Background Diet and nutrition, as a modifiable risk factor, have been demonstrated to play a significant role in the etiology of biliary diseases, whereas few comprehensive studies have been able to evaluate the strength and quality of these evidence. This umbrella review aims to evaluate the evidence pertaining risk factors for biliary diseases in terms of diet and nutrition-related indicators. Methods An umbrella review method was adopted: evidence from observational studies up to 22 November 2021 were identified using PubMed, Web of Science, the Cochrane database, as well as manual screening. Eligible systematic reviews and meta-analyses were screened according to inclusion and exclusion criteria. The inclusion criteria were: (1) meta analysis or systematic review; (2) The theme of the study is the relationship between diet or nutrition and biliary tract diseases; (3) Summarized and reported OR, RR or HR values and corresponding 95% CI; (4) No restrictions on the use of participants and languages; (5) Only extract the data of biliary tract diseases from multiple health outcomes; (6) Only the most recent studies on the same subject were included. This study had been registered at PROSPERO (CRD42021293908). For each eligible systematic review and meta-analysis, we extracted the data of general characteristics and the main findings. The methodological quality of the meta-analyses included in our study were assessed by AMSTAR2 and the quality of evidence was evaluated by the GRADE. Results A total of 323 articles were searched, among which 24 articles with 83 unique outcomes were identified as eligible. 35 of these outcomes were downgraded in GRADE evaluation as they reported heterogeneity. In short, among 83 unique outcomes, 5 were rated as moderate, 16 as low, and the rest as very low. For the prevention of biliary tract diseases, emphasis should be placed on appropriately increasing the intake of fruits, vegetables, coffee and tea, and reducing the intake of alcohol, raw fish and foods with high nitrate. Meanwhile, weight, blood sugar and lipid levels should be controlled, and diabetes should be actively prevented and treated. Drinking is not recommended to prevent gallstones, although studies have shown that it may reduce the risk of cholecystolithiasis. Conclusions Our study summarizes the current multifaceted evidence on the relationship between dietary and nutritional indicators and biliary diseases, but the quality of all evidence was not high. Evidence from additional high-quality prospective studies are needed in the future.

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Background:The optimal timing of surgery after neoadjuvant chemotherapy (NAC) in patients with synchronous colorectal cancer liver metastases (SLM) remains controversial. We plan to analyze whether the choice of different surgical timings will have different effects on the perioperative and oncologic outcomes of patients. Method: We retrospectively collected all patients who met the inclusion and exclusion criteria from 2010 to 2020 in west china hospital . Patients were grouped according to time interval (TI) after NAC to surgery. The perioperative and oncologic outcomes of the two groups were compared after propensity score matching. Univariate and multivariate analyzes were used to screen factors associated with prognosis. Result: Among 255 enrolled patients, 188 were matched with comparable baseline (94 each group). Patients in the 6≦TI≦8 group had longer operation time, less intraoperative blood loss and less postoperative complications than those in the 4≦TI<6 group. However, the OS (p=0.012) and DFS (p=0.013) of the patients in the 4≦TI<6 group were better than those in the 6≦TI≦8 group. Multivariate analysis showed that the prolongation of TI after NAC to surgery was an independent prognostic risk factor for OS and DFS, while postoperative complications were not related to the prognosis of patients. Conclusions: Patients with SLM may be a better choice for surgery within 4-6 weeks after receiving NAC. Although patients with SLM undergoing surgery 4–6 weeks after NAC has a higher rate of postoperative complications, radical surgery is still recommended for a better survival benefit.

In a previous study, we discovered that the lnc-TSPAN12 level was significantly elevated in hepatocellular carcinoma (HCC) and linked to a low chance of survival. In HCC, however, the function of lnc-TSPAN12 in modulating epithelial-mesenchymal transition (EMT) and metastasis is still poorly understood. This study demonstrated that lnc-TSPAN12 positively modulated migration, invasion, and EMT of HCC cells in vitro and exacerbated hepatic metastasis in patient-derived tumour xenograft metastatic models in vivo. The modification of N6-methyladenosine that is driven by METTL3 is essential because it is involved in the upregulation of lnc-TSPAN12, which contributes to the stability of lnc-TSPAN12. Mechanistically, lnc-TSPAN12 exhibits direct physical interactions with EIF3I and SENP1, and it also assumes the role of a scaffold to help enhance the SENP1-EIF3I interaction. This in turn inhibits the SUMOylation of EIF3I and the degradation of ubiquitin, eventually activating the Wnt/β-catenin signalling pathway to stimulate EMT and metastasis of HCC. Our results shed light on the lnc-TSPAN12 regulation mechanism in HCC metastasis and identify the lnc-TSPAN12-EIF3I/SENP1 axis as a novel treatment target for HCC.