{"title":"Clinical performance of a machine learning-based model for detecting lymph node metastasis in papillary thyroid carcinoma: A multicenter study.","authors":"Wei Liu, Jiaojiao Zheng, Jing Han, Weifeng Qu, Qiao Wu, Zhou Yuan, Gaolei Jia, Xiaolong Wang, Linxiong Ye, Jiaqi Zhang, Shisheng Zhang, Xuanye Cao, Ying Liu, Zhilong Ai","doi":"10.1097/JS9.0000000000002400","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002400","url":null,"abstract":"<p><p>Papillary thyroid carcinoma (PTC) is a common endocrine malignancy with a generally favorable prognosis, but lymph node metastasis (LNM) complicates treatment and increases recurrence risk. Current preoperative methods like neck ultrasound often miss LNM, leading to unnecessary surgeries. This study developed a non-invasive, artificial intelligence (AI)-driven predictive model for LNM using gene expression data from 157 PTC patients and validated it with qRT-PCR across 807 participants from multiple centers. The model focused on three key genes - RPS4Y1, PKHD1L1, and CRABP1 - chosen for their predictive strength. A random forest algorithm achieved high accuracy, with an AUROC of 0.992 in training and 0.911-0.953 in external validation. RPS4Y1 emerged as a standout predictor, showing the strongest distinction between metastatic and non-metastatic cases. The study also identified immune-related pathways, such as TGF-β signaling and cancer-associated fibroblast activation, as critical in metastasis. This gene expression-based model offers a non-invasive, cost-effective solution for predicting LNM, providing valuable insights to guide surgical decisions and reduce unnecessary procedures, ultimately improving patient outcomes.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009549","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":"Single-cell transcriptomics reveals the interaction between fibroblasts and activated immune cells: an exploratory bioinformatics study of pro-inflammatory mechanisms in slow transit constipation.","authors":"Fengxu Chi, Weidong Sun, Cong Zhang, Xiangwen Yu, Cen Huang, Xiangchen Ding, Hanman Chang, Jun Gao, Shi Yan, Anlong Zhu, Yanwei Xing, Xiufeng Jiang, An Yan, Niansheng Ren, Linfeng Yu, Xuhui Bao, Yuekun Zhu","doi":"10.1097/JS9.0000000000002415","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002415","url":null,"abstract":"<p><strong>Background: </strong>Slow transit constipation (STC) is an intestinal disease characterized by colonic dyskinesia which involves multiple factors such as neuroendocrine, substance metabolism, gut microbiota, ion channels, and aquaporin. Increasing evidence indicates that modulation of immune signaling, activation of immune cells, and secretion of cytokines impact oxidative stress, disruption of the intestinal mucosal barrier and the subsequent intestinal dysfunction in STC. However, the landscape of the immune microenvironment (IME) and the disease-specific cell type in STC patients is unclear, and the detailed mechanism of how immune cells affect stromal cells during chronic inflammation is still lacking.</p><p><strong>Materials and methods: </strong>We performed single-cell RNA sequencing (scRNA-seq) on 6 STC cases and 6 control cases to elucidate the IME in STC patients. By identifying differentially expressed genes and pathways between groups, tracking cell differentiation trajectories, and constructing an integrated analysis of intercellular communication, we aimed to elucidate the potential mechanisms of specific immune cell types.</p><p><strong>Results: </strong>We identified STC-specific XCL2+CD8+ T cells, which exhibit extensive intercellular communication with other immune cells and intestinal stromal cells. B cells and myeloid cells could promote the immune function of XCL2+CD8+ T cells by CD137 co-stimulatory molecules. Afterwards, the activated XCL2+CD8+ T cells enhanced the secretion of pro-inflammatory cytokines of fibroblasts through IFNG and TNFSF14 signaling pathways. Additionally, fibroblasts exert immune regulation on XCL2+CD8+ T cells through the NECTIN signaling pathway.</p><p><strong>Conclusion: </strong>These results suggested that STC-specific XCL2+CD8+ T cells might influence the homeostasis of the IME and further disrupt intestinal function.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966339","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":"More evidence is needed on the effectiveness of kinesio taping for treating lateral humeral epicondylitis.","authors":"Wen-Hsuan Hou, Po-Han Tsou, Jeng-Cheng Wu","doi":"10.1097/JS9.0000000000002421","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002421","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982858","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":"A commentary on 'Comparison of the efficacy of neoadjuvant chemotherapy and neoadjuvant chemoradiotherapy in locally advanced rectal cancer patients: meta-analysis of randomized controlled trials'.","authors":"Wenjie Zhou, Jie Dan, Mingjie Zhu, Yonghong Wang","doi":"10.1097/JS9.0000000000002402","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002402","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996316","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}
Peng Li, Lijuan Zhu, Xiutian Guo, Wenqi Jin, Jie Hu, Yan Chen, Jingen Lu
{"title":"A commentary on \"The efficacy of diltiazem, glyceryl trinitrate, nifedipine, minoxidil, and lidocaine for the medical management of anal fissure: a systematic review and network meta-analysis of randomized controlled trials\".","authors":"Peng Li, Lijuan Zhu, Xiutian Guo, Wenqi Jin, Jie Hu, Yan Chen, Jingen Lu","doi":"10.1097/JS9.0000000000002410","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002410","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983597","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":"Comments on \"ChatGPT's role in alleviating anxiety in total knee arthroplasty consent process: a randomized controlled trial pilot study\".","authors":"Xu Cai, Bolun Wang, Lin Cheng, Qifeng Ou","doi":"10.1097/JS9.0000000000002390","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002390","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001952","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":"Expanded phenotypic diversity of vascular smooth muscle cells in cerebral vessels.","authors":"Ji Hang, Sun Haogeng, You Chao, Liu Yi","doi":"10.1097/JS9.0000000000002387","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002387","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966348","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}
Jiamei Guo, Kecheng Zhang, Gang Ji, Wei Wang, Gang Li, Zhiqiang Liu, Zuli Yang, Zaisheng Ye, Yantao Tian, Tao Zhang, Xiangyu Wang, Kun Yang, Tong Zhou, Qi You, Yong Li, Peng Ren, Rupeng Zhang, Jingyu Deng
{"title":"Artificial neural network model enhancing the accuracy of clinical evaluation for high-risk population of lymph node metastasis in non-intestinal type early gastric cancer: a multicenter real-world study in China.","authors":"Jiamei Guo, Kecheng Zhang, Gang Ji, Wei Wang, Gang Li, Zhiqiang Liu, Zuli Yang, Zaisheng Ye, Yantao Tian, Tao Zhang, Xiangyu Wang, Kun Yang, Tong Zhou, Qi You, Yong Li, Peng Ren, Rupeng Zhang, Jingyu Deng","doi":"10.1097/JS9.0000000000002405","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002405","url":null,"abstract":"<p><strong>Background: </strong>Recent years have witnessed a proliferation of studies aimed at developing clinical models capable of predicting lymph node metastasis (LNM) in early gastric cancer (EGC), yet tools for prediction grounded in the Lauren classification remain scarce.</p><p><strong>Methods: </strong>Data of 6468 patients diagnosed with EGC from fifteen Chinese high-volume cancer centers between January 2005 and December 2015 were retrospectively analyzed. Utilizing multivariate logistic regression analysis and the multilayer perceptron (MLP) prediction algorithm, a nomogram and an artificial neural network (ANN) model were developed and validated, respectively, for predicting the likelihood of LNM in non-intestinal EGC cases. The models' performances were evaluated and a comparative analysis of their parameters was undertaken. Subsequently, in-depth risk stratification analyses were performed around the two models.</p><p><strong>Results: </strong>Non-intestinal type EGC demonstrated an elevated LNM rate and inferior prognosis compared to the intestinal type. Both nomogram and ANN model were developed and performed well in discrimination, calibration and clinical utility. Notably, the ANN model surpassed the nomogram in specificity (95.8% vs. 71.3%, P < 0.001), positive predictive value (PPV) (62.0% vs. 36.2%, P < 0.001) and overall accuracy (82.7% vs. 70.5%, P < 0.001). Patients with different risk strata derived from the nomogram, ANN model, and their combined application exhibited significantly different outcomes. The extent of lymph node dissection significantly influenced prognoses in high-risk patients identified by the combined model, whereas the anatomical location of metastatic lymph nodes did not.</p><p><strong>Conclusion: </strong>The ANN model established in this study can screen the patients at high risk of LNM in non-intestinal type EGC more accurately. Considering the high extragastric LNM rate observed in the high-risk stratum, radical gastrectomy combined with D2 lymph node dissection is strongly recommended.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000511","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}
Chunyang Zhang, Jie Su, Jun Yao, Miao Wang, Cheng Xu, Aizhong Wang
{"title":"Peripheral nerve blocks for hip fracture surgeries: a bibliometric and visual analysis.","authors":"Chunyang Zhang, Jie Su, Jun Yao, Miao Wang, Cheng Xu, Aizhong Wang","doi":"10.1097/JS9.0000000000002407","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002407","url":null,"abstract":"<p><strong>Background: </strong>Hip fractures - encompassing femoral neck and intertrochanteric injuries - are widely recognized as having high morbidity, mortality, and financial burden, particularly among older adults. Despite the growing adoption of peripheral nerve block (PNB) for postoperative pain management, there is a lack of comprehensive bibliometric analyses that elucidate global research trends, collaborations, and advancements in PNB for hip fracture surgeries.</p><p><strong>Methods: </strong>We employed the Web of Science Core Collection to identify 377 English-language original research articles (2004-2024) on PNB in hip fracture procedures. We then utilized VOSviewer and CiteSpace to map publication dynamics, detect prolific contributors, and reveal keyword clusters.</p><p><strong>Results: </strong>Our analysis showed that the yearly publication rate rose by 31.81%, with the United States, China, and the United Kingdom leading in output and collaboration. Key techniques included the fascia iliaca, quadratus lumborum, triple nerve, and pericapsular nerve group blocks, each with unique advantages and limitations. The PENG block and adapted fascia iliaca approaches were frequently cited, highlighting their promise for improving analgesia and preserving postoperative mobility. However, high-end ultrasound equipment costs and knowledge gaps in resource-limited settings remain barriers to broader clinical implementation.</p><p><strong>Conclusion: </strong>These findings indicate a rapid expansion of PNB research in hip fracture care, reflecting its potential to enhance perioperative recovery and reduce complications. Nonetheless, questions persist regarding long-term outcomes, mortality, and cost-effectiveness - particularly in older, high-risk patients. Addressing these challenges through interdisciplinary research, expanded database inclusion, and standardized guidelines could strengthen the role of PNB in hip fracture management worldwide, ultimately improving patient outcomes and advancing the field of perioperative pain control.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004507","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}