International journal of surgery最新文献

{"title":"The role of phenotypic age acceleration in aneurysmal subarachnoid hemorrhage: analysis of retrospective data from two hospital-based cohorts and prospective UK Biobank cohort.","authors":"Jiarong He, Yuquan Chen, Sidi Xu, Pengwei Hou, Yan Cui, Kai Su, Xieli Guo, Ming Wang, Mingming Zhang","doi":"10.1097/JS9.0000000000002544","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002544","url":null,"abstract":"<p><strong>Background: </strong>Phenotypic age acceleration (PhenoAgeAccel) is considered a major risk factor for various age-related diseases, but its specific role in aneurysmal subarachnoid hemorrhage (aSAH) remains unclear. This study aims to examine the relationship between PhenoAgeAccel and the risk of aSAH, and further explores whether genetic susceptibility modifies this association.</p><p><strong>Methods: </strong>Using data from the UK Biobank, we performed cross-sectional and prospective analyses to investigate the association between PhenoAgeAccel and aSAH. Polygenic risk scores were calculated to evaluate genetic susceptibility, and interactions between genetic risk and PhenoAgeAccel were explored. Additionally, using hospital cohort data, we applied an XGBoost model interpreted via SHapley Additive exPlanations (SHAP) analysis to identify key clinical predictors, including PhenoAgeAccel, which were subsequently incorporated into a nomogram for clinical risk prediction.</p><p><strong>Results: </strong>Cross-sectional analyses revealed that each 1-year increment in PhenoAgeAccel was associated with a 1%-7% elevated risk of aSAH. In the UK Biobank, biologically older individuals had a higher risk of aSAH compared to biologically younger individuals (odds ratio [OR] = 1.48; 95% confidence interval [CI], 1.10-1.97; P = 0.009) for PhenoAgeAccel. Similarly, in the hospital datasets, biologically older individuals also showed increased odds of aSAH (Second Xiangya Hospital: OR = 16.45; 95% CI, 4.72-57.34; Fujian Hospital: OR = 12.41; 95% CI, 3.33-46.26). In the prospective analyses of the UK Biobank, PhenoAgeAccel was associated with an increased risk of incident aSAH (hazard ratio [HR] = 1.04; 95% CI, 1.02-1.07). Moreover, additive interactions between PhenoAgeAccel and genetic susceptibility were observed. Further validation using the XGBoost machine learning model and SHAP analysis confirmed PhenoAgeAccel as a key predictive factor for aSAH. Based on these findings, a nomogram integrating PhenoAgeAccel and relevant clinical parameters was developed to facilitate individualized risk prediction in clinical practice.</p><p><strong>Conclusion: </strong>PhenoAgeAccel is a significant predictor of aSAH risk, particularly among genetically susceptible populations. Identifying individuals with PhenoAgeAccel could serve as a novel clinical biomarker for assessing aSAH.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110835","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":"Effect of dexmedetomidine for epidural supplementation on postpartum sleep disturbance after cesarean delivery: a double-blind, randomized clinical trial.","authors":"Juan Li, Yan-Hong Zhou, Ying-Jie Yang, Qian Wang, Wan Lei, Shu-Xi Li, Jian-Jun Shen, Dong-Xin Wang, Xin-Zhong Chen, Li-Li Xu","doi":"10.1097/JS9.0000000000002489","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002489","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Dexmedetomidine has been proved to be a supplemental narcotic or/and sedative for neuraxial anesthesia during various obstetrics treatment and operation procedures. Our study aimed to investigate the effect of intraoperative low-dose dexmedetomidine epidural supplementation on postpartum sleep quality and the incidence of postpartum sleep disturbance in patients undergoing cesarean delivery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;One hundred and twenty parturients scheduled for elective cesarean delivery with epidural anesthesia were randomized to receive either 1 μg · mL-1 dexmedetomidine or placebo, followed with patient-controlled epidural analgesia with either 0.5 μg · mL-1 dexmedetomidine or placebo, combined with ropivacaine, for up to 2 days. The primary outcome was the incidence of postpartum sleep disturbance on postoperative days 3 defined as numeric rating scale (NRS) score of subjective sleep quality of 6 or higher or Pittsburgh Sleep Quality Index (PSQI) score higher than 5 during the first 3 postoperative nights. Postoperative maternal pain intensity, ropivacaine consumption, and patient-controlled epidural analgesia boluses in 48 h were also recorded.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 120 parturients were randomized to the dexmedetomidine group and the control group. The incidence of postpartum sleep disturbance in the dexmedetomidine group was significantly lower than in the control group on postoperative days 3 (30.0% vs 61.7%; odds ratio [OR], 0.49 [95% CI, 0.32-0.75]; P&lt;0.001), and days 7 (25.9% vs 52.5%; OR, 0.49 [95% CI, 0.30-0.81]; P = 0.003). The NRS score of subjective sleep quality was lower in the dexmedetomidine group than in the control group on postoperative days 3 (P&lt;0.001) and days 7 (P = 0.001). The NRS score of subjective sleep quality and the incidence of postpartum sleep disturbance on postoperative days 14 did not differ between the two groups. The Pittsburgh Sleep Quality Index (PSQI) score, the insomnia severity index score, the self-rating anxiety scale, and the Edinburgh Postnatal Depression Scale (EPDS) on postoperative days 42 did not differ between the two groups. The NRS score of pain was lower in the dexmedetomidine group than those in the control group at the time of end of surgery, 1 h after surgery, 1 d after surgery, 2 d after surgery, and 3 d after surgery (P&lt;0.001); postoperative ropivacaine consumption (mg) and patient-controlled epidural analgesia boluses (n) in 48 h were lower in the dexmedetomidine group than that in the control group (P&lt;0.001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Intraoperative and postoperative continuous epidural infusion of low-dose dexmedetomidine significantly improved postpartum sleep quality, reduced the incidence of postpartum sleep disturbance, which may be associated with optimized analgesia effect and decreased postoperative ropivacaine consumption in parturients undergoing elective cesarean delivery. Further studies are needed to","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110716","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 \"a comparative analysis of perioperative complications and biochemical recurrence between standard and extended pelvic lymph node dissection in prostate cancer patients undergoing radical prostatectomy: a systematic review and meta-analysis\".","authors":"Li Li, Ying Mao","doi":"10.1097/JS9.0000000000002431","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002431","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093710","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":"Ex vivo lung perfusion with GLP-1R agonist mitigates ischemia/reperfusion injury through pyroptosis modulation in lung transplantation- an experimental study.","authors":"Yufei Zhang, Tao Liu, Huaizu Guo, Jianxin Shi, Jun Yang, Shijie Fu, Xufeng Pan, Feng Li, Hai Zhang, Dawei Zhang, Hong Yang, Lulu Zheng, Meng Shi, Wenyong Zhou","doi":"10.1097/JS9.0000000000002438","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002438","url":null,"abstract":"<p><strong>Background: </strong>Ischemia/reperfusion injury (IRI) presents a significant hurdle in lung transplantation. Our previous research showed that the glucagon-like peptide-1 receptor (GLP-1R) agonist liraglutide (Lir) improves lipopolysaccharide-induced acute lung injury in murine models. This study aims to further investigate the lung-protective mechanisms of GLP-1R agonist.</p><p><strong>Methods: </strong>An in vitro hypoxia/reoxygenation (H/R) model with BEAS-2B cells and an in vivo donation after cardiac death (DCD) rat lung transplant model were utilized. Lir was administered using an ex vivo lung perfusion (EVLP) system. Lung function, injury, and pyroptosis mechanisms were assessed. Validation experiments included quantitative reverse transcription PCR, immunoblot analysis, activity assays and proteomic analysis, among others, to evaluate how GLP-1R agonist protect lungs from IRI by modulating pyroptosis, thereby improving lung function and reducing injury.</p><p><strong>Results: </strong>Perfusion of the donor lung with Lir using EVLP improved the function of DCD lungs and mitigated IRI. Bioinformatics analysis and validation experiments provided evidence of increased expression of NOD-like receptors signals and pyroptosis in lung transplantation IRI, which was suppressed by Lir treatment. Further investigations revealed that the thioredoxin-binding protein (TXNIP) played a crucial regulatory role in the pyroptosis of IRI, with the NOD-like receptor family pyrin domain-containing 3 (NLRP3) emerging as a key target. In addition, this study found that Lir promotes GLP-1R-dependent TXNIP ubiquitination and modulates TXNIP mRNA stability via the GLP-1R/miR-17 axis.</p><p><strong>Conclusion: </strong>This study demonstrates, for the first time, that a novel EVLP-based drug delivery approach using GLP-1R agonist can protect lungs from IRI by modulating pyroptosis, thereby improving lung function and reducing injury. The research uncovers a previously unknown mechanism where GLP-1R agonist modulates the protein TXNIP through GLP-1R/miR-17 signaling. These insights underscore the potential of GLP-1R agonists as targeted therapies for primary graft dysfunction in lung transplant recipients, opening new avenues for clinical interventions to improve transplant outcomes.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093777","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":"Group-based trajectory analysis of postoperative quality of recovery and outcomes after esophagectomy.","authors":"Feng Yin, Lan-Tao Li, Xie Wang, Hong-Wei Zhang, Hai Yu","doi":"10.1097/JS9.0000000000002456","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002456","url":null,"abstract":"<p><strong>Background: </strong>Numerous guidelines for perioperative care in esophagectomy have been developed to promote postoperative quality of recovery (QoR). However, the trajectories and predictors of QoR based on patient-reported outcome after esophagectomy have not been characterized.</p><p><strong>Methods: </strong>This multi-center, prospective, observational study enrolled 206 patients undergoing esophagectomy. Primary analysis was to estimate the trajectories of QoR using group-based trajectory modeling.</p><p><strong>Results: </strong>Four distinct QoR trajectories were identified: poor QoR (38, 18.4%), poor to moderate QoR (83, 40.3%), moderate to good QoR (51, 24.8%), and good QoR (34, 16.5%). Secondary analysis revealed that preoperative nutritional risk (odds ratio [OR], 1.13; 95% confidence interval [CI], 1.03 to 1.23), lower preoperative QoR-15 score (OR, 0.75; 95% CI, 0.61 to 0.91), longer duration of surgery (OR, 1.02; 95% CI, 1.01 to 1.04), and higher area under the curve of postoperative pain scores during coughing (OR, 1.22; 95% CI, 1.09 to 1.36) were significantly associated with the poor QoR trajectory.</p><p><strong>Conclusions: </strong>Notably, four postoperative QoR trajectories were identified and the predictors for poor QoR trajectory included preoperative nutritional risks, lower preoperative QoR-15 scores, longer surgical duration, and higher postoperative pain scores during coughing.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093778","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":"Insights into ChatGPT and DeepSeek application in osteoporotic vertebral compression fractures.","authors":"Yize Zhao, Siyi Wang, Ganjun Feng","doi":"10.1097/JS9.0000000000002512","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002512","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093786","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 \"blood-brain barrier-associated biomarker correlated with cerebral small vessel disease and shunt outcome in normal pressure hydrocephalus: a prospective cohort study\".","authors":"Wenqiang Cui, Fei Xu, Hongyun Wu","doi":"10.1097/JS9.0000000000002446","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002446","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093735","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":"Transcutaneous auricular vaguas nerve stimulation promotes adipose tissue browning and mitochondrial integrity by regulating BCAA metabolism in obese rats: an experimental study.","authors":"Chen Xin, Shaoyuan Li, Bowen Feng, Lan Sun, Yifei Wang, Jinling Zhang, Yuzhengheng Zhang, Ningyi Zou, Qing Zhou, Peijing Rong","doi":"10.1097/JS9.0000000000002451","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002451","url":null,"abstract":"<p><strong>Abstract: </strong>Transcutaneous auricular vagus nerve stimulation (taVNS) may exert its anti-obesity effects by promoting the browning of adipose tissue with unclear mechanisms. Modulation of branched-chain amino acid (BCAA) metabolism in adipose tissue may play a key role in this process. In this study, six weeks of taVNS significantly reduced body weight gain, body mass index, and the accumulation of inguinal and epididymal white adipose tissue in high-fat diet (HFD)-induced obese rats, with effects comparable to those of orlistat. Notably, taVNS increased both the content and thermogenic activity of interscapular brown adipose tissue (BAT) in obese rats. Infrared thermal imaging confirmed increased BAT thermogenesis, while transmission electron microscopy indicated improved mitochondrial morphology and function. Molecular analysis revealed that taVNS upregulated uncoupling protein 1 (UCP1), the transporter protein solute carrier family 25 member 44 (SLC25A44), and protein phosphatase Mg 2 + /Mn 2 + dependent 1 K (PPM1K) expression while downregulating branched-chain α-ketoacid dehydrogenase kinase (BCKDK), thereby promoting BCAA metabolism and adipose tissue browning. We conclude that the anti-obesity effects of taVNS are closely related to BCAA metabolism in BAT. These findings highlight taVNS as a promising approach for obesity management, though further studies are needed to clarify the neurobiological pathways involved and advance taVNS technology.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093832","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 \"Comparing surgical outcomes of subcutaneous-flap vs. subplatysmal-flap techniques in total open thyroidectomy: a cohort study\".","authors":"Shahin Nosratzehi, Mahin Nosratzehi, Masoud Keikha","doi":"10.1097/JS9.0000000000002498","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002498","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093772","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":"Laparoscopic radical hysterectomy-karez technique for stage IB3 and IIA2 cervical cancer: a multicenter retrospective cohort study.","authors":"Xiaoming Yang, Sibang Chen, Yuhong Li, Jin Peng, Jiaxi Wang, Xinyu Ni, Roufei Lu, Jiangtao Fan, Shiqian Zhang, Yudong Wang","doi":"10.1097/JS9.0000000000002522","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002522","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic radical hysterectomy with Karez technique (LRH-Karez) is a practical method which is based on special space anatomy. This study investigates the efficacy and safety of LRH-Karez against traditional surgical methods including abdominal radical hysterectomy (ARH) and conventional minimally invasive surgery (MIS).</p><p><strong>Methods: </strong>A multicenter retrospective cohort study was conducted, involving 413 eligible patients diagnosed with 2018 FIGO stage IB3 and IIA2 cervical cancer treated from January 2012 to January 2022. Among these, 66 patients underwent LRH-Karez, 56 patients underwent conventional laparoscopic or robotic surgery (Conventional MIS) and 291 patients received ARH. Patient data were obtained from three tertiary hospitals in China. Surgical outcomes, pathological results, and follow-up data were analyzed using SPSS and R statistical software. Kaplan-Meier survival analysis was performed alongside univariate and multivariate Cox regression analyses.</p><p><strong>Results: </strong>LRH-Karez has less intraoperative blood loss but longer operative time. The five-year progression-free survival (PFS) rates were 85% for LRH-Karez, significantly higher than the 53.6% from conventional MIS (P = 0.002) and comparable to ARH (78.3%, P = 0.898). In terms of overall survival, the five-year overall survival (OS) rate for the LRH-Karez group was 92.2%, compared to 51.9% for the conventional MIS group and 78.3% for the ARH group. Patients who underwent conventional MIS had significantly lower OS compared to those in the LRH-Karez group (P < 0.001). The log-rank test indicated no significant difference in OS between the LRH-Karez group and the ARH group (P = 0.218). However, the Gehan-Breslow-Wilcoxon test revealed a significant difference between the two groups during the early follow-up period (P = 0.047).</p><p><strong>Conclusions: </strong>The LRH-Karez technique has demonstrated superior intraoperative safety and survival prognosis compared to conventional MIS in patients with locally advanced cervical cancer (FIGO stages IB3 and IIA2), with its long-term survival outcomes comparable to ARH. This practical technique, based on refined understanding of surgical space anatomy, may represent a valuable minimally invasive surgical option that warrants further exploration.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093792","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}