Clinical outcomes of surgical resection versus radiofrequency ablation in very-early-stage hepatocellular carcinoma: a propensity score matching analysis.

BACKGROUND: The detection rate of Barcelona Clinic Liver Cancer (BCLC) very-early-stage hepatocellular carcinoma (HCC) is increasing because of advances in surveillance and improved imaging technologies for high-risk populations. Surgical resection (SR) and radiofrequency ablation (RFA) are both first-line treatments for very-early-stage HCC, but the differences in clinical outcomes between patients treated with SR and RFA remain unclear. This study investigated the prognosis of SR and RFA for very-early-stage HCC patients with long-term follow-up. METHODS: This study was retrospectively collected data on the clinicopathological characteristics, overall survival (OS), and disease-free survival (DFS) of 188 very-early-stage HCC patients (≤ 2 cm single HCC). OS and DFS were analyzed using the Kaplan-Meier method and Cox regression analysis. Propensity score matching (PSM) analysis was performed. RESULTS: Of the 188 HCC patients, 103 received SR and 85 received RFA. The median follow-up time was 56 months. The SR group had significantly higher OS than the RFA group (10-year cumulative OS: 55.2% and 31.3% in the SR and RFA groups, respectively). No statistically significant difference was observed in DFS between the SR and RFA groups (10-year cumulative DFS: 45.9% and 32.6% in the SR and RFA groups, respectively). After PSM, the OS in the SR group remained significantly higher than that in the RFA group (10-year cumulative OS: 54.7% and 42.2% in the SR and RFA groups, respectively). No significant difference was observed in DFS between the SR and RFA groups (10-year cumulative DFS: 43.0% and 35.4% in the SR and RFA groups, respectively). Furthermore, in the multivariate Cox regression analysis, treatment type (hazard ratio (HR): 0.54, 95% confidence interval (CI): 0.31-0.95; P = 0.032) and total bilirubin (HR: 1.92; 95% CI: 1.09-3.41; P = 0.025) were highly associated with OS. In addition, age (HR: 2.14, 95% CI: 1.36-3.36; P = 0.001) and cirrhosis (HR: 1.79; 95% CI: 1.11-2.89; P = 0.018) were strongly associated with DFS. CONCLUSION: For patients with very-early-stage HCC, SR was associated with significantly higher OS rates than RFA. However, no significant difference was observed in DFS between the SR and RFA groups.

Modern Clinical Applications and Type of Disease Prevention and Treatment of Guipitang： A Review / 中国实验方剂学杂志

The Chinese herbal medicines contained in Guipitang （GPT） were retrieved in the databases， including traditional Chinese medicine systems pharmacology database and analysis platform （TCMSP）， encyclopedia of traditional Chinese medicine （ETCM）， bioinformatics analysis tool for molecular mechanism of traditional Chinese medicine （BATMAN-TCM）， and database for associated traditional Chinese medicine， gene， and disease information using text mining （TCMGeneDIT）， and the compounds and their potential targets were obtained. Disease enrichment analysis on the potential targets of GPT was carried out to obtain the diseases potentially treated by GPT using MetaCore. Disease enrichment results showed that the potential diseases treated by GPT included encephalopathy， gastrointestinal diseases， nutritional/metabolic diseases， tumors/cancers， cardiovascular system diseases， endocrine system diseases， immune system diseases， drug-related side effects/adverse reactions， and congenital/hereditary diseases. On these grounds， the diseases treated by GPT were reviewed. The results of the previous research on diseases treated by GPT were consistent with analysis results of network pharmacology. The modern applications of GPT clinically went beyond its original indications， but its applications were based on the clinical manifestation of qi and blood deficiency in the heart and spleen， presenting the characteristic of "same treatment for different diseases". This study is expected to provide a reference for the further research and development of GPT.

Current situation of Chinese clinical microbiological laboratories participating in management of healthcare-associated infection and antimicrobial use / 中国感染控制杂志

Objective To investigate current situation of Chinese clinical microbiological laboratories participating in management of healthcare-associated infection and antimicrobial use.Methods Fourteen provinces (municipalities), autonomous regions and army hospitals in seven regions of China were selected, the participation of clinical microbiological laboratories in the consultation of HAI diseases, specimen quality control, antimicrobial use, and management of multidrug-resistant organisms (MDROs) before 2000 and every five years from 2000 to 2015 were investigated, the surveyed results were analyzed statistically.Results A total of 187 hospitals were investigated, in 2015, 96 and 172 hospitals (51.34％, 91.98％) participated in the consultation of infectious diseases and multi-department collaborative management on MDROs respectively.However, 44 hospitals (23.53％) still manually performed statistical analysis on drug susceptibility, only 26 hospitals (13.90％) had the ability of identifying homology of pathogens.Rate of MDRO surveillance data feedbacked to clinical departments increased from 66.84％ (n=125) in 2010 to 95.72％ (n=179) in 2015, the frequency of feedback was mainly monthly and quarterly;rate of antimicrobial susceptibility results feedbacked to clinic departments increased from 62.03％ (n=116) to 94.12％ (n=176), 82.35％ (n=154) of clinical microbiological laboratories conducted quarterly feedback;the quality control rate of microscopic sputum smear before sputum culture increased from63.10％ (n=118) to 87.17％ (n=163);rate of bilateral double blood culture increased from 35.83％ (n=67) to 72.73％ (n=136);rates of other aseptic body fluid culture (except blood and urine) increased from 4.86％ to 5.74％;differences were all significantly different between 2010 and 2015 (all P＜0.05).Conclusion Clinical microbiological laboratories have played an important role in promoting the development of HAI management in China, especially during the period of 2011-2015.However, the homology analysis on HAI pathogens, informatization of result feedback, and sterile body fluid specimens detection need to be further strengthened.