Establishment of a nomogram for survival rate after liver resection for primary small hepatocellular carcinoma based on SEER data and external validation / 临床肝胆病杂志

Objective To establish a nomogram for overall survival rate after liver resection for primary small hepatocellular carcinoma based on SEER data and external validation of Chinese data. Methods The data of 1809 patients, registered in National Cancer Institute SEER database in 2004-2015, who underwent hepatectomy for primary small hepatocellular carcinoma were extracted as modeling group, and 158 patients with small hepatocellular carcinoma who underwent hepatectomy in Affiliated Hospital of North Sichuan Medical College from 2010 to 2017 were collected as validation group. The univariate Cox risk regression analysis, lasso regression analysis, and multivariate Cox hazard regression analysis were used to investigate the influencing factors for OS after hepatectomy in patients with small hepatocellular carcinoma. A nomogram was established based on the independent influencing factors for OS, and index of concordance (C-index), calibration curves, and receiver operating characteristic (ROC) curve were used to analyze the predictive ability of the nomogram. The Kaplan-Meier survival analysis and the log-rank test were used to investigate the difference in survival between the high- and low-risk groups. Results The multivariate Cox hazard regression analysis showed that sex (hazard ratio [ HR ]=1.22, 95% confidence interval [ CI ]: 1.05-1.41, P =0.010), Seer stage ( HR =1.51, 95% CI : 1.23-1.85, P < 0.001; HR =10.31, 95% CI : 2.53-42.04, P =0.001), tumor diameter ( HR =1.22, 95% CI : 1.06-1.39, P =0.004), vascular invasion or metastasis ( HR =1.43, 95% CI : 1.24-1.65, P < 0.001), and alpha-fetoprotein ( HR =1.33, 95% CI : 1.16-1.54, P < 0.001) were independent risk factors for OS after hepatectomy for small hepatocellular carcinoma. The modeling group had a C-index of 0.621, and its area under the ROC curve at 1, 2, and 3 years was 0.666(95% CI 0.628-0.704), 0.678(95% CI 0.647-0.708), and 0.663(95% CI : 0.635-0.690), respectively; the validation group had a C-index of 0.718, and its area under the ROC curve at 1, 2, and 3 years was 0.695(95% CI : 0.593-0.797), 0.781(95% CI : 0.706-0.856), and 0.759(95% CI 0.669-0.848), respectively. Risk stratification was performed based on the nomogram, and the Kaplan-Meier survival analysis showed that for both the modeling group and the validation group, the low-risk group had a significantly better prognosis than the high-risk group ( P < 0.01). Conclusion The model established for survival rate after liver resection for primary small hepatocellular carcinoma can predict the 1-, 2-, and 3-year OS rates and can thus be used in clinical practice in China.

Establishment and predictive value of an early warning system for recurrence after radical resection of BCLC stage 0/A hepatocellular carcinoma / 临床肝胆病杂志

Objective To establish an Early Warning System for Recurrence Scoring after Radical Resection of BCLC stage 0/A Primary Liver Cancer (PLC-EWSPRS), and to investigate its predictive value. Methods A retrospective analysis was performed for the clinical data of 232 patients with BCLC stage 0/A liver cancer who underwent radical resection in Affiliated Hospital of Chuanbei Medical College from January 2009 to January 2015, and according to the presence or absence of recurrence within 5 years after surgery based on telephone or outpatient follow-up data, the patients were divided into recurrence group with 103 patients and non-recurrence group with 129 patients. The t -test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups; the chi-square test or Fisher's exact test was used for comparison of categorical data between groups. The indices with statistical significance were included in the binary logistic regression analysis to investigate the risk factors for recurrence of BCLC stage 0/A liver cancer after surgery. Two points were assigned for independent risk factors and one point was assigned for risk factors to establish the PLC-EWSPRS system. The receiver operating characteristic (ROC) curve and the area under the ROC curve (AUC) were used to evaluate the diagnostic efficiency of this system. Results Compared with the non-recurrence group, the recurrence group had significantly higher levels of aspartate aminotransferase and alanine aminotransferase (ALT) and a significantly lower level of albumin (Alb) before surgery ( Z =3.864 and 4.587, t =-5.628, all P < 0.001), as well as a significantly higher proportion of patients with positive HBsAg, capsular invasion, microvascular invasion (MVI), tumor diameter ≥5 cm, liver cirrhosis (moderate-to-severe), non-R0 resection, or death within 5 years ( χ 2 =35.539, 22.325, 13.398, 7.130, 4.312, 4.034, and 18.527, all P < 0.05). The regression analysis showed that preoperative Alb < 40 g/L (odds ratio [ OR ]=5.796, P < 0.001), preoperative ALT ≥40 U/L ( OR =3.029, P =0.002), MVI ( OR =3.981, P =0.003), positive HBsAg ( OR =7.829, P < 0.001), capsular invasion ( OR =5.357, P < 0.001), and non-R0 resection ( OR =3.048, P =0.018) were independent risk factors for recurrence of BCLC stage 0/A liver cancer within 5 years after surgery. According to the assignment criteria of the PLC-EWSPRS system, the recurrence group had the lowest score of 2 points and the highest score of 14 points, while the non-recurrence had the lowest score of 0 point and the highest score of 11 points, and the recurrence group had a significantly higher score than the non-recurrence group ( P < 0.05). The ROC curve analysis showed that the PLC-EWSPRS system had an AUC of 0.918 (95% confidence interval [ CI ]: 0.883-0.953, P < 0.001) in predicting recurrence within 5 years after surgery in patients with BCLC stage 0/A liver cancer undergoing radical resection, and subgroup analysis showed that the system had an AUC of 0.796 (95% CI : 0.695-0.896, P =0.002), 0.859 (95% CI : 0.791-0.927, P < 0.001), and 0.944 (95% CI : 0.839-1.000, P =0.044), respectively, in predicting recurrence within 5 years after surgery in patients with a low score of 0-5 points, a moderate score of 6-10 points, and a high score of 11-14 points. Conclusion The PLC-EWSPRS system has a good value in predicting the recurrence of BCLC stage 0/A liver cancer within 5 years after surgery and thus has important guiding significance for postoperative reexamination and treatment strategy for patients with BCLC stage 0/A liver cancer undergoing radical resection.

Changes of serum iron and ferritin in regular voluntary blood donors / 中国输血杂志

【Objective】 To study the effect of regular blood donation on the serum iron (SI) and serum ferritin (SF) of regular blood donors. 【Methods】 A total of 240 blood samples (4~5 mL per person, with EDTA-2K anticoagulant) from regular voluntary blood donors in our center from January to June 2019 were randomly selected as the study group. Another 200 healthy subjects without blood donation history were randomly selected as the control group. SI was measured by Ferene method, SF by chemiluminescence method, and blood routine indexes by automatic hematology analyzer. 【Results】 The Hb, RBC count, HCT and other blood routine indexes of the study group and the control group were all in the normal range. SI (mol/L) in the study gourp and the control group was 17.13±4.36 vs 17.82±5.78(P>0.05), and SF (ng/mL) was 98.34±52.74 vs 147.52±91.52 (P<0.05). 【Conclusion】 SI and SF may decrease due to regular blood donation, which deserve close follow-up to ensure the safety of regular blood donors.

Analysis of reasons of insufficient blood collected in Guangzhou during 2018~2020 / 中国输血杂志

【Objective】 To retrospectively analyze the reasons of insufficient blood collected, to provide evidences for further taking targeted measures, to reduce the discard of insufficient whole blood and prevent the loss of blood donors. 【Methods】 Calculate the total number of whole blood donors and the number of whole blood donors donating insufficient blood during 2018~2020 annually in Guangzhou Blood Center Information System, and the data was analyzed in SPSS (22.0) software for χ2test and linear trend test. 【Results】 During 2018~2020, the incidence of insufficient blood collected was 0.066 4%(531/799 439), and the incidence of insufficient blood collected because of poor blood flow, needle-sickness and other reasons were 0.048 7%(389/799 439), 0.010 6%(85/799 439) and 0.007 1%(57/799 439). Furthermore, the incidence of insufficient blood collected of the three above reasons had statistically significant difference between the years respectively (P<0.05), meanwhile the incidence of insufficient blood collected because of poor blood flow was in a general rising trend significantly (0.036 3%<0.038 2%<0.072 7%, P<0.05). 【Conclusion】 The incidence of insufficient blood collected because of poor blood flow was in the rising trend and further precautions should be considered. Under the normalization of the novel corona-virus pneumonia (COVID-19), the professional knowledge of epidemic prevention and control should be learned and trained, in addition the puncture technique, the ability of offering psychological care and dealing with adverse events during blood collection should be also improved among nurses continually, so as to provide high quality services for blood donors.

Effect of bone marrow mesenchymal stem cells on MHCC97-H cells after transforming growth factor beta1 and osteopontin gene interference / 中国组织工程研究

BACKGROUND:Bone marrow mesenchymal stem cel s (BMSCs) are the focus of research on the proliferation and metastasis of hepatocel ular carcinoma cel s. By genetic engineering techniques, the hepatocel ular carcinoma cel s can be induced to reduce the expression of bioactive factors, thereby seeking suitable intervention targets for improving the interventional effect of BMSCs. OBJECTIVE:To silence the expression of transforming growth factor beta1 (TGFβ1) and osteopontin (OPN) in high metastatic potential hepatocel ular carcinoma cel s (MHCC97-H) fol owed by co-culture with BMSCs and then to observe the change of MHCC97-H cel invasion ability as wel as the interventional effect of BMSCs on the animal model of hepatocel ular carcinoma tissue MHCC97-H by fluorescence imaging in vivo. METHODS:MHCC97-H cel s were divided into four groups:MHCC97-H group was set as a blank control group, and MHCC97-H NC siRNA as negative control group, and MHCC97-H siRNA TGFβ1 and siRNA OPN were experimental groups. Transwel s assay was carried out for co-culture experiments. After 48 hours of co-culture, crystal violet staining was performed for cel counting in three randomly selected fields of vision. Combined with the red fluorescence protein gene, MHCC97-H cel lines in each group were inoculated via the right subaxil ary subcutaneous transplantation to make a tumor model in nude mice. When the tumor volume was up to about 50 mm3, BMSCs were injected into the tumor in the nude mice, and 4 weeks later, fluorescence images were analyzed using software for fluorescence intensity. Frozen hepatocel ular carcinoma tissue sections were taken for 4’,6-diamidino-2-phenylindole staining and fluorescence microscope observation. RESULTS AND CONCLUSION:Cel counting results showed that BMSCs significantly decreased MHCC97-H cel s after gene silencing, and crystal violet staining showed that the migration ability of MHCC97-H cel s was significantly decreased. Tumor volume shown by the fluorescence imaging was significantly reduced after the OPN gene transfection, the fluorescence intensity was lower than that in the other groups, and quantitative results showed that the absorbance value of OPN shRNA cel s decreased significantly compared with other groups, indicating the BMSCs exhibit best interventional effectiveness in OPN-silenced MHCC97-H cel s. Pathological sections showed that BMSCs were mainly distributed in the tumor necrosis area, and the fluorescence expression in the OPN siRNA group was more than that in the TGFβ1 siRNA group and the blank control group, indicating that after OPN gene silencing of MHCC97-H cel s, the distribution of BMSCs in the tumor was increased. To conclude, it is able to reduce the invasive ability of hepatocel ular carcinoma cel s by inhibiting the expression of OPN and TGFβ1 factors, and OPN silencing may be more conductive to BMSCs biotherapy.

The expression and significance of macrophagecolony stimulating factor in patients with cervical lntraepi-theliai neoplasia or cervical cancer / 实用医学杂志

Objective To determine the levels of plasma M-CSF in cervical cancer patients and cervical intraepitheliai neoplasia(CIN)patients,and to discuss the diagnostic utility of M-CSF in the development of cervi-cal cancer. Methods Forty-nine cases of cervical cancer,60 cases of CIN and 40 healthy controls were selected from June 2014 to June 2016. Plasma levels of M-CSF and SCC-Ag were determined by using ELISA and MEIA, respectively. Results Significantly different concentrations of M-CSF and SCC-Ag were observed in patients with cervical cancer compared to the healthy controls and CIN patients(P<0.01,respectively). Significant difference in plasma M-CSF level between the healthy controls and benign lesion patients were also found(P<0.05).However, no significant difference in SCC-Ag was found between the healthy controls and benign lesion patients. SCC-Ag combined M-CSF could obviously increase the detection rate of cervical cancer,without increasing the false posi-tive rate. The level of M-CSF in patients with cervical cancer and high grade of CIN reduced to the normal level, with significant difference before and after surgery(P<0.05).Meanwhile,the level of SCCAg in CIN patients was significantly reduced before and after surgery(P<0.05).Conclusions This study suggests the potential utility of M-CSF as a good candidate for a serum marker of cervical cancer,as well as benign lesions of this organ(CIN), and M-CSF may also be use to predict the outcome of CIN.

Evaluation of the effect of ALT activity on blood donors in Guangzhou Blood Center / 中国输血杂志

Objective To understand and to grasp the basic situation on blood donors who were ineligible by ALT dry chemistry testing before blood donation.Methods The ALT rejection ratios used in initial screening and not used in two blood collection point were compared at the same time.The relativity between the dry chemistry testing and rate method were compared.An association was explored in various influencing factors on the activity of ALT.Results The use of ALT initial screening in blood donation had a significantly lower unqualified rate than not using it in early screening (P＜0.05).Dry chemical,biological method and the results had good correlation rates (r=0.993,P＜0.05).The B MI,drinking,sleeping,sports,diabetes,liver disease were independent factors affecting ALT activity (P＜0.05).Conclusion ALT initial screening can significantly reduce the unqualified rates and disposal of blood.

Predictive efficacy of different intrauterine adhesion (IUA) classification systems on the prognosis of patients with IUA / 解放军医学杂志

Objective To explore the effects of different intrauterine adhesion (IUA) classification systems on predicting the IUA prognosis.Methods One hundred cases were selected as the subjects in present study from those diagnosed with IUA and underwent surgery in Zhujiang Hospital of Southern Medical University from Jan.2010 to Jan.2017,and were followed up for two years.According to the actual situation,all patients were scored by March,AFS,ESGE and Chinese classification for comparing the effects of different IUA classification systems on predicting the pregnancy rate,live birth rate and effective rate within 2 years after surgery.Results ESGE classification had a good effect on predicting the postoperative live birth rate and effective rate,and a certain predictive effect on pregnant rate,with the area under curve (AUC) of 0.722,0.754 and 0.635,respectively.March classification had a certain effect on predicting the postoperative live birth rate and effective rate with AUC of 0.635,0.754,respectively,but had a poor effect on predicting pregnant rate.AFS classification and China classification had poor effect on predicting the IUA prognosis.Conclusion ESGE classification system is better than the other systems including March,AFS and Chinese classification,on predicting the IUA prognosis,but further verification in large sample size is still required.

Clinical application of fast track surgery in patients with vaginal hysterectomy for non -prolapsed uterus / 中国基层医药

Objective To investigate the safety and feasibility of fast track surgery (FTS)in patients with vaginal hysterectomy for non -prolapsed uterus.Methods 1 1 0 cases of vaginal hysterectomy for non -prolapsed ute-rus with benign uterine disease were randomly divided into two groups:fast track group (n =55)and conventional group (n =55).The operative time,intraoperative blood loss,postoperative nausea and vomiting,anal exhaust time, postoperative hospital stay,medical cost and perioperative complications were compared between the two groups. Results In FTS group,the incidence rate of postoperative nausea and vomiting,the postoperative anal exhaust time, hospital stay,cost of hospitalization were 1 6.4%,(1 3.73 ±2.41 )h and (4.38 ±1 .08 )d,(7 541 .00 ± 253.1 7)yuan,respectively,which in the control group were 36.4%,(1 8.56 ±1 .54 )h,(4.89 ±1 .26 )d, (8 1 55.1 5 ±495.89)yuan,the differences were statistically significant between the two groups (χ2 =5.67,t =-1 2.53,-2.28,-8.1 7,all P 0.05).Conclusion FTS has good security.It can short the hospitalization time,reduce medical costs and improve the quality of life in patients who underwent vaginal hysterectomy for non -prolapsed uterus with benign uterine disease.

The application of two enterostomy in gerontal patients with obstructive carcinoma of sigmoid and high rectum / 实用医学杂志

Objective To explore the safety and efficacy of loop ileostomy and Hartmann operation in gerontal patients with obstructive carcinoma of sigmoid and high rectum. Methods sixty-two gerontal patients with obstructive carcinoma of sigmoid and high rectum from April 2008 to April 2013 were randomly divided into loop ileostomy group and Hartmann group.The operation time , length of stay and postoperative complications in the two groups were analyzed. Results The time of absolute diet in loop ileostomy group was shorter than that in Hartmann group in Stage I operation (P < 0.05). The time of operation, absolute diet, and length of stay in loop ileostomy group were shorter than that in Hartmann group in Stage II operation (P < 0.05). Conclusion The application of loop iloostomy in gerontal patients with obstructive carcinoma of sigmoid and high rectum was safe and effective.

Research advances in terpenoids biosynthesis pathway of tomatoes / 国际生物医学工程杂志

The metabolic activity of terpenoids not only have a grant effect on normal growth of tomato plants,but also have a great influence on the quality and colour of the fruits.Most terpenoids belong to the carotenoids,which are synthesized through terpenoid pathway.Three acety-CoAs are condensated into one mevalonate (MVA),which will be phosphorylated into diphosphate,then turn into isopentenyl diphosphate (IPP) through decarboxylation.IPP will be isomerased into dimethylallyl diphosphate (DMAPP) by IPP isomerase (IPPI).Geranyl Geranyl diphosphate synthase (GGPPS) catalyze the reaction for DMAPP and IPP.One DMAPP and three IPP molecules condensedinto one GGPP.Two GGPP polymerize into one phytoene by phytoene synthase (PSY).Phytoene desaturase (PDS) catalyze the phytoene into ζ-carotene,which catalyzed into lycopene by ζ-carotene desaturase (ZDS).Lycopene βcyclase (LCYb) and lycopene ε cyclase (LCYe) catalyze the lycopene turn into α-carotene and β-carotene after cyclization reaction.The lutein will be combined after two step of hydroxylation.The latest research advances in terpeniods biosynthesis pathway are summarized in this review and foreground of the field is prospected.

Mini-invasive treatment for patients with vascular malformations in oral and maxillofacial region / 中华医学美学美容杂志

Objective To investigate effects of mini-invasive treatment for patients with vascular malformations in oral and maxillofacial region . Methods 8 cases with vascular malformations in oral and maxillofacial deep or special region were injected pingyangmycin into vein lake by color ultrasound-guided needle aspiration. Results All cases were cured and no facial nerve was damaged. Follow-up ranged from 6 months to 1 year, and no recurrence was found. The vascular malformations of 4 cases in maxillofacial deep region were disappeared or instead of fiber tissue with MRI detection 6 months after treatment. Conclusions Injecting pingyangmycin by color ultrasound guided-needle aspiration for patients with vascular malformations in oral and maxillofacial deep or special region is effective, safe and mini-invasive treatment.