Study on Corrosion Resistance of Stainless-Steel Welded Joints with SnSb8Cu4 and SnZn9.

The use of soldering based on metallurgical bonding, as opposed to conventional rubber sealing, is capable of achieving the firm sealing of stainless-steel subway car bodies, though the corrosion resistance of such joints has rarely been investigated. In this study, two typical solders were selected and applied to the soldering of stainless steel, and their properties were investigated. As indicated by the experimental results, the two types of solder exhibited favorable wetting and spreading properties on stainless-steel plates, and successfully achieved sealing connections between the stainless-steel sheets. In comparison with the Sn-Zn9 solder, the Sn-Sb8-Cu4 solder exhibited lower solidus-liquidus, such that it can be more suitably applied to low-temperature sealing brazing. The sealing strength of the two solders reached over 35 MPa, notably higher than that of the sealant currently used (the sealing strength is lower than 10 MPa). In comparison with the Sn-Sb8-Cu4 solder, the Sn-Zn9 solder exhibited a higher corrosion tendency and a higher degree of corrosion during the corrosion process.

Development of Chemical Isotope Labeling Liquid Chromatography Orbitrap Mass Spectrometry for Comprehensive Analysis of Dipeptides.

Dipeptides have recently attracted considerable attention due to their newly found biological functions and potential biomarkers of diseases. Global analysis of dipeptides (400 common dipeptides in total number) in samples of complex matrices would enable functional studies of dipeptides and biomarker discovery. In this work, we report a method for high-coverage detection and accurate relative quantification of dipeptides. This method is based on differential chemical isotope labeling (CIL) of dipeptides with dansylation and liquid chromatography Orbitrap tandem mass spectrometry (LC-Orbitrap-MS). An optimized LC gradient ensured the separation of dansyl-dipeptides, including positional isomers (e.g., leucine- and isoleucine-containing dipeptides). MS/MS collision energy in Orbitrap MS was optimized to provide characteristic fragment ion information to sequence dansyl-dipeptides. Using the optimized conditions, a CIL standard library consisting of retention time, MS, and MS/MS information of a whole set of 400 dansyl-dipeptides was constructed to facilitate rapid dipeptide identification. For qualitative analysis of dipeptides in real samples, IsoMS data processing software's parameters were tuned to improve the coverage of dipeptide annotation. Data-dependent acquisition was also carried out to improve the reliability of dipeptide identification. As examples of applications, we successfully identified a total of 321 dipeptides in rice wines and 105 dipeptides in human serum samples. For quantitative analysis, we demonstrated that the intensity ratios of the peak pairs from 96% of the dansyl-dipeptides detectable in a 1:1 mixture of 12C- and 13C-labeled rice wine samples were within ±20% of an expected value of 1.0. More than 90% of dipeptides were detected with a relative standard deviation of less than 10%, showing good performance of relative quantification.

Low Dimensional Nanostructure-Assisted Long-Range Surface Plasmon Resonance Sensors With High Figure of Merit.

Long-range surface plasmon resonance (LRSPR) sensors have been extensively studied by virtue of their extremely narrow full width at half maxima (FWHM) characteristics, but their low sensitivity remains an important factor limiting the figure of merit (FOM), making the sensors have difficulties in detecting small refractive index changes accurately. To address this problem, this paper proposes and demonstrates a low dimensional nanostructure (Au nanospheres, WS2) assisted LRSPR sensor to achieve an effective enhancement of the sensor interfaced electric field and thus improve the sensitivity. The performance parameters of the two sensors are compared with the LRSPR sensor by finite element method analysis, and the results showed that the assistance of the low dimensional nanostructure has a positive effect on the sensor. The first refractive index sensing experiment of the WS2-assisted LRSPR sensor was realized with a 25.47% increase in sensitivity and a 7.13% increase in FOM simultaneously, and the Au nanospheres-assisted LRSPR sensor with a 29.23% increase in sensitivity and a 15.95% increase in FOM simultaneously. The introduction of low dimensional nanostructures provides a flexible and effective means of sensitization for LRSPR sensors, making the plasmon resonance sensors combine high sensitivity, narrow FWHM and high FOM, which have promising applications in biochemical sensing.

Enhanced nickel removal and synchronous bioelectricity generation based on substrate types in microbial fuel cell coupled with constructed wetland: performance and microbial response.

In this study, an attempt was made to clarify the impact of substrates on the microbial fuel cell coupled with constructed wetland (CW-MFC) towards the treatment of nickel-containing wastewater. Herein, zeolite (ZEO), coal cinder (COA), ceramsite (CER), and granular activated carbon (GAC) were respectively introduced into lab-scaled CW-MFCs to systematically investigate the operational performances and microbial community response. GAC was deemed as the most effective substrate, and the corresponding device yielded favorable nickel removal efficiencies over 99% at different initial concentrations of nickel. GAC-CW-MFC likewise produced a maximum output voltage of 573 mV, power density of 8.95 mW/m2, and internal resistance of 177.9 Ω, respectively. The strong adsorptive capacity of nickel by GAC, accounting for 54.5% of total contaminant content, was mainly responsible for the favorable nickel removal performances of device GAC-CW-MFC. The high-valence Ni2+ was partially reduced to elemental Ni0 on the cathode, which provided evidence for the removal of heavy metals via the cathodic reduction of CW-MFC. The microbial community structure varied considerably as a result of substrates addition. For an introduction of GAC into the CW-MFC, a remarkably enriched population of genera Thermincola, norank_f__Geobacteraceae, Anaerovorax, Bacillus, etc. was noted. This study was dedicated to providing a theoretical guidance for an effective regulation of CW-MFC treatment on nickel-containing wastewater and accompanied by bioelectricity generation via the introduction of optimal substrate.

High-performance plasmonic lab-on-fiber sensing system constructed by universal polymer assisted transfer technique.

Plasmonic lab-on-fiber (LOF) system has become an emerging sensing platform for the realization of miniaturized and portable plasmonic sensors. Herein, a facile and efficient polymer assisted transfer technique was reported for the preparation of plasmonic LOF systems. The proposed plasmonic LOF system was constructed through transferring plasmonic arrays to the end surface of optical fibers using polylactic acid as the sacrificial layer. The morphology of the transferred plasmonic arrays maintains excellent consistency with the original arrays. Importantly, the as-prepared plasmonic LOF system also possesses outstanding sensing performance in refractive index sensing and quantitative label-free biosensing applications. Additionally, the proposed polymer assisted transfer technique shows broad universality for various plasmonic arrays. Together with the above features, it is believed that the polymer assisted transfer technique will show great potential for the application of future plasmonic LOF systems.

TMS-EEG: An emerging tool to study the neurophysiologic biomarkers of psychiatric disorders.

The etiology of psychiatric disorders remains largely unknown. The exploration of the neurobiological mechanisms of mental illness helps improve diagnostic efficacy and develop new therapies. This review focuses on the application of concurrent transcranial magnetic stimulation and electroencephalography (TMS-EEG) in various mental diseases, including major depressive disorder, bipolar disorder, schizophrenia, autism spectrum disorder, attention-deficit/hyperactivity disorder, substance use disorder, and insomnia. First, we summarize the commonly used protocols and output measures of TMS-EEG; then, we review the literature exploring the alterations in neural patterns, particularly cortical excitability, plasticity, and connectivity alterations, and studies that predict treatment responses and clinical states in mental disorders using TMS-EEG. Finally, we discuss the potential mechanisms underlying TMS-EEG in establishing biomarkers for psychiatric disorders and future research directions. This article is part of the special Issue on 'Stress, Addiction and Plasticity'.

Analysis of survival rates and prognosis of hepatoblastoma in children: a retrospective study from a single center in China.

Hepatoblastoma (HB) is the most common liver cancer in children, this study aims at analyzing the prognostic factors affecting the survival rates and summarizing the treatment experience. In this study, we reviewed patients with primary HB under the age of 14 years who underwent complete tumor resection from June 1997 to March 2019. The data of 72 patients were collected. Survival analysis was performed by Kaplan-Meier, multivariate Cox proportional hazards regression and linear mixed model for repeated measures (LMMRM). The 5-year and the 10-year event-free survival (EFS) of all patients were 78.2% and 73%, respectively. Both the 5-year and 10-year overall survival (OS) were 85.7%. Kaplan-Meier survival analysis showed that patients with tumor capsule infiltration (TCI) and patients with surgical margin less than 1 cm may also have a good prognosis. The Cox proportional hazards regression model analysis results were similar to the Kaplan-Meier analysis results. LMMRM analysis showed that there were significant differences in platelet, alpha-fetoprotein, C-reactive protein and hemoglobin values after surgery in the metastasis group (P < 0.05). This study suggests that patients with TCI or narrow surgical margin (<1 cm) may also have a good prognosis, and the risk stratification of HB can be used as the latest grading standard to evaluate the prognosis of patients.

Spontaneous regression of stage III neuroblastoma: A case report.

BACKGROUND: Neuroblastoma (NB) is the most common type of extracranial solid tumour in children. The overall prognosis of NB is poor, but at the same time, NB shows significant clinical diversity. NB can demonstrate spontaneous regression or can differentiate into benign ganglioneuroma. CASE SUMMARY: This study retrospectively analyzed the clinical data of a patient with spontaneous regression of stage III NB who was admitted in May 2015. Studies of the spontaneous regression of NB published from October 1946 to September 2019 were retrieved through PubMed. The clinical manifestations, diagnosis, treatment, and follow-up results were analysed. CONCLUSION: Spontaneous regression of stage III NB is rare in the clinic. The report of this case is an important supplement to the study of the spontaneous regression of NB.

A comparison of electronic nose and gas chromatography-mass spectrometry on discrimination and prediction of ochratoxin A content in Aspergillus carbonarius cultured grape-based medium.

This study investigated discrimination and prediction of ochratoxin A (OTA) in three Aspergillus carbonarius strains cultured grape-based medium using E-nose technology and GC-MS analysis. Results showed that these strains cultured medium samples were divided into four groups regarding their log 10 OTA value using an equispaced normal distribution analysis. Partial least squares-discriminant analysis (PLS-DA) revealed that GC-MS PLS-DA model only separated the low OTA level medium samples from the rest OTA level samples, whereas all the OTA level samples were segregated from each other using E-nose PLS-DA model. Partial least squares regression (PLSR) analysis indicated that an excellent prediction performance was established on the accumulation of OTA in these medium samples using E-nose PLSR, whereas GC-MS PLSR model showed a screening performance on the OTA formation. These indicated that E-nose analysis could be a reliable method on discriminating and predicting OTA in A. carbonarius strains under grape-based medium.

Laparoscopic splenectomy for littoral cell angioma of the spleen: A case report.

RATIONALE: Littoral cell angioma (LCA) is a rare primary vascular neoplasm of the spleen. It can be benign or malignant. Pathology and immunohistochemistry are the gold standards for the diagnosis of LCA. Therefore, splenectomy is recommended for the purpose of diagnosis and treatment, and subsequent follow-up is necessary. There are limited reports about LCA. Here, we present a case of a female patient with LCA undergoing laparoscopic splenectomy in order to provide clinical experience in LCA treatment. PATIENT CONCERNS: A 32-year-old female attended the outpatient Department of Hepatobiliary Surgery for follow-up of hepatic hemangiomas. The patient presented with intermittent abdominal distension, which was slightly under no obvious inducement. DIAGNOSIS: Physical examination found no signs of abdominal tenderness and rebound tenderness, and liver and spleen were impalpable. The contrast-enhanced computed tomography (CT) showed multiple space-occupying lesions in the spleen, mottled low-density lesions, multiple hypoattenuating nodules with no contrast enhancement on the arterious phase. Delayed contrast-enhanced helical CT scan displayed incomplete filling of hypodense splenic lesions. INTERVENTIONS: Given that it was uncertain whether it was a benign or a malignant tumor, a laparoscopic total splenectomy was performed. OUTCOMES: The final pathological diagnosis was LCA. Her postsurgical course was uneventful, and no surgery-related complications were found. No signs of recurrence were observed in the 16 months after the operation. LESSONS: LCA was a rare primary vascular neoplasm of the spleen, and laparoscopic splenectomy for LCA was safe and feasible, and postoperative course was uneventful. However, regular follow-up and long-time monitoring after splenectomy for LCA is recommended because of its potential malignant biological behavior.

Perineural invasion of cancer: a complex crosstalk between cells and molecules in the perineural niche.

Perineural invasion (PNI) can be found in a variety of malignant tumors. It is a sign of tumor metastasis and invasion and portends the poor prognosis of patients. The pathological description and clinical significance of PNI are clearly understood, but exploration of the underlying molecular mechanism is ongoing. It was previously thought that the low-resistance channel in the anatomic region led to the occurrence of PNI. However, with rapid development of precision medicine and molecular biology, we have gradually realized that the occurrence of PNI is not the result of a single factor. The latest study suggests that PNI of cancer is a continuous and multistep process. A specific peripheral microenvironment, also called the perineural niche, is formed by neural cells, supporting cells, recruited inflammatory cells, altered extracellular matrix, blood vessels, and immune components in the background of carcinoma. Various soluble signaling molecules and their receptors comprise a complex signal network, which achieves the interaction between nerve and tumor. Nerve cells and tumor cells can interact directly or through the opening and closing of the signal transduction pathways and/or the recognition and response of the ligands and receptors. The information is transferred to the targets accurately and effectively, leading to the specific interactions between the nerve cells and the malignant tumor cells. PNI occurs through changes in nerve cells and supporting cells in the background of cancer; change and migration of the perineural matrix; enhancement of the viability, mobility, and invasiveness of the tumor cells; injury and regeneration of nerve cells; interaction, chemotactic movement, contact, and adherence of the nerve cells and the tumor cells; escape from autophagy, apoptosis, and immunological surveillance of tumor cells; and so on. Certainly, exploring the mechanism of PNI clearly has great significance for blocking tumor progression and improving patient survival. The current review aims to elucidate the cellular and molecular mechanisms of PNI, which may help us find a strategy for improving the prognosis of malignant tumors.

[Distribution and Sources of Polycyclic Aromatic Hydrocarbons in a Karst Groundwater System in a Strongly Industrial City].

To understand the spatiotemporal variation characteristics and sources of polycyclic aromatic hydrocarbons in karst groundwater in a strongly industrial city, the authors collected 23 groundwater samples in the water and dry period in Liuzhou using component spectra of 16 types of polycyclic aromatic hydrocarbons in combination with the physical and chemical properties and analyzed the spatiotemporal variation characteristics and sources of the polycyclic aromatic hydrocarbons (PAHs) in karst groundwater in heavy industrial city. The results show that the average concentration of ∑PAHs in the groundwater in the wet period has an order of Liubei District > Liudong District > Liuxi District > Jila Underground River and the concentration proportion of PAHs decreases with the increase of the molecular weight, while the order in the dry period is Jila Underground River > Liubei District > Liuxi District > Liudong District. The PAHs in the groundwater during the dry season have a high pollution level, while a low pollution level is observed in the wet season. The main sources of PAHs are organic matter burns at high temperature such as fossil fuel, which are produced by human activities such as industrial processes, transportation, heating, and cooking.

Calculating freezing point of NaH2PO4-K2HPO4 mixed electrolyte solution with semi-empirical hydration model / 药学学报

The methods for determination of freezing point include cooling curve cryoscopy and air humidity cryoscopy. These methods are usually influenced by many factors, such as instrumentation, environment and operators. Despite the numerous experimental methods, precise freezing point values are challenging to obtain due to time-consuming procedures, limited sample size and extensive manual work. In this study, a semi-empirical hydration model (SEHM) was developed to calculate freezing point of NaH2PO4-K2HPO4 mixed electrolyte solution. According to SEHM, the water activity of mixed electrolyte solution was calculated by molality of solutes. Then the freezing point of solution was calculated. The calculated results were compared with those obtained by cooling curve cryoscopy and air humidity cryoscopy. The results indicate that the SEHM calculations are comparable to the measurements of cooling curve cryoscopy and air humidity cryoscopy.

Vascular anatomy of the stomach and its application in gastric tube reconstruction dur-ing esophagectomy / 中国肿瘤临床

Objective: To investigate the vascular anatomy of the stomach, especially the right gastroepiploic artery for the reconstruc-tion of a gastric tube during esophagectomy. Methods: The vascular anatomy of the stomach was studiing in 28 embalmed human specimens provided by the Department of Anatomy, Shanghai Medical College, Fudan University, included 10 female and 18 male spec-imens. The length and diameter of gastric vessels were measured. The ratio of the length of the right gastroepiploic artery to the length of the greater curvature was calculated. Anastomosis between the left and right gastroepiploic arteries was also assessed. Re-sults: Twenty-five left gastric arteries were observed in the autopsies, with the mean diameter of 3.40 (2.10-6.40) mm. Twenty-one right gastric arteries were measured, with the mean diameter of 1.97 (0.68-3.56) mm. Twenty-six left gastroepiploic arteries were ob-served, with the mean diameter of 1.87 (0.80-2.96) mm. Twenty-eight right gastroepiploic arteries were measured, with the mean di-ameter of 2.82 (1.58-4.80) mm. The mean lengths of the 28 right gastroepiploic arteries and their greater curvatures were 216.71 (120-318) mm and 356.39 (248-487) mm, respectively. The ratio of the length of right gastroepiploic arteries and greater curvatures was 0.61 (0.45-0.82). The anastomosis between the left and right gastroepiploic arteries was observed in 60.7% (17/28) of the specimens. Conclusions: The length and diameter of gastric vessels were calculated. It was assumed that the right gastroepiploic artery provides an average of 61% of the blood supply for the great curvature. In addition, the anastomotic branch of the right and left gastroepiploic arteries was observed in 60.7% specimens. These anatomical data allow surgeons to estimate the blood supply and to choose an opti-mal method of gastric tube reconstruction during esophagectomy.

Treatment of primary hepatic neuroendocrine tumors with associating liver partition and portal vein ligation for staged hepatectomy (ALPPS): A case report and literature review.

RATIONALE: Primary hepatic neuroendocrine tumors (PHNETs) are extremely rare and are difficult to diagnose preoperatively.We report a case of PHNET diagnosed preoperatively and successfully resected using associating liver partition and portal vein ligation for staged hepatectomy (ALPPS). PATIENT CONCERNS: A 72-year-old woman was admitted to our hospital for a hepatic mass, which was incidentally identified during a routine health checkup. The patient has no other obvious symptoms of discomfort. DIAGNOSES: Physical examination revealed a palpable mass in the right upper quadrant of her abdomen. Dynamic contrast-enhanced abdominal computed tomography (CT) showed a low-density mass measuring 13 × 7 × 6 cm in both, the right and left hepatic lobes. F-fluorodesoxyglucose positron emission tomography (F-FDG PET) and fused PET/CT showed increased uptake by the mass, which was indicative of a hepatic tumor. INTERVENTIONS: We use a novel ALPPS surgical procedure to safely and radically remove primary neuroendocrine tumors. OUTCOMES: No postoperative bleeding and bile leakage were reported, and the patient recovered uneventfully.The patient was followed-up for a year without recurrence. LESSONS: PHNETs are rare tumors, and confirming the diagnosis using the best possible preoperative examination is important. An optimal treatment plan is selected based on the patient's condition to ensure a favorable prognosis. Tumors too large to undergo surgical removal can be resected using the ALPPS procedure, as described in this case report.

Screening circular RNA related to chemotherapeutic resistance in osteosarcoma by RNA sequencing.

AIM: To identify circular RNAs (circRNAs) related to osteosarcoma (OS) chemoresistance. MATERIALS & METHODS: CircRNA expression profile was performed in three paired human chemoresistant and chemosensitive OS cell lines by next-generation sequencing. Quantitative real-time-PCR (qRT-PCR) was used to confirm next-generation sequencing data. Bioinformatics analysis was conducted to predict their functions. RESULTS: Eighty circRNAs were dysregulated in the chemoresistant OS cells compared with the control, after validated by qRT-PCR. Bioinformatics analysis showed that some pathways related to drug metabolism were significantly enriched. Additionally, hsa_circ_0004674 was distinctly increased in OS chemoresistant cells and tissues, related to poor prognosis. CircRNA-miRNA-mRNA pathways related to hsa_circ_0004674 were constructed by TargetScan and miRanda. CONCLUSION: CircRNAs may play a role in OS chemoresistance and hsa_circ_0004674 might be a candidate target.

Development of functional docetaxel nanomicelles for treatment of brain glioma.

The efficacy of anticancer drugs is rather limited in the treatment of brain glioma due to the hindrance of the blood-brain barrier (BBB). Herein, we reported an easy formulation of functional docetaxel nanomicelles for the treatment of brain glioma using a graft copolymer soluplus as basic material through dual-modifications with a glucose-lipid derivative and a dequalinium-lipid derivative. The studies were performed on brain glioma U87MG cells, in vitro BBB models and brain glioma-bearing nude mice. The functional docetaxel nanomicelles were approximately 100 nm. The results demonstrated that the functional docetaxel nanomicelles could transport across the BBB, enhance the cellular uptake, target to the mitochondria, induce the apoptosis, increase the cytotoxicity in the brain glioma cells, and extend survival span of the brain glioma-bearing mice. The action mechanisms were associated with dual-modifications by the glucose-lipid derivative and the dequalinium-lipid derivative, both of which are beneficial for the transport across the BBB. Furthermore, the modification with dequalinium-lipid derivative was able to target to the brain glioma cells and to the mitochondria. In conclusion, the functional docetaxel nanomicelles would be a promising formulation for the treatment of brain glioma, deserving further development for clinical trials.

Chemometric Analysis of the Volatile Compounds Generated by Aspergillus carbonarius Strains Isolated from Grapes and Dried Vine Fruits.

Ochratoxin A (OTA) contamination in grape production is an important problem worldwide. Microbial volatile organic compounds (MVOCs) have been demonstrated as useful tools to identify different toxigenic strains. In this study, Aspergillus carbonarius strains were classified into two groups, moderate toxigenic strains (MT) and high toxigenic strains (HT), according to OTA-forming ability. The MVOCs were analyzed by GC-MS and the data processing was based on untargeted profiling using XCMS Online software. Orthogonal projection to latent structures discriminant analysis (OPLS-DA) was performed using extract ion chromatogram GC-MS datasets. For contrast, quantitative analysis was also performed. Results demonstrated that the performance of the OPLS-DA model of untargeted profiling was better than the quantitative method. Potential markers were successfully discovered by variable importance on projection (VIP) and t-test. (E)-2-octen-1-ol, octanal, 1-octen-3-one, styrene, limonene, methyl-2-phenylacetate and 3 unknown compounds were selected as potential markers for the MT group. Cuparene, (Z)-thujopsene, methyl octanoate and 1 unknown compound were identified as potential markers for the HT groups. Finally, the selected markers were used to construct a supported vector machine classification (SVM-C) model to check classification ability. The models showed good performance with the accuracy of cross-validation and test prediction of 87.93% and 92.00%, respectively.

Clinical Characteristics and Prognostic Factors of Lung Adenosquamous Carcinoma in SEER Database between 2010 and 2015 / 中国肺癌杂志

BACKGROUND@#The incidence and the mortality of lung cancer rank first among all malignant tumors and it seriously affects human health. The common types of non-small cell lung cancer (NSCLC) are adenocarcinoma and squamous carcinoma with clinical research and more attention, while adenosquamous carcinoma is a rare pathological subtype of lung cancer, which clinical features and prognostic factors are not yet fully understood. The purpose of this study is to analyze the clinical features and prognosis of lung adenosquamous carcinoma, and construct a nomogram to predict the patients' prognosis.@*METHODS@#We obtained the data of adenosquamous carcinoma patients diagnosed between 2010 and 2015 in the Surveillance, Epidemiology, and End Results (SEER) database of the United States, and compared their clinical features and prognosis with those of lung adenocarcinoma and lung squamous cell carcinoma patients in the same period. Then we used univariate and multivariate analyses to explore the independent prognostic factors of adenosquamous carcinoma. Finally, we constructed and validated a nomogram to visually predict the outcomes of lung adenosquamous carcinoma.@*RESULTS@#1,453 patients with lung adenosquamous carcinoma were finally included. Compared with patients with lung adenocarcinoma and lung squamous cell carcinoma, the distributions of lung adenocarcinoma patients in most of the variables were medium between lung adenocarcinoma and squamous cell carcinoma. The prognosis of adenosquamous carcinoma was better than that of lung squamous cell carcinoma, but worse than that of lung adenocarcinoma. Multivariate analysis showed that age, differentiation, tumor-node-metastasis (TNM), surgery, and chemotherapy were independent prognostic factors (all P were less than 0.001). We constructed a nomogram with a C-index of 0.783 (0.767-0.799). The distinction test and consistency test showed that the nomogram could predict the patient's prognosis effectively.@*CONCLUSIONS@#Lung adenosquamous carcinoma has unique clinical, pathological, and prognostic characteristics. Age, differentiation, T, N, M, surgery, and chemotherapy status are independent predictors of prognosis in patients with adenosquamous carcinoma. Our nomogram can efficiently predict the prognosis of patients.

Recurrence of Barcelona Clinic Liver Cancer Stage A Hepatocellular Carcinoma After Hepatectomy.

BACKGROUND: The Barcelona Clinic Liver Cancer (BCLC) staging system is widely used to classify hepatocellular carcinoma (HCC). This study was performed to investigate the prognostic factors for patients with BCLC stage A HCC after R0 hepatectomy. METHODS: A total of 592 patients with BCLC stage A HCC following R0 hepatectomy from 1997-2012 were enrolled in this study. Kaplan-Meier analysis and Cox regression were used to analyze the risk factors associated with recurrence. Receiver operating characteristic curves were used to establish a new scoring system to evaluate the independent risk factors for recurrence. Furthermore, subgroup analyses were performed to evaluate surgical margins on tumor recurrence between the anatomic and nonanatomic resection group. RESULTS: Independent risk factors for BCLC stage A HCC recurrence were preoperative alanine transaminase >40U/L, liver cirrhosis, surgical margin <5mm, nonanatomic resection and maximum tumor diameter >5cm. Based on these 5 risk factors, we established a new scoring system, named "HCC recurrence scoring system." Patients with a high score (≥3 points, 1 point for each factor) composed the high recurrence risk group. Moreover, the subgroup analyses demonstrated that different surgical margins had no significant effect on tumor recurrence in the anatomic resection group (P = 0.408), while it had a significant effect in the nonanatomic resection group (P = 0.000). CONCLUSIONS: For patients with BCLC stage A with scores ≥3 points, close postoperative follow-up and positive measures to prevent recurrence are particularly important. Anatomic resection is preferred for patients with BCLC stage A. Adequate surgical margins are necessary for patients with poor liver function.