These data suggest that released HMGB1 by ischaemic renal parenchyma cells may act as an essential early mediator in delayed inflammatory response during IRI, and targeting HMGB1 may represent a potential approach in the prevention of clinical IRI associated with kidney transplantation.

For late-stage gastric cancer patients, palliative gastrectomy should be considered for locally late-stage, distant lymph node metastasis, and resectable liver metastasis patients. Especially among patients with liver metastasis, transfer medicine is essential for potentially curable patients to obtain access to radical surgery to improve the prognosis.

Polycomb group (PcG) proteins Ring1B and EZH2, which have been characterized as catalyzing the two epigenetic modifications H2AK119 monoubiquitination (H2AK119Ub1) and H3K27 trimethylation (H3K27Me3), are well-known epigenetic silencers implicated in embryonic development and tumorigenesis. However, the status of polycomb-associated histone modifications and their clinical implications in pancreatic cancer remain unclear. Here, we performed immunohistochemistry on tissue microarrays (TMAs) containing 80 pairs of human pancreatic cancer specimens to assess the expression levels of Ring1B, H2AK119Ub1, EZH2, and H3K27Me3 in tumors. More than 50% of the tumor cells showed a high expression of H2AK119Ub1, Ring1B, and EZH2, whereas more than 50% of the tumor cells showed a low level of H3K27Me3. Different expression patterns of H2AK119Ub1 and H3K27Me3 in tumors were negatively correlated (r = −0.247, P = 0.027). Both H2AK119Ub1 and H3K27Me3 independently predicted the clinical prognosis. In particular, a combinatorial pattern of elevated H2AK119Ub1 and decreased H3K27Me3 in tumors was significantly correlated with a poorer prognosis. Furthermore, compared to the tumor, lymph node, metastasis (TNM) staging system, histone modifications can discriminate the survival difference more accurately, especially for patients with stage I or stage II tumors. Simultaneous silencing of Ring1B and EZH2 via shRNA depleted H2AK119Ub1 and H3K27Me3 in the pancreatic cancer cells PanC1 and AsPC1, enhanced HOX gene derepression, and inhibited tumor cell growth in vitro and in tumor xenograft models. These results demonstrated that H2AK119Ub1 and H3K27Me3 cooperate in tumors and are associated with the clinical prognosis in combinatorial patterns. We have proposed that epigenetic modifications may serve as discriminatory biomarkers for molecular staging of pancreatic cancer.

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Background: Propensity score-matched analyses comparing the safety and efficacy of laparoscopic pancreaticoduodenectomy (LPD) to open pancreaticoduodenectomy (OPD) that consider the effect of the learning curve for LPD are lacking. We use Propensity score-matched to compare the safety and efficacy of LPD during the learning curve to OPD. Methods:The medical records of 296 consecutive patients who had undergone LPD or OPD between September 2016 and August 2019 at Fujian Provincial Hospital were retrospectively reviewed. Patients treated with LPD were matched 1:1 to those treated with OPD. Calculation of propensity scores considered age, gender, body mass index (BMI), tumor location, pathology, incidence of obstructive jaundice, incidence of biliary drainage, pancreatic texture, pancreatic duct diameter, previous abdominal surgery, comorbidities, and case distribution of the surgical team.Results: After propensity score matching, 196 patients were divided into two groups: 98 patients in the LPD group and 98 patients in the OPD group. LPD performed during the learning curve was associated with a longer median operative time (OT) (432 vs. 328 min, P<0.001), a higher incidence of major surgeryassociated complications (32.7% vs. 14.3%, P=0.002), a higher incidence of clinically relevant pancreatic fistula (27.6% vs. 13.3%, P=0.013), and prolonged LOS (21.06 d vs. 16.94 d, P=0.033), but lower median intraoperative blood loss (200 vs. 300 mL, P<0.001) compared to OPD. Mean OT and LOS were significantly shorter in the late phase of the learning curve for LPD (P<0.001), and were similar to that for OPD. Age >60 years and a non-dilated MPD were significant predictors of clinically relevant pancreatic fistula, major surgery-associated complications, prolonged LOS and postoperative mortality at 90 days (all P<0.05).Conclusions: OT, incidence of major surgery-associated complications, and LOS were significantly increased in patients that underwent LPD, but were significantly improved during the learning curve. Elderly patients and patients with a non-dialated MPD should not be treated with LPD performed by inexperienced surgeons.

AimsTo assess the clinical significance and risk factors of solitary lymph node metastasis (SLM) in gastric carcinoma and establish a more accurate method to evaluate the possibility of lymph node metastasis (LM).MethodsA total of 385 patients with gastric carcinoma who underwent D2 lymphadenectomy at the Cancer Center of Sun Yat-Sen University were included in this research. Then we used a group of data from Sun Yat-sen University Gastrointestinal Hospital (SYSUGIH) to validate the accuracy of our developed method. The χ2 test, Kaplan–Meier analysis, log-rank test, COX model, and discriminate analysis were used to analyze the data with SPSS13.0.ResultsWe found that the LM number and pathological T staging were independent prognostic risk factors. CEA grading, LN status by CT, and T staging by CT were independent risk factors for LM in gastric carcinoma. In addition, we developed the equation Y = -5.0 + X 1 + 1.8X 3 + 0.7X 4 (X 1 = CEA grading, X 3 = LN status by CT, X 4 = T staging by CT) to evaluate the situation of LM. The data from SYSUGIH shows this equation has a better accuracy compared with CT.ConclusionsSLM is an independent risk factor in gastric cancer. And there was no survival difference between the skip metastasis group and the other SLM group (P = 0.659). It is inappropriate for the patient with SLM doing a standard D2 lymphadenectomy, due to the fact that LM rarely occurs in the splenic artery, splenic hilum. The risk factors for LM include CEA grading, LN status by CT, and T staging by CT. And we can use Y = -5.0 + X 1 + 1.8X 3 + 0.7X 4 (X 1, CEA grading, X 3 = LN status by CT, X 4 = T staging by CT, the critical value is 0.3) to estimate the possibility of LM, which has a better accuracy compared with CT.

Our study showed that patients with normal postoperative CEA levels have a better prognosis. Furthermore, for marginally elevated postoperative CEA level gastric cancer patients, the tumor position and histological grade were two important factors for predicting the prognosis and the need for aggressive therapy.

Our study showed a highly associative link to the patient's tumor KRAS profile. Monitoring its variations aided in stratifying patients with worse outcome. Urinary specimens that can be extracted non-invasively presents new opportunities to track patients with KRAS mutation undergoing therapy.