelimab in combination with dalpiciclib and endocrine therapy as neoadjuvant treatment for HR+/HER2- early breast cancer: an exploratory study.","authors":"Min Xiao, He Ren, Xinhao Han, Fanxuan Huang, Crystal Song Zhang, Bo Lei, Jinsong Wang, Tong Liu","doi":"10.1097/JS9.0000000000004982","DOIUrl":"https://doi.org/10.1097/JS9.0000000000004982","url":null,"abstract":"<p><strong>Background: </strong>Hormone receptor-positive (HR+)/HER2- breast cancer (BC) exhibits limited sensitivity to neoadjuvant chemotherapy, with low pathologic complete response (pCR) rates. While CDK4/6 inhibitors (CDK 4/6i) combined with endocrine therapy have demonstrated efficacy, the immunogenicity of HR+/HER2- tumors remains low, limiting the benefit of immunotherapy. Emerging evidence suggests potential synergy between CDK4/6 inhibition and immune checkpoint blockade. This study explores the neoadjuvant combination of adebrelimab, dalpiciclib, and endocrine therapy in patients with stage II-III HR+/HER2- BC.</p><p><strong>Methods: </strong>This single-arm, exploratory study enrolled postmenopausal women with histologically confirmed stage II-III HR+/HER2- BC. Eligible patients received neoadjuvant therapy comprising adebrelimab (1200 mg intravenously, day 1), dalpiciclib (125 mg orally, once daily on days 1-21), and letrozole. Treatment was administered over five 28-day cycles prior to surgery. The primary endpoint was total pCR (tpCR; defined as ypT0-is/ypN0).</p><p><strong>Results: </strong>Between October 2024 and March 2025 patients (median age 61.5 years) with stage II-III HR+/HER2- BC were enrolled. Most patients had T2 tumors (85%) and N1 disease (55%). All patients received ≥1 treatment cycle; 17 completed surgery. Radiological partial response was observed in 13 patients (65%), with an overall objective response rate (ORR) of 65%. One patient (5%) achieved tpCR. Three patients discontinued due to adverse events (AE; one death, one hepatitis, and one pneumonia). Common grade ≥ 3 AEs included neutropenia (50%), leukopenia (25%), and elevated liver enzymes.</p><p><strong>Conclusion: </strong>This triplet regimen demonstrated modest clinical activity in HR+/HER2- early BC, with the safety profile of this regimen remains a concern and warrants particular attention in clinical practice.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":10.1,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147276260","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":"Methodological considerations for preoperative hemorrhage risk stratification in pediatric moyamoya disease.","authors":"Ciai Lai, Rongzhen Li, Guangliang Luo","doi":"10.1097/JS9.0000000000003760","DOIUrl":"https://doi.org/10.1097/JS9.0000000000003760","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":10.1,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147276274","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":"Frailty trajectories before and after diabetes: a prospective cohort study in the UK and the US.","authors":"Chenyang Li, Murong Xie, Xiaoqin Luo, Yifan Chen, Zewei Chen, Jiafeng Lin, Zhangling Chen, Yongjian Wu","doi":"10.1097/JS9.0000000000004963","DOIUrl":"https://doi.org/10.1097/JS9.0000000000004963","url":null,"abstract":"<p><strong>Backgrounds: </strong>Frailty trajectories around diabetes onset remain unclear, particularly across countries. We investigated frailty progression before, during, and after diagnosis in the UK and the US.</p><p><strong>Methods: </strong>Data were drawn from the English Longitudinal Study of Ageing (2008-2018; n = 8012) and the US Health and Retirement Study (2010-2020; n = 13,072). Frailty was assessed using a 27-item index. Diabetes onset was defined by self-report, medication, or HbA1c ≥6.5%. Trajectories were estimated using linear mixed-effects models, and results were combined via random-effects meta-analysis.</p><p><strong>Results: </strong>Meta-analysis confirmed accelerated progression pre-diagnosis and acute worsening at onset, but no further acceleration afterward (β = 0.0016; 95% CI: -0.0006, 0.0038; P = 0.165). Subgroups showed stronger acute effects in UK men and older US adults, and faster post-diagnosis decline in older participants in both cohorts.</p><p><strong>Conclusion: </strong>Incident diabetes is linked to faster frailty progression before and at diagnosis, whereas post-diagnosis trajectories diverged between the UK and US - showing continued acceleration in the UK but largely stable frailty in the US - with no overall evidence of further acceleration in pooled analyses. These findings indicate that diabetes diagnosis is a turning point in the frailty trajectory and highlight the need for stage- and context-specific prevention.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":10.1,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147283606","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":"Geographical variation in Hodgkin lymphoma incidence patterns by histological subtype and sex: a population-based analysis of cancer registry data.","authors":"Leiwen Fu, Ke Liu, Weitao Su, Bingyi Wang, Yanxiao Gao, Yi-Fan Lin, Tian Tian, Yuxian Sun, Wei Shu, Yujia Ning, Jian Du, Liang Li","doi":"10.1097/JS9.0000000000004954","DOIUrl":"https://doi.org/10.1097/JS9.0000000000004954","url":null,"abstract":"<p><strong>Background: </strong>Trends in subtype-specific Hodgkin lymphoma (HL) incidence across different populations remain understudied.</p><p><strong>Methods: </strong>This population-based study utilized the GLOBOCAN 2022 database to estimate HL incidence and mortality across 185 countries in 2022. Long-term trends were assessed using the Cancer Incidence in Five Continents plus databases, which provide high-quality data from selected registries. Age-standardized incidence rates (ASIR) were calculated, and Joinpoint regression analysis was applied to examine trends in ASIR for HL by histological subtypes. The average annual percentage change (AAPC) was estimated for each category.</p><p><strong>Results: </strong>For 2022, GLOBOCAN estimated 82 469 new HL cases, corresponding to an ASIR of 0.95 per 100 000 population. The highest ASIR and age-standardized mortality rates of HL in 2022 were observed in Europe and Africa, respectively. From 2003 to 2017, the countries with the largest increase in male HL incidence were Japan (AAPC: 6.0, 95% CI: 4.4-7.7), China (5.7, 3.7-7.6), and Latvia (4.2, 1.4-7.1). For females, the countries with the largest increase in HL incidence were Ecuador (9.3, 0.6-18.8), Japan (8.0, 6.0-10.1), and Kuwait (6.0, 0.4-11.9). From 2003 to 2017, the ASIR of nodular lymphocyte-predominant HL significantly increased in both sexes in Australia, Canada, the Netherlands, and the United Kingdom (UK); the ASIR of nodular sclerosis HL increased in China, Croatia, Ireland, Japan, Latvia, and the Republic of Korea; and the ASIR of mixed cellularity HL increased in Japan and the UK.</p><p><strong>Conclusion: </strong>Observed subtype-specific HL trends appear multifactorial and, because our analyses largely reflect high-quality registries, should be interpreted cautiously in light of heterogeneous data quality and model-based estimates elsewhere.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":10.1,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147276328","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 on \"Chronic pain, inflammatory biomarkers, and risks of mortality and cardiovascular disease in individuals with type 2 diabetes: a prospective cohort study\" by Li et al.","authors":"Mahin Nosratzehi, Shahin Nosratzehi, Sahar Kakaei","doi":"10.1097/JS9.0000000000004931","DOIUrl":"https://doi.org/10.1097/JS9.0000000000004931","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":10.1,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147276269","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}