Design, synthesis, and biological evaluation of imidazolylacetophenone oxime derivatives as novel brain-penetrant agents for Alzheimer's disease treatment.

Alzheimer's disease (AD, also known as dementia) has become a serious global health problem along with population aging, and neuroinflammation is the underlying cause of cognitive impairment in the brain. Nowadays, the development of multitarget anti-AD drugs is considered to be one effective approach. Imidazolylacetophenone oxime ethers or esters (IOEs) were multifunctional agents with neuroinflammation inhibition, metal chelation, antioxidant and neuroprotection properties against Alzheimer's disease. In this study, IOEs derivatives 1-8 were obtained by structural modifications of the oxime and imidazole groups, and the SARs showed that (Z)-oxime ether (derivative 2) had stronger anti-neuroinflammatory and neuroprotective ability than (E)-congener. Then, IOEs derivatives 9-30 were synthesized based on target-directed ligands and activity-based groups hybridization strategy. In vitro anti-AD activity screening revealed that some derivatives exhibited potentially multifunctional effects, among which derivative 28 exhibited the strongest inhibitory activity on NO production with EC50 value of 0.49 µM, and had neuroprotective effects on 6-OHDA-induced cell damage and RSL3-induced ferroptosis. The anti-neuroinflammatory mechanism showed that 28 could inhibit the release of pro-inflammatory factors PGE2 and TNF-α, down-regulate the expression of iNOS and COX-2 proteins, and promote the polarization of BV-2 cells from pro-inflammatory M1 phenotype to anti-inflammatory M2 phenotype. In addition, 28 can dose-dependently inhibit acetylcholinesterase (AChE) and Aß42 aggregation. Moreover, the selected nuclide [18F]-labeled 28 was synthesized to explore its biodistribution by micro-PET/CT, of which 28 can penetrate the blood-brain barrier (BBB). These results shed light on the potential of 28 as a new multifunctional candidate for AD treatment.

Comparison of percutaneous microwave/radiofrequency ablation liver partition and portal vein embolization versus transarterial chemoembolization and portal vein embolization for planned hepatectomy with insufficient future liver remnant.

BACKGROUND: In China, both percutaneous microwave/radiofrequency ablation liver partition plus portal vein embolization (PALPP) and transarterial chemoembolization (TACE) plus portal vein embolization (PVE) have been utilized in planned hepatectomy. However, there is a lack of comparative studies on the effectiveness of these two techniques for cases with insufficient future liver remnant (FLR). METHODS: Patients were categorized into either the PALPP group or the TACE + PVE group. Clinical data, including FLR growth rate, complications, secondary resection rate, and overall survival rate, were compared and analyzed for both groups retrospectively. RESULTS: Between December 2014 and October 2021, a total of 29 patients underwent TACE + PVE (n = 12) and PALPP (n = 17). In the TACE + PVE group, 7 patients successfully underwent two-stage hepatectomy, while in the PALPP group, 13 patients underwent the procedure (two-stage resection rate: 58.3% vs. 76.5%, P = 0.42). There were no significant differences in postoperative complications of one-stage procedures (11.8% vs. 8.3%, P > 0.05) and second-stage resection complication (0% vs. 46.2%, P = 0.05) between the TACE + PVE and PALPP groups. However, the PALPP group demonstrated a shorter time to FLR volume growth for second-stage resection (18.5 days vs. 66 days, P = 0.001) and KGR (58.5 ml/week vs. 7.7 ml/week, P = 0.001). CONCLUSIONS: Compared with TACE + PVE, PALPP results in a more significant increase in FLR volume and a higher rate of two-stage resection without increasing postoperative complications.

Imidacloprid affects human cells through mitochondrial dysfunction and oxidative stress.

Given their relatively low persistence and mammalian toxicity, neonicotinoid pesticides have been extensively used worldwide and are omnipresent in the environment. Recent studies have shown that neonicotinoids may pose adverse effects on non-target organisms other than the known neurotoxicity, raising emerging concerns that these insecticides might pose human health risk through additional toxicity pathways. In the present study, the mitochondria function, oxidative stress, DNA damages, and genes transcription levels were examined in the human neuroblastoma SH-SY5Y cells after 48-h exposure to imidacloprid at concentrations from 0.05 to 200 µmol/L. Results showed that imidacloprid induced mitochondrial dysfunction with the degradation of adenosine triphosphate (ATP) and mitochondrial membrane potential (MMP) levels. In addition, imidacloprid caused oxidative stress by stimulating the generation of reactive oxygen species (ROS) and hydrogen peroxide (H2O2) via the disruption of calcium ion level and mitochondrial function. Ultimately, the oxidative stress continued to produce DNA damage and apoptosis in SH-SY5Y cells at imidacloprid concentrations above 47.6 µmol/L. Among the evaluated endpoints, ATP was the most sensitive, with a median activity concentration of 0.74 µmol/L. The 5 % hazard concentration of imidacloprid was estimated to be 0.69 µmol/L, which can be used as a threshold for human health risk assessment for imidacloprid. Collectively, our results provide an important support for further research on potential toxicity of neonicotinoids related to mitochondrial toxicity in humans.

Biological activity and systemic translocation of the new tetrazolyloxime fungicide picarbutrazox against plant-pathogenic oomycetes.

BACKGROUND: Picarbutrazox is a new tetrazolyloxime fungicide discovered in 2014 by Nippon Soda. It is mostly used to protect against Phytophthora spp. and Pythium spp. However, little is known of its inhibition spectrum, protective and curative activity, and systemic translocation in plants. RESULTS: While picarbutrazox did not show obvious antifungal activity, it exhibited significant activity against oomycetes, including Phytophthora spp., Pythium spp. and Phytopythium spp.. The effective concentration for 50% growth inhibition (EC50) values of picarbutrazox against 16 oomycetes ranged from 3.1 × 10-4 and 7.27 × 10-3 µg mL-1. Furthermore, picarbutrazox could markedly inhibited the mycelial development, sporangia production, zoospore release, and cyst germination of Phytophthora capsici, with EC50 values of 1.34 × 10-3, 1.11 × 10-3, 4.85 × 10-3, and 5.88 × 10-2 µg mL-1, respectively. Additionally, under greenhouse conditions, the protective and curative activities of picarbutrazox at 200 mg L-1 (100%, 41.03%) against the P. capsici infection in peppers were higher than those of the reference fungicide dimethomorph at 200 mg L-1 (77.52%, 36.15%). High-performance liquid chromatography analysis confirmed that picarbutrazox showed excellent systemic translocation in pepper plants. CONCLUSION: The results showed that picarbutrazox markedly inhibited the important plant oomycete pathogens including Phytophthora spp., Pythium spp. and Phytopythium spp.. It also displayed excellent protective, curative and systemic translocation activity. Picarbutrazox thus has significant potential for preventing and controlling diseases caused by oomycetes. © 2024 Society of Chemical Industry.

Exploration of port environmental efficiency measurement and influential factors in the Yangtze River Delta Pilot Free Trade Zone.

This study focuses on the environmental efficiency of ports in China's Yangtze River Delta Pilot Free Trade Zone (YRD PFTZ), a critical factor in advancing the high-quality development of ports and facilitating Chinese-style modernization. Current research on port efficiency primarily focuses on the geographical level, with relatively few studies examining the economic regional framework. We selected the YRD PFTZ port for our study to address this gap. Covering 2013 to 2021, we employed the Super-SBM with undesirable outputs and utilized the GML index method. We conducted a spatiotemporal analysis to assess dynamic and static aspects and used the Tobit model to thoroughly investigate the factors influencing the GML Index of these ports. The study showed that: (1) the overall environmental efficiency of these ports was relatively high with a fluctuating trend of initial increase, followed by a decrease, and then an upturn. (2) From a dynamic perspective, the average Green Total Factor Productivity (GTFP) Index is 1.549, denoting an exceptional level primarily driven by technological efficiency. The technical efficiency change index is the main factor improving GTFP in Shanghai, Jiangsu, and Anhui provinces. (3) The port cargo volume and total import and export volume significantly impact the environmental efficiency.

Rational Design of Oil-Resistant and Electrically Conductive Fluorosilicone Rubber Foam Nanocomposites for Sensitive Detectability in Complex Solvent Environments.

Recent years have witnessed the explosive development of highly sensitive smart sensors based on conductive polymer foam materials. However, the design and development of multifunctional polymeric foam composites as smart sensors applied in complex solvent and oil environments remain a critical challenge. Herein, we design and synthesize vinyl-terminated polytrifluoropropylmethylsiloxane through anionic ring-opening polymerization to fabricate fluorosilicone rubber foam (FSiRF) materials with nanoscale wrinkled surfaces and reactive Si-H groups via a green and rapid chemical foaming strategy. Based on the strong adhesion between FSiRF materials and consecutive oxidized ketjen black (OKB) nano-network, multifunctional FSiRF nanocomposites were prepared by a dip-coating strategy followed by fluoroalkylsilane modification. The optimized F-OKB@FSiRF nanocomposites exhibit outstanding mechanical flexibility in wide-temperature range (100 cycle compressions from -20 to 200 °C), structure stability (no detached particles after being immersed into various aqueous solutions for up to 15 days), surface superhydrophobicity (water contact angle of 154° and sliding angle of ∼7°), and tunable electrical conductivity (from 10-5 to 10-2 S m-1). Additionally, benefiting from the combined actions of multiple lines of defense (low surface energy groups, physical barriers, and "shielding effect"), the F-OKB@FSiRF sensor presents excellent anti-swelling property and high sensitivity in monitoring both large-deformation and tiny vibrations generated by knocking the beaker, ultrasonic action, agitating, and sinking objects in weak-polar or nonpolar solvents. This work conceivably provides a chemical strategy for the fabrication of multifunctional polymeric foam nanocomposite materials as smart sensors for broad applications.

Waterborne Intumescent Fire-Retardant Polymer Composite Coatings: A Review.

Intumescent fire-retardant coatings, which feature thinner layers and good decorative effects while significantly reducing heat transfer and air dispersion capabilities, are highly attractive for fire safety applications due to their effective prevention of material combustion and protection of materials. Particularly, the worldwide demand for improved environmental protection requirements has given rise to the production of waterborne intumescent fire-retardant polymer composite coatings, which are comparable to or provide more advantages than solvent-based intumescent fire-retardant polymer composite coatings in terms of low cost, reduced odor, and minimal environmental and health hazards. However, there is still a lack of a comprehensive and in-depth overview of waterborne intumescent fire-retardant polymer composite coatings. This review aims to systematically and comprehensively discuss the composition, the flame retardant and heat insulation mechanisms, and the practical applications of waterborne intumescent fire-retardant polymer composite coatings. Finally, some key challenges associated with waterborne intumescent fire-retardant polymer composite coatings are highlighted, following which future perspectives and opportunities are proposed.

Vonoprazan and amoxicillin dual therapy for 14 days as the first-line treatment of Helicobacter pylori infection: A non-inferiority, randomized clinical trial.

BACKGROUND: We previously optimized the duration and dose of vonoprazan and amoxicillin dual therapy in China. The efficacy of vonoprazan with b.i.d. amoxicillin in comparison with vonoprazan-containing quadruple therapy as the first-line treatment of Helicobacter pylori infection has not been adequately evaluated. METHODS: In a non-inferiority, randomized clinical trial, H. pylori infected and treatment-naïve patients were randomly assigned to receive 14 days of either vonoprazan dual (vonoprazan 20 mg and amoxicillin 1 g twice daily) or quadruple therapy (vonoprazan 20 mg + amoxicillin 1 g + furazolidone 100 mg + bismuth potassium citrate 600 mg twice daily). H. pylori status was confirmed using 13C-urea breath tests or fecal antigen test. The primary outcome was the H. pylori eradication rate following vonoprazan dual and quadruple therapy at 4-12 weeks. We also compared drug compliance to either regimen and documented their side effect. RESULTS: A total of 190 subjects were randomized. The eradication rate of vonoprazan dual and quadruple therapy were 87.4% and 92.6% (p = 0.23) by intention-to-treat analysis, respectively, and 96.5% and 97.7% (p = 0.63) by per-protocol analysis, respectively. The efficacy of vonoprazan dual therapy was non-inferior to vonoprazan-containing quadruple therapy in per-protocol analysis (p < 0.001; difference: -1.2%; 90% confidence interval: -5.4% to 3.0%). CONCLUSION: Vonoprazan with b.i.d. amoxicillin for 14 days provided similar satisfactory efficacy with vonoprazan-containing quadruple therapy as a first-line H. pylori treatment in China.

Effect driven prioritization of contaminants in wastewater treatment plants across China: A data mining-based toxicity screening approach.

A diversity of contaminants of emerging concern (CECs) are present in wastewater effluent, posing potential threats to receiving waters. It is urgent for a holistic assessment of the occurrence and risk of CECs related to wastewater treatment plants (WWTP) on national and regional scales. A data mining-based risk prioritization method was developed to collect the reported contaminants and their respective concentrations in municipal and industrial WWTPs and their receiving waters across China over the past 20 years. A total of 10,781 chemicals were reported in 8336 publications, of which 1037 contaminants were reported with environmental concentrations. While contaminant categories varied across WWTP types (municipal vs. industrial) and regions, pharmaceuticals and cyclic hydrocarbons were the most studied CECs. Contaminant composition in receiving water was closer to that in municipal than industrial WWTPs. Publications on legacy pesticides and polycyclic aromatic hydrocarbons in WWTP decreased recently compared to the past, while pharmaceuticals and perfluorochemicals have received increasing attention, showing a changing concern over time. Detection frequency, concentration, removal efficiency, and toxicity data were integrated for assessing potential risks and prioritizing CECs on national and regional scales using an environmental health prioritization index (EHPi) approach. Among 666 contaminants in municipal WWTP effluent, trichlorfon and perfluorooctanesulfonic acid were with the highest EHPi scores, while 17ɑ-ethinylestradiol and bisphenol A had the highest EHPi scores among 304 contaminants in industrial WWTPs. The prioritized contaminants varied across regions, suggesting a need for tailoring regional measures of wastewater treatment and control.

Initial trajectory design of low-thrust spacecraft considering attitude constraints.

The fuel carried by deep space exploration spacecraft is crucial for the completion of their exploration missions, and the fuel for attitude control engines is even more precious. In order to reduce the control requirements for attitude control systems, this paper proposes a shape-based trajectory optimization algorithm that considers attitude constraints for low-thrust spacecraft. This method obtains a more accurate transfer trajectory by considering the change rate and change range constraints of the propulsion acceleration direction of spacecraft. By comparing the simulation results without considering spacecraft attitude constraints, it is confirmed that the proposed algorithm considering attitude constraints is very important for the initial design of transfer trajectories. This is of great significance for high-precision initial trajectory optimization of deep space exploration missions.

[Intervention mechanism of ginsenoside Rb_1 on liver steatosis in db/db obese mice based on TLR4/MyD88/NF-κB signaling pathway].

Based on the Toll-like receptor 4(TLR4)/myeloid differentiation factor 88(MyD88)/nuclear factor kappaB(NF-κB) signaling pathway, this study observed the regulatory effect of ginsenoside Rb_1(Rb_1) on liver lipid metabolism in db/db obese mice and explored its potential mechanism. Thirty 6-week-old male db/db mice were randomly divided into a model group, a metformin group, and Rb_1 groups with low, medium, and high doses, with six mice in each group. Additionally, six age-matched male db/m mice were assigned to the normal group. The intervention lasted for five weeks. Body weight, fasting blood glucose, and food intake were mea-sured weekly. At the end of the experiment, serum lipid levels and liver function were detected. Hematoxylin-eosin(HE) staining and oil red O staining were performed to observe pathological changes in liver tissue. Real-time quantitative PCR and immunohistochemistry on paraffin sections were used to detect the mRNA and protein expression of TLR4, MyD88, and NF-κB p65. RESULTS:: showed that compared with the normal group, the model group exhibited significant increases in body weight, liver weight, liver index, epididymal fat mass, epididymal fat index, total cholesterol, low-density lipoprotein cholesterol, liver function parameters, and fasting blood glucose levels. Liver lipid accumulation significantly increased, along with elevated mRNA and protein expression of TLR4, MyD88, and NF-κB p65 in the liver. After Rb_1 treatment, the above-mentioned parameters in the intervention groups showed significant reversals. In conclusion, Rb_1 can improve obesity and obesity-related hepatic steatosis in mice while regulating abnormal lipid and glucose meta-bolism. Mechanistically, Rb_1 may improve liver steatosis in db/db obese mice by modulating the TLR4/MyD88/NF-κB signaling pathway.

Association between dietary inflammatory index and fecal incontinence in American adults: a cross-sectional study from NHANES 2005-2010.

Objective: Recent studies have demonstrated that the Dietary Inflammatory Index (DII) is relevant to abnormal gut health. However, there is a lack of studies that have explicitly explored the link between fecal incontinence (FI) and DII. The current study aims to explore the relationship between DII and FI. Methods: The cross-sectional study enrolled a total of 11,747 participants aged 20-85 from NHANES 2005-2010. Weighted logistic regression was conducted to evaluate the relationship between DII and FI, and restricted cubic spline (RCS) was employed to assess the dose-response relationship between DII and FI. Subgroup analyses were performed according to age, gender, race, and BMI. Result: DII levels were found to be significantly higher in patients with FI than in the normal population (p = 0.016). After adjusting for all covariates, DII was found to be significantly correlated with FI (model 2: Q4 vs. Q1, OR = 1.49, 95% CI: 1.04-2.14, p = 0.032, p for trend = 0.039). The dose-response curve revealed that there was no non-linear correlation between DII and FI (p-non-linear = 0.234). Subsequent subgroup analyses uncovered that DII was notably associated with FI in the old (Q4 vs. Q1, OR = 1.84, 95% CI: 1.07-3.18, p = 0.030), female (Q4 vs. Q1: OR = 2.02, 95% CI: 1.23-3.33, p = 0.008), non-Hispanic white (Q4 vs. Q1: OR = 1.70, 95% CI: 1.12-2.59, p = 0.015) populations. Conclusion: DII was positively associated with FI, particularly among old, female and non-Hispanic white individuals. Decreasing daily dietary inflammatory levels may be an effective tactic to prevent FI, but the precise mechanisms need to be further investigated.

Analysis of asthma incidence and mortality rates among children aged 0-14 in 204 countries from 1990 to 2019.

OBJECTIVE: Asthma is a common chronic respiratory disease in children. Understanding incidence and mortality trends is crucial for prevention and intervention strategies. METHODS: Data from the Global Burden of Disease (GBD) study were used to analyze asthma incidence and mortality trends among children aged 0-14 in 204 countries from 1990 to 2019. The 30-year trends were calculated using the Estimated Annual Percentage Change (EAPC). RESULTS: Globally, pediatric asthma cases increased from 18,857,697 in 1990 to 20,191,786 in 2019. Incidence rates for children <5, 5-9, and 10-14 years are 1509.36, 980.25, and 586.95 per 100,000, respectively. Over 30 years, pediatric asthma mortality rates significantly decreased from 1.59 to 0.51 per 100,000, with minimal gender differences. High-income North America, Tropical Latin America, and the Caribbean show the highest incidence rates at 3203.2, 2493.83, and 2314.8 per 100,000. The USA, Puerto Rico, and Haiti have the highest national rates at 3357.17, 2695.30, and 2605.38 per 100,000. Regions with higher Sociodemographic Index levels tend to have higher incidence rates. Pediatric asthma prevalence varies by region and age group. CONCLUSION: Our study of asthma incidence and mortality rates among children aged 0-14 across 204 countries from 1990 to 2019 reveals significant global disparities. These findings underscore the influence of socioeconomic and environmental factors on asthma prevalence and outcomes.

Structure and Bioactivity of Intracellular and Extracellular Polysaccharides of Trametes lactinea Mycelium.

Trametes lactinea polysaccharides have a high medicinal value; however, we still know little about the structure and bioactivity of intracellular and extracellular polysaccharides in the mycelial liquid fermentation of T. lactinea. This study analyzed the structures of intracellular (IP-1, IP-2, and IP-3) and extracellular (EP-1 and EP-2) polysaccharide components isolated from T. lactinea liquid fermentation, as well as investigated their antioxidant, antibacterial, and immunomodulatory properties. The results showed that IP-3 was the only component with a triple-helix structure, while the other four components did not possess this structure. IP3 has a higher molecular weight, flavonoid, and total phenolic content compared to other components. Both intracellular and extracellular polysaccharide components exhibited strong scavenging abilities against ABTS and DPPH radicals. The components showed limited antibacterial effects against four types of bacteria (Staphylococcus aureus, Bacillus subtilis, Erwinia carotovora, and Escherichia coli), and were found to be non-toxic to RAW264.7 cells, even promoting cell proliferation. Furthermore, within a specific concentration range, all components enhanced the phagocytic activity of RAW264.7 cells, increased the secretion of NO, TNF-α, and IL-6, and demonstrated concentration-dependent effects, with IP-3 displaying the most potent immunomodulatory activity. This study shows a high potential for the development and utilization of polysaccharides derived from the liquid fermentation of T. lactinea mycelium.

The Effects of Combined Treatments of Laser Engraving, Plasma Spraying and Resin Pre-Coating on Improving the Bonding Strength of Titanium Alloy and Carbon Fiber-Reinforced Polymer.

This study focused on effective methods of laser engraving treatment (LET), plasma spraying, and resin pre-coating (RPC) to manufacture the reinforced adhesive joints of titanium alloy and carbon fiber-reinforced polymer (TA-CFRP) composites. The combined treatments contributed to the creation of a better adhesive bonding condition and offer a vertical gap between circular protrusions to form epoxy pins and carbon nanotube (CNT)-reinforced epoxy pins. The bonding strength of the TA-CFRP composite was reinforced by 130.6% via treatments with a twice-engraving unit of 0.8 mm, plasma spraying, and RPC. The original debonding failure on the TA surface was changed into the cohesive failure of the epoxy adhesive and delamination-dominated failure of the CFRP panel. Overall, laser engraving has been confirmed as an effective and controllable treatment method to reinforce the bonding strength of the TA-CFRP joint combined with plasma spraying and RPC. It may be considered as an alternative in industry for manufacturing high-performance metal-CFRP composites.

Spatial profiles of the bacterial microbiota throughout the gastrointestinal tract of dairy goats.

The gastrointestinal tract (GIT) is stationed by a dynamic and complex microbial community with functions in digestion, metabolism, immunomodulation, and reproduction. However, there is relatively little research on the composition and function of microorganisms in different GIT segments in dairy goats. Herein, 80 chyme samples were taken from ten GIT sites of eight Xinong Saanen dairy goats and then analyzed and identified the microbial composition via 16S rRNA V1-V9 amplicon sequencing. A total of 6669 different operational taxonomic units (OTUs) were clustered, and 187 OTUs were shared by ten GIT segments. We observed 264 species belonging to 23 different phyla scattered across ten GITs, with Firmicutes (52.42%) and Bacteroidetes (22.88%) predominating. The results revealed obvious location differences in the composition, diversity, and function of the GIT microbiota. In LEfSe analysis, unidentified_Lachnospiraceae and unidentified_Succinniclassicum were significantly enriched in the four chambers of stomach, with functions in carbohydrate fermentation to compose short-chain fatty acids. Aeriscardovia, Candidatus_Saccharimonas, and Romboutsia were significantly higher in the foregut, playing an important role in synthesizing enzymes, amino acids, and vitamins and immunomodulation. Akkermansia, Bacteroides, and Alistipes were significantly abundant in the hindgut to degrade polysaccharides and oligosaccharides, etc. From rumen to rectum, α-diversity decreased first and then increased, while ß-diversity showed the opposite trend. Metabolism was the major function of the GIT microbiome predicted by PICRUSt2, but with variation in target substrates along the regions. In summary, GIT segments play a decisive role in the composition and functions of microorganisms. KEY POINTS: • The jejunum and ileum were harsh for microorganisms to colonize due to the presence of bile acids, enzymes, faster chyme circulation, etc., exhibiting the lowest α-diversity and the highest ß-diversity. • Variability in microbial profiles between the three foregut segments was greater than four chambers of stomach and hindgut, with a higher abundance of Firmicutes dominating than others. • Dairy goats dominated a higher abundance of Kiritimatiellaeota than cows, which was reported to be associated with fatty acid synthesis.

Prognostic value of the Naples prognostic score in patients with intrahepatic cholangiocarcinoma after hepatectomy.

BACKGROUND: The Naples Prognostic Score (NPS), integrating inflammatory and nutritional biomarkers, has been reported to be associated with the prognosis of various malignancies, but there is no report on intrahepatic cholangiocarcinoma (ICC). This study aimed to explore the prognostic value of NPS in patients with ICC. METHODS: Patients with ICC after hepatectomy were collected, and divided into three groups. The prognosis factors were determined by Cox regression analysis. Predictive efficacy was evaluated by the time-dependent receiver operating characteristic (ROC) curves. RESULTS: A total of 174 patients were included (Group 1: 33 (19.0%) patients; Group 2: 83 (47.7%) patients; and Group 3: 58 (33.3%) patients). The baseline characteristics showed the higher the NPS, the higher the proportion of patients with cirrhosis and Child-Pugh B, and more advanced tumors. The Kaplan-Meier curves reflect higher NPS were associated with poor survival. Multivariable analysis showed NPS was an independent risk factor of overall survival (NPS group 2 vs. 1: HR = 1.671, 95% CI: 1.022-3.027, p = 0.009; NPS group 3 vs. 1: HR = 2.208, 95% CI: 1.259-4.780, p = 0.007) and recurrence-free survival (NPS group 2 vs. 1: HR = 1.506, 95% CI: 1.184-3.498, p = 0.010; NPS group 3 vs. 1: HR = 2.141, 95% CI: 2.519-4.087, P = 0.001). The time ROC indicated NPS was superior to other models in predicting prognosis. CONCLUSIONS: NPS is a simple and effective tool for predicting the long-term survival of patients with ICC after hepatectomy. Patients with high NPS require close follow-up, and improving NPS may prolong the survival time.

Multicenter propensity score-matched analysis to compare perioperative morbidity after laparoscopic or robotic complex hepatectomy for solitary hepatocellular carcinoma.

BACKGROUND: Postoperative complications are vital factors affecting the prognosis of patients with hepatocellular carcinoma (HCC), especially for complex hepatectomy. The present study aimed to compare perioperative complications between laparoscopic and robotic complex hepatectomy (LCH vs. RCH). METHODS: Patients with solitary HCC after complex hepatectomy were collected from a multicenter database. Propensity score-matched (PSM) analysis was adopted to control confounding bias. Multivariable analysis was performed to determine the prognostic factors. RESULTS: 436 patients were included. After PSM, 43 patients were included in both the LCH and RCH groups. The results showed that compared to LCH, RCH had lower rates of blood loss and transfusion, and lower postoperative 30-day and major morbidity, and post-hepatectomy liver failure (PHLF) (all P < 0.05). Additionally, the length of hospital stay was shorter in the RCH group (P = 0.026). Multivariable analysis showed RCH is an independent protective factor for reducing the 30-day morbidity, major morbidity and PHLF. CONCLUSION: RCH has advantages over LCH in the minimally invasive treatment of complex HCC, as it can reduce the incidence of postoperative morbidity. Therefore, RCH should be considered for patients with HCC who require complex hepatectomy.