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1.
Lab Invest ; 2020 May 26.
Artigo em Inglês | MEDLINE | ID: mdl-32457352

RESUMO

Aberrant activation of the hedgehog (Hh) signaling pathway is associated with the formation of medulloblastoma (MB), the most common malignant pediatric brain tumor. However, tumor cells from human and mouse MB can not be passaged or preserved after being adherently cultured. Moreover, Hh signaling in MB cells is inactivated in such culture. Here we demonstrate that MB cells are capable of forming tumoroids (tumor spheroids) in vitro under optimized conditions, which can be further passaged and cryopreserved. More importantly, MB cells maintain Hh pathway activation and cell proliferation in tumoroids. Our studies further reveal that tumoroids-forming capacity of MB cells relies on astrocytes, a major component of the MB microenvironment. Astrocytes facilitate the formation of MB tumoroids by secreting sonic hedgehog (Shh) and generating astrocyte-derived extracellular matrix. These findings demonstrate the critical role of stromal astrocytes in supporting the survival and proliferation of MB cells in vitro. This study establishes a valid model for long-term culture of primary MB cells, which could be greatly beneficial for future investigation of MB tumorigenicity and the development of improved approaches to treat MB.

2.
Vet Parasitol ; : 109128, 2020 May 05.
Artigo em Inglês | MEDLINE | ID: mdl-32402492

RESUMO

The purpose of this study was to determine the biological function of a Trichinella spiralis glutathione S-transferase (TsGST) in larval invasion and development by RNA interference (RNAi). The TsGST-specific siRNA 366 was transfected into T. spiralis muscle larvae (ML) via electroporation. At 1 day following transfection, the larval TsGST mRNA and protein expressions were reduced by 40.09 and 65.22 % (P < 0.05), respectively. The enzymatic activity of natural TsGST in siRNA-transfected ML was also suppressed by 45% compared with PBS group (P < 0.05). Silencing of the TsGST significantly inhibited the ability of larvae to invade intestinal epithelium cells (IECs) and isolated intestine. After challenge with siRNA-366-treated ML, the infected mice exhibited a 62.82% reduction of intestinal adult worms, and 65.03 % reduction of muscle larvae compared to the PBS group. Besides, the length of adults, newborn larvae and muscle larvae was significantly shorter than that of control siRNA and PBS group; the female fecundity of siRNA 366 group was lower than those of control siRNA and PBS group (P <  0.05). The results revealed that the specific RNAi significantly reduced the expression and enzymatic activity of TsGST, inhibited the larval invasive and developmental capacity, and impaired the female fecundity. The results further confirmed that TsGST plays a crucial role in the T. spiralis life cycle and it might be a potential molecular target for anti-Trichinella vaccines.

3.
J Cell Mol Med ; 2020 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-32427405

RESUMO

Kaempferol (kaem) is a dietary flavonoid found in a variety of fruits and vegetables. The inhibitory effects of kaem on primary tumour growth have been extensively investigated; however, its effects on tumour metastasis are largely unknown. In the present study, we found that kaem significantly suppresses both primary tumour growth and lung metastasis in mouse breast tumour model. Furthermore, decreased expression of citrullinated histone H3 (H3-cit), a biomarker of neutrophil extracellular traps (NETs), had been founded in metastatic lung upon treated with kaem. The reduction of H3-cit is not, however, due to the cytotoxicity of kaem on neutrophils since the frequency of CD11b+ Ly6G+ neutrophils did not change in lung, tumour or blood in the presence of kaem. We then confirm the anti-NETs effects of kaem in vitro by co-culturing mouse neutrophils and kaem. Supplementing the neutrophils with GSK484, a potent NET inhibitor, totally abrogated the inhibitory effects of kaem on tumour metastasis while having little or no impact on primary tumour growth, indicating the specificity of kaem acting on NET formation and tumour metastasis. We also found that kaem suppressed ROS production in mouse bone-marrow derived neutrophils. Supplementing with the ROS scavenger DPI abrogated kaem's effects on NET formation, suggesting the involvement of kaempferol in NADPH/ROS-NETs signalling. Finally, we applied the kaem on NET-deficient PAD4-/- mice and found decreased primary tumour volume and weight but similar lung metastatic tumour with kaempferol treatment. Therefore, our findings reveal a novel mechanism of kaem in breast cancer development by targeting NETs induced tumour metastasis.

4.
Zhongguo Gu Shang ; 33(5): 489-92, 2020 May 25.
Artigo em Chinês | MEDLINE | ID: mdl-32452192

RESUMO

Cerebral palsy is a common clinical syndrome of neurological disability in childhood, which seriously affects the quality of life of children and their families, and brings a heavy economic burden to the society. Domestic and foreign scholars had a long history of the application of selective posterior rhizotomy for the treatment of spastic cerebral palsy or mixed cerebral palsy with limb paralysis. It is effective in improving the lower extremity spasm of patients with cerebral palsy, and there are few cases with recurrences. After rehabilitation therapy, the muscle strength of patients with cerebral palsy was significantly improved compared with the previous one. The range of motion was significantly improved after operation, and there is no rebounded in aspect of joint activety in the long-term follow-up. The overall gait of the patient was significant improved. The author thought that selective posterior rhizotomy is effective in improving the motor function of lower limbs in patients with cerebral palsy, and it is worth being spread. However, it has to follow the principle of selecting appropriate cases before surgery, precise operation during operation, and timely and effective rehabilitation treatment after surgery, in order to achieve a better curative effect.

5.
Biol Pharm Bull ; 43(5): 864-872, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32378562

RESUMO

Cardiac fibrosis is a major contributor for diabetic cardiomyopathy and Dendrobium officinale possessed therapeutic effects on hyperglycemia and diabetic cardiomyopathy. To further investigate the possible mechanisms of the Dendrobium officinale on diabetic myocardial fibrosis in mice. Water-soluble extracts of Dendrobium officinale (DOE) from dry stem was analyzed by HPLC and phenol-sulfuric acid method. Diabetic mice were induced by intraperitoneal injection of streptozotocin (STZ) (30 mg/kg) for 4 consecutive days after intragastric administration of a high-fat diet (HFD) for 2 weeks. The groups were as follows: control group, model group, DOE low, medium, high dose group (75, 150, 300 mg/kg) and Metformin positive group (125 mg/kg). The results showed that DOE dose-dependently lower serum insulin, total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) and grew the high-density lipoprotein cholesterol (HDL-C) after 12 weeks of daily administration with DOE. Hematoxylin-eosin staining and Sirius red staining showed obvious amelioration of cardiac injury and fibrosis. In addition, the result of immunoblot indicated that DOE increased the expression of peroxisome proliferator activated receptor-α (PPAR-α), phosphorylation of insulin receptor substrate 1 (p-IRS1) and E-cadherin and repressed the expression of transforming growth factor ß1 (TGF-ß1), phosphorylation of c-Jun N-terminal kinase (p-JNK), Twist, Snail1 and Vimentin. The present findings suggested that DOE ameliorated HFD/STZ-induced diabetic cardiomyopathy (DCM). The possible mechanism mainly associated with DOE accelerating lipid transport, inhibiting insulin resistant and suppressing fibrosis induced by epithelial mesenchymal transition (EMT).

7.
Food Res Int ; 132: 109111, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32331685

RESUMO

Biopolymer complexes fabricated by proteins and neutral polysaccharides may have some specific or innovative functionalities. However, only little is known about the structural characteristics and molecular interaction mechanisms of proteins-neutral polysaccharides biopolymer complexes. Understanding these informations is of major interest for the design of new proteins-polysaccharides biopolymer complexes with specific and/or innovative functionalities. Thus, the aim of the present study was to investigate the structural characteristics and molecular interaction mechanisms of lactoferrin (LF) and oat ß-glucan (OG) with and without heat treatment at different OG concentrations (0.2, 0.5 and 0.9%, w/v). Isothermal titration calorimetry (ITC) results showed that LF and OG could interact with each other. The binding behavior between LF and OG at 25 °C was a spontaneous process, and electrostatic interactions, hydrogen bonding and van der Waals forces contributed to the LF-OG self-assembling behavior. OG concentration influenced the thermodynamic characterization of interactions between LF and OG. LF was susceptible to aggregation and thermal denaturation in the presence of OG. The increased turbidity and particle size of LF-OG complexes suggested the formation of large complexes in aqueous solution. SEM results showed that LF-OG self-assembles exhibited physically cross-linked networks at low OG concentration, while formed some spherical complexes at high OG concentration; LF-OG thermally modified complexes exhibited the honeycomb-like structures with different particle sizes in a concentration-dependent manner. Fluorescence spectroscopy results indicated that OG can change the structure of LF, leading to the exposure of Trp residues of LF molecules toward a more polar microenvironment. Raman difference spectra and circular dichroism revealed that the addition of OG could alter the secondary structure of LF, and the most noticeable changes were in the regions connected ß-structures. The apparent viscosity of LF-OG complexes were higher than that of LF or OG alone, indicating that there was synergism between LF and OG. Overall, the self-assembling complexes and thermal complexes of LF and OG can be formed at 25 °C and 90 °C, respectively. These formed LF-OG nanocomplexes and microcomplexes (both the self-assembling and thermal complexes) with unique structures can be widely used in food, pharmaceutical and cosmetic industries, which will be suitable for encapsulation and transportation of bioactive compounds, or as fat substitutes.

8.
Artigo em Inglês | MEDLINE | ID: mdl-32337672

RESUMO

Agricultural non-point source pollution is one of the important reasons for rural water pollution, and it is also an important source of water eutrophication. In recent years, with the rapid economic growth and social changes in rural areas, large amounts of untreated domestic sewage and agricultural wastewater entering farmland require high efficiency, low operating costs, and minimal maintenance of treatment systems in rural and remote areas to minimize their impact on water and biodiversity. Since there is little research on the ecological treatment technology of agricultural non-point source pollution in China, from the perspective of controlling agricultural non-point source pollution, some ecological treatment technologies suitable for rural areas at home and abroad are summarized. This paper introduces the practical application of ecological treatment technology, the type of process, advantages and disadvantages, and the influencing factors of ecological treatment technology in the purification of sewage engineering and summarizes the removal mechanism of pollutants in ecological treatment technology. Eco-processing technologies are cost-effective in terms of their construction, maintenance, and energy needs and can be considered a sustainable wastewater treatment method, especially in remote areas and developing countries. It provides basic ideas for the construction of rural ecological treatment technology in China and puts forward suggestions and ideas for the future development trend of ecological treatment process sewage.

9.
Small ; : e2001371, 2020 Apr 27.
Artigo em Inglês | MEDLINE | ID: mdl-32338439

RESUMO

Quantum dots (QDs) have numerous potential applications in lighting, engineering, and biomedicine. QDs are mainly excreted through the kidney due to their ultrasmall sizes; thus, the kidneys are target organs of QD toxicity. Here, an organoid screening platform is established and used to study the nephrotoxicity of QDs. Organoids are templated from monodisperse microfluidic Matrigel droplets and found to be homogeneous in both tissue structure and functional recapitulation within a population and suitable for the quantitative screening of toxic doses. Kidney organoids are proved displaying higher sensitivity than 2D-cultured cell lines. Similar to metal-containing QDs, black phosphorus (BP)-QDs are found to have moderate toxicity in the kidney organoids. The nephrotoxicity of BP-QDs are validated in both mice and human renal tubular epithelial cells. BP-QDs are also found to cause insulin insensitivity and endoplasmic reticulum (ER) stress in the kidney. Furthermore, ER stress-related IRE1α signaling is shown to mediate renal toxicity and insulin insensitivity caused by BP-QDs. In summary, this work demonstrates the use of constructed kidney organoids as 3D high-throughput screening tools to assess nanosafety and further illuminates the effects and molecular mechanisms of BP-QD nephrotoxicity. The findings will hopefully enable improvement of the safety of BP-QD applications.

10.
Eur J Oncol Nurs ; 46: 101727, 2020 Feb 06.
Artigo em Inglês | MEDLINE | ID: mdl-32339909

RESUMO

PURPOSE: Whether resilience should be conceptualised as a state or trait is debated. The precise distinction between state versus trait aspects of resilience can help identify dynamic targets for resilience-based intervention trials involving cancer patients. This study was designed to disentangle the state and trait components of resilience in patients with breast cancer with the help of Generalisability Theory (GT) methods. METHODS: The relative contributions of state (temporary) and trait (enduring) aspects of resilience were calculated using a 10-item Resilience Scale Specific to Cancer (RS-SC-10) and GT methods. In all, 391 patients were enrolled from the 'Be Resilient to Breast Cancer ' (BRBC) trial, and data from 317 patients (81.7%) were collected at baseline, 3 months, 6 months, and 12 months after the intervention. RESULTS: The subscale of Generic Elements demonstrated high generalisability value (relative G-coefficient = 0.81) across different occasions and captured 79% of the variance attributed to enduring aspects of resilience. The subscale of Shift-Persist showed low generalisability value (relative G-coefficient = 0.31) and identified 59% of the variance attributed to temporary aspects of resilience. The GT studies suggested that 5-7 items per scale and three measurement occasions were adequate for score reliability evaluation. CONCLUSION: Resilience should be conceptualised as a state-trait mixed psychological variable in breast cancer patients. The subscale of Shift-Persist in RS-SC-10 is amenable to intervention and could be utilised as a primary outcome in resilience-based intervention trials. CLINICAL TRIAL REGISTRATION: None.

11.
Food Res Int ; 131: 109048, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32247490

RESUMO

Protein-polyphenol-polysaccharide non-covalent ternary complexes possess many unique structural and functional properties. However, rare work is available to fabricate the neutral polysaccharide-based ternary complexes. Herein, the ternary complexes composed of lactoferrin (LF), oat ß-glucan (OG), and curcumin (Cur) with three binding sequences were successfully developed through self-assembly technique and spray drying technique, respectively. Spray drying could enhance the extent of the intermolecular associations among LF, OG, and Cur, leading to the formation of ternary complexes with smaller particle sizes and lower turbidities. Cur can be loaded in LF-OG complexes to form an amorphous complex through the intermolecular interactions (mainly hydrophobic interactions and hydrogen bonding). The ternary complexes can be used as potential emulsifiers to stabilize oil-in-water Pickering emulsions. The emulsifying capacity (to enhance physical stability) of the complexes was in the order as follows: the spray-dried ternary complexes > the spray-dried LF-OG complexes > the self-assembled ternary complexes > the self-assembled LF-OG complexes. The structural and functional properties (e.g., emulsifying property) of OG-based ternary complexes can be controlled by adjusting the binding sequences. These results will broaden our current understanding of protein-polyphenol-polysaccharide ternary complexes and provide more applications of OG in food, cosmetics, and pharmaceutical industries.

13.
Artigo em Inglês | MEDLINE | ID: mdl-32259391

RESUMO

It is of pivotal importance to develop efficient catalysts and investigate the intrinsic mechanism for CO2 methanation. Now, it is reported that PdFe intermetallic nanocrystals afforded high activity and stability for CO2 methanation. The mass activity of fct-PdFe nanocrystals reached 5.3 mmol g-1 h-1 , under 1 bar (CO2 :H2 =1:4) at 180 °C, being 6.6, 1.6, 3.3, and 5.3 times as high as that of fcc-PdFe nanocrystals, Ru/C, Ni/C, and Pd/C, respectively. After 20 rounds of successive reaction, 98 % of the original activity was retained for PdFe intermetallic nanocrystals. Further mechanistic studies revealed that PdFe intermetallic nanocrystals enabled the maintenance of metallic Fe species via a reversible oxidation-reduction process in CO2 methanation. The metallic Fe in PdFe intermetallic nanocrystals induced the direct conversion of CO2 into CO* as the intermediate, contributing to the enhanced activity.

14.
J Clin Virol ; 126: 104341, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32278300

RESUMO

With lessons learnt from the SARS outbreak in 2003, Guangdong Province is taking the lead in bringing COVID-19 under control by multiple strict regulations in combination with effective healthcare provision.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Síndrome Respiratória Aguda Grave/epidemiologia , China/epidemiologia , Infecções por Coronavirus/prevenção & controle , Humanos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle
15.
Clin Breast Cancer ; 2020 Mar 06.
Artigo em Inglês | MEDLINE | ID: mdl-32241696

RESUMO

Epidemiologic studies focusing on the association between 1-carbon metabolism-related vitamins (ie, folate, vitamin B6, vitamin B2, vitamin B12) and breast cancer risk have reported inconsistent findings. We conducted a systematic search of the reported data and performed a meta-analysis of prospective case-control and cohort studies to derive a more precise evaluation. The PubMed and EMBASE databases were searched to identify eligible studies. A total of 27 studies involving 49,707 cases and 1,274,060 individuals were included in the meta-analysis. The results indicated that a high intake of folate, vitamin B6, and vitamin B2 might decrease the risk of breast cancer. The corresponding pooled relative risks (RRs) for the highest intake compared with the lowest were 0.93 (95% confidence interval [CI], 0.88-0.99; P = .018), 0.94 (95% CI, 0.89-1.00; P = .037) and 0.90 (95% CI, 0.82-0.99; P = .026). No significant association between vitamin B12 and breast cancer risk was found (RR, 0.99; 95% CI, 0.94-1.04; P = .604). Further study showed that folate and vitamin B6 might decrease the risk of estrogen receptor-negative (ER-)/progesterone receptor-negative (PR-) breast cancer but not ER+/PR+ breast cancer. The dose-response meta-analysis indicated a significant linearity relationship between folate intake and a reduced risk of ER-/PR- breast cancer. An increment of folate intake (100 µg/d) corresponded to a 7% deceased risk of ER-/PR- breast cancer (RR, 0.93; 95% CI, 0.89-0.98; P = .007). In conclusion, a high intake of 1-carbon metabolism-related vitamins might contribute to the prevention of breast cancer, especially ER-/PR- breast cancer.

16.
Ecotoxicol Environ Saf ; 198: 110663, 2020 Apr 21.
Artigo em Inglês | MEDLINE | ID: mdl-32330789

RESUMO

Copper (Cu) is not only an essential metallic element for human and organisms, but also a toxic and pernicious element when its environmental content exceeds a certain threshold. However, to date, little is known about the isotopic compositions and sources of Cu in the suspended particulate matter (SPM) of fluvial ecosystems. To identify the potential sources of Cu in SPM in Zhujiang River (an important river in southwestern China with about 30 million people in the entire basin), we reported the Cu contents of SPM and the Cu isotopic compositions (expressed in δ65Cu) at 22 sites. The relative contribution rates of potential sources were also calculated based on the mixing model. The results indicate that the Cu contents varied from 14 mg kg-1 to 96 mg kg-1 with a relatively low enrichment factor (EF) value (mean value is 1.6). The amount of Cu transferred as suspended loads ranged from 5% to 98% (mean value 60%) in the sampling period. The EF and δ65Cu suggest a ternary mixture of fluvial SPM with the δ65Cu value fluctuating from 0.04‰ to 0.50‰ (mean value 0.17‰). Based on isotope ratios and mass balance equation, we calculate that the rock weathering contributes 76.4% particulate Cu in Zhujiang River, and the contributions of urban sludge and smelting tailings are 15.4% and 8.2%, respectively. These findings regarding to the application of Cu isotope have significant implications for tracing the Cu sources, which significantly supports the control and management of suspended particulate copper pollution in large rivers.

17.
Adv Mater ; : e1907690, 2020 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-32346928

RESUMO

N2 electroreduction into NH3 represents an attractive prospect for N2 utilization. Nevertheless, this process suffers from low Faraday efficiency (FE) and yield rate for NH3 . In this work, a highly efficient metal-free catalyst is developed by introducing F atoms into a 3D porous carbon framework (F-doped carbon) toward N2 electroreduction. At -0.2 V versus reversible hydrogen electrode (RHE), the F-doped carbon achieves the highest FE of 54.8% for NH3 , which is 3.0 times as high as that (18.3%) of pristine carbon frameworks. Notably, at -0.3 V versus RHE, the yield rate of F-doped carbon for NH3 reaches 197.7 µgNH3 mg-1 cat. h-1 . Such a value is more than one order of magnitude higher than those of other metal-free electrocatalysts under the near-ambient conditions for NH3 product to date. Mechanistic studies reveal that the improved performance in N2 electroreduction for F-doped carbon originates from the enhanced binding strength of N2 and the facilitated dissociation of N2 into *N2 H. F bonding to C atom creates a Lewis acid site due to the different electronegativity between the F and C atoms. As such, the repulsive interaction between the Lewis acid site and proton H suppresses the activity of H2 evolution reaction, thus enhancing the selectivity of N2 electroreduction into NH3 .

18.
Water Res ; 177: 115769, 2020 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-32278164

RESUMO

Occurrence of toxic cyanobacterial blooms in natural freshwaters could impair drinking water quality. Chlorine was often employed as an oxidant to treat algal-laden source waters in drinking water treatment plants. However, previous studies only focused on high-viability cyanobacteria at exponential phase. Whether the change of cell-viability of cyanobacteria could affect chlorination was unknown. Here, high- and low-viability Microcystis were collected from a whole life cycle of cyanobacteria in lab-scale, and effects of chlorination on membrane integrity and toxin fate of high- and low-viability Microcystis were subsequently investigated. Results showed chlorine exposure was lower for low-viability cells than high-viability cells with the same initial chlorine dosage, but low-viability cells were less resistant to chlorination, leading to higher rate of membrane damage (kloss) and intracellular toxin release (ki). For high-viability cells, there was no increase of extracellular toxin with sufficient chlorine exposure whereas it showed a continuous increase for low-viability cells mainly due to its lower rate of extracellular toxin degradation (ke, 26 ± 8 M-1 s-1) than intracellular toxin release (ki, 110 ± 16 M-1 s-1) (ke < ki). Besides, total toxin could be completely oxidized for high-viability cells with sufficient chlorine exposure (>30 mg min L-1) whereas chlorination could not work well for low-viability cells even with chlorine exposure of as high as 36 mg min L-1. These findings indicated chlorination may not be a feasible option to treat low-viability cyanobacteria during decline stage of cyanobacterial blooms.


Assuntos
Cianobactérias , Microcystis , Purificação da Água , Cloro , Halogenação
19.
J Clin Lab Anal ; : e23310, 2020 Apr 08.
Artigo em Inglês | MEDLINE | ID: mdl-32267022

RESUMO

BACKGROUND: Genetic polymorphisms in the CXCL2 may participate in the progress of HBV-related HCC. However, no researches have evaluated the association between them. METHODS: To figure out the effects of CXCL2 gene polymorphisms on the risk of HBV-related HCC, two major variants of CXCL2 and their association with chronic hepatitis B (CHB), HBV-related liver cirrhosis (LC), and HCC were conducted in a Guangxi population. CXCL2 polymorphisms rs9131 and rs3806792 were examined in 147 healthy controls, 138 CHB patients, 137 HBV-related LC patients, and 150 HBV-related HCC patients, using the SNaPshot™ genotyping technique. RESULTS: No significant differences were found regarding the CXCL2 rs9131 and rs3806792 polymorphisms among the case groups (including CHB, LC, and HCC) and the healthy controls, no matter in comparisons of alleles, genotypes, or haplotypes. Similar insignificant results were also observed when subgroup analyses were performed in different gender. However, when compared the frequencies of allele and genotype in the healthy individuals of our research and those from the 1000 Genomes Project, CC and C for rs9131, and TT and T for rs3806792 of CXCL2 in our healthy controls were only similar with those in Han Chinese in Beijing, but significantly higher than other ethnicities; this indicates that these two polymorphisms of CXCL2 may be not associated with the pathogenesis of HBV-related HCC in Chinese population, but may play a role in other ethnicities. CONCLUSION: Our observation suggests that SNPs rs9131 and rs3806792 of CXCL2 gene might not contribute to the development of CHB, HBV-related LC, and HCC in a Guangxi population.

20.
J Gastrointest Surg ; 2020 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-32274631

RESUMO

BACKGROUND: Accurate preoperative assessment of hepatic functional reserve is essential for conducting a safe hepatectomy. In recent years, aspartate aminotransferase-to-platelet ratio index (APRI) has been used as a noninvasive model for assessing fibrosis stage, hepatic functional reserve, and prognosis after hepatectomy with a high level of accuracy. The purpose of this research was to evaluate the clinical value of combining APRI with standardized future liver remnant (sFLR) for predicting severe post-hepatectomy liver failure (PHLF) in patients with hepatocellular carcinoma (HCC). METHODS: Six hundred thirty-seven HCC patients who had undergone hepatectomy were enrolled in this study. The performance of the Child-Pugh (CP) grade, model for end-stage liver disease (MELD), APRI, sFLR, and APRI-sFLR in predicting severe PHLF was assessed using the area under the ROC curve (AUC). RESULTS: Severe PHLF was found to have developed in 101 (15.9%) patients. Multivariate logistic analyses identified that prealbumin, cirrhosis, APRI score, sFLR, and major resection were significantly associated with severe PHLF. The AUC values of the CP, MELD, APRI, and sFLR were 0.626, 0.604, 0.725, and 0.787, respectively, indicating that the APRI and sFLR showed significantly greater discriminatory abilities than CP and MELD (P < 0.05 for all). After APRI was combined with sFLR, the AUC value of APRI-sFLR for severe PHLF was 0.816, which greatly improved the prediction accuracy, compared with APRI or sFLR alone (P < 0.05 for all). Stratified analysis using the status of cirrhosis and extent of resection yielded similar results. Moreover, the incidence and grade of PHLF were significantly different among the three risk groups. CONCLUSION: The combination of APRI and sFLR can be considered to be a predictive factor with increased accuracy for severe PHLF in HCC patients, compared with CP grade, MELD, APRI, or sFLR alone.

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