Prevalence of metabolic syndrome among patients with hepatocellular carcinoma of different etiologies: a retrospective study.

AIMS: This study compared the prevalences of metabolic syndrome and of cardiac or kidney comorbidities among patients with hepatocellular carcinoma (HCC) associated with metabolic dysfunction-related fatty liver disease (MAFLD), chronic infection with hepatitis B or C virus (HBV or HCV), or the combination of MAFLD and chronic HBV infection. METHODS: Medical records were retrospectively analyzed for patients with HCC who underwent hepatectomy between March 2013 and March 2023. Patients with HCC of different etiologies were compared in terms of their clinicodemographic characteristics and laboratory data before surgery. RESULTS: Of the 2422 patients, 1,822 (75.2%) were chronically infected with HBV without MAFLD and HCV, 415 (17.2%) had concurrent MAFLD and chronic HBV infection but no HCV infection, 121 (5.0%) had MAFLD without hepatitis virus infection, and 64 (2.6%) were chronically infected with HCV in the presence or absence of MAFLD and HBV infection. Compared to patients chronically infected with HBV without MAFLD and HCV, those with MAFLD but no hepatitis virus infection showed significantly lower prevalence of cirrhosis, ascites, portal hypertension, alpha-fetoprotein concentration ≥ 400 ng/mL, tumor size > 5 cm, multinodular tumors and microvascular invasion. Conversely, they showed significantly higher prevalence of metabolic syndrome, hypertension, type 2 diabetes, abdominal obesity, history of cardiovascular disease, T-wave alterations, hypertriglyceridemia and hyperuricemia, as well as higher risk of arteriosclerotic cardiovascular disease. Compared to patients with MAFLD but no hepatitis virus infection, those with concurrent MAFLD and chronic infection with HBV showed significantly higher prevalence of cirrhosis, ascites and portal hypertension, but significantly lower prevalence of hypertension and history of cardiovascular disease. Compared to patients with other etiologies, those chronically infected with HCV in the presence or absence of MAFLD and HBV infection, showed significantly higher prevalence of cirrhosis, portal hypertension, ascites, and esophagogastric varices. CONCLUSION: Patients with HCC associated with MAFLD tend to have a background of less severe liver disease than those with HCC of other etiologies, but they may be more likely to suffer metabolic syndrome or comorbidities affecting the heart or kidneys.

Entecavir versus tenofovir for prevention of hepatitis B virus-associated hepatocellular carcinoma after curative resection: study protocol for a randomized, open-label trial.

BACKGROUND: Entecavir and tenofovir disoproxil fumarate (TDF) are standard first-line treatments to prevent viral reactivation and hepatocellular carcinoma (HCC) in individuals chronically infected with the hepatitis B virus (HBV), but the long-term efficacy of the two drugs remains controversial. Also unclear is whether the drugs are effective at preventing viral reactivation or HCC recurrence after hepatectomy to treat HBV-associated HCC. This trial will compare recurrence-free survival, overall survival, viral indicators and adverse events in the long term between patients with HBV-associated HCC who receive entecavir or TDF after curative resection. METHODS: This study is a randomized, open-label trial. A total of 240 participants will be randomized 1:1 into groups receiving TDF or entecavir monotherapy. The two groups will be compared in terms of recurrence-free and overall survival at 1, 3, and 5 years after surgery; adverse events; virological response; rate of alanine transaminase normalization; and seroreactivity at 24 and 48 weeks after surgery. DISCUSSION: This study will compare long-term survival between patients with HBV-associated HCC who receive TDF or entecavir monotherapy. Numerous outcomes related to prognosis will be analyzed and compared in this study. TRIAL REGISTRATION: ClinicalTrials.gov NCT02650271. Registered on January 7, 2016.

Hot versus cold subduction initiation.

Initiation of a new subduction zone could act in two different ways, forming either a hot or cold incipient subduction channel with contrasting geological records.

Clinical characteristics and treatment of spinal cord injury in children and adolescents.

Pediatric and adult spinal cord injuries (SCI) are distinct entities. Children and adolescents with SCI must suffer from lifelong disabilities, which is a heavy burden on patients, their families and the society. There are differences in Chinese and foreign literature reports on the incidence, injury mechanism and prognosis of SCI in children and adolescents. In addition to traumatic injuries such as car accidents and falls, the proportion of sports injuries is increasing. The most common sports injury is the backbend during dance practice. Compared with adults, children and adolescents are considered to have a greater potential for neurological improvement. The pathogenesis and treatment of pediatric SCI remains unclear. The mainstream view is that the mechanism of nerve damage in pediatric SCI include flexion, hyperextension, longitudinal distraction and ischemia. We also discuss the advantages and disadvantages of drugs such as methylprednisolone in the treatment of pediatric SCI and the indications and timing of surgery. In addition, the complications of pediatric SCI are also worthy of attention. New imaging techniques such as diffusion tensor imaging and diffusion tensor tractography may be used for diagnosis and assessment of prognosis. This article reviews the epidemiology, pathogenesis, imaging, clinical characteristics, treatment and complications of SCI in children and adolescents. Although current treatment cannot completely restore neurological function, patient quality of life can be enhanced. Continued developments and advances in the research of SCI may eventually provide a cure for children and adolescents with this kind of injury.

miR-133a-3p inhibits the osteogenic differentiation of bone marrow mesenchymal stem cells by regulating ankyrin repeat domain 44.

In this study, we aimed to identify the specific microRNAs (miRNAs) that are involved in the osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) from ovariectomized (OVX) mice, and to further explore the mechanism by which these miRNAs regulate osteogenic differentiation. Based on the existing studies, the expression of seven miRNAs in BMSCs from OVX mice was evaluated using quantitative reverse transcription polymerase chain reaction (qRT-PCR). The expression of miR-133a-3p and osteogenesis-related genes (runt-related transcription factor 2 (Runx2), Osterix, alkaline phosphatase (ALP), and osteopontin) in BMSCs treated with miR-133a-3p mimics or inhibitors was detected by qRT-PCR or Western blotting. Osteogenesis efficiency was determined using ALP and alizarin red staining. The effector-target relationship between miR-133a-3p and ankyrin repeat domain 44 (ANKRD44) was confirmed by bioinformatics and a dual luciferase assay. Among the seven selected miRNAs, miR-133a-3p expression was significantly increased in BMSCs from OVX mice. Overexpression of miR-133a-3p dramatically inhibited the expression of osteogenesis-related genes in BMSCs and reduced ALP activity and mineralization. However, these processes were markedly ameliorated upon miR-133a-3p inhibition. Moreover, miR-133a-3p appeared to target ANKRD44, and the ANKRD44 expression was negatively regulated by miR-133a- 3p. Furthermore, ANKRD44 upregulation eliminated the anti-osteogenic differentiation effects of miR-133a-3p in BMSCs. Thus, our results indicated that miR-133a-3p inhibits the osteogenic differentiation of BMSCs by suppressing ANKRD44.

[Research progress of Rehmanniae Radix in prevention and treatment of osteoporosis].

Osteoporosis fracture with high disability and mortality is a difficult problem that seriously affects the life quality of individuals. At present, there is still a lack of anti-osteoporosis drugs with clear target and significant efficacy in the clinical practice. Rehmanniae Radix and its prescriptions have significant clinical effects. In this regard, more and more studies have reported the effects and mechanisms of Rehmanniae Radix and its active components, and the certain research outputs have been achieved. In this article, the PubMed, Web of science, China National Knowledge Infrastructure, and Wanfang database were searched to collect and organize the latest research progress of Rehmanniae Radix treatment of osteoporosis in the recent 10 years. We summarized the research dynamics as well as the function indexes and mechanisms of the raw and processed Rehmanniae Radix, active ingredients such as catalpol, aucubin, acteoside and Rehmanniae Radix polysaccharide, and their formulating prescriptions, and then excavated the potential active ingredients, targets and signaling pathways, including the effect on bone marrow mesenchymal stem cells, promoting the osteoblast proliferation and promoting osteogenesis differentiation(increasing alkaline phosphatase, typeⅠ collagen, osteoprotegerin, and osteocalcin and promoting calcium deposits), increasing the bone density, inhibiting the osteoclast quantity and differentiation, promoting the osteoclast apoptosis, and reducing tartrate resistant acid phosphatase and bone resorption pit area to provide the reference and develop new ideas for developing Rehmanniae Radix prescriptions for treatment of osteoporosis and exploring its mechanism.

Lateral propagation-induced subduction initiation at passive continental margins controlled by preexisting lithospheric weakness.

Understanding the conditions for forming new subduction zones at passive continental margins is important for understanding plate tectonics and the Wilson cycle. Previous models of subduction initiation (SI) at passive margins generally ignore effects due to the lateral transition from oceanic to continental lithosphere. Here, we use three-dimensional numerical models to study the possibility of propagating convergent plate margins from preexisting intraoceanic subduction zones along passive margins [subduction propagation (SP)]. Three possible regimes are achieved: (i) subducting slab tearing along a STEP fault, (ii) lateral propagation-induced SI at passive margin, and (iii) aborted SI with slab break-off. Passive margin SP requires a significant preexisting lithospheric weakness and a strong slab pull from neighboring subduction zones. The Atlantic passive margin to the north of Lesser Antilles could experience SP if it has a notable lithospheric weakness. In contrast, the Scotia subduction zone in the Southern Atlantic will most likely not propagate laterally.

Comparison of SB-SDS and other decellularization methods for the acellular nerve graft: Biological evaluation and nerve repair in vitro and in vivo.

We aimed to compare the performance of acellular nerves prepared by different decellularization methods, screening out the optimal decellularization protocol, repairing the sciatic nerve defects in rats by the allogeneic transplantation, and evaluating the effect of regenerative nerve on the function reconstruction. The Sondell, SB-SDS, TnBP, and the high/low permeation methods were used to decellularize donor nerves. Nerves without any treatment were as the control group. The histological results were evaluated by HE staining and toluidine blue (TB) staining. The proliferation activity of L929 cells was detected by CCK-8 assay. The adhesion of Schwann cells was observed and quantified by SEM. Balb/c mice were used to evaluate the cellular and humoral immunogenicity of the nerve scaffolds. The rat sciatic nerve defect model was applied to observe the repair effect of acellular nerve scaffold in vivo. To SB-SDS group, it remained the original state of the nerves, with no observed nucleus and axons, the neurotoxicity grade detected by CCK-8 being almost 0, and it kept the largest number of Schwann cells adhered to the acellular nerve and the better morphology. Further, it showed that the selected SB-SDS rats acellular nerve scaffold could promote the nerve repair of the rats by HE staining and TB staining. We could conclude that the acellular nerve matrix prepared by the SB-SDS method effectively removes the cellular components in the nerve tissue and retains the main components of the extracellular matrix of the nerve tissue, whose rats decellularized nerve scaffold could promote the sciatic nerve repair better.

Multi-terrane structure controls the contrasting lithospheric evolution beneath the western and central-eastern Tibetan plateau.

The Tibetan plateau is manifested by contrasting along-strike lithospheric structures, but its formation mechanism and the relationship with the heterogeneous multi-terrane configuration is a challenging problem. Here we conduct systematic numerical modeling to explore the roles of width, density, and rheological properties of the multiple terranes in the lithospheric evolution of the Tibetan plateau, which reveals two distinct collision modes. In Mode-I, the lithospheric mantles of both the strong and weak terranes in the Tibetan plate are completely detached, followed by the underthrusting of Indian lithosphere beneath the whole plateau. Alternatively, Mode-II is characterized by full detachment of the weak terranes, but (partial) residue of the strong terranes during collision. These two contrasting modes, broadly consistent with the lithospheric structures of western and central-eastern Tibetan plateau, respectively, are strongly dependent on the along-strike variation of the width of the strong Lhasa-Qiangtang terranes.

Risk factors and the surgery affection of respiratory complication and its mortality after acute traumatic cervical spinal cord injury.

The aim of this study is to estimate the risk factors of both respiratory complication (RC) and mortality after acute traumatic cervical spinal cord injury (TCSCI). Between July 2005 and July 2015, in 181 patients (142 males and 39 females; mean age 41.0 years) with acute TCSCI, we compared the difference and odds ratio in RC group (n = 73) with that of non-RC group (n = 108), and also death group (n = 15) and survival group (n = 166). We collected injury-related information after half a year of injury, which is as follows: the causes of injury, time of surgery, ICU (intensive care unit) days, ventilator days, ASIA (American Spinal Injury Association) classification, neurological injury, CIPS (Clinical Pulmonary Infection Score), and BMI (body mass index). Besides these, we gathered the general information such as age, gender, smoking history, and use of steroids. The study compared perioperative parameters; surgery-related and instrumentation- and graft-related complication rates; clinical parameters; patient satisfaction; and radiologic parameters. Variations like gender (odds ratio [OR] = 1.269, 95% confidence interval [CI] [0.609-2.646]), smoking history (OR = 2.902, 95% CI [1.564-5.385]), AIS grade (grade A) (OR = 6.439, 95% CI [3.334-12.434]), neurological level (C1-C4) (OR = 2.714, 95% CI [1.458-5.066]), and steroid use (OR = 2.983, 95% CI [1.276-6.969]) have a facilitated effect on RC. When we estimated surgery-related affection, only the time of surgery and anterior approach compared with posterior has significant difference in RC (P < .05). Between death and survival group, the aspect of age, non-surgical, CPIS, AIS grade, and BMI have statistically significant difference. Survival analysis reveals significant difference in aforementioned groups. In patients suffering from acute TCSCI, those who are old, have long smoking history, complete spinal cord injury, C1-C4, high CPIS, and fat have high incidence of RC and mortality.

The Safety and Efficacy of Irreversible Electroporation for Large Hepatocellular Carcinoma.

This study aimed to investigate the safety and effectiveness of irreversible electroporation ablation for unresectable large liver cancer. Fourteen patients were enrolled: 8 with large hepatocellular carcinoma (tumor diameter: 5.1-11.5 cm) and 6 with medium hepatocellular carcinoma (tumor diameter: 3.0-4.1 cm). All patients received percutaneous irreversible electroporation ablation. Ablation time and the incidence of complications were assessed by a t test. Post-irreversible electroporation and regular contrast-enhanced computerized tomography scans were performed to investigate the effect of tumor size (large vs medium) on irreversible electroporation treatment efficacy; 4-table data were assessed using a Fisher exact test. The 14 patients completed irreversible electroporation ablation successfully. In the large hepatocellular carcinoma group, no major complications occurred in the perioperative period. Minor complications comprised bloating, hypokalemia, edema, low white blood cells, and blood clotting abnormalities. All complications were mild and improved after symptomatic treatment. The frequency of minor complications was not significantly different ( P > .05) compared with the medium hepatocellular carcinoma group. The average follow-up time was 2.8 ± 2.1 months and complete ablation was achieved in 25% (2/8; residual = 75%). For the patients with medium hepatocellular carcinoma, the mean follow-up time was 4.3 ± 3.2 months; the rate of complete ablation was 66.6% (4/6; residual rate = 33.3%). The complete ablation rate was not statistically different between the 2 groups ( P > .05). Irreversible electroporation ablation for unresectable large hepatocellular carcinoma is safe, with no major complications. Short-term efficacy is relatively good; however, long-term efficacy remains to be explored.

Percutaneous imaging-guided cryoablation for lung cancer.

Percutaneous cryoablation under imaging guidance has been proved to be a safe and effective method for ablation and debulking of tumors, providing radical cure or palliation, as the case may be, for patients with different stages of disease. The local control rate is high with cryoablation, and the complications are usually controllable, making it a reasonable choice in lung cancer treatment. In this paper the technique and mechanism of action of cryoablation are summarized, and studies performed on the application of percutaneous cryoablation in various stages of lung cancer are reviewed. Its emerging application in the treatment of pure ground-glass nodules (GGNs) is also introduced.

[Study on Subcritical Fluid Extraction of Essential Oil from Cinnamomum camphora and Its Antibacterial Activity].

Objective: To determine the optimum extract condition of essential oil from dry Cinnamomum camphora leaves and to study its antibacterial activity. Methods: The essential oil was extracted by subcritical fluid, and analyzed by response surface methodology based on single factor test. The chemical compositions of essential oil were analyzed by GC-MS, and the components were quantitatively determined by normalization method. The agar disc diffusion and dilution broth method were used to determine antibacterial activity. Results: The extraction rate was highest as 3. 54%,which matched with the predictive yield of 3. 56%,and the extraction time was30 min, the extraction temperature was 40 ℃,and resolution temperature was 65 ℃. 47 chemical constituents were identified and isolated from Cinnamomum camphora, which was analyzed by GC-MS. The main chemical constituents were eucalyptol( 24. 74%),bicyclo[3. 1. 0]hexan-4-methylene-1-( 1-methylethyl) ( 7. 05%),linalool( 5. 82%),caryophyllene ( 4. 75%). The essential oil from Cinnamomum camphora had different degrees of inhibition on Escherichia coli,Staphylococcus aureus, Pseudomonas aeruginosa,Bacillus subtilis. Conclusion: Subcritical fluid is suitable for the extraction of essential oil from Cinnamomum camphora and the essential oil has a good antimicrobial activity.

[Growth activity of osteoblast on a novel strontium incorporated calcium sulfate].

OBJECTIVE: To investigate the growth activity of osteoblast on a novel strontium incorporated calcium sulfate and make comparison with normal calcium sulfate material. METHODS: Osteoblast was inoculated on samples and cell proliferation was measured on the 1st, 3rd, 5th days, and the activities of ALP and osteocalcin were observed on the 5th day. And microcosmic morphology of osteoblast was observed by scanning electron microscopy(SEM). RESULTS: Osteoblast grows robustly on tested material. Cell quantity on the surface of novel material was obviously higher than normal calcium sulfate material (P < 0.05). The activity of ALP and osteocalcin on novel material was 57.8% and 40.2% higher than on normal calcium sulfate material respectively (P < 0.05). On strontium incorporated surface, osteoblast spread well. Cells were polygonal with abundant cytoplasm and the morphology was active. CONCLUSION: Strontium incorporated calcium sulfate can sustain robust growth activity of osteoblast, which is promising to be used for bone substitute materials.

[Clinical observation of dynamic cervical implant (DCI) internal fixation in the surgical treatment of cervical spondylosis].

OBJECTIVE: To investigate the early clinical effects and radiological outcome of dynamic cervical implant (DCI) internal fixation in treating cervical spondylosis, and evaluate its safety and efficiency. METHODS: From June 2009 to December 2011, 19 patients with cervical spondylosis correspond to the indication of DCI internal fixation in the study, including 5 cases of cervical spondylotic myelopathy and 14 cases of cervical spondylotic radiculopathy. There were 8 males and 11 females, aged from 35 to 54 years with a mean of 43.2 years. Pathological segments included C3,4 in 1 case, C4,5 in 6, C5,6 in 6, C6,7 in 4, C3,4 and C5,6, C6,7 in 2. All patients were treated with anterior discectomy and decompression and DCI internal fixation, meanwhile, 2 cases of them with anterior cervical corpectomy and fusion plate fixation. Clinical evaluation included Modified Japanese orthopedics association (mJOA), neck disability index (NDI), visual analogue scale (VAS) score and patient satisfaction index (PSI) at pre-operation and final follow-up. Radiographic evaluation included flexion/extension lateral view at operative level and adjacent segment. The adjacent level degeneration was analyzed according to Miyazaki classification on MRI images. RESULTS: All patients were followed up from 12 to 42 months with an average of 19.8 months. Preoperative mJOA score was 13.6±1.1 and at final follow-up was 16.3±1.2 with improvement rate of 85.0%. Preoperative VAS,NDI was 6.6± 1.4, 17.1±7.4 and at final follow-up was 1.4±0.8, 6.1±3.9, respectively; there was statistical significance in all above-mentioned results between preoperative and final follow-up (P<0.05). Preoperative ROM at operation level was (7.6±1.9)° and final follow-up was (7.8+2.1)°; preoperative ROM at C2-C7 was (38.6±7.2)° and final follow-up was (39.9±6.4)°; there was no statistical significance in all above-mentioned results between preoperative and final follow-up (P>0.05). Preoperative DHI at operation level was (6.3±1.1) mm and final follow-up was (7.1±0.8) mm, there was statistical significance in DHI between preoperative and final follow-up (P<0.05). No heterotopic ossification was found. All patients followed up MRI, degeneration of 3 segments aggravated 1 degree in 38 adjacent segments, without clinical symptom. CONCLUSION: Treatment of cervical spondylosis with dynamic cervical implant can got satisfactory outcome in early follow-up. Activity of operative segment obtain reservation in some degree. The incidence of adjacent segment degeneration is lower and no adjacent segment disease occur. Nevertheless a longer follow-up time should be needed to assess the long term functionality of the DCI and the influence on adjacent levels.

[Study on enzyme extraction technology of total flavonoids from Cryptotaenia japonica].

OBJECTIVE: To study the optimum enzyme extraction process of total flavonoids from Cryptotaenia japonica. METHODS: The process was optimized by single factor experiments and orthogonal, the yield of total flavonoids was used as index. RESULTS: The optimum extraction technology was as follows: enzyme dosage: 1U/mL, pH value: 6.0, enzymatic hydrolysis temperature: 60%, enzymatic hydrolysis time: 1 h, the rate of material to liquid: 1 : 30, extraction temperature: 70 degrees C, extraction time: 1 h, the average extraction rate of total flavonoids from Cryptotaenia japonica was 4.76%. CONCLUSION: The method is an effective way to extract total flavonoids from Cryptotaenia japonica with high extract rate.

[Study on rapid non-destructive detection of the freshness of paddy based on NIRS].

A prediction model of paddy storage time was established based on near infrared reflectance (NIRS) and chemometrics. A spectroradiometer was used for collecting spectra in the wavelength range from 950 to 1 650 nm. The NIR spectra were collected from 90 samples of paddy. The best pretreatment method was obtained while choosing the total spectra area combined with PLS using the UNSCRAMBLER 9.7. The best pretreatment method is first derivative combined with S. Golay, and the number of principal components is 7. The model is feasible, because the r2 is 0.9679, RMSEP is 54.51 and the result of T-test is passable while validation method is cross validation In this paper, a feasible method is established to measure the storage time of paddy based on near infrared reflectance(NIRS)and chemometrics.

[Clinical manifestation and surgical treatment of spinal osteoblastoma].

OBJECTIVE: To investigate the clinical manifestation and surgical outcome of spinal osteoblastoma. METHODS: From June 2006 to July 2010, 11 patients with spinal osteoblastoma treated surgically were analyzed retrospectively. There were 7 males and 4 females with an average age of 23.5 years (range, 16 - 34 years). The tumors were located at C(5) in 3, C(6) in 4, C(7) in 2, C(6) ~ T(1) in 1 and T(11) in 1. Based on WBB classification, 9 were 1 - 3 or 10 - 12 and 2 were 4 - 9 and 1 - 3. All the operations had been performed with en-bloc resection. The posterior approach was used for 9 patients, and combined posterior and anterior approach was used for 2 patients. Reconstruction using instrumentation and fusion was performed using spinal instrumentation in 8 patients. To evaluate the change of pain before and after the operation by visual analogue scales (VAS), and to assess functional status of the spine by McCormick scale. Imaging test was used to review the stability and recurrence rate of spine cord, and the confluence of graft bones. RESULTS: All cases were followed up for 12 - 64 months (average, 28.4 months). The average surgical time was 130.5 minutes (range, 90 - 210 minutes), with the average intraoperative blood loss of 560 ml (range, 300 - 1000 ml). During the follow-up period, the VAS grade reduced from 6.3 ± 1.1 to 2.5 ± 1.0 (t = 8.48, P < 0.05). There were 8 patients had neurological function improved and 3 remained no change which was evaluated by McCormick scale for spinal function status at final follow-up. CONCLUSIONS: Spinal osteoblastoma has its own specific radiographic feature. There are some recurrence in simple curettage of tumor lesion. The thoroughly en-bloc resection of tumor or spondylectomy, bone fusion and strong in ter fixation are the key points for successful surgical treatment.