Background: Capillary isoelectric focusing is a type of capillary electrophoresis method newly used for thalassemia screening in China. Although the good performance has been proved by several studies, whether it can best suit the special needs of Chinese patients still requires further investigations.Methods: Comparisons were made between capillary zone electrophoresis method applied on Sebia Minicap and capillary isoelectric focusing method applied on Helena V8 platform E‐class on identifying Hb E, Hb CS, Hb H, and Hb Barts for patients from southern China. And mixing studies were used to evaluate the lowest detection limits of these 2 kinds of capillary electrophoresis system.Results: Helena V8 could not make a distinction between peaks of Hb E and peaks of Hb A2 as Sebia Minicap did. All chosen patients with Hb H and/or Hb Barts could be screened out by both 2 systems, but when analyzed by Helena V8, it was hard to distinguish Hb H from Hb Barts sometimes, while Sebia Minicap could make a clear distinction between peaks of Hb H and Hb Barts. Only a part of patients (3 of 8, 37.5%) with Hb CS could be screened out by Helena V8, while all patients could be identified by Sebia Minicap. Sebia Minicap had a lower detection limit for trace peaks than Helena V8 (near to 0.2% vs near to 0.6%).Conclusions: Compared with capillary zone electrophoresis, capillary isoelectric focusing applied on Helena V8 maybe is not the first choice for hemoglobinopathy testing in southern China.

Background: Long-course neoadjuvant chemoradiotherapy (Lc-NCRT) is the conventional treatment for locally advanced rectal cancer (LARC). It improves R0 resection rate and reduces local recurrence rate, but it cannot improve long-term oncological outcomes. It also causes several radiotherapy-related side effects. In recent years, some studies have shown that neoadjuvant chemotherapy (NCT) may be noninferior to Lc-NCRT. Therefore, we systematically evaluated the efficacy and safety of NCT and Lc-NCRT for LARC.Methods: Cochrane Library, Embase, PubMed, WanFang Data, and CNKI were systematically searched as the relevant literature. The literature was screened independently by two groups, and data were extracted and evaluated for bias. A meta-analysis was performed using Revman5.4 software. The primary outcomes were tumor response to neoadjuvant therapy and long-term oncological outcomes.Results: A total of 17 studies with 5,168 cases (1,957 cases in NCT and 3,211 cases in Lc-NCRT) were included in our meta-analysis. Compared with the Lc-NCRT group, although the NCT group had a lower pCR rate [RR = 0.65, 95% CI (0.56–0.75), P < 0.0001], less downstaging [RR = 1.11, 95%CI(1.03–1.19), P = 0.06] and more adverse events of neoadjuvant therapy [RR = 1.11, 95% CI (1.03–1.19); P = 0.06], it had no difference in long-term survival outcome [3-year overall survival: HR = 1.13, 95% CI (0.70–1.83), P = 0.62; 3-year disease-free survival: HR = 1.16, 95% CI (0.96–1.39), P = 0.12; 3-year local recurrence-free survival: HR = 1.36, 95% CI (0.9–2.08), P = 0.15] and serious adverse events [RR = 0.84, 95% CI (0.45–1.57), P = 0.58] from the Lc-NCRT group. Moreover, the incidence of anastomotic leakage [RR = 0.48, 95% CI (0.34–0.45)] and permanent stoma rate [RR = 0.7, 95% CI (0.58–0.84), P < 0.0001] after operation was lower in the NCT group.Conclusion: NCT is a potential option for the treatment of LARC as it is beneficial for improving the sphincter preservation rate and reducing anastomotic leakage, the long-term oncological outcome is considerable, and the safety is controllable. Larger randomized controlled trials (RCT) with longer follow-up data are needed to clarify the specific regimens of NCT and the risk stratification of rectal cancer.Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/home identifier, CRD42024579586.

Rationale: Pneumatosis cystoides intestinalis (PCI) is a rare disease characterized by gas accumulation in the intestinal wall, and is usually treated conservatively. Patients with diabetic ketoacidosis (DKA) sometimes present with severe abdominal pain as the first symptom, which may be misdiagnosed. We report a case of PCI in a patient with diabetes mellitus (DM) misdiagnosed as gastrointestinal perforation and underwent exploratory laparotomy. Patient concerns: A 41-year-old woman with a history of DM treated with miglitol, an α-glucosidase inhibitors (αGI), was admitted to the emergency department with severe abdominal pain. Computed tomography revealed thickening of the ascending colon wall and scattered free gas around it, and the possibility of tumor perforation was considered. Diagnosis: The patient was diagnosed with gastrointestinal perforation and DM but was revised to PCI and DKA after surgery. Interventions: The patient underwent exploratory laparotomy; however, no signs of digestive perforation were found. The patient developed DKA after surgery and received conservative treatment, including antibiotics, insulin, fluid support, oxygen therapy, and cessation of miglitol. Outcomes: Ketoacidosis was controlled, and the abdominal pain resolved with conservative treatment. She was discharged 16 days later and no longer required αGI therapy. She did not develop gastrointestinal symptoms or any signs of PCI on computed tomography imaging within 3 months. Lessons: PCI is a rare disease with great heterogeneity in etiology, treatment and prognosis and comorbidities like diabetes may increase the chances of misdiagnosis. Surgeons should pay attention to the patient’s medical history and examination and carefully identify the real disease that triggers the symptoms to avoid misdiagnosis.

Background: The effectiveness of the anastomosis method for laparoscopic left colectomy (LLC) remains inconclusive. Thus, a systematic review and meta-analysis were conducted to compare the outcomes between intraperitoneal anastomosis (IPA) and extraperitoneal anastomosis(EPA)in LLC.Methods: PubMed, Embase, the Cochrane Library, CNKI, and WanFangData were systematically searched for relevant literature. The literature was screened independently by two groups, and data were extracted and evaluated for bias. Meta-analysis was performed using Revman5.4 software.Results: Twelve studies with a total of 1,278 patients were included in our meta-analysis. Compared with the EPA group, the IPA group had less blood loss [odds ratio (OR)=–20.32, 95% confidence interval (CI) (−27.98–12.65), p<0.00001], a lower overall complication rate [OR=0.45, 95% CI (0.33–0.63), p<0.00001], fewer non-severe complications [OR=0.44, 95% CI (0.30–0.64), p<0.0001], and fewer surgical site infections [OR=0.39, 95% CI (0.21–0.71), p=0.002]. Additionally, a longer operation time appeared in the multicenter and propensity score matching (PSM) subgroups of the IPA group. Furthermore, patients in the IPA group had an earlier exhaust time and shorter hospital stays. There were no significant differences between the two groups regarding severe complications, anastomose-related complications, postoperative blood transfusion, ileus, reoperation rate, time to stool, pathologic sample length, and lymph node dissection number.Conclusion: IPA seems more advantageous than EPA for patients receiving LCC in terms of complications and postoperative recovery and has similar oncological outcomes. However, it may take longer and be more difficult to perform.Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/#recordDetails PROSPERO, identifier (CRD4202454391).

Backgroud: Intersphincteric resection (ISR) is an important and challenging sphincter-preserving procedure for patients with low rectal cancer. Preserving anal function is more important than preserving its appearance. Owing to its unique advantages, the robotic platform makes ISR safer and less invasive. Whether this advantage is reflected in functional aspects is worth further exploration. Methods: PubMed, Cochrane Library and Embase were systematic researched for articles published relevant literature. The literature was screened independently by two groups, and data on functional, perioperative, and oncology outcomes were extracted and evaluated for bias. Meta-analysis was performed using Revman5.4 software. Results: Ten studies with a total of 1279 patients were included in our meta-analysis, and Funnel plots suggested no major publication bias. The robotic ISR group had lower Wexner scores [MD = –1.46, 95%CI (–2.03 ∼–0.88), p < 0.001] than the laparoscopic ISR group, but with no significant difference compared to other functional outcomes. The robotic ISR group performed better in preserving the integrity of the rectal mesentery [OR = 3.08, 95%CI (1.72, 5.53), p = 0.0002], had less intraoperative bleeding [MD = –11.47, 95%CI (–17.25, –5.68), p = 0.0001], and had fewer postoperative complications [OR = 0.71, 95%CI (0.53, 0.94), p = 0.02], although the operation took longer [MD = 0.76, 95%CI (0.62∼0.91), p < 0.001]. No significant differences were observed in the long-term oncological outcomes between the two groups. Conclusion: Robotic ISR has potential advantages in preserving the anal function, with fewer complications and similar oncological outcomes compared with Laparoscopic ISR. Due to limitations in sample size and study design, the results of this study still require validation through randomized controlled trials. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO , identifier CRD420251012991.