World Journal of Gastrointestinal Surgery最新文献

{"title":"Clinical characteristics and transabdominal ultrasound features that associated with T3-T4 staging in gastric cancer: A retrospective study.","authors":"Min-Ying Zhong, Guo-Liang Jian, Jie-Yi Ye, Qin-Xue Liu, Wei-Jun Huang, Chao-Jiong Zhen","doi":"10.4240/wjgs.v17.i6.105073","DOIUrl":"10.4240/wjgs.v17.i6.105073","url":null,"abstract":"<p><strong>Background: </strong>Transabdominal ultrasound after the oral administration of an echoic cellulose-based gastric ultrasound contrast agent has recently been suggested to be effective in T staging of gastric cancer (GC).</p><p><strong>Aim: </strong>To explore the clinical characteristics and transabdominal features associated with T3-T4 staging of GC.</p><p><strong>Methods: </strong>In total, 113 patients who underwent transabdominal ultrasonography and had confirmed GC based on surgical pathology were included. Variables including clinical characteristics [age, body mass index, gender, clinical features, pathological type, histologic type, Lauren type, carcinoembryonic antigen (CEA), and CA19-9] and transabdominal ultrasound features (thickness and length of lesion, presence of angle sign, presence of ulcer, and lesion location) were recorded. Univariate and multivariable logistic regression analyses were performed to identify the factors associated with T3-T4 staging.</p><p><strong>Results: </strong>Ninety-two patients were T3-T4 staging and 21 were T1-T2 staging. Univariate analysis revealed that the thickness of gastric lesions (1.6 ± 0.6 cm <i>vs</i> 1.0 ± 0.4 cm, <i>P</i> < 0.001), length of gastric lesions (5.7 ± 2.2 cm <i>vs</i> 2.9 ± 1.0 cm, <i>P</i> < 0.001), presence of angle sign (92.4% <i>vs</i> 19.0%, <i>P</i> < 0.001), elevated CEA (36.9% <i>vs</i> 0%, <i>P</i> < 0.001) and elevated CA19-9 (27.2% <i>vs</i> 14.3%, <i>P</i> = 0.034) were statistically significant between the two groups. Multivariable logistic regression analysis revealed that the length of gastric lesions [odds ratio (OR) = 2.373, 95% confidence interval (95%CI): 1.281-4.396, <i>P</i> = 0.006] and presence of angle sign (OR = 31.083, 95%CI: 4.449-217.164, <i>P</i> < 0.001) were independent factors associated with T3-T4 staging. A receiver operating characteristic curve was plotted, and the area under the curve was 0.950 (95% CI: 0.906-0.994, <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>Transabdominal ultrasound features, including an angle sign and lesion length, help identify T3-T4 staging.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 6","pages":"105073"},"PeriodicalIF":1.8,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of three reconstruction techniques performed after pancreaticoduodenectomy: Using external, internal, or no stent.","authors":"Carlos Jiménez-Romero, Alejandro Marcacuzco-Quinto, Oscar Caso-Maestro, Laura Alonso, Clara Fernández-Fernández, Iago Justo","doi":"10.4240/wjgs.v17.i6.104652","DOIUrl":"10.4240/wjgs.v17.i6.104652","url":null,"abstract":"<p><strong>Background: </strong>Postoperative pancreatic fistula (POPF) is the most frequent cause of morbimortality after pancreaticoduodenectomy, but the best technique to use to prevent its development is unclear. The choice of drainage method external duct stent (EDS), internal duct stent (IDS), or non-ductal stent (NDS) is also controversial.</p><p><strong>Aim: </strong>To compare the three groups (EDS, IDS and NDS), analyzing the patient characteristics, perioperative examinations and survival.</p><p><strong>Methods: </strong>Patients who underwent pancreaticoduodenectomy and pancreaticojejunostomy between 2012 and 2020, were divided into the EDS, IDS and NDS groups.</p><p><strong>Results: </strong>Of the 244 patients included, 129 were in the EDS group, 71 in the IDS group, and 44 in the NDS group. Except for preoperative pancreatitis in the NDS patients, comorbidities were similar among the groups. Patients in the NDS group had a high caliber of the Wirsung duct and frequently presented with a hard pancreas (<i>P</i> < 0.001). A lower rate of grade C POPF was observed in the EDS (1.6%) compared to the NDS (9.1%) and IDS group (14.1%) (<i>P</i> = 0.009). The groups showed similar findings for delayed gastric emptying, postoperative hemorrhage, reoperation, and 5-year survivals. Ninety-day mortality rate was significantly higher in the IDS group (5.6%) compared to the EDS (1.6%) and NDS (4.5%) groups (<i>P</i> = 0.046). Multivariate analysis showed that the use of EDS was a protective factor for grade B/C POPF (<i>P</i> = 0.034), and 90-day mortality (<i>P</i> = 0.018). Additionally, a Wirsung duct diameter < 3 mm was the only risk factor for grade B/C POPF (<i>P</i> = 0.001), and 90-day mortality (<i>P</i> = 0.031).</p><p><strong>Conclusion: </strong>The use of the EDS was a protective factor for grade B/C POPF and 90-day mortality, and the Wirsung duct < 3 mm was a risk factor for grade B/C POPF and 90-day mortality.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 6","pages":"104652"},"PeriodicalIF":1.8,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hereditary chronic intestinal pseudo-obstruction caused by a rare <i>MYH11</i> mutation: A case report.","authors":"Shan Jiang, Ya-Xuan Zhou, Xiao-Hong Sun, Pei-Pei Chen, Hao Tang, Yang Chen, Ya-Ping Liu, Yi-Xuan Li, Lin Kang","doi":"10.4240/wjgs.v17.i6.107235","DOIUrl":"10.4240/wjgs.v17.i6.107235","url":null,"abstract":"<p><strong>Background: </strong>Chronic intestinal pseudo-obstruction (CIPO) is a rare and debilitating disorder, characterized by severe impairments in gastrointestinal motility. The affected sites include the enteric/intrinsic autonomic nerves (neuropathy), intestinal smooth muscle cells (myopathy), and interstitial cells of Cajal (mesenchymopathy). The etiology can be genetic, idiopathic, or acquired. Owing to its nonspecific clinical presentation and lack of definitive diagnostic methods, misdiagnosis of CIPO is common.</p><p><strong>Case summary: </strong>This case involved an older male with insidious onset in adolescence who presented with postprandial bloating, intermittent diarrhea, and weight loss. During the disease course, the patient experienced two episodes of intestinal obstruction. Imaging revealed multisegmental digestive tract abnormalities (gastric emptying disorder, significant duodenal dilatation, and segmental jejunal dilatation). Whole-exome sequencing revealed a rare <i>MYH11</i> mutation [NM_001040113.2: C.5819del (p.Pro1940HisfsTer91)], confirming hereditary myopathic CIPO.</p><p><strong>Conclusion: </strong>This report adds to our current understanding of CIPO etiology by reinforcing the role of <i>MYH11</i> variants in the pathogenesis of the CIPO phenotype.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 6","pages":"107235"},"PeriodicalIF":1.8,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of laser acupuncture on gastrointestinal function recovery in patients after acute appendicitis surgery: A retrospective clinical study.","authors":"Hai-Zhou Ying","doi":"10.4240/wjgs.v17.i6.105897","DOIUrl":"10.4240/wjgs.v17.i6.105897","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic surgery has emerged as the preferred treatment for acute appendicitis, a common acute abdominal condition. Despite surgical advances, postoperative gastrointestinal dysfunction and delayed recovery continue to negatively impact rehabilitation outcomes and patient quality of life. Laser acupuncture represents a promising emerging complementary therapy with potential benefits for promoting functional recovery.</p><p><strong>Aim: </strong>To evaluate the clinical efficacy of laser acupuncture in enhancing gastrointestinal function recovery following laparoscopic appendectomy and to investigate its potential applications in postoperative rehabilitation.</p><p><strong>Methods: </strong>This retrospective controlled clinical study selected 120 acute appendicitis patients who underwent laparoscopic appendectomy from January 2022 to December 2023 at a tertiary hospital. Patients were randomly divided into two groups: Routine treatment group (<i>n</i> = 60) and laser acupuncture intervention group (<i>n</i> = 60). There were no significant statistical differences in baseline characteristics (age, gender, body mass index, appendicitis severity) between the two groups. The routine treatment group received standard postoperative care, while the laser acupuncture intervention group received additional laser acupuncture treatment on top of standard care. Key observation indicators included time to first exhaust, time to first bowel movement, time to gastrointestinal function recovery, and postoperative complication rates.</p><p><strong>Results: </strong>Patients in the laser acupuncture intervention group showed significantly faster gastrointestinal function recovery compared to the routine treatment group. Specifically, time to first exhaust was significantly shortened (intervention group: 12.5 ± 2.3 hours <i>vs</i> control group: 18.7 ± 3.1 hours, <i>P</i> < 0.05), time to first bowel movement was earlier (intervention group: 36.4 ± 4.6 hours <i>vs</i> control group: 48.2 ± 5.7 hours, <i>P</i> < 0.05), postoperative complication rate was significantly reduced (intervention group: 8.3% <i>vs</i> control group: 20.0%, <i>P</i> < 0.05), postoperative pain score was significantly lower (intervention group: 3.2 ± 1.1 <i>vs</i> control group: 4.7 ± 1.5, <i>P</i> < 0.05), and intestinal motility recovery was faster and more effective.</p><p><strong>Conclusion: </strong>Laser acupuncture, as an auxiliary treatment method, can significantly promote gastrointestinal function recovery in patients after laparoscopic appendectomy, reduce complications, and improve postoperative comfort. This technique has advantages such as minimal invasiveness, rapid recovery, and few side effects, making it worthy of further clinical promotion and application.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 6","pages":"105897"},"PeriodicalIF":1.8,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between prognosis and glucose transporter-1 and Ki-67 expression in obstructive colon cancer pre and post stent placement.","authors":"Kun-Ning Zhang, Mu-Lan Jin, Zhi-Wei Zhai","doi":"10.4240/wjgs.v17.i6.104505","DOIUrl":"10.4240/wjgs.v17.i6.104505","url":null,"abstract":"<p><strong>Background: </strong>Self-expandable metallic stent (SEMS) placement is a common intervention for obstructive left-sided colon cancer. However, the long-term prognosis post-SEMS placement remains debated. Mechanical compression within the tumor caused by SEMS may induce vascular compression, leading to tissue ischemia and hypoxia. These alterations in the tumor microenvironment could affect patient prognosis.</p><p><strong>Aim: </strong>To assess the influence of glucose transporter-1 (GLUT-1) and Ki-67 expression in obstructive colon cancer tissues pre and post SEMS placement on patient prognosis.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on clinical and pathological data from 71 patients with obstructive colon cancer who underwent SEMS placement followed by surgery. Paired colon cancer tissue samples were collected from each patient pre and post SEMS placement. Immunohistochemical techniques were employed to evaluate GLUT-1 and Ki-67 expression in the specimens.</p><p><strong>Results: </strong>The high expression rates of GLUT-1 in the samples obtained before and after SEMS placement were 14.1% and 43.7%, respectively (<i>P</i> < 0.001). GLUT-1 expression was associated with vascular invasion post-SEMS placement (<i>P</i> = 0.03). Ki-67 expression showed no significant difference pre and post SEMS placement and was unrelated to clinical pathological characteristics (all <i>P</i> > 0.05). The high expression rates of GLUT-1 in the samples obtained before and after SEMS placement were associated with worse recurrence-free interval (pre-SEMS: 40.0% <i>vs</i> 72.3%, <i>P</i> = 0.026; post-SEMS: 45.5% <i>vs</i> 85.7%, <i>P</i> = 0.001). Cox regression analysis revealed that both pre-SEMS placement (HR = 3.490, 95%CI: 1.165-10.453, <i>P</i> = 0.026) and post-SEMS placement (HR = 4.335, 95%CI: 1.539-12.214, <i>P</i> = 0.006) GLUT-1 expression were adverse prognostic factors for patients.</p><p><strong>Conclusion: </strong>Though the precise impact of stent placement on the mechanical compression and biological behavior of tumors is not fully understood, our study found an increase in GLUT-1 expression in tumor tissues after SEMS placement. Tumor GLUT-1 serves as a prognostic biomarker for the survival of patients with obstructive colon cancer treated with SEMS placement.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 6","pages":"104505"},"PeriodicalIF":1.8,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sigmoid and cecal volvulus in pregnancy and puerperium: A systematic review.","authors":"Goran Augustin, Zrinka Hrgović, Ante Tavra, Bojana Jovović, Leon Serdarević, Jure Krstulović","doi":"10.4240/wjgs.v17.i6.107151","DOIUrl":"10.4240/wjgs.v17.i6.107151","url":null,"abstract":"<p><strong>Background: </strong>Cecal and sigmoid volvulus during pregnancy are extremely rare. Symptoms of intestinal obstruction in pregnancy make accurate clinical diagnosis challenging.</p><p><strong>Aim: </strong>To identify predictive factors for early diagnosis and successful treatment and an association between the diagnosis and maternal/neonatal outcomes.</p><p><strong>Methods: </strong>A systematic review of human studies (PubMed, PubMedCentral, Google Scholar) up to October 2024 was conducted per PRISMA guidelines. Data on demographics, clinical features, diagnostics, treatment, and outcomes were analyzed.</p><p><strong>Results: </strong>Antepartum and postpartum volvulus occurred in 75.5% and 24.5% of cases, respectively, most commonly in the third trimester (70.3%). Nausea was less frequent and obstipation was more common in sigmoid volvulus (<i>P</i> = 0.0004). Endoscopic detorsion was successful in 23.9% of sigmoid cases, with a mean gestational age of 33.5 ± 3.5 weeks. Maternal mortality was 12.5% for cecal and 5.5% for sigmoid volvulus (<i>P</i> = 0.103). While maternal mortality was unaffected by the timing of delivery relative to surgery, fetal mortality was significantly higher when the interval was < 24 hours (52.9% <i>vs</i> 10.4%, <i>P</i> < 0.001). Both maternal and fetal mortality declined over time.</p><p><strong>Conclusion: </strong>Constipation was a risk factor for sigmoid volvulus and prior open appendectomy for cecal volvulus. Endoscopy was more often used in sigmoid cases. Gestational age and maternal age did not affect fetal outcomes. Earlier imaging and appropriate surgery were linked to lower mortality. Delay > 24 hours between intervention and delivery increased fetal, but not maternal mortality. Successful endoscopic detorsion eliminated maternal mortality and significantly lowered fetal mortality.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 6","pages":"107151"},"PeriodicalIF":1.8,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"T2 magnetic resonance imaging combined with diffusion-weighted imaging for colon cancer lymph nodes.","authors":"Yong-Xia Li, Sheng-Li Cai, Ming-Yang Peng, Tong-Xing Wang, Wen Geng, Yue-Hu Ma","doi":"10.4240/wjgs.v17.i6.103298","DOIUrl":"10.4240/wjgs.v17.i6.103298","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer is a malignancy with a high risk of lymph node metastasis and poor prognosis, and thus requires an accurate diagnosis.</p><p><strong>Aim: </strong>To assess the diagnostic value of combined magnetic resonance T2-weighted imaging (T2WI) and diffusion-weighted imaging (DWI) in colorectal cancer.</p><p><strong>Methods: </strong>We included 120 patients with suspected colorectal cancer who underwent magnetic resonance imaging. Surgical pathology was used as the gold standard for comparison. Combined T2WI and DWI showed higher diagnostic efficacy than either of the two methods used individually.</p><p><strong>Results: </strong>The combined method achieved 94.74% sensitivity, 95.45% specificity, 95.00% accuracy, 94.74% positive predictive value, and 95.45% negative predictive value in qualitative diagnosis. It showed 94.44% sensitivity, 95.00% specificity, 94.74% accuracy, 94.44% positive predictive value, and 95.00% negative predictive value in clinical staging. Finally, it showed 94.74% sensitivity, 94.59% specificity, 94.74% accuracy, 94.74% positive predictive value, and 94.59% negative predictive value in diagnosing lymph node metastasis. These results were highly consistent with that of the gold standard.</p><p><strong>Conclusion: </strong>This study combined T2WI and DWI for accurate diagnosis of colorectal cancer, aiding clinical staging and lymph node metastasis assessment. This approach is promising for clinical application.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 6","pages":"103298"},"PeriodicalIF":1.8,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical significance of immune cell and biomarker changes in liver cancer.","authors":"Su-Tao Zhou, Bin Zhang, Ke Ma, Juan Guo","doi":"10.4240/wjgs.v17.i6.104923","DOIUrl":"10.4240/wjgs.v17.i6.104923","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Primary liver cancer (PLC) is characterized by high malignancy, rapid disease progression, and persistent high incidence and mortality rates, posing a significant public health challenge worldwide. Early diagnosis and assessment of PLC are of great significance for guiding clinical treatment and improving patient prognosis. Alpha fetoprotein (AFP) and gamma-glutamyl transpeptidase (GGT) are commonly utilized tumor markers for the clinical diagnosis of PLC. They are ideal indicators for the detection of metastasis and recurrence after LC surgery. Nevertheless, not all patients with PLC secrete large amounts of AFP and GGT, which affects the accuracy of evaluating PLC by monitoring these two tumor markers alone. Cluster of differentiation 3 and 161 double-positive natural killer T (CD3&lt;sup&gt;+&lt;/sup&gt;CD161&lt;sup&gt;+&lt;/sup&gt;NKT) cell subsets are a class of molecules inextricably related to immune function and tumor occurrence and development. This research seeks to explore the clinical significance of CD3&lt;sup&gt;+&lt;/sup&gt;CD161&lt;sup&gt;+&lt;/sup&gt;NKT cell subsets combined with tumor markers AFP and GGT in the diagnosis of patients with PLC.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To probe the clinical significance of CD3&lt;sup&gt;+&lt;/sup&gt;CD161&lt;sup&gt;+&lt;/sup&gt;NKT cell subsets and AFP and GGT changes in the peripheral blood of individuals with PLC.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The PLC group comprised 30 patients diagnosed with PLC who were admitted to our hospital between July 2022 and December 2023, whereas the control group consisted of 30 healthy individuals undergoing routine physical examinations at our hospital. Peripheral blood samples were harvested from both cohorts of patients. The levels of CD4&lt;sup&gt;+&lt;/sup&gt;NKT, CD8&lt;sup&gt;+&lt;/sup&gt;NKT, CD3&lt;sup&gt;+&lt;/sup&gt;CD56&lt;sup&gt;+&lt;/sup&gt;NKT, CD8&lt;sup&gt;+&lt;/sup&gt;CD56&lt;sup&gt;+&lt;/sup&gt;NKT, CD3&lt;sup&gt;+&lt;/sup&gt;CD161&lt;sup&gt;+&lt;/sup&gt;NKT, and CD3&lt;sup&gt;-&lt;/sup&gt;CD161&lt;sup&gt;+&lt;/sup&gt;NKT were measured by flow cytometry. Serum AFP content was determined using a fully automatic immunoassay analyzer, and serum GGT content was ascertained by a fully automatic biochemical analyzer. The diagnostic value of CD3&lt;sup&gt;+&lt;/sup&gt;CD161&lt;sup&gt;+&lt;/sup&gt;NKT cell subsets and AFP and GGT level alterations for PLC was evaluated by receiver operating characteristic curve analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;No significant disparities were observed in the counts of white blood cells, neutrophils, and platelets, as well as the levels of blood urea nitrogen and serum creatinine between the two groups (&lt;i&gt;P&lt;/i&gt; &gt; 0.05). Lymphocytes, red blood cells, hemoglobin, total protein, albumin, and globulin were more attenuated in the PLC group than in the control group, while glutamic-pyruvic transaminase, glutamic oxalacetic transaminase, and carcinoembryonic antigen levels were increased in the PLC cohort compared with the control cohort, with statistical significance (&lt;i&gt;P&lt;/i&gt; &lt; 0.05). No substantial difference was discovered in peripheral blood CD4&lt;sup&gt;+&lt;/sup&gt;NKT, CD8&lt;sup&gt;+&lt;/sup&gt;NKT, and CD3&lt;","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 6","pages":"104923"},"PeriodicalIF":1.8,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of problem management-guided health education with positive incentive nursing after rectal cancer surgery.","authors":"Cheng-Yan Mei, Fei Zou, Jun-Min Deng, Huan Gong","doi":"10.4240/wjgs.v17.i6.103998","DOIUrl":"10.4240/wjgs.v17.i6.103998","url":null,"abstract":"<p><strong>Background: </strong>Patients undergoing rectal cancer surgery frequently encounter challenges in their self-care abilities, disease knowledge, and emotional well-being postoperatively. Effective nursing interventions are critical for improving the quality of life and minimizing complications. This study explored the clinical implications of integrating health education guided by problem management with positive incentive nursing to address these challenges.</p><p><strong>Aim: </strong>To evaluate the effect of this combined nursing model on postoperative self-care ability, disease knowledge, mood state, and complication rates in patients undergoing rectal cancer surgery.</p><p><strong>Methods: </strong>Eighty patients who underwent rectal cancer surgery between October 2021 and August 2024 were allocated into reference (routine care) and experimental (problem management-guided health education combined with positive incentive nursing) groups. The outcomes included exercise of self-care agency scale, disease knowledge (hospital-specific questionnaire), mood state (profile of mood states), and complication rates.</p><p><strong>Results: </strong>The experimental group demonstrated significant improvements in self-care ability (<i>P</i> < 0.05), with higher scores for health knowledge, self-concept, self-care skills, and self-care responsibility than the reference group. Disease knowledge scores also improved markedly in the experimental group (<i>P</i> < 0.05). Mood state scores showed a significant decrease in the negative dimensions (<i>e.g.</i>, anxiety and depression) and an increase in energy vitality (<i>P</i> < 0.05). Additionally, the experimental group exhibited a lower complication rate than the reference group (7.5% <i>vs</i> 27.5%, <i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>The integration of problem management-guided health education with positive incentive nursing significantly enhanced postoperative self-care abilities, disease knowledge, and emotional well-being while reducing complication rates. This model demonstrated potential for widespread adoption in clinical practice by offering a structured approach to improve patient outcomes and quality of life.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 6","pages":"103998"},"PeriodicalIF":1.8,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mitochondrial alanyl-tRNA synthetase 2 mediates histone lactylation to promote ferroptosis in intestinal ischemia-reperfusion injury.","authors":"Wei Dong, San-Xiong Huang, Mo-Liang Qin, Zhuo Pan","doi":"10.4240/wjgs.v17.i6.106777","DOIUrl":"10.4240/wjgs.v17.i6.106777","url":null,"abstract":"<p><strong>Background: </strong>Ferroptosis is a newly recognized form of regulated cell death characterized by iron-dependent accumulation of lipid reactive oxygen species. It has been extensively studied in various diseases, including cancer, Parkinson's disease, and stroke. However, its precise role and underlying mechanisms in ischemia/ reperfusion injury, particularly in the intestinal ischemia-reperfusion (IIR), remain unclear. In current work, we aimed to investigate the participation of histone lactylation during IIR progression.</p><p><strong>Aim: </strong>To investigate the role of mitochondrial alanyl-tRNA synthetase 2 (AARS2) in ferroptosis and its epigenetic regulation of acyl-CoA synthetase long-chain family member 4 (ACSL4) through histone lactylation during IIR injury.</p><p><strong>Methods: </strong>We established a mouse model to mimic IIR and conducted AARS2 knockdown as treatment. The expression of AARS2 in intestinal tissues was measured by western blot. The integrity of intestinal tissues was detected by hematoxylin and eosin staining, serum fatty acid-binding protein, protein levels of ZO-1 and occluding. An <i>in vitro</i> hypoxia-reperfusion (H/R) cell model was established, and cell viability was measured by CCK-8. The <i>in vitro</i> and <i>in vivo</i> ferroptosis was determined by the accumulation of Fe²⁺ and malondialdehyde (MDA). The epigenetic regulation of ACSL4 by AARS2 was detected by chromatin immunoprecipitation (ChIP) assay and luciferase reporter assay.</p><p><strong>Results: </strong>We observed a notable elevated AARS2 level in intestinal tissue of mice in IIR model group, which was reversed by shAARS2 treatment. Knockdown of AARS2 repressed alleviated intestinal barrier disruption and repressed the accumulation of ferroptosis biomarker Fe²⁺ and MDA during IIR. The <i>in vitro</i> results showed that shAARS2 alleviated impaired cell viability caused by H/R, as well as repressed ferroptosis. Knockdown of AARS2 notably downregulated the RNA and protein expression of ACSL4. Mechanistically, knockdown of AARS2 downregulated the enrichment of H3K18 La modification on AARS2, as well as suppressed its promoter activity. Overexpression of AARS2 could abolish the protective effects of shACSL4 <i>in vitro</i>.</p><p><strong>Conclusion: </strong>The elevation of AARS2 during IIR led to cell ferroptosis <i>via</i> epigenetically upregulating the expression of ACSL4. Our findings presented AARS2 as a promising therapeutic target for IIR.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 6","pages":"106777"},"PeriodicalIF":1.8,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}