A combined pre- and intra-operative nomogram in evaluation of degrees of liver cirrhosis predicts post-hepatectomy liver failure: a multicenter prospective study

Background

Adequate evaluation of degrees of liver cirrhosis is essential in surgical treatment of hepatocellular carcinoma (HCC) patients. The impact of the degrees of cirrhosis on prediction of post-hepatectomy liver failure (PHLF) remains poorly defined. This study aimed to construct and validate a combined pre- and intra-operative nomogram based on the degrees of cirrhosis in predicting PHLF in HCC patients using prospective multi-center's data.

Methods

Consecutive HCC patients who underwent hepatectomy between May 18, 2019 and Dec 19, 2020 were enrolled at five tertiary hospitals. Preoperative cirrhotic severity scoring (CSS) and intra-operative direct liver stiffness measurement (DSM) were performed to correlate with the Laennec histopathological grading system. The performances of the pre-operative nomogram and combined pre- and intra-operative nomogram in predicting PHLF were compared with conventional predictive models of PHLF.

Results

For 327 patients in this study, histopathological studies showed the rates of HCC patients with no, mild, moderate, and severe cirrhosis were 41.9%, 29.1%, 22.9%, and 6.1%, respectively. Either CSS or DSM was closely correlated with histopathological stages of cirrhosis. Thirty-three (10.1%) patients developed PHLF. The 30- and 90-day mortality rates were 0.9%. Multivariate regression analysis showed four pre-operative variables [HBV-DNA level, ICG-R15, prothrombin time (PT), and CSS], and one intra-operative variable (DSM) to be independent risk factors of PHLF. The pre-operative nomogram was constructed based on these four pre-operative variables together with total bilirubin. The combined pre- and intra-operative nomogram was constructed by adding the intra-operative DSM. The pre-operative nomogram was better than the conventional models in predicting PHLF. The prediction was further improved with the combined pre- and intra-operative nomogram.

Conclusions

The combined pre- and intra-operative nomogram further improved prediction of PHLF when compared with the pre-operative nomogram.

Trial Registration

Clinicaltrials.gov Identifier: NCT04076631.

[Applications of anterior segment optical coherence tomography in corneal refractive surgery]

Anterior segment optical coherence tomography (AS-OCT) has the characteristics of non-contact, noninvasive, high sensitivity, and repeatability, and offers high-resolution in vivo imaging of the structures of the anterior eye segment. It can be used in the diagnosis and assistance of conditions related to the anterior eye segment. This review provides an update on the research and clinical applications of AS-OCT in corneal refractive surgery, including preoperative keratoconus screening, intraoperative real-time visualization of corneal structures, postoperative corneal evaluation, and management of postoperative complications. We also explore the potential application of AS-OCT in combination with corneal biomechanical detection for corneal refractive surgery.

Dysregulated microRNAs as a biomarker for diagnosis and prognosis of hepatitis B virus-associated hepatocellular carcinoma

Hepatocellular carcinoma (HCC) is a malignancy with a high incidence and fatality rate worldwide. Hepatitis B virus (HBV) infection is one of the most important risk factors for its occurrence and development. Early detection of HBV-associated HCC (HBV-HCC) can improve clinical decision-making and patient outcomes. Biomarkers are extremely helpful, not only for early diagnosis, but also for the development of therapeutics. MicroRNAs (miRNAs), a subset of non-coding RNAs approximately 22 nucleotides in length, have increasingly attracted scientists' attention due to their potential utility as biomarkers for cancer detection and therapy. HBV profoundly impacts the expression of miRNAs potentially involved in the development of hepatocarcinogenesis. In this review, we summarize the current progress on the role of miRNAs in the diagnosis and treatment of HBV-HCC. From a molecular standpoint, we discuss the mechanism by which HBV regulates miRNAs and investigate the exact effect of miRNAs on the promotion of HCC. In the near future, miRNA-based diagnostic, prognostic, and therapeutic applications will make their way into the clinical routine.

Hierarchical hollow superstructure cobalt selenide bird nests for high-performance lithium storage

The inferior cycling performance caused by large volume variation is the main problem that restricts the application of cobalt selenides in lithium-ion batteries. Herein, we synthesize raspberry-like Co-ethylene glycol precursor. It is further selenized into the hierarchical hollow superstructure CoSe₂/CoSe bird nests that are assembled by the hollow nanosphere units of CoSe₂ and CoSe nanocrystalline. CoSe₂/CoSe bird nests achieve excellent cycling performance, high reversible capacity and satisfactory rate capability (1361 mAh/g at 1 A/g after 1000 cycles, 579 mAh/g at 2 A/g after 2000 cycles, 315 mAh/g at 5 A/g after 1000 cycles). Electrochemical kinetics analyses and ex-situ material characterization reveal that the surface capacitive behavior controls the electrochemical reaction, and the composite has low reaction impedance, fast and stable Li⁺ diffusion, and superior structural stability. The superior lithium storage performance is attributed to the unique superstructure bird nest. Large specific surface area, abundant hierarchical pores and the opening mouth result in high electrochemical activity, which induces high reversible capacity. The small hollow nanosphere units, the sufficiently thick hierarchical porous superstructure shell and the large hollow interior bring about the strong synergistic effect to improve cycling performance. The intimately coupling of CoSe₂/CoSe nanocrystalline and the hollow nanosphere units guarantees high conductivity. This work has greatly enriched the understanding of structure design of high-performance cobalt selenide anodes.

[Effect of hormones on keratoconus and its mechanism]

Keratoconus is an ectatic corneal disorder and characterized by central and/or inferior temporal corneal thinning in a cone shape. Studies have shown that its pathogenesis is related to changes in tissue proteins, enzymes, immune functions and specific genes, but the exact pathogenesis has not been clearly clarified yet. Hormones such as sex hormones have been found to be associated with keratoconus. This review aims to summarize and analyze the research progress of the effect of hormones on keratoconus and its mechanism, so as to explore the role of hormones in the early diagnosis of keratoconus and find new targets in the treatment of keratoconus, providing reference for clinical work.

Constructing metal-organic framework-derived Mn2O3multishelled hollow nanospheres for high-performance cathode of aqueous zinc-ion batteries

Herein, we successfully synthesize Mn₂O₃multishelled hollow nanospheres through simply oxidizing Mn-based metal-organic framework microspheres. The number of the shells reaches 4. Many cavities and nanograins are hidden underneath the shell. The multishelled hollow structure brings about a wide hierarchical mesopore size range, large pore volume (0.26 cm³g^-1) and high specific surface area (117.6 m²g^-1). The superior zinc-ion storage performance may be achieved. The reversible capacity reaches 453 mAh g^-1at current density of 0.1 A g^-1. After 500 cycles at 1 A g^-1, the discharge capacity of 152.8 mAh g^-1is still delivered. The discharge capacity at 1.5 A g^-1stabilizes at 107 mAh g^-1. The zinc storage process is further studied through kinetics analyses. It is found that in the zinc storage process, ion diffusion process and capacitive process occur simultaneously, and the capacitive process is dominant. The excellent electrochemical performance is mainly attributed to the multishelled hollow nanosphere structure of Mn₂O₃. This structure promotes contact of electrode materials/electrolyte, offers more active sites, facilitates infiltration of electrolyte, buffer volume change of Mn₂O₃, improving electrochemical activity, reaction kinetics and cycling performance of Mn₂O₃. Overall, Mn₂O₃multishelled hollow nanosphere is an excellent cathode material for aqueous zinc-ion batteries.

[Suggestions on the nomenclature of liver cancer]

Currently, the systematized nomenclature of medicine (SNOMED) of liver cancer is confusing, and it is mixed with the SNOMED of cholangiocarcinoma. We hereby presented our own points, hoping to provide a reference for standardizing the nomenclatures and classifications of liver cancer in future clinical studies. The preface of Chinese Guidelines of Primary Liver Cancer Diagnosis and Treatment (2019 Edition) indicated that primary liver cancer mainly includes three different pathological types, hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (ICC), and mixed-type carcinoma of both HCC and ICC. These three types of carcinoma show great differences in terms of pathogenesis, biological behavior, histological morphology, treatment methods, and prognosis, among which, HCC accounts for 85% to 90%. Therefore, this study is a detailed analysis of the above-mentioned related SNOMED and proposes suggestions for corrections.

Intimately coupled Mn3O4nanocrystalline@3D honeycomb hierarchical porous network scaffold carbon for high-performance cathode of aqueous zinc-ion batteries

Herein, 3D honeycomb hierarchical porous network scaffold carbon is synthesized by a unique PVP-SiO₂-boiling method with the boiling bubbles as soft template and SiO₂nanospheres as hard template. Then MnO₂nanosheets intimately grow on the carbon matrix and are further decomposed to Mn₃O₄nanocrystalline with size of 7-9 nm. The obtained Mn₃O₄nanocrystalline@3D honeycomb hierarchical porous network scaffold carbon has abundant mesopores and large specific surface area (92 m²g^-1). When used as a cathode material for zinc-ion batteries, the synthesized composites exhibit high reversible capacity (546.2 mAh g^-1at 0.5 A g^-1), remarkable cycling stability (discharge capacity of 97.8 mAh g^-1at 3 A g^-1after 600 cycles) and superior rate capability (15.7 mAh g^-1at 10 A g^-1). The kinetics analyses indicate zinc storage mechanism includes diffusion process and capacitive process of Zn²⁺and H⁺ions, and the capacitive storage is dominant. The outstanding zinc storage performance benefits from the structural advantages. The unique carbon matrix improves electronic conductivity of Mn₃O₄, facilitates penetration of electrolyte, and well supports Mn₃O₄nanocrystalline. The small size and large specific surface area of Mn₃O₄nanocrystalline induce significant capacitive storage effect.

Extracorporeal Membrane Oxygenation Therapy for Critically Ill Coronavirus Disease 2019 Patients in Wuhan, China: A Retrospective Multicenter Cohort Study

Currently, little in-depth evidence is known about the application of extracorporeal membrane oxygenation (ECMO) therapy in coronavirus disease 2019 (COVID-19) patients. This retrospective multicenter cohort study included patients with COVID-19 at 7 designated hospitals in Wuhan, China. The patients were followed up until June 30, 2020. Univariate and multivariate logistic regression analyses were performed to identify the risk factors associated with unsuccessful ECMO weaning. Propensity score matching was used to match patients who received veno-venous ECMO with those who received invasive mechanical ventilation (IMV)-only therapy. Of 88 patients receiving ECMO therapy, 27 and 61 patients were and were not successfully weaned from ECMO, respectively. Additionally, 15, 15, and 65 patients were further weaned from IMV, discharged from hospital, or died during hospitalization, respectively. In the multivariate logistic regression analysis, a lymphocyte count ≤0.5×10⁹/L and D-dimer concentration >4× the upper limit of normal level at ICU admission, a peak PaCO₂ >60 mmHg at 24 h before ECMO initiation, and no tracheotomy performed during the ICU stay were independently associated with lower odds of ECMO weaning. In the propensity score-matched analysis, a mixed-effect Cox model detected a lower hazard ratio for 120-day all-cause mortality after ICU admission during hospitalization in the ECMO group. The presence of lymphocytopenia, higher D-dimer concentrations at ICU admission and hypercapnia before ECMO initiation could help to identify patients with a poor prognosis. Tracheotomy could facilitate weaning from ECMO. ECMO relative to IMV-only therapy was associated with improved outcomes in critically ill COVID-19 patients.

Unexpected discovery of intrahepatic cholangiocarcinoma during follow-up in two cases of liver cysts: cases report

Background

The liver cyst is commonly treated by hepatobiliary surgery. Generally, most patients show no apparent symptoms and often get diagnosed accidentally during the imaging examinations. In addition, most patients with liver cysts follow a benign course, with fewer severe complications and rare occurrences of malignant changes. Therefore, based on disease characteristics and healthcare costs, long-term regular follow-up of liver cysts are rarely performed clinically.

Case Description

Here, we reported two previously treated or observed cases for liver cysts, where intrahepatic neoplastic lesions were found unexpectedly at the liver cyst during follow-up. These two patients’ clinical manifestations and laboratory examinations lacked specificity with unclear pre-operative diagnosis, whereas the post-operative pathology confirmed cholangiocarcinoma. One of the patients was a 64-year-old female with right upper abdominal distension. She underwent cyst fenestration for a liver cyst 3 years ago. In the latest admission, imaging examination revealed a tumor in the left inner lobe of the liver. The tumor was located in the exact fenestration location, and the pathological diagnosis of cholangiocarcinoma was made after surgical resection. The patient received Lenvatinib post-operatively and had no recurrence during the follow-up. Another patient, a 68-year-old woman, was asymptomatic, but the liver margin was palpable under the ribs on her physical examination. She had a previous diagnosis of liver cysts and was on regular yearly follow-up. In the last follow-up, a tumor was found close to a cyst. It was diagnosed as intrahepatic cystadenocarcinoma before surgery; however, the pathological features after surgical resection were more consistent with the cholangiocarcinoma. The patient had lung metastases 2 months after the surgery, but her condition improved after receiving targeted therapy and immunotherapy. Moreover, she is alive to this day.

Conclusions

We reported 2 cases of intrahepatic cholangiocarcinoma discovered accidentally during the follow-up of hepatic cysts. The location of the malignant tumor coincided with the location of the cyst, making the clinical differential diagnosis problematic. Therefore, it is necessary to be vigilant about the possibility of combined malignant tumors for the follow-up of complex cysts, as early detection and treatment may help improve the prognosis of these patients. After surgery, multimodal therapy, including chemotherapy, immunotherapy, and targeted therapy, is helpful.

Pomegranate-like C@TiO2 mesoporous honeycomb spheres for high performance lithium ion batteries

Pomegranate-like C@TiO₂ mesoporous honeycomb spheres have been synthesized through two simple steps: formation of TiO₂ mesoporous honeycomb spheres and the coating of polypyrrole followed by carbonization. TiO₂ mesoporous honeycomb spheres are of large specific surface area of 153 m² g^-1 and contain abundant mesopores, which leads to high electrochemical activity and good kinetic performance of TiO₂. A layer of amorphous carbon shell with the thickness of 30-40 nm tightly encapsulates a TiO₂ mesoporous honeycomb sphere, forming a novel pomegranate-like small sphere, which significantly improves electronic conductivity and structural stability of TiO₂. Benefiting from the unique pomegranate-like structure, C@TiO₂ mesoporous honeycomb spheres exhibit high specific capacity, stable long-term cycling performance and good rate capability as an anode material for lithium ion batteries (LIBs). After 500 cycles at 1 C, the discharge capacity still reaches 184 mAh g^-1. The electrochemical performance is superior to pure TiO₂ mesoporous honeycomb spheres and most of the reported high-performance TiO₂-based composites. This work provides a new high-performance TiO₂-carbon-based composite material for LIBs as well as a new valuable research strategy.

Chemoprophylaxis, diagnosis, treatments, and discharge management of COVID-19: An evidence-based clinical practice guideline (updated version)

The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of a rapidly spreading illness, coronavirus disease 2019 (COVID-19), affecting more than seventeen million people around the world. Diagnosis and treatment guidelines for clinicians caring for patients are needed. In the early stage, we have issued "A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version)"; now there are many direct evidences emerged and may change some of previous recommendations and it is ripe for develop an evidence-based guideline. We formed a working group of clinical experts and methodologists. The steering group members proposed 29 questions that are relevant to the management of COVID-19 covering the following areas: chemoprophylaxis, diagnosis, treatments, and discharge management. We searched the literature for direct evidence on the management of COVID-19, and assessed its certainty generated recommendations using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Recommendations were either strong or weak, or in the form of ungraded consensus-based statement. Finally, we issued 34 statements. Among them, 6 were strong recommendations for, 14 were weak recommendations for, 3 were weak recommendations against and 11 were ungraded consensus-based statement. They covered topics of chemoprophylaxis (including agents and Traditional Chinese Medicine (TCM) agents), diagnosis (including clinical manifestations, reverse transcription-polymerase chain reaction (RT-PCR), respiratory tract specimens, IgM and IgG antibody tests, chest computed tomography, chest x-ray, and CT features of asymptomatic infections), treatments (including lopinavir-ritonavir, umifenovir, favipiravir, interferon, remdesivir, combination of antiviral drugs, hydroxychloroquine/chloroquine, interleukin-6 inhibitors, interleukin-1 inhibitors, glucocorticoid, qingfei paidu decoction, lianhua qingwen granules/capsules, convalescent plasma, lung transplantation, invasive or noninvasive ventilation, and extracorporeal membrane oxygenation (ECMO)), and discharge management (including discharge criteria and management plan in patients whose RT-PCR retesting shows SARS-CoV-2 positive after discharge). We also created two figures of these recommendations for the implementation purpose. We hope these recommendations can help support healthcare workers caring for COVID-19 patients.

Watermelon-like TiO2 nanoparticle (P25)@microporous amorphous carbon sphere with excellent rate capability and cycling performance for lithium-ion batteries

To overcome the inferior rate capability and cycling performance of TiO₂ nanomaterials as an anode material of lithium-ion batteries, we encapsulate TiO₂ nanoparticles (P25) in carbon spheres through a facile pyrrole polymerization and carbonization. Material characterization demonstrates TiO₂ nanoparticles are uniformly embedded in microporous amorphous carbon spheres, forming a watermelon-like structure. P25@C exhibits excellent high rate capability with average discharge capacity of 496, 416, 297, 240, 180, 99, 49 and 25 mAh g^-1 at current rate of 0.5C, 1C, 5C, 10C, 20C, 50C, 100C and 200C, which shows superior long-term cycling performance with discharge capacity of 106.9 mAh g^-1 at 20C after 5000 cycles. The capacity loss rate is only 0.008% per cycle. The outstanding lithium storage performance is ascribed to the watermelon-like composite structure, which remarkably improves electronic conductivity and structure stability of TiO₂ nanoparticles. More importantly, the agglomeration of TiO₂ nanoparticles is eliminated, and the entire surface of every TiO₂ nanoparticle participates in the electrochemical reaction, which brings about an intense capacitive Li storage effect and leads to the high specific capacity and excellent rate capability of P25@C. This is confirmed through qualitative and quantitative analysis of the contributions from surface capacitive storage and bulk intercalation storage to the total capacity of the composite.

Perceived infection transmission routes, infection control practices, psychosocial changes, and management of COVID-19 infected healthcare workers in a tertiary acute care hospital in Wuhan: a cross-sectional survey

BACKGROUND

Many healthcare workers were infected by coronavirus disease 2019 (COVID-19) early in the epidemic posing a big challenge for epidemic control. Hence, this study aims to explore perceived infection routes, influencing factors, psychosocial changes, and management procedures for COVID-19 infected healthcare workers.

METHODS

This is a cross-sectional, single hospital-based study. We recruited all 105 confirmed COVID-19 healthcare workers in the Zhongnan Hospital of Wuhan University from February 15 to 29, 2020. All participants completed a validated questionnaire. Electronic consent was obtained from all participants. Perceived causes of infection, infection prevention, control knowledge and behaviour, psychological changes, symptoms and treatment were measured.

RESULTS

Finally, 103 professional staff with COVID-19 finished the questionnaire and was included (response rate: 98.1%). Of them, 87 cases (84.5%) thought they were infected in working environment in hospital, one (1.0%) thought their infection was due to the laboratory environment, and 5 (4.9%) thought they were infected in daily life or community environment. Swab of throat collection and physical examination were the procedures perceived as most likely causing their infection by nurses and doctors respectively. Forty-three (41.8%) thought their infection was related to protective equipment, utilization of common equipment (masks and gloves). The top three first symptoms displayed before diagnosis were fever (41.8%), lethargy (33.0%) and muscle aches (30.1%). After diagnosis, 88.3% staff experienced psychological stress or emotional changes during their isolation period, only 11.7% had almost no emotional changes. Arbidol (Umifenovir; an anti-influza drug; 69.2%) was the drug most commonly used to target infection in mild and moderate symptoms.

CONCLUSION

The main perceived mode of transmission was not maintaining protection when working at a close distance and having intimate contact with infected cases. Positive psychological intervention is necessary.

3D porous framework of ZnO nanoparticles assembled from double carbon shells consisting of hard and soft carbon networks for high performance lithium ion batteries

Low electronic conductivity and large volume variation result in inferior lithium storage performance of ZnO. To overcome these shortcomings of ZnO, herein ZnO nanoparticles are encapsulated in resorcinol-formaldehyde resin-derived hard carbon and then further assembled into a 3-dimensional mesoporous framework structure using a polyvinyl pyrrolidone-derived soft carbon network. The synthesis methods include the polymerization of resorcinol-formaldehyde resin and a polyvinyl pyrrolidone-boiling method. ZnO@dual carbon has af large specific surface area (153.7 m² g^-1) and high porosity. It exhibits excellent cycling performance and high rate capability. After 350 cycles at 500 mA g^-1, the ZnO@dual carbon still delivers a discharge capacity of 701 mAh g^-1 while the actual discharge capacity of ZnO reaches 950.9 mAh g^-1. At 2 A g^-1, ZnO@dual carbon delivers the average discharge capacity of 469.6 mAh g^-1. The electrochemical performance of ZnO@dual carbon is remarkably superior to those of ZnO@single carbon, pure carbon and pure ZnO nanoparticles, demonstrating the superiority of the dual carbon-assembly structure. This composite structure greatly improves the structural stability of ZnO, enhances its electron conductivity and overall electron transport capacity; which facilitates electrolyte penetration and Li ion diffusion, leading to improved cycling stability and good rate capability.

HOXD9 Activates the TGF-β/Smad Signaling Pathway to Promote Gastric Cancer

Background

Gastric cancer (GC) is the most common malignant tumor of the digestive tract and its molecular mechanism is not clear. HOXD9 plays an important role in tumor progression as transcription factor. In the current study, we explored the role of HOXD9 in GC.

Methods

We predicted the expression and potential mechanism of HOXD9 in GC through an online database. The expression of HOXD9 was detected in GC and adjacent tissues, and then we analyzed the relationship between HOXD9 and the prognosis of patients with GC. In vitro, we investigated the effects of HOXD9 on malignant biological behaviors such as proliferation, migration, and invasion of the GC cell line MCG-803. In addition, we have initially studied the underlying mechanism by Western blot.

Results

High expression of HOXD9 in GC was predicted by online database prediction and implied poor prognosis. In the clinical sample, we confirmed the above predictions. In vitro, we found that knockdown of HOXD9 could effectively inhibit the proliferation, migration, and invasion of GC cells. In terms of mechanism, HOXD9 may activate the TGF-β/Smad signaling pathway.

Conclusion

HOXD9 promotes the malignant biological process of GC, which may be a potential therapeutic target for GC.

A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version)

In December 2019, a new type viral pneumonia cases occurred in Wuhan, Hubei Province; and then named "2019 novel coronavirus (2019-nCoV)" by the World Health Organization (WHO) on 12 January 2020. For it is a never been experienced respiratory disease before and with infection ability widely and quickly, it attracted the world's attention but without treatment and control manual. For the request from frontline clinicians and public health professionals of 2019-nCoV infected pneumonia management, an evidence-based guideline urgently needs to be developed. Therefore, we drafted this guideline according to the rapid advice guidelines methodology and general rules of WHO guideline development; we also added the first-hand management data of Zhongnan Hospital of Wuhan University. This guideline includes the guideline methodology, epidemiological characteristics, disease screening and population prevention, diagnosis, treatment and control (including traditional Chinese Medicine), nosocomial infection prevention and control, and disease nursing of the 2019-nCoV. Moreover, we also provide a whole process of a successful treatment case of the severe 2019-nCoV infected pneumonia and experience and lessons of hospital rescue for 2019-nCoV infections. This rapid advice guideline is suitable for the first frontline doctors and nurses, managers of hospitals and healthcare sections, community residents, public health persons, relevant researchers, and all person who are interested in the 2019-nCoV.

A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version)

In December 2019, a new type viral pneumonia cases occurred in Wuhan, Hubei Province; and then named "2019 novel coronavirus (2019-nCoV)" by the World Health Organization (WHO) on 12 January 2020. For it is a never been experienced respiratory disease before and with infection ability widely and quickly, it attracted the world's attention but without treatment and control manual. For the request from frontline clinicians and public health professionals of 2019-nCoV infected pneumonia management, an evidence-based guideline urgently needs to be developed. Therefore, we drafted this guideline according to the rapid advice guidelines methodology and general rules of WHO guideline development; we also added the first-hand management data of Zhongnan Hospital of Wuhan University. This guideline includes the guideline methodology, epidemiological characteristics, disease screening and population prevention, diagnosis, treatment and control (including traditional Chinese Medicine), nosocomial infection prevention and control, and disease nursing of the 2019-nCoV. Moreover, we also provide a whole process of a successful treatment case of the severe 2019-nCoV infected pneumonia and experience and lessons of hospital rescue for 2019-nCoV infections. This rapid advice guideline is suitable for the first frontline doctors and nurses, managers of hospitals and healthcare sections, community residents, public health persons, relevant researchers, and all person who are interested in the 2019-nCoV.

A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version)

In December 2019, a new type viral pneumonia cases occurred in Wuhan, Hubei Province; and then named "2019 novel coronavirus (2019-nCoV)" by the World Health Organization (WHO) on 12 January 2020. For it is a never been experienced respiratory disease before and with infection ability widely and quickly, it attracted the world's attention but without treatment and control manual. For the request from frontline clinicians and public health professionals of 2019-nCoV infected pneumonia management, an evidence-based guideline urgently needs to be developed. Therefore, we drafted this guideline according to the rapid advice guidelines methodology and general rules of WHO guideline development; we also added the first-hand management data of Zhongnan Hospital of Wuhan University. This guideline includes the guideline methodology, epidemiological characteristics, disease screening and population prevention, diagnosis, treatment and control (including traditional Chinese Medicine), nosocomial infection prevention and control, and disease nursing of the 2019-nCoV. Moreover, we also provide a whole process of a successful treatment case of the severe 2019-nCoV infected pneumonia and experience and lessons of hospital rescue for 2019-nCoV infections. This rapid advice guideline is suitable for the first frontline doctors and nurses, managers of hospitals and healthcare sections, community residents, public health persons, relevant researchers, and all person who are interested in the 2019-nCoV.

Construction of Co3O4 three-dimensional mesoporous framework structures from zeolitic imidazolate framework-67 with enhanced lithium storage properties

High-porosity mesoporous framework structures are attractive for electrochemical energy storage and other applications. Herein we demonstrate a novel synthesis strategy to make zeolitic imidazolate framework-67 oxidize to a Co₃O₄ three-dimensional mesoporous framework structure. This strategy relies on the oxygen-limitation effect of the closed nanocage and the affinity effect of polyvinylpyrrolidone towards zeolitic imidazolate framework-67. Several TiO₂ nanospheres, as the unique structure junctions, are uniformly embedded within the Co₃O₄ framework to enhance the framework strength. The TiO₂/hydrous titania polyhedron nanocage, as the protecting shell, further encapsulates the Co₃O₄ framework, forming a perfect capsule-type hybrid. As anode materials for lithium-ion batteries, TiO₂@Co₃O₄ framework capsules show superior lithium storage performance with high reversible capacity, stable cycling life and good rate capability. A reversible capacity of 1042 mAh g^-1 can be delivered after 200 cycles at a current density of 300 mA g^-1. The average discharge capacity over 200 cycles reaches 926 mAh g^-1. This demonstrates the superiority of this material structure and its great potential as an anode for high-performance lithium-ion batteries. This work indicates a new strategy to take advantage of metal-organic frameworks to synthesize their mesoporous framework derivatives.

Co3O4 hollow nanospheres/carbon-assembled mesoporous polyhedron with internal bubbles encapsulating TiO2 nanosphere for high-performance lithium ion batteries

Co₃O₄ hollow nanospheres 15 nm in the diameter were assembled to the mesoporous polyhedron together with carbon. Within the Co₃O₄ polyhedrons, the bubbles 300-500 nm in diameter were uniformly generated. Every bubble further encapsulated one TiO₂ nanosphere, forming a unique sphere-bubble structure. The specific surface area and the pore volume were calculated to be 97.85 and 0.31 cm³ g^-1. When evaluated as anode material for lithium ion batteries, the as-prepared material exhibited superior lithium storage properties with high specific capacity, excellent cycling stability and good rate capability. After 400 cycles, the discharge capacity of 609 mAh g^-1 was still delivered at current density of 335 mA g^-1. Even at a high current density of 2000 mA g^-1, the reversible capacity reached 296 mAh g^-1. The outstanding electrochemical performance was attributed to the unique hybrid structure, which avoids nanomaterial aggregation, promotes ion diffusion and electron transfer, accommodates volume change of Co₃O₄ during (de)lithiation process, enhances structure strength, cycling stability and space utilization ratio of the hollow material.

[Ocular natural killer/T cell lymphoma: a clinicopathologic analysis]

Objective: To evaluate the clinicopathological features of ocular natural killer(NK)/T cell lymphoma. Methods: Data of 21 patients (22 eyes) with ocular NK/T cell lymphoma treated at Eye & ENT Hospital of Fudan University from January 2006 to March 2018 were retrospectively analyzed for clinical data, morphology, immunophenotype and outcomes. Results: There were 10 males and 11 females with ages from 3 to 77 years (mean, 43 years). There were 20 unilateral cases (10 left eyes and 10 right eyes) and 1 bilateral case. Except for 1 case of corneal perforation resulting from the involvement of the conjunctiva and cornea, the other cases all involved the orbit (including eyelids and conjunctiva) as demonstrated by radiologic studies, with the lacrimal sac involved in 3 cases, and the nasal cavity or maxillary sinus involved in 2 cases. Three patients had been previously diagnosed sinonasal NK/T cell lymphoma with radiotherapy and chemotherapy. Two patients had a history of ovarian NK/T cell lymphoma with chemotherapy. One patient had multiple ulcers of skin and mucosa at presentation. There were 13 primary ocular NK/T cell lymphomas without evidence of nasal or systemic involvement. All patients presented with eyelid swelling and decreased visual acuity. There were proptosis in 18 cases, motility restriction in 13 cases, eyelid ulceration in 3 cases, and fever in 4 cases. They had all been previously diagnosed as orbital pseudotumor or cellulitis and there was no response to steroids and antibiotics. Pathological examination showed atypical lymphoid infiltration with an angioinvasive growth pattern causing coagulative necrosis. Cytologically, the medium-sized neoplastic cells showed irregular folded nuclei. The neoplastic cells were positive for cytoplasmic CD3ε, CD56, and cytotoxic molecules and Epstein-Barr virus-encoded RNA (EBER) in situ hybridization. Seven patients were lost to follow-up. Ten patients died 2.0 to 17.0 months after diagnosis (mean, 6.3 months) despite treatment with chemotherapy and radiotherapy. Conclusions: Ocular NK/T cell lymphoma is a rare form of ocular lymphoma. There are primary NK/T cell lymphoma and secondary ocular NK/T cell lymphoma with nasal or systemic involvement. The rarity of this tumor and inflammatory signs make it challenging to identify these tumors early. The neoplastic cells are positive for cytoplasmic CD3ε, CD56, cytotoxic molecules and EBER in situ hybridization. Despite aggressive therapy, it demonstrates high lethality with poor prognosis. (Chin J Ophthalmol, 2019, 55: 374-380).

Ultra-small bimetallic iron–palladium (FePd) nanoparticle loaded macrophages for targeted tumor photothermal therapy in NIR-II biowindows and magnetic resonance imaging

Nanoparticles working in the NIR-II biowindows possess larger maximum permissible exposure (MPE) and desirable penetration depth to the laser. However, most NIR-II responsive nanomaterials lack tumor targeting and Magnetic Resonance Imaging (MRI) ability. This greatly limits their applications. This study reported ultra-small bimetallic iron–palladium (FePd) nanoparticle loaded macrophages for targeted tumor photothermal therapy in NIR-II biowindows and magnetic resonance imaging. The crystal phase, morphology, absorption spectrum and photothermal performance of the synthesized samples were systematically characterized. The effects of photothermal therapy and nuclear magnetic imaging (MRI) were studied both in vitro and in vivo. Since FePd nanoparticles have both iron and palladium elements, it had a good MRI imaging capability and high photothermal conversion efficiency (36.7%). After binding to macrophages, FePd nanoparticles@macrophages (FePd@M) showed a good tumor targeting ability and were used for targeting NIR-II photothermal therapy and MRI imaging of tumors. The results of photothermal treatment showed that the tumor volume decreased by 90% compared to the control group, and no significant organ toxicity was observed. The results of MRI imaging showed that the FePd@M has the best imaging effect. The nanoparticles with the excellent NIR-II PTT ability and MRI effect have overcome the problem of tumor targeting and avoid the rapid removal of ultra-small nanoparticles. The FePd@M delivery system provides new ideas for material construction in the NIR-II region and has great clinical application potential.

Nanoparticles working in the NIR-II biowindows possess larger maximum permissible exposure (MPE) and desirable penetration depth to the laser.

Monocyte Chemoattractant Protein-Induced Protein 1 Targets Hypoxia-Inducible Factor 1α to Protect Against Hepatic Ischemia/Reperfusion Injury

Sterile inflammation is an essential factor causing hepatic ischemia/reperfusion (I/R) injury. As a critical regulator of inflammation, the role of monocyte chemoattractant protein-induced protein 1 (MCPIP1) in hepatic I/R injury remains undetermined. In this study, we discovered that MCPIP1 downregulation was associated with hepatic I/R injury in liver transplant patients and a mouse model. Hepatocyte-specific Mcpip1 gene knockout and transgenic mice demonstrated that MCPIP1 functions to ameliorate liver damage, reduce inflammation, prevent cell death, and promote regeneration. A mechanistic study revealed that MCPIP1 interacted with and maintained hypoxia-inducible factor 1α (HIF-1α) expression by deubiquitinating HIF-1α. Notably, the HIF-1α inhibitor reversed the protective effect of MCPIP1, whereas the HIF-1α activator compensated for the detrimental effect of MCPIP1 deficiency. Thus, we identified the MCPIP1-HIF-1α axis as a critical pathway that may be a good target for intervention in hepatic I/R injury. (Hepatology 2018; 00:000-000).

Caspase Recruitment Domain Protein 6 Protects Against Hepatic Steatosis and Insulin Resistance by Suppressing Apoptosis Signal-Regulating Kinase 1

The rapidly increasing prevalence of metabolic disorders associated with nonalcoholic fatty liver disease (NAFLD) warrants further study of the underlying mechanisms to identify key regulators as targets for the development of therapeutic interventions. Caspase recruitment domain protein 6 (Card6), as a member of the CARD family that regulates cell death and immunity, may potentially control this process. Indeed, Card6 down-regulation was found to be closely associated with the fatty livers observed in NAFLD patients, obese mice, and a palmitate-treated hepatocyte model. Gain-of-function and loss-of-function Card6 mouse models demonstrated that Card6 protected mice from insulin resistance, hepatic steatosis, and inflammatory responses upon high-fat diet administration. Mechanistically, Card6 interacted with and inhibited apoptosis signal-regulating kinase 1 (Ask1) and its subsequent downstream c-Jun N-terminal kinase/p38 signaling. Furthermore, Ask1 was sufficient to mediate Card6 function, and the interaction between Ask1 and Card6 was absolutely required for Card6 function in vivo. Adenovirus-mediated Card6 overexpression in the liver effectively ameliorated insulin resistance and hepatic steatosis in ob/ob mice. Therefore, we identified Card6 as an important negative regulator in NAFLD. Conclusion: Targeting Ask1 by Card6 may be a good strategy to develop a therapeutic method against NAFLD.

Clinicopathologic Significance and Prognostic Value of Programmed Cell Death Ligand 1 (PD-L1) in Patients With Hepatocellular Carcinoma: A Meta-Analysis

Background: There is still a dispute over an issue of the clinical pathology and prognostic of programmed cell death ligand 1 (PD-L1) in hepatocellular carcinoma (HCC) patients. Here, we undertook this meta-analysis to survey the conceivable role of PD-L1 in HCC.

Method: We searched databases like MEDLINE, EMBASE, and Google Scholar for relevant studies published in English up to February 13, 2018. We implemented the appraisal of the eligible studies according to the choice criterion. We used Hazard ratio (HR) and its 95% confidence interval (95% CI) to evaluate the prognostic role of PD-L1 for overall survival (OS), disease-free survival (DFS), and recurrence-free survival (RFS). Odds ratio (OR) and the corresponding 95% CI were calculated to evaluate the connection between PD-L1 and clinicopathological features. Publication bias was tested.

Results: 13 studies, which published range from 2009 to 2017 were contained in this meta-analysis, involving 1,843 patients with HCC. The results indicated that high PD-L1 could predict shorter OS (HR = 1.57, 95% CI: 1.09-2.27, P < 0.00001) as well as poorer DFS (HR = 2.07, 95% CI: 1.20-3.58, P = 0.009). Additionally, high PD-L1 expression was correlated to liver cirrhosis (OR = 1.66, 95% CI: 1.10-2.50, P = 0.02), poorer tumor Barcelona Clinical Liver Cancer (BCLC) stage (OR = 0.30, 95% CI: 0.10-0.88, P = 0.03) and portal vein invasion (OR = 1.96, 95% CI: 1.04-3.68, P = 0.04), but had no correlation with age, gender, tumor size, number of tumors, AFP, vascular invasion, HBVs-Ag, Anti-HCV, differentiation or TNM stage. Besides, no significant publication bias was found among these identified studies.

Conclusion: The meta-analysis suggested that PD-L1 overexpression could foresee worse OS and DFS in HCC. Moreover, the PD-L1 expression has to bear on liver cirrhosis, portal vein invasion, and BCLC stage.

Abstract 4479: Protein arginine methyltransferase PRMT6 regulates cancer stemness through CRAF methylation in hepatocellular carcinoma

Arginine methylation is a post-translational modification that plays pivotal roles in signal transduction and gene transcription during cell fate determination. We found protein methyltransferase 6 (PRMT6) to be frequently down-regulated in hepatocellular carcinoma (HCC) cells and its expression to negatively correlate with aggressive cancer features in HCC patients. Silencing of PRMT6 promoted the tumor-initiating, metastasis and therapy resistance potential of HCC cells. Consistently, loss of PRMT6 expression aggravated liver tumorigenesis in a DEN+CCL4 HCC induced PRMT6-/- mouse model. Integrated transcriptome and protein-protein interaction studies revealed an enrichment of genes implicated in RAS signaling and that PRMT6 interacted with CRAF, and likely other RAF family members, and their methylation at conserved arginine 100, negatively regulating its activity, and as a consequence resulting in enhanced MEK/ERK signaling. Our work uncovered a critical repressive function for PRMT6 in maintenance of HCC cells by regulating the MEK/ERK pathway via arginine methylation of RAF, providing a new avenue of molecular mechanism by which ERK mediated stemness in HCC cells are developed.

Citation Format: LH Chan, L Zhou, Kai Yu Ng, TL Wong, TK Lee, YP Ching, YF Yuan, D Xie, S Richard, MS Huen, XY Guan, S Ma. Protein arginine methyltransferase PRMT6 regulates cancer stemness through CRAF methylation in hepatocellular carcinoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 4479.

Pterostilbene inhibits MTA1/HDAC1 complex leading to PTEN acetylation in hepatocellular carcinoma

PURPOSE

The aim of this study is to investigate the inhibition of cancer growth by pterostilbene through Metastasis-Associated Protein 1 (MTA1) and the histone deacetylase 1 (HDAC1) complex in hepatocellular carcinoma (HCC).

METHODS

We investigate the antitumor effects of pterostilbene (PTER) in HCC. The SMMC-7721 hepatoma cell line was cultured and treated with PTER for different time depending on the experiment. After treatment, we tested the cellular expression of proteins by Western blot and the expression of MTA1 mRNA by real-time PCR. And the immunoprecipitation was performed to confirm the acetylation in PTEN. Animal models have been established to confirm the anti-cancer effects of PTER.

RESULTS

PTER treatment could downregulate the expression of MTA1, and HDAC1 and elevates the Ac-PTEN ratio in tumors. The results suggest that PTER can decrease the expression of MTA1 and destabilize the MTA1/HDAC1 complex allowing acetylation/activation of PTEN on Lys402 site. The expression of MTA1 may be linked to cell apoptosis and invasion in HCC.

CONCLUSION

We demonstrated that PTER suppressed the growth, and invasion of HCC and was effective in regulating the levels of the MTA1/HDAC1/NuRD complex, promoting PTEN acetylation and apoptosis in HCC. Our findings suggest that the novel epigenetic nature of PTER anticancer activity opens up new avenues for primary chemoprevention, as well as anticancer and antimetastatic treatment.

CoO microspheres and metallic Co evolved from hexagonal α-Co(OH)2 plates in a hydrothermal process for lithium storage and magnetic applications

CoO microspheres and metallic Co could be successfully synthesized by simply reacting cobalt acetate with a mixture solvent of ethylene glycol and deionized water in a hydrothermal process for different times. As the reaction proceeded, α-Co(OH)₂, CoO and metallic Co were produced. To understand the phase evolution processes from α-Co(OH)₂ to CoO and then metallic Co, a range of time-dependent experiments were carried out, and the intermediate products obtained at different reaction times were investigated in detail. The investigation revealed that CoO microspheres were actually evolved from α-Co(OH)₂ as a precursor. Just elongating the reaction time, CoO microspheres could be further reduced to metallic Co. With a pure ethylene glycol medium for the same reaction, only α-Co(OH)₂ could be generated, indicating an important role of water. When the obtained CoO microspheres were used as anode materials for lithium-ion batteries, they delivered a specific capacity of 803 mA h g^-1 at 0.1 A g^-1 with a retention of 453 mA h g^-1 after 70 cycles. Meanwhile, the magnetic properties of the obtained CoO microspheres and metallic Co were investigated, with the CoO microspheres showing an antiferromagnetic behavior and the metallic Co exhibiting ferromagnetic characteristics. This study suggested a novel method for synthesizing CoO with a uniform microsphere morphology and bulk metallic Co easily.

[Short-term efficacy of intravitreal injection of melphalan for refractory vitreous seeding from retinoblastoma]

Objective: To evaluate the efficacy and safety of intravitreal chemotherapy for refractory vitreous seeding from retinoblastoma. Methods: Retrospective series of case studies. Nine patients (13 eyes) with the diagnosis of refractory vitreous seeding were enrolled in Department of Ophthalmology of Eye& ENT Hospital of Fudan University from March 2014 to October 2015.There were 6 males and 3 females. Children aged 8 to 40 months, median age of 18 months. In the 13 eyes, 3 eyes were E period, 9 eyes were D period, and 1 eyes were C period. The fundus was examined by indirect ophthalmoscope and recorded by RetcamIII. Systemic chemotherapy was performed using the VEC protocol, that is vincristine, etoposide, and carboplatin. Local treatment also involves cryotherapy and/or thermotherapy. All patients were treated with intravitreal injection of melphalan. They underwent intravitreal melphalan, once every 4 weeks, with an average of 3 times of injections. The treatment dose of melphalan is 20 to 40 μg per dose. Observe the vitreous seed control and complications of therapy. Results: Vitreous seeds control was attained in all cases. There was no case of orbital extension or remote metastasis. Complications included retinal pigment epithelial and choroidal atrophy in 7 eyes, pupillary synechia and iris atrophy in 2 eyes,retinal vasculitis and vascular occlusion in 2 eyes, optic atrophy in 2 eyes, vitreous hemorrhage in 1 eye, and temporary hypotony in 3 eyes. Conclusions: Intravitreal melphalan is an effective treatment for refractory vitreous seeding from retinoblastoma. High dose may lead to local adverse reactions. (Chin J Ophthalmol, 2017, 53: 570-574).

Comparative Efficacy of Interventional Therapies for Early-stage Hepatocellular Carcinoma: A PRISMA-compliant Systematic Review and Network Meta-analysis

There are several interventional therapies that improve the prognosis and increase the survival rate of early-stage hepatocellular carcinoma (early-stage HCC), but it is uncertain about whether one is superior to others, and available researches investigating the comparative effects of different treatments are limited. The main objective of this Bayesian network meta-analysis was to compare the efficacy of these different treatment strategies for early-stage HCC and rank these interventions for practical consideration. We performed an electronic search of PubMed, Embase, and Cochrane Library, and extracted data from randomized controlled trials that compared different interventional therapies for early-stage HCC. Direct comparison and network meta-analyses were conducted with Aggregate Data Drug Information System software. Consistency models were created to determine whether there was a significant difference between any 2 therapies, and cumulative probability was used to rank different treatments. Twenty-one randomized controlled trials involving 2691 patients were included. In our network meta-analysis, the combination therapy of transcatheter arterial chemoembolization (TACE) and radiofrequency ablation (RFA) was associated with better 1-year survival rate, as compared with hepatic resection alone (P < 0.05, odds ratio [OR] 0.25, 95% confidence interval [CI] 0.06-0.83), percutaneous ethanol injection (PEI) alone (P < 0.05, OR 0.13, 95% CI 0.03-0.45), and RFA alone (P < 0.05, OR 0.23, 95% CI 0.07-0.70). TACE + RFA had a higher 3-year survival rate than PEI alone (P < 0.05, OR 0.32, 95% CI 0.15-0.72) and RFA alone (P < 0.05, OR 0.45, 95% CI 0.24-0.87). And there was a statistical difference between RFA + PEI and PEI alone (P < 0.05, OR 0.33, 95% CI 0.12-0.93) for 3-year survival rate. The results of rank test and cumulative probability showed that TACE + RFA ranked highest on the evaluation of 1-year, 3-year, and 5-year survival rate. Based on Bayesian network meta-analysis combining direct and indirect comparisons, the combination therapy of TACE and RFA seemed to be the most effective strategy for early-stage HCC.

IL-6 Plays a Crucial Role in HBV Infection

Interleukin-6 (IL-6), a cytokine mainly produced by activated monocytes, has broad pleiotropic actions that affect the functions of a variety of lymphoid cells. The roles of IL-6 in regulating immunity to infections are currently being defined. Remarkably, IL-6-mediated cellular and humoral immune responses play a crucial role in determining the outcome of viral infection. This article reviews the current knowledge on the critical role of IL-6 in hepatitis B virus (HBV) infection. As a competent intermediary, IL-6 derived from activated monocytes plays an important role in promoting lymphocytes responses that are essential for effective viral control. However, as a mediator of inflammation, IL-6 is also involved in the development of HBV-induced liver cirrhosis and exacerbating liver injury. Overall, the current data point to IL-6 as an immunoregulatory cytokine in HBV infection. Immunotherapeutic strategies aimed at optimizing the beneficial effects of IL-6 in HBV infection may prove to be an ordeal in the future, as they should foster the strengths of IL-6 while circumventing potential drawbacks.

The long noncoding RNA, EGFR-AS1, a target of GHR, increases the expression of EGFR in hepatocellular carcinoma

LncRNA has provided an important new perspective regarding gene regulation. Both the expression and activation of EGFR have been proven to be under the tight control of the GHR pathway. EGFR-AS1 has been found to inhibit the expression of EGFR. GHR-siRNA and EGFR-AS1-siRNA were transfected into HCC cell lines, and a series of WB, q-PCR, and IF experiments was conducted to evaluate whether EGFR-AS1 participated in the regulation of GHR and EGFR. We found that impeded expression of GHR decreased the expression of EGFR and EGFR-AS1 in vivo and in vitro. Then, it was verified that EGFR and EGFR-AS1 were relatively upregulated in HCC tissue, and they were significantly related to some clinical characteristics and patient prognosis. Furthermore, EGFR-AS1 was determined to promote HCC development by improving the ability of invasion and proliferation of HCC cells in vitro, and it was also found to affect the cell cycle. Our study identified that EGFR-AS1 may promote HCC genesis and development. EGFR-AS1 may act as a prognostic factor in HCC. More importantly, we observed that the inhibition of EGFR-AS1 in HCC cells significantly impeded cell proliferation and invasion in vivo, which might provide a potential possibility for targeted therapy of HCC.

Effect of portal vein ligation on tumor growth and liver regeneration in rat cirrhotic liver lobes

The aim of the present study was to investigate the effect of portal vein ligation (PVL) on the tumor growth rate and liver regeneration in rat cirrhotic liver lobes. A total of 45 male Wistar rats were randomly divided into PVL, hepatic tumor (HT) and HT + PVL groups (n=15 per group). Liver regeneration and tumor growth in ligated and non-ligated lobes were evaluated prior to and following PVL. In addition, serum alanine transaminase, total bilirubin levels and liver tissue samples were evaluated. The results indicated that PVL induced apparent hypertrophy in normal and HT rats. However, the ratio of non-ligated lobes to total liver weight or body weight in the HT + PVL group was significantly lower when compared with the PVL group (P<0.05). Compared with the HT group, the tumor growth rate in the ligated lobes of the HT + PVL group significantly increased (P<0.05). However, tumor growth in the non-ligated lobes exhibited no statistically significant difference between the HT and HT + PVL groups. In addition, Knodell scores indicated that fibrosis was more apparent in the non-ligated lobes of the HT + PVL group when compared with the HT group (P<0.05). Therefore, tumor growth was accelerated in ligated lobes following PVL, but not in non-ligated lobes. PVL also induced liver regeneration in cirrhotic liver lobes with lower efficiency than that in the non-cirrhotic lobes. However, hypertrophy in the contralateral cirrhotic lobes appeared to be non-functional.

Effect of endogenous insulin-like growth factor and stem cell factor on diabetic colonic dysmotility

AIM: To investigate whether the reduction of stem cell factor (SCF) is mediated by decreased endogenous insulin-like growth factor (IGF)-1 in diabetic rat colon smooth muscle.

METHODS: Sixteen Sprague-Dawley rats were randomly divided into two groups: control group and streptozotocin-induced diabetic group. After 8 wk of streptozotocin administration, colonic motility function and contractility of circular muscle strips were measured. The expression of endogenous IGF-1 and SCF was tested in colonic tissues. Colonic smooth muscle cells were cultured from normal adult rats. IGF-1 siRNA transfection was used to investigate whether SCF expression was affected by endogenous IGF-1 expression in smooth muscle cells, and IGF-1 induced SCF expression effects were studied. The effect of high glucose on the expression of endogenous IGF-1 and SCF was also investigated.

RESULTS: Diabetic rats showed prolonged colonic transit time (252 ± 16 min vs 168 ± 9 min, P < 0.01) and weakness of circular muscle contraction (0.81 ± 0.09 g vs 2.48 ± 0.23 g, P < 0.01) compared with the control group. Endogenous IGF-1 and SCF protein expression was significantly reduced in the diabetic colonic muscle tissues. IGF-1 and SCF mRNA expression also showed a paralleled reduction in diabetic rats. In the IGF-1 siRNA transfected smooth muscle cells, SCF mRNA and protein expression was significantly decreased. IGF-1 could induce SCF expression in a concentration and time-dependent manner, mainly through the extracellular-signal-regulated kinase 1/2 signal pathway. High glucose inhibited endogenous IGF-1 and SCF expression and the addition of IGF-1 to the medium reversed the SCF expression.

CONCLUSION: Myopathy may resolve in colonic motility dysfunction in diabetic rats. Deficiency of endogenous IGF-1 in colonic smooth muscle cells leads to reduction of SCF expression.

[Raman tweezers-based analysis of carotenoid synthesis in Rhodotorula glutinis]

Carotenoid synthesis in Rhodotorula glutinis was investigated with Raman tweezers in order to find the effect of nitrogen and carbon resource on carotenoid yield. The cells in fermentation terminus were harvested, and then divided into two parts, one for UV analysis, the other for Raman tweezers detection. Original spectra were preprocessed by carrying out background elimination and baseline correction, and the averaged spectra of cells cultivated in different fermentation medium were analyzed qualitatively. The results showed that the Raman intensity of carotenoid were obviously different. There was a high correlation between UV results and Raman peak height data, the correlation coefficients of fitted parameters were 0.907 8 and 0.912 1, respectively. Quantitative analysis of 1 508 cm(-1) peak height indicated that the appropriate nitrogen and carbon resources for the growth of Rhodotorula glutinis cells and synthesis of carotenoid were yeast extract + tryptone, and glucose, respectively. The above results suggest that Raman tweezers can provide information about carotenoids in Rhodotorula glutinis cells and serve as an effective tool for real time measurement of carotenoid synthesis and optimization of fermentation medium.

Insulin regulates the expression of stem cell factor in rat colonic smooth muscle cells

AIM: To investigate the effect of insulin on the expression of stem cell factor (SCF) in rat colonic smooth muscle cells.

METHODS: Rat colonic smooth muscle cells (SMCs) were separated by mechanical and enzymatic methods and identified by immunofluorescence staining of α-actin. Identified colonic SMCs were randomly divided into two groups: cells treated with different concentrations of insulin (0, 2.5, 5, 20, 40, 80 mg/L) and those treated with insulin for different durations (0, 8, 16, 24 h). The expression of SCF was detected by Western blot and RT-PCR. MTT assay was used to measure the proliferation of colonic SMCs.

RESULTS: At a concentration of 5 mg/L, insulin remarkably promoted the proliferation of colonic SMCs (0.052 ± 0.006 vs 0.018 ± 0.006, P < 0.05). Insulin at a concentration of 2.5, 5 or 20 mg/L promoted SCF expression in colonic SMCs (protein: 0.735 ± 0.035, 0.754 ± 0.057, 0.741 ± 0.051 vs 0.658 ± 0.024; mRNA: 0.688 ± 0.077, 0.690 ± 0.080, 0.698 ± 0.074 vs 0.528 ± 0.053; all P < 0.05), but there were no marked differences in the expression levels of SCF protein and mRNA among these three groups of cells. When the dosage of insulin was elevated to 40 mg/L, SCF expression reached its peak (protein: 0.899 ± 0.048 vs 0.658 ± 0.024; mRNA: 0.938 ± 0.117 vs 0.528 ± 0.053; both P < 0.05). The expression of SCF reached the peak at 16 hours after insulin treatment (protein: 0.899 ± 0.011 vs 0.628 ± 0.015; mRNA: 1.038 ± 0.053 vs 0.709 ± 0.042; both P < 0.05).

CONCLUSION: Insulin promotes cell proliferation and up-regulates SCF expression in rat colonic SMCs.

Transfection with siRNA against ERK1/2 inhibits IGF-1-induced stem cell factor expression in colonic smooth muscle cells

AIM: To investigate how insulin-like growth factor-1 (IGF-1) regulates the expression of stem cell factor (SCF) in colonic smooth muscle cells (SMCs).

METHODS: After rat colonic SMCs were treated with different concentrations of IGF-1 (0, 50, 100, 150 μg/L) for different durations (0, 5, 15, 30, 45, 60 min), the levels of phosphorylated ERK1/2 and SCF were determined by RT-PCR and Western blot. Rat colonic SMCs were then transfected with siRNA against ERK1/2 to examine the impact of ERK1/2 down-regulation on IGF-1-induced SCF expression.

RESULTS: After treatment with IGF-1, the level of phosphorylated ERK1/2 in colonic SMCs reached a peak at about 15 min (0.417 ± 0.036 vs 0.101 ± 0.015; P < 0.05). The optimal concentration of IGF-1 to induce the expression of phosphorylated ERK1/2 and SCF was 100 μg/L (0.790 ± 0.051 vs 0.336 ± 0.013; 0.765 ± 0.061 vs 0.289 ± 0.021, both P < 0.05). After treatment with IGF-1, the expression levels of phosphorylated ERK1/2, total ERK1/2, and SCF in colonic SMCs transfected with siRNA against ERK1/2 were lower than those in the control group (0.284 ± 0.021 vs 0.732 ± 0.005; 0.256 ± 0.015 vs 0.712 ± 0.023; 0.219 ± 0.020 vs 0.673 ± 0.013; 0.621 ± 0.027 vs 1.725 ± 0.012; 0.821 ± 0.019 vs 1.751 ± 0.043; 0.275 ± 0.061 vs 0.531 ± 0.047; all P < 0.05).

CONCLUSION: IGF-1 treatment up-regulated the expression of phosphorylated ERK1/2 and SCF in colonic SMCs, while transfection with siRNA against ERK1/2 down-regulated IGF-1-induced expression of phosphorylated ERK1/2 and SCF, suggesting that the ERK/MAPK pathway may be involved in IGF-1-induced expression of phosphorylated ERK1/2 and SCF.

[Role of bFGF and TGF-beta1 in primary cultured prostatic stromal cells]

OBJECTIVE

To study the role of the basic fibroblast growth factor (bFGF) and transforming growth factor beta1 (TGF-beta1) in benign prostatic hyperplasia (BPH).

METHODS

The human stromal cells of BPH were isolated and cultured. The proliferation of the stromal cells cultured in serum-free medium was detected by MTT method, the phenotype changes of smooth muscle cells detected by immunohistochemical method, and the effect of different concentrations of bFGF and TGF-beta1 on the cultured stromal cells of BPH observed.

RESULTS

bFGF stimulated the cultured BPH stromal cell proliferation (P < 0.05, P < 0.01) and decreased the expression of smooth muscle cell (SMC) phenotype in higher concentration (10 microg/L). TGF-beta1 (> 1 microg/L) inhibited stromal cell proliferation and increased the expression of SMC phenotype (P < 0.05, P < 0.01). 5 microg/ml bFGF and TGF-beta1 (0.001 microg/L, 0.01 microg/L) promoted stromal cell proliferation (P < 0.01), while 5 microg/L bFGF and TGF-beta1 (0.1 microg/L, 1 microg/L, 10 microg/L) inhibited it, slightly in 0.1 microg/L (P > 0.05) and significantly in 1 microg/L and 10 microg/L (P < 0.01), and increased the expression of SMC phenotype in higher concentration (> 1 microg/L, P < 0.01).

CONCLUSION

bFGF stimulates the proliferation of the prostatic stromal cells of BPH in a time- and dose-dependent fashion and decreases the expression of SMC phenotype, TGF-beta1 inhibits the growth of stromal cells and induces the differentiation of stromal cells to SMC, both playing an important role in the mechanism of BPH.

[Relationship of hypoxia-inducible factor 1 alpha (HIF-1alpha) gene expression with vascular endothelial growth factor (VEGF) and microvessel density (MVD) in human colorectal adenoma and adenocarcinoma]

BACKGROUND & OBJECTIVE

Hypoxia-inducible factor-1 alpha (HIF-1alpha), a transcriptional factor response to hypoxia plays an important role in tumor angiogenesis. This study was designed to examine the expression of HIF-1alpha gene and its relationship with vascular endothelial growth factor (VEGF) protein and microvessel density (MVD).

METHODS

HIF-1alpha gene expression was analyzed using in situ hybridization, and VEGF expression levels were determined by immunohistochemistry in colorectal adenomas and primary colorectal adenocarcinomas. Microvessel density (MVD) was determined by anti-CD34 immunostaining.

RESULTS

Positive expression of HIF-1alpha mRNA were found in 67.8% (42/62) of the colorectal adenocarcinomas and 44.4% (8/18) of the adenomas. The mean percentage of HIF-1alpha mRNA positive cells increased gradually with the development from Dukes'stage A to stage C+D (P< 0.05). The frequencies of HIF-1alpha positive cells in pathologic stage of the specimens were as follows: adenoma 8%, Dukes A 14%, Dukes B 23%, Dukes C+D 35%. The positive expression rate of VEGF protein in colorectal adenocarcinoma group was significantly higher than that in colorectal adenoma group (59.7% vs 33.3%,P< 0.05). During colorectal tumor progression, the expression of HIF-1alphamRNA was positively correlated with the VEGF protein expression and MVD (r(s) = 0.768 P< 0.01 and r(s) = 0.683 P< 0.05, respectively).

CONCLUSION

These results suggest that tumor angiogenesis induced by HIF-1alpha mRNA and VEGF protein might play an important role in tumorigenesis of colorectal adenoma and progression of colorectal cancer.

[Foundational study of subcritical water chromatography]

AIM

To study the subcritical water chromatographic discipline of compounds with medium and high polarity on the capillary and packed column.

METHODS

A packed and capillary subcritical water chromatography-FID detection system was built up. Six alcohols were well separated on a C18 column and the influence of temperature on chromatographic behavior of alcohols with different polarity was studied. The influence of temperature and pressure on chromatographic behavior of benzoic acid and gensenoside Rg1 on a SE-54 capillary column were also studied.

RESULTS

Increasing temperature resulted in the decreasing polarity of mobile phase, shortened retention times of components separated, narrowed peak shape and improved tailing as well.

CONCLUSION

Temperature programming could be used successfully to separate compounds with various polarity selectively. Thermostable capillary column could enlarge the range of temperature even more.

Use of silica gel with reversed-phase eluents for the separation and determination of alkaloids in Corydalis Yanhusuo W. T. Wang and its preparations

An HPLC method using unmodified silica with reversed-phase eluents was developed for the determination of DL-tetrahydropalmatine in Corydalis Yanhusuo W. T. Wang and its set prescription preparations. The mobile phase was a mixture of methanol and 2 mmol/L phosphate buffer (75:25, v/v). The result was calculated by external standardization. The method is simple, rapid and precise, and could also be used for the separation and determination of alkaloids in other crude drugs and preparations.

Randomized study of chemoembolization as an adjuvant therapy for primary liver carcinoma after hepatectomy

From April 1990 to December 1993, 140 patients were recruited to a randomized study to evaluate transcatheter hepatic arterial chemoembolization (TACE) as an adjuvant therapy for primary liver carcinoma after hepatectomy. This study investigated the principle, techniques and results of TACE. The results showed that the intrahepatic recurrence rate was 48.9% in the patients who underwent radical resection only, but only 21.3% in the patients who also underwent TACE 3-4 weeks after hepatectomy (P < 0.01). The 1-, 2-, 3-, and 4-year survival rates were 72.3%, 52.7%, 35.1%, and 35.1% respectively for the patients who underwent radical resection only, and were 97.9%, 85.5%, 69.5%, and 56.9% for the patients who also underwent TACE 3-4 weeks after radical resection (P < 0.001). The 1-, 2-, 3-, and 4-year survival rates were 38.9%, 0%, 0%, and 0% for the patients who underwent palliative resection only, and were 68.3%, 32.3%, 21.5%, and 21.5% respectively for the patients undergoing TACE 3-4 weeks after palliative hepatectomy (P < 0.001).