Analysis of clinicopathological characteristics of non-alcoholic fatty liver disease / 中华病理学杂志

Objective: To investigate the clinical and pathologic characteristics of obese adults with nonalcoholic fatty liver disease (NAFLD) and to aid the diagnosis of nonalcoholic steatohepatitis (NASH). Methods: A total of 262 patients eligible for inclusion who received volume reduction metabolism surgery and liver biopsy in the First Affiliated Hospital of Nanjing Medical University from June 2018 to September 2019 were selected. HE staining, reticular fiber staining and Masson staining were performed. Statistical analysis was performed using SPSS 20.0. Results: The patients ranged in age from 18 to 66 years. Among the 262 cases, 65 cases (65/262, 24.8%) were male and 197 cases (197/262, 75.2%) were female. Sixty-one cases (61/262, 23.3%) were non-NAFLD, 201 cases (201/262, 76.7%) were NAFLD including 27 cases (27/201, 13.4%) of nonalcoholic fatty live (NAFL) and 174 cases (174/201, 86.6%) of NASH. The main lesions of NAFLD were in hepatic acinus zone 3. There were significant differences in age, alanine aminotransferase (ALT), glutamic oxaloacetic transaminase (AST), body mass index (BMI), fasting blood-glucose (FPG) and apolipoprotein A (APOA) levels among the non-NAFLD group, NAFL group and NASH group (P<0.05). Patients with BMI≥35 m/kg2 combined with type 2 diabetes had a higher prevalence of NASH. Multiple logistic regression showed that ALT and APOA were independent predictors of NASH (P<0.001, OR=1.05, 95%CI: 1.020-1.082; P=0.027, OR=0.916, 95%CI: 0.878-0.941). Total cholesterol (CHO) and high-density lipoprotein (HDL) were independent predictors of lobular inflammation (P=0.043, 95%CI: 0.010-0.634; P=0.024, 95%CI:-3.068--0.216). AST and HDL were independent predictors of fibrosis stage (P=0.029, 95%CI: 0.001-0.021; P<0.001, 95%CI:-2.670--0.645). Conclusions: Biochemical indicators of NAFLD are closely related to its pathology. The histological lesions of NAFLD are mainly present in hepatic acinar area 3. The diagnosis of NASH is supported by extensive steatosis and high levels of CHO, ALT, AST and BMI, low levels of HDL and ApoA in biochemical markers, but pathological examination is still the gold standard for it.

Esculetin protects against early sepsis via attenuating inflammation by inhibiting NF-κB and STAT1/STAT3 signaling / 中国天然药物

Esculetin, a natural derivative from the traditional and widely-used Chinese medicinal herb Cortex Fraxini, has a variety of pharmacological effects, especially in anti-inflammation. However, it is not clear whether esculetin has a therapeutic effect on sepsis. This study aimed to investigate the anti-inflammatory and protective effects of esculetin on early sepsis. The results showed that the lung injury was significantly relieved with the treatment of esculetin, accompanied with the restrained production of inflammatory factors including IL-1β, IL-6, TNF-α, CCL2 and iNOS during the early phase of E.coli-induced sepsis. Of note, activation of NF-κB and STAT1/STAT3 signals, the main upstream signals of many inflammatory factors, were attenuated by esculetin in both lung tissues from septic mice and LPS-stimulated macrophage. These findings suggested that the protection of esculetin against early sepsis should be related to its anti-inflammatory effect, which was at least partly due to its inhibition on NF-κB and STAT1/STAT3 signaling pathway in macrophage. Thus, esculetin could serve as a potential therapeutic agent by rebalancing innate immune response in macrophage for the treatment of early sepsis.

Serum epidemiology of five strong pathogenicity human adenoviruses natural infection in Tupaia belangeri / 中国人兽共患病学报

In order to explore the possibility of human adenovirus infection with tree shrews,the neutralizing antibody ti-ters of five kinds of human adenoviruses (HAdv)in the serum of tree shrews were analyzed.The levels of Ad3,Ad4,Ad7, Ad14 and Ad55 neutralizing antibody were detected by virus neutralization test.The results showed that the positive rate of four adenoviruses in group B were higher than Ad4 in group E,and the positive rates respectively were Ad14 (55.88%),Ad3 (47.06%),Ad55 (29.71%),Ad7 (14.71%)and Ad4 (8.82%).The antiserum mainly mixed with Ad3,Ad14 and Ad55 anti-body.Five species of human adenovirus can be naturally infected with tree shrews.Tree shrews are used as experimental ani-mals to establish human adenovirus infection model is alternative.

Research progress of relevant signals and mechanisms in clearance of apopto-sis cells / 中国免疫学杂志

Our bodies produce a lot of apoptotic cells every day,and the timely removal of these apoptotic cells is essential to maintain the immune balance of the body. In the removal of apoptotic cells,macrophages play a major role,and their removal process is divided into three stages:recruitment,identification and phagocytosis. In the recruitment stage,apoptotic cells secrete′find me′signals, and phagocytes respond and are recruited to apoptotic cells. At the identification stage, the ′eat-me′ signal of apoptotic cells was identified with the phagocytic receptor on the surface of phagocytes. Phagocytic phase, the ′eat-me′ signal transmits signals to macrophages,such as activating the small GTPase Rac1,which leads to actin polymerization and cytoskeleton rearrangement to promote the phagocytosis of apoptotic cells. If the removal mechanism of apoptotic cells is obstructive,the apoptotic cells that have not been cleared in time will enter the secondary necrotic state and release the self-antigens. These self-antigens may stimulate the body′s immune system to produce autoantibodies,leading to autoimmune diseases such as SLE. The research progress of the macrophage on the removal mechanism of apoptosis cells is reviewed in this paper.

Diagnosis and treatment of drug-induced liver injury / 临床肝胆病杂志

Due to a lack of specific biomarkers, the diagnosis of drug -induced liver injury (DILI) mainly depends on the method of exclusion.The Roussel Uclaf Causality Assessment Method (RUCAM) scale is the most widely used causality assessment scale and is relatively objective, but it is still waiting for further improvement.Another method is global introspection or expert opinion , which is relatively subjective,and the simplified global introspection method is commonly used in clinical practice .The Structured Expert Opinion Procedure (SEOP) created by the US DILI network (DILIN) is very complicated and time -consuming and thus cannot be used in clinical practice .The drug rechallenge test (DRT) with a positive result is considered the gold standard for the diagnosis of DILI , but DILI cannot be excluded based on the negative result of DRT.The value of lymphocyte transformation test (LTT), modified LTT, monocyte -derived hepatocyte -like cell lactate -dehydrogenase release test, and various predictive models for drug hepatotoxicity in the diagnosis of DILI awaits further assessment .The differential diagnosis of autoimmune -mediated DILI and traditional autoimmune liver diseases usually depends on liver biopsy , the type and titer of autoantibody, and response to glucocorticoids.Reasonable timing of drug withdrawal and application of anti -inflammatory liver -protecting drugs may help most DILI patients recover .Generally, the prophylactic use of anti -inflammatory liver -protecting drugs is not recommended, except in special situations.In -depth studies are needed for the precise diagnosis and prevention /treatment of DILI.

Features and management of patients with hepatitis C virus/hepatitis B virus dual infection associated with the application of direct-acting antiviral agents / 临床肝胆病杂志

Dual infection with hepatitis C virus (HCV) and hepatitis B virus (HBV) has significantly different clinical,immunological,and virological features from single infection with HCV or HBV,which brings various challenges to clinical diagnosis/treatment and management.Direct-acting antiviral agents used for effective control of HCV infection may cause HBV activation,onset of hepatitis B,and even liver failure.Therefore,during the antiviral treatment of HCV infection,it is of great importance to select appropriate anti-HBV therapy and follow-up management strategies based on the status of HCV/HBV dual infection.

Construction of human adenovirus type 4 vector expressing enhanced green fluorescence protein / 中华微生物学和免疫学杂志

Objective To prepare human adenovirus type 4 (Ad4) vector expressing enhanced green fluorescence protein (EGFP). Methods This study used a previously prepared plasmid pBRAd4 containing the whole genome DNA of Ad4-GZ01 strain. The Ad4 genome E3 region of pBRAd4 was deleted and replaced with the EGFP expression frame by conventional molecular cloning method. Then the recombi-nant plasmid was transfected into AD293 cells to rescue recombinant virus which was identified by sequen-cing,SDS-PAGE and ELISA. The purified virions were injected to mice and the induced immune responses were detected by ELISA and microneutralization test. Results The recombinant Ad4 vector rAd4EGFP ex-pressing EGFP was obtained and could be recognized and neutralized by monoclonal antibody MN4b and an-tisera against Ad4. The Ad4-specific and EGFP-specific antibodies with high titers could be detected in mice immunized with rAd4EGFP. Conclusion Human Ad4 vector expressing EGFP was successfully obtained and could be used in research on vaccine development,drug evaluation and transgene vector.

Molecular epidemiology of HFMD in mainland China and discussion on prevention and control measures / 中华微生物学和免疫学杂志

Objective To summarize the epidemiological data of hand, foot and mouth disease (HFMD) in China from 2013 to 2017 and to analyze its molecular epidemiological characteristics in order to provide scientific basis for improving prevention and control measures. Methods China National Knowledge In-frastructure,Wanfang Database of China,Chinese VIP Journal Net and Pubmed were used to search epidemio-logical data of HFMD published in recent years. National notification data and surveillance data of HFMD in ma-inland China were obtained from the National Health and Family Planning Commission of China and the World Health Organization. Basic statistic tools were used for data analysis. Results From 2013 to 2016, the inci-dence rates of HFMD were 134. 37/100 000, 203. 16/100 000, 145. 30/100 000, 176. 62/100 000 and 140.46/100 000,respectively. Enterovirus 71(EV71),coxsackievirus A16(CA16),CA6 and CA10 were the predominant pathogens causing HFMD in the first half of 2013-2017. CA6 was the main epidemic strain in most areas of China. EV71 remained the predominant pathogen causing severe HFMD, but CA6, CA16 and CA10 were also critical pathogens of concern. The predominant strains of enteroviruses varied with year and region. Conclusion Although the EV71 vaccine has been approved since 2016, HFMD has not been controlled com-pletely in China. It is badly in need of more comprehensive surveillance of other types of enteroviruses and HFMD polyvaccine to improve the prevention and control of HFMD.

Prognostic Analysis of 102 Patients with Synchronous Colorectal Cancer and Liver Metastases Treated with Simultaneous Resection / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The liver is the most common site for colorectal cancer (CRC) metastases. Their removal is a critical and challenging aspect of CRC treatment. We investigated the prognosis and risk factors of patients with CRC and liver metastases (CRCLM) who underwent simultaneous resections for both lesions.</p><p><b>METHODS</b>From January 2009 to August 2016, 102 patients with CRCLM received simultaneous resections of CRCLM at our hospital. We retrospectively analyzed their clinical data and analyzed their outcomes. Overall survival (OS) and disease-free survival (DFS) were examined by Kaplan-Meier and log-rank methods.</p><p><b>RESULTS</b>Median follow-up time was 22.7 months; no perioperative death or serious complications were observed. Median OS was 55.5 months; postoperative OS rates were 1-year: 93.8%, 3-year: 60.7%, and 5-year: 46.4%. Median DFS was 9.0 months; postoperative DFS rates were 1-year: 43.1%, 3-year: 23.0%, and 5-year 21.1%. Independent risk factors found in multivariate analysis included carcinoembryonic antigen ≥100 ng/ml, no adjuvant chemotherapy, tumor thrombus in liver metastases, and bilobar liver metastases for OS; age ≥60 years, no adjuvant chemotherapy, multiple metastases, and largest diameter ≥3 cm for DFS.</p><p><b>CONCLUSIONS</b>Simultaneous surgical resection is a safe and effective treatment for patients with synchronous CRCLM. The main prognostic factors are pathological characteristics of liver metastases and whether standard adjuvant chemotherapy is performed.</p>

Efficacy Observation of Sofre Injection Combined with Isosorbide Mononitrate in the Treatment of Refrac-tory Heart Failure / 中国药师

Objective:To observe the clinical efficacy and safety of Sofre injection combined with isosorbide mononitrate in the treatment of refractory heart failure. Methods:Totally 66 cases of patients with refractory heart failure in our hospital were randomly di-vided into the observation group and the control group with 33 cases in each. Each patient received the conventional treatment. On the basis of routine treatment, the control group was treated with isosorbide mononitrate injection (25mg,qd,ivd). On the basis of control group, the observation group was treated with Sofre injection (10ml, qd, ivd). The treatment course was 14 days. Before and after the treatment, the improvement degree clinical symptoms, left ventricular ejection fraction ( LVEF) , left ventricular end diastolic diameter (LVEDD), cardiac index (CI), stroke volume (SV) and 6-min walking distance (6MWD) were observed, and the rate of heart fail-ure hospitalization, heart failure mortality and 6MWT changes were followed up for 6 months in the two groups. The adverse drug reac-tions ( ADR) in both groups during the treatment were recorded as well. Results:After the 2-week treatment, the effective rate and the total effective rate of the observation group were significantly higher than those of the control group (P<0. 05); LVEF, CI, SV and 6MWD of the two groups after the treatment were significantly higher than those before the treatment, and LVEDD significantly de-creased (P<0. 05), and the improvement of the observation group was more obvious than that of the control group (P<0. 05). After the 6-month follow-up, 6MWD was significantly longer in the observation group than that in the control group (P<0. 05), while there were no statistically significant differences in the hospitalization rate and the mortality rate between the groups (P>0. 05). There were no adverse reactions in both groups during the whole treatment. Conclusion:Sofre injection combined with isosorbide mononitrate can significantly improve cardiac function in the patients with refractory heart failure with improved clinical efficacy and good safety.

Advances in Roussel Uclaf Causality Assessment Method for diagnosis of drug-induced liver injury and its comparison with structured expert opinion process / 临床肝胆病杂志

Up to now, the diagnosis of drug-induced liver injury (DILI) still relies on the exclusive method, and the Roussel Uclaf Causality Assessment Method (RUCAM) is the most commonly used scale. Since the release of the first version of RUCAM scale in 1993, the second version was released in 2015, in which the definition and scoring criteria of each key element were revised appropriately and explained in detail. The Structured Expert Opinion Process (SEOP) was designed by the workgroup of DILI network prospective study, but since it is too complicated and time- and energy-consuming, its application in clinical practice is limited. This article introduces the research and development history and application method of RUCAM, as well as the modifications made in the 2015 version of RUCAM, and briefly compares the difference in bias between RUCAM and SEOP in the diagnosis of DILI. It is pointed out that both RUCAM and SEOP have marked interobserver and intraobserver variabilities, and therefore, it is necessary to explore a more objective, reproducible, accurate, and convenient strategy for the diagnosis of DILI.

Impact of microwave dealing with the cutting surface on the hepatocellular carcinoma recurrence after hepatectomy / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To explore the impact of microwave dealing with cutting surface on perioperative liver function recovery and recurrence and metastasis after hepatectomy for HCC.</p><p><b>METHODS</b>Clinical data of 133 patients with HCC from March 2009 to November 2010 were retrospectively analyzed. They were divided into the conventional surgery group (66 cases) and microwave treatment group (67 cases). A domestic ECO-100 microwave knife was inserted into the liver cutting surface 0.5 cm from the cutting edge, and repeated multi-point burning with an average time of 25 minutes in the microwave treatment group. Then the perioperative liver function recovery and recurrence and metastasis in the two groups were compared.</p><p><b>RESULTS</b>The operation time of conventional surgery group was (158.0 ± 31.0) minutes, and that of microwave treatment group was significantly longer (181.0 ± 28.0) minutes (P=0.027). There were no significant differences in the liver function recovery between the two groups (P>0.05). There were 6 cases of recurrence and metastasis after 6 months and 9 cases after 12 months in the microwave treatment group, while there were 15 cases of recurrence and metastasis after 6 months and 20 cases after 12 months in the conventional surgery group, showing a significant difference (P=0.034 and 0.022, respectively).</p><p><b>CONCLUSIONS</b>Microwave dealing with the cutting surface has no significant effect on perioperative liver function recovery in hepatectomy. However, microwave treatment can reduce the in situ recurrence in HCC patients within the first year after surgery, indicating a good clinical application value.</p>

Evaluation of eight different clinical staging systems associated with overall survival of chinese patients with hepatocellular carcinoma / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Hepatocellular carcinoma (HCC) is a common cancer in China, an area of high hepatitis B virus (HBV) infection. Although several staging systems are available, there is no consensus on the best classification to use because multiple factors, such as etiology, clinical treatment and populations could affect the survival of HCC patients.</p><p><b>METHODS</b>This study analyzed 743 HBV-related Chinese HCC patients who received surgery first and evaluated the predictive values of eight different commonly used staging systems in the clinic.</p><p><b>RESULTS</b>The overall 1-, 3-, 5-year survival rates and a median survival were 91.5%, 70.3%, 55.3% and 72 months respectively. Barcelona Clinic Liver Cancer (BCLC) staging systems had the best stratification ability and showed the lowest Akaike information criterion (AIC) values (2896.577), followed by tumor-node-metastasis 7 th (TNM 7 th ) (AIC = 2899.980), TNM 6 th (AIC = 2902.17), Japan integrated staging score (AIC = 2918.085), Tokyo (AIC = 2938.822), Cancer of the Liver Italian Program score (AIC = 2941.950), Chinese University Prognostic Index grade (AIC = 2962.027), and Okuda (AIC = 2979.389).</p><p><b>CONCLUSIONS</b>BCLC staging system is a better staging model for HBV infection patients with HCC in Chinese population among the eight currently used staging systems. These identifications afford a large group of Chinese HCC patients with HBV infection and could be helpful to design a new staging system for a certain population.</p>

The Association of GSDMB and ORMDL3 Gene Polymorphisms With Asthma: A Meta-Analysis

PURPOSE: ORM1-like 3 (ORMDL3) belongs to a highly conserved protein family which is anchored as transmembrane protein in the endoplasmic reticulum. Gasdermin B (GSDMB) is adjacent to ORMDL3 on chromosome 17q21.2 and belongs to the gasdermin-domain containing the protein family (GSDM family). Recent reports suggest that GSDMB and ORMDL3 are associated with asthma in several populations. However, genetic association studies that examined the association of GSDMB and ORMDL3 gene variants with asthma showed conflicting results. To assess whether combined evidence shows the association between GSDMB/ORMDL3 polymorphism and asthma. METHODS: A bibliographic search from MEDLINE identified 13 original articles using the search keywords 'GSDMB', 'ORMDL3', and 'asthma'. An updated literature-based meta-analysis involving 6,691 subjects with asthma, 9,281 control individuals, and 1,360 families were conducted. Meta-odds ratios (ORs) and 95% confidence intervals (CIs) based on the fixed effects model or the random effects model depended on Cochran's Q-statistic and I2 values. Data from case-control and TDT studies were analyzed in an allelic model using the Catmap software. RESULTS: We selected and identified 3 SNPs of ORMDL3 associated with asthma (rs8076131: OR=1.10; 95% CI, 1.02-1.20; P=0.012. rs12603332: OR=1.15; 95% CI, 1.05-1.25; P=0.002. rs3744246: OR=1.10; 95% CI, 1.02-1.17; P=0.008) and 1 SNP of GSDMB associated with asthma (rs7216389: OR=1.37; 95% CI, 1.27-1.47; P<0.01). Publication bias was estimated using modified Egger's linear regression test proposed by Harbordetal and revealed no evidence of biases. Furthermore, cumulative meta-analysis in chronological order showed the inclination toward significant association for rs7216389 and rs12603332 with continually adding studies, and the inclination toward null-significant association for rs3744246 and rs8076131. CONCLUSIONS: Moderate evidence exists for associations of the ORMDL3 rs8076131, rs12603332, and rs3744246 and GSDMB rs7216389 variants with asthma. Large sample size and representative population-based studies and TDT studies with homogeneous asthmatic patients and well-matched controls are warranted to confirm this finding.

Construction and characterization of a hexon-chimeric human adenovirus type 3 vector expressing one major epitope of dengue virus type 1 / 中华微生物学和免疫学杂志

Objective To construct a recombinant human adenovirus type 3 ( HAd3 ) vector ex-pressing one major epitope of dengue virus type 1.Methods The gene encoding the envelope protein (304-314 aa) of dengue virus type 1 was inserted into the hypervariable region 1 ( HVR1 ) of HAd3 hexon by using overlap PCR.The recombinant gene was cloned into the shuttle plasmid, then linearized with AsisⅠrestriction enzyme and co-transformed into Escherichia coli BJ5183 strains with the digested backbone plas-mid for homologous recombination.The recombinant plasmid pBRAdΔE3GFP-DENV1 was transfected into AD293 cells to rescue recombinant adenovirus strains (rAdΔE3GFP-DENV1).ELISA and Western blot as-say were performed to evaluate the humoral responses induced in BALB/c mice after the immunization with rAdΔE3GFP-DENV1 strains.Results The recombinant adenovirus strains were successfully rescued. ELISA and Western blot assay showed that the antibodies in serum sample could recognize dengue virus type 1 strains.Conclusion The recombinant adenovirus strains expressing the epitope of dengue virus type 1 were successfully constructed.This study provided evidence for the development of multivalent vaccines against dengue virus.

Application value of fast-track surgery on liver transplantation / 器官移植

Objective To explore the impact of fast-track surgery (FTS)on prognosis of liver transplant patients.Methods Inclusion criterias:(1 )primary disease was cirrhosis or primary liver cancer meeting Milan criteria;(2)surgical method was modified piggyback orthotopic liver transplantation (OLT);(3)no liver transplantation operation was performed before.Exclusion criterias:(1 )age ≤ 1 6 years old;(2)receiving OLT more than 1 time;(3)transcatheter hepatic arterial chemoembolization or radiofrequency ablation was performed before or during operation.From January 201 1 to December 201 3 in First Affiliated Hospital of Nanjing Medical University,52 patients meeting the criteria above were enrolled into this prospective random single-blinded study (all operations were performed by same team) .According to different peri-operative managements,they were divided into FTS group (n =21 )and non-FTS (NFTS)group (n =31 ).Protocol of FTS included comprehensive pre-operative education,no bowel preparation,no usage of nasogastric tube pre-operation and surgical drainage post-operation,prevention of hypothermic during operation, smaller incision,early exercise and enhanced oral nutrition. Intra-and post-operative parameters were compared between 2 groups.Step-by-step Logistic regression was used to evaluate relationship between FTS and clinical parameters,in order to analyze the impact of FTS on the prognosis of liver transplantation.Results Compared with NFTS group,operation time and anhepatic phase time decreased significantly in FTS group,as well as intra-operative bleeding and transfusion (all in P <0.05).Besides,intensive care unit (ICU)days and total length of stay in FTS group were shorter than those in NFTS group,which indicated a better prognosis of patients in FTS group (both in P <0.05 ).Logistic regression suggested that FTS management was a favorable factor of shortening ICU days (odds ratio:0.301 ,95% confidence interval:0.1 84-0.494,P =0.000)and total length of stay (odds ratio:0.1 48,95% confidence interval:0.085-0.257,P =0.000).Conclusions Application of FTS in perioperative period can improve the prognosis of liver transplant patients.

Effect of miRNA-155 on phenotype and function of regulatory T cell / 器官移植

Objective Toinvestigatetheeffectofmicroribonucleicacid(miRNA)-155ontwo subtypesofregulatoryTcell(Treg):inducedTreg(iTreg)andnaturalTreg(nTreg).Methods NaveT cells and nTreg were isolated from peripheral blood mononuclear cell (PBMC)of healthy donors by magnetic cell sorting. Cells were divided into 3 groups during culture,including control group (nave T cells were cultured with the presence of interleukin-2 ),iTreg group (nave T cells were cultured with the presence of interleukin-2 and transforming growth factor-β)and nTreg group(nTreg cells was cultured with interleukin-2).Each group was divided into 3 subgroups (none,scramble or miRNA-155 antagomir subgroup,3 wells in each subgroup). Expression level of miRNA-155 gene of none subgroup in 3 groups was detected by low density chip analysis method. The levels of surface marker CD25,Foxp3,CD127 of each subgroup in 3 groups were detected by flow cytometry. The percentage of CD4 +CD25 +Foxp3 +SOCS1 +Treg and suppressive function of Tregofeachsubgroupin3groupswerealsodetectedbyflowcytometry.Results Comparedwithcontrolgroup and iTreg group,the expression level of miRNA-155 was significantly lower and SOCS1 was significantly higher in nTreg group (all in P<0.05 ). After the addition of miRNA-155 antagomir,no significant change was observed in the important surface markers of Treg like Foxp3,CD25,CD127. Compared with control group and iTreg group,the expression of SOCS1 in nTreg group increased significantly (both in P <0.05 ). The expression level of miRNA-155 of none subgroup in iTreg group was lower. The expression of SOCS1 increased after the miRNA-155 was inhibited by antagomir (miRNA-155 antagomir subgroup). In iTreg group,the suppressive function of Treg in miRNA-155 antagomir subgroup was higher than that in none subgroup at the ratioof1∶8,1∶16and1∶32(allinP<0.05).Conclusions AntagonismofmiRNA-155invitrohasno significant effect on the suppression function of nTreg,but can increase the SOCS1 expression level and suppression in vitro of iTreg.

Treatment outcomes of occult breast carcinoma and prognostic analyses / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The surgical management of occult breast cancer is controversial. We compared the outcomes of different treatments of occult breast cancer and evaluated the potential prognostic factors for overall survival and recurrence.</p><p><b>METHODS</b>We retrospectively reviewed 77 patients who presented to our hospital from 1968 to 2011 with a diagnosis of occult breast cancer. Patients were divided into three groups: 42 patients (63%) were treated with modified radical mastectomy+axillary lymph node dissection (ALND), 16 patients (24%) were treated with ALND + postoperative radiotherapy, and 9 patients (13%) with only ALND. Survival analyses were undertaken to compare the efficacy of these three treatments.</p><p><b>RESULTS</b>Of the 77 patients with occult breast cancer, 2 patients were lost to follow-up and 8 patients refused surgical treatment: 67 patients (90.4%) were included in this analysis. The median follow-up was 62.2 (0.6-328.0) months. Kaplan-Meier analyses showed no significant difference in overall survival and recurrence-free survival between the three groups (P = 0.494 and 0.397, respectively). The prevalence of local recurrence was 11.9% for the mastectomy + ALND, 18.8% for ALND + radiotherapy, and 11.1% for ALND-only groups, and those for distant recurrence were 2.4%, 12.5%, and 11.1%, respectively. Compared with progesterone receptor-negative subjects, progesterone receptor-positive patients had better overall survival and lower recurrence rates (P = 0.057 and 0.062, respectively).</p><p><b>CONCLUSIONS</b>There was no significant difference in outcomes between mastectomy and breast-preserving surgery. Expression of the progesterone receptor should be taken into account when evaluating the prognosis of occult breast cancer.</p>

Postoperative low platelet counts correlate with delayed liver function recovery after partial hepatectomy in patients with hepatocellular carcinoma / 中华普通外科杂志

Objective To investigate the correlation of postoperative platelet counts with liver function recovery after partial hepatectomy in patients with hepatocellular carcinoma.Methods 212 patients with hepatocellular carcinoma were enrolled in this study.The relation between postoperative platelet counts and serum levels of ALT,AST,TB and PT after operation was analyzed.Results There were 78 patients with a low (＜ 100 × 109/L) immediate postoperative platelet count in this series of 212 patients who underwent partial liver resection for hepatocellular carcinoma,and 134 patients with a normal platelet count (≥ 100 × 109/L).Based on the criteria,27 patients were categorized as having delayed postoperative liver function recovery.There was no perioperative mortality in this study.Postoperative peak levels of ALT,AST and TB were significantly higher in patients with low postoperative platelet counts than those with normal platelet counts (P ＜ 0.05).Statistical analysis showed that low postoperative platelet counts after partial liver resection for hepatocellular carcinoma correlated with increased risk of delayed postoperative recovery (x2 =9.112,P =0.003).Conclusions Low postoperative platelet counts were associated with delayed liver function recovery after partial hepatectomy in patients with hepatocellular carcinoma.