A multicenter prospective randomized controlled study on the timing of laparoscopic cholecystectomy after percutaneous transhepatic gallbladder drainage for grade Ⅱ-Ⅲ acute cholecystitis / 中华肝胆外科杂志

Objective:To study the optimal timing of laparoscopic cholecystectomy (LC) after percutaneous transhepatic gallbladder drainage (PTGBD) for grade Ⅱ-Ⅲ acute cholecystitis.Methods:A multicenter, single blind and randomized controlled study was conducted at Shanghai Fifth People's Hospital Affiliated to Fudan University, Shanghai Pudong Hospital, and Shanghai Minhang District Central Hospital from October 2018 to September 2021. Patients who underwent LC after PTGBD were divided 1∶1 into the early group and the late group. LC was performed 4-6 weeks after PTGBD in the early group and 7-8 weeks after PTGBD in the late group. Gender, age, AC grade, complications after PTGBD, body mass index, complications before LC, operation time of LC, intraoperative bleeding, total treatment cost, conversion rate to open surgery and complications after LC were compared between the two groups. The 36-Item Short Form Health Survey (SF-36) before and after LC was also compared.Results:Of 248 patients who were eligible for the study, there were 52 males and 196 females, with ages ranging from 18 to 89 years, and mean ±s.d. of (52.5 ± 20.2) years. There were 126 patients in the early group and 122 patients in the late group. There were no significant differences in gender, age, AC grade, body mass index and complications before LC between the two groups (all P>0.05). The preoperative score of SF-36 in the early group was significantly better than that in late group, and the complications of PTGBD in the late group were significantly higher than the early group (both P<0.05). The operation time and total treatment cost of the early group were significantly less than those of the late group (37.2±12.8 min vs. 48.5±19.7 min, 20 856±2 136 yuan vs. 2 2207±2 049 yuan) (both P<0.05). The intraoperative bleeding volume of LC in the early group was [ M( Q1, Q3)] 40 (40, 60) ml and the late group was [ M( Q1, Q3)] 35 (25, 40) ml. The difference was also significant ( P<0.05). There was no significant differences in the conversion rates to open surgery, complications and SF-36 scores after LC between the two groups (all P>0.05). Conclusion:LC should be performed 4-6 weeks after PTGBD for grade Ⅱ-Ⅲ acute cholecystitis. Although the amount of intraoperative bleeding was higher, the operation time was shorter, the burden on patients was reduced and there was more rapid recovery.

Expression and clinical significance of GRHL2 in colorectal cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>The purpose of this study was to detect the expression of GRHL2 in colorectal cancer (CRC) tissues, and to assess the relationship between GRHL2 expression and clinicopathological features.</p><p><b>METHODS</b>Immunohistochemistry was used to examine GRHL2 in 75 CRC tissues. GRHL2 mRNA and protein levels in the CRC tissues were also analyzed by qRT-PCR and Western blot. The relationship between GRHL2 and clinicopathological features was assessed by Pearson's chi-square (χ(2)) test.</p><p><b>RESULTS</b>Positive immunoreactivity for GRHL2 was detected in the nuclei of CRC cells. GRHL2 expression was increased in CRC tissues compared withthat in the paired non-tumor tissues (61.3% vs. 44.0%, P<0.01). Moreover, qRT-PCR results showed that the relative expression level of GRHL2 mRNA in the colorectal cancer tissue was (2.64±0.35), significantly higher than that of normal mucosa tissue (1.19±0.23, P<0.001). The expression level of GRHL2 mRNA was higher in stage III-IV patients (2.84±0.36) than that of stage I-II cases (2.31±0.32, P<0.05). Western blot results also showed that the expression level of GRHL2 protein in the colorectal carcinoma tissue was significantly higher than that in the normal mucosa (P<0.05). GRHL2 expression was positively correlated with tumor size, TNM stage and Ki-67 (P<0.05, respectively).</p><p><b>CONCLUSION</b>Taking together, our findings demonstrate that GRHL2 is overexpressed in CRC, and plays an important role in the progression of CRC.</p>

Surgical treatment of thyroglossal duct cyst in 36 adults / 中华内分泌外科杂志

Objective To analyze clinical features and surgical treatment of thyroglossal duct cyst (TDC) in adult patients.Methods Clinical data of 36 adult patients with TDC were analyzed retrospectively.Results All the 36 patients received surgical resection of Sistrunk's procedure.One case suffered wound infection after the operation.Two cases recurred(recurrence rate:5.6％)but cured after the 2nd operation and showed no sign of recurrence during the follow up of 18 and 26 months respectively.No other complications were reported.Conclusions Etiological factors,pathological and anatomical features need to be analyzed.Surgical treatment should focus on hyoid bone and the upper area.The recurrence rate depends on total resection of cyst.

A survey on malnutrition of surgical patients in a single general hospital / 中国普通外科杂志

60 yrs) were associated with a higher prevalence of malnutrition (47 6%) than those of 60 yrs and younger (31 5%) Malnutrition was more frequently encountered in cancer patients than other patients (64 5% vs 22 4%) Patients with digestive tract disease had higher rates of malnutrition than those without (52 6% vs 30 0%) FFM, FM, BCM, TBW and ICF was significantly lower in malnourished male and female patients than well nourished patients Conclusion The prevalence of malnutrition in hospitalized surgical patients is high