Table of Content

20 February 2026, Volume 26 Issue 01

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Original Articles and Clinical Research

Long-term efficacy of parenchymal-sparing anatomical hepatectomy： a propensity score-matched study based on the SEER database

KOU Chunwei, DUAN Yufan, ZHU Hongtao, JI Ren

2026, 26(01):  1-9.  DOI: 10.3969/j.issn.1009-976X.2026.01.001

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Objective To compare the long-term outcomes between formal anatomical hepatectomy （FAH, left or right hepatectomy） and parenchymal-sparing anatomical hepatectomy （PSAH, resection of 1, 2, or 3 liver segments） based on the SEER database. Methods A retrospective analysis was conducted on patients diagnosed with hepatocellular carcinoma （HCC） between 2000 and 2021 in the SEER database. Patients were divided into two groups according to surgical approach： PSAH group （n=2348） and FAH group （n=2450）. Propensity score matching （PSM） was used to balance intergroup differences. Demographic and tumor characteristics, overall survival （OS）, and cancer-specific survival （CSS） were compared between the two groups. Results Before PSM, compared with the FAH group, the PSAH group had a lower proportion of male patients （71% vs. 74.2%, P=0.012）, a higher proportion of patients aged ≥ 60 years （72.2% vs. 68.2%, P=0.004）, a longer interval from diagnosis to treatment （41.0 vs. 37.0 days, P< 0.001）, a higher proportion of patients with Ishak 5~6 liver fibrosis （53.5% vs. 36.3%, P< 0.001）, smaller tumor size （42.0 mm vs. 66.0 mm, P< 0.001）, earlier AJCC TNM stage （P< 0.001）, fewer patients receiving radiotherapy （P=0.044） and chemotherapy （P< 0.001）, and significantly better OS （P< 0.001） and CSS （P< 0.001）. After PSM, although the PSAH group still had a higher proportion of patients with Ishak 5~6 liver fibrosis compared with the FAH group （50.6% vs. 39.7%, P< 0.001）, OS （P=0.030） and CSS （P=0.032） remained significantly better in the PSAH group. Subgroup analysis results indicated that after balancing key prognostic factors, there were no significant differences in OS and CSS between the PSAH and FAH groups in the small HCC subgroup or the giant HCC subgroup. However, in the large HCC subgroup, the PSAH group demonstrated significantly better CSS （P= 0.004） and OS （P=0.002） compared to the FAH group. Conclusion This study demonstrates that after balancing key prognostic factors such as tumor size, tumor stage, and degree of liver fibrosis, the efficacy of PSAH in patients with HCC is not inferior to that of FAH, and may even be superior in patients with large liver tumors. Therefore, PSAH may be prioritized when tumor characteristics and technical conditions permit.

SNF5 cooperates with RNA helicase DDX5 to resolve R-loop and maintain genome stability in tumor cells

GAO Yuan, XIE Xiaojuan, HU Kaishun

2026, 26(01):  10-21.  DOI: 10.3969/j.issn.1009-976X.2026.01.002

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Objective To investigate the role and molecular mechanism of the chromatin remodeling factor SNF5 in tumor cell proliferation and genome stability maintenance. Methods An SNF5-knockout HeLa cell line was generated using CRISPR-Cas9 technology. Cell proliferation and cell cycle distribution were analyzed by EdU incorporation and flow cytometry, respectively. Colony formation assays were performed to evaluate cellular sensitivity to IR, HU, CPT, and MMC treatments. DNA fiber assays were used to assess DNA replication dynamics, and R-loop accumulation was detected by S9.6 immunofluorescence. Potential SNF5-interacting proteins under replication stress were identified by IP-MS, followed by validation of SNF5-DDX5 interaction through co-immunoprecipitation （CoIP） and GST pull-down assay. Results Loss of SNF5 impaired DNA synthesis, increased the proportion of G1-phase cells, and markedly reduced proliferation of tumor cells, accompanied by enhanced sensitivity to DNA-damaging agents. DNA fiber assay revealed slowed replication fork progression in SNF5-deficient cells, while S9.6 staining indicated increased R-loop accumulation. Protein interaction assays confirmed that SNF5 physically associates with the RNA helicase DDX5, cooperating to alleviate R-loop accumulation under replication stress. Conclusion SNF5 promotes DNA replication and tumor cell proliferation by coordinating with DDX5 to resolve R-loop and maintain genomic stability. SNF5 deficiency leads to R-loop accumulation, replication impairment, and increased sensitivity to radio- and chemotherapy, supporting SNF5 as a potential tumor therapeutic target.

Comparative clinical efficacy of primary excision with primary closure versus rhomboid flap reconstruction in the treatment of sacrococcygeal pilonidal Sinus

LU Zhilin, LIN Yikun, CAI Shihuai

2026, 26(01):  22-26.  DOI: 10.3969/j.issn.1009-976X.2026.01.003

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Objective To compare the efficacy of primary resection and suture versus rhomboid flap transfer in the treatment of sacrococcygeal pilonidal sinus. Methods We retrospectively analyzed 61 patients with sacrococcygeal pilonidal sinus. They were divided into a resection group （n=25） and a flap group （n=36）. Operative time, length of hospital stay, complication rate, recurrence rate, and postoperative aesthetic satisfaction were compared between the two groups. Logistic regression was used to analyze risk factors for postoperative complications and recurrence. Results The two groups were comparable in terms of baseline characteristics, including sex, age, and disease duration. Operative time was significantly shorter in the resection group than in the flap group （P< 0.05）. In contrast, the length of hospital stay was significantly shorter in the flap group （P< 0.05）. Recurrence and complication rates were significantly lower in the flap group （P< 0.05）, whereas postoperative aesthetic satisfaction was higher in the resection group （P< 0.05）. Length of hospital stay was a risk factor for postoperative complications（OR=1.551,P=0.019）. Conclusion Compared with primary resection and suture, rhomboid flap transfer is associated with lower rates of postoperative complications and recurrence, and a shorter hospital stay, making it an effective treatment for sacrococcygeal pilonidal sinus.However, it is associated with a higher risk of scar formation and a longer operative time.

Data volume optimization of pooled library sequencing enhances clinical application and validation of genetic testing efficacy in oncological surgery

LUO Jiahuan, HUANG Jinghua, JIANG Yuanling, HUANG Yongsheng, YIN Xinke, FU Sha, OUYANG Nengtai, LIAO Jian-wei

2026, 26(01):  27-32.  DOI: 10.3969/j.issn.1009-976X.2026.01.004

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Objective To optimize data allocation strategies for tumor libraries of different lengths on the Illumina NextSeq 550 sequencing platform, ensuring detection quality while meeting the timeliness requirements of surgical diagnosis and treatment. Methods In 10 batches of experiments, the output ratio （output data volume/input data volume） of three library types （275 bp/300 bp amplicons, 350 bp hybrid capture） was quantified.This quantification was used to determine the cluster generation capability of different libraries. Further analysis was conducted to derive the adjustment range for the data volume ratio of libraries with different lengths. Based on this range, the concentration of each library was adjusted to regulate its final data volume. Results The data volume for 300 bp amplicon libraries should be adjusted to a range of 0.55× to 0.72×. The data volume of 275 bp amplicon libraries should be adjusted in the range of 0.56× to 0.79×. The data volume of 350 bp hybridization capture libraries can be adjusted according to the amount of redundant data on the flow cell to balance data output. Conclusion Adjusting library loading volumes based on output ratios quantifying clustering capabilities across libraries of varying lengths enables balanced output of tumor pooled sequencing data and optimal utilization of chip resources.

Identification and validation of a carbohydrate metabolism related key gene associated with fibroblast in abdominal aortic aneurysm

LI Gen, ZHAO Ziniu, SHI zhanyue

2026, 26(01):  33-41.  DOI: 10.3969/j.issn.1009-976X.2026.01.005

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Objective To explore the potential role of the （alcohol dehydrogenase 1B, ADH1B）ADH1B gene in abdominal aortic aneurysms （AAA）. Methods Utilizing bioinformatics techniques, we conducted a comprehensive analysis of transcriptome and single-cell data from human AAA and normal abdominal aorta tissue samples. The metabolism-related marker gene ADH1B was identified using logistic regression analysis of carbohydrate metabolism datasets. Results The fibroblast ADH1B gene may be involved in protecting against the development of AAA by modulating smooth muscle cell phenotypic changes. Conclusion The ADH1B gene appears to have a protective role in abdominal aortic aneurysms.

Research of great saphenous vein trunk stripping using the Havst catheter

LIN Xiaowen, HU Minxiang, PENG Xiangyu, LI Pengfei, HUANG Qingjin

2026, 26(01):  42-46.  DOI: 10.3969/j.issn.1009-976X.2026.01.006

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Objective To compare the short-term outcomes of the Havst catheter-assisted stripping technique versus conventional stripping for trunk of great saphenous vein （GSV）. Methods We retrospectively analyzed clinical data from 80 consecutive patients with great saphenous vein （GSV） varicosities who underwent surgical treatment in our department between January 2025 and June 2025. Patients were equally allocated into two groups （n=40 each）： the external stripping group （high ligation of the great saphenous vein + trunk stripping in the thigh + stab phlebectomy in the calf） and the conventional stripping group （high ligation + trunk stripping in the thigh + stab phlebectomy in the calf）. The two groups were compared across multiple parameters： age and sex distribution, clinical severity （CEAP classification）, thigh-level incision length, GSV trunk stripping time （including tumescent anesthesia administration）, length of hospital stay, surgical pain score, and thigh ecchymosis area on postoperative Day 3. Results No statistically significant differences were observed between the external stripping group and conventional stripping group regarding age, gender distribution, clinical classification （CEAP）, length of hospital stay,surgical pain score,and thigh ecchymosis area on postoperative Day 3. （all P> 0.05）. The external stripping group demonstrated significantly shorter incision lengths and reduced stripping times compared to the conventional group （both P< 0.001）. Conclusion The Havst catheter system enables minimally invasive stripping of the great saphenous vein （GSV） trunk through a single small incision, with significantly improved procedural efficiency.

Clinical comparison between 3Fr ureteral catheter and zebra guidewire in guiding scope insertion during ureteroscopy

WU Guanke, HUANG Weichao, CHEN Baizhuang, LI Zhizhen

2026, 26(01):  47-53.  DOI: 10.3969/j.issn.1009-976X.2026.01.007

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Objective To compare the clinical effects of 3Fr ureteral catheter and zebra guidewire in guiding scope insertion duringureteroscopy. Methods A total of 161 patients who were scheduled to undergo ureteroscopy in the hospital from January 2022 to July 2025 were enrolled in this study. They were randomly divided into the 3Fr ureteral catheter group （n=81） and the zebra guidewire group （n=80） by the envelope method. The operation time of the two groups was compared, as well as the differences in C-reactive protein （CRP）, urine protein/creatinine ratio （UPCR） before and after the operation and the occurrence of complications. Results The operation time of the 3Fr ureteral catheter group was significantly longer than that of the zebra guidewire group （P< 0.05）. In all subgroups based on stone size （≤ 1.5 cm or > 1.5 cm） and stone location （upper or mid-lower segment）, the 3Fr catheter group also exhibited significantly longer operative times than the zebra guidewire group （P< 0.05）. Postoperatively, both groups showed elevated CRP and UPCR levels, with the 3Fr catheter group significantly higher than the zebra guidewire group, and this difference remained significant across all subgroups （P< 0.05）. The incidence of ureteral injury in the Fr ureteral catheter group was significantly lower than that in the Zebra guidewire group （4.94% vs. 15.00%）, while the incidence of stones returning to the kidney was significantly higher in the Fr ureteral catheter group than in the Zebra guidewire group （11.11% vs. 2.50%; P< 0.05）. The total incidence of complications between the two groups was not significantly different （P> 0.05）. Conclusion 3Fr ureteral catheter has more advantages in reducing ureteral mucosal injury, while zebra guidewire performs better in shortening operation time, reducing the risk of stone displacement, and alleviating postoperative stress response. It is recommended that the appropriate guidance method be chosen based on the patient′s condition and surgical requirements.

Application of the integrated traditional Chinese and Western medicine health management model in percutaneous vertebroplasty for elderly patients with osteoporotic vertebral compression fractures

LI Bifeng, SHI Jiacheng, YANG Lin, HU Rihe, HUANG Jiasheng, GUO Shun, LAN Guojian, HUANG Guoxing

2026, 26(01):  54-61.  DOI: 10.3969/j.issn.1009-976X.2026.01.008

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Objective To investigate the application effect of the integrated traditional Chinese and Western medicine-enhanced recovery after surgery （ERAS） model in the perioperative period of Percutaneous Vertebroplasty （PVP） for elderly patients with osteoporotic vertebral fracture （OVF）. Methods A retrospective analysis was conducted on 50 elderly OVCF patients who underwent PVP at Qingyuan Hospital of Traditional Chinese Medicine, affiliated with Guangzhou University of Chinese Medicine from September 2021 to March 2022. These patients were designated as the control group and received interventions according to the conventional disease management pathway. Another 50 patients with OVF who underwent the same surgery from April 2022 to September 2022 were assigned to the observation group and received a health management intervention integrating traditional Chinese and Western medicine characteristics. Perioperative indicators such as operation time, bone cement volume, length of hospital stay, hospital costs, and complication rates were collected. Data from assessment scales, including the Patient Health Questionnaire-9 （PHQ-9）, Visual Analogue Scale （VAS）, Oswestry Disability Index （ODI）, and EuroQol-5 Dimensions （EQ-5D）, were collected preoperatively, on postoperative day 1, and at 6 months postoperatively. Vertebral body recovery was assessed by measuring the anterior vertebral height （AVH） and local kyphosis angle （LKA） of the injured vertebra. Results The time to ambulation and hospital stay length in the observation group were significantly shorter than those in the control group （P< 0.05）. Hospitalization costs were also significantly lower in the observation group compared to the control group （P< 0.05）. There were no significant differences in anesthesia time, bone cement volume, or operation time between the two groups （P> 0.05）. The pain level in the observation group was slightly lower than that in the control group on postoperative day 1, with a statistically significant difference in VAS score （P< 0.05）. There were no significant differences in ODI, AVH, or LKA between the two groups at preoperative, postoperative day 1, 3 months, and 6 months compared to preoperative values （P> 0.05）. The incidence of postoperative constipation in the observation group was lower than that in the control group （P< 0.05）, while no significant differences were found in other complications （P> 0.05）. In the quality-of-life scale, the dimensions of pain/discomfort and anxiety/depression had significantly better outcomes in the observation group compared to the control group （P< 0.05）. Conclusion The integrated traditional Chinese and Western medicine ERAS model is a reliable and effective perioperative management strategy. It helps in early pain relief, alleviates postoperative anxiety and depression, promotes rehabilitation after PVP, and improves patients' postoperative quality of life.

Review

Effects of common endocrine disrupting chemicals on hypospadias

WU Xian, NIU Shuaiyu, TANG Jingyuan, WEI Yunfei

2026, 26(01):  62-67.  DOI: 10.3969/j.issn.1009-976X.2026.01.009

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Hypospadias is a relatively common congenital malformation of the pediatric genitourinary system, and its incidence has been increasing worldwide in recent years. This disorder not only leads to abnormal micturition and penile developmental malformations, but may also have an adverse psychological effect on affected children due to penile morphological anomalies and the resulting social stress. In etiological research on hypospadias,epidemiological studies have shown that exposure to endocrine-disrupting chemicals （EDCs） is an important environmental factor that increases the risk of this disease. This paper systematically reviews the main categories of EDCs and their primary exposure routes, and focuses on exploring their pathogenic mechanisms from four aspects： interfering with hormonal signals, impairing the developmental microenvironment and molecular dynamics, affecting and affecting the progesterone receptorhypothesis and the regulation of key genes. It aims to provide a systematic reference for an in-depth understanding of the etiology of hypospadias.

Segmentectomy for early-stage non-small cell lung cancer： current applications and ongoing controversies

SHI Shangzhe, SAI Xiyalatu

2026, 26(01):  68-74.  DOI: 10.3969/j.issn.1009-976X.2026.01.010

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Lung cancer remains a leading cause of cancer-related mortality worldwide, and non-small cell lung cancer （NSCLC） accounts for approximately 85% of all lung cancer cases. For early-stage （stage I） NSCLC, surgical resection is the mainstay of treatment, with anatomical lobectomy having long been regarded as the standard procedure. In recent years, advances in imaging technologies and the wider implementation of early screening have renewed interest in segmentectomy, an anatomical sublobar resection that preserves more functional lung parenchyma. This review summarizes the evolution of segmentectomy, expansion of its indications, oncologic outcomes and recurrence risk, advantages in postoperative pulmonary function preservation, technical challenges, the impact of spread through air spaces （STAS） on procedure selection, current controversies, and future research priorities, with the aim of informing clinical decision-making.