First Affiliated Hospital of Guangxi Medical University

Surgery and thermal ablation are both viable treatment modalities for patients diagnosed with hyperparathyroidism (HPT). However, the comparative efficacy of these approaches remains uncertain. The objective of this meta-analysis is to evaluate the effectiveness of surgical complications and therapeutic strategies in managing HPT.

The databases PubMed, EMBASE, the Cochrane Library, the Web of Science, CNKI and Wan Fang were systematically searched from inception to December 12, 2023 to identify relevant studies comparing thermal ablation with surgical parathyroid hormone therapy. Data analysis was conducted using Review Manager Version 5.4.

A total of 15 studies were incorporated into the meta-analysis, comprising 1,115 participants drawn from 12 cohort studies and three randomized controlled trials. The results indicated no significant difference in parathyroid hormone levels between the two treatment options (mean difference: 29.25, 95% CI: -4.99-63.69, p = 0.09), calcium (MD: 0.00, 95%CI: 0.07-0.08, p = 0.94), phosphorus (MD: -0.05, 95% CI: -0.13-0.04, p = 0.28) and the risk of persistence and/or recurrence (OR: 1.01, 95% CI: 0.63-1.62, p = 0.97). The probability of hoarseness (OR: 0.57, 95% CI: 0.35-0.93, p = 0.02) and hypocalcemia (OR: -0.12, 95% CI: -0.19- -0.05, p < 0.01) was lower after thermal ablation than with surgery. Comparable results were observed in instances of secondary and primary hyperparathyroidism.

It can be concluded that surgery and thermal ablation are effective modalities for treating hyperparathyroidism. Thermal ablation has been shown to reduce the likelihood of hoarseness and hypocalcemia. Further validation of these results necessitates conducting comprehensive multicenter randomized controlled trials.

Ankylosing Spondylitis (AS) and Systemic Sclerosis (SSc) are both autoimmune diseases, albeit with distinct anatomical targets. AS primarily affects the spine and sacroiliac joints, triggering inflammation and eventual fusion of the vertebrae. SSc predominantly impacts the skin and connective tissues, leading to skin fibrosis, thickening, and potential damage to vital organs such as the lungs, heart, and kidneys. Despite their differing anatomical manifestations, inflammation serves as a pivotal factor in both conditions. Exploring the causes of the different pathogenesis of inflammation in AS and SSc could provide new insights into their treatment. We selected RNA-seq profiles of peripheral blood mononuclear cells (PBMCs) from the GEO datasets GSE73754 and GSE19617. DEGs were identified using the Limma R package with an adjusted p-value cutoff of < 0.05. Gene Ontology pathway analysis, SVM recursive feature elimination, and Gene Set Enrichment Analysis (GSEA) were conducted to analyze the DEGs. CIBERSORT was applied to estimate immune cell composition and its correlation with hub genes. Single-cell RNA sequencing data from peripheral blood mononuclear cells in the GSE194315 dataset were included to support differential expression analysis and biomarker identification. Additionally, single-cell RNA sequencing data from bone marrow blood samples were utilized to further validate these findings, offering complementary insights into biomarker expression across distinct sample types. A total of 762 DEGs were identified between AS patients and controls, and 441 DEGs between SSc patients and controls. Both conditions showed enrichment in the Natural killer cell mediated cytotoxicity pathway. ZSWIM6 and CCL3L3 were identified as potential biomarkers in AS and SSc, with significant diagnostic capabilities demonstrated by ROC analysis. Correlation analysis revealed associations between these biomarkers and specific immune cell types. The study utilizing ZSWIM6 and CCL3L3 as potential biomarkers provides deep insights into the distinct molecular mechanisms of SSc and AS. These findings lay the foundation for future research on targeted therapies and enhance our understanding of immune cell interactions in these autoimmune diseases.

Hepatocellular carcinoma (HCC) recurrence was previously characterized into four types, and patients with progression/hyper-progression recurrence (type III-IV) have an extremely poor prognosis. However, the immune background of resectable HCC, particularly in patients who experience recurrence, remains underexplored. Therefore, this study aimed to describe the immune landscape of resectable HCC, especially postoperative type III-IV recurrent HCC, and explore potential immune-targeted anti-relapse strategies for treated populations.

The differences in gene expression in patients with recurrent HCC (type I-II (solitary or multi-intrahepatic oligo recurrence) vs. type III-IV) were investigated using bulk sequencing. Multiple immune infiltration methods (single-sample gene set enrichment analysis (GSEA), Microenvironment Cell Populations-counter and ESTIMATE) were used, and patients were divided into four groups to identify four distinct immune subtypes: immune-enrichment/matrix-poor (IE1), immune-enrichment/matrix-rich (IE2), immune intermediate/matrix-rich (ITM) and immune desert/matrix-poor (ID). Co-expression and protein interaction analyses were used to identify characteristic genes in ITM closely associated with type III-IV recurrence, which was matched with drug targets for Huaier granules (HG) and lenvatinib. Virtual docking was used to identify potential therapeutic targets, and the results were verified using single-nuclei RNA sequencing and histological analysis.

ITM was closely related to type III-IV recurrence and exhibited immunotherapy potential. The potential efficacy of inhibiting CCNA2, VEGFA, CXCL8, PLK2, TIMP1, ITGB2, ALDOA, ANXA5 and CSK in ITM reversal was determined. Molecular docking demonstrated that the proteins of these genes could bind to HG or lenvatinib. The immunohistochemical findings demonstrated differential VEGFA (p < .01) and PLK2 (p < .001) expression in ITM type and ID in type III-IV recurrent HCC.

Three primary immunotypes of resectable HCC (IE2, ITM and ID) were identified, and HG and lenvatinib could potentially overcome immune checkpoint blockade (ICB) resistance in ITM patients with HCC, particularly those classified as type III-IV.