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Background: This study aimed to explore the risk factors associated with esophagojejunal anastomotic leakage (EJAL) in curative total gastrectomy combined with D2 lymph node dissection for gastric cancer.Methods: 390 consecutive patients receiving Roux-en-Y esophagojejunostomy reconstruction after surgery were reviewed. Multivariate analysis was performed using a logistic regression model to identify independent risk factors for EJAL.Results: Of the 390 patients enrolled in this study, EJAL occurred in 10 patients (2.6%). One patient (1/10) with EJAL died. Univariate analysis identified age (P = 0.025), alcohol consumption (P = 0.019), pulmonary insufficiency (P = 0.049), and intraoperative blood loss (P = 0.015) as risk factors for EJAL. Of these four risk factors, age (P = 0.043) and alcohol consumption (P = 0.043) were retained as independent risk factors by multivariate analysis.Conclusions: Surgeons should be very careful about anastomotic leakage during the perioperative period, especially in patients with advanced age and a history of alcohol consumption. Pulmonary insufficiency and intraoperative blood loss, although not being identified as independent risk factors, should also be considered.

Objectives: Acute myeloid leukemia (AML) is a heterogeneous and highly recurrent hematological malignancy. Studies have shown an association between microRNAs and drive genes in AMLs. However, the regulatory roles of miRNAs in AML and how they act on downstream targets and the signaling pathway has been little studied. Methods: As to understand the mechanism of mRNA-miRNA interaction in the blood malignancy from a large scale of transcriptomic sequencing studies, we applied a comprehensive miRNA-mRNA association, co-expression gene network and ingenuity pathway analysis using TCGA AML datasets. Results: Our results showed that his-mir-335 was a critical regulatory of homeobox A gene family. PBX3, KAT6A, MEIS1, and COMMD3-BMI1 were predicted as top transcription regulators in the regulatory network of the HOXA family. The most significantly enriched functions were cell growth, proliferation, and survival in the mRNA-miRNA network. Conclusion: Our work revealed that regulation of the HOXA gene family and its regulation played an important role in the development of AML.

Context Particulate matter (PM) is an important risk factor for diabetes. However, its underlying mechanisms remain poorly understood. Although liver-derived biological intermediates may play irreplaceable roles in the pathophysiology of diabetes, few studies have explored this in the association between PM and diabetes. Objective We investigated the role of liver enzymes in mediating the relationship between PM exposure and diabetes. Methods We included a total of 7,963 participants from the China Multi-Ethnic Cohort. Residential exposure to PM was assessed using a validated spatial-temporal assessment method. Diabetes was diagnosed according to the criteria from American Diabetes Association. Associations between PM, liver enzyme (including alanine aminotransferase [ALT], aspartate aminotransferase, alkaline phosphatase, and γ-glutamyl transpeptidase [GGT]), and diabetes were estimated using multivariable regression models. The function of liver enzymes in the relationship between PM and diabetes was assessed using mediation analysis. Results PM exposure was positively associated with the odds of diabetes, with ORs of 1.32 (95% CI: 0.83, 2.09), 1.33 (95% CI: 1.07, 1.65) and 1.18 (95% CI: 1.02, 1.36) for every 10-μg/m 3-increment in PM1, PM2.5, and PM10, respectively. ALT (4.47%) and GGT (4.78%) exhibited statistically significant mediation effects on the association between PM2.5 and diabetes, and the ALT (4.30%) also had a mediating role on PM10. However, none of the liver enzymes had a significant mediating effect on PM1. Conclusion The relationship between PM and diabetes is partially mediated by liver enzymes, suggesting that lipid accumulation, oxidative stress, and chronic inflammation in the liver may be involved in its pathogenesis.