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1.
Turk J Med Sci ; 49(5): 1308-1316, 2019 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-31648436

RESUMO

Background/aim: Acute aortic dissection (AAD) is a rare but fatal disease if left untreated. Symptoms are often similar to common conditions; therefore, the diagnostic strategy is important. We aimed to identify the atypical symptoms in a timely manner without putting patients at greater risk for undetected AAD. Materials and methods: We conducted a retrospective observational study of 59 AAD patients with both atypical and typical symptoms from January 2012 to December 2016. Patients with atypical symptoms continuing more than 30 min underwent a D-dimer test and computed tomography (CT) or computed tomographic angiography (CTA). Results: Of the 59 AAD patients, 22 were atypical. In the atypical group, the median delay time in our hospital was 3.1 h; average delay time after July 2015 was shorter than average delay time before June 2015 (16.59 ± 24.70 vs. 1.90 ± 0.57 h, P = 0.076). Conclusions: For patients in the emergency department who are suspected of having AAD, incorporating atypical symptoms with high levels of D-dimer into a triage strategy could improve the efficiency of clinical decision making. Furthermore, essential education directed towards the recognition of the atypical symptoms of AAD for front-line physicians may aid in a timely diagnosis, as compared with the usual assessments in the emergency department.

2.
J Biomed Nanotechnol ; 15(9): 1867-1880, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31387675

RESUMO

The present study aims to evaluate the effect of the ethyl acetate extract of Cichorium (EAEC) as a novel photosensitizer in photodynamic therapy (PDT) of colorectal carcinoma (CRC) HCT116 and SW620 cells. The absorption and fluorescence spectra of EAEC were measured using a UV-vis spectrophotometer and fluorescence spectrophotometer, respectively. EAEC-induced reactive oxygen species (ROS) production in HCT116 and SW620 cells was detected using 2',7'-dichlorodihydrofluorescein diacetate (DCFH-DA) and glutathione/glutathione disulfide (GSH/GSSG). The photo- and dark toxicities of EAEC were estimated using the Cell Counting Kit-8 (CCK-8) assay. Cellular uptake and localization of EAEC were detected by confocal laser fluorescence microscopy. Annexin V-FITC/PI staining, Western blotting and immunofluorescence staining were used to assess apoptosis and autophagy. The antitumor activity of EAEC was confirmed in a xenograft model. Finally, effects on the PERK pathway were verified using qRT-PCR and Western blotting. EAEC displayed absorption and fluorescence emission peaks at 660 nm and 678 nm, respectively. EAEC induced ROS production in CRC cells. Assessment of dark toxicity showed that treatment with EAEC alone induced little cytotoxicity in CRC or normal cells but that EAEC-PDT induced significant photocytotoxicity in CRC cells in a time- and dose-dependent manner. After cellular uptake, EAEC was located in the mitochondria. Treatment with EAEC-PDT reduced xenograft tumor size. Further evaluation suggested that activation of the PERK pathway mediates these effects, as the apoptotic rate and autophagy flux increased markedly after EAEC-PDT. EAEC, a natural photosensitizer extracted from Cichorium, displays potential utility in PDT of CRC by targeting the PERK pathway.


Assuntos
Autofagia , Neoplasias Colorretais , Fotoquimioterapia , Acetatos , Apoptose , Linhagem Celular , Linhagem Celular Tumoral , Estresse do Retículo Endoplasmático , Humanos , Fármacos Fotossensibilizantes , Proteínas Quinases , Espécies Reativas de Oxigênio
3.
Dig Liver Dis ; 51(10): 1446-1455, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31147216

RESUMO

BACKGROUND: Emerging data suggest the crucial regulatory roles of circular RNAs (circRNAs) in hepatocellular carcinoma (HCC). However, the pathophysiology role of circZFR in HCC remains largely unknown. AIMS: This study aims to disclose the functions of circZFR in HCC progression and its potential molecular mechanism. METHODS: circZFR and miR-511 were identified by qRT-PCR. Colony formation assay, wound-healing assay, transwell assay, and flow cytometry assay were performed to determine the cell proliferation, migration, invasion and apoptosis. Western blotting and immunohistochemistry (IHC) were utilized to evaluate the expression level of AKT1, GSK3ß, ß-catenin and cascades of proliferation-related proteins both in vitro and in vivo. Dual luciferase reporter assay was conducted to evaluate the interactions among circZFR, miR-511 and AKT1. RESULTS: The expression of circZFR was enhanced and the expression of miR-511 was down-regulated in HCC tissues and cells. Functionally, circZFR silencing or miR-511 overexpression suppressed cell proliferation, migration and invasion, and induced apoptosis of HCC cells. Mechanistically, circZFR acted as a miR-511 sponge to up-regulate its target gene AKT1, which activated cascades of proliferation-related proteins (c-Myc, cyclin D1, Survivin and Bcl-2). Furthermore, depletion of circZFR inhibited tumorigenesis and decreased the expression level of AKT1 in xenograft models. CONCLUSION: circZFR promotes HCC progression by directly down-regulating miR-511 to activate AKT1 signaling, suggesting that circZFR is a potential target in HCC treatment. Targeting circZFR may provide therapeutic benefits for HCC.

4.
J Gastrointest Surg ; 2019 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-31066014

RESUMO

BACKGROUND AND AIMS: The Child-Pugh (CP) score is a widely used method to assess liver function and predict postoperative outcomes in patients with hepatocellular carcinoma (HCC). Recently, the fibrosis index (FIB-4) has been demonstrated to be closely associated with liver fibrosis and cirrhosis. This study aimed to compare the capability of FIB-4 index with CP score in predicting the outcomes for HCC patients after hepatectomy. METHODS: A total of 495 HCC patients who underwent hepatectomy were enrolled. The performance of the FIB-4 index in predicting postoperative liver failure (PHLF) and overall survival was compared with that of the CP score. RESULTS: Of them, 9.3% (46/495) patients developed PHLF. The area under the receiver operating characteristic (ROC) curve of the FIB-4 index for predicting PHLF was greater than that of the CP score (0.744 versus 0.621; P = 0.044). The optimal cutoff value of the FIB-4 index for predicting PHLF was 4.16. Multivariable analyses revealed that the FIB-4 index was an independent predictor of PHLF regardless of the hepatectomy subgroups, but the CP grade was only a significant predictor of PHLF in the minor hepatectomy subgroup. The FIB-4 index (4.16) stratified patients into two distinct overall survival cohorts (P = 0.006). The FIB-4 index also classified patients with the Barcelona Clinical Liver Cancer (BCLC) stages 0 and A into two distinct overall survival cohorts (P = 0.001 and P = 0.034, respectively). CONCLUSION: The FIB-4 index may be a better predictor of PHLF and overall survival in HCC patients with hepatectomy than CP score.

5.
J Biomed Nanotechnol ; 15(6): 1345-1353, 2019 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-31072441

RESUMO

Gastric cancer is the fourth most common cancer worldwide and the third most common in Asia, with a high mortality. Photodynamic therapy (PDT) is a new treatment for cancer. With advantages of minimum invasiveness, small adverse side effects and high selectivity, PDT can be used as palliative treatment for patients with advanced gastric cancer. YLG I, also known as 2-(1 hexyloxyethyl)-2-devinyl porphin e6 trisodium salt (HCE6), is a recently developed photosensitizer. A previous study showed that HCE6 significantly inhibited the growth of QBC939 human cholangiocarcinoma cells. However, the effects and mechanisms of HCE6 on gastric cancer cell suppression are not known. In this study, we investigated the effects of HCE6 on the human gastric cancer cell line MKN45 and found that at the concentration of 2.0 mg/L, HCE6 almost completely killed MKN45 cells at a light intensity of 3.6 J/cm². RNAseq results confirmed that mitochondria and endoplasmic reticulum (ER)-mediated apoptosis was involved in the effects of HCE6 on cell death, and we also found that HCE6 induced chromosome conformational changes in the early phase of apoptosis. The results of our study help elucidate the molecular mechanisms underlying HCE6-mediated inhibition of gastric cancer cell growth and provide a theoretical basis and molecular targets for the treatment of gastric cancer.


Assuntos
Neoplasias Gástricas , Apoptose , Linhagem Celular Tumoral , Humanos , Fotoquimioterapia , Fármacos Fotossensibilizantes
6.
Medicine (Baltimore) ; 98(15): e15168, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30985698

RESUMO

A precise and noninvasive method to predict posthepatectomy liver failure (PHLF) in clinical practice is still lacking. Liver fibrosis or cirrhosis accompanied with varying degrees of portal hypertension plays an important role in the occurrence of PHLF in hepatocellular carcinoma (HCC) patients. This study aims to compare the predictive ability of the albumin-bilirubin score to spleen thickness ratio (ALBI/ST) versus fibrosis-4 index (FIB-4) and aspartate aminotransferase to platelet count ratio index (ARPI) for the occurrence of PHLF. We retrospectively enrolled 932 patients who underwent liver resection for HCC between 2010 and 2017. The predictive accuracy of ALBI/ST ratio, FIB-4, and APRI for occurrence of PHLF was evaluated by receiver operating characteristic curve analysis. PHLF was diagnosed in 69 (7.4%) patients. The ALBI/ST ratio was found to be a significant predictor of PHLF. The AUC of ALBI/ST (AUC = 0.774; 95% CI, 0.731-0.817; P <.001) was larger than that of FIB-4 (AUC = 0.696; 95% CI, 0.634-0.759; P <.001) and APRI (AUC = 0.697; 95% CI, 0.629-0.764; P <.001). Multivariate analysis demonstrated that ALBI/ST ratio was a strong risk factor of PHLF in all hepatectomy subgroups. In conclusion, the ALBI/ST ratio has a superior predictive ability for PHLF compared with APRI and FIB-4.


Assuntos
Carcinoma Hepatocelular/cirurgia , Hepatectomia , Falência Hepática/diagnóstico , Neoplasias Hepáticas/cirurgia , Complicações Pós-Operatórias/diagnóstico , Biomarcadores/sangue , Carcinoma Hepatocelular/diagnóstico , Feminino , Humanos , Neoplasias Hepáticas/diagnóstico , Masculino , Pessoa de Meia-Idade , Tamanho do Órgão , Prognóstico , Curva ROC , Estudos Retrospectivos , Baço/diagnóstico por imagem , Baço/patologia
7.
Scand J Gastroenterol ; 53(12): 1562-1568, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30572742

RESUMO

BACKGROUND AND AIMS: The impact of portal hypertension (PH) on postoperative short-term outcomes and long-term survival in hepatocellular carcinoma (HCC) patients has lately been discussed controversially. This study aimed to explore the influence of PH on postoperative outcomes in HCC patients undergoing surgical resection. METHODS: Patients undergoing hepatectomy for HCC from 2010 to 2014 were enrolled. The impact of PH on postoperative complications, posthepatectomy liver failure (PHLF) and overall survival (OS) was evaluated. RESULTS: A total of 355 HCC patients were enrolled; 129 (36.3%) experienced postoperative complications and 21 (5.9%) developed PHLF. PH was identified as an independent predictor of PHLF. Patients with PH experienced a higher incidence of complications and PHLF than patients without PH. On the Cox proportional hazards regression model, PH was verified as a risk factor of OS for BCLC stage 0/A and B patients. Patients without PH had significantly better long-term survival compared to patients with PH both in the total cohort and in cirrhosis subgroup. CONCLUSION: Liver resection in HCC patients with PH showed a significantly increased postoperative complications and PHLF, and revealed a decreasing long-term survival than non-PH patients. Besides, tumor burden also played an important role in determining the OS. However, due to the improvement in surgical technique and perioperative management, surgery was feasible in carefully selected HCC patients with PH.


Assuntos
Carcinoma Hepatocelular/cirurgia , Hipertensão Portal/complicações , Falência Hepática/epidemiologia , Neoplasias Hepáticas/cirurgia , Complicações Pós-Operatórias/epidemiologia , Adulto , Carcinoma Hepatocelular/mortalidade , China/epidemiologia , Feminino , Hepatectomia , Mortalidade Hospitalar , Humanos , Incidência , Cirrose Hepática/complicações , Neoplasias Hepáticas/mortalidade , Masculino , Pessoa de Meia-Idade , Curva ROC , Estudos Retrospectivos , Fatores de Risco , Análise de Sobrevida
8.
Photodiagnosis Photodyn Ther ; 24: 349-357, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30385297

RESUMO

BACKGROUND: Inflammatory bowel disease (IBD) is a group of inflammatory conditions characterized by chronic inflammation of the gastrointestinal (GI) tract. Recent preclinical and clinical studies have shown the therapeutic value of photodynamic therapy with low doses of photosensitizer and/or light in colitis treatment, but the detailed mechanism is unclear. METHODS: We examined 5-aminolevulinic acid (5-ALA) mediated photodynamic therapy (PDT) in dextran sulfate sodium (DSS)-induced colitis in mice. Endoscopic and macroscopic observations as well as the Disease Activity Index score (DAI) was used to monitor the disease. Cytokine expression was measured by quantitative RT-PCR analysis to evaluate the efficacy of PDT. We applied the Clariom™ D bioinformatics analysis to investigate the differentially expressed genes after PDT. Finally, we used quantitative RT-PCR analysis and Western blotting to validate the targets of differentially expressed genes. RESULTS: 5-ALA-PDT improved the DAI score and decreased the expression of various inflammatory cytokines. The Clariom™ D bioinformatics analysis identified 2043 diff ;erentially expressed genes (702 up-regulated and 1341 down-regulated). We confirmed the down-regulation of lncRNA-Neat1, lncRNA-Snhg5 and lncRNA-Gm9926 and the up-regulation of miRNA-204-5p, miRNA-218-5p, miRNA-200a-3p and miRNA-466h-5p. Additionally, the decreased expression level of the AKT3, p-AKT3, PI3K, p-PI3K protein were confirmed. CONCLUSIONS: This study provides in vivo comprehensive lncRNA and miRNA microarray analysis after 5-ALA-PDT treatment in DSS-induced colitis, and it may help to develop novel lncRNA-miRNA-related therapeutic approaches, such as the Neat1-miRNA204-5p-PI3K-AKT axis, to further increase the efficiency of PDT in IBD.

9.
Anal Chim Acta ; 1044: 29-65, 2018 Dec 31.
Artigo em Inglês | MEDLINE | ID: mdl-30442405

RESUMO

The pivotal role of microfluidic technology in life science and biomedical research is now widely recognized. Indeed, microfluidics as a research tool is unparalleled in terms of its biocompatibility, robustness, efficient reagent consumption, and controlled fluidic, surface, and structure environments. The controlled environments are essential in assessing the complex behavior of cells in response to microenvironmental cues. The strengths of microfluidics also reside in its amenability to integration with other analytical platforms and its capacity for miniaturization, parallelization and automation of biochemical assays. Following previous review on the applications of microfluidic devices for cell-based assays in 2006, we have monitored the progress in the field and summarized the advances in microfluidic technology from 2007 to 2017, with a focus on microfluidics development for applications in cell manipulation, cell capture and detection, and cell treatment and analysis. Moreover, we highlighted novel commercial microfluidic products for biomedical and clinical purposes that were introduced in the review period. Thus, this review provides a comprehensive source for recent developments in microfluidics and presents a snapshot of its remarkable contribution towards basic biomedical research and clinical science. We recognize that although enormous amounts of evidence have reinforced the promise of microfluidic technology across diverse applications, much remains to be done to realize its full potential in mainstream biomedical science and clinical practice.

10.
Phys Chem Chem Phys ; 20(39): 25268-25274, 2018 Oct 10.
Artigo em Inglês | MEDLINE | ID: mdl-30276414

RESUMO

A modulated and conventional DSC study of the transitions between the twist-bend nematic (Ntb), regular nematic (N) and isotropic liquid (Iso) phases was performed on a series of difluoroterphenyl-based dimers with (CH2)n spacers; n = 5, 7, 9, 11. The enthalpy of Ntb-N transition decreases steeply with increasing n, while that of the N-Iso transition increases with n; hence, the greatest effect of increasing n is a lowering N phase enthalpy. Based on past and present X-ray scattering experiments, we estimate the average molecular conformation in the Ntb phase and perform torsion energy calculations on the spacer. From this, the lowering enthalpy of the N phase is attributed to the decreasing torsional energy cost of bringing the two terphenyls from an inclined twisted conformation in the Ntb phase, to almost parallel in the N phase. With increasing n the C-C bonds of the spacers twist less away from their trans conformation, thereby reducing the overall torsion energy of the N phase. It is speculated that the nearly continuous nature of the Ntb-N transition in n = 11 dimer is associated with the divergence of the helical pitch toward infinity which is intercepted by a final jump at the very weak (0.01 J g-1) first-order transition. Small-angle X-ray scattering results suggest similar local cybotactic layering in both nematic phases, with four sublayers, i.e. tails, mesogens, spacers, mesogens.

11.
World J Surg Oncol ; 16(1): 208, 2018 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-30326907

RESUMO

BACKGROUND: Underlying liver function is a major concern when applying surgical resection for hepatocellular carcinoma (HCC). We aimed to explore the capability of the albumin-bilirubin (ALBI) grade to predict post-hepatectomy liver failure (PHLF) and long-term survival after hepatectomy for HCC patients with different Barcelona Clinic Liver Cancer (BCLC) stages. METHODS: Between January 2010 and December 2014, 338 HCC patients who were treated with liver resection were enrolled. The predictive accuracy of ALBI grade system for PHLF and long-term survival across different BCLC stages was examined. RESULTS: A total of 26 (7.7%) patients developed PHLF. Patients were divided into BCLC 0/A and BCLC B/C categories. ALBI score was found to be a strong independent predictor of PHLF across different BCLC stages by multivariate analysis. In terms of overall survival (OS), it exhibited high discriminative power in the total cohort and in BCLC 0/A subgroup. However, differences in OS between ALBI grade 1 and 2 patients in BCLC B/C subgroup were not significant (P = 0.222). CONCLUSION: The ALBI grade showed good predictive ability for PHLF in HCC patients across different BCLC stages. However, the ALBI grade was only a significant predictor of OS in BCLC stage 0/A patients and failed to predict OS in BCLC stage B/C patients.

12.
Dig Dis ; 36(3): 236-243, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29495004

RESUMO

BACKGROUND: The albumin-bilirubin (ALBI) grade is a newly proposed model for assessing the hepatic function. This study aimed to compare the value of the ALBI score with Child-Pugh score, model for end-stage liver disease (MELD) score and indocyanine green (ICG) R15 in predicting posthepatectomy liver failure (PHLF). METHODS: Patients undergoing curative resection for hepatocellular carcinoma (HCC) between January 2014 and June 2017 were enrolled. The values of the Child-Pugh score, MELD score, ICG R15 and ALBI score in predicting PHLF were evaluated. RESULTS: A total of 473 HCC patients were enrolled. The ALBI score was identified as an independent predictor of PHLF. The AUCs for the Child-Pugh score, MELD score, ICG R15 and ALBI score in predicting PHLF were 0.665, 0.649, 0.668, and 0.745 respectively. Multivariable analyses revealed that the ALBI score was an independent predictor of PHLF regardless of the hepatectomy subgroups, but the Child-Pugh score and MELD score were not significant predictors of PHLF both in major and minor hepatectomy subgroups, and ICG R15 was only a significant predictor of PHLF in minor hepatectomy subgroup. CONCLUSION: The ALBI score showed superior predictive value of PHLF over Child-Pugh score, MELD score and ICG R15. We propose to use the ALBI score to evaluate surgical risk for HCC patients undergoing hepatic resection.


Assuntos
Albuminas/metabolismo , Bilirrubina/metabolismo , Carcinoma Hepatocelular/cirurgia , Doença Hepática Terminal/patologia , Hepatectomia/efeitos adversos , Verde de Indocianina/metabolismo , Falência Hepática/etiologia , Neoplasias Hepáticas/cirurgia , Adolescente , Adulto , Idoso , Carcinoma Hepatocelular/patologia , Feminino , Humanos , Neoplasias Hepáticas/patologia , Modelos Logísticos , Pessoa de Meia-Idade , Análise Multivariada , Curva ROC , Adulto Jovem
13.
Soft Matter ; 14(16): 3003-3011, 2018 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-29485649

RESUMO

The main-chain liquid crystal (LC) copolyethers in which the nematic-nematic phase transition was first experimentally observed were revisited and re-characterised. Grazing incidence X-ray scattering revealed that the low-T nematic (Ntb) phase could be highly aligned by shearing, more so than in previously studied bent LC dimers. This was evidenced by a four-point wide-angle X-ray scattering pattern, which originates from convolution of two tilt distributions. Through intensity simulation the orientational order parameter associated with each of the distributions, as well as the conical angle of the Ntb phase, was calculated. Information regarding the polymer chain conformation was obtained using polarised infrared spectroscopy. The findings suggest the average conformation of the chains is a helix, and that the bend angle between mesogenic units is inversely related to temperature. All experimental evidence, including a jump in birefringence at the Ntb-nematic (N) phase transition, shows that copolyether samples mirror the behaviour of bent LC dimers over the transition. This confirms that the low-T nematic phase in copolyethers is indeed the same as that in LC dimers, now known to be the Ntb. The unusual broadening of transition peaks in complex heat capacity, obtained by modulated DSC experiments, is discussed.

14.
J Cancer ; 9(2): 321-330, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29344279

RESUMO

Purpose: SET and MYND domain-containing protein2 (SMYD2), a histone lysine methyltransferases, is a candidate human oncogene in multiple tumors. However, the expression dynamics of SMYD2 in hepatocellular carcinoma (HCC) and its clinical/prognostic significance are unclear. Methods: The SMYD2 expression profile was examined by quantitative real-time polymerase chain reaction (qRT-PCR), and immunohistochemistry (IHC) in HCC tissues and matched adjacent non-tumorous tissues. SMYD2 was silenced in HCC cell lines to determine its role in tumor proliferation and cell cycle progression, and the possible mechanism. Spearman's rank correlation, Kaplan-Meier plots and Cox proportional hazards regression model were used to analyze the data. Results: The SMYD2 expression in HCC tissues were significantly up-regulated at both mRNA and protein levels as compared with the matched adjacent non-tumorous tissues. By IHC, positive expression of SMYD2 was examined in 122/163 (74.85%) of HCC and in 10/59 (16.95%) of tumor-adjacent tissues. Positive expression of SMYD2 was correlated with tumor size, vascular invasion, differentiation and TNM stage (P < 0.05). In univariate survival analysis, a significant association between positive expression of SMYD2 and shortened patients' survival was found (P < 0.05). Importantly, SMYD2 expression together with vascular invasion (P < 0.05) provided significant independent prognostic parameters in multivariate analysis. Functionally, SMYD2 silenced markedly inhibited cell proliferation and cell cycle progression in SMMC-7721 cell. Conclusions: Our findings provide evidences that positive expression of SMYD2 in HCC may be important in the acquisition of an aggressive phenotype, and it is an independent biomarker for poor prognosis of patients with HCC.

15.
Liver Int ; 38(3): 494-502, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-28685924

RESUMO

BACKGROUND AND AIMS: Accurate assessment of liver functional reserve pre-operatively is vital for safe hepatic resection. The ALBI score is a new model for assessing liver function. This study aimed to evaluate the value of combining ALBI score with sFLR in predicting post-operative morbidity and PHLF in HCC patients who underwent hepatectomy. METHODS: Patients undergoing three-dimensional CT reconstruction prior to hepatectomy for HCC between January 2015 and January 2017 were enrolled. The values of the CP score, ALBI score and sFLR in predicting post-operative outcomes were evaluated. RESULTS: A total of 229 HCC patients were enrolled; 24 (10.5%) experienced major complications and 21 (9.2%) developed PHLF. The incidence of major complications and PHLF increased with increasing ALBI grade. The ALBI grade classified patients with CP grade A into two subgroups with different incidences of PHLF (P=.029). sFLR and ALBI scores were identified as independent predictors of PHLF. The AUC values for the CP score, ALBI score, sFLR and sFLR×ALBI for predicting major complications were 0.600, 0.756, 0.660 and 0.790 respectively. The AUC values of the CP score, ALBI score, sFLR and sFLR×ALBI for predicting PHLF were 0.646, 0.738, 0.758 and 0.884 respectively. CONCLUSIONS: The ALBI score showed superior predictive value of post-operative outcomes over CP score, and the combination of sFLR and ALBI score was identified as a stronger predictor of post-operative outcomes than the sFLR or ALBI score alone.

16.
World J Surg Oncol ; 15(1): 216, 2017 Dec 04.
Artigo em Inglês | MEDLINE | ID: mdl-29202837

RESUMO

BACKGROUND: The purpose of this case series is to investigate the relationship between splenic thickness (ST) and postoperative outcomes after hepatic resection in hepatitis B virus (HBV)-associated hepatocellular carcinoma (HCC) patients. METHODS: The clinical data of 320 patients with HBV-associated HCC who had undergone liver resection were retrospectively analyzed. The value of ST in predicting postoperative outcomes was evaluated. RESULTS: A total of 320 patients were enrolled in the study. An increase in ST was significantly associated with an increase in portal vein diameter (PVD), indocyanine green retention rate 15 min (ICG R15), and total bilirubin (TBIL); however, it was negatively correlated with platelet count (PLT). Post-hepatectomy liver failure (PHLF) occurred in 35 (10.9%) patients. Multivariate logistic regression analysis showed that ST was an independent predictor of morbidity and mortality after hepatectomy. Meanwhile, ST was associated with an almost sixfold increased risk for developing perioperative complications (OR 5.678; 95% CI 2.873 to 11.224; P < 0.001) and almost 13-fold increased risk for mortality after hepatectomy (OR 13.007; 95% CI 1.238 to 136.627; P = 0.033).The area under the receiver operating characteristic (ROC) curve (AUC) of ST for predicting the incidence of PHLF was 0.754 (95% confidence interval (CI) 0.667 to 0.841; P < 0.001), with a sensitivity of 57.1% and a specificity of 82.5%, which were significantly greater than those of the ICG R15 level (AUC 0.670; 95% CI 0.560 to 0.779; P < 0.001). The critical value of ST was 43.5 mm. CONCLUSIONS: ST, which is an easy, inexpensive, and routinely available perioperative marker, showed a favorable predictive value for postoperative outcomes in HBV-associated HCC patients.


Assuntos
Carcinoma Hepatocelular/cirurgia , Falência Hepática/epidemiologia , Neoplasias Hepáticas/cirurgia , Complicações Pós-Operatórias/epidemiologia , Baço/patologia , Adulto , Carcinoma Hepatocelular/diagnóstico por imagem , Carcinoma Hepatocelular/mortalidade , Carcinoma Hepatocelular/virologia , Feminino , Hepatectomia/efeitos adversos , Vírus da Hepatite B/isolamento & purificação , Humanos , Fígado/irrigação sanguínea , Fígado/diagnóstico por imagem , Fígado/cirurgia , Fígado/virologia , Falência Hepática/etiologia , Testes de Função Hepática , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/mortalidade , Neoplasias Hepáticas/virologia , Masculino , Pessoa de Meia-Idade , Tamanho do Órgão , Veia Porta/diagnóstico por imagem , Complicações Pós-Operatórias/etiologia , Período Pós-Operatório , Valor Preditivo dos Testes , Prognóstico , Curva ROC , Estudos Retrospectivos , Fatores de Risco , Baço/diagnóstico por imagem
17.
Oncol Lett ; 13(5): 3631-3637, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28521464

RESUMO

Assessment of hepatic functional reserve is important to enable the selection of appropriate treatment methods and safe hepatic resection in hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC). In the present study, an evaluation was made of the clinical value of combining the Child-Pugh score (CPS) with the standardized future liver remnant (sFLR) measurement to predict postoperative liver dysfunction (PLD). A total of 61 HBV-related HCC patients undergoing liver volumetry prior to hepatectomy were enrolled in the study. The sFLR was calculated as the ratio of FLR volume to standardized liver volume. PLD was defined as a prothrombin time of >18 sec or a peak serum bilirubin level of >51.3 µmol/l for 7 days after surgery. Univariate analysis and multivariate logistic regression analysis were performed to identify risk factors associated with PLD. The correlation between PLD and the combination of sFLR and CPS was analyzed. In total, 18 out of 61 patients developed PLD (29.5%), with a significantly higher PLD incidence for a CPS of 6 than a CPS of 5 (P<0.05). Multivariate logistic regression analysis revealed that a prothrombin time of <13.3 sec and an sFLR of <0.55 were independent risk factors for PLD. Receiver operating characteristic (ROC) curve analysis revealed that the cut-off values of sFLR and sFLR/CPS for predicting PLD were 54.5% and 0.0916, respectively, with areas under the ROC curve of 0.820 and 0.860, respectively. The combination of CPS and sFLR appears to yield improved prediction of the occurrence of PLD compared with either CPS or sFLR alone.

18.
Biosens Bioelectron ; 89(Pt 2): 837-845, 2017 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-27816579

RESUMO

Tumor metastasis involves the migration of cells from primary site to a distant location. Recently, it was established that cancer cells from the same tumor were heterogeneous in migratory ability. Numerous studies have demonstrated that cancer cells undergo reorientation and migration directionally under physiological electric field (EF), which has potential implications in metastasis. Microfluidic devices with channel structures of defined dimensions provide controllable microenvironments to enable real-time observation of cell migration. In this study, we developed two polydimethylsiloxane (PDMS)-based microfluidic devices for long-term electrotaxis study. In the first chip, three different intensities of EFs were generated in a single channel to study cell electrotactic behavior with high efficiency. We observed that the lung adenocarcinoma H1975 cells underwent cathodal migration with changing cellular orientation. To address the issue of cell electrotactic heterogeneity, we also developed a cell isolation device integrating cell immobilization structure, stable EF generator and cell retrieval module in one microfluidic chip to sort out different cell subpopulations based on electrotactic ability. High electrotactic and low electrotactic cells were harvested separately for colony formation assay and transcriptional analysis of migration-related genes. The results showed that H1975 cell motility was related to EGFR expression in the absence of EF stimulation, while in the presence of EF it was associated with PTEN expression. Up-regulation of RhoA was observed in cells with high motility, regardless of EF. The easy cell manipulation and precise field control of the microfluidic devices may enable further study of tumor heterogeneity in complex electrotactic environments.


Assuntos
Adenocarcinoma/patologia , Técnicas Biossensoriais/instrumentação , Movimento Celular , Estimulação Elétrica/instrumentação , Neoplasias Pulmonares/patologia , Técnicas Analíticas Microfluídicas/instrumentação , Adenocarcinoma/genética , Adenocarcinoma de Pulmão , Linhagem Celular Tumoral , Eletricidade , Desenho de Equipamento , Regulação Neoplásica da Expressão Gênica , Humanos , Pulmão/citologia , Pulmão/metabolismo , Pulmão/patologia , Neoplasias Pulmonares/genética
19.
Anal Chem ; 87(14): 7098-108, 2015 Jul 21.
Artigo em Inglês | MEDLINE | ID: mdl-26087892

RESUMO

Recent studies reveal that solid tumors consist of heterogeneous cells with distinct phenotypes and functions. However, it is unclear how different subtypes of cancer cells migrate under chemotaxis. Here, we developed a microfluidic device capable of generating multiple stable gradients, culturing cells on-chip, and monitoring single cell migratory behavior. The microfluidic platform was used to study gradient-induced chemotaxis of lung cancer stem cell (LCSC) and differentiated LCSC (dLCSC) in real time. Our results showed the dynamic and differential response of both LCSC and dLCSC to chemotaxis, which was regulated by the ß-catenin dependent Wnt signaling pathway. The microfluidic analysis showed that LCSC and dLCSC from the same origin behaved differently in the same external stimuli, suggesting the importance of cancer cell heterogeneity. We also observed for the first time the acceleration of both LCSC and dLCSC during chemotaxis caused by increasing local concentration in different gradients, which could only be realized through the microfluidic approach. The capability to analyze single cell chemotaxis under spatially controlled conditions provides a novel analytical platform for the study of cellular microenvironments and cancer cell metastasis.


Assuntos
Quimiotaxia/fisiologia , Técnicas Analíticas Microfluídicas , Células-Tronco Neoplásicas/citologia , Adesão Celular , Diferenciação Celular , Linhagem Celular Tumoral , Movimento Celular , Humanos , Microscopia Eletrônica de Varredura , Células-Tronco Neoplásicas/metabolismo
20.
Minim Invasive Ther Allied Technol ; 24(3): 167-74, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25496246

RESUMO

BACKGROUND: Bronchial adenoid cystic carcinoma (ACC) is a rare disease with low malignancy and indolent progression. Airway obstruction caused by ACC can be resolved by endoscopic procedures. The efficacy of different techniques of bronchoscopic interventions for ACC has not been determined. MATERIAL AND METHODS: From November 2004 to March 2012, ACC patients, mainly treated with different techniques of bronchoscopic interventions in our hospital, were reviewed. RESULTS: The study included 37 ACC patients. Five patients (13.5%) with intra-luminal type underwent bronchoscopic therapies for a median of three times (range 1-6 times). Thirty-two patients (86.5%) with mixed type underwent bronchoscopic interventions for a median of 14 times (range 4-20 times). The dyspnea index was significantly improved after the first endoscopic procedure. The overall five- and ten-year survival rate was 85.9% and 45.9%, respectively, similar to surgery-dominant treatments. CONCLUSIONS: The present study demonstrates that different procedures of bronchoscopic interventions, as main treatments for ACC, are as effective as surgery-dominant treatment. More prospective and multicentric studies are required to confirm these favorable results, which may influence the therapeutic strategy for ACC in the future.


Assuntos
Neoplasias Brônquicas/terapia , Broncoscopia/instrumentação , Broncoscopia/métodos , Carcinoma Adenoide Cístico/terapia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Dispneia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores Sexuais , Análise de Sobrevida
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