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Li XC, Li CX, Zhang H, Cheng F, Zhang F, Pu LY, Zhang CY, Wang K, Kong LB, Qian XF, Li DH, Lu WX, Wang P, Yao AH, Bai JF, Wu XF, Chen RX, Wang XH. [Surgical treatment and prognosis analysis of hilar cholangiocarcinoma]. Zhonghua Wai Ke Za Zhi 2024; 62:290-301. [PMID: 38432670 DOI: 10.3760/cma.j.cn112139-20231221-00296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
Objective: To investigate the surgical treatment effect and prognostic factors of hilar cholangiocarcinoma. Methods: This is an ambispective cohort study. From August 2005 to December 2022,data of 510 patients who diagnosed with hilar cholangiocarcinoma and underwent surgical resection at the Hepatobiliary Center of the First Affiliated Hospital of Nanjing Medical University were retrospectively collected. In the cohort,there were 324 males and 186 females,with an age of (M (IQR)) 63(13)years (range:25 to 85 years). The liver function at admission was Child-Pugh A (343 cases,67.3%) and Child-Pugh B (167 cases,32.7%). Three hundred and seventy-two(72.9%) patients had jaundice symptoms and the median total bilirubin was 126.3(197.6) μmol/L(range: 5.4 to 722.8 μmol/L) at admission. Two hundred and fourty-seven cases (48.4%) were treated with percutaneous transhepatic cholangial drainage or endoscopic nasobiliary drainage before operation. The median bilirubin level in the drainage group decreased from 186.4 μmol/L to 85.5 μmol/L before operation. Multivariate Logistic regression was used to identify the influencing factors for R0 resection,and Cox regression was used to construct multivariate prediction models for overall survival(OS) and disease-free survival(DFS). Results: Among 510 patients who underwent surgical resection,Bismuth-Corlett type Ⅲ-Ⅳ patients accounted for 71.8%,among which 86.1% (315/366) underwent hemi-hepatectomy,while 81.9% (118/144) underwent extrahepatic biliary duct resection alone in Bismuch-Corlett type Ⅰ-Ⅱ patients. The median OS time was 22.8 months, and the OS rates at 1-,3-,5-and 10-year were 72.2%,35.6%,24.8% and 11.0%,respectively. The median DFS time was 15.2 months,and the DFS rates was 66.0%,32.4%,20.9% and 11.0%,respectively. The R0 resection rate was 64.5% (329/510), and the OS rates of patients with R0 resection at 1-,3-,5-and 10-year were 82.5%, 48.6%, 34.4%, 15.2%,respectively. The morbidity of Clavien-Dindo grade Ⅲ-Ⅴ complications was 26.1%(133/510) and the 30-day mortality was 4.3% (22/510). Multivariate Logistic regression indicated that Bismuth-Corlett type Ⅰ-Ⅲ (P=0.009), hemi-hepatectomy and extended resection (P=0.001),T1 and T2 patients without vascular invasion (T2 vs. T1:OR=1.43 (0.61-3.35),P=0.413;T3 vs. T1:OR=2.57 (1.03-6.41), P=0.010;T4 vs. T1, OR=3.77 (1.37-10.38), P<0.01) were more likely to obtain R0 resection. Preoperative bilirubin,Child-Pugh grade,tumor size,surgical margin,T stage,N stage,nerve infiltration and Edmondson grade were independent prognostic factors for OS and DFS of hilar cholangiocarcinoma patients without distant metastasis. Conclusions: Radical surgical resection is necessary to prolong the long-term survival of hilar cholangiocarcinoma patients. Hemi-hepatectomy and extended resection,regional lymph node dissection and combined vascular resection if necessary,can improve R0 resection rate.
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Affiliation(s)
- X C Li
- Hepatobiliary Center, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - C X Li
- Hepatobiliary Center, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - H Zhang
- Hepatobiliary Center, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - F Cheng
- Hepatobiliary Center, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - F Zhang
- Hepatobiliary Center, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - L Y Pu
- Hepatobiliary Center, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - C Y Zhang
- Hepatobiliary Center, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - K Wang
- Hepatobiliary Center, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - L B Kong
- Hepatobiliary Center, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - X F Qian
- Hepatobiliary Center, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - D H Li
- Hepatobiliary Center, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - W X Lu
- Hepatobiliary Center, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - P Wang
- Hepatobiliary Center, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - A H Yao
- Hepatobiliary Center, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - J F Bai
- Hepatobiliary Center, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - X F Wu
- Hepatobiliary Center, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - R X Chen
- Hepatobiliary Center, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - X H Wang
- Hepatobiliary Center, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
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Ji GW, Xu Q, Jiao CY, Lu M, Xu ZG, Zhang B, Yang Y, Wang K, Li XC, Wang XH. Translating imaging traits of mass-forming intrahepatic cholangiocarcinoma into the clinic: From prognostic to therapeutic insights. JHEP Rep 2023; 5:100839. [PMID: 37663120 PMCID: PMC10468367 DOI: 10.1016/j.jhepr.2023.100839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/23/2023] [Accepted: 06/16/2023] [Indexed: 09/05/2023] Open
Abstract
Background & Aims The progress toward clinical translation of imaging biomarkers for mass-forming intrahepatic cholangiocarcinoma (MICC) is slower than anticipated. Questions remain on the biologic behaviour underlying imaging traits. We developed and validated imaging-based prognostic systems for resected MICCs with an appraisal of the tumour immune microenvironment (TIME) underpinning patient-specific imaging traits. Methods Between January 2009 and December 2019, a total of 322 patients who underwent dynamic computed tomography/magnetic resonance imaging and curative-intent resection for MICC at three hepatobiliary institutions were retrospectively recruited, divided into training (n = 193) and validation (n = 129) datasets. Two radiological and clinical scoring (RACS) systems, one integrating preoperative variables and one integrating preoperative and postoperative variables, were developed using Cox regression analysis. We then prospectively analysed the TIME of tissue samples from 20 patients who met study criteria from January 2021 to December 2021 using multiplexed immunofluorescence. Results Preoperative and postoperative MICC-RACS systems built on carbohydrate antigen 19-9, albumin, tumour number, radiological/pathological nodal status, pathological necrosis, and three radiological traits (arterial enhancement pattern, tumour boundary, and capsular retraction) demonstrated good performance in predicting disease-specific (C-statistic >0.80) and disease-free (C-statistic >0.75) survival that outperformed rival models and staging systems across study cohorts (P <0.05 for all). Patients with MICC-RACS score of 0-2 (low risk), 3-5 (medium risk), and ≥6 (high risk) had incrementally worse prognosis after surgery. Significant differences in spatial distribution and infiltration level of immune cells were identified between arterial enhancement patterns. Enhanced infiltration of immunosuppressive regulatory T cells and M2-like macrophages at the invasive margin were noted in tumours with distinct boundary and capsular retraction, respectively. Conclusions Our MICC-RACS systems are simple but powerful prognostic tools that may facilitate the understanding of spatially distinct TIMEs and patient-tailored immunotherapy approach. Impact and Implications The progress toward clinical translation of imaging biomarkers for mass-forming intrahepatic cholangiocarcinoma (MICC) is slower than anticipated. Questions remain on the biologic behaviour of MICC underlying imaging traits. In this study, we proposed novel and easy-to-use tools, built on radiological and clinical features, that demonstrated good performance in predicting the prognosis either before or after surgery and outperformed rival models/systems across major imaging modalities. The characteristic radiological traits integrated into prognostic systems (arterial enhancement pattern, tumour boundary, and capsular retraction) were highly correlated with heterogeneous tumour-immune microenvironments, thereby renovating treatment paradigms for this difficult-to-treat disease.
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Affiliation(s)
- Gu-Wei Ji
- Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
- Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, PR China
- NHC Key Laboratory of Living Donor Liver Transplantation (Nanjing Medical University), Nanjing, PR China
| | - Qing Xu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Chen-Yu Jiao
- Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
- Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, PR China
- NHC Key Laboratory of Living Donor Liver Transplantation (Nanjing Medical University), Nanjing, PR China
| | - Ming Lu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Zheng-Gang Xu
- Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
- Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, PR China
- NHC Key Laboratory of Living Donor Liver Transplantation (Nanjing Medical University), Nanjing, PR China
| | - Biao Zhang
- Department of General Surgery, Yancheng No.1 People’s Hospital, Yancheng, PR China
| | - Yue Yang
- Department of General Surgery, The First People’s Hospital of Changzhou, Changzhou, PR China
| | - Ke Wang
- Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
- Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, PR China
- NHC Key Laboratory of Living Donor Liver Transplantation (Nanjing Medical University), Nanjing, PR China
| | - Xiang-Cheng Li
- Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
- Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, PR China
- NHC Key Laboratory of Living Donor Liver Transplantation (Nanjing Medical University), Nanjing, PR China
| | - Xue-Hao Wang
- Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
- Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, PR China
- NHC Key Laboratory of Living Donor Liver Transplantation (Nanjing Medical University), Nanjing, PR China
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Shi GM, Huang XY, Wen TF, Song TQ, Kuang M, Mou HB, Bao LQ, Zhao HT, Zhao H, Feng XL, Zhang BX, Peng T, Zhang YB, Li XC, Yu HS, Cao Y, Liu LX, Zhang T, Wang WL, Ran JH, Liu YB, Gong W, Chen MX, Cao L, Luo Y, Wang Y, Zhou H, Yang GH, Fan J, Zhou J. Pemigatinib in previously treated Chinese patients with locally advanced or metastatic cholangiocarcinoma carrying FGFR2 fusions or rearrangements: A phase II study. Cancer Med 2023; 12:4137-4146. [PMID: 36127767 PMCID: PMC9972033 DOI: 10.1002/cam4.5273] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 07/13/2022] [Accepted: 08/08/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE This study evaluated the antitumor activity and safety of pemigatinib in previously treated Chinese patients with advanced cholangiocarcinoma and fibroblast growth factor receptor 2 (FGFR2) fusions or rearrangements. BACKGROUND Pemigatinib provided clinical benefits for previously treated patients with cholangiocarcinoma carrying FGFR2 fusions or rearrangements and was approved for this indication in multiple countries. METHODS In this ongoing, multicenter, single-arm, phase II study, adult patients with locally advanced or metastatic cholangiocarcinoma carrying centrally confirmed FGFR2 fusions or rearrangements who had progressed on ≥1 systemic therapy received 13.5 mg oral pemigatinib once daily (3-week cycle; 2 weeks on, 1 week off) until disease progression, unacceptable toxicity, or consent withdrawal. The primary endpoint was objective response rate (ORR) assessed by an independent radiology review committee. RESULTS As of January 29, 2021, 31 patients were enrolled. The median follow-up was 5.1 months (range, 1.5-9.3). Among 30 patients with FGFR2 fusions or rearrangements evaluated for efficacy, 15 patients achieved partial response (ORR, 50.0%; 95% confidence interval [CI], 31.3-68.7); 15 achieved stable disease, contributing to a disease control rate of 100% (95% CI, 88.4-100). The median time to response was 1.4 months (95% CI, 1.3-1.4), the median duration of response was not reached, and the median progression-free survival was 6.3 months (95% CI, 4.9-not estimable [NE]). Eight (25.8%) of 31 patients had ≥grade 3 treatment-emergent adverse events. Hyperphosphatemia, hypophosphatasemia, nail toxicities, and ocular disorders were mostly <grade 3, except for 2 events ≥grade 3. CONCLUSIONS The encouraging antitumor activity and favorable safety profile support the use of pemigatinib as a treatment in previously treated Chinese patients with cholangiocarcinoma and FGFR2 rearrangements.
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Affiliation(s)
- Guo-Ming Shi
- Liver Surgery and Transplantation, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xiao-Yong Huang
- Liver Surgery and Transplantation, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Tian-Fu Wen
- Hepatobiliary Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Tian-Qiang Song
- Hepatobiliary Surgery, Tianjin Cancer Hospital, Tian Jin, China
| | - Ming Kuang
- Department of Oncology, Hepatobiliary and Pancreatic Surgery Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Hai-Bo Mou
- Medical Oncology, Shulan (Hangzhou) Hospital, Hangzhou, China
| | - Le-Qun Bao
- Hepatobiliary Surgery, Hubei Cancer Hospital, Wuhan, China
| | - Hai-Tao Zhao
- Liver Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Hong Zhao
- Hematological Surgery Department, Cancer Hospital of Chinese Academy of Medical Science, Beijing, China
| | - Xie-Lin Feng
- Hepatobiliary and Pancreatic Surgery, Sichuan Cancer Hospital, Chengdu, China
| | - Bi-Xiang Zhang
- Hepatobiliary Surgery, Tongji Hospital, Tongji Medical College of HUST, Wuhan, China
| | - Tao Peng
- Hepatological Surgery Department, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yu-Bao Zhang
- Hepatobiliary and Pancreatic Surgery, Cancer Hospital Affiliated to Harbin Medical University, Harbin, China
| | - Xiang-Cheng Li
- Liver Surgery, Jiangsu Province Hospital, Nanjing, China
| | - Hong-Sheng Yu
- Oncology Department, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yu Cao
- Phase 1 Clinical Research Center, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Lian-Xin Liu
- Hepatobiliary Surgery Department, The First Affiliated Hospital of University of Science and Technology of China, Hefei, China
| | - Ti Zhang
- Hepatobiliary Surgery Department, Tianjin Cancer Hospital, Tianjin, China
| | - Wei-Lin Wang
- Hepatopancreatobiliary Surgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Jiang-Hua Ran
- Hepatopancreatobiliary Surgery, The First Hospital of Kunming, Kunming, China
| | - Ying-Bin Liu
- General Surgery, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wei Gong
- General Surgery, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ming-Xia Chen
- Department of Medical Science and Oncological Strategy, Innovent Biologics Inc., Suzhou, China
| | - Lian Cao
- Department of Medical Science and Oncological Strategy, Innovent Biologics Inc., Suzhou, China
| | - Yang Luo
- Department of Medical Science and Oncological Strategy, Innovent Biologics Inc., Suzhou, China
| | - Yan Wang
- Department of Medical Science and Oncological Strategy, Innovent Biologics Inc., Suzhou, China
| | - Hui Zhou
- Department of Medical Science and Oncological Strategy, Innovent Biologics Inc., Suzhou, China
| | - Guo-Huan Yang
- Liver Surgery and Transplantation, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jia Fan
- Liver Surgery and Transplantation, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jian Zhou
- Liver Surgery and Transplantation, Zhongshan Hospital, Fudan University, Shanghai, China
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Li XC, Chen ZX, Li D, Liu WZ, Meng M. Chemical and mechanical stability of an ion-exchanged lithium disilicate glass in artificial saliva. J Mech Behav Biomed Mater 2023; 137:105563. [PMID: 36375276 DOI: 10.1016/j.jmbbm.2022.105563] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 11/03/2022] [Accepted: 11/06/2022] [Indexed: 11/11/2022]
Abstract
Multi-component lithium disilicate (LD) glasses were ion-exchanged in a pure or mixed nitrate salt bath. The surface morphologies, mechanical properties, chemical stability and ion leaching of ion-exchanged LD glasses before and after storage in artificial saliva for 21 days were investigated. It can be found that chemical stability of ion-exchanged LD glass was temperature-dependent. The residual compressive stress induced by ion-exchange increased the chemical potential of alkali ions in glass, and the ion-exchanged LD glass, especially 235 °C/64 h group, chemical stability in artificial saliva for 21 days were deteriorated. Back-exchange treatment could relax the stress on the outermost layer of the ion-exchanged LD glass without deteriorating its strengthening effect, and back-exchanged LD glass presented good chemical and mechanical stability in artificial saliva. The results might help to enhance the service stability of ion-exchanged LD glass-ceramics in the oral condition.
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Affiliation(s)
- X C Li
- Shaanxi Key Laboratory of Biomedical Metallic Materials, Northwest Institute for Non-ferrous Metal Research, Xi'an, 710016, China
| | - Z X Chen
- State Key Laboratory for Manufacturing Systems Engineering, School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, 710049, China
| | - D Li
- School of Science, Xi'an University of Posts and Telecommunications, Xi'an, 710121, China
| | - W Z Liu
- Shaanxi Key Laboratory of Biomedical Metallic Materials, Northwest Institute for Non-ferrous Metal Research, Xi'an, 710016, China
| | - M Meng
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, Fourth Military Medical University, Xi'an, 710032, China.
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Chen RX, Jiang WJ, Liu SC, Wang ZY, Wang ZB, Zhou T, Chen YAL, Wang JF, Chang J, Wang YR, Zhang YD, Wang XH, Li XC, Li CX. Apolipoprotein A-1 protected hepatic ischaemia-reperfusion injury through suppressing macrophage pyroptosis via TLR4-NF-κB pathway. Liver Int 2023; 43:234-248. [PMID: 36203339 DOI: 10.1111/liv.15448] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 09/28/2022] [Accepted: 10/03/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND AND AIMS Apolipoprotein A-1 (ApoA-1), the major apolipoprotein of high-density lipoprotein, plays anti-atherogenic role in cardiovascular diseases and exerts anti-inflammation effect in various inflammatory and infectious diseases. However, the role and mechanism of ApoA-1 in hepatic ischaemia-reperfusion (I/R) injury is unknown. METHODS In this study, we measured ApoA-1 expression in human liver grafts after transplantation. Mice partial hepatic I/R injury model was made in ApoA-1 knockout mice, ApoA-1 mimetic peptide D-4F treatment mice and corresponding control mice to examine the effect of ApoA-1 on liver damage, inflammation response and cell death. Primary hepatocytes and macrophages were isolated for in vitro study. RESULTS The results showed that ApoA-1 expression was down-regulated in human liver grafts after transplantation and mice livers subjected to hepatic I/R injury. ApoA-1 deficiency aggravated liver damage and inflammation response induced by hepatic I/R injury. Interestingly, we found that ApoA-1 deficiency increased pyroptosis instead of apoptosis during acute phase of hepatic I/R injury, which mainly occurred in macrophages rather than hepatocytes. The inhibition of pyroptosis compensated for the adverse impact of ApoA-1 deficiency. Furthermore, the up-regulated pyroptosis process was testified to be mediated by ApoA-1 through TLR4-NF-κB pathway and TLR4 inhibition significantly improved hepatic I/R injury. In addition, we confirmed that D-4F ameliorated hepatic I/R injury. CONCLUSIONS Our study has identified the protective role of ApoA-1 in hepatic I/R injury through inhibiting pyroptosis in macrophages via TLR4-NF-κB pathway. The effect of ApoA-1 may provide a novel therapeutic approach for hepatic I/R injury.
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Affiliation(s)
- Rui-Xiang Chen
- Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.,Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, China
| | - Wang-Jie Jiang
- Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.,Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, China
| | - Shuo-Chen Liu
- Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.,Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, China
| | - Zi-Yi Wang
- Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.,Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, China
| | - Zhi-Bo Wang
- Department of Thoracic Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Tao Zhou
- Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.,Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, China
| | - Yan-An-Lan Chen
- Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.,Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, China
| | - Ji-Fei Wang
- Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.,Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, China
| | - Jiang Chang
- Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.,Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, China
| | - Yi-Rui Wang
- Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.,Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, China
| | - Yao-Dong Zhang
- Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.,Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, China
| | - Xue-Hao Wang
- Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.,Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, China
| | - Xiang-Cheng Li
- Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.,Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, China
| | - Chang-Xian Li
- Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.,Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, China
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Wang FQ, Wang Q, Wang YJ, Li ZM, Li R, Li XC, Yang LA, Lu JW. Propagation rules of shock waves in confined space under different initial pressure environments. Sci Rep 2022; 12:14352. [PMID: 35999350 PMCID: PMC9399105 DOI: 10.1038/s41598-022-18567-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 08/16/2022] [Indexed: 11/17/2022] Open
Abstract
In this paper, an initial pressure adjustable explosion vessel was developed, and the effect of negative pressure, positive pressure (0.2–1.8 atm) different initial ambient pressure on the explosive shock wave generated by the explosion of explosives was studied. The relationships between the specific impulse, shock wave velocity, the amount of explosive gas products and the ambient pressure were analyzed for different initial pressure environments. It was found that: the overpressure of the blast shock wave decreases with the initial ambient pressure of the explosion, and there exists a negative pressure environment with a dramatic pressure decrease near 0.6 atm, defined as the super-sensitive negative pressure Pcr. The propagation velocity of an explosive wave increases with a decrease in the ambient pressure, and the propagation velocity at a pressure of 1.8 atm is four times less than the velocity at a pressure of 0.2 atm. The production of explosive gas products did not change. The greater the initial pressure of the environment where the explosive is located, the smaller the ratio of the gas generated by the explosion to the initial force gas in the explosion vessel is, and the greater the impact on the propagation of shock waves is. The maximum attenuation of the first specific impulse i1 is 72.97% and the maximum attenuation of the second specific impulse i2 is 72.39%. The experiments provide reference data for high-altitude military confrontation, high-altitude weapons and ammunition development, and deep-earth protection engineering.
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Affiliation(s)
- F Q Wang
- School of Chemical Engineering, Anhui University of Science & Technology, Huainan, 232001, China
| | - Q Wang
- School of Chemical Engineering, Anhui University of Science & Technology, Huainan, 232001, China. .,Engineering Laboratory of Explosive Materials and Technology of Anhui Province, Huainan, 232001, China.
| | - Y J Wang
- BGRIMM Technology Group, Beijing, 100160, China
| | - Z M Li
- School of Civil Engineering and Architecture, Anhui University of Science & Technology, Huainan, 232001, China
| | - R Li
- School of Chemical Engineering, Anhui University of Science & Technology, Huainan, 232001, China
| | - X C Li
- School of Chemical Engineering, Anhui University of Science & Technology, Huainan, 232001, China
| | - L A Yang
- School of Chemical Engineering, Anhui University of Science & Technology, Huainan, 232001, China
| | - J W Lu
- School of Chemical Engineering, Anhui University of Science & Technology, Huainan, 232001, China
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Xia YX, Zhang H, Zhang F, Li XC, Rong DW, Tang WW, Cao HS, Zhao J, Wang P, Pu LY, Qian XF, Cheng F, Wang K, Kong LB, Zhang CY, Li DH, Song JH, Yao AH, Wu XF, Wu C, Wang XH. [Efficacy and safety of neoadjuvant immunotherapy for hepatocellular carcinoma]. Zhonghua Wai Ke Za Zhi 2022; 60:688-694. [PMID: 35775262 DOI: 10.3760/cma.j.cn112139-20220408-00150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To study the surgical safety and efficacy of preoperative neoadjuvant therapy with immune checkpoint inhibitors combined with anti-angiogenic drugs in patients with China liver cancer staging(CNLC)-Ⅱb and Ⅲa resectable hepatocellular carcinoma. Methods: The data of 129 patients with Ⅱb and Ⅲa hepatocellular carcinoma who underwent surgery at the First Affiliated Hospital of Nanjing Medical University from January 2018 to December 2020 were analyzed. All patients were divided into two groups: the neoadjuvant therapy group(n=14,13 males and 1 female,aged (55.4±12.6)years(range:34 to 75 years)) received immune combined targeted therapy before surgery,immune checkpoint inhibitor camrelizumab was administered intravenously at a dose of 200 mg each time,every 2 weeks for 3 cycles,anti-angiogenesis drug apatinib was taken orally and continuously with a dose of 250 mg for 3 weeks and the conventional surgery group(n=115,103 males and 12 females,aged (55.8±12.0)years(range:21 to 83 years)) did not receive antitumor systemic therapy before surgery. There were 3 patients with CNLC-Ⅱb,11 with CNLC-Ⅲa in the neoadjuvant group;28 patients with CNLC-Ⅱb,87 with CNLC-Ⅲa in the conventional group. Student's t test or rank-sum test was used to compare the differences between two groups for quantitative data, Fisher's exact probability method was used to compare the differences of proportions between two groups, and Log-rank test was used to compare survival differences between two groups. Results: The 1-year recurrence rate in the neoadjuvant group was 42.9%,and the 1-year recurrence rate in the conventional group was 64.0%,with a statistically significant difference between the two groups(χ²=3.850,P=0.050);The 1-year survival rate in the neoadjuvant group was 100% and that in the conventional group was 74.2%,with a statistically significant difference between the two groups(χ²=5.170,P=0.023). According to the stratified analysis of the number of tumors,for single tumor,the 1-year recurrence rate in the neoadjuvant group was 25.0%,and that in the conventional surgery group was 71.0%,and the difference between the two groups was statistically significant(χ²=5.280, P=0.022). For multiple tumors, the 1-year recurrence rate in the neoadjuvant group was 66.7%,and the 1-year recurrence rate in the conventional surgery group was 58.9%,with no significant difference between the two groups(χ²=0.110,P=0.736). The operative time,intraoperative blood loss,and postoperative hospital stay in the neoadjuvant group were similar to those in the conventional group,and their differences were not statistically significant. Conclusions: Immune checkpoint inhibitors combined with anti-angiogenic targeted drugs as a neoadjuvant therapy for resectable hepatocellular carcinoma can reduce the 1-year recurrence rate and improve the 1-year survival rate,especially for those with solitary tumor. Limited by the sample size of the neoadjuvant group,the safety of immune combined targeted therapy before surgery cannot be observed more comprehensively,and further studies will be explored.
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Affiliation(s)
- Y X Xia
- Hepatobiliary Center,the First Affiliated Hospital of Nanjing Medical University,Key Laboratory of Liver Transplantation,Chinese Academy of Medical Sciences,National Health Commission Key Laboratory of Living Donor Liver Transplantation, Nanjing 210000, China
| | - H Zhang
- Hepatobiliary Center,the First Affiliated Hospital of Nanjing Medical University,Key Laboratory of Liver Transplantation,Chinese Academy of Medical Sciences,National Health Commission Key Laboratory of Living Donor Liver Transplantation, Nanjing 210000, China
| | - F Zhang
- Hepatobiliary Center,the First Affiliated Hospital of Nanjing Medical University,Key Laboratory of Liver Transplantation,Chinese Academy of Medical Sciences,National Health Commission Key Laboratory of Living Donor Liver Transplantation, Nanjing 210000, China
| | - X C Li
- Hepatobiliary Center,the First Affiliated Hospital of Nanjing Medical University,Key Laboratory of Liver Transplantation,Chinese Academy of Medical Sciences,National Health Commission Key Laboratory of Living Donor Liver Transplantation, Nanjing 210000, China
| | - D W Rong
- Hepatobiliary Center,the First Affiliated Hospital of Nanjing Medical University,Key Laboratory of Liver Transplantation,Chinese Academy of Medical Sciences,National Health Commission Key Laboratory of Living Donor Liver Transplantation, Nanjing 210000, China
| | - W W Tang
- Hepatobiliary Center,the First Affiliated Hospital of Nanjing Medical University,Key Laboratory of Liver Transplantation,Chinese Academy of Medical Sciences,National Health Commission Key Laboratory of Living Donor Liver Transplantation, Nanjing 210000, China
| | - H S Cao
- Hepatobiliary Center,the First Affiliated Hospital of Nanjing Medical University,Key Laboratory of Liver Transplantation,Chinese Academy of Medical Sciences,National Health Commission Key Laboratory of Living Donor Liver Transplantation, Nanjing 210000, China
| | - J Zhao
- Hepatobiliary Center,the First Affiliated Hospital of Nanjing Medical University,Key Laboratory of Liver Transplantation,Chinese Academy of Medical Sciences,National Health Commission Key Laboratory of Living Donor Liver Transplantation, Nanjing 210000, China
| | - P Wang
- Hepatobiliary Center,the First Affiliated Hospital of Nanjing Medical University,Key Laboratory of Liver Transplantation,Chinese Academy of Medical Sciences,National Health Commission Key Laboratory of Living Donor Liver Transplantation, Nanjing 210000, China
| | - L Y Pu
- Hepatobiliary Center,the First Affiliated Hospital of Nanjing Medical University,Key Laboratory of Liver Transplantation,Chinese Academy of Medical Sciences,National Health Commission Key Laboratory of Living Donor Liver Transplantation, Nanjing 210000, China
| | - X F Qian
- Hepatobiliary Center,the First Affiliated Hospital of Nanjing Medical University,Key Laboratory of Liver Transplantation,Chinese Academy of Medical Sciences,National Health Commission Key Laboratory of Living Donor Liver Transplantation, Nanjing 210000, China
| | - F Cheng
- Hepatobiliary Center,the First Affiliated Hospital of Nanjing Medical University,Key Laboratory of Liver Transplantation,Chinese Academy of Medical Sciences,National Health Commission Key Laboratory of Living Donor Liver Transplantation, Nanjing 210000, China
| | - K Wang
- Hepatobiliary Center,the First Affiliated Hospital of Nanjing Medical University,Key Laboratory of Liver Transplantation,Chinese Academy of Medical Sciences,National Health Commission Key Laboratory of Living Donor Liver Transplantation, Nanjing 210000, China
| | - L B Kong
- Hepatobiliary Center,the First Affiliated Hospital of Nanjing Medical University,Key Laboratory of Liver Transplantation,Chinese Academy of Medical Sciences,National Health Commission Key Laboratory of Living Donor Liver Transplantation, Nanjing 210000, China
| | - C Y Zhang
- Hepatobiliary Center,the First Affiliated Hospital of Nanjing Medical University,Key Laboratory of Liver Transplantation,Chinese Academy of Medical Sciences,National Health Commission Key Laboratory of Living Donor Liver Transplantation, Nanjing 210000, China
| | - D H Li
- Hepatobiliary Center,the First Affiliated Hospital of Nanjing Medical University,Key Laboratory of Liver Transplantation,Chinese Academy of Medical Sciences,National Health Commission Key Laboratory of Living Donor Liver Transplantation, Nanjing 210000, China
| | - J H Song
- Hepatobiliary Center,the First Affiliated Hospital of Nanjing Medical University,Key Laboratory of Liver Transplantation,Chinese Academy of Medical Sciences,National Health Commission Key Laboratory of Living Donor Liver Transplantation, Nanjing 210000, China
| | - A H Yao
- Hepatobiliary Center,the First Affiliated Hospital of Nanjing Medical University,Key Laboratory of Liver Transplantation,Chinese Academy of Medical Sciences,National Health Commission Key Laboratory of Living Donor Liver Transplantation, Nanjing 210000, China
| | - X F Wu
- Hepatobiliary Center,the First Affiliated Hospital of Nanjing Medical University,Key Laboratory of Liver Transplantation,Chinese Academy of Medical Sciences,National Health Commission Key Laboratory of Living Donor Liver Transplantation, Nanjing 210000, China
| | - C Wu
- Hepatobiliary Center,the First Affiliated Hospital of Nanjing Medical University,Key Laboratory of Liver Transplantation,Chinese Academy of Medical Sciences,National Health Commission Key Laboratory of Living Donor Liver Transplantation, Nanjing 210000, China
| | - X H Wang
- Hepatobiliary Center,the First Affiliated Hospital of Nanjing Medical University,Key Laboratory of Liver Transplantation,Chinese Academy of Medical Sciences,National Health Commission Key Laboratory of Living Donor Liver Transplantation, Nanjing 210000, China
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Li XC, Zhai RQ, Chen B. [A case of primary inverted papilloma of the middle ear]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2022; 57:488-490. [PMID: 35527442 DOI: 10.3760/cma.j.cn115330-20210519-00283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- X C Li
- Department of Otology, Otorhinolaryngology Hospital, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - R Q Zhai
- Department of Otology, Otorhinolaryngology Hospital, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - B Chen
- Department of Otology, Otorhinolaryngology Hospital, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
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Ji GW, Jiao CY, Xu ZG, Li XC, Wang K, Wang XH. Development and validation of a gradient boosting machine to predict prognosis after liver resection for intrahepatic cholangiocarcinoma. BMC Cancer 2022; 22:258. [PMID: 35277130 PMCID: PMC8915487 DOI: 10.1186/s12885-022-09352-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 03/01/2022] [Indexed: 12/13/2022] Open
Abstract
Background Accurate prognosis assessment is essential for surgically resected intrahepatic cholangiocarcinoma (ICC) while published prognostic tools are limited by modest performance. We therefore aimed to establish a novel model to predict survival in resected ICC based on readily-available clinical parameters using machine learning technique. Methods A gradient boosting machine (GBM) was trained and validated to predict the likelihood of cancer-specific survival (CSS) on data from a Chinese hospital-based database using nested cross-validation, and then tested on the Surveillance, Epidemiology, and End Results (SEER) database. The performance of GBM model was compared with that of proposed prognostic score and staging system. Results A total of 1050 ICC patients (401 from China and 649 from SEER) treated with resection were included. Seven covariates were identified and entered into the GBM model: age, tumor size, tumor number, vascular invasion, number of regional lymph node metastasis, histological grade, and type of surgery. The GBM model predicted CSS with C-Statistics ≥ 0.72 and outperformed proposed prognostic score or system across study cohorts, even in sub-cohort with missing data. Calibration plots of predicted probabilities against observed survival rates indicated excellent concordance. Decision curve analysis demonstrated that the model had high clinical utility. The GBM model was able to stratify 5-year CSS ranging from over 54% in low-risk subset to 0% in high-risk subset. Conclusions We trained and validated a GBM model that allows a more accurate estimation of patient survival after resection compared with other prognostic indices. Such a model is readily integrated into a decision-support electronic health record system, and may improve therapeutic strategies for patients with resected ICC. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-022-09352-3.
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Wan Q, Wang YZ, Li XC, Xia XY, Wang P, Peng Y, Liang CH. [The stability and repeatability of radiomics features based on lung diffusion-weighted imaging]. Zhonghua Yi Xue Za Zhi 2022; 102:190-195. [PMID: 35042287 DOI: 10.3760/cma.j.cn112137-20210608-01309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objective: To evaluate the feasibility, robustness and reproducibility of radiomics features derived from lung diffusion-weighted imaging (DWI). Methods: Thirty patients with pulmonary nodules/masses who underwent magnetic resonance imaging examination in the Department of Radiology, the First Affiliated Hospital of Guangzhou Medical University, from January 4 2019 to May 5 2019, including 16 males and 14 females, aged from 27 to 69 (57±11) years, were prospectively collected. Planar echo imaging (EPI) -DWI and fast spin-echo (TSE) -DWI scans were performed under free-breathing conditions. Each scan was repeated at an interval of 5 minutes, and the corresponding apparent diffusion coefficient (ADC) maps were reconstructed. Each DWI and ADC sequence (a total of eight groups of images) were manually segmented by two radiologists, and a total of 396 radiomics features in 6 categories were extracted from each group of images. Consistency correlation coefficient (CCC) and dynamic range (DR) were used to evaluate the robustness of features between two scans, and stable features were defined as both CCC values and DR values ≥0.85. Intra-observer and interobserver reproducibility were evaluated by intra-group correlation coefficient (ICC), and ICC values≥0.75 was considered to be good reproducibility. Results: Regardless of EPI or TSE technique, the number of robust features extracted fromDWI (TSE: n=197, EPI: n=169) were higher than that of the corresponding ADC (TSE: n=126, EPI: n=148). The proportion of robust features of TSE-DWI、EPI-DWI、TSE-ADC、EPI-ADC was 49.7% (197/396), 42.7% (169/396), 31.8% (126/396) and 37.4% (148/396), respectively. Of the 396 features, 54 (13.6%) of them demonstrated great robustness (CCC and DR≥0.85) and interobserver and interobserver reproducibility (ICC≥0.75) across all sequences. Conclusions: Radiomics features derived from lung DWI showed robustness and reproducibility. Different sequences and different feature clusters have different proportions of stable features, and some features have good robustness and reproducibility between different scans, different observers, and even different sequences.
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Affiliation(s)
- Q Wan
- Department of Radiology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Y Z Wang
- Department of Radiology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - X C Li
- Department of Radiology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - X Y Xia
- Department of Radiology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - P Wang
- Department of Radiology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Y Peng
- Department of Radiology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - C H Liang
- Department of Radiology, Guangdong Provincial People's Hospital, Guangzhou 510080, China
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Men TJ, Chai ZG, Li XC, Li D, Wang F, He L, Zhang SF, Meng M. Improving early running-in wear characteristics for dental lithium disilicate glass-ceramics by ion-exchange. J Mech Behav Biomed Mater 2021; 126:105037. [PMID: 34906862 DOI: 10.1016/j.jmbbm.2021.105037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 12/03/2021] [Accepted: 12/07/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVES This study examined the effects of Li+→Na+ ion-exchange on the early wear performance of dental lithium disilicate (LD) glass-ceramics. METHODS Specimens with different shapes were prepared using IPS e.max Press as the LD glass-ceramics. Ion-exchange was conducted by placing polished specimens in molten salt containing 25% NaNO3 and 75% KNO3 at 385 °C for 16 or 64 h. The ion-exchanged specimens were analyzed using X-ray diffraction (XRD) and energy-dispersive X-ray spectroscopy (EDS) to investigate the structure and the elemental distribution. Thereafter, the specimens were tested for flexural strength, Vickers hardness, and fracture resistance. A portion of the specimens were tested with a pin-on-disk tribometer with 10 N for 40 × 104 wear cycles in artificial saliva. Wear analysis of the specimens was performed using a 3D profilometer and analyzed with one-way analyses of variance and Tukey's post hoc pairwise comparisons. Worn surfaces were examined with scanning electron microscopy. RESULTS The LD glass-ceramics exhibited strong time-dependent wear behavior, with typical running-in and steady wear stages. Ion-exchange treatments at 385 °C for 16 h and 64 h both enhanced the mechanical properties and decreased the wear rates of early running-in wear stage. The early wear performance of specimens treated with ion-exchange for long time (64 h) was improved significantly. CONCLUSION A thicker ion-exchange layer may be obtained by processing ion-exchange for a long time. This protocol improves the early wear performance of the glass-ceramics effectively. CLINICAL SIGNIFICANCE Dental restorations may fail prematurely due to excessive wear. It is important to improve the early wear performance of the glass-ceramics. Ion-exchange has the potential to strengthen dental LD glass-ceramics. Understanding the effect of ion-exchange on the early wear performance of glass-ceramics provides insight improving the early wear performance of these restorations.
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Affiliation(s)
- T J Men
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, Fourth Military Medical University, Xi'an, 710032, China
| | - Z G Chai
- UB-Care Dental Clinic of Xian Beilin, Xi'an, 710032, China
| | - X C Li
- Northwest Institute for Non-ferrous Metal Research, Xi'an, 710016, China
| | - D Li
- School of Science, Xi'an University of Posts and Telecommunications, Xi'an, 710121, China
| | - F Wang
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, Fourth Military Medical University, Xi'an, 710032, China
| | - L He
- State Key Laboratory for Mechanical Behavior of Materials, Xi'an Jiaotong University, Xi'an, 710049, China.
| | - S F Zhang
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, Fourth Military Medical University, Xi'an, 710032, China.
| | - M Meng
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, Fourth Military Medical University, Xi'an, 710032, China.
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Li XC, Li D, Zhang SF, Jing L, Zhou WH, He L, Yu S, Meng M. Effect of Li +/Na + exchange on mechanical behavior and biological activity of lithium disilicate glass-ceramic. J Mech Behav Biomed Mater 2021; 126:105036. [PMID: 34902754 DOI: 10.1016/j.jmbbm.2021.105036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 12/03/2021] [Accepted: 12/07/2021] [Indexed: 11/26/2022]
Abstract
Lithium disilicate (LD) glass-ceramics with a stoichiometric composition were ion-exchanged in pure NaNO3 or mixed NaNO3 + KNO3 molten salt baths below the glass transition temperature (Tg). The microstructures, surface morphologies, mechanical properties and bioactivities of the ion-exchanged glass-ceramics were studied in detail. It was found that the strength and toughness of LD glass-ceramic could be enhanced from 175 MPa to 0.96 MPa m1/2 before ion-exchange to 546 MPa and 4.31 MPa m1/2 respectively under a lowered ion-exchange temperature because the less stress relaxation. In addition, a gradient of Na+ rich layer in the surface of glass-ceramic was induced by Li+/Na+ exchange, which could be beneficial to the formation of HA (Hydroxyapatite) with nano-size porous after soaking in SBF (Simulated Body Fluid) solution and exhibited better bioactivity compared with the original LD glass-ceramic. The results might provide a reference for the strengthening and biological activation of LD glass-ceramics in bone restoration applications.
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Affiliation(s)
- X C Li
- Shaanxi Key Laboratory of Biomedical Metallic Materials, Northwest Institute for Non-ferrous Metal Research, Xi'an, 710016, China.
| | - D Li
- School of Science, Xi'an University of Posts and Telecommunications, Xi'an, 710121, China
| | - S F Zhang
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, Fourth Military Medical University, Xi'an, 710032, China
| | - L Jing
- Shaanxi Key Laboratory of Biomedical Metallic Materials, Northwest Institute for Non-ferrous Metal Research, Xi'an, 710016, China
| | - W H Zhou
- Shaanxi Key Laboratory of Biomedical Metallic Materials, Northwest Institute for Non-ferrous Metal Research, Xi'an, 710016, China
| | - L He
- State Key Laboratory for Mechanical Behavior of Materials, Xi'an Jiaotong University, Xi'an, 710049, China.
| | - S Yu
- Shaanxi Key Laboratory of Biomedical Metallic Materials, Northwest Institute for Non-ferrous Metal Research, Xi'an, 710016, China.
| | - M Meng
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, Fourth Military Medical University, Xi'an, 710032, China.
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Ji GW, Fan Y, Sun DW, Wu MY, Wang K, Li XC, Wang XH. Machine Learning to Improve Prognosis Prediction of Early Hepatocellular Carcinoma After Surgical Resection. J Hepatocell Carcinoma 2021; 8:913-923. [PMID: 34414136 PMCID: PMC8370036 DOI: 10.2147/jhc.s320172] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 07/29/2021] [Indexed: 01/27/2023] Open
Abstract
Background Improved prognostic prediction is needed to stratify patients with early hepatocellular carcinoma (EHCC) to refine selection of adjuvant therapy. We aimed to develop a machine learning (ML)-based model to predict survival after liver resection for EHCC based on readily available clinical data. Methods We analyzed data of surgically resected EHCC (tumor≤5 cm without evidence of extrahepatic disease or major vascular invasion) patients from the Surveillance, Epidemiology, and End Results (SEER) Program to train and internally validate a gradient-boosting ML model to predict disease-specific survival (DSS). We externally tested the ML model using data from 2 Chinese institutions. Patients treated with resection were matched by propensity score to those treated with transplantation in the SEER-Medicare database. Results A total of 2778 EHCC patients treated with resection were enrolled, divided into 1899 for training/validation (SEER) and 879 for test (Chinese). The ML model consisted of 8 covariates (age, race, alpha-fetoprotein, tumor size, multifocality, vascular invasion, histological grade and fibrosis score) and predicted DSS with C-Statistics >0.72, better than proposed staging systems across study cohorts. The ML model could stratify 10-year DSS ranging from 70% in low-risk subset to 5% in high-risk subset. Compared with low-risk subset, no remarkable survival benefits were observed in EHCC patients receiving transplantation before and after propensity score matching. Conclusion An ML model trained on a large-scale dataset has good predictive performance at individual scale. Such a model is readily integrated into clinical practice and will be valuable in discussing treatment strategies.
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Affiliation(s)
- Gu-Wei Ji
- Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China.,Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, People's Republic of China.,NHC Key Laboratory of Living Donor Liver Transplantation (Nanjing Medical University), Nanjing, People's Republic of China
| | - Ye Fan
- Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China.,Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, People's Republic of China.,NHC Key Laboratory of Living Donor Liver Transplantation (Nanjing Medical University), Nanjing, People's Republic of China
| | - Dong-Wei Sun
- Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China.,Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, People's Republic of China.,NHC Key Laboratory of Living Donor Liver Transplantation (Nanjing Medical University), Nanjing, People's Republic of China
| | - Ming-Yu Wu
- Department of Hepatobiliary Surgery, Wuxi People's Hospital, Wuxi, People's Republic of China
| | - Ke Wang
- Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China.,Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, People's Republic of China.,NHC Key Laboratory of Living Donor Liver Transplantation (Nanjing Medical University), Nanjing, People's Republic of China
| | - Xiang-Cheng Li
- Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China.,Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, People's Republic of China.,NHC Key Laboratory of Living Donor Liver Transplantation (Nanjing Medical University), Nanjing, People's Republic of China
| | - Xue-Hao Wang
- Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China.,Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, People's Republic of China.,NHC Key Laboratory of Living Donor Liver Transplantation (Nanjing Medical University), Nanjing, People's Republic of China
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14
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Yi L, Dou Y, Zhou ZD, Li XC, Zheng JX, Zhang Q, Huan JN, Liu Y. [Observation on the clinical effect of self-designed modified rhomboid skin flap in facial wound repair]. Zhonghua Shao Shang Za Zhi 2021; 37:788-792. [PMID: 34420279 DOI: 10.3760/cma.j.cn501120-20200504-00250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the clinical effect of self-designed modified rhomboid flap in repairing rhomboid, round, and teardrop-shaped wounds on the face. Methods: A retrospective observational study was conducted. From August 2018 to April 2020, 30 patients with facial lesions admitted into Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine and the People's Hospital of Jianchuan County in Yunnan province met the inclusion criteria, including 16 males and 14 females, aged 23 to 88 years. The wound area ranged from 1.0 cm×1.0 cm to 7.0 cm×5.0 cm, with 10 cases of rhomboid wounds, 12 cases of round wounds, and 8 cases of teardrop-shaped wounds. The self-designed modified rhomboid flaps were applied to repair the wounds and after that, the patients were followed up for 1 to 18 months to record the survival of flaps, wound tension, scar formation and complications after surgery. Results: No necrosis or blackening was observed at the tip of the flaps after surgery. All the flaps survived and the wounds healed well with little tension, minimal scars, and no complications. Conclusions: The self-designed modified rhomboid flap is especially suitable for facial wounds with multiple important organs, multiple anatomical subunits, and areas with large changes in soft tissue tension, which can reduce not only the rotation of the flap, but also unnecessary excision of normal skin and soft tissue.
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Affiliation(s)
- L Yi
- Department of Burn, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Y Dou
- Department of Burn, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Z D Zhou
- Department of Burn, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - X C Li
- Department of Burn, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - J X Zheng
- Department of Burn, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Q Zhang
- Department of Burn, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - J N Huan
- Department of Burn, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Y Liu
- Department of Burn, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
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Ji GW, Wang K, Xia YX, Li XC, Wang XH. [Application value of machine learning algorithms for predicting recurrence after resection of early-stage hepatocellular carcinoma]. Zhonghua Wai Ke Za Zhi 2021; 59:679-685. [PMID: 34192861 DOI: 10.3760/cma.j.cn112139-20201026-00768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To compare the performance of multiple machine learning algorithms in predicting recurrence after resection of early-stage hepatocellular carcinoma(HCC). Methods: Clinical data of 882 early-stage HCC patients who were admitted to the First Affiliated Hospital of Nanjing Medical University from May 2009 to December 2019 and treated with curative surgical resection were retrospectively collected. There were 701 males and 181 females,with an age of (57.3±10.5)years(range:21 to 86 years). All patients were randomly assigned in a 2∶1 ratio, the training dataset consisted of 588 patients and the test dataset consisted of 294 patients. The construction of machine learning-based prediction models included random survival forest(RSF),gradient boosting machine,elastic net regression and Cox regression model. The prediction accuracy of the model was measured by the concordance index(C-index). The prediction error of the model was measured by the integrated Brier score. Model fit was assessed by the calibration plot. The performance of machine learning models with that of rival model and HCC staging systems was compared. All models were validated in the independent test dataset. Results: Median recurrence-free survival was 61.7 months in the training dataset while median recurrence-free survival was 61.9 months in the validation dataset, there was no significant difference between two datasets in terms of recurrence-free survival(χ²=0.029,P=0.865). The RSF model consisted of 5 commonly used clinicopathological characteristics, including albumin-bilirubin grade,serum alpha fetoprotein,tumor number,type of hepatectomy and microvascular invasion. In both training and test datasets,the RSF model provided the best prediction accuracy,with respective C-index of 0.758(95%CI:0.725 to 0.791) and 0.749(95%CI:0.700 to 0.797),and the lowest prediction error,with respective integrated Brier score of 0.171 and 0.151. The prediction accuracy of RSF model for recurrence after resection of early-stage HCC was superior to that of other machine learning models,rival model(ERASL model) as well as HCC staging systems(BCLC,CNLC and TNM staging),with statistically significant difference(P<0.01). Calibration curves demonstrated good agreement between RSF model-predicted probabilities and observed outcomes.All patients could be stratified into low-risk,intermediate-risk or high-risk group based on RSF model;statistically significant differences among three risk groups were observed in both training and test datasets(P<0.01). The risk stratification of RSF model was superior to that of TNM staging. Conclusion: The proposed RSF model assembled with 5 commonly used clinicopathological characteristics in this study can predict the recurrence risk with favorable accuracy that may facilitate clinical decision-support for patients with early-stage HCC.
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Affiliation(s)
- G W Ji
- Hepatobiliary Center,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China
| | - K Wang
- Hepatobiliary Center,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China
| | - Y X Xia
- Hepatobiliary Center,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China
| | - X C Li
- Hepatobiliary Center,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China
| | - X H Wang
- Hepatobiliary Center,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China
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Seesaha PK, Wang KX, Wang GQ, Cui TY, Zhao FJ, Pan LL, Li XC, Shu YQ, Chen XF. Current Progress and Future Perspectives of Immune Checkpoint Inhibitors in Biliary Tract Cancer. Onco Targets Ther 2021; 14:1873-1882. [PMID: 33737812 PMCID: PMC7966382 DOI: 10.2147/ott.s269671] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 11/27/2020] [Indexed: 12/30/2022] Open
Abstract
Biliary tract cancer (BTC) is an uncommon and aggressive neoplasm, with most patients presenting in an advanced stage. Systemic chemotherapy is the limited treatment available but is unsatisfactory, while targeted therapy is still awaiting validation from clinical trials. Given the potential effect of immune checkpoint inhibitors (ICIs) in the treatment of BTC, this review aims to summarize the evidence-based benefits and predictive biomarkers for using inhibitors of cytotoxic T-lymphocyte-associated protein-4 (CTLA-4) ligand, or programmed cell death protein-1 and its ligand (PD-1 and PD-L1) as monotherapy or combined with other anti-tumor therapies, while also pointing out certain pitfalls with the use of ICIs which need to be addressed.
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Affiliation(s)
- Poshita-Kumari Seesaha
- Department of Oncology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, People's Republic of China
| | - Kang-Xin Wang
- Department of Oncology, Pukou Branch Hospital of Jiangsu Province Hospital (Nanjing Pukou Central Hospital), Nanjing, 211800, People's Republic of China
| | - Guo-Qun Wang
- Department of Oncology, Pukou Branch Hospital of Jiangsu Province Hospital (Nanjing Pukou Central Hospital), Nanjing, 211800, People's Republic of China
| | - Ting-Yun Cui
- Department of Oncology, Pukou Branch Hospital of Jiangsu Province Hospital (Nanjing Pukou Central Hospital), Nanjing, 211800, People's Republic of China
| | - Feng-Jiao Zhao
- Department of Oncology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, People's Republic of China
| | - Lan-Lan Pan
- Department of Oncology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, People's Republic of China
| | - Xiang-Cheng Li
- Hepatobiliary Center of the First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, People's Republic of China
| | - Yong-Qian Shu
- Department of Oncology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, People's Republic of China
| | - Xiao-Feng Chen
- Department of Oncology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, People's Republic of China.,Department of Oncology, Pukou Branch Hospital of Jiangsu Province Hospital (Nanjing Pukou Central Hospital), Nanjing, 211800, People's Republic of China
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Li CX, Zhang H, Wu XF, Han S, Jiao CY, Wang D, Wang K, Li XC. [Clinical efficacy and prognostic factors analysis following curative hepatectomy for hepatocellular carcinoma patients with different China Liver Cancer Staging]. Zhonghua Wai Ke Za Zhi 2021; 59:134-143. [PMID: 33378806 DOI: 10.3760/cma.j.cn112139-20200803-00605] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To examine clinical efficacy and prognostic factors of hepatocellular carcinoma(HCC) patients with different China Liver Cancer Staging (CNLC) after hepatectomy. Methods: From January 2010 to December,2019,549 patients underwent surgical resection and pathologically proven HCC were retrospectively reviewed in the First Affiliated Hospital of Nanjing Medical University. There were 462 males(84.2%) and 87 females(15.8%);the median age was 57 years (range: 21-84 years). Preoperative parameters,intraoperative and postoperative conditions,and postoperative pathological examination were observed.Survival analysis was performed by Kaplan-Meier method and the Log-rank test. Factors associated with disease-free survival(DFS) and overall survival(OS) of HCC patients were identified using univariate and multivariate Cox proportional hazards regression models. Results: Among the 549 patients underedwent liver resection,200 patients(36.4%) belonged to CNLC Ⅰa,whiles 148 patients(27.0%) belonged to CNLC Ⅰb. Furthermore,there were 49 patients(8.9%) with CNLC Ⅱa,32 patients(5.8%) with CNLC Ⅱb, 101 patients(18.4%) with CNLC Ⅲa and 19 patients(3.5%) with CNLC Ⅲb.The 1-,3-,5-,10-year OS for the entire cohort was 83.8%,69.0%,54.2%,37.7%,respectively,while 1-,3-, 5-year DFS was 61.0%,44.2%,36.0%, respectively. The 1-,3-, 5-year OS and DFS for CNLC Ⅰa were 97.3%,90.6%,80.5% and 83.9%,65.0%,54.0%,respectively;The 1-, 3-, 5-years OS and DFS for CNLC Ⅰb were 87.9%,71.0%,47.7%,and 58.4%,42.3%,33.4%,respectively.The 5-year OS for CNLC Ⅱa (37.2%) and Ⅱb(44.3%) were similar to CNLC Ⅰb. The 1-, 3-, 5-year OS and DFS for CNLC Ⅲb were 35.3%,13.2%,0 and 23.5%,0 and 0,respectively. Univariate analysis showed that preoperative symptoms,AFP level,total protein level,AST level,total bilirubin level,intraoperative blood loss,intraoperative or postoperative blood transfusion,postoperative complications,tumor number and size,microvascular invasion,macrovascular invasion and tumor differentiation were prognostic factors for long-term survival(≥5 years)(all P<0.05). The multivariate analysis suggested that AST level,intraoperative blood loss,tumor number and size,macrovascular invasion and tumor differentiation were the independent prognostic factors of long-term OS (all P<0.05). Conclusions: HCC patients with different stages of CNLC have different recurrence patterns and prognosis.After strict preoperative evaluation,patients with CNLC Ⅱa-Ⅲb can also benefit from radical resection. AST level,intraoperative blood loss,tumor number,tumor size,macrovascular invasion and tumor differentiation were independent factors that affect long-term survival. This will provide an important basis for the choice of treatment and the evaluation of surgical prognosis for patients with HCC.
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Affiliation(s)
- C X Li
- Hepatobiliary Center,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China
| | - H Zhang
- Hepatobiliary Center,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China
| | - X F Wu
- Hepatobiliary Center,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China
| | - S Han
- Hepatobiliary Center,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China
| | - C Y Jiao
- Hepatobiliary Center,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China
| | - D Wang
- Hepatobiliary Center,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China
| | - K Wang
- Hepatobiliary Center,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China
| | - X C Li
- Hepatobiliary Center,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China
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Xia YX, Zhang F, Li XC, Kong LB, Zhang H, Li DH, Cheng F, Pu LY, Zhang CY, Qian XF, Wang P, Wang K, Wu ZS, Lyu L, Rao JH, Wu XF, Yao AH, Shao WY, Fan Y, You W, Dai XZ, Qin JJ, Li MY, Zhu Q, Wang XH. [Surgical treatment of primary liver cancer:a report of 10 966 cases]. Zhonghua Wai Ke Za Zhi 2021; 59:6-17. [PMID: 33412628 DOI: 10.3760/cma.j.cn112139-20201110-00791] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To summarize the experience of surgical treatment of primary liver cancer. Methods: The clinical data of 10 966 surgically managed cases with primary liver cancer, from January 1986 to December 2019 at Hepatobiliary Center, the First Affiliated Hospital of Nanjing Medical University, were retrospectively analyzed. The life table method was used to calculate the survival rate and postoperative recurrence rate. Log-rank test was used to compare the survival process of different groups, and the Cox regression model was used for multivariate analysis. In addition, 2 884 cases of hepatocellular carcinoma(HCC) with more detailed follow-up data from 2009 to 2019 were selected for survival analysis. Among 2 549 patients treated with hepatectomy, there were 2 107 males and 442 females, with an age of (56.6±11.1) years (range: 20 to 86 years). Among 335 patients treated with liver transplantation, there were 292 males and 43 females, with an age of (51.0±9.7) years (range: 21 to 73 years). The outcomes of hepatectomy versus liver transplantation, anatomic versus non-anatomic hepatectomy were compared, respectively. Results: Of the 10 966 patients with primary liver cancer, 10 331 patients underwent hepatectomy and 635 patients underwent liver transplantation. Patients with liver resection were categorized into three groups: 1986-1995(712 cases), 1996-2008(3 988 cases), 2009‒2019(5 631 cases). The 5-year overall survival rate was 32.9% in the first group(1986-1995). The 5-year overall survival rate of resected primary liver cancer was 51.7% in the third group(2009-2019), among which the 5-year overal survival rates of hepatocellular carcinoma, intrahepatic cholangiocarcinoma and mixed liver cancer were 57.4%, 26.6% and 50.6%, respectively. Further analysis was performed on 2 549 HCC patients with primary hepatectomy. The 1-, 3-, 5-, and 10-year overall survival rates were 88.1%, 71.9%, 60.0%, and 41.0%, respectively, and the perioperative mortality rate was 1.0%. Two hundred and forty-seven HCC patients underwent primary liver transplantation, with 1-, 3-, 5-, and 10-year overall survival rates of 84.0%, 64.8%, 61.9%, and 57.6%, respectively. Eighty-eight HCC patients underwent salvage liver transplantation, with the 1-, 3-, 5-, and 10-year overall survival rates of 86.8%, 65.2%, 52.5%, and 52.5%, respectively. There was no significant difference in survival rates between the two groups with liver transplantation (P>0.05). Comparing the overall survival rates and recurrence rates of primary hepatectomy (2 549 cases) with primary liver transplantation (247 cases), the 1-, 3-, 5-, and 10-year overall survival rates in patients within Milan criteria treated with hepatectomy and transplantation were 96.3%, 87.1%, 76.9%, 54.7%, and 95.4%, 79.4%, 77.4%, 71.7%, respectively (P=0.754). The 1-, 3-, 5-year recurrence rates were 16.3%, 35.9%, 47.6% and 8.1%, 11.7%, 13.9%, respectively(P<0.01). The 1-, 3-, 5-, 10-year overall survival rates in patients with no large vessels invasion beyond the Milan criteria treated with liver resection and transplantation were 87.2%, 65.9%, 53.0%, 33.0% and 87.6%, 71.8%, 71.8%, 69.3%, respectively(P=0.003); the 1-, 3-, 5-year recurrence rate were 39.2%, 57.8%, 69.7% and 29.7%, 36.7%, 36.7%, respectively (P<0.01). The 1-, 3-, 5-, and 10-year overall survival rates in patients with large vessels invasion treated with liver resection and transplantation were 62.1%, 36.1%, 22.2%, 15.0% and 62.9%, 31.8%,19.9%, 0, respectively (P=0.387); the 1-, 3-, 5-year recurrence rates were 61.5%, 74.7%, 80.8% and 59.7%, 82.9%, 87.2%, respectively(P=0.909). Independent prognostic factors for both overall survival and recurrence-free survival rates of HCC patients treated with liver resection included gender, neoadjuvant therapy, symptoms, AST, intraoperative or postoperative blood transfusion, tumor number, tumor size, cirrhosis, macrovascular invasion, microvascular invasion, and pathological differentiation. Propensity score matching analysis of 443 pairs further showed that there was no significant difference in overall survival rate between anatomical liver resection and non-anatomical liver resection(P=0.895), but the recurrence rate of non-anatomical liver resection was higher than that of anatomical liver resection(P=0.035). Conclusions: In the past decade, the overall survival rate of HCC undergoing surgical treatment is significantly higher than before. For HCC patients with good liver function reservation, surgical resection can be performed first, and salvage liver transplantation can be performed after recurrence. The effect of salvage liver transplantation is comparable to that of primary liver transplantation. As for the choice of liver resection approaches, non-anatomical resection can reserve more liver tissue and can be selected as long as the negative margin is guaranteed.
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Affiliation(s)
- Y X Xia
- Hepatobiliary Center, the First Affiliated Hospital of Nanjing Medical University;Liver Cancer Institute, Nanjing Medical University, Nanjing 210000, China
| | - F Zhang
- Hepatobiliary Center, the First Affiliated Hospital of Nanjing Medical University;Liver Cancer Institute, Nanjing Medical University, Nanjing 210000, China
| | - X C Li
- Hepatobiliary Center, the First Affiliated Hospital of Nanjing Medical University;Liver Cancer Institute, Nanjing Medical University, Nanjing 210000, China
| | - L B Kong
- Hepatobiliary Center, the First Affiliated Hospital of Nanjing Medical University;Liver Cancer Institute, Nanjing Medical University, Nanjing 210000, China
| | - H Zhang
- Hepatobiliary Center, the First Affiliated Hospital of Nanjing Medical University;Liver Cancer Institute, Nanjing Medical University, Nanjing 210000, China
| | - D H Li
- Hepatobiliary Center, the First Affiliated Hospital of Nanjing Medical University;Liver Cancer Institute, Nanjing Medical University, Nanjing 210000, China
| | - F Cheng
- Hepatobiliary Center, the First Affiliated Hospital of Nanjing Medical University;Liver Cancer Institute, Nanjing Medical University, Nanjing 210000, China
| | - L Y Pu
- Hepatobiliary Center, the First Affiliated Hospital of Nanjing Medical University;Liver Cancer Institute, Nanjing Medical University, Nanjing 210000, China
| | - C Y Zhang
- Hepatobiliary Center, the First Affiliated Hospital of Nanjing Medical University;Liver Cancer Institute, Nanjing Medical University, Nanjing 210000, China
| | - X F Qian
- Hepatobiliary Center, the First Affiliated Hospital of Nanjing Medical University;Liver Cancer Institute, Nanjing Medical University, Nanjing 210000, China
| | - P Wang
- Hepatobiliary Center, the First Affiliated Hospital of Nanjing Medical University;Liver Cancer Institute, Nanjing Medical University, Nanjing 210000, China
| | - K Wang
- Hepatobiliary Center, the First Affiliated Hospital of Nanjing Medical University;Liver Cancer Institute, Nanjing Medical University, Nanjing 210000, China
| | - Z S Wu
- Hepatobiliary Center, the First Affiliated Hospital of Nanjing Medical University;Liver Cancer Institute, Nanjing Medical University, Nanjing 210000, China
| | - L Lyu
- Hepatobiliary Center, the First Affiliated Hospital of Nanjing Medical University;Liver Cancer Institute, Nanjing Medical University, Nanjing 210000, China
| | - J H Rao
- Hepatobiliary Center, the First Affiliated Hospital of Nanjing Medical University;Liver Cancer Institute, Nanjing Medical University, Nanjing 210000, China
| | - X F Wu
- Hepatobiliary Center, the First Affiliated Hospital of Nanjing Medical University;Liver Cancer Institute, Nanjing Medical University, Nanjing 210000, China
| | - A H Yao
- Hepatobiliary Center, the First Affiliated Hospital of Nanjing Medical University;Liver Cancer Institute, Nanjing Medical University, Nanjing 210000, China
| | - W Y Shao
- Hepatobiliary Center, the First Affiliated Hospital of Nanjing Medical University;Liver Cancer Institute, Nanjing Medical University, Nanjing 210000, China
| | - Y Fan
- Hepatobiliary Center, the First Affiliated Hospital of Nanjing Medical University;Liver Cancer Institute, Nanjing Medical University, Nanjing 210000, China
| | - W You
- Hepatobiliary Center, the First Affiliated Hospital of Nanjing Medical University;Liver Cancer Institute, Nanjing Medical University, Nanjing 210000, China
| | - X Z Dai
- Hepatobiliary Center, the First Affiliated Hospital of Nanjing Medical University;Liver Cancer Institute, Nanjing Medical University, Nanjing 210000, China
| | - J J Qin
- Hepatobiliary Center, the First Affiliated Hospital of Nanjing Medical University;Liver Cancer Institute, Nanjing Medical University, Nanjing 210000, China
| | - M Y Li
- Hepatobiliary Center, the First Affiliated Hospital of Nanjing Medical University;Liver Cancer Institute, Nanjing Medical University, Nanjing 210000, China
| | - Q Zhu
- Hepatobiliary Center, the First Affiliated Hospital of Nanjing Medical University;Liver Cancer Institute, Nanjing Medical University, Nanjing 210000, China
| | - X H Wang
- Hepatobiliary Center, the First Affiliated Hospital of Nanjing Medical University;Liver Cancer Institute, Nanjing Medical University, Nanjing 210000, China
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Ji GW, Wang K, Xia YX, Wang JS, Wang XH, Li XC. Integrating Machine Learning and Tumor Immune Signature to Predict Oncologic Outcomes in Resected Biliary Tract Cancer. Ann Surg Oncol 2020; 28:4018-4029. [PMID: 33230745 DOI: 10.1245/s10434-020-09374-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 10/27/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Improved methods are needed to predict outcomes in biliary tract cancers (BTCs). We aimed to build an immune-related signature and establish holistic models using machine learning. METHODS Samples were from 305 BTC patients treated with curative-intent resection, divided into derivation and validation cohorts in a two-to-one ratio. Spatial resolution of T cell infiltration and PD-1/PD-L1 expression was assessed by immunohistochemistry. An immune signature was constructed using classification and regression tree. Machine learning was applied to develop prediction models for disease-specific survival (DSS) and recurrence-free survival (RFS). RESULTS The immune signature composed of CD3+, CD8+, and PD-1+ cell densities and PD-L1 expression within tumor epithelium significantly stratified patients into three clusters, with median DSS varying from 11.7 to 80.8 months and median RFS varying from 6.2 to 62.0 months. Gradient boosting machines (GBM) outperformed rival machine-learning algorithms and selected the same 11 covariates for DSS and RFS prediction: immune signature, tumor site, age, bilirubin, albumin, carcinoembryonic antigen, cancer antigen 19-9, tumor size, tumor differentiation, resection margin, and nodal metastasis. The clinical-immune GBM models accurately predicted DSS and RFS, with respective concordance index of 0.776-0.816 and 0.741-0.781. GBM models showed significantly improved performance compared with tumor-node-metastasis staging system. CONCLUSIONS The immune signature promises to stratify prognosis and allocate treatment in resected BTC. The clinical-immune GBM models accurately predict recurrence and death from BTC following surgery.
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Affiliation(s)
- Gu-Wei Ji
- Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China.,Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, People's Republic of China.,NHC Key Laboratory of Living Donor Liver Transplantation (Nanjing Medical University), Nanjing, People's Republic of China
| | - Ke Wang
- Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China.,Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, People's Republic of China.,NHC Key Laboratory of Living Donor Liver Transplantation (Nanjing Medical University), Nanjing, People's Republic of China
| | - Yong-Xiang Xia
- Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China.,Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, People's Republic of China.,NHC Key Laboratory of Living Donor Liver Transplantation (Nanjing Medical University), Nanjing, People's Republic of China
| | - Jin-Song Wang
- Department of Pathology, Nanjing First Hospital, Nanjing, People's Republic of China
| | - Xue-Hao Wang
- Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China. .,Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, People's Republic of China. .,NHC Key Laboratory of Living Donor Liver Transplantation (Nanjing Medical University), Nanjing, People's Republic of China.
| | - Xiang-Cheng Li
- Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China. .,Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, People's Republic of China. .,NHC Key Laboratory of Living Donor Liver Transplantation (Nanjing Medical University), Nanjing, People's Republic of China.
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Li D, Chen ZX, Zhang YM, Li XC, Meng M, He L, Zhang ZZ. Improved reliability of mechanical behavior for a thermal tempered lithium disilicate glass-ceramic by regulating the cooling rate. J Mech Behav Biomed Mater 2020; 114:104191. [PMID: 33254008 DOI: 10.1016/j.jmbbm.2020.104191] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 10/26/2020] [Accepted: 10/27/2020] [Indexed: 10/23/2022]
Abstract
Traditional thermal tempering was applied to lithium disilicate (LD) glass-ceramic specimens with bar-like and disc-like shapes. The tempering process was conducted by heating the specimens to a temperature below the dynamic softening point, and then rapid cooling in silicone oil with different temperatures ranging from room-temperature to 300 °C to regulate the cooling rate. Effect of the oil-temperature on mechanical behavior of the tempered glass-ceramic was investigated. For the tempering at the lower oil-temperature (e.g., at room-temperature), it was found that the LD glass-ceramic specimens with both the bar-like and disc-like shapes could be remarkably strengthen and toughen, however, obvious anisotropy in fracture toughness was displayed by the specimens with the bar-like shape. With increasing the oil-temperature up to 250 °C, the mechanical anisotropy of the bar-like specimens could be significantly alleviated without much loss of the strengthening effect. The results can provide references for improving reliability of mechanical behavior for the tempered LD glass-ceramic by regulating the cooling condition according to specimen geometry.
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Affiliation(s)
- D Li
- School of Science, Xi'an University of Posts and Telecommunications, Xi'an, 710121, China
| | - Z X Chen
- State Key Laboratory for Manufacturing Systems Engineering, Xi'an Jiaotong University, Xi'an, 710049, China
| | - Y M Zhang
- School of Science, Xi'an University of Posts and Telecommunications, Xi'an, 710121, China
| | - X C Li
- State Key Laboratory for Mechanical Behavior of Materials, Xi'an Jiaotong University, Xi'an, 710049, China
| | - M Meng
- State Key Laboratory of Military Stomatology, Department of Prosthodontics, School of Stomatology, Fourth Military Medical University, Xi'an, 710032, China
| | - L He
- State Key Laboratory for Mechanical Behavior of Materials, Xi'an Jiaotong University, Xi'an, 710049, China.
| | - Z Z Zhang
- State Key Laboratory of Military Stomatology, Department of Prosthodontics, School of Stomatology, Fourth Military Medical University, Xi'an, 710032, China.
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Li XC, Zhou YB, Si KY, Li HT, Zhang L, Zhang YL, Liu JF, Liu JM. [Relationship of plasma vitamin A levels between neonates and pregnant women in third trimester]. Beijing Da Xue Xue Bao Yi Xue Ban 2020; 52:464-469. [PMID: 32541979 DOI: 10.19723/j.issn.1671-167x.2020.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To study the correlation of plasma vitamin A (VitA) levels between neonates and pregnant women in third trimester. METHODS A total of 688 pregnant women were recruited in Yuanshi and Laoting counties of Hebei Province, from May to June 2009. Venous blood samples of women before delivery and cord blood samples of newborns were collected and measured for retinol (retinol concentration was used to reflect VitA level) using high performance liquid chromatography assay. According to venous blood plasma retinol concentration, maternal VitA nutritional status was divided into deficiency (<0.70 μmol/L), marginal deficiency (0.70-<1.05 μmol/L), and sufficiency (≥1.05 μmol/L). According to cord blood plasma retinol concentration, neonatal VitA nutritional status was divided into deficiency (<0.35 μmol/L), marginal deficiency (0.35-<0.70 μmol/L), and sufficiency (≥0.70 μmol/L); neonatal VitA relative deficiency was further defined as cord blood plasma retinol concentration lower than the 10th percentile. VitA placental transport ratio was defined as retinol concentration in the neonates divided by that in pregnant women. Multivariable fractional polynomials (MFP) model and Pearson correlation were used to study the dose-response relationship between maternal and neonatal plasma VitA levels, Logistic regression model to estimate the effect of maternal VitA nutritional status on neonatal VitA deficiency, and MFP model and Spearman correlation to describe the relationship between maternal VitA level and VitA placental transport ratio. RESULTS The average retinol concentration of the pregnant women was (1.15±0.30) μmol/L, and the prevalence of VitA deficiency and marginal deficiency were 4.5% and 37.8%, respectively. Average retinol concentration of the neonates was (0.78±0.13) μmol/L, and no neonates were VitA deficiency, 28.2% of the neonates were marginal deficiency. After multivariable adjustment, the VitA level of the neonates was positively and linearly related to maternal VitA level (pm=1, P<0.05), with the corresponding Pearson correlation coefficient of 0.13 (P<0.01). As compared with the women with sufficient VitA, those with VitA deficiency (crude OR=2.20, 95%CI:1.04-4.66) and marginal deficiency (crude OR=1.43, 95%CI:1.01-2.02) had higher risks to deliver neonates with VitA marginal deficiency; while the risks turned to be non-significant after multivariable adjustment. The pregnant women with VitA deficiency had higher risk to deliver neonates with relative VitA deficiency before and after multivariable adjustment (crude OR=3.02, 95%CI:1.21-7.50; adjusted OR=2.76, 95%CI:1.05-7.22). The maternal VitA level was negatively and non-linearly correlated with placental transport ratio (pm= -0.5, P<0.05), with corresponding adjusted Spearman correlation coefficient of -0.82 (P<0.001). CONCLUSION There was a positive linear dose-response relationship between VitA levels of newborns and pregnant women in third trimester, indicating that neonatal VitA storing levels at birth was affected by maternal VitA nutritional status.
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Affiliation(s)
- X C Li
- Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China.,Institute of Reproductive and Child Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing 100191, China
| | - Y B Zhou
- Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China.,Institute of Reproductive and Child Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing 100191, China
| | - K Y Si
- Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China.,Institute of Reproductive and Child Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing 100191, China
| | - H T Li
- Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China.,Institute of Reproductive and Child Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing 100191, China
| | - L Zhang
- Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China.,Institute of Reproductive and Child Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing 100191, China
| | - Y L Zhang
- Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China.,Institute of Reproductive and Child Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing 100191, China
| | - J F Liu
- Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China.,Institute of Reproductive and Child Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing 100191, China
| | - J M Liu
- Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China.,Institute of Reproductive and Child Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing 100191, China
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Xu LX, He MH, Dai ZH, Yu J, Wang JG, Li XC, Jiang BB, Ke ZF, Su TH, Peng ZW, Guo Y, Chen ZB, Chen SL, Peng S, Kuang M. Genomic and transcriptional heterogeneity of multifocal hepatocellular carcinoma. Ann Oncol 2020; 30:990-997. [PMID: 30916311 DOI: 10.1093/annonc/mdz103] [Citation(s) in RCA: 75] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Hepatocellular carcinoma (HCC) often presents with multiple nodules within the liver, with limited effective interventions. The high genetic heterogeneity of HCC might be the major cause of treatment failure. We aimed to characterize genomic heterogeneity, infer clonal evolution, investigate RNA expression pattern and explore tumour immune microenvironment profile of multifocal HCC. PATIENTS AND METHODS Whole-exome sequencing and RNA sequencing were carried out in 34 tumours and 6 adjacent normal liver tissue samples from 6 multifocal HCC patients. Protein expression of Ki67, AFP, P53, Survivin and CD8 was detected by immunohistochemistry. Fluorescence in situ hybridization was carried out to validate the amplification status of sorafenib-targeted genes. RESULTS We deciphered genomic and transcriptional heterogeneity among tumours in each multifocal HCC patient including mutational profiles, copy number alterations, tumour evolutionary trajectory and tumour immune microenvironment profiles. Of note, sorafenib-targeted alterations were identified in the trunk of phylogenetic tree in only one out of the six patients, which may explain the relative low treatment response rate to sorafenib in clinical practice. Moreover, we demonstrated RNA expression patterns and tumour immune microenvironment profiles of all nodules. We found that RNA expression pattern was associated with Edmondson-Steiner grading. Based on the differential expression of 66 reported immune markers, unsupervised hierarchical clustering analysis of 34 nodules identified immune subsets: one low expression cluster with seven nodules and one high expression cluster with 11 nodules. CD8+ T cells were more enriched in nodules of the high expression cluster. CONCLUSIONS Our study provided a detailed view of genomic and transcriptional heterogeneity, clonal evolution and immune infiltration of multifocal HCC. The heterogeneity of druggable targets and immune landscape might help interpret the clinical responsiveness to targeted drugs and immunotherapy for multifocal HCC patients.
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Affiliation(s)
- L X Xu
- Departments of Gastroenterology and Hepatology
| | - M H He
- Liver Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Z H Dai
- Liver Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - J Yu
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong
| | - J G Wang
- State Key Laboratory of Molecular Neuroscience, Division of Life Science, Department of Chemical and Biological Engineering, Center of Systems Biology and Human Health, The Hong Kong University of Science and Technology, Hong Kong
| | - X C Li
- Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin Cancer Institute, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University, Tianjin
| | - B B Jiang
- State Key Laboratory of Molecular Neuroscience, Division of Life Science, Department of Chemical and Biological Engineering, Center of Systems Biology and Human Health, The Hong Kong University of Science and Technology, Hong Kong
| | | | - T H Su
- Liver Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | | | - Y Guo
- Liver Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Z B Chen
- Liver Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - S L Chen
- Division of Interventional Ultrasound
| | - S Peng
- Departments of Gastroenterology and Hepatology; Clinical Trials Unit, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.
| | - M Kuang
- Liver Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China; Division of Interventional Ultrasound.
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Chen JH, Lu L, Wen TF, Huang ZY, Zhang T, Zeng YY, Li XC, Xiang BD, Lu CD, Xu X, Qin LX. Adjuvant lenvatinib in combination with TACE for hepatocellular carcinoma patients with high risk of postoperative relapse (LANCE): Interim results from a muticenter prospective cohort study. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.4580] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
4580 Background: Surgical resection was the main treatment for hepatocellular carcinoma (HCC) in China. Multiple clinical studies had demonstrated that the overall survival (OS) of the surgical resection group was significantly better than the transcatheter arterial chemoembolization (TACE) or radiotherapy group even for HCC patients with BCLC stage B or C. There was no standard adjuvant therapy for HCC patients to decrease the post-operative tumor relapse. For HCC patients with high recurrence risk, TACE significantly reduced tumor recurrence, prolonged the disease free survival (DFS) and OS, and was recommended as the adjuvant therapy. However, its effect is not very satisfactory. The purpose of this study was to assess the efficacy and safety of lenvatinib in combination with TACE versus TACE alone as adjuvant therapy in HCC patients with high recurrence risk after resection. Methods: This is a muti-center prospective cohort study. The criteria of HCC patients with high postoperative recurrence risk included: accompanied with gross vascular or bile duct invasion (tumor thrombi in portal vein, hepatic vein or bile duct); or tumor rupture or invasion of adjacent organs; or grade 2 of microvascular invasion (MVI) (M2) along with the tumor number more than 3 or the maximum diameter of tumor larger than 8cm or tumor showed invasive growth with unclear boundaries and imcomplete capsules. The patients were divided into two groups, the lenvatinb (8mg qd for weights < 60kg and 12mg qd for weights≥60kg) in combination with TACE (Len+TACE) group and the TACE group. Results: A total of 90 patients were enrolled into the study, while 45 patients in the Len+TACE group and 45 in TACE group. The media age was 52 years (range from 23 to 73 years). Most patients were males (82.2%) and 66 patients had HBV background (73.3%). There were no significant differences between the two groups in the baseline clinicopathological characteristics including gender, age, HBV background, liver cirrhosis, liver function, tumor characteristic and AFP level. The media DFS was 12.0 months (95% CI 8.0-NA) in the Len+ TACE group, which was longer than that of TACE group (8.0 months, 95% CI 6.0-12.0, P = 0.0359; HR 0.5, 95% CI 0.3-1.0). The most common grade 3 or 4 adverse events were hypertension (11.1%) and diarrhea (7.7%) in the Len+TACE group. Conclusions: Lenvatinib in combination with TACE was effective and safe as adjuvant therapy, which can prolong the DFS of HCC patients with high recurrence risk after resection. Clinical trial information: NCT03838796 .
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Affiliation(s)
- Jin-hong Chen
- Department of General Surgery, Huashan Hospital, Cancer Metastasis Institute, Fudan University, Shanghai, China
| | - Lu Lu
- Department of General Surgery, Huashan Hospital, Cancer Metastasis Institute, Fudan University, Shanghai, China
| | - Tian-Fu Wen
- Department of Liver Surgery, Huaxi Hospital, Sichuan University, Sichuan, China
| | - Zhi-Yong Huang
- Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ti Zhang
- Department of Hapato-biliary Surgery, Tianjin Cancer Hospital, Tianjin, China
| | - Yong-Yi Zeng
- Department of Hepatobiliary Surgery, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, China
| | - Xiang-Cheng Li
- Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, China
| | - Bang-De Xiang
- Department of Hepato-Pancreato-Biliary Surgery, cancer Hospital of Guangxi Medical University, Nanning, China
| | - Cai-de Lu
- Department of Hepato-Pancreato-Biliary Surgery, Ningbo Medical Center LiHuiLi Hospital, Ningbo University, Ningbo, China
| | - Xiao Xu
- Department of Hepato-Pancreato-Biliary Surgery, The First Affiliated Hospital of Zhejiang University, Hangzhou, China
| | - Lun-xiu Qin
- Department of General Surgery, Huashan Hospital, Cancer Metastasis Institute, Fudan University, Shanghai, China
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24
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Wu MY, Qiao Q, Wang K, Ji GW, Cai B, Li XC. Development and Validation of Pre- and Post-Operative Models to Predict Recurrence After Resection of Solitary Hepatocellular Carcinoma: A Multi-Institutional Study. Cancer Manag Res 2020; 12:3503-3512. [PMID: 32523380 PMCID: PMC7237125 DOI: 10.2147/cmar.s251413] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 04/19/2020] [Indexed: 01/27/2023] Open
Abstract
Background The ideal candidates for resection are patients with solitary hepatocellular carcinoma (HCC); however, postoperative recurrence rate remains high. We aimed to establish prognostic models to predict HCC recurrence based on readily accessible clinical parameters and multi-institutional databases. Patients and Methods A total of 485 patients undergoing curative resection for solitary HCC were recruited from two independent institutions and the Cancer Imaging Archive database. We randomly divided the patients into training (n=323) and validation cohorts (n=162). Two models were developed: one using pre-operative and one using pre- and post-operative parameters. Performance of the models was compared with staging systems. Results Using multivariable analysis, albumin-bilirubin grade, serum alpha-fetoprotein and tumor size were selected into the pre-operative model; albumin-bilirubin grade, serum alpha-fetoprotein, tumor size, microvascular invasion and cirrhosis were selected into the postoperative model. The two models exhibited better discriminative ability (concordance index: 0.673–0.728) and lower prediction error (integrated Brier score: 0.169–0.188) than currently used staging systems for predicting recurrence in both cohorts. Both models stratified patients into low- and high-risk subgroups of recurrence with distinct recurrence patterns. Conclusion The two models with corresponding user-friendly calculators are useful tools to predict recurrence before and after resection that may facilitate individualized management of solitary HCC.
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Affiliation(s)
- Ming-Yu Wu
- Department of Hepatobiliary Surgery, Wuxi People's Hospital, Wuxi, People's Republic of China
| | - Qian Qiao
- Department of Hepatobiliary Surgery, Wuxi People's Hospital, Wuxi, People's Republic of China
| | - Ke Wang
- Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China.,Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, People's Republic of China.,NHC Key Laboratory of Living Donor Liver Transplantation (Nanjing Medical University), Nanjing, People's Republic of China
| | - Gu-Wei Ji
- Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China.,Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, People's Republic of China.,NHC Key Laboratory of Living Donor Liver Transplantation (Nanjing Medical University), Nanjing, People's Republic of China
| | - Bing Cai
- Department of Hepatobiliary Surgery, Wuxi People's Hospital, Wuxi, People's Republic of China
| | - Xiang-Cheng Li
- Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China.,Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, People's Republic of China.,NHC Key Laboratory of Living Donor Liver Transplantation (Nanjing Medical University), Nanjing, People's Republic of China
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25
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Xia SJ, Chen HR, Li Z, Li XC, Zhi EL, Tian RH, Li P, Huang YH, Hu JL, Qiu Y. [Efficacy and safety of low-intensity pulsed ultrasound at different intervals by mechanical force in treating erectile dysfunction: a preliminary study]. Zhonghua Yi Xue Za Zhi 2020; 100:1432-1436. [PMID: 32392996 DOI: 10.3760/cma.j.cn112137-20191207-02679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To study the efficacy and safety of low-intensity pulsed ultrasound (LIPUS) at different intervals by mechanical force in treating erectile dysfunction (ED). Method: Forty patients with mild to moderate ED were randomized in a 1∶1 ratio to receive 16-treatment sessions of LIPUS in group A and group B, applied 3 times per week and 2 times per week, respectively. End-point assessments were made at 8th week after treatment. Efficacy were evaluated using International Index of Erectile Function-Erectile Function domain score (IIEF-EF), Erectile Hardness Score (EHS), Self-Esteem and Relationship Questionnaire (SEAR), Sexual Encounter Profile (SEP), Global Assessment Question (GAQ), and pain were assessed by Visual Analogue Score (VAS).Treatment response was confirmed by a minimal clinically importance difference (MCID) at 8th week. Results: Compared with baseline, IIEF-EF score [(17.1±5.48 vs 23.4±3.75, P<0.05) and (18.9±4.34 vs 24.1±4.32, P<0.05)], proportion of EHS 4 [(0 vs 40%, P<0.05) and (16.7% vs 55.6%, P<0.05)], and Overall Relationship score [(50.6 vs 67.5, P<0.05) and (44.4 vs 70.1, P<0.05)] were significantly improved at 8th week in two groups, respectively. Compared with baseline, the positive responses to SEP-3 increased significantly at 8th week in two groups (50.0% vs 80.0%,P<0.05) and (44.4% vs 88.9%, P<0.05), respectively. The positive responses to GAQ-2 were 90.0% and 88.9% at 8th week in two groups, respectively. There were no significant differences in IIEF-EF, EHS, SEAR, SEP and GAQ at 8th week between two groups. There was no significant difference in treatment response using MCID between two groups at end-point (80.5% vs 77.5%). The treatment duration for full sessions were 2.5 weeks less in group A than group B. No adverse effects were reported in all cases. Conclusion: LIPUS at two different intervals is effective and safe for mild to moderate ED, and the regimen at 3 times per week can achieve quite good effect in relatively short duration,while the long-term effects is still be clarified in further study.
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Affiliation(s)
- S J Xia
- Urologic Medical Center, Institute of Urology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai 200080, China
| | - H R Chen
- Urologic Medical Center, Institute of Urology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai 200080, China
| | - Z Li
- Urologic Medical Center, Institute of Urology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai 200080, China
| | - X C Li
- Clinical Research Center, Shanghai General Hospital, Shanghai 200080, China
| | - E L Zhi
- Urologic Medical Center, Institute of Urology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai 200080, China
| | - R H Tian
- Urologic Medical Center, Institute of Urology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai 200080, China
| | - P Li
- Urologic Medical Center, Institute of Urology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai 200080, China
| | - Y H Huang
- Urologic Medical Center, Institute of Urology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai 200080, China
| | - J L Hu
- Urologic Medical Center, Institute of Urology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai 200080, China
| | - Y Qiu
- Clinical Research Center, Shanghai General Hospital, Shanghai 200080, China
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26
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Zheng MH, Ye CL, Li XC, Wang LJ, Shen YJ, Xu DL. [Screening and bioinformatic analysis of trehalase in Thelazia callipaeda]. Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi 2020; 32:60-68. [PMID: 32185929 DOI: 10.16250/j.32.1374.2019133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To characterize the trehalase gene in Thelazia callipaeda through screening the annotated data of the T. callipaeda genome, and to investigate the biological characteristics of the trehalase gene-coding protein. METHODS The trehalase gene was screened from the T. callipaeda genome and subjected to validation by using a PCR assay. The structural features of the coding protein were analyzed with bioinformatics tools, including hydrophobicity, transmembrane region, signal peptides, conserved domains, as well as the secondary and tertiary structures and the antigen epitope. Homology analysis of the amino acid sequences was performed, and the phylogenetic tree was built by the MEGA X software. In addition, the protein-protein interaction network was deduced from the STRING database. RESULTS The sequence of the trehalase gene with the complete CDS region was obtained from T. callipaeda genome, which had a length of 1 638 bp and encoded 545 amino acids. The encoded protein was predicted to have a molecular weight of 63 478.48 ku and be a secretory protein. The 5' domain of the encoded protein contained a signal peptide without transmembrane regions, and was predicted to contain 7 antigen epitopes. Based on the protein-protein interaction network of nematodes in the STRING database, the protein-protein interaction network of the trehalase gene of T. callipaeda was deduced, and 27 interactions covering 10 genes were identified. CONCLUSIONS A trehalase gene is successfully identified in T. callipaeda genome and its coding protein receives a bioinformatics analysis, which provides insights into the research on the biological functions of the protein and the screening of vaccine candidates for thelaziasis callipaeda.
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Affiliation(s)
- M H Zheng
- Zunyi Medical University, Zunyi 563003, China.,Key Laboratory of Gene Diagnosis and Therapy of Education Office of Guizhou Province, China.,Chinese Center for Disease Control and Prevention, China
| | - C L Ye
- Xinpu District Sub-bureau of Public Security, Zunyi Municipal Bureau of Public Security, Guizhou Province, China
| | - X C Li
- Zunyi Medical University, Zunyi 563003, China
| | - L J Wang
- Zunyi Medical University, Zunyi 563003, China.,Key Laboratory of Gene Diagnosis and Therapy of Education Office of Guizhou Province, China
| | - Y J Shen
- Chinese Center for Disease Control and Prevention, China
| | - D L Xu
- Zunyi Medical University, Zunyi 563003, China
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27
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Ji GW, Zhu FP, Xu Q, Wang K, Wu MY, Tang WW, Li XC, Wang XH. Radiomic Features at Contrast-enhanced CT Predict Recurrence in Early Stage Hepatocellular Carcinoma: A Multi-Institutional Study. Radiology 2020; 294:568-579. [PMID: 31934830 DOI: 10.1148/radiol.2020191470] [Citation(s) in RCA: 146] [Impact Index Per Article: 36.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background Early stage hepatocellular carcinoma (HCC) is the ideal candidate for resection in patients with preserved liver function; however, cancer will recur in half of these patients and no reliable prognostic tool has been established. Purpose To investigate the effectiveness of radiomic features in predicting tumor recurrence after resection of early stage HCC. Materials and Methods In total, 295 patients (median age, 58 years; interquartile range, 50-65 years; 221 men) who underwent contrast material-enhanced CT and curative resection for early stage HCC that met the Milan criteria between February 2009 and December 2016 were retrospectively recruited from three independent institutions. Follow-up consisted of serum α-fetoprotein level, liver function tests, and dynamic imaging examinations every 3 months during the first 2 years and then every 6 months thereafter. In the development cohort of 177 patients from institution 1, recurrence-related radiomic features were computationally extracted from the tumor and its periphery and a radiomics signature was built with least absolute shrinkage and selection operator regression. Two models, one integrating preoperative and one integrating pre- and postoperative variables, were created by using multivariable Cox regression analysis. An independent external cohort of 118 patients from institutions 2 and 3 was used to validate the proposed models. Results The preoperative model integrated radiomics signature with serum α-fetoprotein level and tumor number; the postoperative model incorporated microvascular invasion and satellite nodules into the above-mentioned predictors. In both study cohorts, two radiomics-based models provided better predictive performance (concordance index ≥0.77, P < .05 for all), lower prediction error (integrated Brier score ≤0.14), and larger net benefits, as determined by means of decision curve analysis, than rival models without radiomics and widely adopted staging systems. The radiomics-based models gave three risk strata with high, intermediate, or low risk of recurrence and distinct profiles of recurrent tumor number. Conclusion The proposed radiomics models with pre- and postresection features helped predict tumor recurrence for early stage hepatocellular carcinoma. © RSNA, 2020 Online supplemental material is available for this article.
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Affiliation(s)
- Gu-Wei Ji
- From the Hepatobiliary Center (G.W.J., K.W., X.C.L., X.H.W.) and Department of Radiology (F.P.Z., Q.X.), The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, P.R. China; Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, P.R. China (G.W.J., K.W., X.C.L., X.H.W.); NHC Key Laboratory of Living Donor Liver Transplantation, Nanjing Medical University, Nanjing, P.R. China (G.W.J., K.W., X.C.L., X.H.W.); Department of Hepatobiliary Surgery, Wuxi People's Hospital, Wuxi, P.R. China (M.Y.W.); and Department of General Surgery, Nanjing First Hospital, Nanjing, P.R. China (W.W.T.)
| | - Fei-Peng Zhu
- From the Hepatobiliary Center (G.W.J., K.W., X.C.L., X.H.W.) and Department of Radiology (F.P.Z., Q.X.), The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, P.R. China; Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, P.R. China (G.W.J., K.W., X.C.L., X.H.W.); NHC Key Laboratory of Living Donor Liver Transplantation, Nanjing Medical University, Nanjing, P.R. China (G.W.J., K.W., X.C.L., X.H.W.); Department of Hepatobiliary Surgery, Wuxi People's Hospital, Wuxi, P.R. China (M.Y.W.); and Department of General Surgery, Nanjing First Hospital, Nanjing, P.R. China (W.W.T.)
| | - Qing Xu
- From the Hepatobiliary Center (G.W.J., K.W., X.C.L., X.H.W.) and Department of Radiology (F.P.Z., Q.X.), The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, P.R. China; Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, P.R. China (G.W.J., K.W., X.C.L., X.H.W.); NHC Key Laboratory of Living Donor Liver Transplantation, Nanjing Medical University, Nanjing, P.R. China (G.W.J., K.W., X.C.L., X.H.W.); Department of Hepatobiliary Surgery, Wuxi People's Hospital, Wuxi, P.R. China (M.Y.W.); and Department of General Surgery, Nanjing First Hospital, Nanjing, P.R. China (W.W.T.)
| | - Ke Wang
- From the Hepatobiliary Center (G.W.J., K.W., X.C.L., X.H.W.) and Department of Radiology (F.P.Z., Q.X.), The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, P.R. China; Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, P.R. China (G.W.J., K.W., X.C.L., X.H.W.); NHC Key Laboratory of Living Donor Liver Transplantation, Nanjing Medical University, Nanjing, P.R. China (G.W.J., K.W., X.C.L., X.H.W.); Department of Hepatobiliary Surgery, Wuxi People's Hospital, Wuxi, P.R. China (M.Y.W.); and Department of General Surgery, Nanjing First Hospital, Nanjing, P.R. China (W.W.T.)
| | - Ming-Yu Wu
- From the Hepatobiliary Center (G.W.J., K.W., X.C.L., X.H.W.) and Department of Radiology (F.P.Z., Q.X.), The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, P.R. China; Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, P.R. China (G.W.J., K.W., X.C.L., X.H.W.); NHC Key Laboratory of Living Donor Liver Transplantation, Nanjing Medical University, Nanjing, P.R. China (G.W.J., K.W., X.C.L., X.H.W.); Department of Hepatobiliary Surgery, Wuxi People's Hospital, Wuxi, P.R. China (M.Y.W.); and Department of General Surgery, Nanjing First Hospital, Nanjing, P.R. China (W.W.T.)
| | - Wei-Wei Tang
- From the Hepatobiliary Center (G.W.J., K.W., X.C.L., X.H.W.) and Department of Radiology (F.P.Z., Q.X.), The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, P.R. China; Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, P.R. China (G.W.J., K.W., X.C.L., X.H.W.); NHC Key Laboratory of Living Donor Liver Transplantation, Nanjing Medical University, Nanjing, P.R. China (G.W.J., K.W., X.C.L., X.H.W.); Department of Hepatobiliary Surgery, Wuxi People's Hospital, Wuxi, P.R. China (M.Y.W.); and Department of General Surgery, Nanjing First Hospital, Nanjing, P.R. China (W.W.T.)
| | - Xiang-Cheng Li
- From the Hepatobiliary Center (G.W.J., K.W., X.C.L., X.H.W.) and Department of Radiology (F.P.Z., Q.X.), The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, P.R. China; Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, P.R. China (G.W.J., K.W., X.C.L., X.H.W.); NHC Key Laboratory of Living Donor Liver Transplantation, Nanjing Medical University, Nanjing, P.R. China (G.W.J., K.W., X.C.L., X.H.W.); Department of Hepatobiliary Surgery, Wuxi People's Hospital, Wuxi, P.R. China (M.Y.W.); and Department of General Surgery, Nanjing First Hospital, Nanjing, P.R. China (W.W.T.)
| | - Xue-Hao Wang
- From the Hepatobiliary Center (G.W.J., K.W., X.C.L., X.H.W.) and Department of Radiology (F.P.Z., Q.X.), The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, P.R. China; Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, P.R. China (G.W.J., K.W., X.C.L., X.H.W.); NHC Key Laboratory of Living Donor Liver Transplantation, Nanjing Medical University, Nanjing, P.R. China (G.W.J., K.W., X.C.L., X.H.W.); Department of Hepatobiliary Surgery, Wuxi People's Hospital, Wuxi, P.R. China (M.Y.W.); and Department of General Surgery, Nanjing First Hospital, Nanjing, P.R. China (W.W.T.)
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Li XC, Wang MY, Yang M, Dai HJ, Zhang BF, Wang W, Chu XL, Wang X, Zheng H, Niu RF, Zhang W, Chen KX. A mutational signature associated with alcohol consumption and prognostically significantly mutated driver genes in esophageal squamous cell carcinoma. Ann Oncol 2019; 29:938-944. [PMID: 29351612 DOI: 10.1093/annonc/mdy011] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background Esophageal squamous cell carcinoma (ESCC) is often diagnosed at an advanced and incurable stage. Information on driver genes and prognosticators in ESCC remains incomplete. The objective was to elucidate significantly mutated genes (SMGs), mutational signatures, and prognosticators in ESCC. Patients and methods Three MutSig algorithms (i.e. MutSigCV, MutSigCL and MutSigFN) and '20/20+' ratio-metric were employed to identify SMGs. Nonnegative matrix factorization was used to decipher mutational signatures. Kaplan-Meier survival analysis, multivariate Cox and logistic regression models were applied to analyze association between mutational features and clinical parameters. Results We identified 26 SMGs, including 8 novel (NAV3, TENM3, PTCH1, TGFBR2, RIPK4, PBRM1, USP8 and BAP1) and 18 that have been previously reported. Three mutational signatures were identified to be prevalent in ESCC including clocklike C>T at CpG, APOBEC overactive C>T at TpCp[A/T], and a signature featured by T>C substitution. The T>C mutational signature was significantly correlated with alcohol consumption (OR: 3.59; 95% CI: 2.30-5.67; P < 0.001). This alcohol consumption signature was also observed in liver cancer and head and neck squamous cell carcinoma, and its mutational activity was substantially higher in samples with mutations in TP53. Survival analysis revealed that TENM3 mutations (HR: 5.54; CI: 2.68-11.45; P < 0.001) and TP53 hotspot mutation p.R213* (HR: 3.37; CI: 1.73-8.06; P < 0.001) were significantly associated with shortened survival outcome. The association remained statistically significant after controlling for age, gender, TNM stage and tumor grade. Conclusions We have uncovered several new SMGs in ESCC and defined an alcohol consumption related mutational signature. TENM3 mutations and the TP53 hotspot mutation p.R213* are independent prognosticators for poor survival in ESCC.
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Affiliation(s)
- X C Li
- Public Laborato, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - M Y Wang
- Beijing Genomics Institute-Shenzhen, Shenzhen, Guangdong, China
| | - M Yang
- Department of Epidemiology and Biostatisti, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China; Wake Forest Baptist Comprehensive Cancer Center, Wake Forest Baptist Medical Center, Winston-Salem, USA; Department of Cancer Biology, Wake Forest School of Medicine, Winston-Salem, USA
| | - H J Dai
- Department of Epidemiology and Biostatisti, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - B F Zhang
- Beijing Genomics Institute-Shenzhen, Shenzhen, Guangdong, China
| | - W Wang
- Department of Epidemiology and Biostatisti, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - X L Chu
- Department of Epidemiology and Biostatisti, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - X Wang
- Department of Epidemiology and Biostatisti, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - H Zheng
- Department of Epidemiology and Biostatisti, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - R F Niu
- Public Laborato, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - W Zhang
- Wake Forest Baptist Comprehensive Cancer Center, Wake Forest Baptist Medical Center, Winston-Salem, USA; Department of Cancer Biology, Wake Forest School of Medicine, Winston-Salem, USA.
| | - K X Chen
- Department of Epidemiology and Biostatisti, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.
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Ji GW, Zhu FP, Xu Q, Wang K, Wu MY, Tang WW, Li XC, Wang XH. Machine-learning analysis of contrast-enhanced CT radiomics predicts recurrence of hepatocellular carcinoma after resection: A multi-institutional study. EBioMedicine 2019; 50:156-165. [PMID: 31735556 PMCID: PMC6923482 DOI: 10.1016/j.ebiom.2019.10.057] [Citation(s) in RCA: 107] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 10/23/2019] [Accepted: 10/31/2019] [Indexed: 02/07/2023] Open
Abstract
Background Current guidelines recommend surgical resection as the first-line option for patients with solitary hepatocellular carcinoma (HCC); unfortunately, postoperative recurrence rate remains high and there is no reliable prediction tool. We explored the potential of radiomics coupled with machine-learning algorithms to improve the predictive accuracy for HCC recurrence. Methods A total of 470 patients who underwent contrast-enhanced CT and curative resection for solitary HCC were recruited from 3 independent institutions. In the training phase of 210 patients from Institution 1, a radiomics-derived signature was generated based on 3384 engineered features extracted from primary tumor and its periphery using aggregated machine-learning framework. We employed Cox modeling to build predictive models. The models were then validated using an internal dataset of 107 patients and an external dataset of 153 patients from Institution 2 and 3. Findings Using the machine-learning framework, we identified a three-feature signature that demonstrated favorable prediction of HCC recurrence across all datasets, with C-index of 0.633–0.699. Serum alpha-fetoprotein, albumin-bilirubin grade, liver cirrhosis, tumor margin, and radiomics signature were selected for preoperative model; postoperative model incorporated satellite nodules into above-mentioned predictors. The two models showed superior prognostic performance, with C-index of 0.733–0.801 and integrated Brier score of 0.147–0.165, compared with rival models without radiomics and widely used staging systems (all P < 0.05); they also gave three risk strata for recurrence with distinct recurrence patterns. Interpretation When integrated with clinical data sources, our three-feature radiomics signature promises to accurately predict individual recurrence risk that may facilitate personalized HCC management. We identified a three-feature fusion signature using machine-learning framework. The signature coupled with clinical sources accurately predicted HCC recurrence. This signature may serve as an early detector of aggressive disease. We highlight the complementary nature of radiomics and existing variables.
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Affiliation(s)
- Gu-Wei Ji
- Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China; Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, PR China; NHC Key Laboratory of Living Donor Liver Transplantation (Nanjing Medical University), Nanjing, PR China.
| | - Fei-Peng Zhu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Qing Xu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China.
| | - Ke Wang
- Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China; Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, PR China; NHC Key Laboratory of Living Donor Liver Transplantation (Nanjing Medical University), Nanjing, PR China
| | - Ming-Yu Wu
- Department of Hepatobiliary Surgery, Wuxi People's Hospital, Wuxi, PR China
| | - Wei-Wei Tang
- Department of General Surgery, Nanjing First Hospital, Nanjing, PR China
| | - Xiang-Cheng Li
- Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China; Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, PR China; NHC Key Laboratory of Living Donor Liver Transplantation (Nanjing Medical University), Nanjing, PR China.
| | - Xue-Hao Wang
- Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China; Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, PR China; NHC Key Laboratory of Living Donor Liver Transplantation (Nanjing Medical University), Nanjing, PR China.
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Meng M, Li XC, Guo JW, Zhou M, Niu LN, Tay FR, He L, Zhang SF. Improving the wear performance of feldspathic veneering porcelain by ion-exchange strengthening. J Dent 2019; 90:103210. [PMID: 31600535 DOI: 10.1016/j.jdent.2019.103210] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Revised: 09/28/2019] [Accepted: 10/04/2019] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES The present study examined the effects of Na+→K+ ion-exchange on the wear performance of feldspathic veneering porcelain. METHODS Bar and disk specimens were prepared using IPS classic as the feldspathic veneering porcelain. After ion-exchange by immersion of the specimens in melted KNO3 at two temperatures for different time-periods, the bars were tested for flexural strength and Vickers surface hardness. The disks were paired with zirconia antagonists and tested with a pin-on-disk tribometer with 10 N for 70☓104 wear cycles in artificial saliva. Wear analysis of the porcelain and zirconia was performed using 3D profilometer and analysed with one-way analysis of variance and Tukey's post-hoc pairwise comparison procedures. Worn surfaces were examined with scanning electron microscopy. RESULTS The feldspathic veneering porcelain exhibited strong time-dependent wear behaviour, with typical running-in and steady wear stages. Ion-exchange treatments at 380 °C and 440 °C both enhanced the mechanical properties, decreased the wear rates of running-in wear and steady wear. The wear performance of porcelain treated by ion-exchange at lower temperature (380 °C) was improved significantly, especially reducing the wear rate of the running-in stage. CONCLUSION A thicker ion-exchange layer with less stress relaxation may be obtained by ion-exchange at lower exchange temperature for a long processing time. Such a protocol improves the wear performance of the porcelain effectively. CLINICAL SIGNIFICANCE Restorations with veneering porcelain may fail prematurely due to excessive wear. It important to improve the wear performance of the porcelain. Ion-exchange has the potential to strengthen dental veneering porcelain. Understanding the effect of ion-exchange on the wear performance of porcelain provides insight improving the wear performance of these restorations.
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Affiliation(s)
- M Meng
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, Fourth Military Medical University, Xi'an, 710032, China
| | - X C Li
- State Key Laboratory for Mechanical Behavior of Materials, Xi'an Jiaotong University, Xi'an, 710049, China
| | - J W Guo
- Department of Prosthodontics, Guanghua School of Stomatology & Hospital of Stomatology, Guangdong Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, 510055, China
| | - M Zhou
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, Fourth Military Medical University, Xi'an, 710032, China
| | - L N Niu
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, Fourth Military Medical University, Xi'an, 710032, China
| | - F R Tay
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, Fourth Military Medical University, Xi'an, 710032, China; The Dental College of Georgia, Augusta University, Augusta, GA, USA.
| | - L He
- State Key Laboratory for Mechanical Behavior of Materials, Xi'an Jiaotong University, Xi'an, 710049, China.
| | - S F Zhang
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, Fourth Military Medical University, Xi'an, 710032, China.
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Liu R, Zhu H, Yang JH, Gao ZA, Yuan XX, Li XC, Wang JY, Chang BC. [Can urine albumin/creatinine ratio replace 24 hours urinary albumin?]. Zhonghua Nei Ke Za Zhi 2019; 58:377-381. [PMID: 31060147 DOI: 10.3760/cma.j.issn.0578-1426.2019.05.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To analyze the correlation between urinary albumin/creatinine ratio (ACR) and 24-hour urinary microalbumin (UMA) and evaluate the predictive value of ARC for early diabetic nephropathy. Methods: A total of 368 patients with type 2 diabetes mellitus were retrospectively collected. Early diabetic nephropathy was defined as 24h UMA 30~<300 mg/24h. The correlation between ACR and 24hUMA, and the area under the receiver operating characteristic (ROC) curve of ACR in diagnosis of early diabetic nephropathy were calculated. Gender, age, course of disease, fasting venous blood glucose, glycosylated hemoglobin, blood pressure, triglyceride and total cholesterol were used as adjusting variables to establish univariate and multivariate logistic models of ACR for early diabetic nephropathy, respectively. A regression model was used to evaluate the diagnostic value of ACR for early diabetic nephropathy. Results: The correlation between ACR and 24h UMA was 0.658. The area under ROC curve of ACR for early diabetic nephropathy was 0.907 before and 0.933 after adjustments of gender, age, course of disease, fasting venous blood glucose, glycosylated hemoglobin, blood pressure, triglyceride and total cholesterol, respectively. The OR value of ACR of diabetic nephropathy was 2.016 before and 2.762 after same adjustments. The calibration of Hosmer-Lemeshow chi-square test evaluation model was 19.362 before (P=0.13) and 14.928 after adjustments (P=0.061). Conclusion: ACR is a better predictor for early diabetic nephropathy although its value is influenced by gender, age, course of disease, blood sugar, lipid, and blood pressure.
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Affiliation(s)
- R Liu
- NHC Key Laboratory of Hormones and Development (Tianjin Medical University), Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University Metabolic Diseases Hospital & Tianjin Institute of Endocrinology, Tianjin 300070, China
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Ji GW, Zhu FP, Zhang YD, Liu XS, Wu FY, Wang K, Xia YX, Zhang YD, Jiang WJ, Li XC, Wang XH. A radiomics approach to predict lymph node metastasis and clinical outcome of intrahepatic cholangiocarcinoma. Eur Radiol 2019; 29:3725-3735. [DOI: 10.1007/s00330-019-06142-7] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 02/19/2019] [Accepted: 03/08/2019] [Indexed: 12/18/2022]
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Ji GW, Zhang YD, Zhang H, Zhu FP, Wang K, Xia YX, Zhang YD, Jiang WJ, Li XC, Wang XH. Biliary Tract Cancer at CT: A Radiomics-based Model to Predict Lymph Node Metastasis and Survival Outcomes. Radiology 2018; 290:90-98. [PMID: 30325283 DOI: 10.1148/radiol.2018181408] [Citation(s) in RCA: 139] [Impact Index Per Article: 23.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Purpose To evaluate a radiomics model for predicting lymph node (LN) metastasis in biliary tract cancers (BTCs) and to determine its prognostic value for disease-specific and recurrence-free survival. Materials and Methods For this retrospective study, a radiomics model was developed on the basis of a primary cohort of 177 patients with BTC who underwent resection and LN dissection between June 2010 and December 2016. Radiomic features were extracted from portal venous CT scans. A radiomics signature was built on the basis of reproducible features by using the least absolute shrinkage and selection operator method. Multivariable logistic regression model was adopted to establish a radiomics nomogram. Nomogram performance was determined by its discrimination, calibration, and clinical usefulness. The model was internally validated in 70 consecutive patients with BTC between January 2017 and February 2018. Results The radiomics signature, composed of three LN-status-related features, was associated with LN metastasis in primary and validation cohorts (P < .001). The radiomics nomogram that incorporated radiomics signature and CT-reported LN status showed good calibration and discrimination in primary cohort (area under the curve, 0.81) and validation cohort (area under the curve, 0.80). Patients at high risk of LN metastasis portended lower disease-specific and recurrence-free survival than did those at low risk after surgery (both P < .001). High-risk LN metastasis was an independent preoperative predictor of disease-specific survival (hazard ratio, 3.37; P < .001) and recurrence-free survival (hazard ratio, 1.98; P = .003). Conclusion A radiomics model derived from portal phase CT of the liver has good performance for predicting lymph node metastasis in biliary tract cancer and may help to improve clinical decision making. © RSNA, 2018 Online supplemental material is available for this article. See also the editorial by Laghi and Voena in this issue.
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Affiliation(s)
- Gu-Wei Ji
- From the Hepatobiliary Center (G.W.J., H.Z., K.W., Y.X.X., Yao-Dong Zhang, W.J.J., X.C.L., X.H.W.) and Department of Radiology (Yu-Dong Zhang, F.P.Z.), The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, P.R. China; and Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, P.R. China (G.W.J., H.Z., K.W., Y.X.X., Yao-Dong Zhang, W.J.J., X.C.L., X.H.W.)
| | - Yu-Dong Zhang
- From the Hepatobiliary Center (G.W.J., H.Z., K.W., Y.X.X., Yao-Dong Zhang, W.J.J., X.C.L., X.H.W.) and Department of Radiology (Yu-Dong Zhang, F.P.Z.), The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, P.R. China; and Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, P.R. China (G.W.J., H.Z., K.W., Y.X.X., Yao-Dong Zhang, W.J.J., X.C.L., X.H.W.)
| | - Hui Zhang
- From the Hepatobiliary Center (G.W.J., H.Z., K.W., Y.X.X., Yao-Dong Zhang, W.J.J., X.C.L., X.H.W.) and Department of Radiology (Yu-Dong Zhang, F.P.Z.), The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, P.R. China; and Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, P.R. China (G.W.J., H.Z., K.W., Y.X.X., Yao-Dong Zhang, W.J.J., X.C.L., X.H.W.)
| | - Fei-Peng Zhu
- From the Hepatobiliary Center (G.W.J., H.Z., K.W., Y.X.X., Yao-Dong Zhang, W.J.J., X.C.L., X.H.W.) and Department of Radiology (Yu-Dong Zhang, F.P.Z.), The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, P.R. China; and Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, P.R. China (G.W.J., H.Z., K.W., Y.X.X., Yao-Dong Zhang, W.J.J., X.C.L., X.H.W.)
| | - Ke Wang
- From the Hepatobiliary Center (G.W.J., H.Z., K.W., Y.X.X., Yao-Dong Zhang, W.J.J., X.C.L., X.H.W.) and Department of Radiology (Yu-Dong Zhang, F.P.Z.), The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, P.R. China; and Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, P.R. China (G.W.J., H.Z., K.W., Y.X.X., Yao-Dong Zhang, W.J.J., X.C.L., X.H.W.)
| | - Yong-Xiang Xia
- From the Hepatobiliary Center (G.W.J., H.Z., K.W., Y.X.X., Yao-Dong Zhang, W.J.J., X.C.L., X.H.W.) and Department of Radiology (Yu-Dong Zhang, F.P.Z.), The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, P.R. China; and Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, P.R. China (G.W.J., H.Z., K.W., Y.X.X., Yao-Dong Zhang, W.J.J., X.C.L., X.H.W.)
| | - Yao-Dong Zhang
- From the Hepatobiliary Center (G.W.J., H.Z., K.W., Y.X.X., Yao-Dong Zhang, W.J.J., X.C.L., X.H.W.) and Department of Radiology (Yu-Dong Zhang, F.P.Z.), The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, P.R. China; and Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, P.R. China (G.W.J., H.Z., K.W., Y.X.X., Yao-Dong Zhang, W.J.J., X.C.L., X.H.W.)
| | - Wang-Jie Jiang
- From the Hepatobiliary Center (G.W.J., H.Z., K.W., Y.X.X., Yao-Dong Zhang, W.J.J., X.C.L., X.H.W.) and Department of Radiology (Yu-Dong Zhang, F.P.Z.), The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, P.R. China; and Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, P.R. China (G.W.J., H.Z., K.W., Y.X.X., Yao-Dong Zhang, W.J.J., X.C.L., X.H.W.)
| | - Xiang-Cheng Li
- From the Hepatobiliary Center (G.W.J., H.Z., K.W., Y.X.X., Yao-Dong Zhang, W.J.J., X.C.L., X.H.W.) and Department of Radiology (Yu-Dong Zhang, F.P.Z.), The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, P.R. China; and Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, P.R. China (G.W.J., H.Z., K.W., Y.X.X., Yao-Dong Zhang, W.J.J., X.C.L., X.H.W.)
| | - Xue-Hao Wang
- From the Hepatobiliary Center (G.W.J., H.Z., K.W., Y.X.X., Yao-Dong Zhang, W.J.J., X.C.L., X.H.W.) and Department of Radiology (Yu-Dong Zhang, F.P.Z.), The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, P.R. China; and Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, P.R. China (G.W.J., H.Z., K.W., Y.X.X., Yao-Dong Zhang, W.J.J., X.C.L., X.H.W.)
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Ji GW, Zhang YD, Wang K, Zhang H, Shao ZC, Jiang WJ, Li XC, Wang XH. Short- and long-term outcomes of middle hepatic vein-oriented hepatectomy for advanced perihilar cholangiocarcinoma. J Surg Oncol 2018; 118:446-454. [PMID: 30098303 DOI: 10.1002/jso.25181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 06/24/2018] [Indexed: 01/15/2023]
Abstract
BACKGROUND This study aimed to compare clinical outcomes of the middle hepatic vein (MHV)-oriented versus conventional hemihepatectomy for perihilar cholangiocarcinoma (PHC). METHODS From 2008 to 2017, medical records of patients undergoing hemihepatectomy with caudate lobectomy for advanced PHC were reviewed retrospectively. MHV-oriented hepatectomy was defined as full exposure of the MHV on the dissection plane. Predictors of morbidity and survival were identified. RESULTS A total of 125 patients were enrolled. MHV-oriented and conventional hepatectomies were performed in 44 and 81 patients, respectively. The curative resection rate, blood loss, transfusion, and survival were comparable between two groups; however, severe morbidity rate was significantly lower in the MHV-oriented group (9.1% vs 38.3%, P < 0.001). MHV-oriented approach was an independent predictor of severe morbidity, as were the age, bilirubin level, and blood transfusion. Severe morbidity was associated with significantly decreased overall survival and recurrence-free survival (RFS) (median 29.0 vs 46.9 months, P = 0.011 and 20.3 vs 31.1 months, P = 0.003, respectively). Multivariate analysis revealed that severe morbidity independently predicted shorter RFS (P = 0.025). CONCLUSIONS MHV-oriented approach for advanced PHC is safe and associated with a significant decrease in severe morbidity. Severe morbidity adversely affects survival after surgery; therefore, optimal preoperative preparation and MHV-oriented hepatectomy with meticulous dissection remain of critical importance.
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Affiliation(s)
- Gu-Wei Ji
- Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yao-Dong Zhang
- Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Ke Wang
- Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Hui Zhang
- Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Zi-Cheng Shao
- Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Wang-Jie Jiang
- Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xiang-Cheng Li
- Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xue-Hao Wang
- Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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Yu HS, Guo H, Shen SS, Li XC, Zhang LP, Fan XF. [Prenatal diagnosis of women with an adverse reproductive history using both traditional karyotyping and SNP-array]. Zhonghua Fu Chan Ke Za Zhi 2018; 53:155-159. [PMID: 29609228 DOI: 10.3760/cma.j.issn.0529-567x.2018.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To explore the occurrence of fetal chromosomal abnormalities among pregnant women with an adverse reproductive history using traditional karyotyping and single nucleotide polymorphism microarray (SNP-array) technology. Methods: Totally 94 in 2 163 (4.35%) cases of singleton pregnant women with an adverse reproductive history were performed amniocentesis in Jinhua Maternal and Child Health Care Hospital from June 2015 to June 2017. Traditional karyotyping and SNP-array were employed simultaneously for prenatal diagnosis, and the detection rates of the two methods were compared. Results: All of the 94 specimens were successfully analyzed, 11 cases were found with chromosomal anomaly, the overall detection rate was 11.7%(11/94). Seven (7.4%,7/94) abnormalities cases were detected by karyotyping, and 7(7.4%) by SNP-array. The karyotyping results of trisomy 21, and 45,X and the deletion of chromosome 13 were consistent with SNP-array. Only 3 (3.2%, 3/94) microdeletion/duplications (the sizes of duplications and deletions were between 422.4-1 708.4 kb) and 1 (1/4) loss of heterozygosity were detected by SNP-array, but were missed by karyotyping. Furthermore, 2 cases' copy number variation were found pathogenic gene related, while the other 2 were considered benign or variant of uncertain significance. Four cases (4/7) of abnormalities were detected by karyotyping, while confirmed balanced translocation and inversion by SNP-array. All patients were informed and chosen to continue the pregnancy. Conclusions: The rate of abnormal fetal chromosomes in pregnant women with an adverse reproductive history is still high. SNP-array is a new molecular genetic technique, and combined with use of traditional karyotyping, it could improve the detection rate of fetal chromosomal abnormalities and reduce abortion rate, thus providing a basis for genetic counseling and prenatal diagnosis.
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Affiliation(s)
- H S Yu
- Prenatal Diagnosis Center, Jinhua Maternal and Child Health Care Hospital, Jinhua 321000, China
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Li XC, Chen D, Chen TX, Lu FL, Ma J, Zhao CM. [Langerhans cell histiocytosis with periodontal lesions as the initial manifestation: a case report]. Zhonghua Kou Qiang Yi Xue Za Zhi 2018; 53:187-190. [PMID: 29972977 DOI: 10.3760/cma.j.issn.1002-0098.2018.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- X C Li
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - D Chen
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - T X Chen
- Cimplant Dental Clinic, Zhengzhou 450000, China
| | - F L Lu
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - J Ma
- Department of Hematology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - C M Zhao
- Department of Radiology, The Second People's Hospital of Zhengzhou, Zhengzhou 450006, China
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Li XC, Wang CC, Zhao JM, Liu LH. Temperature-dependent optical constants of highly transparent solids determined by the combined double optical pathlength transmission-ellipsometry method. Appl Opt 2018; 57:1260-1266. [PMID: 29469874 DOI: 10.1364/ao.57.001260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Accepted: 01/13/2018] [Indexed: 06/08/2023]
Abstract
The optical constants of five highly transparent substrates (polycrystalline BaF2, CaF2, MgF2, ZnSe, and ZnS) were experimentally determined based on a combined technique using both the double optical pathlength transmission method and the ellipsometry method within temperature range 20°C-350°C in the ultraviolet-infrared region (0.2-20 μm). The results show that the refractive index spectra of polycrystalline BaF2, CaF2, and MgF2 are similar, but differ from that of polycrystalline ZnSe and ZnS. The thermo-optic coefficient of these highly transparent substrates increases with increasing temperature. The absorption indices show a significant temperature-dependent behavior, which increases with increasing temperature from 20°C to 350°C over the transparent region. For the sake of application, the fitted formulas of the refractive index of the five highly transparent substrates as a function of wavelength and temperature are presented.
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Li XC, Li JS, Meng L, Bai YN, Yu DS, Liu XN, Liu XF, Jiang XJ, Ren XW, Yang XT, Shen XP, Zhang JW. [Study on the classification of dominant pathogens related to febrile respiratory syndrome, based on the method of Bayes discriminant analysis]. Zhonghua Liu Xing Bing Xue Za Zhi 2017; 38:1094-1097. [PMID: 28847061 DOI: 10.3760/cma.j.issn.0254-6450.2017.08.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Objective: To understand the dominant pathogens of febrile respiratory syndrome (FRS) patients in Gansu province and to establish the Bayes discriminant function in order to identify the patients infected with the dominant pathogens. Methods: FRS patients were collected in various sentinel hospitals of Gansu province from 2009 to 2015 and the dominant pathogens were determined by describing the composition of pathogenic profile. Significant clinical variables were selected by stepwise discriminant analysis to establish the Bayes discriminant function. Results: In the detection of pathogens for FRS, both influenza virus and rhinovirus showed higher positive rates than those caused by other viruses (13.79%, 8.63%), that accounting for 54.38%, 13.73% of total viral positive patients. Most frequently detected bacteria would include Streptococcus pneumoniae, and haemophilus influenza (44.41%, 18.07%) that accounting for 66.21% and 24.55% among the bacterial positive patients. The original-validated rate of discriminant function, established by 11 clinical variables, was 73.1%, with the cross-validated rate as 70.6%. Conclusion: Influenza virus, Rhinovirus, Streptococcus pneumoniae and Haemophilus influenzae were the dominant pathogens of FRS in Gansu province. Results from the Bayes discriminant analysis showed both higher accuracy in the classification of dominant pathogens, and applicative value for FRS.
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Affiliation(s)
- X C Li
- Department of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - J S Li
- Department of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - L Meng
- Gansu Provincial Center for Disease Control and Prevention, Lanzhou 730000, China
| | - Y N Bai
- Department of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - D S Yu
- Gansu Provincial Center for Disease Control and Prevention, Lanzhou 730000, China
| | - X N Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - X F Liu
- Gansu Provincial Center for Disease Control and Prevention, Lanzhou 730000, China
| | - X J Jiang
- Gansu Provincial Center for Disease Control and Prevention, Lanzhou 730000, China
| | - X W Ren
- Department of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - X T Yang
- Gansu Provincial Center for Disease Control and Prevention, Lanzhou 730000, China
| | - X P Shen
- Department of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - J W Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
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Abstract
BACKGROUND Preoperative evaluation of vasculobiliary anatomy in the umbilical fissure (U-point) is pivotal for perihilar cholangiocarcinoma (PCCA) applied to right-sided hepatectomy. The purpose of our study was to review the vasculobiliary anatomy in the U-point using three-dimensional (3D) reconstruction technique, to investigate the diagnostic ability of 2D scans to evaluate anatomic variations, and to discuss its surgical implications. METHODS A retrospective study of 159 patients with Bismuth type I, II, and IIIa PCCA, who received surgery at our institution from November 2012 to September 2016, was conducted. Anatomic structures were assessed using multidetector computed tomography (MDCT) by one hepatobiliary surgeon, whereas 3D images were reconstructed by an independent radiologist. Normal confluence pattern of left biliary system was defined as the left medial segmental bile duct (B4) joining the common trunk of segment II (B2) and segment III (B3) ducts, whereas aberrant confluence patterns were classified into 3 types: type I, triple confluence of B2, B3, and B4; type II, B2 draining into the common trunk of B3 and B4; type III, other patterns. Surgical anatomy of B4 was classified into the central, peripheral, and combined type according to its relation to the hepatic confluence. The lengths from the bile duct branch of Spiegel's lobe (B1l) to the orifice of B4 and the junction of B2 and B3 were measured on 3D images. The anatomy of left hepatic artery (LHA) was classified according to different origins and the spatial relationship related to the U-point. RESULTS 3D reconstruction revealed that normal confluence pattern of left biliary system was observed in 71.1% (113/159) of all patients, and variant patterns were type I in 11.9% (19/159), type II in 12.6% (20/159), and type III in 4.4% (7/159). The length from B1l to the junction of B2 and B3 was 12.1 ± 3.1 mm in type I variation, which was significantly shorter than that in normal configuration (30.0 ± 6.8 mm, P < 0.001) but significantly longer than that in type II variation (9.6 ± 3.4 mm, P = 0.019). Surgical anatomy of B4: the peripheral type was most commonly seen (74.2%, 118/159), followed by central type (15.7%, 25/159) and combined type (10.1%, 16/159). The distance between the B1l and B4 was 8.4 ± 2.4 mm in central and combined type, which was significantly shorter than that in peripheral type (14.5 ± 4.1 mm, P < 0.001). A replaced or accessory LHA from the left gastric artery was present in 6 (3.8%) and 9 (5.7%) patients, respectively. LHA running along the left caudal position of U-point was present in 143 cases (89.9%), along the right cranial position of U-point in nine cases (5.7 %), and combined position in seven cases (4.4%). Interobserver agreement of two imaging modalities was almost perfect in biliary confluence pattern (kappa = 0.90; 95% confidence interval: 0.79-1.00), substantial in surgical anatomy of B4 (kappa = 0.74; 95% confidence interval: 0.62-0.86), and perfect in LHA (kappa = 1.00). CONCLUSIONS Thoroughly understanding the imaging characters of surgical anatomy in the U-point may be benefit for preoperative evaluation of PCCA by successive review of 2D images alone, whereas 3D reconstruction technique allows detailed hepatic anatomy and individualized surgical planning for advanced cases.
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Affiliation(s)
- Gu-Wei Ji
- Key Laboratory on Living Donor Liver Transplantation, Department of liver surgery, Ministry of Health, First Affiliated Hospital of Nanjing Medical University, Nanjing, P.R. China
| | - Fei-Peng Zhu
- Department of Radiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, P.R. China
| | - Ke Wang
- Key Laboratory on Living Donor Liver Transplantation, Department of liver surgery, Ministry of Health, First Affiliated Hospital of Nanjing Medical University, Nanjing, P.R. China
| | - Yong-Xiang Xia
- Key Laboratory on Living Donor Liver Transplantation, Department of liver surgery, Ministry of Health, First Affiliated Hospital of Nanjing Medical University, Nanjing, P.R. China
| | - Chen-Yu Jiao
- Key Laboratory on Living Donor Liver Transplantation, Department of liver surgery, Ministry of Health, First Affiliated Hospital of Nanjing Medical University, Nanjing, P.R. China
| | - Zi-Cheng Shao
- Key Laboratory on Living Donor Liver Transplantation, Department of liver surgery, Ministry of Health, First Affiliated Hospital of Nanjing Medical University, Nanjing, P.R. China
| | - Xiang-Cheng Li
- Key Laboratory on Living Donor Liver Transplantation, Department of liver surgery, Ministry of Health, First Affiliated Hospital of Nanjing Medical University, Nanjing, P.R. China.
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Zhao DX, Chen SY, Zhou YM, Li XC, Liu S, Chen L, Pu JD, Ran PX. [Preliminary analysis of lung function of population with biofuel smoke exposure]. Zhonghua Jie He He Hu Xi Za Zhi 2017; 40:349-353. [PMID: 28482420 DOI: 10.3760/cma.j.issn.1001-0939.2017.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To analyse the impaired lung functions of people with biofuel smoke exposure. Methods: Nonsmokers with biofuel smoke exposure were selected as research objects in a mountainous area of northern Guangdong where the families used biofuels as main energies and the nonsmokers without biofuel smoke exposure in the same area as control. Questionnaire interviews and spirometry tests were performed on all subjects. To analyse the differences of lung functions in both. Results: Seventy hundred and seventeen subjects were enro1led in this study.There were 530 nonsmokers with biofuel smoke exposure(observation group) including 442 women and 88 men, average age 54±10. There were 187 nonsmokers without biofuel smoke exposure(control group) including 141 women and 46 men, average age 54±10. There was no significant difference between two groups in age, height, weight, BMI, waist circumference, hip circumference and waist/hip ratio(P>0.05). The pulmonary ventilation function index(FEV(1)%Pred, FEV(1)/FVC) in the observation group was significantly less than that in control group [(100±18) vs.(106±25); (80±10) vs.(83±6) respectively, P<0.05]. Small airway function index(PEF25, PEF50, PEF75, MMPEF and MMPEF%Pred) was significantly less than that in control group(P<0.01). According to the univariate regression analysis and multivariate regression analysis, regression coefficients between BIOFUEL-INDEX and FEV/FVC was -0.1, 95%CI(-0.1, -0.1, P<0.01). According to the threshold analysis, the vertice of BIOFUEL-INDEX was 46.0, where the predicted Y value was 81.76, 95%CI (80.2, 83.33). When BIOFUEL-INDEX<46.0, the regression coefficient was 0, 95%CI (-0.1, 0.0)(P>0.05); when BIOFUEL-INDEX> 46.0, the regression coefficient 2 was -0.1, 95%CI (-0.2, -0.1)(P<0.01). The difference between coefficient 2 and 1 was -0.1, 95%CI (-0.2, 0.0), which was statistically significant (P<0.05). The Log-Likelihood ratio between Model I and Model Ⅱ had statistical significance (P=0.019). Conclusions: The biofuel smokes exposure causes damages in lung function.
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Affiliation(s)
- D X Zhao
- State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Diseases, First Affiliated Hospital, Guangzhou Medical University of Guangzhou, Guangzhou 510120, China
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Ji GW, Zhu FP, Li XC. [Progress in application of three-dimensional imaging technique in complex hepatobiliary surgery]. Zhonghua Wai Ke Za Zhi 2017; 55:316-320. [PMID: 28355772 DOI: 10.3760/cma.j.issn.0529-5815.2017.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Hepatobiliary surgery is considered to be technically challenging because of complex intrahepatic and perihilar anatomical structures and variations.Nowadays, three-dimensional imaging technique plays an important role in the time of precise liver surgery.Three-dimensional images depict the spatial location of tumor, and the course, confluence pattern and variation of portal vein, hepatic artery, biliary system and hepatic vein distinctly while showing involved hepatic segments and the relationship with adjacent vessels from omnidirectional view, measuring the length of margin and future remnant liver.With the help of surgical simulation, surgeons can determine the significant vessels preoperatively.The application of three-dimensional imaging technique may improve the resectability and safety of complex hepatobiliary surgery, such as hilar cholangiocarcinoma, centrally located liver tumor, hepatolithiasis and living donor liver transplantation.Meanwhile, three-dimensional visualization facilitates the understanding of two-dimensional images and complicated surgical anatomy for surgeons.
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Affiliation(s)
- G W Ji
- Liver Transplantation Center, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
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Ji GW, Zhu FP, Wang K, Jiao CY, Shao ZC, Li XC. Clinical Implications of Biliary Confluence Pattern for Bismuth-Corlette Type IV Hilar Cholangiocarcinoma Applied to Hemihepatectomy. J Gastrointest Surg 2017; 21:666-675. [PMID: 28168674 DOI: 10.1007/s11605-017-3377-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 01/23/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Since biliary variations are commonly seen, our aims are to clarify these insidious variations and discuss their surgicopathologic implications for Bismuth-Corlette (BC) type IV hilar cholangiocarcinoma (HC) applied to hemihepatectomy. METHODS Three-dimensional images of patients with distal bile duct obstruction (n = 97) and advanced HC (n = 79) were reconstructed and analyzed retrospectively. Normal biliary confluence pattern was defined as the peripheral segment IV duct (B4) joining the common trunk of segment II (B2) and segment III (B3) ducts to form the left hepatic duct (LHD) that then joined the right hepatic duct (RHD). The lengths from left and right secondary biliary ramifications to the right side of the umbilical portion of the left portal vein (Rl-L) and the cranio-ventral side of the right portal vein (Rr-R) were measured, respectively, and compared with the resectable bile duct length in HCs. Surgicopathologic findings were compared between different BC types. RESULTS The resectable bile duct length in right hemihepatectomy for eradication of type IV tumors was significantly longer than the Rl-L length in normal biliary configuration (17.4 ± 1.8 and 10.3 ± 3.4 mm, respectively, p < 0.001), and type III variation (B2 joining the common trunk of B3 and B4) was the predominant configuration (53.8%). The resectable length in left hemihepatectomy for eradication of type IV tumors was comparable with the Rr-R length in RHD absent cases (15.2 ± 2.5 and 16.4 ± 2.6 mm, respectively, p = 0.177) but significantly longer than that in normal configuration (p < 0.001). The estimated length was 8.5 ± 2.0 mm in unresectable cases. There was no significant difference between type III and IV tumors, except for the rate of nodal metastasis (29.7 and 76.0%, respectively, p < 0.001). CONCLUSION Hemihepatectomy might be selected for curative-intent resection of BC type IV tumors considering the advantageous biliary variations, whereas anatomical trisegmentectomy is recommended for the resectable bile duct length less than 10 mm. Biliary variations might result in excessive classification of BC type IV but require validation on further study.
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Affiliation(s)
- Gu-Wei Ji
- Key Laboratory on Living Donor Liver Transplantation, Ministry of Health, Department of Liver Surgery, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, People's Republic of China
| | - Fei-Peng Zhu
- Department of Radiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, People's Republic of China
| | - Ke Wang
- Key Laboratory on Living Donor Liver Transplantation, Ministry of Health, Department of Liver Surgery, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, People's Republic of China
| | - Chen-Yu Jiao
- Key Laboratory on Living Donor Liver Transplantation, Ministry of Health, Department of Liver Surgery, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, People's Republic of China
| | - Zi-Cheng Shao
- Key Laboratory on Living Donor Liver Transplantation, Ministry of Health, Department of Liver Surgery, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, People's Republic of China
| | - Xiang-Cheng Li
- Key Laboratory on Living Donor Liver Transplantation, Ministry of Health, Department of Liver Surgery, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, People's Republic of China.
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Qiao L, Yang HZ, Li XC, Huang XQ, Yuan B, Zhou ZD. [Effects of transient exposure to high glucose on biological behaviors of human dermal microvascular endothelial cells]. Zhonghua Shao Shang Za Zhi 2017; 33:77-82. [PMID: 28219140 DOI: 10.3760/cma.j.issn.1009-2587.2017.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To observe the effects of transient exposure to high glucose on biological behaviors of human dermal microvascular endothelial cells cultured in vitro. Methods: The dividing method and treatment of cells for the detection of all indexes in this study were as follows. Human dermal microvascular endothelial cells of the 4th passage were divided into 3 groups according to the random number table, with 12 wells in each group. Cells in control group (C) were cultured with complete culture solution containing 5 mmol/L D-glucose for 7 d. Cells in transient high glucose group (THG) were cultured with complete culture solution containing 30 mmol/L D-glucose for 2 d and complete culture solution containing 5 mmol/L D-glucose for 5 d. Cells in prolonged high glucose group (PHG) were cultured with complete culture solution containing 30 mmol/L D-glucose for 7 d. (1) The cell morphology in groups C and PHG on culture day 7 and that in group THG on culture day 2 and 7 was observed by inverted optical microscope. (2) On culture day 0, 2, 4, and 7, cell proliferation rate was determined by cell viability analyzing counter. (3) After culture day 2, the scratch experiment was performed, and the cells were further cultured. At post scratch hour (PSH) 0, 24, 48, 72, 96, and 120, the scratch area was measured, and the cell migration rates of the latter 5 time points were calculated. (4) On culture day 0, 2, 4, and 7, the cell apoptosis rate was determined by cell analyzer. (5) Cells were seeded into Matrigel to culture for 24 h after culture day 7. The formation of vessel-like structure was observed by inverted optical microscope. The length and number of branch point of vessel-like structure were calculated. (6) On culture day 2, 4, and 7, mRNA expression of vascularization-related gene tissue inhibitor of matrix metalloproteinase-3 (TIMP-3) was determined with real-time fluorescent quantitative reverse transcription polymerase chain reaction. Data were processed with analysis of variance of factorial design, analysis of variance for repeated measurement, one-way analysis of variance, and LSD test. Results: (1) Cells in group C exhibited ovary shape in cobble stone order on culture day 7. Cells in group THG exhibited long ovary shape and lost cobble stone order on culture day 2 and kept the same changes on culture day 7. Cells in group PHG exhibited long ovary shape and lost cobble stone order on culture day 7. (2) On culture day 0, there was no significant difference in cell proliferation rate among the 3 groups (F=0.23, P>0.05). On culture day 2, cell proliferation rates in groups THG and PHG were similar (P>0.05), which were significantly lower than the cell proliferation rate in group C (with P values below 0.01). On culture day 4 and 7, the cell proliferation rates in groups THG and C were similar (with P values above 0.05), which were significantly higher than those in group PHG (with P values below 0.01). (3) At PSH 24-120, the cell migration rates in groups THG and PHG were similar (with P values above 0.05), which were significantly lower than those in group C (with P values below 0.01). (4) On culture day 0, there was no statistically significant difference in cell apoptosis rate among the 3 groups (F=0.78, P>0.05). On culture day 2, cell apoptosis rates in groups THG and PHG were similar (P>0.05), which were significantly higher than the cell apoptosis rate in group C (with P values below 0.01). On culture day 4 and 7, the cell apoptosis rates in groups THG and C were similar (with P values above 0.05), which were significantly lower than those in group PHG (with P values below 0.01). (5) The length of vessel-like structure of cells in group THG was (1.84±0.10)×10(5) μm, close to (1.82±0.11)×10(5) μm in group PHG (P>0.05), both significantly shorter than (2.75±0.23)×10(5) μm in group C (with P values below 0.01). The numbers of branch point of vessel-like structure of cells in groups THG and PHG were 43±5 and 46±8 respectively, which were close to each other (P>0.05) and both significantly less than 103±21 in group C (with P values below 0.01). (6) On culture day 2, 4, and 7, mRNA expressions of TIMP-3 of cells in groups THG and PHG were similar (with P values above 0.05), which were significantly lower than those in group C (with P values below 0.05). Conclusions: Transient exposure to high glucose can cause metabolic memory of morphology, migration, and angiogenesis in human dermal microvascular endothelial cells cultured in vitro, resulting in sustained changes in biological behaviors. The mechanism may be related to the changes of vascularization-related genes.
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Affiliation(s)
- L Qiao
- Department of Burns and Plastic Surgery, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200025, China
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Li XC, Zhao JM, Wang CC, Liu LH. Improved transmission method for measuring the optical extinction coefficient of micro/nano particle suspensions. Appl Opt 2016; 55:8171-8179. [PMID: 27828070 DOI: 10.1364/ao.55.008171] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Extinction coefficients are fundamental for analyzing radiative transport in micro/nano particle suspensions. In the traditional transmission method for measuring the extinction coefficient of particles in a cuvette, a reference system is used to compensate for the influence of the cuvette and base fluid. However, the multiple reflections and refractions between the air-glass and liquid-glass interfaces cannot be sufficiently eliminated by using the reference system, and the induced measurement error increases significantly with increasing difference in refractive index between the two neighboring media at these interfaces. In this paper, an improved transmission method is proposed to measure the extinction coefficient of micro/nano particles. The extinction coefficient of the particles is determined based on an optical model, taking into account the multiple reflection and refraction at the glass-liquid interfaces. An experimental validation was conducted for suspensions with various mean particle sizes. By considering the higher-order transmission terms, the improved transmission method generally achieved high-accuracy improvement over the traditional transmission method for extinction coefficient measurement, especially for the case with a small optical thickness of particle suspensions. This work provides an alternative and more accurate way for measuring the extinction characteristics of micro/nano particle suspensions.
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Wang X, Bai J, Xue Q, Song XF, Qiu CM, Li XC, Pei HF. [Tumor necrosis factor-α inhibitor protects against myocardial ischemia/reperfusion injury via Notch1 mediated inhibition of oxidative/nitrative stress in traumatic mice]. Zhonghua Xin Xue Guan Bing Za Zhi 2016; 44:156-60. [PMID: 26926510 DOI: 10.3760/cma.j.issn.0253-3758.2016.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To test the effects of TNF-α inhibitor Etanercept on myocardial ischemia/reperfusion (MI/R) injury in posttraumatic mice, and explore related mechanisms. METHODS Traumatic mouse model was established with Noble-Collip drum. Five days after trauma, Notch1 was knocked down by intramyocardial injection of Notch1 small interfering RNAs (siRNA) or scrambled siRNA (20 μg). Seven days after trauma, mice were subjected to MI/R (30 minutes ischemia followed by reperfusion). Sham operation was similarly performed without coronary artery ligation. Ten minutes before reperfusion, mice received Etanercept (8 mg/kg, i. p.). ELISA was used to detect plasma levels of TNF-α and troponin I (cTnI) and myocardial nitrotyrosine content. Twenty-four hours after reperfusion, left ventricular ejection fraction (LVEF) was measured by echocardiography. Infarct size was determined by Evans blue/2, 3, 5-triphenyl tetrazolium chloride (TTC) double staining. Cardiac caspase-3 activity was detected using a caspase-3 kit. Myocardial TNF-α and Notch1 intracellular domains (Notch1 ICD) expressions were determined by Western blot. Chemiluminescence was used to assess myocardial superoxide anion content. RESULTS (1) Compared to vehicle group, Etanercept treatment significantly reduced cTnI content, infarct size and caspase-3 activity (all P<0.01), while obviously increased LVEF (P<0.01). (2) Etanercept treatment also significantly reduced plasma and myocardial TNF-α contents (P<0.01), whereas markedly increased myocardial Notch1 ICD content (P<0.05). (3) Compared to scrambled siRNA group, Notch1 deficiency significantly increased cTnI content, infarct size and caspase-3 activity (P<0.05), whereas obviously reduced LVEF (P<0.05). (4) Etanercept significantly reduced myocardial superoxide anion and nitrotyrosine content (P<0.01), which was reversed by downregulation of Notch1 (P<0.05). CONCLUSIONS TNF-α inhibitor Etanercept can alleviate MI/R injury after trauma by reducing myocardial oxidative/nitrative stress via activating Notch1 signaling pathway.
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Affiliation(s)
- X Wang
- Department of Cardiology, Chengdu Military General Hospital, Chengdu 610083, China
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Lu YL, Li XC, Xu WT, Wu D, Yang M. Effects of process parameters on microstructural evolution and properties of AZ61 alloy during hot extrusion. ACTA ACUST UNITED AC 2015. [DOI: 10.1088/1757-899x/103/1/012037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Geng XP, Wang X, Meng T, Li JJ, Li XC, Fu GY. THE INFLUENCE OF POSTERIOR APPROACH CERVICAL INTRASPINAL TUMOR RESECTION ON THE STABILITY OF CERVICAL VERTEBRA. J BIOL REG HOMEOS AG 2015; 29:389-394. [PMID: 26122227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This paper discusses the influence of posterior approach cervical intraspinal tumor resection on the stability of cervical vertebra. A total of 32 patients with cervical intraspinal tumor were included and divided into a group undergoing posterior approach bilateral vertebral lamina resection (group A) (n=16) and a group undergoing posterior approach semi-laminectomy (group B) (n=16). It was found, through follow-up visits, that the incidence rate of cervical instability of the patients was 25% and the incidence rate of cervical curvature deterioration of the patients was 37.5% in group A, whereas the two incidence rates of group B were 6.25% and 12.5% respectively; the incidence rates of cervical curvature deterioration and instability were significantly increased compared to group B (P< 0.05). It is concluded that, both regular posterior approach vertebral lamina resection and semi-laminectomy influence the biomechanical change of cervical vertebra, but the influence of the latter is less. Also, it is found that, applying titanium connectors and titanium nails for rigid internal fixation maintains the completeness and stability of the structure of the cervical vertebra.
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Affiliation(s)
- X P Geng
- Department of Spinal Surgery, Binzhou Medical University Hospital, Binzhou, China
| | - X Wang
- Department of Orthopedics, Binzhou Peoples Hospital, Binzhou, China
| | - T Meng
- Department of Spinal Surgery, Binzhou Medical University Hospital, Binzhou, China
| | - J J Li
- Department of Spinal Surgery, Binzhou Medical University Hospital, Binzhou, China
| | - X C Li
- Department of Spinal Surgery, Binzhou Medical University Hospital, Binzhou, China
| | - G Y Fu
- Department of Spinal Surgery, Binzhou Medical University Hospital, Binzhou, China
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Li XC, Wang W, Liu JQ, Wen F, Yue CY. Different limited resection of pulmonary lobe methods under the thoracoscopy in the treatment of early nonsmall cell lung cancer occurred in the old age. Indian J Cancer 2015; 51 Suppl 2:e29-32. [PMID: 25712838 DOI: 10.4103/0019-509x.151995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES The objective was to explore clinical effect of limited resection of lung lobe under the thoracoscopy in the treatment of early nonsmall cell lung cancer occurred in the old age. METHODS A total of 150 patients with nonsmall cell lung cancer in the old age is treated by limited resection of lung lobe under thoracoscope. It can be divided into segmental resection group and wedge resection group by surgical methods, to make a comparative analysis of operation time, intraoperative blood loss, hospital stays, and complications during the perioperative period. And there will be postoperation follow-up on survival, relapse and death situation etc., RESULTS 10 cases are changed to make other operation because of maladaptation to limited resection, and a total of 140 patients have undergone limited resection. Operation time and hospital stays of wedge resection group are shorter than those of segmental resection group (P < 0.05); compared with the bleeding and indwelling drainage tube time in two groups, differences have no statistical significance (P > 0.05). Compared with cases of complications, recurrence and death for groups of segmental resection and wedge resection group, the differences have no statistical significance (P > 0.05). CONCLUSION Limited resection of lung lobe in the early treatment of nonsmall cell lung cancer occurred in the old age under the thoracoscopy is safe and feasible.
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Affiliation(s)
| | - W Wang
- Department of Thoracic Surgery, Navy General Hospital of PLA, Beijing, China
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Wang D, Han S, Peng R, Wang X, Yang XX, Yang RJ, Jiao CY, Ding D, Ji GW, Li XC. FAM83D activates the MEK/ERK signaling pathway and promotes cell proliferation in hepatocellular carcinoma. Biochem Biophys Res Commun 2015; 458:313-20. [PMID: 25646692 DOI: 10.1016/j.bbrc.2015.01.108] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 01/22/2015] [Indexed: 12/22/2022]
Abstract
Publicly available microarray data suggests that the expression of FAM83D (Family with sequence similarity 83, member D) is elevated in a wide variety of tumor types, including hepatocellular carcinoma (HCC). However, its role in the pathogenesis of HCC has not been elucidated. Here, we showed that FAM83D was frequently up-regulated in HCC samples. Forced FAM83D expression in HCC cell lines significantly promoted their proliferation and colony formation while FAM83D knockdown resulted in the opposite effects. Mechanistic analyses indicated that FAM83D was able to activate the MEK/ERK signaling pathway and promote the entry into S phase of cell cycle progression. Taken together, these results demonstrate that FAM83D is a novel oncogene in HCC development and may constitute a potential therapeutic target in HCC.
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Affiliation(s)
- Dong Wang
- Liver Transplantation Center, First Affiliated Hospital of Nanjing Medical University, Key Laboratory of Living Donor Liver Transplantation, Ministry of Public Health, Nanjing, China
| | - Sheng Han
- Liver Transplantation Center, First Affiliated Hospital of Nanjing Medical University, Key Laboratory of Living Donor Liver Transplantation, Ministry of Public Health, Nanjing, China
| | - Rui Peng
- Liver Transplantation Center, First Affiliated Hospital of Nanjing Medical University, Key Laboratory of Living Donor Liver Transplantation, Ministry of Public Health, Nanjing, China
| | - Xing Wang
- Liver Transplantation Center, First Affiliated Hospital of Nanjing Medical University, Key Laboratory of Living Donor Liver Transplantation, Ministry of Public Health, Nanjing, China
| | - Xin-Xiang Yang
- Liver Transplantation Center, First Affiliated Hospital of Nanjing Medical University, Key Laboratory of Living Donor Liver Transplantation, Ministry of Public Health, Nanjing, China
| | - Ren-Jie Yang
- Liver Transplantation Center, First Affiliated Hospital of Nanjing Medical University, Key Laboratory of Living Donor Liver Transplantation, Ministry of Public Health, Nanjing, China
| | - Chen-Yu Jiao
- Liver Transplantation Center, First Affiliated Hospital of Nanjing Medical University, Key Laboratory of Living Donor Liver Transplantation, Ministry of Public Health, Nanjing, China
| | - Dong Ding
- Liver Transplantation Center, First Affiliated Hospital of Nanjing Medical University, Key Laboratory of Living Donor Liver Transplantation, Ministry of Public Health, Nanjing, China
| | - Gu-Wei Ji
- Liver Transplantation Center, First Affiliated Hospital of Nanjing Medical University, Key Laboratory of Living Donor Liver Transplantation, Ministry of Public Health, Nanjing, China
| | - Xiang-Cheng Li
- Liver Transplantation Center, First Affiliated Hospital of Nanjing Medical University, Key Laboratory of Living Donor Liver Transplantation, Ministry of Public Health, Nanjing, China.
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Jiang W, Chen L, Zhang XJ, Chen J, Li XC, Hou WS, Xiao N. Red photon treatment inhibits apoptosis via regulation of bcl-2 proteins and ROS levels, alleviating hypoxic-ischemic brain damage. Neuroscience 2014; 268:66-74. [PMID: 24607343 DOI: 10.1016/j.neuroscience.2014.02.034] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Revised: 02/14/2014] [Accepted: 02/21/2014] [Indexed: 10/25/2022]
Abstract
Therapeutic options for hypoxic-ischemic brain damage (HIBD) are scarce and inefficient. Recently, many studies have demonstrated that red photon plays an important role in anti-inflammatory processes as well as apoptosis, the main trait of HIBD. In this study, we investigated whether red photon can protect from HIBD in SD rats and oxygen-glucose deprivation (OGD) in PC12 cells. Apoptosis, mitochondrial transmembrane potential (MMP), and reactive oxygen species (ROS) rates were assessed in PC12 cells. We found that 6-h irradiation resulted in decreased MMP, ROS and apoptosis rates, although these changes were reversible with prolonged irradiation. Importantly, these effects were sustained for 2-8h upon quenching of the red photon. Similar trends were observed for protein and mRNA expression of bax and bcl-2, with short-term irradiation (6h) inhibiting apoptosis in PC12 Cells. However, long-term (>6h) irradiation caused cell damage. In vivo experiments, bax mRNA and protein levels were reduced after 7days in HIBD model rats treated with red photon, in contrast to bcl-2. Furthermore, we found that bax and bcl-2 were mainly expressed in pyramidal cells of the hippocampus CA1 and CA3. Importantly, Morris Water Maze test results revealed an improvement in learning ability and spatial memory in rats after irradiation. Overall, our data showed that short-term irradiation with red photon in the acute phase inhibits the mitochondrial apoptotic pathway via regulation of bcl-2-related proteins and reduction of ROS levels, thereby decreasing apoptosis in nerve cells and improving the neurological prognosis of HIBD.
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Affiliation(s)
- W Jiang
- Rehabilitation Centers, Children's Hospital of Chongqing Medical University, Chongqing 400014, China; Children Nutrition Research Center, Children's Hospital of Chongqing Medical University, Chongqing 400014, China
| | - L Chen
- Rehabilitation Centers, Children's Hospital of Chongqing Medical University, Chongqing 400014, China; Children Nutrition Research Center, Children's Hospital of Chongqing Medical University, Chongqing 400014, China; Department of Pediatrics, University-Town Hospital of Chong Qing Medical University, Chongqing 401331, China
| | - X J Zhang
- Children Nutrition Research Center, Children's Hospital of Chongqing Medical University, Chongqing 400014, China
| | - J Chen
- Children Nutrition Research Center, Children's Hospital of Chongqing Medical University, Chongqing 400014, China; Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Developmental Diseases in Childhood, Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, Chongqing 400014, China
| | - X C Li
- Biological Engineering Institute of Chongqing University, Chongqing 400014, China
| | - W S Hou
- Biological Engineering Institute of Chongqing University, Chongqing 400014, China
| | - N Xiao
- Rehabilitation Centers, Children's Hospital of Chongqing Medical University, Chongqing 400014, China; Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Developmental Diseases in Childhood, Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, Chongqing 400014, China.
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