Preoperative alkaline phosphatase-to-platelet count ratio as a prognostic factor for hepatocellular carcinoma with microvascular invasion.

OBJECTIVES: The association between platelet status and hepatocellular carcinoma (HCC) prognoses remains controversial. Herein, we aimed to clarify the prognostic value of multiple platelet-related biomarkers, including platelet count, platelet/lymphocyte ratio (PLR), aspartate aminotransferase to platelet ratio index (APRI), and alkaline phosphatase-to-platelet count ratio index (APPRI) in HCC with microvascular invasion (MVI) after curative resection or liver transplantation. MATERIALS AND METHODS: A retrospective review of 169 patients with solitary HCC and MVI who underwent resection or liver transplantation between January 2015 and December 2018 was conducted. Preoperative clinical, laboratory, pathologic, and imaging data were collected and analyzed. Overall survival (OS) and disease-free survival (DFS) were defined as the clinical endpoints. Univariate and multivariate Cox proportional hazards regression analyses were conducted to investigate potential predictors of DFS and OS. RESULTS: Multivariate Cox regression analyses revealed that maximum tumor diameter, poor cell differentiation, and APPRI were independent predictors of DFS; while poor cell differentiation, APRI, APPRI, prothrombin time, and alpha-fetoprotein were independent prognostic factors for OS. The 1-, 3-, and 5-year DFS rates were 66.90%, 48.40%, and 37.40% for patients with APPRI ≤0.74 and 40.40%, 24.20%,and 24.20% for patients with APPRI>0.74. The corresponding rates of OS over 1, 3, and 5 years were 92.40%, 88.10% and 77.70%, and 72.30%, 38.20%, and 19.10%, respectively. The DFS and OS rates of patients whose APPRI was more than 0.74 were substantially lower than those of patients whose APPRI was less than or equal to 0.74 (p = 0.002 and p < 0.001, respectively). CONCLUSION: Elevated preoperative APPRI is a noninvasive, simple, and easily assessable parameter linked to poor prognosis in individuals with single HCC and MVI after resection or liver transplantation.

[Measurement of anatomical relationships of facial nerve canal related to middle ear and mastoid surgery on multi-slice computed tomography-multiplanar reformation images].

OBJECTIVE: To investigate the anatomical relationships of facial nerve canal related to middle ear and mastoid surgery by multi-slice computed tomography (MSCT) and its multiplanar reconstruction ( MPR) technology. METHODS: High-resolution CT scanning with multislice spiral CT of temporal bones without bone abnormality of 373 ears in 187 adult patients were examined. All original images were processed by MPR. The distances between facial nerve canal (FNC) and jugular foramen (JF), lateral surface of mastoid bone (M), external acoustic canal (EAC), posterior fossa dural plate (PFD), sigmoid sinus (SS), promontory (P), cochlear window (CW), pyramidal eminence (PE), posterior semicircular canal (PSC), oval window (OW), head of malleus (MH), incus lenticular process (ILP) and lateral semicircular canal (LSC) were measured on different MPR images. These measurements were also analyzed with respects to side, gender, pneumatization and jugular foramen position differences. RESULTS: On average, FNC-JF was 5.43 mm, FNC-M 15.99 mm, FNC-EAC 4.42 mm, FNC-PFD 9.01 mm, FNC-SS 9.44 mm, FNC-P 6.02 mm, FNC-CW 6.51 mm, FNC-PE 2.64 mm, FNC-PSC 3.12 mm, FNC-OW 1.19 mm, FNC-MH 2.27 mm, FNC-ILP 3.09 mm and FNC-LSC 0.90 mm. FNC-M was longer in males than that of females (P < 0.05). FNC-JF and FNC-SS were longer on left side than those of the right (P < 0.05). FNC-PFD was shorter on left side (P < 0.05). FNC-PFD, FNC-EAC, FNC-SS and FNC-M were longer in well pneumatized mastoids than those of poorly pneumatized mastoids (P < 0.05). FNC-PE was longer in poorly pneumatized mastoids than that of well pneumatized mastoids (P < 0.05). FNC-PFD, FNC-P, FNC-CW and FNC-PSC were longer in bones with jugular foramen variation than those of bones without jugular foramen variation (P < 0.05). FNC-JF, FNC-SS and FNC-M were longer in bones without jugular foramen variation than those of bones with jugular foramen variation (P < 0.05). CONCLUSIONS: Anatomical relationships of facial nerve canal related to middle ear and mastoid surgery can be accurately measured on MSCT-MPR images. It is helpful to avoid injuring facial nerve in middle ear and mastoid surgery.

Rice XA21 binding protein 3 is a ubiquitin ligase required for full Xa21-mediated disease resistance.

XA21 is a receptor-like kinase protein in rice (Oryza sativa) that confers gene-for-gene resistance to specific races of the causal agent of bacterial blight disease, Xanthomonas oryzae pv oryzae. We identified XA21 binding protein 3 (XB3), an E3 ubiquitin ligase, as a substrate for the XA21 Ser and Thr kinase. The interaction between XB3 and the kinase domain of XA21 has been shown in yeast and in vitro, and the physical association between XB3 and XA21 in vivo has also been confirmed by coimmunoprecipitation assays. XB3 contains an ankyrin repeat domain and a RING finger motif that is sufficient for its interaction with the kinase domain of XA21 and for its E3 ubiquitin ligase activity, respectively. Transgenic plants with reduced expression of the Xb3 gene are compromised in resistance to the avirulent race of X. oryzae pv oryzae. Furthermore, reduced levels of Xb3 lead to decreased levels of the XA21 protein. These results indicate that Xb3 is necessary for full accumulation of the XA21 protein and for Xa21-mediated resistance.