ABSTRACT
BACKGROUND@#Hepatectomy for hepatocellular carcinoma (HCC) beyond the Milan criteria is shown to be beneficial. However, a high rate of post-operative HCC recurrence hinders the long-term survival of the patients. This study aimed to investigate and compare the impacts of tenofovir (TDF) and entecavir (ETV) on the recurrence of hepatitis B viral (HBV)-related HCC beyond the Milan criteria.@*METHODS@#Data pertaining to 1532 patients who underwent hepatectomy and received antiviral therapy between January 2014 and January 2019 were collected from five centers. Recurrence-free survival (RFS) analysis was performed using the Kaplan-Meier method. Cox proportional hazards regression analysis was performed to determine prognostic factors for HCC recurrence.@*RESULTS@#The analysis incorporates 595 HBV-related HCC patients. The overall 5-year RFS was 21.3%. Among them, 533 and 62 patients received ETV and TDF treatment, respectively. The 1-, 3-, and 5-year RFS rates were 46.3%, 27.4%, and 19.6%, respectively, in the ETV group compared with 65.1%, 41.8%, and 37.2%, respectively, in the TDF group (P < 0.001). Multivariate analysis showed that TDF treatment (hazard ratio [HR]: 0.604, P = 0.005), cirrhosis (HR: 1.557, P = 0.004), tumor size (HR: 1.037, P = 0.008), microvascular invasion (MVI) (HR: 1.403, P = 0.002), portal vein tumor thrombus (PVTT) (HR: 1.358, P = 0.012), capsular invasion (HR: 1.228, P = 0.040), and creatinine levels (CREA) (HR: 0.993, P = 0.031) were statistically significant prognostic factors associated with RFS.@*CONCLUSIONS@#Patients with HCC beyond the Milan criteria exhibited a high rate of HCC recurrence after hepatectomy. Compared to the ETV therapy, TDF administration significantly lowered the risk of HCC recurrence.
Subject(s)
Humans , Antiviral Agents/therapeutic use , Carcinoma, Hepatocellular/surgery , Guanine/analogs & derivatives , Hepatectomy , Hepatitis B virus , Hepatitis B, Chronic/drug therapy , Liver Neoplasms/surgery , Retrospective Studies , Tenofovir/therapeutic useABSTRACT
Objective To evaluate the MRA by measuring the diameter of the stenosis artery and the contralateral normal vertebral artery with unilateral stenosis. Methods Seventeen-six patients were divided into normal group and vertebral arterial type of cervical spondylosis group.Among 26 vertebral arterial type of cervical spondylosis cases,13 cases appeared as vertebral arterial type with unilateral stenosis of ≤1.6 mm in diameter .Statistics assessment of MRA in stenosis and contralateral artery was engaged. Results The unilateral artery stenosis diameter measured
ABSTRACT
@#ObjectiveTo study the therapeutic mechanisms of electro-acupuncture on chronic spinal cord injury in rats.MethodsA model of chronic spinal cord injury was made. After 60 days, the pressure installs were removed, and the animals were treated with electro-acupuncture. A quantitive analysis was carried out using Basso, Beattie, Bresnahan Locomotor Rating Scale (BBB scale). The expression of Neurotrophin-3 (NT-3) and its receptor TrkC were observed through immunohistochemistrical method and western blotting.ResultsAfter spinal cord injury, enhanced NT-3 and TrkC immunoreactivities were evident in neurons and glial cells. Furthermore, they were diminished in the electro-acupuncture group. Meanwhile, both evoked potentials and BBB scales were improved after EA treatment (P<0.05). ConclusionThe treatment of electro-acupuncture may promote behavioral function recovery of experimental animals, and NT-3 and TrkC may take part in the recovery.
ABSTRACT
@# ObjectiveTo explore the mechanism of electro-acupuncture (EA) on chronic spinal cord injury.MethodsAn animal model of moderate chronic progressive compression on spinal cord was made. Then the animals were decompressed and treated with EA. The combined behavioral scores (CBS) were tested, and the expressions of choline acetyltransferase (ChAT), brain derived neurotrophic factor (BDNF) and its receptor TrkB on the section of the rat's spinal cord were examined with immunohistochemical method.Results90 days after injury, the CBS of EA group was significantly better than that of decompression group ( P<0.05) and the number of positive ChAT cells in ventral horn of spinal cord in EA group was more than that in decompression group (P<0.05). The expressions of BDNF and TrkB enhanced after injury were recovered in the EA group.ConclusionThe electro-acupuncture may be effect on chronic spinal cord injury in rats by influencing the expressions of BDNF and its receptor, and improvs the expression and activity of ChAT.
ABSTRACT
Objective To explore the phenomenon of neural apoptosis after chronic compressive spinal cord injury. Methods A newly designed chronic progressive compressive spinal cord injury model of rat was adopted in this study. Forty-five Wister rats were divided into mild, moderate, and severe group according to the compressive degree of the spinal cord. The Feulgen stain and TUNEL were used to investigate the apoptosis and its characteristics in different kinds of neural cells. Results Apoptosis index in moderate injury group was the highest. Apoptotic cells largely located in ventral, lateral and dorsal column of the white matter. Most of them were oligodendrocytes. Positive neuron occasionally presented in laminae Ⅲ～Ⅸ part of the sections. Most of them located in dorsal gray horn. Conclusions Apoptosis is an important event in secondary pathophysiological process of chronic progressive compressive spinal cord injury. Apoptosis is one of the reasons for neural cell death. The apoptosis of oligodendrocytos may contribute to myelin sheath disruption of white matter.