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Objective: To analyze clinical features and prognosis of hepatocellular carcinoma (cHCC) patients after liver resection, so as to clarify the prognostic risk factors. Methods: We retrospectively reviewed the data of patients who underwent mesohepatectomy for cHCC at Tianjin Medical University Cancer Hospital and Chinese Academy of Medical Sciences Cancer Hospital between October 2006 and December 2014. The patients were assigned into three subgroups according to disease-free survival (DFS): high risk (DFS≤1 year), middle risk (1 year<DFS≤3 years), and low risk (DFS>3 years). Clinicopathological characteristics were compared and prognostic factors were evaluated using univariate and multivariate analyses. Results: In total, 173 patients were reviewed. The median overall survival (OS) in the high-risk group was 13.5 months compared with 24.0 months in the middle-risk group and 45.5 months in the low-risk group. Univariate analysis showed that liver capsule invasion (P=0.022), tumors adjacent to major vascular vessels (<1 cm) (P<0.01), HCC size>50 mm (P=0.012), presence of microvascular invasion (P<0.001), tumor invasive growth (P<0.001), and preoperative transarterial chemoembolization (TACE; P=0.028) were significant risk factors for recurrence. The main risk factors for OS were male gender (P=0.013), alpha-fetoprotein >200 ng/mL (P=0.005), tumor size >50 mm (P=0.013), adjacent to major vascular vessels (P<0.001), high Edmondson-Steiner differentiation grade (P=0.003), preoperative TACE (P=0.010), and tumor invasive growth (P=0.001). Cox multivariate analysis demonstrated that tumors adjacent (<1 cm) to major vascular trunks and tumor invasive growth were inde-pendent prognostic factors for both DFS and OS. In total, 40.5% patients in the high-risk group had both risk factors; this percentage was 13.4% in the middle-risk group and 3.1% in the low-risk group (P=0.001). A prognostic model including the above 9 factors were created based on Logistic regression to predict the percentage of patients belonging to the high-risk group. The results showed that the prediction accuracy continued to increase with the number of more factors added. When all the 9 factors were included, the pre-dictive percentage was 82.1%. Conclusions: cHCC patients in the high-risk group had more risk factors than those in the middle-and low-risk groups. A prognostic model containing these factors may provide accurate prediction of survival or risk stratification, and cHCC patients with these risk factors should be candidates for aggressive following-up and adjuvant therapy.
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To optimize the belt drying process conditions optimization of Gardeniae Fructus extract from Reduning injection by Box-Behnken design-response surface methodology, on the basis of single factor experiment, a three-factor and three-level Box-Behnken experimental design was employed to optimize the drying technology of Gardeniae Fructus extract from Reduning injection. With drying temperature, drying time, feeding speed as independent variables and the content of geniposide as dependent variable, the experimental data were fitted to a second order polynomial equation, establishing the mathematical relationship between the content of geniposide and respective variables. With the experimental data analyzed by Design-Expert 8. 0. 6, the optimal drying parameter was as follows: the drying temperature was 98.5 degrees C , the drying time was 89 min, the feeding speed was 99.8 r x min(-1). Three verification experiments were taked under this technology and the measured average content of geniposide was 564. 108 mg x g(-1), which was close to the model prediction: 563. 307 mg x g(-1). According to the verification test, the Gardeniae Fructus belt drying process is steady and feasible. So single factor experiments combined with response surface method (RSM) could be used to optimize the drying technology of Reduning injection Gardenia extract.
Subject(s)
Chemistry, Pharmaceutical , Methods , Desiccation , Methods , Drugs, Chinese Herbal , Chemistry , Fruit , Chemistry , Gardenia , Chemistry , Research Design , VacuumABSTRACT
<p><b>OBJECTIVE</b>To investigate the differences between clinicopathological features and prognosis of alpha-fetoprotein (AFP) negative (AFP < 20 ng/ml) and positive (AFP ≥ 20 ng/ml) hepatocellular carcinoma (HCC) patients.</p><p><b>METHODS</b>Clinicopathological data of 142 AFP-negative and 109 AFP-positive HCC patients who underwent RO radical hepatectomy in the Cancer Hospital of Chinese Academy of Medical Sciences between January 2006 and December 2011 were retrospectively reviewed and analyzed in this study.</p><p><b>RESULTS</b>Compared with the AFP-negative patients, a higher female to male sex ratio, the later Barcelona Clinic Liver Cancer ( BCLC) stage, more liver capsule invasion and poorer Edmondson-Steiner grade were in the AFP-positive cases (P < 0.05 for all). Furthermore, the 1-, 3-, and 5- year overall survival rates were 94.4%, 82.4% and 61.0% in the AFP-negative group and 87.2%, 61.1% and 40.2%, respectively, in the AFP-positive group (P < 0.001). The multivariate analysis with Cox's proportional hazards model showed that AFP status, tumor size and Edmondson-Steiner grade are independent risk factors for survival of all the patients (P < 0.05) , and large tumor and Edmondson-Steiner grades III/IV are independent risk factors for worse survival in AFP-negative patients (P < 0.05). However, large tumor diameter was proved to be an independent risk factor leading to poor prognosis of AFP-positive cases (P < 0.05).</p><p><b>CONCLUSION</b>High levels of AFP indicate that the tumors are more malignant and with unfavorable prognosis.</p>