Correlation between HLA-Cw*0602 and LCE3B_LCE3C-del allele interaction and psoriasis vulgaris in a population of Mongolian nationality in Inner Mongolia / 中国基层医药

Objective:To investigate the effect of HLA-Cw*0602 and LCE3B_LCE3C-del allele interaction on the risk of psoriasis vulgaris in a population of Mongolian nationality in Inner Mongolia. Methods:A total of 365 Mongolian patients with psoriasis vulgaris who received treatment in The Affiliated Hospital of Inner Mongolia Medical University from January 2006 to December 2015 (case group) and 284 healthy subjects who concurrently received physical examination in the same hospital (control group) were included in this study. After sex and age matching, and quality control, the correlations between HLA-Cw*0602 and LCE3B_LCE3C-del allele and psoriasis vulgaris in a population of Mongolian nationality were analyzed using SPSS 20.0 software. The interaction between HLA-Cw*0602 and LCE3B_LCE3C-del alleles (adjusting for potential confounders including age and sex) was analyzed using logistic regression. Results:Logistic regression interaction item Int of dominant inheritance mode HLA-Cw*0602 allele and recessive inheritance mode LCE3C_LCE3B-del allele revealed OR = 2.38, P = 0.033, and interaction index S = 1.21, indicating that there was a synergistic effect between the two alleles. Conclusion:The co-existence of HLA-Cw*0602 and LCE3B_LCE3C-del may increase the risk of psoriasis vulgaris in a population of Mongolian nationality in Inner Mongolia.

Sequential transcatheter arterial chemoembolization and selective portal vein embolization before major hepatectomy for large hepatocellular carcinoma: a pilot study / 中华肝胆外科杂志

Objective:To preliminarily study the feasibility, safety and efficacy of transcatheter arterial chemoembolization (TACE) combined with selective portal vein embolization (SPVE) before surgical resection in the treatment of large liver cancer.Methods:A retrospective study was conducted on the clinical data of 17 patients with large liver cancer treated with TACE combined with SPVE from January 2016 to December 2019 at the Department of Hepatobiliary Surgery, the Sixth Medical Center of PLA General Hospital. The study included 15 males and 2 females, aged (59.17±10.30) years. The levels of alanine aminotransferase, tumor changes and patient survival were analyzed before operation, after TACE, and after SPVE.Results:Among the 17 patients, the levels of alanine aminotransferase on the 1st and 3rd day after SPVE was significantly higher than those after TACE [191.4 (30.5-1966.4) IU/L vs 125.3 (35.7-846.2) IU/L on the first day, and 298.5 (24.6-1334.2) IU/L vs 208.6 (21.6-775.6) IU/L on the 3rd day], all P<0.05. One month after the two combined embolism, among the 6 patients with a tumor diameter of 5-10 cm, 2 patients (33.3%) had complete remission, 3 patients (50.0%) had partial remission, and 1 patients (16.6%) had stable disease. For the tumor’s longest diameter, among the 11 patients with tumors >10 cm, 1 patient had complete remission (9.1%), 4 patients had partial remission (36.4%), 5 patients had stable diseases (45.5%), and 1 patient had disease progression (9.1%). Eventually, 11 patients underwent surgical exploration. The median residual liver volume before treatment was 329.5 (284.9-365.7) ml, and after the combined procedure 415.6 (354.7-718.8) ml. The median hyperplasia ratio was 28.1% (14.1%-51.3%). Eight patients finally underwent surgical resection. There was no death in the perioperative periods. The median tumor-free survival time was 17 (7-42) months, and the median survival time was 27 (7-42) months. Conclusion:For patients with large liver cancer with insufficient remnant liver volume, preoperative TACE+ SPVE has certain value in controlling tumor progression, promoting remnant liver hyperplasia, increasing surgical resection rate and improving prognosis.

Targeting DNA damage response in tumor therapy / 中国临床药理学与治疗学

Chemotherapy plays an important role in cancer treatment. With deeply understanding the mechanism of tumorigenesis, different chemotherapeutic drugs have been emerged as initial choices for cancer treatment. However, most patients gradually develop to chemotherapeutic resistance, resulting in failure to initial standard therapy. The mechanisms of chemoresistance are extensively explored. Recent studies indicated intrinsic or acquired alteration of DNA damage repair ability is the key determinant of chemoresistance. In this review, we present deregulation of DNA damage repair pathway in cancers and its involvement contributing to chemoresistance. Furthermore, we discuss strategies to sensitize chemotherapy by targeting at a parallel DNA repair pathway, which become promising approaches to overcome chemotherapeutic resistance.

Expression and significance of L-FABP in hilar cholangiocarcinoma / 中华消化外科杂志

Objective To explore the expression of liver fatty acid binding protein (L-FABP) in tissues of hilar cholangiocarcinoma and the relationship between expression of L-FABP and clinicopathological factors and prognosis of the patients.Methods The retrospective case-control study was conducted.The clinicopathological data of 132 patients with hilar cholangiocarcinoma who were admitted to the Navy General Hospital between January 2003 and January 2013 were collected.The expression of L-FABP in tumor tissues and adjacent tissues of hilar cholangiocarcinoma and normal bile duct tissues were respectively detected by immunohistochemistry.Observation indicators:(1) expression of L-FABP by immunohistochemistry;(2) relationship between clinicopathological factors of patients and expression of L-FABP in tumor tissues;(3) follow-up and survival situations;(4) prognostic analysis of patients after radical resection of hilar cholangiocarcinoma.Follow-up using outpatient examination and telephone interview was performed to detect postoperative overall survival time up to June 2017.Count data were described as percentage and compared using the chi-square test.The survival time was calculated by the Kaplan-Meier method.Measurement data with skewed distribution were described as M (range).The univariate analysis and multivariate analysis were respectively done using the nonparametric test and COX regression model.Results (1) Expression of L-FABP by immunohistochemistry:the positive expressions of L-FABP were located in the cytoplasm.The low,moderate and high expression rates of L-FABP in tumor tissues were respectively 11.36％ (15/132),71.97％ (95/132) and 16.67％ (22/132),and positive-staining cells showed platy and / or diffuse distribution;the low,moderate and high expression rates of L-FABP in adjacent tissues of hilar cholangiocarcinoma were respectively 77.27％ (102/132),7.58％ (10/132) and 15.15％ (20/132),and positive-staining cells showed scattered or platy distribution,with a weaker staining intensity compared with tumor tissues;there was no positive expression in normal bile duct tissues.There was a statistically significant difference in expressions of L-FABP among tumor tissues and adjacent tissues of hilar cholangiocarcinoma and normal bile duct tissues (x2=5.423,P ＜ 0.05).(2) Relationship between clinicopathological factors of patients and expression of L-FABP in tumor tissues:cases with low,moderate and high expressions of L-FABP in tumor tissues were respectively 10,30,5 in 45 patients with tumor diameter ＜ 3 cm and 4,29,9 in 42 patients with 3 cm ≤ tumor diameter ≤ 5 cm and 1,36,8 in 45 patients with tumor diameter ＞ 5 cm,with a statistically significant difference (x2 =10.171,P＜ 0.05).(3) Follow-up and survival situations:132 patients were followed up for 5-90 months,with a median time of 33 months.During the followup,postoperative overall median survival time of 132 patients was 31 months.(4) Prognostic analysis of patients after radical resection of hilar cholangiocarcinoma:results of univariate analysis showed that tumor differentiation,lymph node metastasis and expressions of L-FABP in tumor tissues were related factors affecting prognosis of patients after radical resection of hilar cholangiocarcinoma (Z =1.845,3.156,1.243,P＜0.05).Results of multivariate analysis showed that tumor differentiation,lymph node metastasis and expressions of L-FABP in tumor tissues were independent factors affecting prognosis of patients after radical resection of hilar cholangiocarcinoma (odds ratio =0.431,1.806,3.692,95％ confidence interval:0.292-0.693,0.974-2.973,1.875-11.364,P＜0.05).Conclusions The high expression of L-FABP in tumor tissues is significantly correlated with the tumor diameter.Tumor differentiation,lymph node metastasis and expressions of L-FABP in tumor tissues are independent factors affecting prognosis of patients after radical resection of hilar cholangiocarcinoma.

Clinical efficacy of end-inside anastomosis for keeping biliary mucosal integrity / 中华肝胆外科杂志

Objective To compare the effect of two procedures,named "mucosa to mucosal "and "end-inside" anastomosis for cholangiojejunostomy,and analyze its applicable scope.Methods A retrospective analysis was performed on the clinical data of 340 patients who underwent choledochojejunostomy from May 2012 to May 2017 in the Navy General Hospital.These patients were divided into two groups according to the procedure they received,including " mucosa to mucosal" anastomosis (n =249) and " end-inside"anastomosis (n =91).Two anastomotic methods of intraoperative state and postoperative complications were compared respectively under normal bile duct condition and cholangiectasis condition.Results When the common bile duct was not dilated,time spent for anastomoting in "end-inside" anastomosis was significantly shorten than that in "mucosa to mucosal" anastomosis (12.7 ± 1.2) min vs.(25.2 ± 5.8) min,and incidences of anastomotic leakage,bile duct infection,liver abscess,blie duct stricture postoperation (1.6％ vs.9.7％) in "end-inside" anastomosis were significantly lower than those in "mucosa to mucosal" anastomosis (P ＜ 0.05).Whether the common bile duct was dilated or not,the shrinking extents of stoma in " end-inside" anastomosis were lower than those in " mucosa to mucosal" anastomosis (1.4 ± 0.4) mm vs.(3.6 ± 1.2),(2.9 ± 0.6) mm vs.(4.2 ± 1.2) mm with statistical significances (P ＜ 0.05).There was no significant differences between two procedures when common bile duct was dilated.Conclusion Compared to the mucosa to mucosal anastomosis,the end-inside anastomosis had the advantage of easy operating and low postoperative complications when the bile duct was not dilated.

Association of HLA-Cw and -DRB1 alleles with psoriasis vulgaris in Mongolian population / 中华皮肤科杂志

ObjectiveTo investigate the association of HLA-Cw and -DRB1 alleles with psoriasis vulgaris,and to provide a clue to the study into the etiology of psoriasis.MethodsVenous blood samples were obtained from 81 patients with psoriasis vulgaris collected during 2006-2011 at the Department of Dermatology,First Affiliated Hospital of Inner Mongolia Medical College,as well as 100 age- and gender-matched healthy controls.Both the patients and controls are unrelated Mongolia in Inner Mongolia.PCR with sequence-specific primers(PCR-SSP) technique was used to genotype the HLA-Cw and DRB1 loci.ResultsThe patients with psoriasis vulgaris showed a significantly higher frequency of HLA-Cw*06(0.438 vs.0.175,Pc ＜ 0.01) and DRB1*07(0.241 vs.0.110,Pc ＜ 0.012),but a lower frequency of HLA-Cw*04(0.031 vs.0.150,Pc ＜ 0.01 ) and DRB1*04 (0.093 vs.0.235,Pc ＜ 0.01 ) than the healthy controls did.Increased frequencies of HLA-Cw*06 and DRB1*07 alleles were observed in patients with an onset before 40 years of age and those without a family history,together with a decreased frequency of HLA-Cw*04 and DRB1*04 alleles,compared with the healthy controls(Pc ＜ 0.05).The frequency of HLA-Cw*06 allele was significantly higher in patients with a positive family history and patients with an onset of no younger than 40 years of age than in the healthy controls (both Pc ＜ 0.05).ConclusionsHLA-Cw*06 and -DRB1*07 alleles may be susceptibility determinants to psoriasis vulgaris,while HLA-Cw*04 and -DRB1*04 alleles may be protective factors against psoriasis vulgaris,in Mongolia from Inner Mongolia.HLA-DRB1*07 allele may be a susceptibility gene for psoriasis,while HLA-Cw*04 and -DRB1*04 alleles may be protective factors against psoriasis,in patients with an onset before 40 years of age.

Establishment and evaluation of models for small-for-size graft injury without veno-venous bypass in miniature pigs / 中华肝胆外科杂志

Objective To establish small-for-size (SFS) graft injury models in miniature pigs with high standardization, reproducibility and similarity to clinical situation. Methods Ba-Ma miniature pigs were introduced in this study and orthotopic liver transplantations (OLTs) were performed in 12 pigs with 30% liver volume allogeneil grafts (small portion of right paramedian lobe, right lateral lobe and caudate lobe) without veno-venous bypass. The profiles of intra-operational hemodynamics and metabolism were investigated. Animals were observed for 7 days with daily serum biochemistry and coagulation function exam. The survival rate related to operation itself and the SFS grafts were respectively calculated as well as the graft regenerative ratio at post-operational day (POD) 7. Results Graft weight as a percentage of the recipient's native liver weight (GW/RLW) and the total body weight (GW/BW) were (28. 63±4. 42)% and (0. 73±0.06)%. The mean operation time, anhepatic phase, and the time of blockage of infra-hepatic IVC were (191. 7±14. 2) min, (28. 3±3. 6) min, and (45. 0±5. 8) min. The survival rate related to the operation itself and the SFS graft were 83. 33% (10/12) and 40% (4/10), and the graft regenerative ratio at POD7 was (278. 06±42. 95) %. Contrast to the remarkable increase of heart rate and serum potassium during anhepatic phase, the mean arterial pressure, central venous pressure, rectal temperature, PH value and buffer excess had a significant decrease (P<0.01) with a gradual recovery after reperfusioa Serum ALT, AST, PT, Cr, and TB were significantly increased with a peak level at POD1 for the former 4 and POD2 for TB, and then began to decrease and favorably recovered at POD7, but TB, PT, and AST levels were still high when compared to those of prereperfusion (P<0. 05). Conclusion This model of OLT performed with 30% liver volume graft without veno-venous bypass was an ideal large animal model for series studies related to SFS graft injury.