Impact of perioperative blood transfusion on long-term survival in patients with different stages of perihilar cholangiocarcinoma treated with curative resection: A multicentre propensity score matching study.

Background & aim: The association of perioperative blood transfusion (PBT) with long-term survival in perihilar cholangiocarcinoma (pCCA) patients after surgical resection with curative intent is controversial and may differ among different stages of the disease. This study aimed to investigate the impact of PBT on long-term survival of patients with different stages of pCCA. Methods: Consecutive pCCA patients from three hospitals treated with curative resection from 2012 to 2019 were enrolled and divided into the PBT and non-PBT groups. Propensity score matching (PSM) was used to balance differences in baseline characteristics between the PBT and non-PBT groups. Kaplan-Meier curves and log-rank test were used to compare overall survival (OS) and recurrence-free survival (RFS) between patients with all tumor stages, early stage (8th AJCC stage I), and non-early stage (8th AJCC stage II-IV) pCCA in the PBT and non-PBT groups. Cox regression analysis was used to determine the impact of PBT on OS and RFS of these patients. Results: 302 pCCA patients treated with curative resection were enrolled into this study. Before PSM, 68 patients (22 patients in the PBT group) were in the early stage and 234 patients (108 patients in the PBT group) were in the non-early stage. Patients with early stage pCCA in the PBT group had significantly lower OS and RFS rates than those in the non-PBT group. However, there were with no significant differences between the 2 groups with all tumor stages and non-early stage pCCA. After PSM, there were 18 matched pairs of patients with early stage and 72 matched pairs of patients with non-early stage. Similar results were obtained in the pre- and post-PSM cohorts: patients with early stage pCCA in the PBT group showed significantly lower OS and RFS rates than those in the non-PBT group, but there were no significant differences between the 2 groups for patients with all tumor stages and non-early stage pCCA. Cox regression analysis demonstrated that PBT was independently associated with worse OS and RFS for patients with early stage pCCA. Conclusions: PBT had a negative impact on long-term survival in patients with early stage pCCA after curative resection, but not in patients with non-early stage pCCA.

A ratiometric fluorescent sensing of proanthocyanidins by MnO2 nanosheets simultaneously tuning the photoluminescence of Au/AgNCs and thiamine.

By simultaneously regulating the photoluminescence of alloy Au/Ag nanoclusters (NCs) and thiamine (VB1) through MnO2 nanosheets (MnO2 NS), a novel ratiometric fluorescent probe (RF-probe) was established for sensitively and selectively monitoring proanthocyanidins (PAs). The introduction of Ag (I) ions could enhance significantly the quantum yields (QYs, 11.1%) of AuNCs based on the synthetic method of UVI (UV irradiation) combined with MWH (microwave heating). MnO2 NS could quench the fluorescence (FL) of Au/AgNCs mainly coming from Förster resonance energy transfer (FRET), while it could act as a nanozyme catalyst for directly catalyzing the oxidation of VB1 to produce highly fluorescent oxVB1. In the presence of PAs, MnO2 was reduced to Mn2+, which caused that its quenching capacity and oxidase-like activity were vanished, thus the FL of oxVB1 and Au/AgNCs was reduced and recovered. The concentration of PAs could be monitored by the RF-probe with a linear range of 0.27-22.4 µmol L-1 and corresponding limit of detection (LOD) and limit of quantification (LOQ) were calculated to be 75.9 and 250.5 nmol L-1. Furthermore, the RF-probe was successfully used for the determination of PAs in mineral water, PAs additive and PAs capsule with satisfactory results compared to the standard HPLC method.

Effects of Different Levels of Intra-Abdominal Pressure on the Postoperative Hepatic Function of Patients Undergoing Laparoscopic Cholecystectomy: A Systematic Review and Meta-Analysis.

OBJECTIVE: The aim of this meta-analysis is to compare the differences in postoperative markers of the hepatic function under different intra-abdominal pressures in laparoscopic cholecystectomy (LC). METHODS: Several databases were searched for control studies, and then the weighted data were pooled with random-effect models. RESULTS: A total of 11 studies involving 865 patients were included. The meta-analysis reveals that the level of the aspartate aminotransferase and alanine transaminase of the low-pressure group has a lower postoperative increase than the moderate-pressure group (P<0.001). The level of the aspartate aminotransferase and alanine transaminase of the moderate-pressure group has a lower postoperative increase than the high-pressure group (P<0.001). Totally, the effect of lower pressure LC on postoperative hepatic functions is less significant than that of the higher one. Potential subgroup analysis does not modify these results. CONCLUSIONS: The recommended pressure in LC is suggested to be lower so as to result in a better surgical safety, especially for special populations.

Investigation of the interaction between indigotin and two serum albumins by spectroscopic approaches.

The binding characteristics of indigotin with human serum albumin (HSA) and bovine serum albumin (BSA) have been investigated by various spectroscopic techniques. Spectroscopic analysis revealed that the quenching mechanism between indigotin and HSA/BSA belonged to the static quenching. The displacement experiments suggested that indigotin primarily bound to tryptophan residues on proteins within site I. The thermodynamic parameters indicated that the binding of indigotin-HSA/BSA mainly depended on the hydrophobic interaction. The binding distance of indigotin to HSA/BSA was evaluated. The results by synchronous fluorescence, three-dimensional fluorescence, Fourier Transform Infrared spectroscopy (FT-IR) and circular dichroism (CD) spectra showed that the conformation of proteins altered in the presence of indigotin.

[Application of wavelet packets analysis-interpolation-RBF to the simultaneous determination of Fe, Mn, Cu and Zn in aluminous-alloy].

A new approach was proposed so that noises invisible spectra are eliminated by wavelet packets, and the specimen numbers of calibration samples are increased by linear interpolation. It can used to solve problems of few specimen numbers and many variables in simultaneous spectrophotometric determination. Thus forecasting resultant veracity is improved. The contents of Fe, Mn, Cu and Zn in aluminous-alloy was determined simultaneously by using wavelet packets analysis-linear interpolation-RBF (radial basis function) neural networks (WPA-Interp-RBF). Wavelet packets analysis can eliminate noises to a desired level. Linear interpolation makes specimenof training samples cover recognizable room better. So RBF can abstract more characteristic information and improve its performance. Relative error(RE) of sample is reduced remarkably with desired results.