Association between Pre-operative Body Mass Index and Surgical Infection in Perihilar Cholangiocarcinoma Patients Treated with Curative Resection: A Multi-center Study.

Background: The objective of this study was to investigate the association between pre-operative body mass index (BMI) and surgical infection in perihilar cholangiocarcinoma (pCCA) patients treated with curative resection. Methods: Consecutive pCCA patients were enrolled from four tertiary hospitals between 2008 and 2022. According to pre-operative BMI, the patients were divided into three groups: low BMI (≤18.4 kg/m2), normal BMI (18.5-24.9 kg/m2), and high BMI (≥25.0 kg/m2). The incidence of surgical infection among the three groups was compared. Multivariable logistic regression models were used to determine the independent risk factors associated with surgical infection. Results: A total of 371 patients were enrolled, including 283 patients (76.3%) in the normal BMI group, 30 patients (8.1%) in the low BMI group, and 58 patients (15.6%) in the high BMI group. The incidence of surgical infection was significantly higher in the patients in the low BMI and high BMI groups than in the normal BMI group. The multivariable logistic regression model showed that low BMI and high BMI were independently associated with the occurrence of surgical infection. Conclusions: The pCCA patients with a normal BMI treated with curative resection could have a lower risk of surgical infection than pCCA patients with an abnormal BMI.

Long-term prognosis of patients with gallbladder carcinoma after curative-intent resection based on changes in the ratio of carbohydrate antigen 19-9 to total bilirubin (CA19-9/TB): a multicenter retrospective cohort study.

BACKGROUND: The prognostic value of carbohydrate antigen 19-9 (CA19-9) is known to be affected by elevated bilirubin levels in patients with gallbladder carcinoma (GBC). The clinical significance of changes in the ratio of CA19-9 levels to total bilirubin (TB) levels in patients with GBC after curative-intent resection remains unknown. The aim of this study was to determine the prognostic value of changes in preoperative and postoperative CA19-9/TB ratio in these patients. METHODS: Prospectively collected data on consecutive patients who underwent curative-intent resection for GBC between January 2015 and December 2020 stored in a multicenter database from 10 hospitals were analyzed in this retrospective cohort study. Based on the adjusted CA19-9 defined as the ratio of CA19-9 to TB, and using 2×10 3  U/µmol as the upper normal value, patients were divided into a normal group (with normal preoperative and postoperative adjusted CA19-9), a normalization group (with abnormal preoperative but normal postoperative adjusted CA19-9), and a non-normalization group (with abnormal postoperative adjusted CA19-9). The primary outcomes were overall survival (OS) and recurrence-free survival (RFS). The log-rank test was used to compare OS and RFS among the groups. The Cox regression model was used to determine factors independently associated with OS and RFS. RESULTS: The normal group ( n =179 patients) and the normalization group ( n =73 patients) had better OS and RFS than the non-normalization group ( n =65 patients) (the 3-year OS rates 72.0%, 58.4% and 24.2%, respectively; the RFS rates 54.5%, 25.5% and 11.8%, respectively; both P <0.001). There were no significant differences between the normal and the normalization groups in OS and RFS (OS, P =0.255; RFS, P =0.130). Cox regression analysis confirmed that the non-normalization group was independently associated with worse OS and RFS. Subgroup analysis revealed that the non-normalization group of patients who received adjuvant therapy had significantly improved OS and RFS as compared to those who did not receive adjuvant therapy (OS, P =0.025; RFS, P =0.003). CONCLUSIONS: Patients with GBC who underwent curative-intent surgical resection with postoperative abnormal levels of adjusted CA19-9 (the CA19-9/TB ratio) were associated with poorer long-term survival outcomes. Adjuvant therapy after surgery improved the long-term outcomes of these patients.

Yeast mediates the interspecific interaction between introduced Bactrocera dorsalis and indigenous Bactrocera minax.

BACKGROUND: Host plant-microbe associations mediate interspecific interactions amongst herbivorous insects. However, this theory has rarely been ecologically verified in tephritid fruit flies. Research on this subject can not only help predict tephritid species invasion and occurrence patterns, but also develop potential novel lures for the control of the tephritid fruit fly pests. Recently, we observed mixed infestation of Bactrocera minax and Bactrocera dorsalis larvae in citrus orchards, which prompted us to explore the underlying mechanism. RESULTS: Following oviposition by B. minax, the yeast Pichia kluyveri translocated to and proliferated inside the citrus fruit. The level of d-limonene released from citrus fruits containing P. kluyveri was 27 times higher than that released from healthy fruits. Mature B. dorsalis females were attracted to d-limonene and oviposited into fruits previously infested by B. minax. Furthermore, the interspecific interaction between B. dorsalis and B. minax within the same fruit significantly decreased the number of surviving larvae and pupal weight in B. dorsalis, but its effect on B. minax was weaker. CONCLUSION: In the studied interspecific interaction, B. minax occupies the dominant position, implying ecological significance for this species in terms of consolidating its own niche and inhibiting the invasion of exotic species. To our best knowledge, this is the first report from both ecological and physiological perspectives on a symbiotic yeast mediating the interaction between B. minax and B. dorsalis through altering fruit volatiles. © 2022 Society of Chemical Industry.

Role of Imbalance between Th17 Cells and Treg Cells in the Pathogenesis of Children with Henoch-Schonlein Purpura / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To explore the role of Th17 cells, CD4⁺ CD25⁺ regulatory Treg cells (Treg) and its transcription factor RORγt and FoxP3 in the pathogenesis of children with Henoch-Schonlein purpura (HSP) so as to provide a new strategy for treatment of children with Henoch-Schonlein purpura by regulating the balance of Th17 and Treg cells.</p><p><b>METHODS</b>Forty children with Henoch-Schonlein purpura in acute phase admitted in our hospital from February 2012 to March 2013 were enrolled in this study, forty healthy children were simultaneously used as controls. The expression of RORγt mRNA and FoxP3 mRNA in peripheral blood mononuclear cells was detected by real-time PCR using SYBR Green I. The levels of IL-17A, TGF-β1, IL-2 and IL-6 in serum were measured by ABC-ELISA. The ratio of Th17 cells to Treg cells in peripheral blood T lymphocytes was detected by flow cytometry.</p><p><b>RESULTS</b>The levels of Th17 cells (2.75 ± 0.60%) and RORγt mRNA (1.11 ± 0.51) in HSP group were significantly higher than levels of Th17 cells (1.41 ± 0.29%) and RORγt mRNA (0.65 ± 0.24) (P < 0.01) in control group, but the levels of Treg cells (4.56 ± 1.26%) and FoxP3 mRNA (1.15 ± 0.45) in HSP group were lower than those of Treg cells (7.85 ± 1.97%) and FoxP3 mRNA (2.32 ± 1.1) (P < 0.01) in the control group. The relative levels of serum IL-17A, IL-6, TGF-β1 (40.40 ± 11.81 pg/ml, 75.38 ± 27.19 pg/ml, 309.41 ± 81.03 pg/ml) in the HSP group were significantly higher than those in the control group [IL-17A (20.32 ± 10.70 pg/ml), IL-6 (25.16 ± 8.31 pg/ml), TGF-β1 (236.34 ± 66.01 pg/ml)] (P < 0.01), but the level of serum IL-2 (25.60 ± 13.19 pg/ml) in the HSP group was lower than that (34.42 ± 11.69 pg/ml) in the control group (P < 0.01). The further detection demonstrated that in the children with acute HSP, the expression of Th17 cells positively correlated with RORγt mRNA, IL-17A and IL-6 with the correlation coefficients of 0.887, 0.938 and 0.934 (P < 0.01), respectively. The positive correlation was also shown between the Treg cells and FoxP3 mRNA, IL-2 with the correlation coefficients of 0.834 and 0.932 (P < 0.01), respectively.</p><p><b>CONCLUSION</b>There are higher expression levels of Th17 cells, RORγt mRNA and IL-17A, and lower expression levels of Treg cells, FoxP3 mRNA of children with HSP in acute phase, which shows that Th17/Treg imbalance exists in children with HSP in acute phase. The levels of serum IL-6, TGF-β1 increase and the serum IL-2 decrease in children with HSP in acute phase, moreover, there are the positive correlations between the levels of Th17 cells and expression of IL-6, as well as the level of Treg cells and expression of IL-2 in children with HSP in acute phase.</p>