ABSTRACT
Due to the special functions of liver, the topic of liver physiological function and pathophysiological changes has always been the main issue in life science area. Human liver is composed of multiple types of cells, among which the hepatocyte is the most essential one. Primary human hepatocytes are considered as the gold standard model in vitro for the liver study and the ideal cell for hepatocyte transplantation and bioartificial liver. Nowadays, primary human hepatocytes play a vital role in the field of basic science research and applied research. Therefore, we presented recent advances in research based on primary human hepatocytes in vitro.
ABSTRACT
Objective:To determine the risk factors of drainage time longer than 1 day in patients with selective abdominal drainage after laparoscopic cholecystectomy.Methods:The clinical data related to patients with selective abdominal drainage undergoing laparoscopic cholecystectomy from November 2009 to November 2019 at Chinese PLA General Hospital were retrospectively analyzed. Of 233 patients enrolled into this study, there were 147 males and 86 females, with a median aged 59.0 (47.5, 65.5) years old. The patients were divided into drainage time 1 day group of 65 patients and longer than 1 day group of 168 patients according to postoperative drainage time. The baseline data and perioperative data were collected, the risk factors correlated with drainage time longer than 1 day were analyzed.Results:The drainage time was 1 in the 1 day group and 2~8 in another group. Among the 233 patients, there was one with biliary leakage and 14 patients had abdominal bleeding, all of them healed after 2~3 days. All of the 233 patients were recovered when discharged. Independent risk factors related to drainage time longer than 1 day include BMI≥28 kg/m 2 ( OR=3.443, 95% CI: 1.411-8.405, P=0.007), operation time ≥65 min ( OR=2.570, 95% CI: 1.310-5.045, P=0.006), thickness of gallbladder wall ≥0.5 cm ( OR=12.720, 95% CI: 1.350-5.478, P=0.005), postoperative stomachache ( OR=13.537, 95% CI: 1.685-108.748, P=0.014) and postoperative fever ( OR=8.156, 95% CI: 1.035-64.249, P=0.046). Conclusion:For patients undergoing selective abdominal drainage after laparoscopic cholecystectomy with BMI ≥28 kg/m 2, operation time ≥65 min, gallbladder wall thickness ≥0.5 cm, postoperative abdominal pain and fever, clinicians should appropriately prolong the drainage time to ensure medical safety.
ABSTRACT
Objective:To investigate the safety and efficacy of combining programmed death-1 (PD-1) with tyrosine kinase inhibitors (TKIs) in patients with advanced hepatocellular carcinoma (HCC) before liver transplantation(LT).Methods:The data of six males with a mean ± s. d. age of (57.5±4.3) years who were treated with PD-1 inhibitors combined with TKIs for advanced HCC before LT at Beijing You'an Hospital, Capital Medical University and the First Medical Center of Chinese PLA General Hospital were retrospectively analysed. The tumor stagings, the use of PD-1 inhibitors and TKIs with their discontinuation in pre-LT/post-LT liver function recovery durations, incidences of complication. The tumor recurrence and disease-free survival rates were determined on follow-up of these patients at outpatients clinics.Results:For the 6 patients included in this study, four patients were classified by the Barcelona Clinic Liver Cancer Staging (BCLC) as C and the China Liver Cancer Staging (CNLC) as Ⅲa, and two patients were classified by the BCLC staging as B and the CNLC asⅡb. The mean cycle of PD-1 inhibitor used was 5.5 (1-20), and the mean duration of PD-1 inhibitor discontinuation was 19.5 (12-45) days pre-LT. All patients who were treated with PD-1 inhibitors combined with TKIs reached the liver transplantation standard, and all successfully underwent orthotopic liver transplantation. The liver function recovered well without any serious complications post-LT. All the patients survived without developing any acute rejection or other complications. The follow-up time ranged from 8.2 to 27.3 months, with a median of 11.9 months. No patients had died, and 2 patients developed tumor recurrence. The median (range) tumor-free survival time was 10.9 (2.9-27.3) months.Conclusion:Patients with advanced HCC could benefit from combined PD-1 inhibitors with TKIs therapy pre-LT. There were no increased incidences of acute rejection and other complications post-LT.
ABSTRACT
Objective:To study the safety and efficacy of a treatment protocol using immune checkpoint inhibitors (ICIs) and antiangiogenic targeted drugs (AATDs) in converting 41 patients with initially unresectable to resectable hepatocellular carcinoma (HCC).Methods:The data of 41 patients with initially unresectable HCC treated with immunotherapy combined with targeted therapy from December 2018 to April 2021 in Chinese PLA General Hospital were analysed. There were 34 males and 7 females, aged (51.8±10.7) years. The clinical characteristics, conversion to resectable HCC, adverse drug reactions, surgical data and postoperative complications were analysed. Patients were followed-up by outpatients clinics or telephone calls.Results:There were 5 patients with Chinese Liver Cancer Staging (CNLC)-Ⅰb, 4 with CNLC-Ⅱ, 28 with CNLC-Ⅲa and 4 with CNLC-Ⅲb before the treatment protocol. Among them, 28 patients had portal vein tumor thrombosis (PVTT) and 4 had retroperitoneal lymph node metastases. All patients had a mean tumor diameter of (9.16±4.43) cm before and (6.49±4.69) cm after the treatment protocol. The latter was based on the last assessment before hepatectomy. The efficacy of the treatment protocol in converting unresectable to resectable HCC was assessed by the modified Response Evaluation Criteria in Solid Tumors after 3-15 cycles (median dose cycles, 5) of protocal therapy: 15 patients achieved a complete response; 15 patients achieved a partial response; 6 patients had a stable disease, and 5 patients had a progressive disease. 21 patients (51.2%) experienced adverse reactions associated with drug treatment, which resolved with symptomatic treatment or brief discontinuation of the therapy. All patients underwent successful hepatectomy. Postoperative complications of grade Ⅱ or higher occurred in 9 patients (22.0%). The cumulative overall survival rates at 6 months, 1 year and 2 years from diagnosis were 100.0%, 92.6% and 64.7% respectively. The cumulative overall survival rates at 6 months, 1 year and 2 years after surgery were 95.1%, 74.7% and 60.8%, and the recurrence-free survival rates at 6 months, 1 year and 2 years after surgery were 87.8%, 56.7% and 48.6%, respectively.Conclusions:This study provided preliminary evidences that surgical resection after immunotherapy combined with targeted therapy in patients with initially unresectable HCC was safe and efficacious.
ABSTRACT
Objective:The study aimed to study the efficacy and safety of combined dual therapy using anti-programmed death (PD)-1 and tyrosine kinase inhibitor (TKI) with combined triple therapy using anti-PD-1, TKI and locoregional intervention triple therapy in patients with postoperative refractory recurrent liver cancer.Methods:Patients with postoperative refractory recurrent liver cancer who had undergone either anti-PD-1 and TKI dual therapy or anti-PD-1, TKI and locoregional intervention triple therapy between July 2016 and March 2019 at the First Medical Center, Chinese PLA General Hospital were retrospectively studied. Tumor responses were assessed by the modified response evaluation criteria in solid tumors and overall survival and progression free survival were compared. Adverse events were evaluated according to the National Cancer Institute Common Terminology Criteria for Adverse Events.Results:Of 63 patients who were included in this study, there were 25 patients in the dual therapy group (16 males and 9 females, aged 54.3±8.8 years) and 38 patients in the triple therapy group (31 males and 7 females, aged 55.5±8.4 years). The 1-year survival rate of the triple therapy group was significantly higher than the dual therapy group (94.5%vs 54.9%) ( P<0.01). The disease control rate was 64.0% (16/25) in the dual therapy group and 84.2% (32/38) in the triple therapy group, and the difference was not significant ( P>0.05). The incidence of treatment-related adverse events in the triple therapy group and the dual therapy group were 78.9% (30/38) and 80% (20/25), respectively. There was no treatment-related death in the 2 groups. Conclusions:Anti-PD-1 and TKI dual therapy and anti-PD-1, TKI and locoregional intervention triple therapy were effective and tolerable treatments for postoperative refractory recurrent liver cancer. The latter treatment had a significantly better clinical benefit on survival outcomes.
ABSTRACT
Objective To evaluate preoperative oral carbohydrate in patients receiving LC day surgery.Methods 117 patients undergoing LC day surgery in PLA General Hospital from Oct 2016 to Mar 2017 were evenly divided into three groups.Patients in group A took oral carbohydrate preoperatively,group B by iv glucose,group C by overnight fasting.The preoperative thristy and the indicators of inflammation,heart rate,blood glucose,serum insulin,insulin resistance index postoperatively were collected and compared.Results No patients suffered aspiration.There were no complications above Clavien Ⅰ level.Differences in insulin resistance index,fasting serum insulin were statistically significant between group A and group B (Z =-5.60,-4.78,P ＜ 0.05).That of insulin resistance index,fasting serum insulin and procalcitonin between group A and group C were statistically significant (Z =-2.65,-2.49,-4.02,P ＜0.05).Procalcitonin between group B and group C were statistically different (Z =-2.183,P ＜ 0.05).The preoperative thristy between group A and group B,group C were statistically different (x2 =6.47,P ＜ 0.05).Conclusions Preoperative oral carbohydrate intake is safe and feasible with the benefits of improving the quality of life in patients operated on LC day surgery.
ABSTRACT
Objective To develop an SPE‐HPLC method for the determination of methotrexate (M TX) in human plasma to monitor the clinical drug use of M TX ,and to identify the human metabolite of M TX by mass spectrometry .Methods M TX was extracted from human plasma using C18 SPE column and analyzed directly after elution .The separation of MTX was per‐formed on Diamonsil C18 column (150 mm × 4 .6 mm ,5 m) with a gradient mobile phase of methanol and 0 .5% acetic acid solu‐tion (containing 0 .3% triethylamine) at a flow rate of 1 .0 ml/min .The detection wavelength was 306 nm .QLMS and MRM‐IDA‐EPI scan modes were used to obtain the mass spectrum of MTX metabolite .Results The calibration curve of MTX in plasma was linear over the range of 0 .05‐100 μmol/L(r=0 .999 9) .The extraction recovery was above 95% and accuracy was between 97% and 105% .Both intra‐and inter‐day precision were less than 5% .7‐OH MTX was identified to be the metabolite through the analysis of the mass spectrum .Conclusion The method is sensitive ,reproducible ,easy to operate and suits for monitoring the concentration of M TX in clinical practice .
ABSTRACT
Objective:To evaluate the efficacy and toxicity of single-agent bendamustine in patients with indolent B-cell non-Hodgkin's lymphoma (NHL) refractory to rituximab. Methods:Between April 2010 and April 2013, 100 patients with rituximab-refrac-tory indolent B-cell NHL from 8 institutions were enrolled. Bendamustine was administered at 120 mg/m2 on days 1 and 2 every 21 days for 6-8 cycles. The primary endpoint was the overall response rate (ORR). The secondary endpoints included disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and safety. Results:One hundred patients with a median age of 56 (rang-ing from 28 to 74) years were recruited in this clinical study. The total number of chemotherapy was 447 cycles, and the median number was 4 cycles. Ninety-three patients could be evaluated for efficacy. Fifteen patients (16.1%) had complete remission (CR), 52 (55.9%) had partial remission (PR), 22 (23.7%) had stable disease (SD), and 4 (4.3%) had progression disease (PD). The ORR and DCR were 72%and 95.7%, respectively. After a median follow-up of 26.6 months (ranging from 2 to 48.4 months), 59 patients (63.4%) had PD.The median PFS was 8.53 (95%CI:6.518-10.542) months, and PFS rate for 1 year was (40.6±5.3)%. Forty-eight patients (48%) had 3/4 grade adverse events, including leucopenia (26%), neutropenia (24%), and anemia (11%). Conclusion:Single-agent bendamustine produced a high rate of objective responses in patients with rituximab-refractory indolent B-cell NHL and could be one of the new op-tions for second-line treatment of these patients. The most common adverse event is hematologic toxicity.
ABSTRACT
<p><b>OBJECTIVE</b>The aim of this study was to compare the safety and efficacy profiles of R-CHOP and R-fCHOP regimes in the treatment of primary gastric diffuse large B cell lymphoma (PG-DLBCL).</p><p><b>METHODS</b>Data of PG-DLBCL patients admitted in our hospital from March 2010 to March 2014 were collected retrospectively. Differences in gastrointestinal bleeding and perforation between the R-CHOP group and R-fCHOP group were compared. The influence of the gastrointestinal complication on subsequent treatment was also analyzed. Treatment outcome of the two groups was also compared.</p><p><b>RESULTS</b>A total of 50 patients were included in this retrospective study. Forty of them were in the R-CHOP group, another ten were in the R-fCHOP group. Patients in the R-fCHOP group had a higher rate of Lugano late stage disease, and a relatively high rate of a deeper/larger ulcer. Fence occult blood test (FOBT) was positive in one (10.0%) patient in the R-fCHOP group, and 11 (31.4%) patients in the R-CHOP group, among them one had hematemesis and had to give up the subsequent chemotherapy. No perforation was observed in both groups. The response rate (RR) was 92.5% in the R-CHOP group and 90.0% in the R-fCHOP group (P > 0.05). The PFS was also comparable between the two groups (P > 0.05).</p><p><b>CONCLUSIONS</b>R-fCHOP regimen has a good safety profile in patients with Lugano late stage and deep/large ulcers, who are of high risk of gastrointestinal bleeding or perforation, and also has a comparable efficacy profile when compared with the R-CHOP regimen in short-term follow-up.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Antibodies, Monoclonal, Murine-Derived , Therapeutic Uses , Antineoplastic Combined Chemotherapy Protocols , Therapeutic Uses , Cyclophosphamide , Doxorubicin , Lymphoma, Large B-Cell, Diffuse , Drug Therapy , Lymphoma, Non-Hodgkin , Prednisone , Retrospective Studies , Rituximab , Stomach Neoplasms , Treatment Outcome , VincristineABSTRACT
Purpose:To investigate the efficacy and adverse effects of irinotecan, a novel and potent inhibitor of topoisomerase Ⅰ, for second line treatment of advanced colorectal cancer.Methods:14 patients who previously failed with fluorouracil treatment received single drug irinotecan 300 mg/m 2 intravenously every 3 weeks . All patients had received adjuvant therapy containing fluorouracil. Two patients had received pelvic radiotherapy.Results:Nine patients had received three cycles and five patients completed six cycles . Ten cases had stable disease, and four with progressive disease were observed among the 14 patients. The common treatment related adverse events were cholinergic syndrome (92.9%) ,delayed diarrhea (78.6%) and neutropenia (78.6%) . Grade Ⅲ side effects occurred in several patients: two nausea/ vomiting , two delayed diarrhea and one neutropenia / leucytopenia . Only one patient developed grade Ⅳ diarrhea.Conclusions: Irinotecan is an active drug in the treatment of advanced colorectal cancer with acceptable toxicity.
ABSTRACT
300?10~(9)/L. Results:One hundred and six patients were enrolled into this study. Of the 106 patients, 100 patients completed the study and were evaluable for efficacy. The median nadir of platelet was 49(5-76)?10~(9)/L in the control cycle and 69(6-221)?10~(9)/L in the study cycle. Median durations of PLT≤75?10~(9)/L, ≤50?10~(9)/L, and ≤20?10~(9)/L were 7 (0-26), 2 (0-20), and 0 (0-9) days in control cycle versus 3.5 (0-28) (P0.05) days in study cycle, respectively. The median duration of platelet recovery to 80?10~(9)/L was 5 (1-18) days in control cycle versus 2(0-28) days in study cycle (P
ABSTRACT
Purpose:To evaluate the efficacy and toxicity of combination of MabThera and CEOP regimen in the treatment of aggressive B-cell lymphoma. Methods:21 patients diagnosed as aggressive B-cell lymphoma with median age of 48 years old (from 15 to 68 years old),received the treatment of MabThera plus CEOP regimen. This treatment consisted of MabThera 375 mg/m2 intravenously infusion on day 1,cyclophosphamide 750 mg/m 2 ,epirubicin 60 mg/m 2 ,vincristine 2 mg on day3 ,prednisone 40 mg/m 2 orally taken on day 3～7. Results:In all 21 patients,16 (76.2%) complete response and 3 (14.2%) partial response were observed. Thus,the overall response rate was 90.5%. Moreover,of the remaining patients,1(4.8%) achieved stable disease and 1(4.8%) had progressive disease. In the 19 responsive patients,the follow-up duration were from 2 to 15 months. One case of thyroid lymphoma experienced recurrence after 14 months with complete response. Until now,the other responses have been maintained. Only one dose of MabThera infusion related-toxicity was observed in all who received 87 cycles. The hematological toxicities were mainly leucopenia and neutropenia. 5( 23.8% ) experienced 3-4 grade neutropenia. Only 1 patient developed neutropenia fever. The other non-hematological toxicities were 1-2 grade except grade 3 alopecia. Conclusions:The combination of MabThera and CEOP regimen had high efficacy with mild toxicity in the treatment of aggressive B-cell lymphoma,hopefully may become the standard treatment.