Air pollution has emerged as a major public health concern, being implicated in the pathogenesis of diverse diseases. This study investigates the underlying associations between air pollutants and hepatocellular carcinoma (HCC). Target genes associated with both air pollutants and HCC were obtained through integration of multiple bioinformatics databases. Protein-protein interaction (PPI) network construction and visualization were performed on overlapping genes, followed by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses to elucidate potential mechanistic pathways. A predictive model was developed using LASSO regression and validated on external datasets. Core genes were identified through consensus across multiple topological algorithms, with their clinical relevance further explored. Finally, molecular docking analysis was conducted to investigate interaction patterns between core genes and airborne pollutants at the structural level. Integrated multi-database analyses identified 48 air pollutant-HCC associated genes. Functional enrichment through GO and KEGG revealed these targets predominantly regulate apoptosis and oncogenic pathways. Survival analysis demonstrated robust predictive capacity of the LASSO-derived prognostic model, which maintained strong stability and reliability in external validation cohorts. CDK1 and TERT emerged as core genes from multi-algorithm screening, strongly correlated with HCC pathological progression. Molecular docking simulations further confirmed stable binding conformations between particulate matter components and these core targets at atomic resolution. Our study elucidates the critical roles of CDK1 and TERT between air pollutants and hepatocellular carcinoma, thereby providing novel molecular insights into air pollution-driven hepatocarcinogenesis.

Background: Intrahepatic bile duct stones, a prevalent condition within hepato-biliary diseases, present a considerable challenge due to the high rates of recurrence, complications, and difficulty in treatment. Selecting an optimal surgical approach is vital for effective stone clearance and minimizing patient morbidity. While laparoscopic hepatectomy and percutaneous transhepatic choledochoscopy are established modalities, their comparative efficacy and safety profiles necessitate further investigation to inform clinical decision-making. Objective: To explore the effectiveness and safety of different surgical methods for intrahepatic bile duct stones. Methods: The clinical data of 65 patients with intrahepatic bile duct stones admitted to Nanchong Central Hospital, China, from January 2021 to January 2022 were retrospectively analyzed. According to the differences in surgical methods, patients undergoing laparoscopic hepatectomy were included in the laparoscopic group (n = 33), and patients undergoing percutaneous transhepatic choledochoscopy were included in the percutaneous transhepatic group (n = 32). The differences in perioperative indicators, inflammatory factors, postoperative complications, and one-year follow-up recurrence rates between the two groups were compared. Results: Compared with percutaneous transhepatic group, laparoscopic group had significantly shorter operation time and hospitalization time (p < 0.05), and significantly higher blood loss (p < 0.05). After the operation, C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-alpha), and interleukin-6 (IL-6) in the laparoscopic and percutaneous transhepatic groups were significantly lower than those in the same group before the operation (p < 0.05). CRP, TNF-alpha, and IL-6 in the laparoscopic group were significantly lower than in the percutaneous transhepatic group (p < 0.05). There was no significant difference in the incidence of postoperative complications and the recurrence rate of one-year follow-up between the laparoscopic group and the percutaneous transhepatic puncture group (p > 0.05). Conclusion: Laparoscopic hepatectomy and percutaneous transhepatic choledochoscopy are both practical and safe, and the appropriate surgical scheme should be selected according to the patient's specific condition.

原发性肝癌是我国常见恶性肿瘤之一,恶性程度高,进展迅速,预后较差.目前手术仍是原发性肝癌首选治疗方法.随着腹腔镜技术的普遍开展,腹腔镜下肝切除术已成为主流手术方式[1].精准医学首次由Collins于2011 年提出,精准外科治疗要求在保证治疗效果的同时,尽可能的减少手术带来的创伤,提高患者术后生活质量,改善预后[2].近年来,原发性肝癌的腹腔镜下精准肝切除术已经在临床逐渐开展,但临床对该手术方法的研究还处于探索阶段.无论采用哪种手术方式,都不可避免的引起应激反应[3],对患者的术后恢复产生一定的影响.我们观察了腹腔镜精准肝切除术治疗原发性肝癌的临床疗效及对患者应激指标和肝功能的影响,希望为临床应用提供依据.

目的 探讨行腹腔镜胰十二指肠切除术(laparoscopic pancreatoduodenectomy,LPD)患者围手术期血清胃泌素和胃动素水平变化,分析胃泌素和胃动素与LPD术后胃瘫的关系.方法 对2019年2月至2020年8月在南充市中心医院接受腹腔镜胰十二指肠切除术的32例患者资料进行回顾性分析,测定患者血清胃泌素和胃动素水平,根据术后有无发生胃瘫,分为胃瘫组(5例)和无胃瘫组(27例),比较两组的血清胃泌素和胃动素水平差异.结果 32例患者术前及术后第1、3、7天总体胃泌素和胃动素的表达呈上升趋势,但差异均无统计学意义(P>0.05).胃瘫组(n=5)术前胃泌素、胃动素均低于无胃瘫组(n=27);术后1、3、7天胃瘫组胃泌素下降;胃动素先下降,后上升至术前水平;无胃瘫组术后胃泌素和胃动素均逐步上升.胃瘫组术前、术后第1、3、7天胃泌素分别为(71.25±20.24)pg/mL、(64.26±19.88)pg/mL、(62.81±16.27)pg/mL、(63.45±22.34)pg/mL,无胃瘫组为(128.78±37.54)pg/mL、(147.12±67.22)pg/mL、(179.25±48.67)pg/mL、(185.98±57.27)pg/mL],两组总体比较(F分组=39.040,P=0.002)、变化趋势(F时间=17.256,P=0.026)、变化幅度(F交互=11.275,P=0.031)差异均有统计学意义.胃瘫组术前、术后第1、3、7天胃动素分别为(164.90±16.98)pg/mL、(136.45±16.77)pg/mL、(165.70±39.36)pg/mL、(169.62±16.41)pg/mL;无胃瘫组为(225.34±74.58)pg/mL、(277.17±117.45)pg/mL、(348.52±89.71)pg/mL、(338.28±84.27)pg/mL,两组总体比较(F分组=28.457,P=0.003)、变化趋势(F时间=19.248,P=0.021)、变化幅度(F交互=13.623,P=0.027)差异均有统计学意义.结论 围手术期胃泌素、胃动素的分泌不足可能是胰十二指肠切除术后胃瘫综合征发生的诱因.

BackgroundCurrently, many nutritional indicators, including controlling nutritional status score (CONUT), can be used to assess a patient’s nutritional status and have been reported as reliable predictors of multiple malignancies. However, the value of CONUT score in predicting postoperative outcomes in patients with hilar cholangiocarcinoma has not been explored. In this study, its predictive value will be discussed and compared with the known predictors the neutrophil lymphocyte ratio (NLR) and prognostic nutritional index (PNI).MethodsPreoperative CONUT scores, PNI and NLR levels of 94 Hilar cholangiocarcinoma (HCCA) patients who underwent radical-intent resection of hepatobiliary surgery in our hospital from March 2010 to April 2019 were retrospectively collected and analyzed. They were grouped according to their optimal cutoff value and the prognostic effects of patients in each group were compared respectively.ResultsCONUThigh was more frequent in patients with Clavien–Dindo classification of ≥IIIa (P = 0.008) and Bile leakage presence (P = 0.011). Kaplan-Meier curves analyzing the relationship between CONUT, PNI, and NLR values and HCCA patient survival (including total survival (OS) and recurrence-free survival (RFS) showed significant differences between groups (P <0.001). Meanwhile, multi-factor analysis found that Degree of cure, PNI, NLR, and preoperative CONUT score were independent prognostic factors for OS and RFS. The predictive power of CONUT score was higher than that of NLR and PNI based on time-dependent receiver operating Characteristic (ROC) analysis and the net reclassification index (NRI) and integrated discriminatory index (IDI) values (P < 0.05).ConclusionCONUT score may be of some clinical reference value in evaluating postoperative prognosis of HCCA patients.

Background Metastasis of the pancreas to myxoid liposarcoma is very rare. Case presentation We report a 43-year-old woman who underwent radical surgery for myxoid liposarcoma (MLPS) of the sigmoid colon 9 years earlier and for liposarcoma of the neck 7 years earlier. The lesion later metastasized to the pancreas, and we performed pancreaticoduodenectomy, which was pathologically confirmed as myxoid liposarcoma. Unfortunately, the patient died a year later from unexplained gastrointestinal bleeding. Conclusions Myxoid liposarcoma is a very rare malignancy that carries a risk of invasion to the pancreas, and complete surgical resection is the best chance for clinical treatment.

PI3K/Akt/mTOR信号传导通路是哺乳动物细胞内自噬非常重要的信号传导通路之一,它通过影响其下游多种效应分子的活化状态,发挥在细胞内抑制凋亡、促进增殖的作用.最新研究表明PI3K/Akt/mTOR信号传导通路与肝癌自噬发生发展密切相关,且PI3K/Akt/mTOR信号传导通路在肝癌的治疗中同样发挥着重要的作用.因此抑制该信号通路己成为肝癌向治疗的热点.