Xin Fan

Gastrointestinal filling, distension, and contraction subject the gut wall to dynamic mechanical loads. Interstitial cells of Cajal (ICC) help generate electrical slow waves, but the mechanisms coupling mechanical stimuli to pacemaker activity remain incompletely defined. This focused narrative review distinguishes currents recorded in identified ICC from candidate mechanisms and indirect epithelial, neural, and smooth-muscle pathways. In isolated human jejunal ICC, perfusion shear enhances a Na_V1.5-associated Na⁺ current; its recruitment by physiological wall loading and contribution to propulsion in vivo remain unknown. Hypotonic swelling evokes a volume-sensitive Cl⁻ current in cultured murine ICC without identifying the channel protein. ANO1 couples intracellular Ca²⁺ signals to depolarization. Piezo1 and TRPM7 are candidates for mechanical signaling in native gastrointestinal ICC, whereas Piezo2 has established epithelial and sensory-neuronal functions. Within the electrically coupled network of smooth muscle cells, ICC, and platelet-derived growth factor receptor α-positive cells, these responses may alter contraction timing and coordination. Clinical studies link ICC abnormalities and SCN5A channel dysfunction to motor disorders, but do not establish a causal ICC-specific mechanical defect. Translation requires experiments connecting controlled loading, currents in identified cells, and organ-level motor outcomes.

Gastrointestinal filling and contraction expose the gut wall to changing mechanical loads. Interstitial cells of Cajal (ICC) respond to these loads, but the channels that couple force to pacemaker activity remain incompletely defined. This narrative review examines direct recordings from ICC, proposed channel mechanisms and the epithelial, neural and muscular pathways that shape the motor response. Perfusion shear enhances NaV1.5 current in human jejunal ICC, whereas hypotonic swelling activates a Cl⁻ current in cultured murine ICC whose molecular identity remains unresolved. ANO1 converts intracellular Ca²⁺ signals into depolarization; evidence for its direct mechanical gating is lacking. Piezo1 and TRPM7 are candidate upstream mechanisms in ICC. Piezo2 instead has established functions in epithelial mechanosensing and extrinsic sensory pathways, with effects that depend on the cells and circuits involved. Within the electrically coupled smooth muscle–ICC–PDGFRα⁺ cell network, these inputs alter excitability, propagation and the timing of contraction. Increased local slow-wave frequency can therefore disrupt coordination rather than improve propulsion. Human genetics and tissue studies link channel dysfunction and ICC abnormalities to gastrointestinal motor disorders, but do not yet establish an ICC-specific mechanosensory lesion. Progress toward treatment will require experiments that connect defined mechanical stimuli, currents in identified cells and organ-level motor function.

Previous studies have established that Hepatitis B virus (HBV) infection contributes to the development of cirrhosis and hepatocellular carcinoma (HCC). In recent years, growing attention has been directed towards the association between HBV and extrahepatic malignant tumors, particularly gastric cancer (GC), with increasing evidence suggesting that HBV infection may elevate the risk of GC. Several meta-analyses have examined the link between HBV and GC. However, the underlying pathogenic mechanisms remain poorly understood. This study conducts a systematic review of existing research to investigate the association between HBV infection and GC risk. Additionally, it offers a comprehensive analysis of the epidemiological data, virological characteristics, and molecular mechanisms. The available evidence suggests that HBV may contribute to GC development and progression through mechanisms such as HBV DNA integration, regulation of HBx protein, chronic inflammation, and immune dysregulation. However, limitations in the current literature—such as reliance on single-source samples, insufficient control of confounding factors, and limited mechanistic studies—should be acknowledged. Large-scale, multicenter, prospective studies with clearly defined mechanisms are needed to further clarify the causal relationship between HBV and GC and to identify potential biomarkers. In conclusion, addressing HBV-related GC is a critical clinical and public health priority.

Background: By counting the volume of gastric contents aspirated under gastroscopy after tracheal intubation, ph and monitoring some indicators in the perioperative period. To assess the effect of preoperative oral administration of different doses of carbohydrates on ERAS results in patients undergoing laparoscopic gastric cancer resection.Methods: The present study was conducted as an investigator-initiated, randomised controlled, parallel group, equivalence trial. The study population comprised 66 patients diagnosed with gastric adenocarcinoma, who were randomly assigned to either group A or group B. Patients in group A consumed 200 ml of 5% dextrose solution 2 h prior to the operation, and patients in group B consumed 400 ml of 5% dextrose solution 2 h prior to the operation. gastric contents were suctioned through a gastroscope immediately after endotracheal intubation. The main observation indexes were preoperative gastric residual volume.Results: The final study analyzed 60 patients (30 in group A and 30 in group B). The baseline characteristics of the patients in both groups were comparable. There were no significant differences between the two groups in terms of residual stomach volume (36.4 ± 9.6 vs. 37.7 ± 8.8 ml, P = 0.565), pH (2.57 ± 0.49 vs. 2.62 ± 0.53, P = 0.67), variability in suction volume per aspiration (SVV: 12.69 ± 3.21 vs. 11.85 ± 2.56, P = 0.105), and incidence of postoperative complications (13.3% vs. 16.7%, P = 0.105). 13.3% vs. 16.7%, P = 0.105) Compared with Group A, there was a difference in the degree of discomfort before surgery among patients in Group B. (thirst score: 2.03 ± 1.15 vs. 1.57 ± 1.01, P = 0.049; hunger score: 3.1 ± 1.3 vs. 2.3 ± 1.1, P = 0.002).Conclusion: In gastric cancer patients undergoing elective laparoscopic radical gastric cancer surgery, consumption of 200 ml and 400 ml of carbohydrate beverages 2 h before surgery did not significantly increase gastric residual volume, acidity, or perioperative complications, and no significant differences in intraoperative hemodynamics were observed. Increasing preoperative oral intake within safe limits may further reduce thirst and hunger scores. Individualized adjustment of rehydration volume is recommended for elderly or obese patients.

Objective: This study explores the clinical significance of elevated tumor markers in patients with biliary pancreatitis. It aims to develop a machine learning-based clinical prediction model to facilitate early intervention and improve outcomes in acute biliary pancreatitis (ABP).Methods: We collected data from patients admitted with biliary pancreatitis to the Department of General Surgery at Jiangsu University Hospital from January 1, 2016, to December 31, 2023. We recorded general patient information.Results: Markers including Carbohydrate Antigen (CA) 50, CA19-9, CA125, CA724, CA242, ferritin, leukocyte count, high-sensitivity C-reactive protein (HS-CRP), total bilirubin, direct bilirubin, alanine aminotransferase, and aspartate aminotransferase were significantly higher in the severe acute pancreatitis (SAP) and moderately severe acute pancreatitis (MSAP) groups compared to the mild acute pancreatitis (MAP) group (P < 0.05). Univariate logistic regression analysis identified white blood cell count, HS-CRP, CA50, CA19-9, CA125, urinary amylase, total bilirubin, aspartate aminotransferase, and hospitalization duration as risk factors for progression to MSAP or SAP. Multivariate logistic regression analysis confirmed hospitalization duration as an independent risk factor.Conclusion: Elevated tumor markers have clinical significance in biliary pancreatitis. We propose a clinical prediction model based on machine learning to screen variables and guide treatment adjustments for MAP.

This study aimed to analyze the clinical efficacy of π-shaped esophagojejunostomy and the overlap method in treating upper gastric cancer with double-tract reconstruction in proximal gastrectomy under total laparoscopy. Clinical data were collected from patients with upper gastric cancer who underwent surgery in the General Surgery Department of Jiangsu University Affiliated Hospital from June 1, 2017, to January 1, 2023. Patients were categorized into the overlap method group and the π-shaped esophagojejunostomy group. We collected perioperative and gastroscopy follow-up data from both groups 1 year after surgery. Seventy-nine patients were included, with 46 in the overlap anastomosis group and 33 in the π-shaped esophagojejunostomy group. Both groups were evaluated for age, sex, body mass index, tumor diameter, tumor pathological Tumor, Node, Metastasis staging, intraoperative bleeding volume, number of lymph node dissections, postoperative hospitalization days, postoperative hospitalization days, catheter removal time, drainage tube removal time, recovery time, anal defecation time, postoperative bedtime activity time, hospitalization cost, Visual Analog Scale (VAS) score at rest on the first day after surgery, VAS score at activity on the first day after surgery, short-term postoperative complications and 1-year gastroscopy follow-up. No significant difference was observed in these factors (P > 0.05). However, the π-shaped esophagojejunostomy group had a significantly lower surgical time and anastomosis time than the overlap anastomosis group (P < 0.05). Both overlap anastomosis and π-shaped esophagojejunostomy are safe for double-tract reconstruction in proximal gastrectomy under total laparoscopy without increasing the incidence of perioperative and short-term complications in patients. π-shaped esophagojejunostomy has shorter surgical time and anastomosis time than overlap anastomosis.

Background: Essential trace elements are vital for human growth and development. Nevertheless, excessive intake can pose risks. As of yet, no research has looked at the possibility of a relationship between the prevalence of gallstones and urinary concentrations of nickel, molybdenum, and iodine.Objectives: The purpose of this study was to examine the correlation between urinary levels of iodine, molybdenum, and nickel and the occurrence of gallstones in a U.S. population and to verify whether excessive iodine intake is associated with the occurrence of gallstones.Methods: Data from 2,734 participants that were gathered between 2017 and 2020 were examined. Employing inductively coupled plasma mass spectrometry (ICP-MS), the levels of nickel (Ni), iodine (I), and molybdenum (Mo) in the urine were determined. Gallstones presence was determined using a standardized questionnaire. Restricted cubic spline analysis, subgroup analysis, and logistic regression analysis were used to evaluate the relationship between the occurrence of gallstones and urinary essential trace elements.Results: The logistic regression analysis indicated an increased risk of gallstone development in Quartiles 2, Quartiles 3, and Quartiles 4 groups in comparison to the Quartiles 1 group, based on urinary iodine levels (OR = 1.69, 95% CI: 1.11–2.56; OR = 1.68, 95% CI: 1.10–2.55; OR = 1.65, 95% CI: 1.09–2.51). Urinary iodine levels were nonlinearly positively linked with the development of gallstones, according to restricted cubic spline analysis (P-Nonlinear = 0.032). Subgroup analyses showed that high levels of urinary iodine were associated with a high risk of gallstones in different populations, and were more pronounced in adults aged 60 years and older, in women, with a BMI ≥ 25, and in diabetic patients.Conclusion: Our research revealed a correlation between an increased risk of gallstones and increasing urinary iodine levels. Urinary iodine levels serve as indicators of the body’s iodine status, thus suggesting that excessive iodine intake may be linked to an elevated risk of gallstone formation.

Background: With the use of cobalt alloys in medical prosthetics, the risk of cobalt exposure has increased. The objective of this study was to investigate the correlation between blood cobalt levels and the occurrence of gallstones utilizing data from the National Health and Nutrition Examination Survey (NHANES).Methods: Data collected between 2017 and 2020 were analyzed, encompassing a total of 5,610 participants. Cobalt concentrations in whole blood specimens were directly measured using inductively coupled plasma mass spectrometry (ICP-MS). The presence of gallstones was ascertained through a standardized questionnaire. To assess the association between blood cobalt levels and the presence of gallstones, logistic regression analysis, restricted cubic spline analysis, and subgroup analysis were utilized.Results: The results of logistic regression analysis revealed a heightened risk of developing gallstones in the Quartiles 2 and Quartiles 4 groups based on blood cobalt levels when compared to the Quartiles 1 group (OR = 1.54, 95% CI: 1.15–2.07; OR = 1.35, 95% CI: 1.03–1.77). The restricted cubic spline analysis exhibited a positive linear correlation between blood cobalt levels and the occurrence of gallstones. Subgroup analyses further demonstrated a statistically significant correlation between the Quartiles 4 category of blood cobalt levels and an elevated risk of gallstones, particularly among individuals aged 60 years or older, females, those with a body mass index (BMI) equal to or exceeding 25, serum total cholesterol levels below 200 mg/dL, as well as individuals diagnosed with hypertension or diabetes.Conclusion: Our study findings indicate a notable association between elevated blood cobalt levels and an increased risk of gallstones. To establish a causal relationship between blood cobalt levels and the elevated risk of developing gallstones, further prospective cohort studies are warranted.

Background and objectives: Enhanced recovery after surgery (ERAS) recommends avoiding enteral nutrition (EN) due to undesirable sequelae such as pulmonary aspiration and infections. Not using of EN in nongastric resections under ERAS pathways is often successful. However, parenteral nutrition (PN) alone followed by early postoperative oral feeding in gastric cancer patients, recommended by the ERAS guidelines, has unclear benefit and is only adopted after gastric resection. This study aimed to compute the postoperative outcomes of EN and PN compared to those of the ERAS-recommended nutritional pathway. Our secondary objective was to compare postoperative complications between the two groups. Materials and methods: Of 173 gastrectomy patients, 116 patients were in the combined group (EN and PN), whereas 57 patients were in the PN alone group. Statistical analysis was performed with the Statistical Package for the Social Sciences (SPSS) version 26.0.0 software. The data were analyzed by one-way ANOVA, the independent sample t-test, or, in the case of several independent samples, by the Kruskal–Wallis test. Categorical data were analyzed by Pearson’s χ² test or Fisher’s exact test. Results: The observed indices included C-reactive protein (CRP), platelet (PLT), white blood cells (WBC), hemoglobin (Hb), albumin, and PRE-albumin. The secondary outcomes included length of hospital stay (LOS), cost, incidence of pulmonary infection, and total incidence of infection. Conclusion: The combined mode of nutrition is feasible and is not associated with postoperative complications in gastric cancer patients under ERAS.

Copper, an indispensable trace element for the human body, serves not only as a crucial auxiliary factor in redox reactions within the organism but also as a significant constituent of numerous key metabolic enzymes. The COMMD family plays a vital role in regulating copper at both the cellular and systemic levels, particularly in the realm of tumor research, an area notably deficient in gastric cancer investigations. With the advancement of precision medical techniques, individualized and precise screening and treatment have become paramount considerations in the contemporary medical landscape for gastric cancer therapy. In light of this, we meticulously scrutinized existing transcriptomic datasets for gastric cancer, validating the expression levels and prognostic value of COMMD family genes. Simultaneously, employing the ssGSEA algorithm, we devised the COMMDs score. Enrichment analysis, gene mutations, and clinical features were incorporated into the assessment of this score. Furthermore, we contextualized the COMMDs score within the framework of the immune microenvironment, evaluating the relationship between the COMMDs family and immune factors as well as immune cells. The results suggest a correlation between the COMMDs score and various immune-related features. Based on this foundation, multiple machine learning approaches indicated Logistic Regression, with a remarkable ROC of 0.972, as the optimal diagnostic model. To accentuate the translational medical value of the COMMDs family, we selected COMMD10 as a differential gene in gastric cancer for further validation. Functional experiments revealed a decline in the proliferative and migratory capabilities of gastric cancer cells upon silencing COMMD10. Additionally, through pathway intervention, we unveiled the PI3K-AKT pathway as a potential mechanism through which COMMD10 influences gastric cancer activity. In summary, our study affirms the prospective role of the COMMDs family as potential markers for the diagnosis and treatment of gastric cancer in the future.