To explore the clinical efficacy and safety of modified laparoscopic transcystic common bile duct exploration (LTCBDE) in the treatment of choledocholithiasis.

A retrospective analysis was conducted on the clinical data of 103 choledocholithiasis patients who underwent modified LTCBDE in the Department of General Surgery in Beijing Electric Power Hospital between January 2022 and December 2024. Patients were divided into an elderly group (≥60 years, 77 cases) and a non-elderly group (<60 years, 26 cases) based on the age of 60. Additionally, the patients were categorized into a non-AOSC group (80 cases) and an AOSC group (23 cases) based on the presence or absence of acute obstructive suppurative cholangitis (AOSC).

All the surgeries were successful with a stone clearance rate of 100.0%. Preoperative American Society of Anesthesiologists (ASA) grading and the incidence of comorbidities were significantly higher in the elderly group compared to the non-elderly group, with more stones and longer postoperative hospital stays (P<0.05). Preoperative ASA grading and comorbidity rates were significantly higher in the AOSC group than those in the non-AOSC group, and more stones, with longer postoperative hospital stay (P<0.05). Minor bile leakage occurred in 3 patients in the elderly group, all of whom recovered after conservative management. During the 6-month postoperative follow-up, no patients exhibited complications such as residual common bile duct stones or stenosis, and no stone recurrence was observed.

Modified LTCBDE is a safe and effective treatment for choledocholithiasis in elderly patients, offering significant advantages including a high stone clearance success rate and fewer postoperative complications. For elderly patients with AOSC, this surgical procedure is not only safe and effective, but also promotes early recovery of patients, making it worthy of clinical application and promotion.​

To investigate the clinical effectiveness of laparoscopic common bile duct exploration (LCBDE) versus endoscopic retrograde cholangiopancreatography combined with endoscopic duodenal sphincterotomy (ERCP+EST) in the treatment of elderly patients with simple common bile duct stones (CBDs), and to analyze the independent risk factors of postoperative complications.

The clinical data of 240 elderly patients with simple CBDs admitted to the First Affiliated Hospital of Xinjiang Medical University from January 2017 to December 2024 were retrospectively analyzed. The patients were divided into the LCBDE group (70 cases) and the ERCP+EST group (170 cases) according to the operation method. The general data of the two groups were matched by the propensity score matching method. Among them, there were 47 cases in the LCBDE group and 88 cases in the ERCP+EST group. The surgical operation-related indicators, including the incidence of postoperative complications, length of hospital stay, and total hospitalization costs, were compared between the two groups. Multivariate Logistic regression analysis was used to analyze the risk factors associated with postoperative complications following two surgical procedures.

The ERCP+EST group had significantly better outcomes (all P<0.01), including shorter operation duration (40.00 min vs 190.00 min), less intraoperative blood loss (2.00 ml vs 50.00 ml), shorter hospitalization stay (6 days vs 13 days), and lower costs (24 768.53 yuan vs 35 699.11 yuan. ICU transfer emerged as an independent risk factor for postoperative complications in the LCBDE group (OR=8.59, 95% CI: 1.75-48.79, P<0.01). Elderly age, cardiovascular disease, and large diameter of common bile duct significantly increased the risk of ICU transfer (P<0.05). Hypertension (OR=2.90, 95% CI: 1.04-8.04) and diabetes mellitus (OR=4.64, 95% CI: 1.16-17.73) were independent risk factors for postoperative complications in the ERCP+EST group (both P<0.05).

In elderly patients with CBDs, LCBDE and ERCP+EST have good safety, while ERCP+EST is superior in terms of operation duration, intraoperative blood loss, hospitalization stay and costs. LCBDE should be avoided in patients with severe cardiovascular disease or bile duct dilation, while ERCP+EST is recommended. For patients with diabetes or hypertension, ERCP+EST should be carefully selected, and the control of blood glucose and blood pressure should be strengthened during the perioperative period.

To construct a gene prediction model that can effectively predict the response to neoadjuvant chemotherapy combined with targeted therapy in human epidermal growth factor receptor 2 (HER2)-positive breast cancer patients.

The datasets from patients with HER2-positive breast cancer undergoing neoadjuvant chemotherapy combined with targeted therapy were integrated from the GEO database. Differential gene analysis, WGCNA analysis, and LASSO regression were used to screen key genes and construct a predictive model. Potential associated pathways and mechanisms were explored using GSEA, immune cell infiltration levels, immune scoring, and drug sensitivity assessments.

Nine key genes (CD8A, CST7, CXCL13, IL2RB, LDHB, RTN3, SEMA4D, EPB41L1, MYO5C) were identified, and the constructed predictive model demonstrated good predictive performance in both the training set (AUC=0.836) and the validation set (AUC=0.827). The low-risk group (sensitive to treatment) exhibited characteristics of immune activation, while the high-risk group (resistant to treatment) was relatively in an immunosuppressive state.

The gene model constructed in this study can effectively predict the response to neoadjuvant therapy in HER2-positive breast cancer, with the activation status of the immune microenvironment closely related to treatment sensitivity. The key genes provide potential biomarkers and intervention targets for personalized treatment.

This study aims to investigate the diagnosis and treatment challenges, through analyzing the clinical characteristics, pathological features, treatment approaches, and prognostic factors of patients with pregnancy-associated breast cancer (PABC).

A retrospective review was conducted on 38 PABC patients treated in the First Affiliated Hospital of Sun Yat-sen University from January 2010 to December 2022. Data on clinical presentation, tumor pathology, treatment regimens, and outcomes were colleted and analyzed. Survival outcomes were assessed using Kaplan-Meier analysis, and prognostic factors were evaluated through univariate and multivariate analyses.

All patients presented with breast masses, with additional symptoms reported in 21% of cases. Invasive ductal carcinoma was the predominant pathological type (97.37%). Chemotherapy, predominantly anthracycline-based regimens, was initiated in the second trimester or postpartum for most patients. Surgical interventions, including breast-conserving surgery and mastectomy, were performed at various gestational stages. The five-year overall survival (OS) rate was 81.58%. Univariate analysis identified the N stage and TNM stage as significant predictors of OS, though neither was independent factors in multivariate analysis. The timing of diagnosis (pregnancy or postpartum) did not significantly affect OS.

PABC exhibits aggressively pathological characteristics and requires individualized, multidisciplinary management to optimize outcomes. While survival rates are slightly lower than those of non-PABC populations, adherence to evidence-based guidelines may mitigate adverse outcomes. Future studies should focus on larger cohorts and molecular profiling to refine therapeutic approaches.

Primary liver cancer (PLC) is a prevalent malignancy globally characterized by poor prognosis. Recent research has focused on the association between the gut microbiota and PLC. The gut microbiota interacts with the liver via the gut-liver axis; its dysbiosis can affect hepatic metabolism and immune function, thereby contributing to the initiation and progression of PLC. This review will detail in the relationship between the gut microbiota and PLC in terms of pathogenesis, diagnosis, treatment, and prevention, beginning with an overview of the gut microbiota’s composition and function, as well as an overview of PLC. The aim is to provide novel insights and theoretical foundations for the prevention and treatment of PLC.

Ex vivo liver resection and autotransplantation (ELRA) represents a pioneering technique that provides a curative solution for complex hepatic diseases untreatable by conventional hepatectomy. This article systematically reviews the indications, key techniques, and clinical outcomes of ELRA. By utilizing ex vivo hypothermic perfusion, precision lesion resection, and vascular reconstruction, ELRA significantly expands surgical indications for benign and malignant diseases, such as hepatic alveolar echinococcosis (AE), hepatocellular carcinoma, and cholangiocarcinoma involving the hepatic hilum, hepatic veins or inferior vena cava, while avoiding donor shortages and immunosuppressive risks associated with allogeneic liver transplantation. Preoperative three-dimensional reconstruction and functional liver volume assessment, combined with intraoperative venous bypass-free techniques and outflow reconstruction strategies, enhance procedural safety. Postoperative anticoagulation therapy and monitoring of complications such as hepatic venous obstruction and biliary stricture, reduce mortality and severe morbidity. Studies demonstrated that ELRA achieved a 1-year survival rate of 89.7% in benign lesions and a >80% 5-year survival rate in end-stage hepatic AE, significantly outperforming non-surgical approaches. Future advancements in artificial intelligence navigation, minimally invasive techniques, and novel organ preservation solutions, may further optimize ELRA, establishing it as a standard intervention for complex hepatobiliary diseases.

Tumor abnormal proteins (TAP) are formed due to abnormal glycosylation when human cells become malignant, and are eventually released into blood. Researches of TAP in gastrointestinal tumors have been extensively conducted, with the results indicating a high expression in many malignant tumors. This article discusses the research progress of digestive tract tumors in combination with domestic and foreign literature, providing references for clinical work.