Safety and efficacy of postoperative adjuvant therapy with atezolizumab and bevacizumab after radical resection of hepatocellular carcinoma.

BACKGROUND: The effects of postoperative adjuvant therapy for high-risk recurrent hepatocellular carcinoma (HCC) in immunotherapy are still under investigation. This study evaluated the preventive effects and safety of postoperative adjuvant therapy, including atezolizumab, and bevacizumab, against the early recurrence of HCC with high-risk factors. METHODS: The complete data of HCC patients who underwent radical hepatectomy with or without postoperative adjuvant therapy after two-year follow-up were analyzed retrospectively. The patients were divided into high-risk or low-risk groups based on HCC pathological characteristics. High-risk recurrence patients were divided into postoperative adjuvant treatment and control groups. Due to the difference in approaches in postoperative adjuvant therapies, they were divided into transarterial chemoembolization (TACE), atezolizumab, and bevacizumab (T + A), and combination (TACE+T + A) groups. The two-year recurrence-free survival rate (RFS), overall survival rate (OS), and associated factors were analyzed. RESULTS: The RFS in the high-risk group was significantly lower than that in the low-risk group (P = 0.0029), and the two-year RFS in the postoperative adjuvant treatment group was significantly higher than that in the control group (P = 0.040). No severe complications were observed in those who received atezolizumab and bevacizumab or other therapy. CONCLUSION: Postoperative adjuvant therapy was related to two-year RFS. TACE, T + A, and the combination of these two approaches were comparable in reducing the early recurrence of HCC without severe complications.

The role and application of fibroblast activating protein.

Fibroblast activation protein-α (FAP), a type-II transmembrane serine protease, is rarely expressed in normal tissues but highly abundant in pathological diseases, including fibrosis, arthritis, and cancer. Ever since its discovery, we have deciphered its structure and biological properties and continue to investigate its roles in various diseases while attempting to utilize it for targeted therapy. To date, no significant breakthroughs have been made in terms of efficacy. However, in recent years, several practical applications in the realm of imaging diagnosis have been discovered. Given its unique expression in a diverse array of pathological tissues, the fundamental biological characteristics of FAP render it a crucial target for disease diagnosis and immunotherapy. To obtain a more comprehensive understanding of the research progress of FAP, its biological characteristics, involvement in diseases, and recent targeted application research have been reviewed. Moreover, we explored its development trend in the direction of clinical diagnoses and treatment.

Food Packaging: A Comprehensive Review and Future Trends.

Innovations in food packaging systems will help meet the evolving needs of the market, such as consumer preference for "healthy" and high-quality food products and reduction of the negative environmental impacts of food packaging. Emerging concepts of active and intelligent packaging technologies provide numerous innovative solutions for prolonging shelf-life and improving the quality and safety of food products. There are also new approaches to improving the passive characteristics of food packaging, such as mechanical strength, barrier performance, and thermal stability. The development of sustainable or green packaging has the potential to reduce the environmental impacts of food packaging through the use of edible or biodegradable materials, plant extracts, and nanomaterials. Active, intelligent, and green packaging technologies can work synergistically to yield a multipurpose food-packaging system with no negative interactions between components, and this aim can be seen as the ultimate future goal for food packaging technology. This article reviews the principles of food packaging and recent developments in different types of food packaging technologies. Global patents and future research trends are also discussed.

Identification of risk factors for intraoperative hemobilia and its correlation with early postoperative complications in patients with hepatolithiasis.

BACKGROUND: This study intends to determine the risk factor(s) for intraoperative hemobilia in patients with hepatolithiasis and examine whether the occurrence of intraoperative hemobilia influences the rate of early postoperative complications. METHODS: A retrospective analysis of 867 eligible patients was performed. Patients were divided into 2 groups: group A (hemobilia, n = 76) and group B (nonhemobilia, n = 791). RESULTS: The incidence of intraoperative hemobilia was 8.8% (76/867). Independent risk factors of intraoperative hemobilia for patients with hepatolithiasis were interval between surgery and latest attack of acute cholangitis less than or equal to 38.8 days; preoperative attack of acute severe cholangitis; and intrahepatic duct stricture. Group A had a higher incidence of early postoperative complications than group B. Shorter interval between surgery and latest attack of acute cholangitis correlated with intraoperative hemobilia and postoperative complications. CONCLUSION: The severity and time of onset of preoperative acute cholangitis influence the risk of intraoperative hemobilia, which is positively correlated with early postoperative complications.

Analyzing risk factors for early postoperative bile leakage based on Clavien classification in bile duct stones.

OBJECTIVES: To identify the risk factors of bile leakage, with different severity, based on Clavien-Dindo complication classification system. MATERIALS AND METHODS: A retrospective analysis of 943 eligible patients was performed. Sixty-eight patients, with bile leakage, were divided into 2 groups: mild bile leakage (grades I, II, n = 41) and severe bile leakage (grades III, IV, V, n = 27). Twenty-five potential factors were analyzed, by multivariate regression analyses, to identify independent risk factors of bile leakage. RESULTS: The independent risk factors of bile leakage, for the entire cohort, included attacks of acute cholangitis within 1 month, associated biliary-enteric anastomosis (BEA), associated hepatectomy and previous biliary surgery. The independent risk factors for patients with mild bile leakage were attacks of acute cholangitis within 1 month, associated hepatectomy, and a history of previous biliary surgery. Similarly, the independent risk factors for patients with severe bile leakage were attacks of acute cholangitis within 1 month, associated hepatectomy, and associated BEA. CONCLUSIONS: Risk factors for mild and severe postoperative bile leakage, in bile duct stones, were different.

Identification of risk and prognostic factors for patients with clonorchiasis-associated intrahepatic cholangiocarcinoma.

BACKGROUND: Intrahepatic cholangiocarcinoma caused by clonorchiasis (CICC) has a poor prognosis, and there have been insufficient studies regarding risk and prognostic factors. We aimed to identify CICC-associated factors. METHODS: A retrospective analysis of 127 eligible patients with CICC was performed with 254 clonorchiasis cases used as matched controls to identify risk factors for CICC. The main outcomes analyzed included overall survival (OS) and disease-free survival (DFS). RESULTS: Out of 127 surgeries, R0 resection was performed in 61 patients, R1 in 32 patients, and R2 in 22 patients; nonresection surgery was performed in 12 patients. Median OS for the entire cohort was 29.5 months. Median OS and DFS for 61 patients with R0 resection were 52.4 months and 41.5 months, respectively. We found independent risk factors for CICC were duration of raw fish consumption of ≥28 years (p < 0.001) and hepatitis B virus infection (p = 0.040). R0 resection (p < 0.001), well or moderately differentiated tumor (p = 0.019), and stage I to II tumor (p < 0.001) predicted improved OS for CICC. Serum carcinoembryonic antigen level of ≤5 ng/ml (p = 0.029) and stage I to II tumor (p < 0.001) predicted improved DFS. CONCLUSIONS: Duration of raw fish consumption ≥28 years and hepatitis B virus infection were significant risk factors for CICC in patients with clonorchiasis. For patients with CICC, curative resection is an effective treatment. Higher tumor differentiation and earlier American Joint Committee on Cancer stage predicted good prognosis. Serum carcinoembryonic antigen level was found to predict the possibility of recurrence after curative resection.

Analysis of risk factors for pancreatic duct stones formation in patients with alcoholic chronic pancreatitis.

BACKGROUND: Alcoholic chronic pancreatitis (ACP) is the dominant cause of chronic pancreatitis (CP). As a main complication of CP, the formation of pancreatic duct stones (PDS) compromises pancreatic function and symptomatic patients are often subjected to aggressive treatments. The present study aimed to identify PDS risk factors in patients with ACP. METHODS: A retrospective analysis of 93 ACP patients was performed; patients were divided into two groups: ACP with PDS (n = 48) and ACP without PDS (n = 45). Fourteen potential factors were analyzed by univariate and multivariate analyses to identify independent risk factors of PDS formation in ACP patients. A comparison of demographic and clinical characteristics between ACP patients with PDS and non-ACP patients with PDS (n = 43) was also carried out. RESULTS: ACP accounted for 47.7% (93/195) of CP in this cohort. Among ACP patients, the morbidity of PDS was 51.6% (48/93). Significant risk factors of PDS formation for ACP patients included duration of drinking ≥24.7 years (OR, 9.036; 95% CI, 2.737-29.837; p < 0.001); daily alcohol consumption ≥147.0 g (OR, 3.147; 95% CI, 1.040-9.522; p = 0.042); and MPD narrowing (OR, 7.245; 95% CI, 2.205-23.811; p = 0.001). Shorter periods between diagnosis and PDS formation (PDP) were observed in ACP patients than non-ACP patients. CONCLUSIONS: Alcohol consumption accelerates the progression of PDS formation in patients with CP.

Identification of prognostic factors and the impact of palliative resection on survival of patients with stage IV hepatolithiasis-associated intrahepatic cholangiocarcinoma.

BACKGROUND: Hepatolithiasis-associated intrahepatic cholangiocarcinoma (IHHCC) has a poor prognosis, because of lower curative resection rate when diagnosed in the advanced stage. There has been insufficient data regarding prognostic factors and the impact of palliative resection on its outcome. METHODS: A retrospective analysis of 78 eligible patients with stage IV IHHCC was performed. The potential prognostic factors were assessed by univariate and multivariate analyses. Patients were divided into groups A (margin positive) and B (nonresection) based on surgical methods. Demographic and operative data were compared. RESULTS: Of 78 surgeries, R1 was achieved in 11, R2 in 21 and nonresection in 46 patients. Median overall survival (OS) of the entire cohort was 10.5 months. Surgery (P < 0.01), tumor differentiation (P = 0.03), AJCC stage (P < 0.01), and serum CEA levels (P < 0.01) were independent prognostic factors. Significant differences were achieved in OS (P < 0.01), operation time (P < 0.01), estimated blood loss (P < 0.01), and postoperative complications (P = 0.02) between groups A and B. CONCLUSIONS: For patients with stage IV IHHCC, palliative resection is a rational and effective treatment. Normal serum CEA levels, higher tumor differentiation, and stage IVa predict good prognosis in stage IV IHHCC.

[Study on hair Hg and Pb content distribution of traffic polices, Guilin].

95 hair samples from traffic polices and 110 hair samples from ordinary people were collected from 6 areas of Guilin, China, and Hg, Pb contents in hairs were determined. The result shows that the heavier the traffic was, the higher hair Hg, Pb contents of traffic polices are. Hair Hg, Pb contents of traffic polices also increase with their working time. Average hair Hg, Pb contents of outdoor polices are higher than those of indoor polices. The average hair Hg content (1.340 microg x g(-1)) of traffic polices is 1.74 times as high as the Chinese average value (0.77 microg x g(-1)), while the average hair Pb content (2.877 microg x g(-1)) is below the Chinese average value (6.60 microg x g(-1)). The use of unleaded petrol reduced the air Pb pollution, but Hg pollution still exists. The average hair Hg content (1.504 microg x g(-1)) in male traffic polices is higher than that (1.176 microg x g(-1)) of female traffic polices,while the average hair Pb content (2.852 microg x g(-1) in male traffic polices lower than that (2. 902 microg x g(-1)) of female traffic polices.