Laparoscopic liver resection versus radiofrequency ablation for small hepatocellular carcinoma: randomized clinical trial.

BACKGROUND: The aim of this study was to compare the efficacy of laparoscopic liver resection versus radiofrequency ablation for treatment of small hepatocellular carcinoma. METHODS: This single-centre RCT was conducted at a tertiary referral centre in China. Patients with small hepatocellular carcinoma who had a single nodule no larger than 5 cm, or up to three nodules of 3 cm or smaller, were eligible. Patients were assigned randomly in a 1 : 1 ratio to either laparoscopic liver resection or radiofrequency ablation. Blinding was not attempted. Sample size calculations led to 75 patients per group. The primary outcome was overall survival, and the secondary outcome was recurrence-free survival. RESULTS: Seventy-five patients were included in each group. Overall survival (HR 1.26, 95% c.i. 0.69 to 2.30; P = 0.451) and recurrence-free survival (HR 1.34, 0.86 to 2.08; P = 0.189) did not differ between the resection and ablation groups. The 1-, 3- and 5-year overall survival rates were 94.7, 80.0, and 74.7% respectively after laparoscopic liver resection versus 93.3, 78.7, and 67.9% after radiofrequency ablation. Corresponding recurrence-free survival rates were 78.7, 61.3, and 51.6%, and 69.3, 53.3, and 41.0%, respectively. CONCLUSION: For small hepatocellular carcinoma, percutaneous radiofrequency ablation provides therapeutic effects similar to those of laparoscopic liver resection. REGISTRATION NUMBER: NCT02243384 (http://www.clinicaltrials.gov).

Percutaneous radiofrequency ablation may provide similar therapeutic effects to laparoscopic liver resection for patients with small hepatocellular carcinoma. This study compared the two treatments. Survival was similar after the two treatments. The choice of treatment may depend on the patient's preference and local availability.

Tumor burden score and carcinoembryonic antigen predict outcomes in patients with intrahepatic cholangiocarcinoma following liver resection: a multi­institutional analysis.

BACKGROUND: The prognostic significance of tumor burden score (TBS) in relation to carcinoembryonic antigen (CEA) has not been investigated among patients undergoing hepatectomy for intrahepatic cholangiocarcinoma (ICC). This study aimed to develop and validate a simplified model, a combination of TBS and CEA (CTC grade), for predicting the long-term outcomes of postoperative ICC patients. METHODS: Patients who underwent curative - intent resection of ICC between 2011 and 2019 were identified from a large multi - institutional database. The impact of TBS, CEA, and the CTC grade on overall survival (OS) and recurrence - free survival (RFS) was evaluated in both the derivation and validation cohorts. The receiver operating characteristic curve was utilized for assessing the predictive accuracy of the model. Subgroup analyses were performed across 8th TNM stage system stratified by CTC grade to assess the discriminatory capacity within the same TNM stage. RESULTS: A total of 812 patients were included in the derivation cohort and 266 patients in the validation cohort. Survival varied based on CEA (low: 36.7% vs. high: 9.0%) and TBS (low: 40.3% vs. high: 17.6%) in relation to 5 - year survival (both p < 0.001). As expected, patients with low CTC grade (i.e., low TBS/low CEA) were associated with the best OS as well as RFS, while high CTC grade (i.e., high TBS/high CEA) correlated to the worst outcomes. The model exhibited well performance in both the derivation cohort (area under the curve of 0.694) and the validation cohort (0.664). The predictive efficacy of the CTC grade system remains consistently stable across TNM stages I and III/IV. CONCLUSION: The CTC grade, a composite parameter derived from the combination of TBS and CEA levels, served as an easy - to - use tool and performed well in stratifying patients with ICC relative to OS and RFS.

Manipulating HGF signaling reshapes the cirrhotic liver niche and fills a therapeutic gap in regeneration mediated by transplanted stem cells.

Long-term stem cell survival in the cirrhotic liver niche to maintain therapeutic efficacy has not been achieved. In a well-defined diethylnitrosamine (DEN)-induced liver fibrosis/cirrhosis animal model, we previously showed that liver-resident stem/progenitor cells (MLpvNG2+ cells) or immune cells have improved survival in the fibrotic liver environment but died via apoptosis in the cirrhotic liver environment, and increased levels of hepatocyte growth factor (HGF) mediated this cell death. We tested the hypothesis that inhibiting HGF signaling during the cirrhotic phase could keep the cells alive. We used adeno-associated virus (AAV) vectors designed to silence the c-Met (HGF-only receptor) gene or a neutralizing antibody (anti-cMet-Ab) to block the c-Met protein in the DEN-induced liver cirrhosis mouse model transplanted with MLpvNG2+ cells between weeks 6 and 7 after DEN administration, which is the junction of liver fibrosis and cirrhosis at the site where most intrahepatic stem cells move toward apoptosis. After 4 weeks of treatment, the transplanted MLpvNG2+ cells survived better in c-Met-deficient mice than in wild-type mice, and cell activity was similar to that of the mice that received MLpvNG2+ cells at 5 weeks after DEN administration (liver fibrosis phase when most of these cells proliferated). Mechanistically, a lack of c-Met signaling remodeled the cirrhotic environment, which favored transplanted MLpvNG2+ cell expansion to differentiation into mature hepatocytes and initiate endogenous regeneration by promoting mature host hepatocyte generation and mediating functional improvements. Therapeutically, c-Met-mediated regeneration can be mimicked by anti-cMet-Ab to interfere functions, which is a potential drug for cell-based treatment of liver fibrosis/cirrhosis.

Epidemiology of plaque-induced gingivitis among 12-15-year-old Chinese schoolchildren: A study based on the 2018 case definition.

AIM: To explore the epidemiology of plaque-induced gingivitis and related factors among Chinese adolescents. MATERIALS AND METHODS: This cross-sectional survey comprised 118,601 schoolchildren in the 12-15-year age group. Data came from the National Oral Health Survey in mainland China. The field investigation was conducted according to the World Health Organization guidelines. The new 2018 case definition for plaque-induced gingivitis was used. Participants underwent clinical examinations and completed a structured questionnaire. Bleeding on probing (BOP) was performed on all teeth. Multinomial logistic regression was used to explore the factors related to the extent of gingivitis. RESULTS: Nearly half of the study population (47.3%) had plaque-induced gingivitis; 23.9% and 23.3% presented with localised and generalised gingivitis, respectively. The first molars were the most affected by BOP. Well-established factors, such as demographic characteristics, socioeconomic status, local factors and smoking habits, were significantly associated with the extent of gingivitis. Odds ratios for localised and generalised gingivitis increased with the decrease in frequency of toothbrushing with a fluoride dentifrice. CONCLUSIONS: The study population had high plaque-induced gingivitis prevalence. The extent of gingivitis appeared to have a dose-response relationship with the frequency of toothbrushing with a fluoride dentifrice.

Prognosis value of microscopic bile duct invasion in hepatocellular carcinoma: A multicenter study.

OBJECTIVE: To evaluate the prognostic significance of microscopic bile duct invasion (MiBDI) in hepatocellular carcinoma (HCC) following R0 resection. PATIENTS AND METHODS: Patients who underwent R0 resection for HCC at nine medical centers were stratified into five groups: neither bile duct nor vascular invasion (MiBDI-MVI-), microscopic bile duct invasion alone (MiBDI+MVI-), both microscopic bile duct and vascular invasion (MiBDI+MVI+), microscopic vascular invasion alone (MiBDI-MVI+), and macroscopic bile duct invasion (MaBDI). Overall survival (OS) was assessed using Kaplan-Meier analysis, and independent risk factors of OS were determined using Cox proportional hazards models. RESULTS: A total of 377 HCC cases were analyzed. The OS for MiBDI+MVI- was similar to that of MiBDI-MVI- (p > 0.05) but better than MiBDI+MVI+, MiBDI-MVI+, and MaBDI (all p < 0.05). Multivariate analysis indicated that MiBDI was not an independent risk factor for OS, while MVI and MaBDI were. CONCLUSIONS: Overall survival (OS) in patients with MiBDI was superior to those with MVI and MaBDI. Isolated MiBDI did not influence OS in patients with HCC after R0 resection.

Anatomic versus non-anatomic resection for early-stage intrahepatic cholangiocarcinoma: a propensity score matching and stabilized inverse probability of treatment weighting analysis.

BACKGROUND: Radical resection is still the most cost-effectiveness curative strategy for intrahepatic cholangiocarcinoma (ICC), but it remains controversial on the survival benefit of anatomic resection (AR). In this study, we sought to compare the oncologic outcomes between AR versus non-AR (NAR) as the primary treatment for early-stage ICC patients. METHODS: Data of ICC patients who underwent hepatectomy and staged at AJCC I were retrospectively collected from 12 hepatobiliary centers in China between Dec 2012 and Dec 2015. Propensity score matching (PSM) and stabilized inverse probability of treatment weighting (IPTW) analysis were performed to minimize the effect of potential confounders, and the perioperative and long-term outcomes between AR and NAR groups were compared. RESULTS: Two hundred seventy-eight ICC patients staged at AJCC I were eligible for this study, including 126 patients receiving AR and 152 patients receiving NAR. Compared to the NAR group, the AR group experienced more intraoperative blood loss before and after PSM or stabilized IPTW (all P > 0.05); AR group also experienced more intraoperative transfusion after stabilized IPTW (P > 0.05). In terms of disease-free survival (DFS) and overall survival (OS), no significant differences were observed between the two groups before and after PSM or stabilized IPTW (all P > 0.05). Multivariable Cox regression analyses found that AR was not an independent prognostic factor for either DFS or OS (all P > 0.05). Further analysis also showed that the survival benefit of AR was not found in any subgroup stratified by Child-Pugh grade (A or B), cirrhosis (presence or absence), tumor diameter (≤ 5 cm or > 5 cm) and pathological type (mass-forming or non-mass-forming) with all P > 0.05. CONCLUSION: Surgical approach does not influence the prognosis of patients with stage I primary ICC, and NAR might be acceptable and oncological safety.

Schisandrin B induces HepG2 cells pyroptosis by activating NK cells mediated anti-tumor immunity.

Pyroptosis, an inflammatory programmed cell death, has been suggested as a novel molecular mechanism for the treatment of hepatocellular carcinoma (HCC) with chemotherapeutic agents. Recent studies showed that natural killer (NK) cells could inhibit apoptosis and regulate the progression of pyroptosis in tumor cells. Schisandrin B (Sch B), a lignan isolated from Schisandrae chinensis (Turcz.) Baill. (Schisandraceae) Fructus, has various pharmacological activities including anti-cancer effects. The purpose of this study was to investigate the effect of NK cells on Sch B's regulation of pyroptosis in HCC cells and the molecular mechanisms implicated. The results showed that Sch B alone could decrease cell viability and induce apoptosis in HepG2 cells. However, Sch B induced apoptosis in HepG2 cells was transformed into pyroptosis in the presence of NK cells. The mechanisms underlying NK cell's effect on pyroptosis in Sch B-treated HepG2 cells was related to its activation of caspase 3-Gasdermin E (GSDME). Further studies revealed that NK cell induced caspase 3 activation was derived from its activation of perforin-granzyme B pathway. This study explored the effect of Sch B and NK cells on pyroptosis in HepG2 cells and revealed that perforin-granzyme B-caspase 3-GSDME pathway is involved in the process of pyroptosis. These results proposed an immunomodulatory mechanism of Sch B on HepG2 cells pyroptosis and suggested Sch B as a promising immunotherapy combination partner for the treatment of HCC.

RUNX2 mutation inhibits the cellular senescence of dental follicle cells via ERK signalling pathway.

OBJECTIVE: The aim of this study was to explore the regulatory effect of RUNX2 mutation on dental follicle cells (DFCs) senescence and clarify the underlying mechanism. This study aimed to explore the basis for a novel mechanism of delayed permanent tooth eruption in cleidocranial dysplasia (CCD) patients. MATERIALS AND METHODS: Dental follicles were collected from a CCD patient and healthy controls. Senescence-associated ß-galactosidase (SA-ß-gal) staining, Ki67 staining, cell cycle assays, and senescence-related gene and protein expression assays were performed to assess DFCs senescence. Western blotting was performed to detect the activation of mitogen-activated protein kinase (MAPK) signalling pathways, and the molecular mechanism underlying RUNX2 regulating in DFCs senescence was explored. RESULTS: RUNX2 mutation inhibited the cellular senescence of DFCs from the CCD patient compared with healthy controls. Ki67 staining showed that mutant RUNX2 promoted DFCs proliferation, and cell cycle assays revealed that the healthy control-derived DFCs arrested at G1 phase. RUNX2 mutation significantly downregulated senescence-associated gene and protein expression. RUNX2 mutation suppressed ERK signalling pathway activation, an ERK inhibitor decreased healthy control-derived DFCs senescence, and an ERK activator promoted CCD patient-derived DFCs senescence. CONCLUSIONS: RUNX2 mutation delayed DFCs senescence through the ERK signalling pathway, which may be responsible for delayed permanent tooth eruption in CCD patients.

Schisandrin B promotes senescence of activated hepatic stellate cell via NCOA4-mediated ferritinophagy.

CONTEXT: Schisandrin B (Sch B), an active ingredient from Schisandrae chinensis (Turcz.) Baill. (Schisandraceae) Fructus, possesses diverse pharmacological activities including antitumor, anti-inflammation, and hepatoprotection. OBJECTIVE: To explore the effect of Sch B on activated HSCs senescence in hepatic fibrosis and the mechanisms implicated. MATERIALS AND METHODS: ICR mice with CCl4-induced hepatic fibrosis were supplemented with Sch B (40 mg/kg) for 30 d and LX2 cells were treated with Sch B (5, 10 and 20 µM) for 24 h. Cellular senescence was assessed by senescence-related indicators senescence-associated ß-galactosidase (SA-ß-gal) activity and the expression of p16, p21, p53, γ-H2AX, H3K9me3, TERT, TRF1, and TRF2. Ferric ammonium citrate (FAC) and NCOA4 siRNA were used to evaluate the mechanisms underlying Sch B's regulation of cellular senescence. RESULTS: Sch B (40 mg/kg) reduced serum levels of AST and ALT (53.2% and 63.6%), alleviated hepatic collagen deposition, and promoted activated HSCs senescence in mice. Treatment with Sch B (20 µM) decreased cell viability to 80.38 ± 4.87% and elevated SA-ß-gal activity, with the levels of p16, p21 and p53 increased by 4.5-, 2.9-, and 3.5-fold and the levels of TERT, TRF1 and TRF2 decreased by 2.4-, 2.7-, and 2.6-fold in LX2 cells. FAC (400 µM) enhanced Sch B's effect mentioned above. NCOA4 siRNA weakened the effects of Sch B on iron deposition and HSCs senescence. CONCLUSIONS: Sch B could ameliorate hepatic fibrosis through the promotion of activated HSCs senescence, which might be attributed to its induction of NCOA4-mediated ferritinophagy and subsequent iron overload.

Laparoscopic resection of focal nodular hyperplasia in the hepatic caudate lobe.

OBJECTIVE: To investigate the safety and feasibility of laparoscopic resection of focal nodular hyperplasia (FNH) in the hepatic caudate lobe. METHODS: The clinical data of eight patients who underwent laparoscopic hepatic caudate lobe FNH resection at the Department of Hepatobiliary Surgery, Southwest Hospital, First Affiliated Hospital of Army Medical University, were retrospectively analyzed. RESULTS: The laparoscopic procedures were successful in all eight patients, and no patients required conversion to open surgery. Five patients underwent partial caudate lobe resection, one patient underwent caudate lobe resection, and two patients underwent combined left hemihepatectomy with caudate lobe resection. Tumor resection was performed using the left approach in five cases, the right approach in one case, the middle hepatic fissure approach in one case, and the left and right combined approach in one case. The operation time ranged from 120 to 360 min, with a mean of 225 min. The intraoperative blood loss ranged from 50 to 600 ml, with a mean of 235 ml. No postoperative bleeding, bile leakage or abdominal infection occurred. CONCLUSIONS: Laparoscopic resection of hepatic caudate lobe FNH was safe and feasible in appropriate patients. Skilled laparoscopic hepatectomy techniques, adequate preoperative evaluation, appropriate choice of surgical approach and the control of intraoperative bleeding are critical to perform this surgery.

Long-term outcomes of laparoscopic liver resection versus open liver resection for hepatocellular carcinoma: A single-center 10-year experience.

Background: Laparoscopic liver resection (LLR) for hepatocellular carcinoma (HCC) has increased. However, the long-term outcomes of LLR for HCCs should be validated further. Besides, the validity of laparoscopic minor liver resection in difficult segments (1, 4a, 7, 8) (LMLR-DS) and laparoscopic major hepatectomy (LMH) for HCCs need to be studied. Methods: A total of 1773 HCC patients were collected: 683 received LLR and 1090 received OLR. Propensity score matching (PSM) with 1:1 ratio was used to eliminate the selection bias. Short-term and long-term outcomes were compared. In subgroup analyses, the validity of LMLR-DS or LMH for HCCs was studied. Results: After PSM, 567 patients were in LLR or OLR group. LLR had lower intraoperative blood-loss and shorter postoperative hospital-stays than OLR. The postoperative complications were lower in LLR group (23.8% vs. 32.8%, P=0.001). The Overall survival (OS) and disease-free survival (DFS) had no significant difference between LLR and OLR groups (P=0.973, P=0.812). The cumulative 1-, 3-, and 5-year OR rates were 87.9%, 68.9%, and 57.7% for LLR group, and 85.9%, 68.8%, 58.8% for OLR group. The cumulative 1-, 3-, and 5-year DFS rates were 73.0%, 51.5%, 40.6% for LLR group, and 70.3%, 49.0%, 42.4% for OLR group. In subgroup analyses, 178 patients were in LMLR-DS or open surgery (OMLR-DS) group after PSM. LMLR-DS had lower intraoperative blood-loss and shorter postoperative hospital-stays than OMLR-DS. The postoperative complications were lower in LMLR-DS group. The OS and DFS had no difference between LMLR-DS and OMLR-DS groups. The cumulative 5-year OR and DFS rates were 61.6%, 43.9% for LMLR-DS group, and 66.5%, 47.7% for OMLR-DS group. In another subgroup analyses, 115 patients were in LMH or open major hepatectomy (OMH) group. LMH had lower blood-loss and shorter postoperative hospital-stays than OMH. The complications, OS and DFS had no significantly differences between two groups. The cumulative 5-year OR and DFS rates were 44.3%, 29.9% for LMH group, and 44.7%, 33.2% for OMH group. Conclusions: LLR for HCCs showed better short-term outcomes and comparable long-term outcomes with OLR, even for patients who received LMLR-DS or LMH. LLR could be reliable and recommended for HCC treatment.

The effect of the root dilaceration on the treatment duration and prognosis of unilateral impacted immature maxillary central incisors.

INTRODUCTION: This study aimed to investigate the effect of root dilaceration on the closed-eruption technique treatment and prognosis on impacted immature maxillary central incisors. METHODS: In this retrospective study, we compared the age at the beginning of the treatment, the treatment duration, root development, and alveolar bone mass after the closed-eruption technique between the impacted immature maxillary central incisors with dilacerated roots (group 1) and those with straight roots (group 2). RESULTS: The mean age at the time of the surgery of group 1 was 0.9 years younger than that of group 2 (P = 0.008). The mean traction time was greater in group 1 (8.0 ± 1.8 months), with a difference of 1.4 months than in group 2 (6.6 ± 2.1 months) (P = 0.042). The measurements of lingual bone thickness at the alveolar crest (C) showed significant differences between the 2 groups (P = 0.025). No significant differences were found in other treatment duration or measurements of root development and alveolar bone mass between the 2 groups. CONCLUSIONS: Patients with impacted immature incisors with dilacerated roots were younger at the beginning of the closed-eruption treatment and had a longer traction time than those with impacted immature incisors having straight roots. The root dilaceration had little or no effect on root development and alveolar bone mass after the closed-eruption treatment. The closed-eruption treatment of impacted immature incisors with root dilaceration is suggested to commence as early as possible.

Dynamic evaluation of postoperative survival in intrahepatic cholangiocarcinoma patients who did not undergo lymphadenectomy: a multicenter study.

BACKGROUND: The prognosis of Intrahepatic cholangiocarcinoma (ICC) patients who did not undergo lymphadenectomy is difficult to assess. This study aims to have a dynamic evaluation on the postoperative survival of ICC patients by calculating conditional survival. METHODS: Relevant data were from patients treated in 12 large-scale hospitals from December 2011 to December 2017. The influence of relevant clinical baseline data on the prognosis of ICC patients was analyzed by Cox regression. Conditional survival (CS) is a method that may predict the prognostic probability dynamically. For a patient with x years of survival, the 1-year CS (CS1) may be calculated as CS1= OS(x + 1)/OS(x). RESULT: A total of 361 patients who met the criteria were included in the study. Conditional survival (CS) means that the patients' prognosis varies with survival time, meanwhile, relevant factors affecting the prognosis have a time-varying effect. The probability of survival assessed by CS1 increased year by year and the 1,2,3-year survival improved from 68.4% to 87.8%, while the postoperative actuarial OS decreased from 69.4% at 1 years to 36.9% at 3 years. CONCLUSIONS: In terms of CS, the estimated survival for ICC varies with the increase of survival time after excision. Patients who live longer were likely to live longer. At the same time, with the passage of time, the role of the original adverse factors of the tumor would gradually decrease. Conditional survival allows a more accurate assessment of ICC patients who did not undergo lymphadenectomy.

Characterising salivary peptidome across diurnal dynamics and variations induced by sampling procedures.

OBJECTIVES: This study aimed to characterise diurnal dynamics of salivary peptidome and variations induced by sampling procedures. MATERIALS AND METHODS: A supervised short-term longitudinal study was conducted amongst ten healthy participants. Saliva samples were collected by different procedures (stimulated/unstimulated conditions, forepart/midstream segments) on three consecutive days. The peptidome compositions of saliva samples were analysed using matrix-assisted laser desorption/ionisation-time of flight-mass spectrometry (MALDI-TOF MS). RESULTS: The salivary peptidome exhibited a stable trend generally, even though some diurnal dynamics happened in aspects of both overall structure and certain single peptides. The results indicated saliva samples collected under unstimulated and stimulated conditions have significantly different structures of peptidome, whilst the peptidome profile of stimulated saliva was more abundant than that of unstimulated saliva. It was also indicated that the midstream segment effect might exist in the segmented process of saliva sampling. CONCLUSIONS: In summary, salivary peptidome was able to maintain stability though some dynamic changes might happen within a short-term period. Stimulated and unstimulated saliva samples had significantly different peptidome profiles, whilst the stimulated whole saliva was a larger pool of low molecular weight peptides. CLINICAL RELEVANCE: The stability of the salivary peptidome highlights the reliability of salivary peptidome as a source of diagnostic biomarker. We recommend keeping one collection condition (stimulated/unstimulated) consistently within one study on salivary peptidome. Stimulated whole saliva would be preferred if more abundant peptidome profile is needed.

Lateral dorsal infundibular approach: an alternative option for the safe completion of difficult laparoscopic cholecystectomy.

BACKGROUND: Difficult laparoscopic cholecystectomy (LC) due to acute cholecystitis (AC) increases the risk of bile duct injuries and postoperative complications. Here, we added the lateral dorsal infundibular approach as an initial surgical maneuver during LC to improve outcomes. METHODS: We describe the detailed technical procedure of the lateral dorsal infundibular approach in patients with AC resulting in difficult LC. This technique was developed after nearly 10 years of experience in laparoscopic surgery, and has been routinely used in the past 5 years. We also retrospectively analyzed the perioperative data for 469 patients with difficult LC. RESULTS: A total of 469 patients with AC received difficult LC between July 2016 and June 2021, of which 438 (93.4%) performed a lateral dorsal infundibular approach. Sixty-four patients (13.6%) had variations of the hepatic bile duct and cystic duct according to preoperative magnetic resonance cholangiopancreatography, 438 patients (93.4%) received elective surgery, 31 (6.6%) received emergency surgery, and 10 (2.1%) underwent conversion. There was no postoperative bile leaks and no bile duct injuries in the described technique. CONCLUSION: During difficult LC, the critical view of safety can be gradually achieved by changing the surgical approach to achieve cholecystectomy.

A Novel lncRNA Mediates the Delayed Tooth Eruption of Cleidocranial Dysplasia.

Delayed eruption of permanent teeth is a common symptom of cleidocranial dysplasia (CCD). Previous studies have focused on the anomaly of osteogenesis resulting from mutations in the Runt-related transcription factor-2 gene (RUNX2). However, deficiencies in osteoclastogenesis and bone resorption, and the epigenetic regulation mediated by long non-coding (lnc)RNAs in CCD remain to be elucidated. Here, a novel osteoclast-specific lncRNA (OC-lncRNA) was identified during the osteoclast differentiation of RAW 264.7 cells transfected with a RUNX2 mutation expression cassette. We further confirmed that OC-lncRNA positively regulated osteoclastogenesis and bone resorption. The OC-lncRNA promoted the expression of CXC chemokine receptor type 3 (CXCR3) by competitively binding to microRNA (miR)-221-5p. The CXCR3-CXC-motif chemokine ligand 10 (CXCL10) interaction and nuclear factor-κB constituted a positive feedback that positively regulated osteoclastogenesis and bone resorption. These results demonstrate that OC-lncRNA-mediated osteoclast dysfunction via the OC-lncRNA-miR-221-5p-CXCR3 axis, which is involved in the process of delayed tooth eruption of CCD.

A survey of the awareness and knowledge of oral cancer among residents in Beijing.

BACKGROUND: The present study aimed to investigate oral cancer awareness and its related knowledge among residents in Beijing. METHODS: A questionnaire survey was conducted among Beijing residents concerning their knowledge of oral cancer, and its prevention and treatment. RESULTS: A total of 3055 questionnaires were completed, 45.8% by males and 54.2% by females. The ages of the respondents ranged from 15 to 93 years; 12.4% were smokers, 1.1% chewed betel nuts, and 82.5% brushed their teeth at least twice a day. Lung cancer was heard of by the most respondents, followed by gastric cancer and liver cancer; oral cancer was the least heard of. More than 60% of respondents were unaware of the risk factors and early signs of oral cancer. CONCLUSIONS: This survey demonstrated a general lack of public awareness and knowledge about oral cancer. Specific measures should be taken to improve public awareness of oral cancer and its prevention and treatment.

Laparoscopic Anatomical Versus Non-anatomical hepatectomy in the Treatment of Hepatocellular Carcinoma: A randomised controlled trial.

BACKGROUND: The choice of surgical modality for laparoscopic hepatectomy for hepatocellular carcinoma (HCC) has not been supported by high level of medical evidence hitherto. A prospective randomised controlled trial (RCT) was conducted to compare the perioperative and follow-up outcomes of patients with HCC treated by laparoscopic anatomical hepatectomy (LAH) and non-anatomical hepatectomy (LNAH). METHODS: Between March 2013 and Jan 2018, eligible patients undergoing LAH and LNAH were enrolled and divided randomly into LAH group and LNAH group in this study. The perioperative and follow-up outcomes of both groups were compared and analysed. RESULTS: A total of 385 patients with HCC were randomly divided into LAH (n = 192) and LNAH (n = 193) groups. The groups were evenly matched for age, sex, liver background, segment involvement, tumor size, Child-Pugh grade and preoperative liver function. The operative time in the LAH group was longer than that of the LNAH group (p = 0.003). No significant between-group differences in intraoperative blood loss (p = 0.368), transfusion rate (p = 0.876), conversion to laparotomy rate (p = 0.365), overall complication rates (p = 0.054) were observed. The 1-year, 3-year and 5-year overall survival rates (OS) in the LAH group were 91.1%, 67.2%, 43.2%, respectively. The corresponding data in the LNAH group were 89.1%, 63.7%, and 35.2%, respectively. No significant difference was observed with regard to the 5-year OS rate (p = 0.054) between the two groups. The 1-year, 3-year and 5-year disease-free survival (DFS) rates in the LAH group were 87.0%, 54.7%, 33.9%, respectively. The corresponding data in LNAH group were 70.5%, 34.7%, and 30.1%, respectively. The 5-year DFS rate in the LAH group was significantly higher than that in the LNAH group (p = 0.009). CONCLUSIONS: LAH versus LNAH for selected HCC patients was associated with increased DFS, lower intrahepatic ipsilateral recurrence rate, comparable long-term OS and postoperative complications. LAH is therefore recommended for selected HCC patients. REGISTRATION NUMBER: NCT02009176 (https://www. CLINICALTRIALS: gov/).

Laparoscopic Glissonian pedicle versus hilar dissection approach hemihepatectomy: A prospective, randomized controlled trial.

BACKGROUND/PURPOSE: This over 7-year case study is the first to compare the results of laparoscopic Glissonian pedicle approach hemihepatectomy (LGAH) and laparoscopic hilar dissection approach hemihepatectomy (LHAH) in a randomized controlled trial (RCT). METHODS: Patients who had undergone laparoscopic hemihepatectomy, either LGAH or LHAH, between March 2012 and December 2019 at our center were prospectively enrolled and assigned to the LGAH or LHAH group. Both groups were stratified and compared, and the preoperative and follow-up outcomes were analyzed. The primary endpoint was total operative time. RESULTS: The groups were equally matched for age, sex, HBsAg, Child-Pugh class, benign disease, malignancy, liver cirrhosis, tumor diameter and type of resection. Ninety-six patients had undergone LGAH and 94 had undergone LHAH. No preoperative death occurred in the two groups. LGAH did not enhance the postoperative overall complication rates (P = .465) or intraoperative blood loss (P = .535) compared with LHAH. However, the overall operative time (P = .014) and hilar dissection time (P = .000) were significantly shorter in the LGAH group than in the LHAH group. No significant differences were found between the groups regarding the 1-year (P = .384), 3-year (P = .332), and 5-year overall survival rates (P = .662) or 1-year (P = .856), 3-year (P = .348), and 5-year disease-free survival rates (P = .573). CONCLUSIONS: LGAH and LHAH are both effective procedures for treating the hilar structures in selected patients. LGAH has advantages over LHAH in reducing total operation time under the condition where both procedures can be used. LGAH for selected patients is worthy of promotion owing to its simplicity and convenience. REGISTRATION NUMBER: NCT01567631 (http://www. CLINICALTRIALS: gov).

Laparoscopic liver resection for primary liver cancers originating in the paracaval portion of the caudate lobe: a preliminary retrospective analysis with 31 patients.

Paracaval-originating cancers have been considered a contraindication for laparoscopic liver resection (LLR). This study aimed to explore the safety and feasibility of LLR in the treatment of paracaval-originating cancers. This study included 11 patients who underwent LLR and 20 who underwent open liver resection (OLR) for paracaval-originating cancers between May 2010 and November 2020. The outcomes of the procedures were retrospectively analyzed. There were no cases of perioperative death or conversion to laparotomy. The LLR group had an earlier postoperative feeding time, shorter postoperative hospital stay, and lower total bilirubin levels on the first day after surgery. No significant differences in the incidence of overall postoperative complications were noted between the LLR and OLR groups, but the incidence of grade IIIa complications was significantly higher in the LLR group than in the OLR group. Tumor recurrence occurred in 4 of 11 patients in the LLR group and in 11 of 20 patients in the OLR group. LLR for the treatment of paracaval-originating cancers is safe and feasible in selected patients.