Prognostic model for identifying candidates for hepatectomy among patients with hepatocellular carcinoma and hepatic vein invasion.

BACKGROUND: Hepatic vein tumour thrombus (HVTT) is a major determinant of survival outcomes for patients with hepatocellular carcinoma (HCC). An Eastern Hepatobiliary Surgery Hospital (EHBH)-HVTT model was established to predict the prognosis of patients with HCC and HVTT after liver resection, in order to identify optimal candidates for liver resection. METHODS: Patients with HCC and HVTT from 15 hospitals in China were included. The EHBH-HVTT model with contour plot was developed using a non-linear model in the training cohort, and subsequently validated in internal and external cohorts. RESULTS: Of 850 patients who met the inclusion criteria, there were 292 patients who had liver resection and 198 who did not in the training cohort, and 124 and 236 in the internal and external validation cohorts respectively. Contour plots for the EHBH-HVTT model were established to predict overall survival (OS) rates of patients visually, based on tumour diameter, number of tumours and portal vein tumour thrombus. This differentiated patients into low- and high-risk groups with distinct long-term prognoses in the liver resection cohort (median OS 34·7 versus 12·0 months; P < 0·001), internal validation cohort (32·8 versus 10·4 months; P = 0·002) and external validation cohort (15·2 versus 6·5 months; P = 0·006). On subgroup analysis, the model showed the same efficacy in differentiating patients with HVTT in peripheral and major hepatic veins, the inferior vena cava, or in patients with coexisting portal vein tumour thrombus. CONCLUSION: The EHBH-HVTT model was accurate in predicting prognosis in patients with HCC and HVTT after liver resection. It identified optimal candidates for liver resection among patients with HCC and HVTT, including tumour thrombus in the inferior vena cava, or coexisting portal vein tumour thrombus.

ANTECEDENTES: La trombosis tumoral de la vena hepática (hepatic vein tumour thrombus, HVTT) es un determinante importante de los resultados de supervivencia en pacientes con carcinoma hepatocelular (hepatocellular carcinoma, HCC). Se desarrolló el modelo llamado Eastern Hepatobiliary Surgery Hospital (EHBH)-HVTT para predecir el pronóstico de los pacientes con HCC y HVTT después de la resección hepática (liver resection, LR), con el fin de identificar los candidatos óptimos para LR entre estos pacientes. MÉTODOS: Se incluyeron pacientes con HCC y HVTT de 15 hospitales en China. El modelo EHBH-HVTT con gráfico de contorno se desarrolló utilizando un modelo no lineal en la cohorte de entrenamiento, siendo posteriormente validado en cohortes internas y externas. RESULTADOS: De 850 pacientes que cumplieron con los criterios de inclusión, hubo 292 pacientes en el grupo LR y 198 pacientes en el grupo no LR en la cohorte de entrenamiento, y 124 y 236 en las cohortes de validación interna y externa. Los gráficos de contorno del modelo EHBH-HVTT se establecieron para predecir visualmente las tasas de supervivencia global (overall survival, OS) de los pacientes, en función del diámetro del tumor, número de tumores y del trombo tumoral de la vena porta (portal vein tumour thrombus, PVTT). Esto diferenciaba a los pacientes en los grupos de alto y bajo riesgo, con distinto pronóstico a largo plazo en las 3 cohortes (34,7 versus 12,0 meses, 32,8 versus 10,4 meses y 15,2 versus 6,5 meses, P < 0,001). En el análisis de subgrupos, el modelo mostró la misma eficacia en la diferenciación de pacientes con HVTT, con trombo tumoral en la vena cava inferior (inferior vena cava tumour thrombus, IVCTT) o en pacientes con PVTT coexistente. CONCLUSIÓN: El modelo EHBH-HVTT fue preciso para la predicción del pronóstico en pacientes con HCC y HVTT después de la LR. Identificó candidatos óptimos para LR en pacientes con HCC y HVTT, incluyendo IVCTT o PVTT coexistente.

High expression of lncRNA GACAT3 inhibits invasion and metastasis of non-small cell lung cancer to enhance the effect of radiotherapy.

OBJECTIVE: To clarify the role of long non-coding RNA (lncRNA) GACAT3 in invasion and metastasis of non-small cell lung cancer (NSCLC) and its effect on radiotherapy. PATIENTS AND METHODS: The expression of GACAT3 and TIMP2 in cells and tissues of NSCLC were detected by quantitative Real-time PCR (qRT-PCR). The influence of GACAT3 on cell proliferation and the capacity of colony formation were estimated by MTT test and colony forming experiment respectively. Luciferase reporting assay was used to confirm the correlation between GACAT3 and TIMP2. In addition, we observed the influence of GACAT3 on radiosensitivity of NSCLC cells. RESULTS: Using lncRNA array analysis, we found that GACAT3 expression increased significantly. Further studies showed that overexpression of ectopic GACAT3 in A549 cells promoted cell proliferation and migration, and enhanced the sensitivity of lung cancer cells to radiotherapy. TIMP2, confirmed a direct target of GACAT3 by bioinformatics analysis and our experiments, may be involved in the GACAT3-induced upregulation of MMP10. CONCLUSIONS: LncRNA GACAT3 may be a potential biomarker for the evaluation of curative effect and prognosis of lung cancer.

[A trend analysis of the incidence of occupational diseases in Chongqing, China, from 2006 to 2014].

Objective: To investigate the incidence of occupational diseases in Chongqing, China, from 2006 to 2014, and to analyze the harm, features, and trend of occupational diseases in Chongqing. Methods: The data of new cases of occupational diseases from 2006 to 2014 were collected, and the patients with a confirmed diagnosis of occupational diseases were selected as study subjects to analyze the incidence of occupational diseases in Chongqing. Results: There were 17499 cases of occupational diseases in total in Chongqing from 2006 to 2014. Among these patients, 17124 (97.86%) were male, most of whom (95.40%) had occupational pneumoconiosis, and 375 (2.14%) were female, most of whom (72.80%) had occupational chemical poisoning. There were 16400 cases (93.72%) of occupational pneumoconiosis in total, mainly coal workers' pneumoconiosis (55.87%) and silicosis (43.02%) , and the main industries involved were coal mining and washing, railway transport equipment manufacturing, and mining and washing of bituminous coal and anthracite. There were 724 cases of occupational poisoning in total; there were 281 cases of acute occupational poisoning, mainly gas poisoning (39.86%) and carbon monoxide poisoning (33.10%) ; there were 443 cases of chronic occupational poisoning, mainly poisoning caused by benzene (47.63%) , mercury and its inorganic compounds (32.74%) , and lead and its inorganic compounds (9.03%) . Conclusion: Occupational diseases in Chongqing are mainly occupational pneumoconiosis, and occupational health supervision should be enhanced in the industries of coal mining and washing and railway transport equipment manufacturing to protect workers' health.

Characterisation of a novel cell line (CSQT-2) with high metastatic activity derived from portal vein tumour thrombus of hepatocellular carcinoma.

BACKGROUND: Portal vein tumour thrombus (PVTT) is highly associated with the progression and metastasis of hepatocellular carcinoma (HCC). However, there are no appropriate cell models of PVTT with which to study the biological and physiological characteristics of PVTT. METHODS: Primary cell culture was performed by the use of a successive xenograft line called PVTT-#1, which was obtained from a 60-year-old male HCC patient accompanied by PVTT. RESULTS: A successive cell line named CSQT-2 was established. The cell line showed aggressive phenotypes in terms of cell growth, survival, migration, xenograft and metastasis. Moreover, an orthotopic transplantation assay showed that PVTT can be generated in nude mice when CSQT-2 cells were inoculated in the liver and that it shows a typical migratory tendency in the vascular branches of portal vein. Moreover, the established CSQT-2 cells also showed varied expression of tumour-initiating cell (TIC) markers such as CD133, CD90 and EpCAM. CONCLUSION: Establishment of CSQT-2 may provide a suitable model with which to investigate the molecular mechanisms of PVTT-related HCC.

Cloning of insertion sequence IS1485 from Enterococcus species.

We have cloned and identified an insertion sequence, IS1485, that was present in several members of the genus Enterococcus. IS1485 exists in varying copy numbers with at least 12 copies in E. durans (ATCC 11576), 3 copies in E. faecium (ATCC 19434), and one copy each in E. faecalis (ATCC 19433) and E. avium (ATCC 14024). It was also detected in clinical strains of E. gallinarum, E. casseliflavus, and E. saccharolyticus. IS1485 is 1366 bp in length, it has imperfect terminal inverted repeats with 25 of the terminal 39 residues matched, and it contains three open reading frames exceeding 50 codons, designated orfA, orfB, and orfC. The largest, orfB, was located 36 bp downstream and in the -1 reading frame relative to orfA; orfC is oriented in the opposite direction and overlaps orfA. The genetic organization of IS1485 resembles that of members of the IS3 family of transposable elements. Sequence homology exists with several members of the IS3 family especially with IS199 from Streptococcus mutans.

High-intensity focused ultrasound in the treatment of experimental liver tumour.

This project aimed to determine the adequacy and accuracy of high-intensity focused ultrasound (HIFU) for ablating experimental liver tumour, and to assess imaging methods for monitoring the therapeutic results. The rabbit liver pseudotumour model was established by injection of Freund's complete adjuvant into the liver; the animals then received HIFU therapy via laparotomy at the focal point of the beam (1.1 MHz, 500 W/cm2, 20 s). The rabbits were sacrificed at scheduled times after treatment and liver tumours were examined histologically. Sequential imaging of the liver tumour was performed before and after HIFU treatment. HIFU accurately destroyed the rabbit liver tumour and induced coagulation necrosis 24 h later. Sonographic imaging studies revealed that characteristic changes occurred. A hyperechoic mass turned to a hypoechoic lesion with no Doppler signal, and a high echogenic rim appeared 24 h after HIFU treatment, correlating well with the pathological changes of a sonoablated lesion. These results verify that HIFU has the power to ablate liver tumour quite adequately and accurately, and that sonography is useful for monitoring sonoablated liver tumour.

Iodized oil enhances the thermal effect of high-intensity focused ultrasound on ablating experimental liver cancer.

The influence of the biological medium on high-intensity focused ultrasound (HIFU) therapy for ablating experimental liver cancer was studied. In study 1, the temperature rise in the focal zone in the presence of iodized oil or castor oil was observed in vitro. The results showed that HIFU with iodized oil produced a higher and faster temperature rise than did HIFU with castor oil, whether high-power (500 W/cm2) or relatively low-power (136 W/cm2) conditions were used (P = 0.0008 and P = 0.0004 respectively). With the excised liver samples, the temperature also rose higher and more rapidly after injection of iodized oil into the liver than when castor oil was injected (P = 0.0239), and the target liver tissue revealed more radically and extensive destruction with iodized oil than with castor oil. In study 2, 48 nude mice, bearing primary liver cancer LTNM4 implanted subcutaneously, were randomly divided into four groups. Group I (n = 12) were the controls, group II (n = 12) were injected with iodized oil alone, group III (n = 12) received HIFU treatment, and group IV (n = 12) were exposed to HIFU after iodized oil injection. Significant inhibition of tumor growth was seen in groups III and IV as compared with group I or group II (P < 0.05), the tumor growth inhibition rate on the 28th day after treatment being 87% and 93% respectively. Significantly improved survival was noted in groups III and IV compared with groups I and II (P < 0.05). Histologically, group IV showed more complete tumor necrosis than did group III. These data suggest that HIFU combined with iodized oil might have achieve of synergism, location and targeting in the treatment of liver cancer.

Influence of diet intake on liver function test.

AIM: To study whether dietary intake influences liver function test. METHODS: Blood samples were obtained from patients liver diseases (n = 100) and controls (without liver diseases; n = 100) first at 07: 00 in the morning (fasting state) and then 2 h after a meal (fed state). The Hitachi-7150 automatic biochemistry analyzer was used to assess the following liver function indexes: Serum bilirubin, thymol turbidity test, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, lactate dehydrogenase, gamma glutamyl transferase, SP, A and G. Statistical significance of differences between inter-group values was determined using SAS software. RESULTS: None of the indexes showed statistically significant differences between the fasting state and the fed state (P = 0.476-0.978). CONCLUSION: Liver function test can be performed after a meal.

Ultrastructural observation of liver tissue ablation induced by high-intensity focused ultrasound.

AIM: To observe the ultrastructural changes of liver tissues on normal rabbit ablated by high-intensity focused ultrasound (HIFU). METHODS: A single shot of 1.1 MHz focused ultrasound at an intensity of 500 W/cm(2) with 20-s duration of continuous exposure was applied intraoperatively in normal rabbit livers. Ultrastructural changes of the sonoablated lesion, as viewed by light and electron microscopy, were observed. RESULTS: Liver cells at the center of the sonoablated lesion showed irreversible degeneration immediately after HIFU treatment; electron microscopy showed that although the liver cells appeared normal histologically, irregularly shaped cavities of about 0.3-0.5 µm in diameter were present in the cytoplasm. CONCLUSION: Thermal damages may be the main mechanism of HIFU-induced ablation of liver tissues besides cavitation effect.

[Mechanism of intracellular calcium homeostasis in heat-exposed cardiomyocytes of rats].

The activity of Ca(2+)-ATPase and calcium content were measured in sarcoplasmic reticulum (SR) and mitochrondria of myocardium from 40 adult female Wistar rats after exposure to 37 degrees C, 39 degrees C, 41 degrees C and 43 degrees C for 40 min respectively in vitro. The 45Ca uptake, intracellular free Ca2+ concentration ([Ca2+]i) and the relatively active calmodulin content were also observed in cultured cardiomyocytes from 120 neonatal Wistar rats under the same condition of heat exposure. The results showed that (1) the activity of Ca(2+)-ATPase of SR and mitochrondria of myocardium decreased after heat exposure, (2) the calcium content of SR and mitochrondria also showed a tendency of decrease with increase of exposure temperature, (3) the 45Ca uptake and mean [Ca2+]i increased, whereas the calmodulin content decreased. It is suggested that disturbances of intracellular calcium homeostasis may be responsible for cardiac functional disorder after heat exposure.

[Genomic cloning of Fasciola hepatica secretory antigens in Escherichia coli].

This paper reported the immunoscreening of three recombinants expressing secretory antigens from the genomic DNA library of F. hepatica and the primary study of expression of the three recombinants. To construct the genomic DNA library, DNA from the adult F. hepatica was cut with Sau3AI to an average length of about 2.0 kb and inserted into the BamHI site of the expression vector pUC18, the size of the genomic DNA library of F. hepatica being 1.5 x 10(5) recombinants. Three recombinants expressing antigenic determinants of F. hepatica pFH16, pFH23, pFH48 were detected through primary screening and rescreening with F. hepatica infected rabbit serum (1:50) preabsorbed to remove antibodies to E. coli and SPA-HRP (1:40). The test of the ability of expressing fusion proteins showed pFH16 > pFH48 > pFH23. These studies provide the possibility of further research on the expression of recombinant antigenic genes, the immunity of their expressed products and the protection of animals.

[Sodium nitroprusside in treating acute high-altitude pulmonary edema].

Sodium nitroprusside (NP) alone Was given to the 39 cases with acute high-altitude pulmonary edema (AHPE). 33 of them (84.6%) fully recovered and 6 (15.38%) obviously improved in 72 hours. The total efficacy was 100%. There was obvious improvement in the cardiac pumping and contractile function as well as total peripheral resistance. The mean pulmonary artery pressure (MPAP) decreased from 52.22 +/- 7.51mmHg to 25.13 +/- 10.36mmHg in 3 to 5 hours after the first dose. Strophanthin K was given to another 11 cases with AHPE, But none fully recovered or obviously improved. During the 72 hours of treatment, 4 improved slightly, 4 showed no therapeutic effect and 3 became worse. The heart rate was reduced obviously and cardiac contractile function strengthened while the cardiac pumping function and total peripheral resistance had no change. Vasodilator therapy is a new method for AHPE treatment and this study shows that the NP is an ideal drug in treating AHPE and that dilation of the small pulmonary arteries by NP may explain its efficacy.