Association of microvascular invasion with recurrence and prognosis of patients with small hepatocellular carcinoma undergoing liver transplantation / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To evaluate the risk factors for recurrence in patients with hepatocellular carcinoma (HCC) after liver transplantation (LT).</p><p><b>METHODS</b>One hundred and fifteen small HCC patients, who met Milan criteria (single<5 cm or showing up to three nodules, each of them<3 cm without major vascular invasion or distant metastasis) and underwent LT in our hospital from January 2007 to November 2013, were enrolled in the study. The risk factors for recurrence were analyzed by Cox regression and the influence of the Milan criteria and microvascular invasion (MVI) on the disease-free survival (DFS) and recurrence of patients were assessed with survival analysis and ROC method.</p><p><b>RESULTS</b>Ninety-eight out of 115 small HCC patients were included for analysis, the 1-,3-, 5-year overall survival of patients was 91.8%, 80.6%, 79.6% and DFS was 87.8%, 74.5%, 73.5%, respectively. Survival analysis identified that MVI, macro-vascular invasion, exceeding the Milan criteria and pre-transplant down-staging treatment were related to tumor recurrence (P<0.05). Multivariate Cox regression analysis showed that MVI and exceeding the Milan criteria were two independent prognostic indicators for early recurrence of small HCC after LT. The 1-,3-,5-year DFS for 69 patients without MVI and 29 patients with MVI were 92.8%, 85.5%, 85.5% and 75.9%, 55.2%, 48.3%, respectively (P<0.01). The 1-,3-,5-year DFS for 84 patients meeting the Milan criteria and 14 exceeding the Milan criteria were 91.7%, 83.3%, 79.8% and 64.3%, 42.9%, 42.9%, respectively (P<0.01).</p><p><b>CONCLUSION</b>For early HCC patients undergoing LT, the presence of MVI would predict tumor recurrence and can be an indicator for the adjuvant treatment or other salvage treatments.</p>

Effect of thyroxine treatment on expression of hippocampus syntaxin-1 in rats with hypothyroidism / 中国地方病学杂志

ObjectiveTo observe the expression of syntaxin-1 in hippocampus of adult rats with hypothyroidism and the role of different doses of thyroid hormone replacement therapy,further to explore the molecular mechanism of brain damage.MethodsAll 44 male adult SD rats were randomly divided into 4 groups according to their body mass(250 - 300 g):hypothyroidism group,routine dosage thyroxine treatment group,high dosage thyroxine treatment group and control group (11 in each group).Hypothyroidism group,routine dosage thyroxine treatment group and high dosage thyroxine treatment group received daily intraperitoneal injection of propylthiouracil (PTU) 10 mg/kg.Hypothyroidism group was given PTU by intraperitoneal injection for two weeks after the previous four week treatment,the routine dosage thyroxine treatment group and the high dosage thyroxine treatment group were given 50,200 μg/kg L-thyroxine daily intraperitoneally for two weeks; the control group received daily intraperitoneal injection of saline.The levels of serum T3,T4 were assayed by radioimmunoassay method,and the level of syntaxin-1 in hippocampus was analyzed by immunohistochemistry.ResultsIn the hypothyroidism group,the levels of serum T3,T4[(0.34 ± 0.04),(43.01 ± 2.95)nmol/L] were significantly lower than those in the control group[(0.65 ± 0.05),(55.20 ± 3.56)nmol/L,all P ＜ 0.05].In the routine dosage of thyroxine treatment group,the levels of serum T3,T4[(0.63 ± 0.05),(55.04 ± 3.77)nmol/L] were not significantly different compared to the control group (all P ＞ 0.05 ).In the high dosage thyroxine thyroid hormone treatment group,the levels of serum T3,T4[(1.11 ± 0.10),(96.68 ± 6.42)nmol/L] were significantly higher than those in the control group(all P ＜ 0.05).The levels of syntaxin-1 protein in the CA1,CA3 and dentate gyrus(DG) of all layer regions of hippocampus (0.059 ± 0.016,0.064 ± 0.014,0.068 ± 0.016,0.069 ± 0.017,0.072 ± 0.016,0.070 ± 0.011,0.051 ± 0.012,0.072 ± 0.017) were significantly higher compared to the control group(0.037 ± 0.008,0.045 ± 0.010,0.042 ±0.009,0.040 ± 0.010,0.053 ± 0.009,0.042 ± 0.009,0.032 ± 0.007,0.047 ± 0.010,all P ＜ 0.05).In the routine dosage and the high dosage thyroxine thyroid hormone treatment group,the level of syntaxin-1 in CA1,CA3and DG regions(0.041 ± 0.011,0.046 ± 0.017,0.044 ± 0.014,0.037 ± 0.008,0.051 ± 0.010,0.043 ± 0.010,0.033 ± 0.011,0.045 ± 0.014 and 0.040 ± 0.010,0.045 ± 0.011,0.043 ± 0.010,0.033 ± 0.009,0.050 ± 0.010,0.041 ± 0.009,0.032 ± 0.009,0.046 ± 0.009)were not significantly different compare to the control group(all P＞0.05).ConclusionThe expression of syntaxin-1 in hippocampus of adult-onset hypothyroidism is increased,which can be reversed by routine dosage treatment of thyroxine.