Efficacy and safety of sodium hyaluronate combined with celecoxib for knee osteoarthritis: A systematic review and meta-analysis.

Due to the large cost of joint replacement for surgical treatment of knee osteoarthritis, there are many complications in elderly patients, and there are many contraindications to surgery, and conservative treatment is still based on drugs. To further evaluate the efficacy and safety of sodium hyaluronate combined with celecoxib for the treatment of osteoarthritis of the knee. In total, 202 studies were screened, with a final selection of 9 RCTs involving 2339 participants; of these, 9 RCTs were included in the final meta-analysis. Treatment group reduces VAS (SMD = -1.61; 95 % CI [-2.25, -0.98]; I2 = 95 %; P < 0.00001) and adverse reactions (OR = 0.45; 95 % CI [0.22,0.94]; I2 = 0 %; P < 0.33); Meanwhile, improving Lysholm knee scores (SMD = 0.19; 95 % CI [-0.06, -0.44]; I2 = 76 %; P = 0.0004) and Clinical efficiency (OR = 0.31; 95 % CI [0.19,0.50]; I2 = 0 %; P < 0.00001). All indicators were superior to the control group. Our primary findings suggest that KOA treatment with celecoxib combined with sodium hyaluronate reduces VAS, while improving Lysholm scores and Clinical efficiency. In addition, we found that celecoxib combined with sodium hyaluronate treatment had fewer adverse effects than the control group, indicating that the combination is safe and effective in the treatment of KOA.

Three-Way Junction-Assisted Rolling Circle Amplification Integrated with trans-Cleavage of Cas12a for Sensitive and Reliable Detection of miRNA.

MicroRNAs (miRNAs) serve a crucial role in numerous biological processes, such as acute pancreatitis development. Due to its low abundance and high similarity among homogeneous family members, sensitive and reliable detection of microRNA remains a formidable challenge. By combining the three-way junction-assisted rolling circle amplification (RCA) with the trans-cleavage of Cas12a, we propose a novel fluorescent technique for sensitive miRNA detection. In order to increase the amplification efficiency of RCA-based methods, catalytic hairpin amplification (CHA) is incorporated into the RCA process, playing the roles of specific target recognition and three-way junction formation. Consequently, the method demonstrated a six-orders-of-magnitude detection range and a LOD as low as 27 aM, making it a promising method for the early diagnosis of various diseases.

Downregulation of miR-137 Facilitates CD4+ T Cell Pyroptosis in Systemic Lupus Erythematosus via Stimulating AMPK Pathway.

Objective: From the pathogenic mechanism point of view, systemic lupus erythematosus (SLE) features prominently in T lymphocyte apoptosis. Yet the regulatory mechanism underlying SLE cell apoptosis remains to be explored. This research intends to clarify the role played by miR-137 in SLE and the underlying mechanisms. Methods: Twenty SLE patients (SLE group) and twenty healthy controls (control group) were selected, from whom peripheral blood CD4+ T cells were isolated via magnetic-activated cell sorting. Reverse transcription-polymerase chain reaction (RT-PCR) quantified miR-137 and AMP-activated protein kinase (AMPK) in CD4+ T cells. Further, transfection of miR-137 mimics and inhibitors into CD4+ T cells was carried out to alter miR levels. Levels of pyroptosis, apoptosis, and inflammatory- and pyroptosis-related proteins were determined through PI staining, flow cytometry, and Western blotting, respectively. A luciferase reporter gene assay identified the targeting relation between miR-137 and AMPK. Results: SLE patients showed downregulated miR-137 and upregulated AMPK in CD4+ T cells than controls. miR-137 upregulation by miR-137 mimic transfection inhibited Jurkat cell pyroptosis and apoptosis at both mRNA and protein levels and suppressed NOD-like receptor thermal protein domain-associated protein 3 (NLRP3) inflammasome activity and pyroptosis-related protein gasdermin D (GSDMD), while miR-137 inhibitor transfection contributed to completely opposite effects. miR-137 directly targeted AMPK, as indicated by the luciferase reporter gene assay. Furthermore, miR-137 inhibitor intervention induced healthy CD4+ T cell pyroptosis and apoptosis via mediating AMPK, whereas miR-137 mimic transfection into CD4+ T cells of SLE patients leads to opposite results. Conclusion: Upregulating miR-137 inhibits CD4+ T cell pyroptosis in SLE patients by modulating the AMPK pathway, suggesting the potential diagnostic and therapeutic role of miR-137 in SLE.

Paroxetine combined with traditional chinese medicine prescriptions in the treatment of postpartum depression: A systematic review of randomized controlled trials.

BACKGROUND: Postpartum depression is a common mental disease in obstetric puerperium. Its etiology is not completely clear, and its clinical manifestations are complex. It has serious adverse effects on the body and mind of mothers and infants. Treatment should also follow the principle of individualization. Preliminary studies have shown that traditional chinese medicine prescriptions combined with paroxetine is effective in treating postpartum depression. In order to better determine the therapeutic effect, further exploration was carried out. HYPOTHESIS: Does the study better evaluate the therapeutic effect and provide data support for clinical promotion? STUDY DESIGN: The search comes from using the following electronic databases established until January 2022. STUDY RESULTS: The meta analysis results show that paroxetine combined with traditional chinese medicine prescriptions can reduce the Hamilton Depression Scale (HAMD) score [WMD = -7.35, 95 % CI (-10.84, -3.87), P＜0.001] and Edinburgh Postpartum Depression Scale (EPDS) score [WMD = -3.24, 95 % CI (-5.96, -0.53), P < 0.001].And better than paroxetine treatment alone in terms of improving clinical efficacy [RR = 1.22, 95 % CI (1.16, 1.30), P < 0.001]. CONCLUSIONS: Based on the combination of paroxetine and traditional chinese medicine prescriptions in the treatment of postpartum depression, there is a certain clinical effect, and a strong research design and a certain number of RCTs are required at the same time. Future research should clarify the specific composition and composition of traditional Chinese medicine prescriptions.

Development and validation of reassigned CEA, CYFRA21-1 and NSE-based models for lung cancer diagnosis and prognosis prediction.

BACKGROUND: The majority of lung cancer(LC) patients are diagnosed at advanced stage with a poor prognosis. However, there is still no ideal diagnostic and prognostic prediction model for lung cancer. METHODS: Data of CEA, CYFRA21-1 and NSE test of patients with LC and benign lung diseases (BLDs) or healthy people from Physical Examination Center was collected. Samples were divided into three data sets as needed. Reassign three kinds of tumor markers (TMs) according to their distribution characteristics in different populations. Diagnostic and prognostic models were thus established, and independent validation was conducted with other data sets. RESULTS: The diagnostic prediction model showed good discrimination ability: the area under the receiver operating characteristic curve (AUC) differentiated LC from healthy people and BLDs (diagnosed within 2 months), being 0.88 and 0.84 respectively. Meanwhile, the prognostic prediction model did great in prediction: AUC in training data set and test data set were 0.85 and 0.8 respectively. CONCLUSION: Reassigned CEA, CYFRA21-1 and NSE can effectively predict the diagnosis and prognosis of LC. Compared with the same TMs that were considered individually, this diagnostic prediction model can identify high-risk population for LC screening more accurately. The prognostic prediction model could be helpful in making more scientific treatment and follow-up plans for patients.

A Combined Two-mRNA Signature Associated With PD-L1 and Tumor Mutational Burden for Prognosis of Lung Adenocarcinoma.

Due to biological heterogeneity, lung adenocarcinoma (LUAD) patients with the same stage may exhibit variable responses to immunotherapy and a wide range of outcomes. It is urgent to seek a biomarker that can predict the prognosis and response to immunotherapy in these patients. In this study, we identified two genes (ANLN and ARNTL2) from multiple gene expression data sets, and developed a two-mRNA-based signature that can effectively distinguish high- and low-risk patients and predict patients' response to immunotherapy. Furthermore, taking full advantage of the complementary value of clinical and molecular features, we combined the immune prognostic signature with clinical features to construct and validate a nomogram that can predict the probability of high tumor mutational burden (>10 mutations per megabyte). This may improve the estimation of immunotherapy response in LUAD patients, and provide a new perspective for clinical screening of immunotherapy beneficiaries.

Chinese herbal medicine Buyang Huanwu Decoction combined with acupuncture to treat sequela of apoplexy: a meta-analysis of randomized controlled trials.

BACKGROUND: Buyang Huanwu Decoction combined with acupuncture has a wide range of applications in the treatment of stroke sequelae, and there are many clinical trial reports. We systematically evaluated the clinical efficacy and safety of Buyang Huanwu Decoction combined with acupuncture in treating stroke sequelae, and evaluated overall research quality. METHODS: We searched 7 databases which includes the Chinese Journal Full-text Database (CNKI), VIP Database (VIP), China Biomedicine (SinoMed), Wanfang Database and PubMed, Cochrane Central, EMBASE from January 2010 to December 2019 Literature references. We selected randomized controlled trials that tested the effects of Buyang Huanwu Decoction combined with acupuncture on stroke sequelae. The authors extracted data and independently assessed quality. We used RevMan 5.3.0 software to analyze the data of randomized trials. RESULTS: A total of 7 articles were identified, including 902 patients. The overall quality of the included trials was poor, and one of them was moderate. Meta-analysis results showed that the experimental group of Buyang Huanwu decoction combined with acupuncture treatment of stroke sequela compared with the control group clearly improved the clinical efficacy improved the clinical efficacy rate (RR 1.18, 95% CI: 1.12, 1.25), P<0.00001]. Among them, three trials included the incidence of adverse reactions (RR 0.22, 95% CI: 0.09, 0.52, P=0.0006), which also confirmed the safety of its treatment. CONCLUSIONS: Buyang Huanwu Decoction combined with acupuncture is an effective therapy to ameliorate the clinical symptoms of stroke sequelae. In order to further determine the effectiveness and safety of Buyang Huanwu Decoction combined with acupuncture in treating stroke sequelae, more rigorous design, multicenter and prospective RCT must be carried out.

Traditional Chinese medicine Lianhua Qingwen treating corona virus disease 2019(COVID-19): Meta-analysis of randomized controlled trials.

INTRODUCTION: As the global epidemic continues to spread, countries have tapped effective drugs to treat new coronavirus pneumonia. The therapeutic effect of the traditional Chinese medicine Lianhua Qingwen in this new coronary pneumonia epidemic has attracted attention from all walks of life, and relevant research reports continue to appear. Therefore, we conducted a systematic review of the clinical efficacy and safety of the traditional Chinese medicine Lianhua Qingwen in the treatment of new coronavirus pneumonia (COVID-19) (referred to as "new coronary pneumonia"), and evaluated the overall level of research quality. METHODS: We searched seven databases and retrieved the Chinese Journal Full-text Database (CNKI), Vip Database (VIP), China Biomedicine (SinoMed), Wanfang Database and PubMed, Cochrane Central, EMBASE from October 2019 to May 2020 Literature references. We included randomized controlled trials (RCTs) that tested the efficacy of the traditional Chinese medicine lotus clearing plague in the treatment of new coronavirus pneumonia. The authors extracted data and independently assessed quality. We used Stata15.1 software to analyze the data of randomized trials. RESULTS: A total of 2 articles were identified, including 154 patients. All the participating patients were diagnosed with new coronavirus pneumonia (COVID-19). The meta-analysis results showed that the disappearance rate of the main clinical symptoms of Chinese medicine Lianhua Qingwen in the treatment of new coronavirus pneumonia was significantly higher than that of the control group [OR = 3.34, 95% CI (2.06, 5.44), P <0.001]; the disappearance rate of other clinical secondary symptoms is significantly higher than the control group [OR = 6.54, 95% CI (3.59, 11.90), P <0.001]. The duration of fever was significantly lower than that of the control group [OR = -1.04, 95% CI (-1.60, -0.49), P <0.001]. It is confirmed that the traditional Chinese medicine Lianhua Qingwen treatment improves the clinical effectiveness, and also has certain advantages in relieving cough and fever. CONCLUSION: The treatment of new pneumonia with traditional Chinese medicine lotus clearing plague can be used as an effective therapy to improve the clinical symptoms of new coronary pneumonia. More rigorous design, multi-center, and prospective RCTs are necessary to further determine the effectiveness and safety of the traditional Chinese medicine lotus decoction in the treatment of new pneumonia.

Comparison of efficacy, complications and TGF-ß2 expression between DHS and PFNA in elderly patients with osteoporotic femoral intertrochanteric fracture.

The aim of the present study was to compare the efficacy and complications of two fixation techniques, namely dynamic hip screw (DHS) and proximal femoral nail antirotation (PFNA), in the treatment of osteoporotic femoral intertrochanteric fracture in elderly patients, and to detect changes in transforming growth factor ß2 (TGF-ß2) expression in the two groups. A total of 100 elderly patients with femoral intertrochanteric fracture were randomly divided into two groups that were treated with either DHS or PFNA. Peri-operative complications were observed in the patients and ELISA was used to detect TGF-ß2 expression levels at 1, 7, 15 and 30 days after surgical treatment. The clinical efficacy and the incidence rate of complications at 3 months after the operation were compared. In comparison with the DHS group, the PFNA group had a shorter operation time, a lower bleeding volume and a shorter post-operative weight-bearing time. The contents of TGF-ß2 in the two groups at 7 days after the operation were higher than those at 1 day, reached a peak at 15 days and had gradually decreased again at 30 days after the operation. The contents of TGF-ß2 at 1, 7 and 15 days in the PFNA group were higher than those at the identical time-points in the DHS group (P<0.01). Regarding the clinical efficacy in the two groups at 3 months of post-surgery, the rate of excellent/good efficacy in the PFNA fixation group (90.0%) was higher than that in the DHS fixation group (74.0%). Of note, PFNA fixation had a higher clinical efficacy, a shorter operation time, less intra-operative trauma, a relatively faster fracture healing process and fewer complications in comparison with DHS fixation, and is therefore more suitable for treating osteoporotic femoral intertrochanteric fracture in the elderly. PFNA fixation is superior to DHS fixation, which may be associated with the higher level of TGF-ß2 expression in comparison with that in the DHS group.

Microstructure and phases of deposited metal of SUPER304H steel under high temperature Persistent stress.

In order to investigate the high temperature rupture property of deposited metal of SUPER304H steel, the high temperature tensile test was carried out, and the microstructure transformation of deposited metal of SUPER304H steel under high temperature persistent stress were studied. Most of the solidification subgrain boundaries dissolve. The effect of the high temperature enduring on the microstructure is not obvious. Temperature and time are the main factors that influence the change of microstructure. Under the action of high temperature stress, the corrosion resistance of austenite decreases significantly due to the occurrence of chromium deficiency. With the persistent stress of 200 MPa, the precipitated phase of deposited metal is Nb (C, N), M23C6, NbCrN phase, and a certain amount of alpha phase is precipitated in the deposited metal with a persistent stress of 78 MPa. The precipitation of M23C6 phase is the main reason for the decrease of the corrosion resistance, especially the decrease of the corrosion resistance.

Twenty-year survivors after resection for hepatocellular carcinoma-analysis of 53 cases.

PURPOSE: To clarify the clinicopathologic features of patients surviving > or =20 years after resection for hepatocellular carcinoma (HCC). METHODS: Between 1961 and 1987, a total of 396 patients underwent hepatic resection for HCC; 53 (13.4%) patients survived > or =20 years, and 343 (86.6%) patients survived <20 years. A comparative study between the two groups was made. RESULTS: By March of 2007, 67.6% (36/53) patients are still alive, disease free; 5.7% (3/53) patients died of tumor recurrence or metastasis; 11.3% (6/53) patients died of liver failure; 5.7% (5/53) patients were lost during follow-up. The longest patient survived 43 years and 2 months. Five young patients got married after resection and have had babies. One patient with a tumor measuring 17 x 13 x 9 cm (largest tumor in this series) survived for 37 years after resection, still alive, free of disease. Reresection for recurrence was done in nine patients, mean survival being 26 years and 11 months. Reresection for solitary pulmonary metastasis was carried out in three patients, mean survival being 29 years and 2 months. In comparison with patients surviving <20 years, patients surviving > or =20 years were significantly younger (P = 0.031), had a higher incidence of asymptomatic tumors (56.6 vs. 34.4%, P = 0.002); lower gamma-glutamyl transpeptidase level (< or =50 U/L, 64.2 vs. 25.9%, P < 0.000), lower proportion of liver cirrhosis (66.0 vs. 83.6%, P = 0.002); higher percentage of small tumors (< or =5 cm, 62.3 vs. 29.9%, P < 0.000), single nodule tumors (90.6 vs. 62.9%, P < 0.000), and well-encapsulated tumors (86.8 vs. 43.6%, P < 0.000); lower proportion of tumor emboli in the portal vein (3.8 vs. 22.5%, P = 0.002), better differentiation of tumor cells (Edmondson grade I, 21.6 vs. 9.1%, P = 0.036), and higher curative resection rate (100 vs. 64.1%, P < 0.000). CONCLUSIONS: Early detection and curative resection are the principal factors improving long-term survival. Long-term follow-up after resection of HCC is very important, and should continue for the remainder of the patient's life. Reresection for recurrence and metastasis is important approach to improve prognosis.

Intrahepatic cholangiocarcinoma: report of 272 patients compared with 5,829 patients with hepatocellular carcinoma.

PURPOSE: To clarify clinicopathologic differences between patients with intrahepatic cholangiocarcinoma (ICC) and hepatocellular carcinoma (HCC), and identify potential factors influencing survival after hepatectomy for ICC. METHODS: Comparison of clinicopathologic data was made between patients who underwent hepatectomy for ICC (n = 272) and HCC (n = 5,829) during the same period. Twenty-five clinicopathologic variables were selected for univariate and multivariate analyses to evaluate their influence on prognosis of ICC. RESULTS: Compared with patients with HCC, ICC patients were more common in females and more elderly, had a lower proportion of asymptomatic tumors, lower serum alpha-fetoprotein, higher serum carcinoembryonic antigen, carbohydrate antigen 19-9 and alkaline phosphatase levels; lower incidence of hepatitis history, associated cirrhosis and serum hepatitis B surface antigen; lower proportion of small tumors, well-encapsulated tumors and tumor emboli in the portal vein; higher proportion of single tumor, perihila lymph node involvement and poor differentiation; and less frequency of limited resection (all, P < 0.0001). Distant metastasis was less frequent in patients with ICC (P = 0.027). A total of 5-years overall and disease-free survival (in brackets) after resection was 26.4% (13.1%) and 44.5% (33.1%) (P < 0.0001, P < 0.0001) for patients with ICC and HCC, respectively. Factors influencing survival after resection of ICC can be divided mainly into two categories: early detection of asymptomatic ICC (P < 0.0001) and curative resection (P = 0.002). CONCLUSION: ICC Patients have distinct clinicopathologic features as compared with HCC patients. Surgery remains the only effective treatment for ICC. Early detection of asymptomatic ICC and curative resection were the key to achieve optimal survival.

Intrahepatic splenosis mimicking hepatoma.

A 54-year-old man with a past history of splenectomy some 20 years previously presented with a hepatic mass. Subsequent histopathology revealed that the mass was due to intrahepatic splenosis. The presentation of this case is discussed together with a literature review of splenosis.

[Treatment of postoperative recurrence of hepatocellular carcinoma with radiofrequency ablation comparing with repeated surgical resection].

OBJECTIVE: To evaluate the efficacy of radiofrequency ablation for the treatment of postoperative recurrence of hepatocellular carcinoma and whether radiofrequency ablation can be used as first line treatment for recurrent hepatocellular carcinoma. METHODS: There were 213 patients with small recurrent hepatocellular carcinoma (tumor size of 3 cm or less and no more than 3 nodules) who treated in Liver Cancer Institute, Fudan University from January 2000 to December 2005. Among these patients 68 were treated with radiofrequency ablation and 145 were treated with repeated surgical resection. Kaplan-Meier method was used to evaluate the overall survival or disease free survival. Log-rank used to determine the survival difference between groups and COX proportional hazard was used for multivariate analysis to evaluate the risk factors for prognosis. The overall survival or disease free survival was calculated from the time treated with radiofrequency or repeated surgical resection. RESULTS: The 1-, 3-, 5-years overall survival rates were 94.7%, 65.1%, 37.3% and 88.1%, 62.6%, 41.0% in radiofrequency ablation group and surgical repeated resection group, respectively. There was no significant difference between two groups (P = 0.693). However, the disease free survival was better in repeated surgical resection than in radiofrequency ablation, which were 79.4%, 48.1%, 34.4% and 58.0%, 27.8%, 12.4% in repeated surgical resection and radiofrequency ablation, respectively (P = 0.001). The interval between recurrence and initial hepatectomy with more than 2 years was independent factor favor to good prognosis. CONCLUSIONS: Radiofrequency ablation seems to be as effective as repeated surgical resection owing to comparable overall survival and can be considered as alternative therapy for surgical resection treatment of small recurrent hepatocellular carcinoma.

Cytokeratin 10 and cytokeratin 19: predictive markers for poor prognosis in hepatocellular carcinoma patients after curative resection.

PURPOSE: Cytokeratin 10 (CK10) was found to be expressed differently in human hepatocellular carcinoma (HCC) cell lines with different metastatic potentials in our previous research. The aim of this study was to assess the value of CK10 alone or in combination with cytokeratin 19 (CK19) in predicting tumor recurrence after curative resection in HCC patients. EXPERIMENTAL DESIGN: CK10 expression in stepwise metastatic HCC cell lines and tumor tissues from 50 HCC patients was investigated using immunofluorescence assay, quantitative real-time reverse transcription-PCR, and Western blot analyses. Tumor tissue microarrays of 300 HCC patients who underwent curative resection between 1997 and 2000 were used to detect the expressions of CK10 and CK19. Clinicopathologic data for these patients were evaluated. The prognostic significance was assessed using Kaplan-Meier survival estimates and log-rank tests. RESULTS: CK10 was overexpressed in the high metastatic HCC cell line and in tumor tissues of recurrent patients. Both univariate and multivariate analyses revealed that CK10 was a significant predictor for overall survival (OS) and disease-free survival, and that CK19 was a significant predictor for OS. CK10 expression was correlated with poor prognosis regardless of alpha-fetoprotein, tumor-node-metastasis stage, and vascular invasion. The 7-year OS and disease-free survival rates in CK10+ and/or CK19+ patients were 30.0% and 37.6%, respectively, which were significantly lower than that of CK10-/CK19- patients (56.1% and 60.0%, respectively; P < 0.001). CONCLUSION: CK10 is associated with HCC invasiveness. CK10 alone, or in combination with CK19, can be a novel predictor for poor prognosis of HCC patients after curative resection.

Identification of side population cells in human hepatocellular carcinoma cell lines with stepwise metastatic potentials.

PURPOSE: To identify the side population (SP) cells from four hepatocellular carcinoma (HCC) cell lines with stepwise metastatic potentials. METHODS: SP cells were sorted from HCCLM3, MHCC97-H, MHCC97-L and Hep3B by flow cytometry, and then analyzed by differentiation study, clonogenic assay, chemoresistance study and tumorigenicity assay in vivo. The expression of ABCG(2) in SP cells was detected by immunocytochemistry, western blotting and real-time quantitative PCR, respectively. RESULTS: There was significant difference in SP proportion among HCCLM3, MHCC97-H, MHCC97-L and Hep3B (28.7 +/- 1.6%, 14.5 +/- 0.6%, 4.2 +/- 0.4%, 0.9 +/- 0.1%, respectively, P < 0.01). All the SP cells showed similar characteristics of self-renewal, high clonogenicity, remarkable chemo-resistance and high expression of ABCG(2). As low as 2,000 SP cells could initiate tumors in non-obese diabetic/severe combined immunodeficiency mice successfully. CONCLUSIONS: SP cells purified from HCC cell lines harbors cancer stem cell-like properties, and may be related to the metastatic potentials and therapeutic-resistance of HCC.

[Pulmonary infection and its risk factors after orthotopic liver transplantation].

OBJECTIVES: To investigate the characteristics of pulmonary infection and its risk factors after orthotopic liver transplantation (OLT). METHODS: Clinical data of 250 cases having liver transplantations from April 2001 to August 2005 were retrospectively studied in order to analyse the differences between patients with and without pulmonary infection. RESULTS: Fifty-seven (57/250, 22.8%) recipients had 72 episodes of pulmonary infection after liver transplantation. Bacterial infection was the most common followed by fungal infection (13/72, 18.1%), and cytomegalovirus infection (12/72, 16.7%). There were 36 episodes of pulmonary infection caused by one kind of bacteria, 5 episodes by two kinds of bacteria and 6 episodes by multiple kinds of bacteria. Seven episodes of fungal infection were accompanied with bacterial infection, and three episodes of cytomegalovirus infection were accompanied with bacterial infection simultaneously. The 1-, 2- and 3- year survival rates were 71.9%, 61.4%, and 53.4% of the patients with pulmonary infection and 93.1%, 75.8%, and 67.2% of those without the infection. Logistic regression analysis suggested that preoperative infection, mechanical ventilation > 12 hours, a long duration of the operation, total volume of blood transfusion during operation >1000 ml, reoperation after OLT, postoperative pleural effusion and the duration of stay in the intensive care unit were independent risk factors of pulmonary infection after OLT. CONCLUSION: Bacterial infections were the main pulmonary infection after OLT and the infections caused by multiple pathogens or multiple-antibiotic-resistant bacteria were seen more frequently. The risk factors of pulmonary infection should be controlled to decrease the infection rate after OLT. It is important to make a correct diagnosis for pulmonary infection after OLT and use appropriate antibiotics as soon as possible.

[Influence of tumor characteristics on the outcome of liver transplantation among patients with hepatocellular carcinoma].

OBJECTIVE: To identify the influence of tumor characteristics on the outcome of liver transplantation (LT) among patients with hepatocellular carcinoma (HCC). METHODS: A retrospective analysis was performed on 251 consecutive patients with HCC who underwent LT between April 2001 and February 2006 at our institution. We compared the outcome of the patients classified by different tumor related factors. Survival analysis was performed using Kaplan-Meier and Cox proportional hazards regression methods. RESULTS: Macroscopic vascular invasion, lymph node metastasis, Edmondson pathologic classification, microscopic tumor thrombosis, tumor location, satellite nodules and alpha-fetal protein (AFP) all significantly affected the overall survival and/or recurrence-free survival post-LT (P < 0.01 or P < 0.05). Pre-operative treatment and hepatitis background had no effect to the prognosis (P > 0.05). At multivariate Cox regression analysis, the factors associated with mortality or recurrence were macroscopic vascular invasion, microscopic tumor thrombosis and satellite nodules (P < 0.01 or P < 0.05). CONCLUSION: Edmondson grade III - IV, microscopic tumor thrombosis, left lobar or bilobar tumor, satellite nodules and AFP > or = 300 microg/L were predictive factors of poor prognosis. Presence of macroscopic vascular invasion or lymph node metastasis should be contraindicated.

[Focal adhesion kinase mRNA overexpression in hepatocellular carcinoma HCC) and correlation thereof with prognosis of HCC].

OBJECTIVE: To investigate whether focal adhesion kinase (FAK) is involved in the progression of human hepatocellular carcinoma (HCC) and whether FAK mRNA expression has prognostic significance for HCC. METHODS: Real-time PCR and immunohistochemistry were used to det4ec the mRNA and protein expression of FAK in 50 specimens of HCC obtained during operation. The correlation between FAK expression and clinicopathologic parameters was. RESULTS: The mRNA expression of FAK was significantly higher in the HCC specimens than in the corresponding non-cancerous liver tissues (P < 0.001), in the embolism than in the tumor tissue by the emboli of the same specimen (P < 0.05), and in the HCC with embolism than in the HCC without embolism (P = 0.003). Cox regression analysis showed that the FAK mRNA expression was correlated significantly with embolism (P = 0.003) and invasion (P = 0.020). Univariate and multivariate analyses revealed that FAK expression was an independent prognostic factor for survival. CONCLUSION: FAK plays an important role in HCC progression, especially in vascular invasion and FAK expression has prognostic significance for HCC.