The correlation between insulin-like growth factor II mRNA binding protein 3 expression in hepatocellular carcinoma and prognosis.

BACKGROUND/AIMS: The study aims to explore the expression of IMP3 in HCC and the correlation between its expression and prognosis. METHODOLOGY: We collected several clinical and pathological files including 92 cases of HCC and 58 cases of adjacent liver tissues. Expression of IMP3 in these tissues was detected by immunohistochemistry, while compared with clinicopathological characteristics and expression of Ki-67. A χ2 test was used to analyze the relationship between expression of IMP3 and clinicοpathologic factors. The Kaplan-Meier survival curve was used to calculate survival rate. A Cox analysis was used to evaluate the relationship between index and patients' lifetime. RESULTS: The positive rate of IMP3 in HCC tissues was significantly higher than that in adjacent tissues. The expression of IMP3 was related to the histological differentiation of HCC, metastasis, the stage of ACJJ, the expression of Ki-67 and survival. The ACJJ stage, metastases and the expression of IMP3 were independent factors for the HCC patients' survival. CONCLUSIONS: IMP3, which is associated with tumor formation, invasion, tumor cell proliferation and so on, may become the target for inhabiting cell proliferation and the biomarker for predicting prognosis.

The role of DEK protein in hepatocellular carcinoma for progression and prognosis.

OBJECTIVE: The study aim was to explore the role of DEK in tumor progression and prognostic of hepatocellular carcinoma (HCC). METHODOLOGY: DEK protein in 178 samples of HCC was evaluated by immunohistochemical method. Additionally, the correlation between DEK expression and the clinicopathological features was evaluated by x(2) test or Fisher's exact test, the survival rates were calculated by the Kaplan-Meier method, and the relationship between prognostic factors and patient survival was also by the Cox analysis. RESULTS: DEK protein expression was noted in 86 cases of HCC, and 61 cases of normal liver tissues. DEK positive rate were closely correlated with the tumor size, grade, AJCC stage and survival rate (P<0.05, respectively). HCC with large tumor, lower grade, and late-stage, concomitant with DEK expression, had the lowest 5-years survival rate than HCC with above factors but without DEK expression (P<0.01, respectively). DEK expression emerged as significant independent hazard factors for survival in HCC (P<0.01). CONCLUSIONS: DEK could promote aggressiveness of cancer behavior, and hence poor prognosis of the HCC. It might be an independent poor prognostic factor and can serve as a useful new therapeutic biomarker.

A retrospective study on the clinical significance of cardiac computed tomography in heart failure patients with preserved ejection fraction.

Background: This study investigated the correlation between cardiac function parameters by cardiac computed tomography (CT) and the clinical outcomes of heart failure patients with preserved ejection fraction (HFpEF) to provide experimental data for the diagnosis of HFpEF. Methods: A total of 157 HFpEF patients admitted to our hospital from January 2017 to January 2019 were retrospectively analyzed. The patients were divided into event and non-event groups according to the occurrence or absence of adverse events. Cardiac function parameters, such as the left ventricular (LV) end-diastolic volume (LVEDV) and LV end-diastolic volume index (LVEDVI), were obtained via CT scan. Also, the N-terminal-pro hormone b-type natriuretic peptide (NT-proBNP) levels in patients' serum were measured using an enzyme linked immunosorbent assay (ELISA) kit, and echocardiographic parameters such as LV posterior wall thickness (LVPWT) were also recorded. Further, Cox regression was employed to analyze factors associated with the clinical outcomes. Results: Compared with patients in the non-event group, the left ventricular end-diastolic mass (LVM), LVEDVI, left ventricular end-systolic volume index (LVESVI), left atrial end-diastolic volume index (LAEDVI), and left atrial end-systolic volume index (LAESVI) were significantly increased, and the left ventricular total emptying fraction (LVTEF) and left atrial total emptying fraction (LATEF) were markedly decreased in the event group patients. Also, the E/e' and LAEDVI were related factors affecting the clinical outcomes of HFpEF patients. The above indicators displayed a significant predictive for the clinical outcomes of HFpEF patients. Conclusions: Several cardiac function measures, including LAEDVI, are factors associated with the clinical outcomes of HFpEF patients.

[Catheter balloon dilation combined with acupuncture for cricopharyngeal achalasia after brain stem infarction: a randomized controlled trial].

OBJECTIVE: To screen the optimal acupuncture regimen for cricopharyngeal achalasia (CPA) after brain stem infarction and compare the therapeutic effect between the combined therapy of catheter balloon dilation and acupuncture and the simple application of catheter balloon dilation. METHODS: The patients suffering from neuropathic dysphagia in CPA after brain stem infarction were selected as the subjects. After confirmed in the diagnosis with video fluoroscopic swallowing study (VFSS), they were randomized into 6 groups, 15 cases in each one, named group A (routine treatment), group B (catheter balloon dilation), group C1 (treated with acupuncture in local area), group C2 (treated with acupuncture based on zangfu differentiation), group C3 (treated with acupuncture at the local area and the acupoints based on zangfu differentiation) and group D (catheter balloon dilation combined with the optimal acupuncture). Two phases were included in the study. In the first phase of study, the therapeutic effect was compared among the three acupuncture groups, named C1, C2 and C3 group, so as to screen the optimal acupuncture regimen. In the group C1, the main acupoints included Fengchi (GB 20), Wangu (GB 12), Yifeng (TE 17) and three-tongue points (Extra). In the group C2, the main acupoints were Neiguan (PC 6), Tongli (HT 5), Zusanli (ST 36) and Sanyinjiao (SP 6) as well as the supplementary acupoints in accordance with the syndrome differentiation. In the group C1 and group C2, after deqi, the electroacupuncture was used, with continuous dense wave, 5 to 8 Hz in frequency. The needles were retained for 30 min. Acupuncture was given once a day, 5 treatments a week. Before treatment, in 6 weeks of treatment or after removal of gastric tube, the rehabilitation was evaluated. In the group C3, the acupoints, manipulation and treating course were same as the group C1 and group C2. In the 2nd phase of study, theresults of rehabilitation treatment were compared among the group A, group B and group D. The treatment was given once a day, 5 times a week. Before treatment, after gastric tube removal or in 6 weeks of treatment, the evaluation was conducted. The feeding-swallowing function grade and VFSS were adopted in the evaluation among the above 6 groups. RESULTS: ① In the VFSS comparison at 1st phase of study after treatment, the food transporting ability at oral dysphagia, the results in the group C3 and group C1 were better obviously than the group C2 (both P<0.05). For the improvement in aspiration, the result in the group C3 was better obviously than the group C2 (P<0.05). In comparison of the three acupuncture groups with the group A, the difference was not significant statisticallys in the extubation rate among the four groups (P>0.05). The severity of dysphagia in the group C3 was milder than the group C2 and group A (both P<0.05). ② In the VFSS comparison at the 2nd phase of study, for the food transporting ability, the results in the group D and the group B were obviously better than the group A (both P<0.05). Regarding the function at the pharyngeal dysphagia and aspiration, the results in the group D were better than the group B and group A, those in the group B were better than the group A (all P<0.05). The difference in the extubation rate among the group A, group B and group D after treatment was significant statistically (P<0.01), of which, the extubation rate in the group D was the highest and the rate in the group A was the lowest. The dysphagia degree in the group D was milder than the group B and group A and that in the group B was milder than the group A (all P<0.05). CONCLUSION: In the study of the different acupuncture methods, the acupuncture at the local acupoints and the acupoints selected based on zangfu differentiation is the optimal acupuncture regimen for cricopharyngeal achalasia after brain stem infarction. The catheter balloon dilation combined with acupuncture present the synergistc effect on cricopharyngeal achalasia after brain stem infarction, obviously relieve dysphagia and reduce aspiration.

Association between ezrin protein expression and the prognosis of colorectal adenocarcinoma.

Ezrin is involved in maintaining cell structure and cell motility. Expression levels of the ezrin gene correlate with numerous human malignancies. The aim of this study was to explore the role of ezrin in tumor progression and the prognostic evaluation of colorectal adenocarcinoma (CRA). The levels of ezrin protein in 186 CRA samples were evaluated using immunohistochemistry. Furthermore, the correlation between the expression of ezrin and the clinicopathological features of CRA was evaluated with the χ2 and Fisher's exact tests, survival rates were calculated using the Kaplan-Meier method, and the correlation between prognostic factors and patient survival was calculated by Cox analysis. Ezrin protein expression demonstrated an immunohistochemical cytoplasmic staining pattern in CRA. The difference between the positive rate of ezrin expression in CRA (38.7%, 72/186) and the adjacent normal mucosal tissues was deemed to be statistically significant (91.9%, 171/186; P=0.000). The positive rate of ezrin expression in cases with a large tumor, serosal invasion, lymph node (LN) metastasis, high LN ratio (LNR) and at a late tumor stage was significantly lower than in cases without these factors (P=0.044, P=0.032, P=0.002, P=0.011 and P=0.000, respectively). The 5-year survival rate of CRA without ezrin expression was lower than CRA with expression (P=0.000). Furthermore, analysis by Kaplan-Meier demonstrated that CRA cases with poor differentiation, serosal invasion and at a late tumor stage combined with no ezrin expression had a lower survival rate than cases that had these factors plus ezrin expression (P=0.000, respectively). Additionally, the non-expression of ezrin emerged as a significant independent prognostic factor in CRA prognosis (HR, 0.562; 95% CI, 0.404-0.783; P=0.001), in addition to the LNR (HR, 0.589; 95% CI, 0.369-0.939; P=0.026) and tumor stage (HR, 0.655; 95% CI, 0.487-0.880; P=0.005). This study demonstrated that ezrin may be useful to identify at-risk patients who may benefit from a more aggressive adjuvant therapy following tumor resection. Ezrin may serve as a useful therapeutic biomarker.