Primary retroperitoneal liposarcoma (PRPLS) is a rare malignancy with a high risk of recurrence and poor prognosis. To evaluate the prognostic value of the systemic inflammation response index (SIRI) in patients with PRPLS undergoing curative-intent surgical resection and to compare its predictive performance with other inflammatory markers. This retrospective study included 122 patients with pathologically confirmed PRPLS who underwent surgical resection at Peking University International Hospital between January 2021 and January 2024. Patients were stratified into high-SIRI and low-SIRI groups based on an optimal cutoff value determined by receiver operating characteristic (ROC) curve analysis. Clinical characteristics, laboratory parameters, and surgical outcomes were compared between groups. Recurrence-free survival (RFS) and locoregional recurrence-free survival (LRFS) were assessed using Kaplan-Meier survival curves and log-rank tests. Univariate and multivariate Cox proportional hazards regression analyses were performed to identify independent prognostic factors. Post-hoc power analysis was conducted to ensure sample adequacy. SIRI demonstrated the highest prognostic accuracy among evaluated inflammatory markers, with an AUC of 0.831 (P < 0.001), outperforming NLR (AUC = 0.724), PLR (AUC = 0.730), and MLR (AUC = 0.747). Patients with high SIRI (≥ 1.95) had significantly shorter RFS and LRFS compared to those with low SIRI (P < 0.001 and P = 0.008, respectively). High SIRI was associated with larger tumor size, higher Ki-67 index, abnormal liver function markers, elevated CRP, and lower albumin levels. In multivariate Cox regression analysis, SIRI remained the only independent predictor of RFS (HR = 5.19, 95% CI: 2.356, P < 0.001). Preoperative SIRI is an independent and superior prognostic biomarker for recurrence in patients with PRPLS following surgical resection. Compared to conventional inflammatory indices, SIRI shows stronger predictive value for both RFS and LRFS, offering a simple and effective tool for risk stratification in clinical practice.

Retroperitoneal tumors pose significant challenges in colorectal surgery due to their complex anatomical location, aggressive behavior, and heterogeneous nature. Traditional diagnostic and treatment methods often fall short in effectively managing these tumors. This study leverages advanced in-silico methodologies to perform a comprehensive analysis of retroperitoneal tumors associated with colorectal conditions. By integrating computational modeling and cutting-edge bioinformatics tools, we aim to enhance the understanding of tumor biology, improve diagnostic precision, and optimize surgical outcomes. Our integrative approach combines transcriptomic, and proteomic data from publicly available databases such as The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO). Transcriptomic analysis reveals differentially expressed genes (DEGs) that serve as potential biomarkers for early diagnosis and prognosis. Proteomic analysis highlights critical protein interaction networks and pathways involved in tumorigenesis and metastasis. Our integrative approach identifies key DEGs and constructs protein-protein interaction (PPI) networks to pinpoint critical regulatory genes, such as VWF, PF4, ITGA2B, CXCL8, and GP9, that may serve as potential biomarkers or therapeutic targets. Functional enrichment analysis reveals significant pathways involved in tumorigenesis, including cell proliferation, immune response, and DNA repair. Additionally, immune cell infiltration analysis using the CIBERSORT algorithm demonstrates an immunosuppressive tumor microenvironment characterized by increased regulatory T cells (Tregs) and M2 macrophages, which could contribute to tumor immune evasion.Future studies should focus on clinical validation of these findings and the expansion of computational models to include diverse patient populations. Through these efforts, we aim to revolutionize the management of retroperitoneal tumors in colorectal surgery, ultimately improving patient care and survival rates.

Background： Retroperitoneal schwannomas are rare. The purpose of this study was to present our experience with the diagnosis and treatment of 67 such tumors. Methods： Retrospective analysis of 67 patients with retroperitoneal schwannoma admitted to Peking University International Hospital from 2015 to 2021. Results： 67 patients presented with retroperitoneal schwannomas, 37 cases had no obvious clinical symptoms. 62 cases were completely excised, 5 cases were subtotal resection, 7 cases were combined with organ resection. The intraoperative blood loss was 300ml (20-9000ml), the tumor maximum size was 9cm (2.5-26cm), post-complication occurred in 6 cases (9.0%). Compared with abdominal retroperitoneal tumors, pelvic retroperitoneal tumors had larger tumor volume, more bleeding, higher proportion of block resection, and longer postoperative hospitalization time (P<0.05). The residual mass progressed slowly in 5 patients with subtotal resection, and no obvious malignant transformation occurred. Conclusion：Complete resection of schwannoma can achieve a good long-term prognosis. Patients with residual tumor after surgery progress slowly and rarely become malignant. We recommend early resection after the discovery of a pelvic retroperitoneal schwannoma. Keywords： Schwannoma; Retroperitoneal neoplasms; Postoperative complications

Objective:To explore the clinical diagnosis and treatment methods and curative effect of retroperitoneal ganglioneuromaMethods:The clinical data of 32 cases of retroperitoneal ganglioneuroma admitted to Peking University International Hospital from Apr 2015 to May 2022 were retrospectively analyzed, and their clinical characteristics, surgical efficacy and prognosis were discussed.Results:Of the 32 patients with retroperitoneal ganglioneuroma, 17 had no obvious clinical symptoms, 7 complained abdominal distension and pain, 6 had lower back pain, and 2 had abdominal mass. Tumors were located near the adrenal and renal regions in 18 cases, on both sides of the spine below the kidneys in 11 cases, and in the pelvis in 3 cases. tumors were single in 28 cases, multiple in 4 cases.Tumors were surrounded by major blood vessels in 12 cases. R 0 or R 1 resection was carried out in 27 cases, and palliative R 2 resection in 5 cases, combined organ resection in 6 cases, and piecemed resection in 8 cases. The maximum tumor diameter was (13.2±4.9)cm, the intraoperative blood loss was 500 (50-6 000 ml), and 6 cases suffered from major postoperative complications. Between patients with tumors encircling and encroaching major blood vessels or not, there were significant differences in age, intraoperative blood loss, R 2 resection rate, and pieceneal resection rate between the two groups ( t=2.44, P=0.021; Z=2.37, P=0.018; χ2=4.57, P=0.033; χ2=11.38, P=0.001). There was no recurrence in patients with R 0 or R 1 resection. Conclusions:The prognosis of complete resection of retroperitoneal ganglioneuroma is good .Major blood vessels encroachment of the tumor often leads to incomplente (R 2) resection.

ObjectiveTo identify the risk factors for functional delayed gastric emptying (FDGE) after retroperitoneal tumor resection. MethodsSixty-seven patients with postoperative FDGE after retroperitoneal tumor resection from September 2017 to December 2022 admited in Peking University International Hospital were included in the observation group, and 836 normal patients who underwent retroperitoneal tumor resection during the same period were included in the control group. Medical histories and clinical treatment data were obtained for each group and compared to identify the risk factors for FDGE after retroperitoneal tumor resection. ResultsThe overall incidence of postoperative FDGE was 7.42%. Factors that were significantly elevated (P<0.05) in the observation group relative to the control group included adverse mental factors (37.31%), preoperative digestive tract obstruction (41.79%), postoperative abdominal cavity complications (79.10%), diabetes (29.86%), average age of (61.85±6.11) years, and blood loss (1011.94±507.30) mL. Pre-and post-surgery albumin levels [(38.22±3.75) g/L and (30.22±3.36) g/L, respectively] were significantly reduced (P<0.05) in the observation group compared to the control group. Risk factor analyses revealed that advanced age, diabetes, preoperative digestive tract obstruction, intraoperative blood loss, perioperative albumin level, postoperative abdominal cavity complications, and adverse mental factors were correlated with postoperative FDGE. ConclusionsDiverse factors could impact the risk of FDGE after retroperitoneal tumor resection. Patients should be accurately evaluated; reasonable and detailed prevention and treatment plans should be developed.

Background Complete resection (CR) serves as the standard of surgical treatment for retroperitoneal liposarcoma (RPLS). Unfortunately, even at referral centers, recurrence rates are high, and CR may not address multifocal diseases, which are a common phenomenon in RPLS. We sought to retrospectively compare the clinical outcomes of RPLS patients treated with total (ipsilateral) retroperitoneal lipectomy (TRL) and CR. Because TRL remove potentially multifocal tumors in the fat, patients may have a better prognosis than CR. Methods Patients with primary/first-recurrent RPLS who had been treated at 5 referral centers were recruited from December 2014 to June 2018. Multivariable Cox regression analyses were conducted to determine the effects of demographic, operative, and clinicopathological variables on the following primary endpoints: local recurrence (LR), local recurrence-free survival (LRFS), and overall survival (OS). Results A total of 134 patients were enrolled in this retrospective study, 53 of whom underwent TRL, and 81 of whom underwent CR. The 2 groups were comparable in terms of age, gender, presentation (primary vs. first-recurrent RPLS), number of tumors (unifocal vs. multifocal) at presentation, and Fédération Nationale des Centres de Lutte Contre le Cancer (FNCLCC) grade. The TRL group had higher levels of preoperative hemoglobin (Hb) (13 vs. 12.5 g/dL; P=0.008) and a lower amount of intraoperative blood loss (400 vs. 500 mL; P=0.034), but there were no significant differences in the length of hospital stay (23 vs. 22 d; P=0.47) or complications (32 vs. 30; P=0.82) between the 2 groups. In a subset of patients with multifocal tumors at initial presentation, OS was more prolonged in those treated with TRL than those treated with CR (P=0.0272). Based on the multivariable analysis, primary liposarcoma and a low FNCLCC grade were associated with decreased LR and improved OS. Conclusions TRL is a safe procedure that positively affects the OS of patients with multifocal RPLS. This novel strategy deserves further investigation in prospective studies.

目的 探讨单侧肿瘤和腹膜后脂肪切除+腹腔热灌注化疗(HIPEC)治疗腹膜后脂肪肉瘤(RPLS)的效果.方法 搜集2015年1月—2018年12月133例RPLS患者的病例资料进行回顾性研究.根据手术方法的不同将其分为3组,A组:单纯肿瘤切除术;B组:A组基础上+腹膜后脂肪切除(单侧);C组:B组基础上+HIPEC治疗.采用Kaplan-Meier法绘制生存曲线,分析平均总生存期(OS);采用Log-rank检验进行单因素分析,观察每组患者的术中出血量和肿瘤大小的关系,记录患者基本情况及术后随访情况.结果 3组平均OS分别是:A组(25.31个月,95％CI:21.32～29.30个月);B组(31.35个月,95％CI:28.23～34.48个月);C组(36.92个月,95％CI:36.10～37.74个月).相对于A组、B组,C组的总生存率最有优势(P值均<0.05).采用COX比例风险回归模型对P<0.10的变量进行多因素分析显示,A组患者死亡风险显著高于C组(HR=15.622>1,P=0.000<0.05);B组患者死亡风险显著高于C组(HR=4.198>1,P=0.015<0.05),故治疗方法是影响OS的独立因素.3组患者术中出血量与肿瘤最大直径呈线性关系,但3组间的出血量比较差异无统计学意义(P值均>0.05).结论 采用单侧肿瘤切除+腹膜后脂肪切除+HIPEC治疗能够提高初次或再次手术的RPLS患者的OS,且不增加出血量.

目的 探讨复发性腹膜后脂肪肉瘤(RPLS)患者多次复发的危险因素.方法 搜集2018年1月—2021年12月123例经术后病理确诊为RPLS,复发≥1次且接受手术的患者的病例资料进行回顾性研究.按照结局事件是否再次复发,将患者分为再次复发组(Rrec组)44例和未再次复发组(NRrec组)79例;调查两组的年龄、性别、手术次数、肿瘤最大径、手术时间、出血量、输注红细胞量、输注血浆量、肉眼完整切除(R1)、R1+全腹膜后脂肪清扫(R1+TRFD)、姑息性术中残留切除(R2)+多柔比星脂质体+异环磷酰胺(AI方案)补救性化疗治疗(R2+AI)、病理类型(高分化、去分化、黏液性、多形性)与可能多次复发相关因素进行单因素分析,对具有显著差异的变量纳入多因素Logistic回归,分析复发的独立危险因素.结果 在P<0.10显著性水平下,R1共101例、R2+AI共22例、手术时间(290.0±128.7)min,在RPLS是否复发上差异具有统计学意义;性别、R1+TRFD共23例、病理类型、年龄、手术次数、肿瘤最大径、出血量、输注红细胞、输注血浆在是否复发上差异无统计学意义.R1(OR=6.856,P=0.006)及手术时间(OR=1.005,P=0.010)均为RPLS多次复发的独立危险因素.结论 R1切除及手术时间是RPLS术后多次复发的独立危险因素.

Background: Surgery is the main treatment for recurrent retroperitoneal liposarcoma (RPLS). The aim of the present study was to explore the factors associated with blood loss during surgery for recurrent RPLS. Methods: This retrospective study included patients with first recurrence of RPLS who were treated at our hospital between January 2015 and December 2019. Factors associated with intraoperative blood loss were identified by univariate and multivariate logistic regression analyses. Receiver-operating characteristic (ROC) curve analyses were conducted to evaluate whether tumor size and number of tumor-containing abdominal/pelvic zones were predictive of the need for blood transfusion. Results: The study included 67 cases. The number of zones containing tumors was 1 in 4 cases (6%), 2 in 36 cases (53.7%), 3 in 14 cases (20.9%), and 4 in 13 cases (19.4%). Tumor size was associated with blood loss >500 mL [odds ratio (OR): 1.153, 95% confidence interval (CI): 1.051-1.266, P=0.003]. The number of tumor-containing zones was associated with blood loss >1,000 mL (OR: 3.161, 95% CI: 1.248-8.003, P=0.015) and >1,500 mL (OR: 2.674, 95% CI: 1.061-6.739, P=0.037). Multiple tumors were associated with blood loss >2,000 mL (OR: 3.161, 95% CI: 1.092-13.133, P=0.036) and >2,500 mL (OR: 2.674, 95% CI: 1.243-16.299, P=0.022). Tumor dedifferentiation was associated with blood loss >1,000 mL (OR: 4.802, 95% CI: 1.287-17.916, P=0.019) and >1,500 mL (OR: 9.249, 95% CI: 1.927-44.39, P=0.005). ROC curve analysis showed that tumor size >15.25 cm [area under the ROC curve (AUC): 0.772, P<0.001] and the number of tumor-containing zones >2.5 (AUC: 0.670; P=0.023) were predictive of the need for blood transfusion. Conclusions: The main finding of the present study was that a larger tumor size, a larger number of tumor-containing zones, multiple tumors, and dedifferentiation were independently associated with a larger volume of intraoperative blood loss in patients with recurrent RPLS. The tumor size >15.25 cm and the tumor area >2.5 areas predicted the need for blood transfusion. Formulating the intraoperative blood transfusion plan for recurrent RPLS, it is necessary to pay attention to two spatial factors, tumor size and affected area, rather than one of them.

目的 刺槐素(acacetin,Aca)是从豆科植物刺槐的花中提取的一种黄酮类化合物,具有抗感染、抗菌和抗肿瘤等药理作用,但是否具有抗骨肉瘤活性尚不明确.本研究旨在探讨Aca对人骨肉瘤MG-63细胞增殖和凋亡的影响及其可能的分子机制.方法 体外常规培养MG-63细胞,用0、15、30、60、120和240μmol/L Aca处理MG-63细胞24或48 h后,CCK-8法检测细胞活力,集落形成实验检测细胞增殖,AnnexinⅤ-PI染色检测细胞凋亡,PI染色检测细胞周期,蛋白质印迹法分析Survivin、Cdc25C、c-Met、p-c-Met、Akt和p-Akt蛋白的表达.结果 Aca可抑制MG-63细胞活力,24和48 h的IC50分别为77.94和57.36μmol/L,且具有剂量和时间依赖性.MG-63细胞经0、30、60和120μmol/L Aca作用24 h后,平板克隆形成实验结果显示,克隆形成率分别为(62.73±4.59)％、(50.42±3.83)％、(37.65±3.14)％和(25.18±2.67)％,差异有统计学意义,F=59.64,P<0.001;AnnexinⅤ-PI染色结果显示,细胞凋亡率分别为(2.41±0.68)％、(9.72±1.43)％、(20.36±1.92)％和(31.85±2.27)％,差异有统计学意义,F=174.89,P<0.001;PI染色结果显示,G2/M期细胞构成比分别为(10.73±1.81)％、(20.36±2.05)％、(31.58±1.72)％和(42.11±2.16)％,差异有统计学意义,F=138.42,P<0.001;蛋白质印迹法结果显示,Survivin和Cdc25C蛋白表达水平以及c-Met和Akt蛋白磷酸化水平随药物剂量增加而降低,两两比较差异均有统计学意义,F值分别为110.49、70.85、93.72和96.14,均P<0.001.结论 Aca可诱导MG-63细胞发生G2/M期阻滞和凋亡,这可能与其下调Survivin和Cdc25C蛋白表达,以及抑制c-Met/Akt信号通路有关.

尽管当今社会各方面都呈现出快速发展的局势,医学也不例外,当然也包括剖宫产,然而剖宫产并不是万无一失、绝对安全的.剖宫产应当在严格的管理以及完备的手术准备的基础上进行.通过科学的麻醉方式来提高产妇和胎儿的生存质量.此外,剖宫产手术之后,产妇会受到宫缩痛、切口痛、尿管刺激等因素的影响而导致交感神经异常兴奋,继而影响正常的泌乳和育儿健康.本文对临床妇产科2018年1月2018年11月收治的58例剖宫产产妇病例展开了回顾性的分析和研究.对剖宫产术麻醉与术后镇痛的临床分析,旨在对相关情况的产妇床治疗提供借鉴.