BACKGROUND Complete portal vein thrombosis (PVT) is a severe form of PVT that carries a high risk of portal hypertension-related complications and poses major therapeutic challenges. Although contrast-enhanced computed tomography (CT) is widely used for diagnosis and treatment planning, current classifications in both international and domestic practice are largely time-based (acute vs chronic). However, clinical onset frequently fails to align with true histopathological maturity, particularly in cases of complete occlusion. Consequently, establishing an objective, imaging-based classification system is essential to accurately characterize thrombus biology and guide tailored intervention strategies. AIM To analyze the radiological signs on contrast-enhanced CT images of the livers of patients with complete PVT, propose a new classification scheme, and establish the clinical significance of the scheme. METHODS We retrospectively analyzed 171 patients who were diagnosed with complete PVT treated at one of three Beijing centers from January 2018 to December 2023. Among patients without contraindications to anticoagulation who underwent interventional or surgical treatment combined with or followed by anticoagulation therapy, thrombus samples were obtained from 102 cases for pathological examination. Treatment outcomes were compared among groups based on the newly proposed imaging feature-based thrombus classifications. RESULTS Acute PVT (26.9%) was characterized by very low-density thrombus shadows in the blood vessel with uniform density, absent or minimal collateral blood vessel formation and no vascular wall thickening. Chronic PVT accounted for 34.5% of the patients, characterized by somewhat low-density thrombus shadows in the blood vessel, potentially with uneven density, increased collateral blood vessel formation, and thickening of the blood vessel wall. Cavernous transformation, which was observed in 12.9% of patients, involved the complete replacement of normal vascular anatomy with collateral vessels, whereas mixed PVT (25.7%) displayed heterogeneous features. Pathological examination revealed that different compositions correlated with distinct thrombus types. The posttreatment portal pressure gradient significantly decreased across all groups (P < 0.001), indicating favorable therapeutic efficacy. CONCLUSION Complete PVT has distinct properties and imaging manifestations. The proposed new thrombosis classification includes four types with distinct properties. Thrombosis with acute or chronic properties can be treated locally or with thrombolysis with good results.

BACKGROUND Wedged hepatic venous pressure (WHVP) is a crucial variable for accurately assessing the hepatic venous pressure gradient (HVPG) and is vital for the diagnosis and prognostic evaluation of patients with portal hypertension (PH). AIM To investigate the anatomical characteristics of balloon-occluded hepatic venous angiography in patients with PH and analyze the relationship between the WHVP and portal venous pressure (PVP). METHODS This retrospective study included 877 patients with PH who met the inclusion criteria from January 2020 to June 2024. Routine and innovative hepatic venous angiography was performed during transjugular intrahepatic portosystemic shunt procedures to measure hepatic venous and PVPs. All patients' angiographic images were collected for analysis. The associations between WHVP and PVP in each group were analyzed via linear regression analysis, and a predictive model was established. RESULTS The 877 patients had a mean age of 52.6 ± 13.0 years, with 582 males and 295 females. Patients were categorized into four groups on the basis of their anatomical structure. All groups showed strong correlations between WHVP and PVP. The regression coefficient between the WHVP and PVP in the hepatic right vein-portal venous angiography group was 0.884 (P < 0.05); in the hepatic right vein-accessory hepatic venous angiography group, it was 0.721 (P < 0.05); in the hepatic right vein-middle hepatic venous angiography group, it was 0.344 (P < 0.05); and in the hepatic right vein-nonangiography group, it was 0.293 (P < 0.05). CONCLUSION The presence and anatomical classification of hepatic venous collaterals are key factors influencing the relationship between WHVP with and PVP. Based on the different anatomical classifications of hepatic veins, WHVP can be used to estimate PVP, improving the accuracy of PVP prediction.

Background: Our study examines the relationship between gastroesophageal reflux disease (GERD) and small intestinal bacterial overgrowth (SIBO), focusing on the potential impact of acid-suppressive drugs. We also explore changes in gut microbiota and metabolism in patients with both conditions. Methods: This study included patients from the Department of Gastroenterology, Beijing Shijitan Hospital, between February 2021 and November 2023. All patients underwent assessments including questionnaires, hydrogen and methane breath tests, and gastroscopy. GERD was diagnosed using the GERD-Q scale and gastroscopy, while SIBO was diagnosed via breath tests. We analyzed the correlation between GERD and SIBO, identified risk factors for SIBO, and examined the gut microbiota using 16S rRNA sequencing to explore the relationship between GERD and SIBO. Results: The retrospective study included 394 patients.148 with GERD and 287 with positive SIBO results. Among these, 270 had a positive methane (CH4) breath test and 97 had a positive hydrogen (H2) breath test. GERD was more common in patients with positive SIBO (P = 0.007), and the link between CH4 breath tests and GERD was stronger than that with H2 breath tests (P = 0.020). Logistic regression showed GERD is an independent risk factor for SIBO. Short-term, low-dose acid-suppressive drugs did not affect SIBO development. 16S rRNA sequencing of fecal microbiota from 24 patients showed dominant microbiota in SIBO-positive GERD patients included bacteroides uniformis and bacteroides stercoris. Patients with both GERD and SIBO had differential metabolites, mainly associated with ATP-Binding Cassette transporters (ABC transporters). Conclusion: GERD is strongly linked to SIBO, especially in patients with a positive CH4 breath test. The gut microbiota in GERD and SIBO patients differs from healthy individuals, with bacteroides uniformis as a key marker. Metabolic changes are mainly related to ABC transporter metabolites.

BACKGROUND:Portal hypertension (PHT), a complication of liver cirrhosis, is sometimes managed with transjugular intrahepatic portosystemic shunt (TIPS) to reduce portal pressure. Although effective, TIPS poses risks, including hepatic encephalopathy (HE). This study investigates whether a significant reduction in the portal pressure gradient (PPG) after TIPS improves outcomes in PHT patients. AIM:To evaluate the impact of post-TIPS PPG reduction on clinical outcomes and explore the relationship between PPG reduction and portal vein diameter. METHODS:This retrospective cohort study included 815 patients with PHT who underwent TIPS at two tertiary hospitals between 2014 and 2022. Patients were categorized based on whether they achieved a 50% reduction in PPG. Propensity score matching was applied to balance baseline characteristics. Kaplan-Meier analysis assessed clinical outcomes, including rebleeding, HE, liver failure, and hepatocellular carcinoma. Cox regression identified risk factors, and Spearman correlation analyzed the relationship between PPG reduction and portal vein diameter. RESULTS:Patients with a PPG reduction > 50% had significantly lower risks of rebleeding (P = 0.004), shunt dysfunction (P = 0.002), and mortality (P = 0.024) compared to those with a PPG reduction ≤ 50%. However, these patients faced higher risks of HE (P < 0.001) and liver failure (P = 0.003). A significant negative correlation was observed between the percentage of PPG reduction and portal vein diameter (ρ = -0.632, P < 0.001), suggesting that patients with smaller portal vein diameters may achieve greater PPG reductions. CONCLUSION:A significant PPG reduction following TIPS is associated with improved clinical outcomes, including reduced risks of rebleeding, shunt dysfunction, hepatocellular carcinoma, and mortality, though it increases HE and liver failure risks. The observed correlation between portal vein diameter and PPG reduction highlights the potential role of portal vein anatomy in predicting TIPS efficacy, warranting further investigation.

BACKGROUND:Portal hypertension (PHT) is a life-threatening complication of cirrhosis, often resulting in gastrointestinal bleeding that requires transjugular intrahepatic portosystemic shunt (TIPS). While TIPS effectively reduces portal pressure, predicting long-term survival remains challenging due to the multifactorial nature of patient outcomes. Accurate survival prediction tools are lacking, and existing models often omit critical factors such as portal vein diameter. This study aimed to develop and validate a nomogram incorporating key clinical and biochemical variables to predict 1-year and 2-year survival following TIPS in PHT patients. We hypothesized that this model would provide improved risk stratification and guide clinical decisions. AIM:To develop and validate a nomogram for predicting 1-year and 2-year survival in PHT patients post-TIPS. METHODS:This retrospective cohort study included 848 TIPS-treated PHT patients with gastrointestinal bleeding from two tertiary hospitals (2013-2021). Mortality was the primary endpoint. Predictive variables were selected using least absolute shrinkage and selection operator regression, and a nomogram was developed with Cox regression to predict 1-year and 2-year survival. Model performance was evaluated through receiver operating characteristic curves, calibration plots, and decision curve analysis. RESULTS:The mean age of the included (848) patients was 53.00 years ± 12.51, where 69.58% were men. Results showed that portal vein diameter, serum creatinine, potassium, and alpha-fetoprotein were the independent predictors of post-TIPS survival. Besides, the model showed strong discriminatory ability (C-index, 0.816 in the training set; 0.827 in the validation set) and good calibration. The area under the curve for 1-year and 2-year survival in the training set were 0.890 [95% confidence interval (CI): 0.802-0.948] and 0.838 (95%CI: 0.803-0.869), respectively. The area under the curve for 1-year and 2-year survival in the validation set were 0.934 (95%CI: 0.815-0.987) and 0.864 (95%CI: 0.811-0.907), respectively. CONCLUSION:The developed nomogram could reliably predict 1-year and 2-year survival in patients undergoing TIPS for PHT-induced gastrointestinal bleeding.

BACKGROUND Transjugular intrahepatic portosystemic shunt (TIPS) placement is a procedure that can effectively treat complications of portal hypertension, such as variceal bleeding and refractory ascites. However, there have been no specific studies on predicting long-term survival after TIPS placement. AIM To establish a model to predict long-term survival in patients with hepatitis cirrhosis after TIPS. METHODS A retrospective analysis was conducted on a cohort of 224 patients who underwent TIPS implantation. Through univariate and multivariate Cox regression analyses, various factors were examined for their ability to predict survival at 6 years after TIPS. Consequently, a composite score was formulated, encompassing the indication, shunt reasonability, portal venous pressure gradient (PPG) after TIPS, percentage decrease in portal venous pressure (PVP), indocyanine green retention rate at 15 min (ICGR15) and total bilirubin (Tbil) level. Furthermore, the performance of the newly developed Cox (NDC) model was evaluated in an internal validation cohort and compared with that of a series of existing models. RESULTS The indication (variceal bleeding or ascites), shunt reasonability (reasonable or unreasonable), ICGR15, postoperative PPG, percentage of PVP decrease and Tbil were found to be independent factors affecting long-term survival after TIPS placement. The NDC model incorporated these parameters and successfully identified patients at high risk, exhibiting a notably elevated mortality rate following the TIPS procedure, as observed in both the training and validation cohorts. Additionally, in terms of predicting the long-term survival rate, the performance of the NDC model was significantly better than that of the other four models [Child-Pugh, model for end-stage liver disease (MELD), MELD-sodium and the Freiburg index of post-TIPS survival]. CONCLUSION The NDC model can accurately predict long-term survival after the TIPS procedure in patients with hepatitis cirrhosis, help identify high-risk patients and guide follow-up management after TIPS implantation.

目的 观察肝静脉交通支对肝硬化门静脉高压(PHT)患者肝静脉压力梯度(HVPG)的影响.方法 回顾性分析接受T IPS治疗的513例肝硬化P H T患者,T IPS术中均测量肝静脉压力并行球囊阻断加压肝静脉造影;根据肝静脉交通支显影情况将患者分为早期交通支显影组(早显组)、中晚期交通支显影组(中晚显组)、门静脉显影组及无交通支组,对比组间HVPG、门静脉压力梯度(PPG)、肝静脉楔压(WHVP)和门静脉压(PVP),分别以Pearson相关分析、组内相关系数(ICC)及Bland-Altman分析评估各组内WHVP与PVP、HVPG与PPG的相关性及其一致性.结果 球囊阻断加压肝静脉造影中,163例肝静脉交通支早期显影,140例中晚期显影,166例门静脉显影,44例无交通支显影;4组间H V PG、PPG、WHVP及PVP总体差异均有统计学意义(P均<0.01),HVPG、WHVP呈逐渐增加,PPG、PVP呈逐渐降低趋势.各组内HVPG与PPG、WHVP与PVP差异均有统计学意义(P均<0.05);HVPG与PPG、WHVP与PVP均呈正相关(P均<0.001),且相关性及一致性在门静脉显影组均优于其他3组、而在早显组均不及其他3组.结论 肝静脉交通支对肝硬化PHT患者HVPG存在一定影响.

Abstract Background The hemodynamics of patients with cirrhosis and portal hypertension are complex and variable. We aimed to investigate differences in venous pressures determined by innovative angiography and conventional angiography using balloon occlusion of the hepatic veins in patients with alcoholic cirrhosis and portal hypertension. Methods A total of 134 patients with alcoholic cirrhosis who fulfilled the inclusion criteria from June 2017 to June 2020 were included. During transjugular intrahepatic portosystemic shunt, conventional and innovative angiography were performed, and venous pressures were measured. A paired t-test and Pearson’s correlation coefficient were used for analysis. Results Conventional and innovative hepatic angiography detected lateral branches of the hepatic vein in 26 (19.4%) and 65 (48.5%) cases, respectively (P < 0.001). Innovative angiography detected a total of 65 patients with lateral shunts, of whom 37 (56.9%) had initial shunts. The average wedged hepatic venous pressure and portal venous pressure of the initial lateral branches were 21.27 ± 6.66 and 35.84 ± 7.86 mmHg, respectively, with correlation and determination coefficients of 0.342 (P < 0.05) and 0.117, respectively. The mean hepatic venous pressure gradient and portal pressure gradient were 9.59 ± 7.64 and 26.86 ± 6.78 mmHg, respectively, with correlation and determination coefficients of 0.292 (P = 0.079) and 0.085, respectively. Conclusions Innovative angiography reveals collateral branches of the hepatic veins more effectively than conventional angiography. Hepatic vein collateral branches are the primary factors leading to underestimation of wedged hepatic venous pressures and hepatic venous pressure gradients, with the initial hepatic vein collateral branches resulting in the most severe underestimations.

Esophageal cancer (EC) is one of the most common digestive system malignancies in the world. The combined modality treatment of EC is usually surgery and radiation therapy, however, its clinical efficacy for advanced patients is relatively limited. Ferroptosis, a new type of iron-dependent programmed cell death, is different from apoptosis, necrosis and autophagy. In recent years, many studies have further enlightened that ferroptosis plays an essential role in the occurrence, development and metastasis of tumors. Targeting ferroptosis stimulates a new direction for further exploration of oncologic treatment regimens. Furthermore, ferroptosis has a critical role in the immune microenvironment of tumors. This paper reviews the mechanism of ferroptosis and the ferroptosis research progress in the treatment of EC. We further elaborate the interaction between ferroptosis and immunotherapy, and the related mechanisms of ferroptosis participation in the immunotherapy of EC, so as to provide new directions and ideas for the treatment of EC.

We aim to develop a nomogram to predict overt hepatic encephalopathy (OHE) after transjugular intrahepatic portosystemic shunt (TIPS) in patients with portal hypertension, according to demographic/clinical indicators such as age, creatinine, blood ammonia, indocyanine green retention rate at 15 min (ICG-R15) and percentage of Portal pressure gradient (PPG) decline. In this retrospective study, 296 patients with portal hypertension who received elective TIPS in Beijing Shijitan Hospital from June 2018 to June 2020 were included. These patients were randomly divided into a training cohort (n = 207) and a validation cohort (n = 89). According to the occurrence of OHE, patients were assigned to OHE group and non-OHE group. Both univariate and multivariate analyses were performed to determine independent variables for predicting OHE after TIPS. Accordingly, receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA) were used to compare the accuracy and superiority of a novel model with conventional Child–Pugh and MELD scoring model. Age (OR 1.036, 95% CI 1.002–1.070, p = 0.037), Creatinine (OR 1.011, 95% CI 1.003–1.019, p = 0.009), Blood ammonia (OR 1.025, 95% CI 1.006–1.044, p = 0.011), ICG-R15 (OR 1.030, 95% CI 1.009–1.052, p = 0.004) and Percentage decline in PPG (OR 1.068, 95% CI 1.029–1.109, p = 0.001) were independent risk factors for OHE after TIPS using multifactorial analysis. A nomogram was constructed using a well-fit calibration curve for each of these five covariates. When compared to Child–Pugh and MELD score, this new nomogram has a better predictive value (C-index = 0.828, 95% CI 0.761–0.896). Consistently, this finding was reproduceable in validation cohort and confirmed with DCA. A unique nomogram was developed to predict OHE after TIPS in patients with PHT, with a high prediction sensitivity and specificity performance than commonly applied scoring systems.

To the Editor : Proximal gastrectomy (PG) is the traditional treatment for early-stage adenocarcinoma of the esophagogastric junction (AEG). The new concept of super minimally invasive surgery (SMIS) by endoscopic submucosal dissection (ESD) and endoscopic submucosal tunnel dissection (ESTD) has the same curative effect as traditional surgery, with the advantage of not anatomi-cally changing the digestive tract. [1] With the higher success rate of this therapy, health-related quality of life (HRQoL) has become an important outcome parameter. We aimed to compare differences in HRQoL after SMIS and PG for early-stage AEG to provide a reference for clinical decision-making. In this single-center retrospective cohort study, SMIS was compared with PG for AEG in terms of post-operative HRQoL. This study was approved by the hospital ethics committee (No. S2017-0). Informed consent was obtained from participants. We reviewed patients who were hospitalized in the Chinese PLA General Hospital with AEG from January 2010 to December 2019 and received SMIS or PG. Patients diagnosed with T1N0M0 AEG were included, while those diagnosed with double primary cancer, chemotherapy or radiation, and previous gastrointestinal surgery were

BACKGROUND:The liver is one of the most important organs in the human body, with functions such as detoxification, digestion, and blood coagulation. In terms of vascular anatomy, the liver is divided into the left and the right liver by the main portal vein, and there are three hepatic efferent veins (right, middle, and left) and two portal branches. Patients with impaired liver function have increased intrahepatic vascular resistance and splanchnic vasodilation, which may lead to an increase in the portal pressure gradient (PPG) and cause portal hypertension (PHT). In order to measure the increased pressure gradient of portal vein, the hepatic venous pressure gradient (HVPG) can be measured to reflect it in clinical practice. The accuracy of PPG measurements is directly related to patient prognosis. AIM:To analyze the correlation between HVPG of three hepatic veins and PPG in patients with PHT. METHODS:From January 2017 to December 2019, 102 patients with PHT who met the inclusion criteria were evaluated during the transjugular intrahepatic portosystemic shunt procedure and analyzed. RESULTS:The mean HVPG of the middle hepatic vein was 17.47 ± 10.25 mmHg, and the mean HVPG of the right and left hepatic veins was 16.34 ± 7.60 and 16.52 ± 8.15 mmHg, respectively. The average PPG was 26.03 ± 9.24 mmHg. The correlation coefficient and coefficient of determination of the right hepatic vein, middle hepatic vein, and left hepatic vein were 0.15 and 0.02 (P = 0.164); 0.25 and 0.05 (P = 0.013); and 0.14 and 0.02 (P = 0.013), respectively. The mean wedged hepatic vein/venous pressure (WHVP) of the middle and left hepatic veins was similar at 29.71 ± 12.48 and 29.1 ± 10.91 mmHg, respectively, and the mean WHVP of the right hepatic vein was slightly lower at 28.01 ± 8.95 mmHg. The mean portal vein pressure was 34.11 ± 8.56 mmHg. The correlation coefficient and coefficient of determination of the right hepatic vein, middle hepatic vein, and left hepatic vein were 0.26 and 0.07 (P = 0.009); 0.38 and 0.15 (P < 0.001); and 0.26 and 0.07 (P = 0.008), respectively. The average free hepatic venous pressure (FHVP) of the right hepatic vein was lowest at 11.67 ± 5.34 mmHg, and the average FHVP of the middle and left hepatic veins was slightly higher at 12.19 ± 4.88 and 11.67 ± 5.34 mmHg, respectively. The average inferior vena cava pressure was 8.27 ± 4.04 mmHg. The correlation coefficient and coefficient of determination of the right hepatic vein, middle hepatic vein, and left hepatic vein were 0.30 and 0.09 (P = 0.002); 0.18 and 0.03 (P = 0.078); and 0.16 and 0.03 (P = 0.111), respectively. CONCLUSION:Measurement of the middle hepatic vein HVPG could better represent PPG. Considering the high success rate of clinical measurement of the right hepatic vein, it can be the second choice.

BACKGROUND The appearance of the intestinal mucosa during endoscopy varies among patients with primary intestinal lymphangiectasia (PIL). AIM To classify the endoscopic features of the intestinal mucosa in PIL under endoscopy, combine the patients' imaging and pathological characteristics of the patients, and explain their causes. METHODS We retrospectively analyzed the endoscopic images of 123 patients with PIL who were treated at the hospital between January 1, 2007 and December 31, 2018. We compared and analyzed all endoscopic images, classified them into four types according to the endoscopic features of the intestinal mucosa, and analyzed the post-lymphographic computed tomography (PLCT) and pathological characteristics of each type. RESULTS According to the endoscopic features of PIL in 123 patients observed during endoscopy, they were classified into four types: nodular-type, granular-type, vesicular-type, and edematous-type. PLCT showed diffuse thickening of the small intestinal wall, and no contrast agent was seen in the small intestinal wall and mesentery in the patients with nodular and granular types. Contrast agent was scattered in the small intestinal wall and mesentery in the patients with vesicular and edematous types. Analysis of the small intestinal mucosal pathology revealed that nodular-type and granular-type lymphangiectasia involved the small intestine mucosa in four layers, whereas ectasia of the vesicular- and edematous-type lymphatic vessels largely involved the lamina propria mucosae, submucosae, and muscular layers. CONCLUSION Endoscopic classification, combined with the patients' clinical manifestations and pathological examination results, is significant and very useful to clinicians when scoping patients with suspected PIL.

PURPOSE:The hepatic venous pressure gradient (HVPG) has been employed as the gold standard for indicating the portal venous pressure gradient (PPG) in the diagnosis of portal hypertension (PHT). However, little has been reported on whether the HVPG can accurately estimate the PPG in patients with hepatic vein collateral shunts. We aimed to explore the correlation between the HVPG and the PPG in hepatitis B cirrhosis patients with different hepatic vein anatomies. METHODS:A total of 461 hepatitis B cirrhosis patients with portal hypertension (PHT) who were treated with a transjugular intrahepatic portosystemic shunt (TIPS) between January 2016 and June 2020 were included. All patients underwent various venous pressure measurements and balloon-occluded compression hepatic venography during the TIPS operation. Agreements were evaluated by Pearson's correlation and the Bland-Altman method. Disagreements were assessed by paired t tests. RESULTS:The correlation coefficient (r) values (P < 0.001) between the HVPG and the PPG of the early (151 patients, 32.8 %), middle (73 patients, 15.8 %), late (46 patients, 10.0 %), portal vein (151 patients, 32.8 %), and no lateral branch development groups (40 patients, 8.7 %) were 0.373, 0.487, 0.569, 0.690, and 0.575, respectively; the determination coefficient (R2) values were 0.139, 0.238, 0.323, 0.475, and 0.330, respectively. According to the Bland-Altman method, agreement was the greatest in the portal vein development group, with the 95 % limits of agreement (95 % LoA, mean differences ± 1.96 SD) being the smallest. The differences were statistically significant (P < 0.05). CONCLUSION:The correlation between the HVPG and the PPG is the worst in early lateral branch development, followed by middle development, and the influence of lateral branches becomes significantly reduced in late development. Hepatic venous collateral formation is a vital factor for underestimation of the HVPG, which is the most accurate predictor of PPG in patients with portal vein development. Patients with no collateral channel development in the hepatic vein have a higher HVPG than PPG, which is an important reason for overestimation of the HVPG.

BACKGROUNDPatients with hepatocellular carcinoma complicated with main portal vein tumor thrombosis (mPVTT) and cirrhotic portal hypertension (CPH) have an extremely poor prognosis, and there is a lack of a clinically effective treatment paradigm.AIMTo evaluate the efficacy and safety of transjugular intrahepatic portosystemic shunt (TIPS) combined with radioactive seed strand for the treatment of mPVTT patients with CPH.METHODSThe clinical data of 83 consecutive patients who underwent TIPS combined with I-125 seed strand placement for mPVTT and CPH from January 2015 to December 2018 were retrospectively reviewed. Procedure-related data (success rate, relief of portal vein pressure and CPH symptoms, and adverse events), PVTT response, and patient survival were assessed through a 2-year follow-up.RESULTSThe success rate was 100.0% without perioperative death or procedure-related severe adverse events. The mean portal vein pressure was significantly decreased after the procedure (22.25 & PLUSMN; 7.33 mmHg vs 35.12 & PLUSMN; 7.94 mmHg, t = 20.61, P < 0.001). The symptoms of CPH were all effectively relieved within 1 mo. The objective response rate of PVTT was 67.5%. During a mean follow-up of 14.5 & PLUSMN; 9.4 mo (range 1-37 mo), the cumulative survival rates at 6, 12 and 24 mo were 83.1%, 49.7%, and 21.8%, respectively. The median survival time was 12.0 & PLUSMN; 1.3 mo (95% confidence interval: 9.5-14.5). In multivariate Cox regression analysis, body mass index, Child-Pugh grade, cTNM stage, and PVTT response were independent prognostic factors (P < 0.05).CONCLUSIONTIPS combined with radioactive seed strand might be effective and safe in treating mPVTT patients with CPH.

Pancreatic cancer is one of the most life-threatening malignancies worldwide. Despite advances in checkpoint immunotherapy for patients with cancer, the current immunotherapies have demonstrated limited benefits for the treatment of pancreatic cancer. Apart from the intricate microenvironments that restrict T-cell function, membrane proteins other than programmed death-ligand 1 may also facilitate immune escape of tumor cells. The present study investigated the membrane proteins of seven paired pancreatic adenocarcinoma (PAAD) and adjacent normal tissues with mass spectrometry, and identified 10 up-and eight downregulated membrane proteins in PAAD. Together with the online database analysis, the results showed that the CASK protein was upregulated in PAAD samples and cell lines, and predicts poor outcomes in patients with PAAD. Furthermore, the results exhibited downregulated CD36 and EPB42 in PAAD samples and cell lines, and higher levels of CD36. EPB42 was shown to predict improved survival outcomes in patients with PAAD. Overall, the results of the present study revealed PAAD-specific membrane proteins as potential diagnostic markers and drug-targets for the immunotherapy of pancreatic cancer.

Cryptococcosis caused by Cryptococcus gattii, is a life threatening fungal infection with recently increasing prevalence. C. gattii is a species complex comprising multiple independent species. However, many biological characteristics and clinical features of cryptococcosis due to C. gattii are relatively less well defined. In this paper, we identify two cases of C. gattii infection, and laboratory findings of genotype VGI and VGII in two groups of apparently immunocompetent Chinese individuals respectively. Upon detailed review of all 35 cases of C. gattii infections, it was observed that C. gattii can cause debilitating illness in both immunocompetent and immunocompromised individuals. Cryptococcosis due to C. gattii is a serious systemic fungal infection, with pulmonary central nervous system tropism. Epidemiologically, C. gattii infection is not only restricted in tropical and subtropical regions, but also in other geographical settings.

Liver diseases affect millions of people worldwide. In most developed countries, the incidence of viral hepatitis is waning as a result of modern advances in disease prevention, diagnosis, and therapies. Expanded programmes for systematic immunisation against hepatitis B virus have also significantly brought down the number of new cases in many countries, including China. In contrast, with the improvement in living standards, the prevalence of metabolic liver diseases including non-alcoholic fatty liver disease and alcohol-related liver disease is set to rise, ultimately leading to more cases of end-stage liver diseases (liver failure, cirrhosis, and liver cancer). Over the past 30 years, visionary governments of major nations have provided strong incentives for basic/clinical research, vaccination programmes, and drug discovery and development in the field of hepatology. To get rid of her unflattering title as the "leader in liver diseases", China has also made a serious effort to initiate nationwide preventive measures for liver diseases, global partnerships, and mentoring programmes for young hepatologists. Instrumental to such progress is the continuous support of the National Natural Science Foundation of China (NSFC), which has helped hepatology to thrive in virtually all research directions within the country. In this article, we seek to provide stimulating glimpses into the evolving liver disease epidemiology, institutional research profiles, funding landscape, and drug development trends in China, with an attempt to compare her status and achievements with those of the United States, European countries, and Japan.

As the No.1 killing cancer in the world, the incidence of lung cancer is still on the rise across the globe these years, such a trend is particularly apparent in China. To study the molecular mechanism of the occurrence of lung cancer and develop new anti-cancer drugs is an arduous task confronting medical researchers of the whole world. Multiple signaling pathways are involved in the lung carcinogenesis. Transforming Growth Factor-β family(TGF-β), known as a multi-functional cytokine superfamily, plays extensively regulatory roles in life activities, including morphogenesis, embryonic development, immunoregulation, healing of wound, as well as inflammation and tumor. Here we review the roles of TGF-β signal transduction pathway in lung cancer. Correspondence to: Dr. Jianxin Wang, The Department of Respiratory Diseases of Chinese PLA General Hospital, 28 Fuxing Road, Beijing, China, Tel: 01066936616; Fax: +86-010-66936616; E-mail: jianxinwang2010@163.com Dr. Lei Pan, Address: 10 Tieyi Rd, Bejing, 100038, China, Tel: 010-63926748; Fax: +86-010-63926748; E-mail: leipan2010@163.com Received: July 28, 2016; Accepted: August 20, 2016; Published: August 24, 2016 Introduction Lung cancer remains the leading cause of death by cancer in the world, marked by the fastest growth of morbidity and mortality and is one of the malignant tumors posing the biggest threat to human health and lives [1,2]. The incidence of lung cancer in China has come close to the level of advanced countries, but the cause of it is unclear yet. Substantial data reveal that the genesis and progression of lung cancer are co-impacted by hereditary and environmental factors, long-term heavy smoking is closely related to the genesis of lung cancer. Based on different morphological characteristics of cancer cell, lung cancer can be mainly divided into two types: non-small cell lung cancer and small cell lung cancer. Non-small cell lung cancer further includes squamous cell carcinoma, lung adenocarcinoma and large cell carcinoma. These two categories of lung cancer differ distinctly in terms of biological characteristics, prognosis and method of treatment. Small cell lung cancer, less common as it is, is one of the most malignant types, accounting for 10-15% of the primary lung cancer, featuring fast spreading of cancer cells, strong invasiveness, and early distant metastasis. It is sensitive to chemotherapy at first, but often ends in poor prognosis and distant metastasis. This kind of lung cancer is, to a great extent, smoking-related. Squamous cell carcinoma (squamous carcinoma) is the most common type of lung cancer, taking up roughly 40-50% of primary lung cancer, often found in aged male, strongly related to smoking. Squamous carcinoma grows at a slow rate and features late metastasis. It has increased chances of surgical resection, and higher five-year survival rate, but is not so sensitive to chemo radiotherapy as small cell undifferentiated carcinoma. Adenocarcinoma of the lung, featuring early onset and relatively larger number of female patients, has little to do with smoking, accounting for 25% of primary lung cancer. Adenocarcinomas features earlier local infiltration and hematogenous metastasis than squamous carcinoma, and its incidence rate is lower than squamous carcinoma and undifferentiated carcinoma. Metastasis occurs later in large cell carcinoma than in small cell undifferentiated carcinoma, hence gains greater chances of surgical resection [3-5]. If lung cancer is detected in the early phase, even it recurs; it is highly possible to be cured. However, at present, a very good lung cancer marker is still absent for being used as early diagnosis and adjuvant therapy indicator. Transforming growth factor-β superfamily, known as a big class of multifunctional cell factors, is widely involved in the adjustment of life activities such as embryonic development, cell proliferation, differentiation, migration, apoptosis, vascularization, wound healing, and immune system regulation, and is also related to inflammation, rheumatic disease, heart disease, diabetes, etc. At present, an increasing number of researches have indicated that TGF-β signaling pathway is relevant to the progression of tumor [6-12]. In this review, we focus on the TGF-β signaling pathway and its roles in lung cancer. The TGF-β superfamily and TGF-β signaling pathway TGF-β belongs to a group of TGF-β family that regulates cell Xue X (2016) The relationship of Transforming Growth Factor-β and lung cancer Volume 1(2): 32-40 Clin Proteom Bioinform, 2016 doi: 10.15761/CPB.1000109 growth and differentiation [10,11]. By now, more than 30 members of the TGF-β family have been found, all featuring dimer structure and cysteine group structure motifs. In addition to TGF-β, this family also includes activins, inhibins, Müllerian inhibitory substance (MIS), and bone morphogenetic proteins (BMPs) [13-16]. The naming of TGF-β is based on that this kind of cell factor can change the phenotype of normal fibroblast, that is, in case epidermal growth factor (EGF) coexists, it changes the wall-adherent growth characteristic of fibroblast and gains the ability to grow in agar, and loses the inhibiting effect of density reliance during growth [17-22]. TGF-β is a multifunctional polypeptide cytokine and makes up a group of protein family that regulates cell growth, migration, apoptosis and differentiation. Being the basis of the balance, development and maintenance of tissues in normal or morbid state, it can effectively inhibit the proliferation of most types of cells, such as epithelial cells, endothelial cells, hematopoietic cells, leukomonocyte, etc [9,23,24]. It is known as a powerful proliferation and tumor suppressor. According to the researches, TGF-β expression in serum and tissues of tumor patients rises notably along with the malignant degree of tumor, indicating a close relationship between TGF-β and malignant transformation of tumor. Therefore, TGF-β plays a dual role in the genesis and progression of tumor. In other words, it is a tumor suppressor in the early stage of tumor, but promotes malignant transformation of tumor in the later stage through autocrine and paracrine. However, the mechanisms of how TGF-β changes from tumor suppressor into tumor promoter and further promotes malignant transformation of tumor is still unknown [25-30].

To evaluate the effectiveness of systematic training in the application of narrow‐band imaging (NBI) International Colorectal Endoscopic (NICE) classification for the prediction of the histology of colorectal polyps.