Prognostic value of hemoglobin to red blood cell distribution width ratio in pancreatic ductal adenocarcinoma: a retrospective study.

BACKGROUND: Previous studies have identified the hemoglobin (Hb) to red blood cell distribution width (RDW) ratio (HRR) is associated with the prognosis of a variety of malignant tumors. However, the relationship between HRR and pancreatic ductal adenocarcinoma (PDAC) prognosis remains unexplored. This study aims to ascertain the prognostic significance of HRR in PDAC patients. METHODS: In a retrospective analysis, 128 PDAC patients undergoing initial surgical resection at Ningbo Medical Center Lihuili Hospital between January 2016 and September 2021 were included. Based on receiver operating characteristic curve-derived cut-off values, participants were categorized into low and high HRR groups. The correlation between HRR and patient prognosis was subsequently examined. RESULTS: Significant disparities in age, Hb levels, RDW, tumor locality, surgical intervention, and postoperative chemotherapy were observed between the two groups (P < 0.05). Notably, the low HRR cohort exhibited inferior disease-free survival (DFS) and overall survival (OS) rates (P = 0.002 for both). Univariate analysis indicated that male gender, adjacent tissue invasion, TNM stages III/IV, non-O blood types, low HRR, and lack of postoperative chemotherapy were linked to adverse DFS and OS outcomes (P < 0.05). Multivariate analysis further delineated low HRR as an independent predictor of poor DFS and OS outcomes (HR: 1.520, 95% CI: 1.028-2.247, P = 0.036; HR: 1.537, 95% CI: 1.034-2.284, P = 0.034, respectively). CONCLUSION: Our findings suggest that a lower HRR is indicative of poorer DFS and OS in PDAC patients, underscoring its potential utility as a prognostic biomarker for this population.

Association of ABO blood group, Rh phenotype and MN blood group with susceptibility to COVID-19.

BACKGROUND: Previous studies have reported that the susceptibility to coronavirus disease 2019 (COVID-19) is related to ABO blood group, but the relationship with Rh phenotype and MN blood group is unknown. China had adopted a strict control policy on COVID-19 until December 5, 2022, when local communities were liberalized. Therefore, we aimed to explore the correlation between ABO blood group, Rh phenotype, MN blood group and susceptibility to COVID-19 based on the time sequence of infection during the pandemic. METHODS: A total of 870 patients who were routinely hospitalized in Ningbo Medical Center Lihuili Hospital from March 1, 2023 to March 31, 2023 were randomly selected to enroll in this study. Patients were divided into susceptible group and non-susceptible group, according to the time of their previous infection. The demographics and clinical information of the enrolled participants were collected from electronic medical records. The association of ABO blood group, Rh phenotype and MN blood group with susceptibility to COVID-19 was analyzed. RESULTS: A total of 650 cases (74.7%) had been infected with COVID-19, with 157 cases (18.0%) in the second week and 252 cases (29.0%) in the third week, reaching the peak of infection. Compared with the non-susceptible group, the susceptible group had no statistically significant differences in ABO blood group and Rh phenotype, but the proportion of N+ was higher (75.6% vs 68.9%, P = 0.030) and the proportion of MM was lower (24.4% vs 31.1%, P = 0.030). Consistent with this, ABO blood group and Rh phenotype were not significantly associated with susceptibility to COVID-19 (P>0.05), while N+ and MM were associated with susceptibility to COVID-19 (OR: 1.432, 95% confidence interval [CI]: 1.049, 1.954, P = 0.024; OR: 0.698, 95% CI: 0.512, 0.953, P = 0.024, respectively), after adjusting for age, sex, BMI, basic disease, and vaccination status in multivariate logistic regression analysis. CONCLUSION: Our study showed that ABO blood group and Rh phenotype may not be related to the susceptibility to COVID-19, but MN blood group may be associated with the susceptibility to COVID-19.

Clinical efficacy of laparoscopic radical hepatectomy and laparotomy for hepatocellular carcinoma and factors of postoperative recurrence.

Objective: For exploring the clinical efficacy of laparoscopic radical hepatectomy and laparotomy for hepatocellular carcinoma and analysing related factors of postoperative recurrence. Methods: Totally 212 patients with hepatocellular carcinoma admitted to our hospital between April 2017 and December 2020 were enrolled, and all of them were followed up after the operation. According to the treatment modes, the patients were assigned to a laparotomy group (n=106) and a laparoscopic group (n=106). Perioperative indicators, haematological examination results, complications and recurrence were compared between the two groups. The recurrence time of hepatocellular carcinoma after the operation was confirmed by imaging examination with definite mass, and logistic multivariate analysis was used for analyzing the risk factors associated with postoperative recurrence. Results: Patients in both groups were comparable in terms of general baseline data. The laparoscopic group experienced longer operation time and shorter incision length, less intraoperative blood loss, early time to have the first off-bed activity and time to eat liquid and shorter hospital stay than the laparotomy group (all P<0.05). Seven days after the operation, the laparoscopic group showed notably lower levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), tumour necrosis factor-α (TNF-α), interleukin-8 (IL-8), and C-reactive protein (CRP) than the laparotomy group (all P<0.05), and also showed notably higher levels of immunoglobulin A (IgA), IgG and IgM than the laparotomy group (all P<0.05). Additionally, the laparotomy group showed a higher total incidence rate of complications than the laparoscopic group (19.81% vs. 9.43%, P<0.05). During the one-year follow-up, the laparotomy group was not greatly different from the laparoscopic group in recurrence rate (22.64% (24/106) vs. 16.98% (18/106), P>0.05). Multivariate analysis showed that average tumour diameter and microvascular invasion were risk factors for postoperative recurrence (P<0.05). Conclusion: Laparoscopic radical hepatectomy for hepatocellular carcinoma can reduce the influence on liver function and immune function, with less damage to tissues, and can ameliorate postoperative inflammatory reaction, and promote postoperative recovery of patients as soon as possible. There are many factors influencing the postoperative recurrence of hepatocellular carcinoma, and average tumour diameter and microvascular invasion are the risk factors.

Erianin suppresses hepatocellular carcinoma cells through down-regulation of PI3K/AKT, p38 and ERK MAPK signaling pathways.

BACKGROUND: Hepatocellular carcinoma (HCC) is the dominant pathological type of primary liver cancer and no effective methods are available for its treatment. Erianin is a natural product extracted from Dendrobium, which possesses multiple pharmacological activities, including antioxidative and antitumor activity. OBJECTIVE: To evaluate the anti-HCC activities of erianin and explore its underlying mechanism. METHODS: MTT assay and Crystal Violet staining assay were used to select the non-toxic concentrations for the subsequent experiments. The colony formation assay and PCNA fluorescent staining were used to investigate the antiproliferative effects of erianin on human SMMC-7721 and HepG2 cells. Wound healing and transwell test were used to analyze cell migration and invasion. Caspase3 and Tunel staining were used to detect apoptosis. Western blot was used to examine the expression levels of proteins associated with invasion and key proteins in the phosphatidylinositol-3-kinase/protein kinase B (PI3K/Akt), p38 and ERK mitogen-activated protein kinase (MAPK) signaling pathways. RESULTS: Erianin inhibited HCC cell proliferation in a dose-dependent manner. Decreased migration rate and invaded cells were observed with erianin supplement. The expression of invasion-associated proteins in the erianin group was also down-regulated. Besides, more apoptotic cells were observed after erianin treatment. For the molecular mechanism, erianin inhibited the phosphorylation of Akt, ERK and P38 in the PI3K/Akt and ERK/P38 pathway. CONCLUSION: We demonstrated, for the first time, that erianin inhibited the proliferation, migration, invasion and induced the apoptosis of HCC through PI3K/Akt, p38 and ERK MAPK signaling pathway, indicating that erianin is a promising agent for the HCC treatment.