To evaluate the features of carotid web (CW) by ultrasonography.

A total of 66 patients with CW were retrospectively enrolled from January 2018 to June 2019 at Xuanwu Hospital, Capital Medical University. All patients were examined by both ultrasonography and CTA, and were divided into either a<50% stenosis group (54 cases) or a ≥50% stenosis group (12 cases). The ultrasonographic characteristics of CW, including the length, thickness, direction (forward or backward to the flow), acute angle between the web and carotid wall, and thrombus between the web and carotid wall were compared between the two groups. The stenosis degrees of carotid artery were compared between patients with and without ischemic stroke.

Forty-two (42/66, 63.6%) patients were diagnosed with CW by initial CDFI examination, of whom 21 (21/66, 31.8%) were diagnosed with ulcerative plaque and 3 (3/66, 4.5%) were diagnosed with carotid dissection at first but confirmed by second examination. There were no differences in the web length, thickness, direction, or thrombus detected between the two groups (P>0.05). The angle between the web and carotid wall in the<50% stenosis group was significantly smaller than that of the ≥50% stenosis group (median angel 39o vs 73o, P=0.002), and the percentage of patients with an angle≤ 60o in the<50% stenosis group was significantly higher than that of the ≥50% stenosis group (74.1% vs 41.7%, P=0.042). The diameter of the residual carotid artery at CW location in the<50% stenosis group was significantly larger and peak systolic velocity was significantly higher in the<50% stenosis group than in the≥50% stenosis group (P<0.001). The stenosis degrees of carotid artery were not statistically different between patients with and without ischemic stroke (P=0.321).

Ultrasonography can be used to evaluate the characteristics of carotid web in 2D and color mode. When the angle between the CW and carotid wall is large, the carotid artery stenosis ≥ 50% is more likely to happen, but carotid artery stenosis is not the main cause of ischemic stroke.

The aim of the present study was to evaluate the efficiency of sling exercise, therapeuticultrasound, therapeuticultrasound and sling exercise in patients to alleviate pain and improve lumbar function with lumbar disc herniation.

Individuals were selected from a list of patients being followed at the department of Rehabilitation in the third hospital of Hebei Medical University. 30 patients who were diagnosed with lumbar disc herniation were collected, the diagnoses were established upon medical history, physical examination, and results of imaging studies. The patients were randomly divided into three groups: therapeuticultrasound group received 14 sessions of ultrasonic therapy to the lumbar region, Sling exercise group received 14 sessions of sling exercise, and therapeuticultrasound and sling exercise group received therapeuticultrasound and sling exercise therapy 14 sessions of therapeuticultrasound to the lumbar region,7 sessions per week, 2 weeks. The VAS and ODI were compared with the assessment of the patients before and at the end of the therapy.

At the end of treatment, three groups VAS scores (F=3.069, P=0.043) and ODI scores (t=12.676, P<0.001) was lower than that at the beginning of treatment (P<0.05), at the end of treatment the VAS scores (F=59.400, P<0.001) and of the ODI scores (t=12.737, P<0.001) of ultrasonic and sling exercise therapy group was lower than the other group, the difference is significantly.

All three groups could reduce pain and improve lumbar function, and the ultrasonic and sling exercise therapy was most effective for lumbar disc herniation treatment in the three groups.

To analyze the treatment of different types of traumatic cerebral infarction in children, and explore its pathogenesis in combination with literature so as to improve the cure rate and reduce disability rate.

The clinical data of 42 cases of traumatic cerebral infarction in children were retrospectively analyzed in The Hospital of 81^st Group Army PLA from January 2015 to December 2019. The diagnosis of traumatic cerebral infarction in children was made by CT scan and MRI scan. According to different conditions, children with traumatic cerebral infarction were classified, and different treatment strategies were selected. Children with lacunar infarction were treated with calcium antagonists and neurotrophic drugs, supplemented by hyperbaric oxygen and exercise rehabilitation. The children of focal cerebral infarction and complex cerebral infarction treated by junior dehydrant and hormone also included the calcium antagonist and nutritional nerve drugs. The therapeutic regimen perhaps adjusted by the evolution of the disease. The children of extensive cerebral infarction underwent emergency cranial decompression, and was treated by reducing intracranial pressure and preventing complications after operation. The treatment results and recovery were observed.

In 42 cases of traumatic cerebral infarction in children, 35 cases (83.3%) were good recovery, 4 cases (9.5%) were moderate disability, 2 cases (4.8%) were severe disability, 1 case (2.4%) died, and no vegetative state. The good recovery rate of lacunar infarction was 100%, that of focal cerebral infarction was 62.5%, that of mixed cerebral infarction was 60%, and that of extensive cerebral infarction was 50%.

It is of great significance to improve the therapeutic effect and prognosis of children with traumatic cerebral infarction to adopt different treatment schemes for different types of cerebral infarction.

To characterize the patients with supratentorial hypertensive intracerebral hemorrhage (ICH) in the Tibetan Plateau over an altitude of 4000 meters.

A total of 68 cases with supratentorial hypertensive ICH were retrospectively included in Ali Regional People’s Hospital from January 2017 to September 2018. The clinical and laboratory data were collected. A simple linear correlation analysis was applied to analyze the correlation between the amount of bleeding and sex, age, nationality, time from onset , systolic blood pressure (SBP), diastolic blood pressure (DBP), hemoglobin (Hb), serum triglyceride (TG), and cholesterol. According to computed tomography (CT) findings, 68 cases were divided into the basal ganglia ICH group (33 cases) and the lobar ICH group (35 cases). The characteristics between two groups were analyzed using t-test or χ² test.

The data of sex, age, nationality, time from onset, SBP, DBP, Hb, TG, and cholesterol of 68 cases on admission did not show any definitive correlation with the hematoma volumes (P＞0.05). The SBP and DBP of patients in the basal ganglia ICH group were significantly higher than that in the lobar ICH group, respectively [(184.9±28.5) mmHg vs (164.6±24.4) mmHg; (113.0±18.1) mmHg vs (103.0±18.4) mmHg] (t=0.499, 0.486; P=0.002, 0.033).

The relevant factors of hematoma volumes in patients with ICH in plateau area were not yet clear. Diastolic and systolic blood pressure of patients in the basal ganglia ICH group was higher than that in those in lobar ICH group.

To compare the efficacy evaluation of electrospun composite biomaterials and a porcine small intestine submucosa mesh for hernia repair.

A randomized, single-blind, controlled multicenter trial was performed in 3 hospitals in Shanghai. Eligible adult patients with primary unilateral reducible groin hernias were randomly assigned (1∶1) to electrospun composite biomaterials (experimental group) or porcine small intestine submucosa (control group) mesh groups. Patients were treated with the tARB technique and assessed at 1,3 and 6 months after the surgery. The primary endpoint was hernia recurrence. The secondary endpoints were postoperative complications including groin pain and operative site infections.

172 patients were assigned to experimental (n=86) and control (n=86) groups. At 6 months follow-up, postoperative complications occurred in 5 patients (5/86, 5.95%) and 2 (2/86, 2.35%) patients in the control and experimental groups, respectively (P>0.05). There was no significant difference in VAS or SVS score between the two groups.

We demonstrate that electrospun composite biomaterial mesh can be used as a ideal choice for inguinal hernia repair. Electrospun composite biomaterial has the characteristics of low recurrence rate, absorbability and long-term comfort.It can be further applied in clinical practice in the future.

Pancreaticoduodenectomy(PD)remains one of the most complicated hepatobiliary operations. The development of minimally invasive surgery for PD has always been an hot spot. Laparoscopic pancreaticoduodenectomy(LPD) has not been widespread carried out due to its difficulty and long learning curve. LPD accounts for 9% of all PD, according to the National Cancer Data base. Compared with laparoscopic surgery, robotic surgery system has significant advantages in the field of minimally invasive PD, including stereotactic amplified vision, filtering hand tremor and simulating the wrist. The article would review the surgical techniques and notes, which could provide clinical reference for other surgeons.

To investigate the expression of cellular Mesenchymal-Epithelial Transition Factor (cMET) in colorectal cancer, its relationship with clinicopathological features and molecular characteristics, and its prognostic value, in order to inform clinical decision-making.

In this retrospective study, 314 colorectal cancer patients who underwent surgery at the National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College between April 2017 and December 2023 were included. cMET expression was assessed by immunohistochemistry, and genetic alterations in MET and other common genes (BRAF, KRAS, NRAS, TP53, PIK3CA) were analyzed via next-generation sequencing. Clinical data were collected from electronic medical records, and recurrence and survival outcomes were evaluated using SPSS.

Among the 314 patients, 248 had low cMET expression and 66 had high expression. Most patients(78.34%, 246/314) had stage Ⅲ~Ⅳ disease. The median disease-free survival was 11 months, with 292 cases (92.99%) experiencing recurrence or metastasis. cMET expression was associated only with tumor differentiation, and genetic alterations varied by tumor location. Only one case showed low-level MET amplification. Kaplan-Meier analysis indicated shorter disease-free survival in stage Ⅳ patients with high cMET expression (χ²=6.224, P=0.013). Univariate and multivariate Cox regression analyses confirmed that cMET expression (HR=2.542, P=0.015) and N stage (HR=2.668, P=0.019) were independent risk factors for worse disease-free survival in stage Ⅳ colorectal cancer.

cMET expression can serve as a useful prognostic indicator in stage Ⅳ colorectal cancer, with high cMET expression associated with shorter disease-free survival.

To evaluate the prognostic performance of two lymph node-based staging systems, tumor-ratio-metastasis (TRM) and tumor-log odds-metastasis (TSM), developed from the lymph node ratio (LNR) and log odds of positive lymph nodes (LODDS), and to compare them with the American Joint Committee on Cancer (AJCC) TNM staging system in colorectal cancer.

The training cohort consisted of postoperative colorectal cancer patients with pathologically confirmed lymph node metastasis registered in the Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2015 (n=13 469). The external validation cohort was a two-center cohort composed of patients treated at Chuzhou First People's Hospital and Shanghai General Hospital between 2018 and 2022 (n=402). X-tile software was used to determine the optimal cut-off values for LNR and LODDS (0.20/0.57 and −0.58/0.17, respectively), on the basis of which the TRM and TSM staging systems were constructed. Prognostic performance was assessed using multivariable Cox regression, Harrell's concordance index, time-dependent receiver operating characteristic curves and the corresponding area under the receiver operating characteristic curve at 36 and 60 months, calibration plots, and decision curve analysis. Model fit and comparative performance were further evaluated using the Akaike information criterion, Bayesian information criterion, and likelihood ratio test.

In the training cohort, both TRM and TSM were independent prognostic factors for overall survival (both P＜0.05). The 3-and 5-year area under the receiver operating characteristic curve values were 0.829 and 0.828 for TRM, 0.827 and 0.823 for TSM, and 0.823 and 0.822 for TNM, respectively. Harrell's C-index was also slightly higher for TRM (0.757) and TSM (0.755) than for TNM (0.751). The Akaike information criterion, Bayesian information criterion, and likelihood ratio test consistently favored TRM. In the external validation cohort, the 3-year area under the receiver operating characteristic curve values were 0.757 for TNM, 0.827 for TRM, and 0.829 for TSM, while the corresponding 5-year values were 0.650, 0.710, and 0.709. TRM showed the highest C-index overall and outperformed TNM and TSM in overall predictive performance. Calibration plots showed acceptable agreement between predicted and observed survival. Decision curve analysis indicated greater net clinical benefit for TRM and TSM than for TNM across most clinically relevant threshold probabilities, with TRM showing the most consistent overall performance.

The TRM and TSM systems, derived from LNR and LODDS, provided better prognostic discrimination and potential clinical utility than the conventional AJCC TNM staging system in colorectal cancer. External validation in a two-center cohort further supported their robustness, and TRM showed the most favorable overall performance. Further large-scale prospective multicenter studies are needed to confirm their generalizability and support clinical implementation.

This study utilized bioinformatics methods to screen out genes related to lysosomes in colorectal cancer and constructed a prognostic model.

The colorectal cancer data sets were downloaded from TCGA and GEO databases, respectively. The R package was used to screen out the differentially expressed LRGs related to CRC survival, and univariate Cox regression and LASSO regression were used to screen the related prognostic genes to construct a prognostic risk model. Univariate Cox regression analysis was used to construct a clinical prognostic model, and independent prognostic and survival analysis was performed. The performance of the model was verified by K-M survival curve and ROC curve analysis. Finally, the relationship between ATP6V1G2, DLG4, LZTS1 gene and protein expression and pathological features and prognosis of colorectal cancer was further verified by in vitro experiments.

Seven related prognostic genes were screened out, including ATP6V1G2, LZTS1, CLU, PDGFRA, CLVS2, DLG4 and RAMP1, and a prognostic model of colorectal cancer was constructed based on these genes. K-M survival curve showed that the prognosis of low-risk group was significantly better than that of high-risk group (χ²=15.14, P=0.0001), which was verified in GEO database. The ROC curve showed that the AUC values of 5-year and overall survival time were greater than 0.65 (0.67, 0.66), indicating that the model had certain predictive ability. GO enrichment analysis showed that LRGs were mainly involved in autophagy, endocytosis, macroautophagy, cell degradation and other processes, thereby affecting the occurrence, development and transformation of colorectal cancer. KEGG enrichment analysis showed that Rap1 signaling pathway, endocytosis and salivary secretion were mainly enriched. The results of in vitro experiments showed that ATP6V1G2 and DLG4 were highly expressed (ATP6V1G2: t=−6.847, P＜0.05; DLG4: t=−6.324, P＜0.05) and LZTS1 was lowly expressed (t=5.568, P＜0.05) in colorectal cancer. The high expression of ATP6V1G2 and DLG4 and low expression of LZTS1 were significantly correlated with the depth of tumor invasion (ATP6V1G2: χ²=5.333, P=0.021; DLG4: χ²=6.522, P=0.011; LZTS1: χ²=6.095, P=0.014), lymph node metastasis (ATP6V1G2: χ²=7.065, P=0.008; DLG4: χ²=5.265, P=0.022; LZTS1: χ²=5.224, P=0.022) and patient age (ATP6V1G2: χ²=4.844, P=0.028; DLG4: χ²=6.332, P=0.012; LZTS1: χ²=4.969, P=0.026). The higher the expression levels of ATP6V1G2 and DLG4, and the lower the expression level of LZTS1, the worse the prognosis of the patients will be. ROC curve showed that ATP6V1G2, DLG4 and LZTS1 alone and in combination had predictive value for the diagnosis and prognosis of colorectal cancer (ATP6V1G2: AUC=0.886, P＜0.001; DLG4: AUC=0.781, P=0.003; LZTS1: AUC: 0.667, P=0.029; Combination of the three: AUC=0.894, P＜0.001).

This study successfully constructed a prognostic model of colorectal cancer based on 7 lysosome-related genes, which can better predict the prognosis of patients. The high expression of ATP6V1G2 and DLG4 and low expression of LZTS1 can be used as potential molecular markers for poor prognosis of colorectal cancer.

To compare the efficacy of sequential neoadjuvant therapy following self-expanding metal stent (SEMS) placement versus laparoscopic surgery alone in obstructive colorectal cancer (OCRC).

A retrospective cohort study with propensity score matching (PSM) was conducted. Clinical data of 157 patients with OCRC who underwent SEMS placement at Tangdu Hospital, Air Force Medical University from February 2018 to October 2024 were collected. Patients were divided into a bridging laparoscopic surgery group (bridging group) and a sequential neoadjuvant therapy plus laparoscopic surgery group (sequential group) according to subsequent treatment strategies. After 1:2 PSM, a total of 60 patients were included, with 20 in the bridging group and 40 in the sequential group. Perioperative outcomes, tumor pathological characteristics, and survival outcomes were compared between the two groups.

The interval from stent placement to surgery was significantly longer in the sequential group (t=8.22, P＜0.05), but the postoperative hospital stay was significantly shorter (t=3.15, P＜0.05). Regarding safety and feasibility, the proportion of patients with moderate surgical risk (ASA class III) was slightly lower in the sequential group (7.5% vs. 20.0%, Z=−1.81, P＞0.05), and the rate of primary stoma creation was also lower (7.5% vs. 20.0%, χ²=0.99, P＞0.05). The two groups were comparable in terms of operative time, R0 resection rate, intraoperative blood transfusion rate, quality of surgical specimens (CME or TSME), time to first postoperative flatus, and overall incidence of postoperative complications. In terms of oncological outcomes, there was a statistically significant difference in postoperative pathological TNM staging between the two groups (Z=−2.10, P＜0.05), with a pathological complete response rate of 12.5% in the sequential group. The tumor diameter was slightly smaller in the sequential group (Z=−1.17, P＞0.05). The sequential group had a higher number of harvested lymph nodes and fewer positive lymph nodes, as well as a lower positive lymph node ratio compared to the bridging group, although these differences were not statistically significant (all P＞0.05). The disease-free survival rate was significantly better in the sequential group (χ²=4.13, P＜0.05). Although the difference in overall survival rate was not statistically significant (χ²=1.31, P＞0.05), a superior trend was observed in the sequential group.

Sequential neoadjuvant therapy following SEMS placement and laparoscopic surgery is safe and feasible for OCRC patients, facilitating postoperative recovery and improving disease-free survival.

To explore the clinical characteristics of patients with non-hereditary colorectal polyp disease and investigate the risk factors associated with polyp recurrence.

A total of 442 patients with non-hereditary colorectal polyp disease who underwent endoscopic resection from January 2021 to December 2023 were selected. Clinical data and colonoscopy monitoring results within one year post-resection were collected to analyze the influencing factors of polyp recurrence.

The mean age of patients at initial colonoscopy was (56.63±10.71) years, with 241 males (54.52%) and a BMI of (23.25±3.35) kg/m². During the 1-year follow-up, a total of 90 patients (20.36%) experienced recurrence. Compared with the non-recurrence group, the recurrence group had older age (t=2.290, P=0.023), higher BMI (t=2.550, P=0.011), higher triglyceride (TG) levels (t=2.558, P=0.011), a higher proportion of males (χ²=10.915, P=0.001), a higher proportion of smokers (χ²=9.919, P=0.002), a higher proportion of dyslipidemia (χ²=11.256, P=0.001), lower high-density lipoprotein(HDL) levels (t=2.285, P=0.023), and a higher TG/HDL (t=6.473, P＜0.001). There were significant differences between the recurrence and non-recurrence groups in the stratification of maximum polyp diameter, polyp number, and pathological type of polyps (χ²=6.345, 19.390, and 14.484; P=0.042, ＜0.001, and 0.002, respectively). The recurrence group had higher proportions of patients with a maximum polyp diameter＞15 mm, polyp number＞10, and tubulovillous adenoma. Stratified analysis showed that among patients with hyperplastic polyps, the recurrence group had higher TG levels (t=3.092, P=0.007) and TG/HDL ratio (t=4.041, P=0.001); among patients with tubulovillous adenomas, the recurrence group had higher TG levels (t=4.254, P＜0.001) and TG/HDL ratio (t=5.102, P＜0.001) and lower HDL levels (t=−2.391, P=0.020). Multivariate logistic regression analysis revealed that male sex (OR=5.426, P=0.010), smoking (OR=6.945, P=0.004), maximum polyp diameter＞15 mm (OR=7.574, P=0.013), polyp number＞10 (OR=9.152, P=0.019), and elevated TG (OR=4.444, P=0.018) were independent risk factors for polyp recurrence.

The 1 year polyp recurrence rate after endoscopic resection in patients with non hereditary colorectal polyposis was 20.36%. Male sex, smoking, a maximum polyp diameter ＞15 mm, a polyp number ＞10, and elevated TG were independent risk factors for polyp recurrence. Clinically, enhanced postoperative colonoscopic surveillance and intervention for metabolic risk factors should be implemented in patients with the above characteristics.

The treatment of colorectal cancer is frequently constrained by tumour microenvironment (TME)-mediated immune suppression and multidrug resistance. Protein degradation-targeting chimeras (PROTACs) demonstrate significant potential in targeting “undruggable” molecules by recruiting E3 ubiquitin ligases to degrade target proteins. This paper provides a systematic review of PROTAC research progress in colorectal cancer therapy, with a particular emphasis on its interaction mechanisms with the TME. It explores in depth how PROTACs inhibit tumour proliferation and overcome resistance by degrading oncogenic proteins, and how they can be combined with novel delivery systems to remodel the immunosuppressive microenvironment and enhance anti-tumour immune responses. Results indicate that PROTAC technology, leveraging its precision degradation and microenvironment remodelling advantages, offers novel avenues for overcoming current therapeutic challenges in colorectal cancer.

Acute appendicitis is one of the common causes of acute abdominal pain. In the past, the main clinical treatment for acute appendicitis was appendectomy. However, with deeper research in the function of appendix and considering issues such as residual surgical scars from surgical procedures, along with the rapid development of endoscopic technology, endoscopic retrograde appendicitis therapy (ERAT) was pioneered in 2012 by Professor Liu Bingrong's team. After more than a decade of development, ERAT technology has become quite mature and can be used to treat various types of acute appendicitis, including peri-appendiceal abscesses and appendiceal fecalith impactions. Moreover, with the advent of currently direct endoscopic retrograde appendicitis therapy（D-ERAT）, the success rate and safety of the procedure have improved, significantly reducing radiation exposure to patients and medical staff, and addressing the difficulty of performing ERAT in special patient populations such as pregnant women. This article briefly reviews the historical development of the ERAT procedure, explores the innovative treatment approach of D-ERAT, and looks forward to the future prospects of D-ERAT.

The treatment of thyroid nodules is progressively shifting toward minimally invasive and precision-oriented strategies. While traditional high-temperature thermal ablation techniques such as microwave ablation and radiofrequency ablation have been widely adopted, potential risks associated with their thermal effects including thermal injury to surrounding tissues and incomplete ablation due to thermal sink effects have spurred increasing interest in non-thermal ablation methods. Non-thermal ablation techniques exhibit diverse mechanisms of action and varying clinical applications. This article aims to review the principles of non-thermal ablation techniques and their current applications and advancements in treating thyroid nodules. It focuses on exploring the evolution of therapeutic strategies from classic chemical ablation to emerging approaches like irreversible electroporation and cryoablation, offering new insights for selecting treatment plans for thyroid nodules in clinical practice.

Intussusception is a distinctive form of intestinal obstruction characterized by the telescoping of a segment of bowel and its mesentery into an adjacent distal segment. Although its exact pathogenesis remains unclear, it is frequently associated with abnormal intestinal peristalsis, submucosal lymphoid hyperplasia, and the presence of a pathological lead point. Small bowel intussusception typically presents in infants under 1 year of age, with fever and vomiting being common. In contrast, ileocolic intussusception occurs more frequently in children over 1 year old and is often associated with an abdominal mass and pain. The nuclear-to-wall ratio (lipid core thickness/outer bowel wall thickness) is the most accurate differentiator: a ratio ＞1 indicates ileocolic intussusception, while a ratio ＜1 suggests small bowel intussusception. Treatment strategies vary depending on the type and clinical context. For small bowel intussusception with a symptom duration under 24 hours and an intussuscepted segment length ≤3.0 cm, spontaneous reduction is likely, and initial management with fasting and supportive care is recommended. For ileocolic intussusception, fluoroscopy-guided pneumatic reduction or ultrasound-guided hydrostatic reduction is the first-line treatment. Surgical intervention is indicated upon failure of enema reduction after three attempts, or if there is ultrasonographic evidence of secondary/persistent intussusception, or specific imaging findings (e.g., "appendiceal sign" or "air encircling the intussusceptum") during air enema reduction, or abnormal laboratory values (D-dimer ＞1.005 mg/L, lactate ≥3.0 mmol/L, or lymphocyte-to-CRP ratio＜0.121). The surgical approach is tailored to the underlying etiology. For primary ileocolic intussusception, laparoscopic reduction with ileocecal-lateral peritoneal fixation is optimal. In cases of persistent small bowel intussusception, transumbilical single-incision laparoscopic reduction, with or without resection, may be performed. For secondary intussusception, surgical management must include reduction, excision of the pathological lead point, and resection of any necrotic bowels.

Toinvestigate the prognostic values of nutrition-and inflammation-related indicators in pancreatic cancer and construct a personalized predictive model.

Clinical data from 158 patients with pancreatic cancer who underwent radical resection in Peking Union Medical College Hospital and Qilu Hospital of Shandong University from January 2016 to September 2021 were retrospectively analyzed. Cox regression was used to identify markers associated with overall survival (OS) and disease-free survival (DFS). The prognostic nutritional inflammation score (PNIS) system and PNIS-nomogram were developed using the ‘rms’ package and evaluated via time-dependent receiver operating characteristic curves, calibration curves, and decision curve analysis (DCA).

The PNIS formula, based on prognostic nutritional index, neutrophil-to-lymphocyte ratio, alanine aminotransferase, and high-sensitivity C-reactive protein, stratified patients into low- and high-risk groups, with high-risk patients showing significantly shorter OS (P<0.001) and DFS (P<0.001). The PNIS-nomogram, incorporating pathological grade, N stage, chemotherapy, and smoking history, demonstrated excellent predictive performance for 1-, 2-, and 3-year OS (AUC: 0.896, 0.782, 0.783) and DFS (AUC: 0.775, 0.766, 0.784), with favorable calibration and DCA results.

The PNIS-nomogram serves as a reliable tool for effectively predicting long-term postoperative outcomes in pancreatic cancer patients and may provide new insights into the role of abnormal inflammatory responses and malnutrition in pancreatic cancer.

To investigate the prognostic values of tertiary lymphoid structures (TLS), perineural invasion, lymph node metastasis, and other pathological features in patients with intrahepatic cholangiocarcinoma (ICC) after curative resection.

Clinicopathological and follow-up data of 302 patients with pathologically confirmed ICC who underwent curative resection from June 2009 to April 2021 were retrospectively analyzed. TLS in tumor and liver tissues were evaluated by hematoxylin-eosin staining and classified as lymphoid aggregates (Agg), primary follicles (FL-1), and secondary follicles (FL-2). Survival was analyzed using the Kaplan-Meier method and Cox regression model.

The median recurrence-free survival (RFS) and overall survival (OS) were 9.9 months (95% CI: 7.14-11.83) and 29.5 months (95% CI: 21.39-36.63), respectively. Intratumoral TLS were observed in 124 patients (41.06%). Multivariate analysis showed that intratumoral TLS positivity was an independent protective factor for RFS (P=0.015) and OS (P=0.006). Perineural invasion was an independent risk factor for RFS (P=0.006) and OS (P<0.001). Lymph node metastasis was also an independent risk factor for OS (P<0.001) and RFS (P<0.001). TLS in liver tissue and TLS maturation were not significantly associated with RFS or OS.

Intratumoral TLS positivity is an independent protective factor for OS and RFS in patients with ICC after surgery, while perineural invasion and lymph node metastasis are independent risk factors. These pathological features may provide valuable references for postoperative prognostic evaluation in ICC.

To compare the clinical efficacy of laparoscopic commom bile duct exploration+laparoscopic cholecystectomy (LTCBDE+LC) versus endoscopic retrograde cholangiopancreatography/endoscopic sphincterotomy+laparoscopic cholecystectomy (ERCP/EST+LC) in the treatment of patients with gallbladder stones and non-expanding common bile duct stones.

A retrospective analysis was conducted on the relevant data of 98 patients with gallbladder stones and non-expanding common bile duct stones from August 2020 to August 2025 in Fuyang City Tumor Hospital. 50 patients underwent LTCBDE + LC (surgical group), and 48 patients underwent ERCP/EST + LC (endoscopic group). The preoperative and intraoperative data, postoperative recovery conditions, and complications of the two groups of patients were observed.

There was no statistically significant difference in the preoperative baseline data and laboratory tests between the two groups. The intraoperative blood loss of the surgical group (23.68±8.97) ml was comparable to that of the endoscopic group (25.90±9.80) ml, with no significantly statistical difference. The operation time of the surgical group (105.76±21.47) min was significantly shorter than that of the endoscopic group (146.67±23.19) min, with statistical difference (P<0.05). The postoperative time to get out of bed, postoperative defecation time, postoperative removal time of abdominal drainage tube/nasobiliary tube, and postoperative pain score of the surgical group were significantly better than those of the endoscopic group [(6.88±2.36) h, (19.63±4.93) h, (4.02±0.33) d, (2.65±1.08) points], with statistical differences (P<0.05). The postoperative hospital stay and treatment cost of the surgical group (3.84±0.89) days and (25 624.46±2 599.82) yuan were also significantly better than those of the endoscopic group [(6.42±1.15) days, (28 672.56±3 835.13) yuan], with statistical differences (P<0.05). The overall complication rate of the endoscopic group (27.08%) was significantly higher than that of the surgical group (10.00%), with statistical difference (P<0.05).

Compared with ERCP/EST + LC, LTCBDE + LC can reduce intraoperative blood loss, accelerate postoperative recovery, reduce treatment costs, and decrease postoperative complications. Under the premise of strictly controlling the surgical indications, it is worthy of clinical application.