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Objective@#To explore an effective long non-coding RNA (lncRNA) signature in predicting the prognosis of hepatocellular carcinoma through the analysis on RNA sequencing data of hepatocellular carcinoma patients and peritumoral tissues in the Cancer Genome Atlas (TCGA) database.@*Methods@#The clinical characteristics and RNA sequencing data of 377 hepatocellular carcinoma patients were obtained from TCGA database by the end of February 2018. Then, differentially expressed lncRNAs between 50 pairs of tumor and peritumoral tissues were explored using student’s t-test. Next, a lncRNA signature was established through LASSO Cox regression analysis. All the patients were divided into four groups (<P25, P25-, P50-, ≥P75) based on the cut-off quartiles signature. Finally, compared with the control group (<P25), the hazard ratios (HRs) of three groups (P25-, P50-, ≥P75) were calculated by using Cox regression. The survival outcomes of patients in the four groups were compared to evaluate the capacity of the lncRNA signature model.@*Results@#A total of 951 differentially expressed lncRNAs were identified between tumor and peritumoral tissues. A three-lncRNA signature, including LNCSRLR, MKLN1-AS and ZFPM2-AS1, was established to predict the prognosis of hepatocellular carcinoma patients. The outcome suggested that the death risk of the ≥P75 group was 1.57 times larger than that of the <P25 group (95%CI: 1.06-2.31, P<0.05).@*Conclusion@#The three-lncRNA signature, which established by LNCSRLR, MKLN1-AS and ZFPM2-AS1, was significantly associated with the prognosis of hepatocellular carcinoma patients based on TCGA database data.
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Objective To investigate the effect of lower thoracic epidural block on intestinal epithelial cell apoptosis during hemorrhagic shock and resuscitation in rats.Methods Sixty-four male SD rats placed with lower thoracic epidural catheter were randomly divided into four groups (n=1 6 each):group Sham (sham operation),group HSR (hemorrhagic shock and resuscitation),group NS (hemorrhagic shock and resuscitation+epidural saline 100 μl/kg),and group TEA (hemorrhagic shock and resuscitation+epidural 0.075% ropivacaine 100 μl/kg).The hemorrhagic shock was made described by Chaudry.Rats were resuscitated by transfusing shed blood and normal saline 60 min after hemorrhagic shock.Malondialdehyde (MDA)content,superoxide dismutase (SOD)activity, and protein expression of Bax and Bcl-2 in intestinal epithelium were detected,and epithelial apoptosis index was calculated at 2 h after resuscitation.Results Compared with group Sham,intestinal epithe-lial MDA,Bax expression and epithelial apoptosis were significantly increased,while SOD activity were markedly decreased in groups HSR,NS and TEA (P<0.05).Compared with groups HSR and NS,intestinal epithelial MDA,Bax expression and epithelial apoptosis were significantly decreased, while SOD activity and Bcl-2 expression were markedly increased in group TEA (P <0.05 ). Conclusion Lower thoracic epidural block can enhance the antioxidant and anti-apoptotic ability,and inhibit the oxidative stress and cell apoptosis of intestinal epithelium.Therefore,it can promote the survival rate after hemorrhagic shock and resuscitation through protecting intestinal barrier.
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Objective To evaluate the effect of anti-microbia-l coated central venous catheter (CVC),compared with routine CVC,on catheter-associated deep venous thrombosis (CADVT). Methods A total of 1 359 patients,aged 26-82 years,ASA physical status Ⅰ-Ⅲ,undergoing internal jugular,axillary-subclavian,or femoral vein CVC catheterization during January to June of 2017,were retrospectively reviewed.The patients were divided into intoanti-microbial-coated CVC group (group A)and routine CVC group (group B).Gender,age,ASA class,pre-operative risk of thrombus (Caprini score),CVC site,surgical site,ultrasound-guided catheterization,and anticoagu-lation therapy,CADVT and the degree,as well as the other adverse events were recorded.Results A total of 938 patients were successfully matched.There were 323 (34.4%)articipants diagnosed with CADVT with bedside point-of-care ultrasound,in which 172 cases (36.7%)in group A and 151 (32.2%)in group B.There was no statistical significance of CADVT and the degree between the two groups.The subgroup analysis results indicated that the patients using anti-microbial-coated CVC with high risk of thrombus (Caprini score ≥ 5 points)(OR 1.34,95% C I 1.01-1.78),undergoing catheterization according to anatomical landmark (OR 1.69,95% C I 1.04-2.74),and not-receiving anticoagulation therapy (OR 1.39,95% C I 1.01-1.92)had an increased risk of CADVT compared with those using routine CVC.A significantly decreased incidence of catheter-associated infection in group A was observed compared with group B (0.9% vs 4.1%,P<0.05).Conclusion Anti-micro-bial-coated CVC does not increase the incidence of CADVT.
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Objective To evaluate the value of postoperative prophylactic radiotherapy for N0 e-sophageal squamous carcinoma. Methods From January 1993 to December 2006,859 patients with patho-logically staged N0 and M0 esophageal squamous cell carcinoma were included in this study. Among them, 760 received surgery alone, and 99 received surgery followed by postoperative radiotherapy. Radiotherapy started within 3 to 4 weeks after surgery. The median total dose was 50 Gy(2 Gy/F,5 F/w). Results In surgery alone group and postoperative radiotherapy group,the 5-yeur overall survival rotes were 72.2% vs 77.4% (X2 =0. 13,P >0.05) for all patients,34.6% vs67.1% (X2 =7.72,P <0.05) forpT4 disease,and 70.2% vs 81.3% (X2 =4.01 ,P <0.05) for tumor length >5 cm. Postoperative radiotherapy could lower the recurrence rate for pT4 patients. Conclusions For patients with NO esophageal squamous carcinoma, postoperative radiotherapy can significantly improve the survival for pT4 and tumor length > 5 cm,and also re-duce the recurrence for pT4 patients.
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Objective To compare the accuracy of CT with other methods to measure the length of thoracic esophageal carcinoma. Methods 598 patients with thoracic esophageal squamous carcinoma were enrolled in this study.All the patients received three-field(cervical,thoracic:and abdominal)radical surgery without pre-operative radiotherapy or chemotherapy.The length of each Iesion was recorded and compared by measuring intraoperative specimen,formalin-fixed specimen,X-ray barium meal examination and CT,respectivelv. Results By the measurement of intraoperative specimen,formalin-fixed specimen,Xray barium meal examination and CT,the mean lengths of lesion were(5.22±1.94),(4.28±1.71),(5.12±1.92)and(6.71±2.52) cm,respectively.The measured length was significantly different between intraoperative specimen and formalin-fixed specimen or CT(t=16.01,P＜0.01;t=-15.54,P＜0.01),but not between intraoperative specimen and X-ray barium meal examination(t=1.62,P＞0.05).The measured lengths gradually decreased in the order of CT,intraoperative specimen,X-ray bailam meal examination and formalin-fixed specimen.For different pathological type(except intracavitary type)and different T staging,there was significant difference in lesion length between intraoperative specimen and CT(P＜0.05),but not between intraoperative specimen and X-ray barium meal examination(P＞0.05). Conclusions The length of esophageal carcinoma measured by intraoperative specimen is shorter than by CT,but longer than by X-ray barium meal examination.Specimen could shrink after foriBalin fixation.X-ray barium meal and other examinations should be referred when using CT to delineate tumor target volume of esophageal carcinoma for radiotherapy.