摘要：Introduction Cholangioscopy has become a prevalent method for treating common bile duct(CBD)stones.Two primary types of cholangio-scopes are commonly used:through-the-scope cholangioscopy and peroral direct cholangioscopy(PDCS).In the literature,three kinds of endoscopes are documented for PDCS:ultra-slim endo-scopes,double-bending cholangioscopes and standard endo-scopes[1].Among these options,standard endoscopes offer superior advantages,including better image quality,larger work-ing channels and more available accessories[2].Particularly in cases where patients exhibit significant CBD dilation,typically with a diameter exceeding 12 mm,a standard endoscope proves to be an effective choice for PDCS.Consequently,we presented a successful case where a giant CBD stone was effectively treated using PDCS through a standard gastroscope.

摘要：Background:Currently,the prognosis for metastatic colorectal cancer(mCRC)still remains poor.The management of mCRC has be-come manifold because of the varied advances in the systemic and topical treatment approaches.For patients with limited number of metastases,radical local therapy plus systemic therapy can be a good choice to achieve long-term tumor control.In this study,we aimed to explore the efficacy and safety of the combination of fruquintinib,tislelizumab,and stereotactic ablative radiotherapy(SABR)in mCRC(RIFLE study). Methods:RIFLE was designed as a single-center,single-arm,prospective Phase Ⅱ clinical trial.A total of 68 mCRC patients who have failed the first-line standard treatment will be recruited in the safety run-in phase(n=6)and the expansion phase(n=62),respec-tively.Eligible patients will receive SABR followed by fruquintinib(5 mg,d1-14,once every day)and tislelizumab(200 mg,d1,once every 3 weeks)within 2 weeks from completion of radiation.The expansion phase starts when the safety of the treatment is deter-mined(dose limiting toxicity occur in no more than one-sixth of patients in the run-in phase).The primary end point is the objective response rate.The secondary end points include the disease control rate,duration of response,3-year progression-free survival rate,3-year overall survival rate,and toxicity. Conclusions:The results of this trial will provide a novel insight into SABR in combination with PD-1 antibody and vascular endothe-lial growth factor receptor inhibitor in the systematic treatment of metastatic colorectal cancer,which is expected to provide new therapeutic strategies and improve the prognosis for mCRC patients. Trial registration:NCT04948034(ClinicalTrials.gov).

摘要：Background:Neoadjuvant chemotherapy(NCT)alone can achieve comparable treatment outcomes to chemoradiotherapy in locally advanced rectal cancer(LARC)patients.This study aimed to investigate the value of texture analysis(TA)in apparent diffusion coef-ficient(ADC)maps for identifying non-responders to NCT. Methods:This retrospective study included patients with LARC after NCT,and they were categorized into nonresponse group(pTRG 3)and response group(pTRG 0-2)based on pathological tumor regression grade(pTRG).Predictive texture features were extracted from pre-and post-treatment ADC maps to construct a TA model using RandomForest.The ADC model was developed by manually measuring pre-and post-treatment ADC values and calculating their changes.Simultaneously,subjective evaluations based on mag-netic resonance imaging assessment of TRG were performed by two experienced radiologists.Model performance was compared using the area under the curve(AUC)and DeLong test. Results:A total of 299 patients from two centers were divided into three cohorts:the primary cohort(center A;n¼194,with 36 non-responders and 158 responders),the internal validation cohort(center A;n¼49,with 9 non-responders)and external validation cohort(center B;n¼56,with 33 non-responders).The TA model was constructed by post_mean,mean_change,post_skewness,post_entropy,and entropy_change,which outperformed both the ADC model and subjective evaluations with an impressive AUC of 0.997(95%confidence interval[CI],0.975-1.000)in the primary cohort.Robust performances were observed in internal and external validation cohorts,with AUCs of 0.919(95%CI,0.805-0.978)and 0.938(95%CI,0.840-0.985),respectively. Conclusions:The TA model has the potential to serve as an imaging biomarker for identifying nonresponse to NCT in LARC patients,providing a valuable reference for these patients considering additional radiation therapy.

摘要：Introduction Herbal and dietary supplements(HDS)-induced liver injury has garnered interest in recent years for the increasing trend world-wide[1].Chinese oral herbal paste,a popular herbal formula to enhance immunity as HDS in a Chinese medicine clinic,has been less reported to induce liver injury.Here we reported a case of drug reaction with eosinophilia and systemic symptoms(DRESS)syndrome with abrupt transaminitis,which was caused by daily consumption of herbal formulas for 4 weeks.

摘要：Anorexia nervosa(AN)is one of the most common psychiatric disorders among young adults and is associated with a substantial risk of death from suicide and medical complications.Transaminase elevations are common in patients with AN at the time of hospital admission and have been associated with longer lengths of hospital stay.Multiple types of hepatitis may occur in these patients,including two types that occur only in patients with AN:starvation hepatitis and refeeding-induced hepatitis.Starvation hepatitis is characterized by severe transaminase elevation in patients in the advanced phase of protein-energy deprivation and is associated with complications of severe starvation,such as hypoglycaemia,hypothermia,and hypotension.Refeeding-induced hepatitis is characterized by a milder increase in transaminases that occurs in the early refeeding phase and is associated with hypophosphatemia,hypokalemia,and hypomagnesaemia.Among the most common forms of hepatitis,drug-induced liver injury is particularly relevant in this patient cohort,given the frequent use and abuse of methamphetamines,laxatives,antidepressants,and antipsychotics.In this review,we provided an overview of the different forms of anorexic-associated hepatitis,a diagnostic approach that can help the clinician to correctly frame the problem,and indications on their management and treatment.

摘要：Background:Visceral fat represents a metabolically active entity linked to adverse metabolic sequelae of obesity.We aimed to determine if celiac artery mesenteric fat thickness can be reliably measured during endoscopic ultrasound(EUS),and if these meas-urements correlate with metabolic disease burden. Methods:This was a retrospective analysis of patients who underwent celiac artery mesenteric fat measurement with endosonogra-phy(CAMEUS)measurement at a tertiary referral center,and a validation prospective trial of patients with obesity and nonalcoholic steatohepatitis who received paired EUS exams with CAMEUS measurement before and after six months of treatment with an intra-gastric balloon. Results:CAMEUS was measured in 154 patients[56.5%females,mean age 56.5±18.0 years,body mass index(BMI)29.8±8.0 kg/m2]and was estimated at 14.7±6.5 mm.CAMEUS better correlated with the presence of non-alcoholic fatty liver disease(NAFLD)(R2=0.248,P<0.001)than BMI(R2=0.153,P<0.001),and significantly correlated with metabolic parameters and diseases.After six months of intragastric balloon placement,the prospective cohort experienced 11.7%total body weight loss,1.3 points improvement in hemoglo-bin A1c(P=0.001),and a 29.4%average decrease in CAMEUS(-6.4±5.2 mm,P<0.001).CAMEUS correlated with improvements in weight(R2=0.368),aspartate aminotransferase to platelet ratio index(R2=0.138),and NAFLD activity score(R2=0.156)(all P<0.05). Conclusions:CAMEUS is a novel measure that is significantly correlated with critical metabolic indices and can be easily captured during routine EUS to risk-stratify susceptible patients.This station could allow for EUS access to sampling and therapeutics of this metabolic region.

摘要：Inflammatory bowel disease(IBD)is an immune-mediated inflammatory condition involving both the innate and adaptive immune systems.Recently,the role of intestinal fungal flora and their downstream immune pathways has been highlighted in the pathogen-esis of IBD.Cytokines as primary immune mediators require a delicate balance for maintaining intestinal homeostasis.Although most cytokines have a predictable role in either amplifying or attenuating inflammation in IBD,a few cytokines have shown a dual function in the inflammatory state of the intestine.Some of these dual-faced cytokines are also involved in mucosal anti-microbial defense pathways,particularly against intestinal fungal residents.Here,we reviewed the role of these cytokines in IBD pathogenesis to achieve a better understanding of the fungal interactions in the development of IBD.

摘要：Objective:To explore the impact of common gastrointestinal(GI)symptoms on psychological symptoms,sleep quality,and quality of life in patients with inflammatory bowel disease(IBD). Methods:A unified questionnaire was developed to collect clinical data on the mental psychology and quality of life of IBD patients from 42 hospitals in 22 provinces in P.R.China from September 2021 to May 2022.The general clinical characteristics,psychological symptoms,sleep quality,and quality of life of IBD patients with different numbers of GI symptoms were analyzed by descriptive sta-tistical analysis. Results:A total of 2,478 IBD patients were finally analysed in this study,including 365 without GI symptoms(14.7%),752 with single symptoms(30.4%),841 with double symptoms(33.9%),and 520 with three symptoms(21.0%).Compared with patients without GI symptoms,patients with only simple abdominalgia or diarrhea or hematochezia showed significantly higher levels of anxiety and depression and worse quality of life(all P<0.05).Compared with asymptomatic patients,patients with double symptoms(e.g.abdominalgia plus hematochezia,diarrhea plus hematochezia,abdominalgia plus diarrhea)and patients with three symptoms(abdominalgia,diarrhea,and hematochezia)showed significantly higher levels of anxiety and depression and worse sleep quality and quality of life(all P<0.05). Conclusion:Compared with IBD patients without gastrointestinal symptoms,patients with gastrointestinal symptoms were more likely to experience anxiety,depression,sleep disturbances,and poorer quality of life.

摘要：Background:Gastric varices(GV)with spontaneous portosystemic shunts(SPSS)pose considerable risks and challenges for adminis-tering endoscopic cyanoacrylate(CYA)injection.This study aimed to evaluate the efficacy and safety of EUS-guided coil embolization in combination with CYA injection compared to conventional endoscopic CYA injection for managing GV with SPSS. Methods:This retrospective analysis included patients with SPSS treated with either EUS-guided coil embolization in combination with CYA injection or conventional CYA injection for gastric variceal bleeding at Ningbo Medical Center Lihuili Hospital(Zhejiang,China)between January 2018 and March 2023.Patient demographics,procedural details,and follow-up results were reviewed. Results:The study evaluated 57 patients:21 in the combined treatment group undergoing EUS-guided coil embolization in combina-tion with CYA injection and 36 in the conventional group receiving conventional endoscopic CYA injection.Both cohorts achieved a 100%technical success rate.The mean volume of CYA used was significantly lower in the combined group(1.64±0.67 mL)than in the conventional group(2.38±0.72 mL;P<0.001).Early GV rebleeding rates did not differ significantly between the groups;in contrast,the combined treatment group exhibited a considerably lower incidence of late GV rebleeding than the conventional group(4.8%vs 27.8%,P=0.041). Conclusions:EUS-guided coil embolization in combination with CYA injection demonstrated superiority over conventional endo-scopic CYA injection in reducing late GV rebleeding in treating GV with SPSS.

摘要：Non-alcoholic fatty liver disease,recently renamed metabolic dysfunction-associated steatotic liver disease(MASLD),is a complex multifactorial disease that progresses from steatohepatitis(MASH)to liver cirrhosis and liver cancer.Recent research has revealed that crosstalk between innate immune cells and hepatic parenchymal and non-parenchymal cells is involved in the pathogenesis of liver disease in MASLD/MASH.Of particular importance,novel inflammatory mechanisms,including macrophage diversity,neutro-phil NETosis,B-cell biology,auto-reactive T cells,unconventional T cells,and dendritic cell-T cell interactions,are considered key drivers for disease progression.These mechanisms and factors are potential targets for the therapeutic intervention of MASLD/MASH.In this review,we focus on recent discoveries related to liver inflammation and discuss the role of innate immune cell subsets in MASLD/MASH.

摘要：Background:Exclusive enteral nutrition(EEN)therapy effectively induces remission in pediatric Crohn's disease(CD).However,this may depend on the type of enteral formula used.Moreover,data on the efficacy of amino acid-based EEN are limited.Thus,we aimed to prospectively evaluate the efficacy of amino acid-based formulas for EEN in pediatric patients with active CD. Methods:Patients with active CD aged between 6 and 17 years were recruited into this prospective study from four hospitals in China between March 2019 and December 2021.Patients received EEN for 8 weeks.Inflammatory and nutrition-associated indices were evaluated at 0,4,and 8 weeks after treatment.Paired t-tests and Wilcoxon signed-rank tests were used to compare continuous and categorical variables before and after intervention,respectively. Results:Twenty-four patients were included in the analysis.After an 8-week intervention period,the CD activity index significantly decreased(26.3±12.2 vs 7.1±8.3,P<0.001).Most patients(66.7%)achieved complete clinical remission.Among the 22 patients who had ulcers and erosions diagnosed endoscopically at baseline,10(45.5%)achieved complete mucosal healing.The degree of thicken-ing of the intestinal wall was significantly reduced after EEN intervention,with a transmural healing rate of 42.9%.Furthermore,the serum inflammatory markers decreased and there was a significant improvement in the nutrition-related indices(P<0.05).There were no severe adverse effects. Conclusions:Amino acid-based EEN is effective and safe for treating pediatric-onset CD.Studies with larger sample sizes and mech-anistic and follow-up studies are required to further validate these findings.

摘要：Background:MLH1 promoter methylation analysis is recommended in screening for Lynch syndrome(LS)in patients with MLH1-deficient colorectal cancer(CRC).The study aims to identify specific methylation regions in the MLH1 promoter and to evaluate the clinicopathologic characteristics of and prognosis for patients with MLH1 methylation. Methods:A total of 580 CRC cases were included.The DNA mismatch repair(MMR)protein expression was assessed by using immu-nohistochemistry(IHC).The methylation status of the Regions A,B,C,D,and E in the MLH1 promoter was tested by using bisulfite sequencing PCR.The specificities of the five regions were calculated.Associations between MLH1 methylation and clinicopathologic characteristics were evaluated.Kaplan-Meier analyses for overall survival(OS)were carried out. Results:In 580 CRC cases,the specificities of the methylation test in Regions D and E were both 97.8%.In the MLH1-deficient CRCs,the frequencies of MLH1 methylation and BRAFV600E mutation were 52.6%and 14.6%,respectively;BRAFV600E mutation occurred in 27.7%of patients with MLH1-methylated CRC.In the MMR-deficient patients,compared with MLH1 unmethylation,MLH1 methyla-tion was more common in patients who were aged≥50 years,female,had no family history of LS-related tumors,and had tumors located at the right colon.In the MMR-deficient patients,the MLH1-methylated cases had lower OS rates than the unmethylated cases with a family history of LS-related tumors(P=0.047). Conclusions:Regions D and E in the MLH1 promoter are recommended for determining the MLH1 methylation status in screening for LS in MLH1-deficient CRC.In MMR-deficient patients,the MLH1-methylated cases had a worse OS than the unmethylated cases with a family history of LS-related cancer.

摘要：Background:Binge drinking(BD)has been associated with elevated liver enzymes,but the joint association of BD and adiposity with liver enzymes is understudied.We aimed to examine the combined association of BD and obesity with elevated liver enzymes. Methods:Data were obtained from 285,600 patients in the Korean National Health check-up program during 2009-2015.Level I BD(BD I)was defined as alcohol consumption of>60 g(men)or>40 g(women)on one occasion in the previous year.High-intensity BD(HIBD)corresponded to at least two times the BD I levels.General and abdominal obesity were defined by body mass index and waist circumference.Logistic regression was used to examine the independent and joint associations of BD and obesity with elevated ala-nine aminotransferase(ALT),aspartate aminotransferase(AST),and gamma-glutamyl transferase(GGT)levels.Relative excess risk(RERI),attributable proportion(AP),and synergy index(SI)were calculated to estimate the additive interaction effects. Results:The mean age was 42.1±0.03 years and 50.2%were women.Elevated ALT[odds ratio(OR)1.09,95%confidence interval(CI)1.02-1.16],AST(OR 1.16,95%CI 1.11-1.23),and GGT(OR 1.84,95%CI 1.05-1.94)were associated with HIBD.Higher odds of elevated ALT(OR 3.57,95%CI 3.43-3.71),AST(OR 3.47,95%CI 3.37-3.58),and GGT(OR 2.10,95%CI 1.98-2.12)were observed in individuals with general obesity.A similar trend was observed for abdominal obesity.The RERI,AP,and SI for the interaction effect of BD and general obesity were 23%,7%,and 13%for elevated AST levels,and 67%,24%,and 58%for elevated GGT levels,respectively.Similar effects were observed for the interaction between BD and abdominal obesity. Conclusions:Obesity aggravated the odds of elevated liver AST and GGT levels in HIBD.

摘要：Introduction Histoplasmosis is a mycotic infection caused by Histoplasma cap-sulatum.The usual clinical presentation is pulmonary disease.Disseminated disease can occur and involve multiple organs[1].Gastrointestinal(GI)involvement can be seen in 70％of autopsy cases,but only 3％-12％are symptomatic[1].Moreover,isolated GI histoplasmosis without accompanying pulmonary symptoms is exceedingly rare.Recognizing this rare entity can be difficult,especially in patients with pre-existing GI disorders such as in-flammatory bowel disease(IBD).

摘要：Background:The effect of neoadjuvant immunotherapy on minimally invasive gastrectomy(MIG)for locally advanced gastric cancer(LAGC)remains controversial.This study aimed to compare short-term outcomes between MIG after neoadjuvant chemo-immunotherapy(NICT-MIG)and MIG after neoadjuvant chemotherapy alone(NCT-MIG),and determine risk factors for post-operative complications(POCs). Methods:This retrospective study included clinicopathologic data from 193 patients who underwent NCT-MIG or NICT-MIG between January 2020 and February 2023 in the Department of General Surgery,Chinese People’s Liberation Army General Hospital First Medical Center(Beijing,China).Propensity score-matched analysis at a ratio of 1:2 was performed to reduce bias from confounding patient-related variables and short-term outcomes were compared between the two groups. Results:The baseline characteristics were comparable between 49 patients in the NICT-MIG group and 86 patients in the NCT-MIG group after propensity score matching.Objective and pathologic complete response rates were significantly higher in the NICT-MIG group than in the NCT-MIG group(P<0.05).The overall incidence of treat-related adverse events,intraoperative bleeding,operation time,number of retrieved lymph nodes,time to the first flatus,post-operative duration of hospitalization,overall morbidity,and se-vere morbidity were comparable between the NCT-MIG and NICT-MIG groups(P>0.05).By multivariate logistic analysis,estimated blood loss of>200 mL(P¼0.010)and prognostic nutritional index(PNI)score of<45(P¼0.003)were independent risk factors for POCs after MIG following neoadjuvant therapy. Conclusions:Safety and feasibility of NICT were comparable to those of NCT in patients undergoing MIG for LAGC.Patients with an estimated blood loss of>200 mL or a PNI score of<45 should be carefully evaluated for increased POCs risk.

摘要：Postpartum elevation of alanine aminotransferase(ALT)in mothers with chronic hepatitis B(CHB)presents a significant clinical challenge.However,the existing literature demonstrates inconsistencies regarding its incidence and predictors in mothers infected with the hepatitis B virus(HBV).Recent advancements in antiviral prophylaxis against mother-to-child transmission of HBV and postpartum cessation of antiviral therapy further complicate this issue.Our literature review,spanning PubMed,and two Chinese-language databases(CNKI and Wanfang)from 1 January 2000 to 31 December 2023 aimed to consolidate and analyse available data on the frequency and severity of postpartum ALT flares,identify risk factors,and propose a management algorithm.Data from 23 eli-gible studies involving 8,077 pregnant women revealed an overall incidence of postpartum ALT elevation:25.7%for mild cases,4.4%for moderate cases,and 1.7%for severe cases.In the subgroup of mothers who were HBeAg-positive and on antiviral prophylaxis for preventing mother-to-child transmission,postpartum intermediate and severe ALT elevations were reported with pooled rates of 5.9%and 0.8%,respectively.Importantly,none resulted in mortality or necessitated liver transplantation.Identified risk factors for postpartum ALT flares in mothers with CHB included HBV DNA levels,ALT levels during pregnancy,postpartum cessation of antivi-ral treatment,and HBeAg status.By leveraging this evidence and recent data on predictors of intermediate or severe postpartum ALT flares,we propose a risk-stratified algorithm for managing postpartum ALT elevation and selecting therapy in mothers with CHB,tai-loring different approaches for treatment-naive vs treatment-experienced populations.These recommendations aim to provide guidance for clinical decision-making and enhance patient outcomes.

摘要：Background:Systemic chemotherapy for gastric cancer with peritoneal metastasis has limited clinical benefit;for those with intraopera-tive detection of occult peritoneal metastasis,cytoreductive surgery followed by hyperthermic intraperitoneal chemotherapy(HIPEC)is an alternative treatment.However,the feasibility and effects of this modality and criteria for selecting suitable groups remain unclear.This study aimed to explore the safety and efficacy of laparoscopic cytoreductive surgery(L-CRS)followed by HIPEC in gastric cancer with limited peritoneal metastasis,and this study also aimed to determine the optimized cut-off of the peritoneal cancer index. Methods:Between March 2017 and November 2019,patients diagnosed with gastric cancer peritoneal metastases by using laparoscopy and the Sugarbaker peritoneal cancer index of?12 were eligible for inclusion.All patients received L-CRS(including gastrectomy with D2 lymph node dissection)and resection of visible peritoneal metastasis,followed by post-operative HIPEC,and systemic chemotherapy.The primary end points were median progression-free survival and median survival time,and the secondary outcomes were morbidity and mortality within 30 days after surgery. Results:Thirty patients were eligible for analysis,of whom 19(63.3%)were female,and the overall mean age was 53.0 years.The post-operative morbidity was 20%and the severe complication rate was 10%.The median survival time was 27.0 months with a 2-year overall survival rate of 52.3%and median progression-free survival was 14.0 months with a 2-year progression-free survival of 30.4%. Conclusions:L-CRS followed by HIPEC can be safely performed for gastric cancer with limited peritoneal metastasis and potential survival benefits.

摘要：Background:Compared with conventional laparoscopic surgery,natural orifice specimen extraction surgery(NOSES)has many advantages.Laparoscopic right colectomy with transvaginal specimen extraction has been reported,but the safety and feasibility of transrectal specimen extraction in male patients with ascending colon cancer remain to be verified.This study aimed to preliminar-ily evaluate the feasibility and safety of laparoscopic right hemicolectomy with transrectal specimen extraction. Methods:The study was conducted at a single tertiary medical center in China.A total of 494 consecutive patients who underwent laparoscopic right colectomy between September 2018 and September 2020 were included.Transrectal specimen extraction was performed in 40 male patients(the NOSES group).Patients in the NOSES group were matched to the conventional laparoscopic group using propensity score matching at a 1∶2 ratio.Short-term and long-term outcomes between the two groups were compared and evaluated. Results:Forty patients in the NOSES group and 80 patients in the conventional laparoscopic group were matched for analysis.Baseline characteristics were balanced after propensity matching.The operative features,including operating time,intraoperative bleeding,and the number of harvested lymph nodes,were statistically comparable in both groups.In terms of post-operative recov-ery,patients in the NOSES group showed preferable outcomes,as evidenced by less post-operative pain and faster return to flatus,defecation,and discharge.The post-operative complications rate,according to the Clavien-Dindo classification system,was similar in both groups.No differences in overall survival or disease-free survival were observed between the two groups. Conclusions:Laparoscopic right colectomy with transrectal specimen extraction is oncologically safe.Compared with conventional laparoscopic right colectomy,it can reduce post-operative pain,accelerate post-operative recovery,shorten the hospital stay,and achieve better cosmetic effect.

摘要：Background:Insufficient post-operative future liver remnant(FLR)limits the feasibility of hepatectomy for patients.Staged hepatectomy is an effective surgical approach that can improve the resection rate of hepatocellular carcinoma(HCC).This study aimed to compare the safety and efficacy of laparoscopic microwave ablation and portal vein ligation for staged hepatectomy(LAPS)and classical associating liver partition and portal vein ligation for staged hepatectomy(ALPPS)in the treatment of hepatitis B virus(HBV)-related HCC. Methods:Clinical data of patients with HBV-related HCC who underwent LAPS or ALPPS in our institute between January 2017 and May 2022 were retrospectively analysed. Results:A total of 18 patients with HBV-related HCC were retrospectively analysed and divided into the LAPS group(n=9)and ALPPS group(n=9).Eight patients in the LAPS group and eight patients in the ALPPS group proceeded to a similar resection rate(88.9％vs 88.9％,P=1.000).The patients undergoing LAPS had a lower total comprehensive complication index than those undergoing ALPPS but there was not a significant different between the two groups(8.66 vs 35.87,P=0.054).The hypertrophy rate of FLR induced by ALPPS tended to be more rapid than that induced by LAPS(24.29 vs 13.17 mL/d,P=0.095).The 2-year recurrence-free survival(RFS)was 0％for ALPPS and 35.7％for LAPS(P=0.009),whereas the 2-year overall survival for ALPPS and LAPS was 33.3％and 100.0％(P=0.052),respectively. Conclusions:LAPS tended to induce lower morbidity and FLR hypertrophy more slowly than ALPPS,with a comparable resection rate and better long-term RFS in HBV-related HCC patients.

摘要：Introduction Anal cancer is a rare cancer accounting for～2％of all gastroin-testinal tract malignancies[1].Among anal cancers,squamous cell cancer(SCC)is the most common and lymphoma is one of the least frequent.The gastrointestinal tract is the most common site for extranodal non-Hodgkin's lymphoma(NHL),and diffuse large B-cell lymphoma(DLBCL)is the most common histologic subtype.However,primary colorectal lymphoma accounts for only 0.3％of all large intestinal malignancies and～3％of all gas-trointestinal lymphomas[2].Anal canal SCC and lymphomas are treated differently;thus,accurate diagnosis is crucial.