Aims: To identify subgroups of patients with renal stones ≥20 mm that are more suitable for extracorporeal shock wave lithotripsy (ESWL) monotherapy. Methods: A total of 376 patients with renal stones ≥20 mm underwent monotherapy with ESWL. The treatment outcome was evaluated after 3 months of follow-up. A stone-free status or fragmentation of stones to 4 mm or smaller was considered efficacious. Results: At 3 months after treatment, the overall stone-free rate was 64.4%, and the efficacy rate was 70.7%. The efficacy rate was 89.4% for patients with a residual stone surface area ≤50% of baseline after the first ESWL, while the efficacy rate was 32.4% for other patients. The efficacy was 92.2% for stones ≤400 mm2 and those with lower radiodensity, as determined by a plain (KUB) film. Conclusions: For renal stones with a surface area ≤400 mm2 and a radiodensity equal to or less than that of the 12th rib as determined by a KUB film, ESWL may be considered the first line of treatment, even for stones with a diameter ≥20 mm. For large stones requiring repeat treatments, the surface area of the residual stones after the first ESWL is a predictor of the final treatment result.
Background and objectives. Laparoscopic total gastrectomy has developed rapidly in recent years. End-to-side Roux-en-Y esophagojejunostomy by using a circular stapler is a widely accepted reconstruction method, with low rates of anastomotic complications. However, although seldom reported, difficulty of stapler insertion sometimes occurs during operation because of the small diameter of the jejunum, and that will increase the risk of anastomotic leakage or stenosis. Herein, we describe a modified technique for esophagojejunostomy which can make the insertion of the stapler easier. Patients and methods. In this retrospective study, 112 patients who had undergone laparoscopiy-assisted total gastrectomy (LATG) with D2 lymphadenectomy were examined between January 2016 and December 2020. All of these operations were performed by the same surgeon team. Of these, 44 received a conventional Roux-en-Y end-to-side esophagojejunostomy (cRY) group, and the remaining 68 underwent pant-shaped Roux-en-Y esophagojejunostomy (pRY). Clinicopathological characteristics, surgical outcomes, and postoperative complications were compared between the groups. Results. There were no significant differences between the cRY group and pRY group regarding age, sex, BMI, neoadjuvant therapy, preoperative comorbidities, history of laparotomy, ASA score, tumor location, pathological stage, total operative time, incision length, blood loss, time-to-first flatus, time-to-first soft diet, and postoperative hospital stays. The proportions of patients who received a 21 mm stapler were higher in the cRY group (7/44) than that in the pRY group (0/68) (
P
=
0.003
). 7 anastomotic complications were reported (6 in the cRY group versus 1 in pRY group;
P
=
0.028
) of which five (83.3%) in the cRY were anastomotic stenosis versus none in the pRY group (
P
=
0.044
). Conclusions. The application of pant-shaped anastomosis for esophagojejunostomy after LTG is a safe and feasible procedure and has an advantage when the jejunum diameter is small.
Background: Gastric cancer (GC) is among the common malignancies in the world. Studies of the KPNAs proteins’ participation in gastric cancer are still lacking. Materials and methods: The transcript levels and differential expression relating to tumor stage of KPNAs were analyzed through oncomine dataset and the Gene Expression Profile Interaction Analysis dataset. Experimental validation of mRNA and protein of KPNAs in non-malignant gastric mucosal tissues versus gastric cancer tissues was carried out using RT-qPCR, WB, and IHC. The prognostic value of KPNAs was analyzed using Kaplan-Meier Plotter. The association of KPNAs with immune invasion was assessed via the TIMER dataset. Mutations in the KPNAs family of genes were analyzed using the cBioportal dataset. In addition, inter-protein interactions expressed by the KPNAs family factors were analyzed using the String dataset, GeneMANIA. Finally, R software was adopted to analyze GO/KEGG functional enrichment of the KPNAs family factors. Results: The study illustrated that the transcript levels of KPNAs factors were elevated in GC tissues, both in mRNA and protein expression. The increased expression level of KPNA1/4/5/7 was linked to poor OS, FP and PPS. Further, it was noted that all KPNAs were linked to invasion of B-cell and the invasion of CD8+ T-cell was linked to KPNA2/3/4 expression. GO/KEGG enrichment assessment data of the KPNAs family estimated the functional role of the target host genes and biological processes showed that the observed changes were mainly cellular components, and molecular functions. Further, the cBioPortal online tool indicated that overexpression of mRNA was the most frequent alteration. Lastly, the String dataset, GeneMANIA dataset revealed that the KPNAs family factors have interactions in nuclear protein import. Conclusion: The results of the present research work showed that KPNAs might provide novel insights into potential biomarkers of prognosis along with immune invasion in GC.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.