Genome-wide identification of heat shock protein gene family and their responses to pathogen challenge in Trachinotus ovatus.

Heat Shock Proteins (HSPs) are a widely distributed family of proteins produced in response to heat and other stresses. To develop a deeper understanding of the mechanisms governing expression of HSPs in the bony fish Trachinotus ovatus, we carried out a whole genome analysis and identified 43 HSP genes. Based on their phylogenetic relationships with Danio rerio, Seriola dumerili, and Seriola lalandi, they were divided into four subfamilies: HSP20, HSP60, HSP70, and HSP90. We performed an analysis of the predicted physicochemical properties and subcellular localization of proteins encoded by these genes. The chromosomal localization results showed that the HSP genes are distributed across 20 chromosomes of T. ovatus.These genes were found to be expressed in different tissues, and they showed differential expression in the immune response against Streptococcus agalactiae. However, there was no significant differential expression in the different skin tissue locations of T. ovatus after infection by Cryptocaryon irritans Brown. This study provides basic information for further research on the evolution and structure and function of HSPs in teleosts.

Prognostic value of preoperative circulating tumor cells for hepatocellular carcinoma with portal vein tumor thrombosis: A propensity score analysis.

PURPOSE: The role of circulating tumor cells (CTCs) in hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) is not fully understood. METHODS: In this retrospective analysis, we included 316 HCC patients who underwent hepatectomy and preoperative CTC detection. We selected 41 pairs of matched HCC patients with and without PVTT using propensity score matching (PSM) analysis. We compared the preoperative CTC counts in patients from both the full cohort and the PSM model. We also analyzed their associations with disease-free survival (DFS) and overall survival (OS). RESULTS: Before and after PSM analysis, the preoperative CTC counts in the HCC with PVTT group were substantially higher than in the HCC without PVTT group. In both the full cohort of patients and the PSM model, patients with CTC ≥ 2 had significantly shorter OS and DFS than patients with CTC < 2. The outcomes of HCC patients with PVTT could be well differentiated by preoperative CTC levels. HCC patients with CTC ≥ 2 had noticeably shorter OS (9.9 months vs. 24.6 months, P = 0.0003) and DFS (6.0 months vs. 12.3 months, P = 0.0041) than those with CTC < 2. Moreover, preoperative CTC ≥ 2 remained an independent predictor in all groups' multivariate analysis. CONCLUSION: We discovered a link between preoperative CTC counts and the occurrence of PVTT and confirmed the prognostic significance of preoperative CTC in HCC patients with PVTT. These findings suggest that preoperative CTC counts have the potential to assist in identifying patients with HCC and PVTT who may benefit from surgery.

Postoperative outcomes and recurrence patterns of intermediate-stage hepatocellular carcinoma dictated by the sum of tumor size and number.

BACKGROUND: The selection criteria for Barcelona Clinic Liver Cancer (BCLC) intermediate-stage hepatocellular carcinoma (HCC) patients who would truly benefit from liver resection (LR) remain undefined. AIM: To identify BCLC-B HCC patients more suitable for LR. METHODS: We included patients undergoing curative LR for BCLC stage A or B multi-nodular HCC (MNHCC) and stratified BCLC-B patients by the sum of tumor size and number (N + S). Overall survival (OS), recurrence-free survival (RFS), recur-rence-to-death survival (RTDS), recurrence patterns, and treatments after recurrence in BCLC-B patients in each subgroup were compared with those in BCLC-A patients. RESULTS: In total, 143 patients who underwent curative LR for MNHCC with BCLC-A (n = 25) or BCLC-B (n = 118) were retrospectively analyzed. According to the N + S, patients with BCLC-B HCC were divided into two subgroups: BCLC-B1 (N + S ≤ 10, n = 83) and BCLC-B2 (N + S > 10, n = 35). Compared with BCLC-B2 patients, those with BCLC-B1 had a better OS (5-year OS rate: 67.4% vs 33.6%; P < 0.001), which was comparable to that in BCLC-A patients (5-year OS rate: 67.4% vs 74.1%; P = 0.250), and a better RFS (median RFS: 19 mo vs 7 mo; P < 0.001), which was worse than that in BCLC-A patients (median RFS: 19 mo vs 48 mo; P = 0.022). Further analysis of patients who developed recurrence showed that both BCLC-B1 and BCLC-A patients had better RTDS (median RTDS: Not reached vs 49 mo; P = 0.599), while the RTDS in BCLC-B2 patients was worse (median RTDS: 16 mo vs not reached, P < 0.001; 16 mo vs 49 mo, P = 0.042). The recurrence patterns were similar between BCLC-B1 and BCLC-A patients, but BCLC-B2 patients had a shorter recurrence time and a higher proportion of patients had recurrence with macrovascular invasion and/or extrahepatic metastasis, both of which were independent risk factors for RTDS. CONCLUSION: BCLC-B HCC patients undergoing hepatectomy with N + S ≤ 10 had mild recurrence patterns and excellent OS similar to those in BCLC-A MNHCC patients, and LR should be considered in these patients.

Myrothecol A, a new alkylresorcinol with cytotoxicity from Myrothecium sp.

A new alkylresorcinol, myrothecol A (1), along with two known ones (2 and 3), were isolated from a fungal strain Myrothecium sp. GY170016. Their structures were elucidated by extensive spectroscopic analysis. The absolute configuration of 1 was determined by electronic circular dichroism experiment. This is the first case of the presence of alkylresorcinols in genus Myrothecium. All the isolates were evaluated for their cytotoxic activities against human cancer cell line MCF-7 with IC50 values of 16.7, 13.2, 21.3 µM, respectively.

The Presence of Circulating Tumor Cell Cluster Characterizes an Aggressive Hepatocellular Carcinoma Subtype.

BACKGROUND: Growing evidence suggests that circulating tumor cell (CTC) clusters may be an important factor in the metastatic process, but their role in hepatocellular carcinoma (HCC) remains unclear. This study aimed to characterize the molecular and clinical features of CTC cluster-positive human HCC and to assess its prognostic value in HCC patients. METHODS: The CTCs and CTC clusters were evaluated in 204 HCC patients using CellSearch™ System. The counts of CTCs and CTC clusters were correlated with different clinical features, while their associations with progression-free survival (PFS) and overall survival (OS) were evaluated integrally and hierarchically by Kaplan-Meier estimates or Cox proportional regression analysis. Five cases each of CTC cluster-negative and cluster-positive patients were selected for RNA-sequencing analysis. The results of gene enrichment analysis were further verified using tissue microarray (TMA) by immunohistochemistry (IHC). RESULTS: CTCs and CTC clusters were detected in 76 (37.3%) and 19 (9.3%) of 204 preoperative samples, respectively. CTC cluster-positive HCC represented an aggressive HCC phenotype with larger tumor size, more frequent microvascular invasion, and higher tumor stages. The survival of HCC patients utilizing CTCs and CTC clusters individually showed prognostic significance, while joint analysis revealed patients in Group III (CTC ≥ 2 and CTC cluster > 0) had the worst outcome. Stratified analysis of outcomes in Barcelona Clinic Liver Cancer (BCLC) and tumor-node-metastasis (TNM) stages indicated that patients with CTC clusters had significantly poorer prognosis in each stage than those without CTC clusters. Moreover, the RNA sequencing and TMA staining results showed that CTC cluster-positive HCCs were usually associated with Wnt/ß-catenin signaling activation. CONCLUSION: The presence of CTC clusters characterizes an aggressive HCC subtype. CTC clusters may be used as a biomarker in predicting the prognosis on each stage of malignancy in HCC, which provides evidence for formulating therapeutic strategies for more precise treatment.

Preparation of phenyl-boronic acid polymeric monolith by initiator-free ring-opening polymerization for microextraction of sulfonamides prior to their determination by ultra-performance liquid chromatography-tandem mass spectrometry.

In this study, a novel phenyl-boronic acid polymeric monolith (PBAPM) in polyether ether ketone (PEEK) tube was fabricated. The inner wall of PEEK tube was modified with mussel inspired polydopamine layer to firmly bond PBAPM, so as to avoid the outflow of PBAPM from PEEK tube and improve the service life and application scope of PBAPM. The PBAPM was synthesized by initiator-free ring-opening polymerization based on our previous work. The boric acid groups provided B-N coordination sites, as well as the hydrophobic amino and epoxy monomers provided hydrophobic interaction sites. Due to the synergistic effect of hydrophobic interaction and B-N coordination, the PBAPM exhibited excellent binding amounts for nitrogen-containing sulfonamides (SAs). In addition, the PBAPM possessed excellent stability, rigidity and permeability. Therefore, the PBAPM was used as solid phase microextraction (SPME) material for enrichment and separation of SAs from aqueous samples. The PBAPM SPME was optimized in detail, and combined with ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) analysis for simultaneous determination of 10 kinds of SAs from tap, lake and river water. Using only 1 mL of water samples, limit of quantitation of SAs could reach 0.54-4.5 ng L-1. Recoveries of standard spiked SAs from water samples were between 82.0% and 105.4%, with intra-day and inter-day relative standard deviation ranging from 3.3% to 5.6% and 4.2% to 8.1%, respectively. The PBAPM SPME combined with UPLC-MS/MS method shown better or similar recoveries, and used fewer samples than previous methods. These results demonstrated that the PBAPM could selectively separate and enrich ultra-trace nitrogen-containing SAs from aqueous samples.

Clinical Value of Trans-parenchymal Compressing Suture to Decrease the Cutting Surface Related Complications after Non-anatomical Liver Resection.

Non-anatomical liver resection with appropriate resection margin is regarded as a potential curative treatment for selected major hepatic carcinoma due to preserving maximal normal liver, especially in cirrhotic patients. But occurrence of cutting surface related complications becomes a main challenge. From June 2010 to June 2016, 448 patients with major hepatic carcinoma received non-anatomical liver resection in our liver surgery center. After excluding 66 cases that were incongruent with the purpose of study, 235 patients undergoing transparenchymal compressing suture (TCS) to "not good" cutting surface were allocated as study group; 147 patients with exposed surface (ES) were matched as control group. The characteristics of postoperative drainage, postoperative hepatic and renal functions, hospital days, and outcomes were collected retrospectively. We further compared cutting surface related complications under different levels of liver cirrhosis between the two groups. Compared with ES group, patients in TCS group had a decreased incidence of cutting surface related complications (14.3% vs. 6.8%, P=0.011) and a decreased probability of interventions for cutting surface related complications (8.2% vs. 3.4%, P=0.042). TCS application was much more effective to prevent cutting surface related complications in patients with moderate and severe cirrhosis (5.4% vs. 15.8%, P=0.003). Postoperative hepatic and renal function, hospital days and mortality did not differ between the two groups. In conclusion, TCS decreases the probability of cutting surface related complications and postoperative interventions for related complications, especially in patients with moderate and severe cirrhosis.

Preparation of phenyl-boronic acid polymer monolith by initiator-free ring-opening polymerization for microextraction of sulfamethoxazole and trimethoprim from animal-originated foodstuffs.

Boronate affinity materials are usually used for selective enrichment of cis-diol-containing compounds, mainly based on formation of pH-dependent cyclic ester between cis-diol and boronic acid. Recently, B-N coordination, or combined with hydrogen-bonding interaction, was employed as primary interaction for the extraction of nitrogen-containing compounds. However, there are no reports about the combination of hydrophobic (or π-π) interaction and B-N coordination for the extraction. Here, we prepared a novel hydrophobic phenyl-boronic acid polymer (PBAP) through initiator-free ring-opening polymerization. The adsorption experiment indicated that the PBAP could combine hydrophobic (or π-π) interaction and B-N coordination to enhance their adsorption capacity toward hydrophobic and nitrogen-containing compounds, for example sulfamethoxazole (SMX) and trimethoprim (TMP). In addition, the PBAP monolith synthesized in pipette tip was used as solid phase microextraction (SPME) sorbent with combination of ultra high performance liquid chromatography to extract and monitor SMX and TMP from animal-originated foodstuffs. The proposed method exhibited low limit of quantitation as 5.0 and 1.0 ng mL-1 for SMX and TMP, respectively. The recoveries at three spiked levels were between 92.4% to 100.5% for SMX, and 92.7% to 102.6% for TMP, with intra-day and inter-day relative standard deviations no more than 5.3% and 8.6%, respectively. These results well demonstrated that the combination of hydrophobic (or π-π) interaction and B-N coordination played an important role in the extraction of hydrophobic and nitrogen-containing compounds.

[Heavy Metal Content of Rural Living Solid Waste and Related Source and Distribution Analysis].

Living solid waste of 72 typical villages and towns in 12 provinces was investigated, and related heavy metal pollution characteristics, source, and distribution were analyzed. Results showed that heavy metal content of As, Hg, Pb, Cd, Cr, Cu, Zn, and Ni in living solid waste of typical northern villages of China was (7.51±8.89), (0.64±0.42), (21.91±12.29), (4.82±8.37), (86.36±59.99), (36.43±15.98), (62.19±36.61), and (46.07±25.22) mg·kg-1, respectively. Content of As, Hg, Pb, Cd, Cr, Cu, Zn, and Ni in living solid waste of typical southern towns was (7.43±8.82), (0.83±0.74), (21.62±13.76), (1.84±4.55), (131.06±74.96), (37.20±16.80), (98.04±63.71), and (46.75±25.75) mg·kg-1, respectively. Cd and Hg exceeded the standards for urban garbage agricultural control and soil environmental quality. Sources of heavy metals in domestic waste were explored by Pearson correlation analysis, cluster analysis, and principal component analysis. Results showed that Pb and Cd were mainly derived from kitchen waste, dust, paper, rubber, and plastic. Hg was mainly from kitchen waste and dust. Zn and Cr were mainly from dust. Cu was mainly from dust, paper, rubber, plastic, battery, and electronic waste. Ni was mainly from battery and electronic wastes. As was mainly derived from pesticides and fertilizers.

Personalized stepwise vascular control during complex hepatectomy involving hepatocaval confluence.

BACKGROUND: This study introduces an innovative stepwise vascular control technique to address the high risk of massive bleeding from main hepatic veins and the retro-hepatic inferior vena cava during hepatectomy involving hepatocaval confluence. METHODS: From January 2010 to July 2016, 80 patients underwent stepwise vascular occlusion during complex liver resection involving hepatocaval confluence. Relevant clinical data were collected and compared with those obtained in parallel studies. The protocol has been registered in the Protocol Registration and Results System as protocol NCT02996006. RESULTS: All 80 patients underwent portal triad (PT), infra-hepatic inferior vena cava (IIVC) and supra-hepatic inferior vena cava (SIVC) preparation for occlusion in that order; PT, PT + SIVC and PT + IIVC + SIVC occlusions were performed during liver resection for six, 42 and 32 patients, respectively. The PT, IIVC and SIVC clamping times were 12.9 ± 2.5, 9.1 ± 2.1 and 5.1 ± 1.4 min, respectively. The mean blood loss was 504.1 ± 234.5 mL. Sixteen patients received blood transfusions. Haemodynamic parameters remained stable. No patients had life-threatening complications or died (Clavien-Dindo grade IV or V). Compared with other techniques used in parallel studies, this technique has the advantage of decreased blood loss in less warm ischaemia time. CONCLUSION: For complex hepatectomy involving hepatocaval confluence, this newly described stepwise vascular control technique was efficacious and feasible for controlling intraoperative bleeding.

[Nursing care of endovascular aneurysm repair patients].

The treatment of aortic disease previously used conventional open surgery to replace the aorta with artificial vascular prosthesis after resecting the lesioned segment. The recently developed technique of endovascular aneurysm repair (EVAR) uses a stent graft to reinforce the diseased aortic wall while allowing blood flow continuity and preventing further aortic expansion, dissection and aortic rupture. Taiwan's National Health Insurance now covers payment for authorized EVAR procedures, making treatments safer for patients who are elderly, have congestive heart failure, have multiple comorbidities, or have other high-risk factors. EVAR is gradually replacing previous methods to become the primary treatment approach for aortic disease. This article discusses the development of EVAR, indications, operative procedures, complications, postoperative risk factors, and clinical nursing problems. We hope that this article provides new information on nursing care for patients undergoing endovascular aneurysm repair surgery.

Effectiveness of education programs about oral antibiotic suspensions in pediatric outpatient services.

BACKGROUND: The effectiveness of education programs for pediatric patients receiving oral antibiotic suspension was unclear. METHODS: When pediatric patients were prescribed antibiotics in powder form for suspension at the outpatient clinic of a university hospital, the responsible 150 caregivers were consecutively allocated into three education programs: Group 1 subjects read the package insert; Group 2 read a photograph-designed educational sheet; and Group 3 received a face-to-face medication education from a pharmacist with the photograph-designed educational sheet. The effectiveness of the three education programs for pediatric patients' caregivers was evaluated using a questionnaire comprised of 12 questions. RESULTS: The proportions of the caregivers in Groups 1, 2 and 3 who answered the questionnaire perfectly with 100% accuracy were 2%, 14% and 74%, respectively (p < 0.001). The means ± standard deviations of the overall time spent by the caregivers in Groups 1, 2 and 3 were 353 ± 135, 334.2 ± 115.1, and 281.4 ± 114 seconds, respectively (p = 0.013). Clearly, the pharmacist's face-to-face mediation education program provided effective and time-saving medication instructions for pediatric oral antibiotics. The specific questions regarding easy-to-make errors related to the reconstitution step (p < 0.001), water volume for reconstitution (p < 0.001), storage temperature (p = 0.004) and shelf life (p = 0.002) of stock powder, whether the drug should be taken before or after a meal (p < 0.001), and the method and volume for syrup measurement (p < 0.001). CONCLUSION: This study demonstrated that when compared to reading a package insert or education sheet, a pharmacist's verbal education with photographic education materials was significantly more effective and time-saving in providing caregivers with the correct knowledge of oral antibiotic suspensions in pediatrics.