Development of porcine induced pluripotent stem cells with a CD163 reporter system / 生物工程学报

As main recipient cells for porcine reproductive and respiratory syndrome virus (PRRSV), porcine alveolar macrophage (PAM) are involved in the progress of several highly pathogenic virus infections. However, due to the fact that the PAM cells can only be obtained from primary tissues, research on PAM-based virus-host interactions remains challenging. The improvement of induced pluripotent stem cells (iPSCs) technology provides a new strategy to develop IPSCs-derived PAM cells. Since the CD163 is a macrophage-specific marker and a validated receptor essential for PRRSV infection, generation of stable porcine induced pluripotent stem cells lines containing CD163 reporter system play important roles in the investigation of IPSCs-PAM transition and PAM-based virus-host interaction. Based on the CRISPR/Cas9- mediated gene editing system, we designed a sgRNA targeting CD163 locus and constructed the corresponding donor vectors. To test whether this reporter system has the expected function, the reporter system was introduced into primary PAM cells to detect the expression of RFP. To validate the low effect on stem cell pluripotency, we generated porcine iPSC lines containing CD163 reporter and assessed the pluripotency through multiple assays such as alkaline phosphatase staining, immunofluorescent staining, and EdU staining. The red-fluorescent protein (RFP) expression was detected in CD163-edited PAM cells, suggesting that our reporter system indeed has the ability to reflect the expression of gene CD163. Compared with wild-type (WT) iPSCs, the CD163 reporter-iPSCs display similar pluripotency-associated transcription factors expression. Besides, cells with the reporter system showed consistent cell morphology and proliferation ability as compared to WT iPSCs, indicating that the edited-cells have no effect on stem cell pluripotency. In conclusion, we generated porcine iPSCs that contain a CD163 reporter system. Our results demonstrated that this reporter system was functional and safe. This study provides a platform to investigate the iPS-PAM development and virus-host interaction in PAM cells.

Drug target inference by mining transcriptional data using a novel graph convolutional network framework

A fundamental challenge that arises in biomedicine is the need to characterize compounds in a relevant cellular context in order to reveal potential on-target or off-target effects. Recently, the fast accumulation of gene transcriptional profiling data provides us an unprecedented opportunity to explore the protein targets of chemical compounds from the perspective of cell transcriptomics and RNA biology. Here, we propose a novel Siamese spectral-based graph convolutional network (SSGCN) model for inferring the protein targets of chemical compounds from gene transcriptional profiles. Although the gene signature of a compound perturbation only provides indirect clues of the interacting targets, and the biological networks under different experiment conditions further complicate the situation, the SSGCN model was successfully trained to learn from known compound-target pairs by uncovering the hidden correlations between compound perturbation profiles and gene knockdown profiles. On a benchmark set and a large time-split validation dataset, the model achieved higher target inference accuracy as compared to previous methods such as Connectivity Map. Further experimental validations of prediction results highlight the practical usefulness of SSGCN in either inferring the interacting targets of compound, or reversely, in finding novel inhibitors of a given target of interest.

Microsurgery for ruptured intracranial dural arteriovenous fistula: a retrospective case series of 8 patients / 国际脑血管病杂志

Objective:To investigate the emergency surgical effect of ruptured intracranial dural arteriovenous fistula (DAVF).Methods:Patients with ruptured intracranial DAVF underwent microsurgery in the Department of Neurosurgery, Nanping First Hospital Affiliated to Fujian Medical University from May 2013 to July 2022 were retrospectively included. The clinical, imaging and follow-up data were collected, and the clinical characteristics, selection of surgical methods and treatment effects of patients were summarized.Results:A total of 8 patients with DAVF were enrolled. Their age ranged from 11 to 60 years (average, 48 years). There were 7 males and 1 female. All 8 patients suffered from intracranial hemorrhage, manifested as headache and vomiting in 2 cases, simple conscious disturbance in 2 cases, conscious disturbance with cerebral hernia in 3 cases, and conscious disturbance with limb paralysis in 1 case. The fistula was located in the anterior fossa in 4 cases (including 2 cases with aneurysms), the middle fossa in 2 cases (including 1 case with moyamoya disease), the transverse sinus in 1 case, and the anterior 1/3 area of the sagittal sinus in 1 case. Cognard classification: 7 patients were type Ⅲ and 1 was type Ⅳ. After admission, all patients underwent emergency craniotomy and microsurgery to remove hematoma. Among them, 4 patients underwent decompressive craniectomy at the same time, 1 patient with moyamoya disease underwent dural turnover and temporalis muscle application at the same time, and 2 patients with aneurysms at the same location were clipped at the same time. Postoperative re-examination of head CT showed that the hematoma was cleared satisfactorily and the midline was no shift in all 8 patients. CT angiography (CTA) showed that the fistula disappeared within 2 weeks. Seven patients were followed up within 1-12 months after operation. CTA or digital subtraction angiography showed no recurrence of DAVF. Two patients with aneurysms did not have residual or recurrent aneurysms. All patients had no new neurological symptoms, and the Glasgow Outcome Scale score in 2 patients increased by 1 compared with that at discharge.Conclusion:Emergency microsurgery is an effective method for the treatment of ruptured intracranial DAVF, especially for patients with special parts or complicated hematoma, cerebral hernia, and other vascular diseases.

Induction and differentiation of induced pluripotent stem cells into macrophages: a review / 生物工程学报

Induced pluripotent stem cells (iPSCs) are a type of cells similar to embryonic stem cells but produced by reprogramed somatic cells. Through in vitro differentiation of iPSCs, we can interrogate the evolution history as well as the various characteristics of macrophages. iPSCs derived macrophages are not only a good model for drug screening, but also an important approach for immunotherapy. This review summarizes the advances, challenges, and future directions in the field of iPSCs-derived macrophages.

Effect Evaluation of Prescription Comment of Chinese Patent Medicine Based on Self-developed Rational Drug Use System / 中国药房

OBJECTIVE：To conduct the prescri ption comment of Chinese patent medicine based on self-developed rational drug use system and evaluate its effect ，and to promote rational use of Chinese patent medicine. METHODS ：The self-developed rational drug use system was used to evaluate the complete prescriptions and classified special prescriptions of Chinese patent medicines in our hospital from Jan. to Jun. 2019（before implementation ）and from Jan. to Jun. 2020（after implementation ）； combined with pharmacists ’manual comments ，the situation of irrational drug use in the two periods was compared ，and the effect of prescription comment by rational drug use system was evaluated. RESULTS ：Results of full prescription comment of Chinese patent medicine in our hospital showed that the unqualified rate of Chinese patent medicine prescriptions was 1.5％，which was significantly lower than 5.6％ before the implementation （P＜0.05）. Results of special prescription comment of Chinese patent medicine showed that the unqualified rates of TCM injection ，toxic Chinese patent medicines and emergency Chinese patent medicines were 11.8％，10.7％，11.0％ before implementation ；while after implementation ，they were 3.6％，4.2％ and 6.6％， which were significantly lower than before implementation （P＜0.05）. CONCLUSIONS ：Self-developed rational drug use system of Chinese patent medicine shows remarkable effect on full prescription comment and special comment ，which greatly improves the level of rational drug use of Chinese patent medicines in our hospital.

Establishment of HPLC Fingerprints and Content Determination of 7 Components of Jingu Tongxiao Pill / 中国药房

OBJECTIVE：To establish the fingerprint of Jingu tongxiao pill ，and to determine the contents of 7 components. METHODS：HPLC method was adopted. The determination was performed on Cosmosil 5C18-MS-Ⅱ column with acetonitrile- 0.02％ phosphoric acid solution as mobile phase （gradient elution ）at the flow rate of 1.0 mL/min. The detection wavelength was 230 nm and the column temperature was set at 25 ℃. The sample size was 10 μL. HPLC fingerprint of 10 batches of Jingu tongxiao pill was established by using Similarity Evaluation System of TCM Chromatographic Fingerprint （2012 edition），and common peak was identified by comparing with the mixed reference substance. The contents of corresponding components of the identified common peak were determined by the same HPLC method. RESULTS ：There were 20 common peaks in HPLC fingerprint of 10 batches of samples ，and the similarity with the control fingerprint was not less than 0.980. By comparing with the mixed reference substance， 7 components were identified ， which were loganic acid ，gentiopicroside，paeoniflorin，salvianolic acid B ， cryptotanshinone，tanshinone Ⅰ and tanshinone Ⅱ A. The linear range of the above 7 components were 4.509-45.090， 15.090-150.900，14.985-149.850，14.982-149.820，2.967-29.670，1.944-19.440，3.094-30.940 μg/mL（all r＞0.999），respectively. The limits of detection were 0.060 1，0.161 0，0.399 6，0.159 8，0.031 6，0.051 8，0.082 5 μg/mL，respectively. The limits of quantitation were 0.200 4，0.503 0，0.999 0，0.399 5，0.079 1，0.259 2，0.412 6 μg/mL，respectively. RSDs of precision ，stability （24 h） and reproducibility tests were all lower than 3.0％ （n＝6）. Average recoveries were 98.81％ -100.28％ ，RSDs were 0.20％-1.21％（n＝6）. In 10 batches of samples ，the contents of the above 7 components were 0.441 0-0.969 4，3.283 4-4.733 4， 1.947 7-3.674 9，1.336 6-2.270 9，0.293 2-0.372 1，0.190 2-0.293 9 and 0.352 8-0.518 8 mg/g，respectively. CONCLUSIONS ：In this study，HPLC fingerprint and content determination method of Jingu tongxiao pill are successfully established and can be used for quality control.

Primary breast diffuse large B-cell lymphoma: a report of 21 cases / 中国肿瘤临床

Objective: To investigate the clinical characteristics, treatment regimens, and outcomes of patients with primary breast dif-fuse large B-cell lymphoma (PB-DLBCL). Methods: Between January 2010 and January 2018, 21 patients with PB-DLBCL were diag-nosed, treated, and followed up at the First Affiliated Hospital of Zhengzhou University. All patients were female, with a median age of 49 years (ranging from 21 to 77 years) at presentation. All patients received chemotherapy, of which 17 patients received the CHOP regimen and 4 received the EPOCH regimen. Eight patients received chemotherapy followed by radiotherapy, and 13 received chemo-therapy alone. Six patients received prophylactic intrathecal injections. The incidences of refractory and progressive disease between patients who received different regimens were analyzed using the Chi-square test. The overall survival (OS) and progression-free sur-vival (PFS) rates were calculated using the Kaplan-Meier method, and differences in survival were compared using the Log-rank test. Multivariate analysis was performed with the Cox-regression model for those factors that were confirmed as significant in the univari-ate analysis. Results: The most common presentation was a painless mass. The 5-year OS and PFS rates were 74% and 66%, respective-ly. There was no significant difference in the incidence of refractory or progressive disease between the EPOCH and CHOP groups (P=0.603). Six of those who received prophylactic intrathecal injections had no central nervous system recurrence, and 2 patients who did not receive prophylactic intrathecal injections had central nervous system recurrence. Univariate and multivariate analyses showed that both the level of serum β2 microglobulin [P=0.044, hazard ratio (HR)=0.431, 95% confidence interval (CI): 0.432-0.967] and radio-therapy (P=0.002, HR=0.495, 95% CI: 1.073-2.508) were related to the OS of PB-DLBCL. Conclusions: PB-DLBCL often occurs in women, mostly involving the unilateral breast, which manifests mainly as a painless mass. The level of serum β2 microglobulin is a factor of poor prognosis in PB-DLBCL. The treatment modality of chemotherapy combined with radiotherapy can significantly improve the OS of PB-DLBCL. Prophylactic intrathecal injections may be useful to reduce the incidence of refractory disease or recurrence in the central nervous system.

Exploration and Practice of Pharmaceutical Service Mode for Chronic Disease Management in TCM Ortho-pedics Hospital / 中国药师

Objective: To explore a feasible work mode of clinical pharmacist for chronic disease management in TCM orthopedics hospital so as to provide new ideas for the optimization of pharmaceutical service. Methods: In view of clinical practice, the work mode and feature of clinical pharmacist in TCM orthopedics hospital were summarized in order to find the key questions, and according-ly provide the effective proposals. Results and Conclusion: The concept of pharmacy service mode is a patient-based idea and rational drug use in TCM orthopedics hospital, which can promote the level improvement of pharmacy service.

Correlation between postoperative neutrophil to lymphocyte ratio and recurrence and prognosis of hepatocellular carcinoma after radical liver resection / 中华肿瘤杂志

Objective@#To investigate the correlation between postoperative peripheral blood neutrophil to lymphocyte ratio (NLR) and recurrence and prognosis of patients with hepatocellular carcinoma (HCC).@*Methods@#The clinicopathological and follow-up data of 344 patients with HCC who underwent radical liver resection from May 2010 to April 2014 were analyzed retrospectively.@*Results@#Of the 344 patients, 104 had early recurrence and 84 had late recurrence. Receiver operating characteristic (ROC) curve analysis showed that the NLR predicted area under the curve (AUC) of early recurrence was 0.622 (P<0.001), the optimal cut-off value was 2.41. The AUC of late recurrence was 0.634 (P=0.001), the optimal cut-off value was 2.15. Cox multivariate analysis showed the serum concentration of hepatitis B surface antigen (HR=2.508, 95% CI: 1.311-4.798), microvascular invasion (HR=2.422, 95% CI: 1.239-4.734), Milan criteria (HR=2.373, 95% CI: 1.427-3.948) and postoperative NLR (HR=2.285, 95% CI: 1.379-3.788) were independent risk factors of early recurrence after HCC resection. Postoperative NLR (HR=2.927, 95% CI: 1.630-5.255), liver cirrhosis (HR=2.531, 95% CI: 1.291-4.962) and serum concentration of albumin (HR=2.257, 95% CI: 1.251-4.073) were independent risk factors of late recurrence after HCC resection. The median recurrence-free survival (RFS) of the 344 patients was 45.0 months, and the median overall survival (OS) was 63.2 months. ROC curve analysis showed that the postoperative NLR predicted 5-year survival AUC was 0.689 (P<0.05), with an optimal cutoff of 2.29. Cox multivariate analysis showed microvascular invasion (HR=2.247, 95% CI: 1.534-3.291), postoperative NLR (HR=2.217, 95% CI: 1.653-2.974), and liver cirrhosis (HR=1.685, 95% CI: 1.168-2.431), Milan criteria (HR=1.679, 95% CI: 1.238-2.277), serum concentration of hepatitis B surface antigen (HR=1.623, 95% CI: 1.102-2.392), serum concentration of albumin (HR=1.43, 95% CI: 1.066-1.918) were independent factors of RFS after HCC resection, while microvascular invasion (HR=3.862, 95% CI: 2.407-6.197), Barcelona staging (HR=2.864, 95% CI: 1.600-5.125), postoperative NLR (HR=2.688, 95% CI: 1.782-4.055), liver cirrhosis (HR=2.039, 95% CI: 1.184-3.514), serum concentration of albumin (HR=1.81, 95% CI: 1.204-2.720) were independent factors of OS.@*Conclusions@#For HCC patients who receive radical liver resection, postoperative NLR ≥2.29 implicates poor prognosis. Moreover, postoperative NLR ≥2.41 suggests early recurrence, while NLR ≥2.15 suggests late recurrence.

Prognostic significance of neutrophil to lymphocyte ratio in patients with hepatocellular carcinoma / 中华肝胆外科杂志

Objective To compare the clinical significance of peripheral blood neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) in predicting prognosis of patients with hepatocellular carcinoma (HCC).Methods The clinical data of 661 patients with HCC were retrospectively analyzed.Routine peripheral blood test results were used to calculate the NLR and PLR,and the receiver operating characteristic (ROC) curves were drawn.Using the thresholds of NLR and PLR,the patients were divided into the low NLR group and the high NLR group,and the low PLR group and the high PLR group.Overall survival (OS) and disease free survival (DFS) were evaluated by the Kaplan-Meier method.Independent prognostic predictors were determined by the Cox proportional hazard model.Results The NLR and PLR thresholds were 2.790 and 99,respectively.Analysis of the ROC curves showed higher NLR and PLR were significantly associated with poorer OS and DFS (all P ＜ 0.05).Multivariate analysis showed that NLR was an independent risk factor of OS and DFS (both P ＜ 0.05).The results remained unchanged when the NLR was further analyzed by applying different cut-off values of 2.810 and 3.In subgroup analysis,NLR remained an independent factor of Barcelona Clinical Liver Cancer staging system (BCLC) 0/A/B (P ＜ 0.05 for all measurements).Conclusion An elevated preoperative NLR could be a better prognostic predictor for HCC patients in comparison with PLR,especially for BCLC 0/A/B patients.

A new prognostic score system of hepatocellular carcinoma following hepatectomy / 中华肿瘤杂志

Objective@#To establish a new scoring system based on the clinicopathological features of hepatocellular carcinoma (HCC) to predict prognosis of patients who received hepatectomy.@*Methods@#A total of 845 HCC patients who underwent hepatectomy from 1999 to 2010 at Cancer Hospital, Chinese Academy of Medical Sciences were retrospectively analyzed. 21 common clinical factors were selected in this analysis. Among these factors, the cut-off values of alpha-fetoprotein (AFP), alkaline phosphatase (ALP) and intraoperative blood loss were evaluated by using a receiver operating characteristic (ROC) curve analysis.The Kaplan-Meier method and Cox regression model were used to evaluate the independent risk factors associated with the prognosis of HCC patients after hepatectomy. HCC postoperatively prognostic scoring system was established according to the minimum weighted method of these independent risk factors, and divided the patients into 3 risk groups, including low-risk, intermediate-risk and high-risk group. The relapse-free survival (RFS) and overall survival (OS) were compared among these groups.@*Results@#The univariate analysis showed that clinical symptoms, preoperative α-fetoprotein (AFP) level, serum alkaline phosphatase (ALP) level, tumor size, tumor number, abdominal lymph node metastasis, macrovascular invasion or tumor thrombus, extrahepatic invasion or serosa perforation, the severity of hepatic cirrhosis, intraoperative blood loss, the liver operative method, pathological tumor thrombus, intraoperative blood transfusion, perioperative blood transfusion were significantly associated with median RFS of these HCC patients (P<0.05). Alternatively, clinical symptoms, preoperative AFP level, serum ALP level, tumor size, tumor number, abdominal lymph node metastasis, macrovascular invasion or tumor thrombus, extrahepatic invasion or serosa perforation, the severity of hepatic cirrhosis, intraoperative blood loss, the liver operative method, pathological lymphocyte invasion, pathological tumor thrombus, intraoperative blood transfusion, perioperative blood transfusion were significantly associated with the median OS of these HCC patients (P<0.05). The multivariate analysis showed that AFP ≥20 ng/ml, clinical symptoms, tumor diameter ≥5 cm, multiple tumors, macrovascular invasion or tumor thrombus, extrahepatic invasion or serosa perforation, moderate and severe liver cirrhosis, non- anatomic resection were the independent risk factors of RFS and OS (P<0.05). The independent risk factor of RFS was intraoperative bleeding loss ≥325 ml (P<0.05); The independent risk factors of OS were abdominal lymph node metastasis and pathological tumors thrombus (P<0.05). The respective weight of 11 independent factors was used to establish the scoring system (scores range from 0 to 26). In the score system, 0 to 5 points were defined as the low-risk group (286 cases), 6 to 12 points were determined as the intermediate-risk group (503 cases), more than 13 points were classified as the high-risk group (56 cases). The median RFS of the low-risk, intermediate-risk and high-risk group were 80, 27 and 6 months, respectively. The differences were statistically significant (P<0.001). The median OS of the three groups were 134, 51 and 15 months, respectively, and the differences were statistically significant (P<0.001).@*Conclusion@#This new score system provides effective prediction of postoperative prognosis for HCC patients.

Prognostic analysis of colorectal liver metastases treated by surgery combined with intraoperative radiofrequency ablation / 中华外科杂志

Objective@#To investigate the clinical value of intraoperative radiofrequency ablation (RFA) in the treatment of colorectal liver metastasis (CLM).@*Methods@#A retrospectively analysis of 187 patients with CLM who underwent liver resection with or without RFA from January 2009 to August 2016 in Department of Hepatobiliary Surgery, Cancer Hospital, Chinese Academy of Medical Sciences was performed. According to whether RFA was used intraoperatively, patients were divided into resection only group and combined treatment group. The clinical and pathological characteristics of the two groups were compared to explore factors influencing survival and recurrence. Imbalance of background characteristics between the two groups was further overcome by propensity score matching method (PSM).@*Results@#The number of liver metastases (267), simultaneous liver metastases (100%), bilobar involvement (73.3%) and preoperative chemotherapy (93.3%) rates were significantly higher in the combined treatment group than those in the resection only group(471, 74.7%, 42.0% and 63.1%)(all P<0.05). In the combined treatment group, median overall survival (OS) was 25.7 months; and 3-year and 5-year OS were 47.9% and 28.8%, respectively. In the resection only group, the median survival time was 46.9 months; and 3-year and 5-year OS rate was 59.1% and 42.4%, respectively (χ2=4.579, P=0.034). Median disease-free survival (DFS) was 5.4 months in the combined treatment group, and 10.1 months in the resection only group (χ2=5.399, P=0.023). In multivariate analysis, intraoperative RFA was not an independent prognostic factor for OS and DFS (HR=0.98, 95%CI: 0.47-2.08, P=0.965; HR=1.21, 95%CI: 0.71-2.07, P=0.465). After PSM, the median OS of the resection only and the combined treatment groups were 30.2 and 25.7 months (χ2=0.876, P=0.350). The median DFS in the two groups was 5.3 and 4.2 months, respectively (χ2=0.199, P=0.650).@*Conclusion@#In patients with similar tumor burden, liver resection combined with intraoperative RFA for unresectable CLM can achieve long-term outcomes similar to hepatectomy alone for resectable CLM.

Safety evaluation of intraoperative peritoneal chemotherapy with Lobaplatin for advanced colorectal cancers / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To observe the impact of intraoperative peritoneal chemotherapy with Lobaplatin on the safety of postoperative bowel function and complications in patients with advanced colorectal cancer.</p><p><b>METHODS</b>A total of 103 colorectal cancer patients undergoing surgical operations in our department between October 2013 and October 2014 were prospectively enrolled in this study and were randomly divided into peritoneal chemotherapy group(55 cases) and control group(48 cases) according to the random table. In therapy group, patients were treated with peritoneal implantation of 40 mg Lobaplatin intraoperatively and followed by intravenous chemotherapy using FOLFOX regimen with Oxaliplatin, Fluorouracil and Leucovorin. In control group, only FOLFOX regimen was fulfilled. Then the recovery time of bowel function, the incidence of adverse reactions and complications, and the pre- and post-chemotherapy routine blood tests and hepatorenal functions were compared.</p><p><b>RESULTS</b>The recovery time of bowel function in peritoneal chemotherapy group and control group was(72.1±11.8) h and(68.7±13.4) h respectively without significant difference(P>0.05). Each group had 6 cases with incisional fat liquefaction(10.9% vs. 12.5%, P>0.05). There was no serious infection in both groups. During intravenous chemotherapy, in peritoneal chemotherapy group and control group, the incidence of nausea and vomit(42 cases, 76.4% vs. 40 cases, 83.3%), constipation(38 cases, 69.1% vs. 29 cases, 60.4%), and diarrhea(4 cases, 7.3% vs. 5 cases, 10.4%) were observed and there were no significant differences(all P>0.05). It was noted that all these side effects vanished after chemotherapy or cured by symptomatic treatment. There were no significant differences between two groups in indexes of white blood cell, platelet, alanine aminotransferase, aspartate transaminase, and creatinine(all P>0.05), neither after operation nor after chemotherapy.</p><p><b>CONCLUSION</b>Peritoneal implantation of Lobaplatin as intraoperative chemotherapy for advanced colorectal cancer is safe and tolerable.</p>

Multivariate analysis of factors influencing hepatocellular carcinoma prognosis after hepatectomy / 国际肿瘤学杂志

Objective To retrospectively study the relationship between several risk factors such as cirrhosis,Child-Pugh classification,tumor size,portal vein tumor thrombus,intraoperative transfusion,hepatic portal occlusion time and the prognosis of hepatic cellular cancer( HCC ) patients after hepatic resection. Methods The clinical data of 123 patients who received hepatic resection for HCC at Tongji Hospital between 2007 and 2009 were retrospectively analyzed. Log-Rank test and Cox proportional hazard model were used in the univariate and multivariate analyses of risk factors. Results 1,2,3,5 year recurrence and survival rates were 54. 17%,66. 67%,81. 40%,87. 50% and 93. 50%,73. 17%,58. 54%,27. 64%,respectively. The mean recurrence time and survival time were 19. 5 months and 42. 9 months. In univariate analysis,presence of cirrhosis(χ2 =11. 159,P=0. 005),Child-Pugh classification(χ2 =7. 715,P=0. 028),tumor size(≥5cm)(χ2 =11. 483,P=0. 004),presence of portal vein invasion(χ2 =22. 271,P=0. 001)were risk factors affecting HCC recurrence. In multivariate analysis,presence of cirrhosis(χ2 =8. 993,P=0. 003),tumor size (≥5cm)(χ2 =4. 022,P=0. 039),presence of portal vein invasion(χ2 =5. 023,P=0. 027)were inde-pendent risk factors affecting HCC recurrence. In univariate analysis,presence of cirrhosis(χ2 =7. 339,P=0. 025),AFP﹥400 ng/ml(χ2 =5. 431,P=0. 042),Child-Pugh classification(χ2 =13. 389,P=0. 002), tumor size(≥5cm)(χ2 =11. 342,P=0. 003),presence of portal vein invasion(χ2 =52. 167,P﹤0. 001), hepatic portal occlusion(χ2 =5. 801,P=0. 037),intraoperative blood transfusion(χ2 =14. 959,P=0. 001) were risk factors affecting a shorter overall survival. In multivariate analysis,presence of cirrhosis(χ2 =9. 133, P=0. 003),Child-Pugh classification(χ2 =4. 799,P=0. 028),tumor size(≥5 cm)(χ2 =9. 101,P=0. 004),presence of portal vein invasion(χ2 =11. 126,P=0. 001),hepatic portal occlusion(χ2 =3. 985, P=0. 046)were independent prognostic factors affecting shorter overall survival. Conclusion Cirrhosis, Child-Pugh classification,tumor size(≥5 cm),presence of portal vein invasion,and hepatic portal occlusion were independent prognostic factors for HCC patients after hepatic resection.

Study on intestinal probiotics for the prevention of recurrent liver cirrhosis spontaneous bacterial peritonitis / 中国综合临床

Objective To explore the risk factors and the recurrence of spontaneous bacterial peritonitis after taking intestinal probiotics.Methods Fifty-six patients with spontaneous bacterial peritonitis were randomly divided into control group and probiotics group,and each group were 28 cases.Patients in control group were treated by regular hepatoprotective drug,while in probiotics group were administrated with Jinshuangqi orally,every time 0.5 g × 4 tablets,2 times a day besides regular hepatoprotective drug.The course of the treatment was for 3 months.The symptoms and other risk factors,and the relief time were recorded.Results Incidence of spontaneous bacterial peritonitis in probiotics group and control group were 21.4％ and46.4％ respectively(x2 =3.784,P ＜ 0.05).Rate of gastric ulcer were 17.9％ and 42.9％ respectively and the difference was significant(x2 =4.139,P ＜ 0.05).The relief time of fever in probiotics group was (2.52 ± 0.78) d,lower than that of control group ((4.21 ± 1.34) d,t =2.029,P ＜ 0.05).Meanwhile the relief time of abdominal tenderness was (4.02 ± 0.96) d in probiotics group,and (6.34 ± 1.27) d in control group (t =2.433,P ＜ 0.05).Conclusion Intestinal probiotics treatment can significantly reduce the recurrence rate of spontaneous bacterial peritonitis,shorten the relief time of each symptom and reduce the incidence of other risk factors.

Clinical significance of BRCA1 and Ki-67 expression in breast cancer / 肿瘤研究与临床

Objective To investigate the clinicopathologic features and prognostic significance of BRCA1 and Ki-67 expression in breast cancer.Methods The expression levels of BRCA1 and Ki-67 were assayed by immunohistochemistry in 194 cases of breast cancer tissues.The correlations of BRCA1 and Ki-67 expression with patients' clinicopathologic features were also analysed.Results Low expression of BRCA1 was detected in the lymph node metastasis group,ER/PR negative group,and HER-2 positive group in 194 patients with breast cancer (P ＜ 0.05),as well as in the triple negative breast cancer (TNBC) group compared to non-TNBC group (P ＜0.05).High expression of Ki-67 was detected in patients with higher histological grade,negative ER/PR,and positive HER-2 (P ＜ 0.05).Furthermore,negative correlation was found between the expression of BRCA1 and Ki-67 (P ＜ 0.05).The combination of low expression of BRCAl and high expression of Ki-67 was mostly found in the patients with postmenopausal,lower histological grade,lymph node metastasis,negative ER/PR and positive HER-2 (P ＜ 0.05).However,there was no significant difference between TNBC and non-TNBC.Conclusion Joint detection of BRCA1 and Ki-67 might play an important role in predicting clinical outcomes of breast cancer,especially BRCA1 may be one of prognostic factors in TNBC.

Retention enema with rhubarb for the treatment of severe acute pancreatitis with intestine paralysis / 中华胰腺病杂志

ObjectiveTo investigate the efficacy of retention enema with rhubarb for severe acute pancreatitis (SAP) with intestine paralysis.MethodsTotally 60 patients with SAP since last five years were included,and then they were randomly divided into control group and treatment group with 30 patients in each group.Patients in control group received routine treatment of SAP,including fasting,gastrointestinal decompression,antibiotics,inhibition of pancreatic secretion,inhibition of SIRS and organ support.Patients in treatment group received additional retention-enema with rhubarb (200mL soak solution by 100g rhubarb),once daily until the recovery of bowel function.The bladder pressure ( the 1,2,5 and 6 days after admission)was evaluated,and APACHE Ⅱ score was determined.The recovery of bowel function ( the bowel sounds,the flatus and defecation of intestinal tract),SIRS recovery time,hospital stay,and the mortality were observed.ResultsAt the 5 and 6 days after admission,the bladder pressure and APACHE Ⅱ score in treatment group were significantly lower than those in control group [ (21.9 ±9.0)cmH2O vs (25.3 ±9.5)cmH2O,( 16.5 ±7.5)cmH2O vs (20.6 ±7.7)cmH2O,1 cmH2O =0.098 kPa; (9.8 ±3.8) vs (12.5 ±3.6),(9.2 ±2.4)vs ( 11.2 ± 2.5 ),P ＜ 0.05 ) ].The recovery time of bowel function and SIRS recovery time,hospital stay,and the mortality in treatment group were ( 126.8 ± 28.2 ) h,( 131.2 ± 29.6) h,( 25.6 ± 6.2) d and 16.7 ％,and the recovery time of bowel function and SIRS recovery time,hospital stay were significantly lower than those in control group [ ( 169.9 ± 53.4 ) h,( 160.4 ± 30.4) h,( 33.2 ± 6.4) d,P ＜ 0.05 ).The mortality was reduced,but the difference between the two groups was not statistically significant ( 26.7％,P ＞ 0.05 ).ConclusionsThe retention-enema with rhubarb can accelerate the recovery time of bowel function of SAP patients and reduce the hospital stay.