Meta-analysis of cryoablation versus radiofrequency ablation in the treatment of malignant liver tumors.

OBJECTIVE: A meta-analysis was conducted to assess the efficacy and safety of cryoablation (CRA) compared with radiofrequency ablation (RFA). METHODS: A systematic search of PubMed, EMBASE, Cochrane Library, Wanfang, CNKI, and VIP databases was conducted to identify clinical controlled studies comparing CRA versus RFA for hepatic malignancies up to July 2022. The meta-analysis was performed using RevMan 5.3. RESULTS: A comprehensive analysis was conducted on 8 clinical controlled studies involving a total of 943 patients. There were no significant differences in the incidence of complications, complete ablation of lesions, local recurrence, and 1-year survival between the CRA and RFA groups (OR = 0.98, 95%CI: 0.61-1.55, p = 0.92; OR = 1.08, 95%CI: 0.62-1.90, p = 0.78; OR = 1.28, 95%CI: 0.49-3.36, p = 0.61; and OR = 1.14, 95%CI: 0.63-2.06, p = 0.66, respectively). CONCLUSION: The efficacy and safety profile of CRA was comparable to that of RFA in the context of ablation therapy for hepatic malignancies. These findings suggested that CRA may be a valuable alternative to RFA in the treatment of hepatic malignancies.

Machine learning-based algorithm identifies key mitochondria-related genes in non-alcoholic steatohepatitis.

BACKGROUND: Evidence suggests that hepatocyte mitochondrial dysfunction leads to abnormal lipid metabolism, redox imbalance, and programmed cell death, driving the onset and progression of non-alcoholic steatohepatitis (NASH). Identifying hub mitochondrial genes linked to NASH may unveil potential therapeutic targets. METHODS: Mitochondrial hub genes implicated in NASH were identified via analysis using 134 algorithms. RESULTS: The Random Forest algorithm (RF), the most effective among the 134 algorithms, identified three genes: Aldo-keto reductase family 1 member B10 (AKR1B10), thymidylate synthase (TYMS), and triggering receptor expressed in myeloid cell 2 (TREM2). They were upregulated and positively associated with genes promoting inflammation, genes involved in lipid synthesis, fibrosis, and nonalcoholic steatohepatitis activity scores in patients with NASH. Moreover, using these three genes, patients with NASH were accurately categorized into cluster 1, exhibiting heightened disease severity, and cluster 2, distinguished by milder disease activity. CONCLUSION: These three genes are pivotal mitochondrial genes implicated in NASH progression.

Machine learning-based integration identifies the ferroptosis hub genes in nonalcoholic steatohepatitis.

BACKGROUND: Ferroptosis, is characterized by lipid peroxidation of fatty acids in the presence of iron ions, which leads to cell apoptosis. This leads to the disruption of metabolic pathways, ultimately resulting in liver dysfunction. Although ferroptosis is linked to nonalcoholic steatohepatitis (NASH), understanding the key ferroptosis-related genes (FRGs) involved in NASH remains incomplete. NASH may be targeted therapeutically by identifying the genes responsible for ferroptosis. METHODS: To identify ferroptosis-related genes and develop a ferroptosis-related signature (FeRS), 113 machine-learning algorithm combinations were used. RESULTS: The FeRS constructed using the Generalized Linear Model Boosting algorithm and Gradient Boosting Machine algorithms exhibited the best prediction performance for NASH. Eight FRGs, with ZFP36 identified by the algorithms as the most crucial, were incorporated into in FeRS. ZFP36 is significantly enriched in various immune cell types and exhibits significant positive correlations with most immune signatures. CONCLUSION: ZFP36 is a key FRG involved in NASH pathogenesis.

Origins of the Photocurrent Multiplication Effect in the Polythiophene-Based Photodetectors.

The photocurrent multiplication (PM) effect has been used to boost the device performance of polymer-based photodetectors (PDs), but its origin is rarely addressed. In this study, the origins of the PM effect in polymer PDs based on the P3HT:PC71 BM bulk heterojunction (BHJ) composite thin film, where P3HT is poly(3-hexylthiophene), and PC71 BM is [6,6]phenyl-C71 -butyric acid methyl ester, through both computational simulation and experimental investigation are reported. Systematic studies indicate that two key factors play an important role in the realization of the PM effect in polymer PDs. One factor is the work function of the metal electrode, and the other is the PC71 BM aggregations at the interface between the P3HT:PC71 BM BHJ composite thin film and the metal electrode. Moreover, the results from both experimental and computational simulation indicate that the values of the current density under light illumination minus the current density in the dark of polymer PDs are increased simultaneously along with the reduction of the thickness of the P3HT:PC71 BM BHJ composite thin film. The results provide an understanding of the PM effect in polymer PDs and guidance for the development of high-performance polymer PDs based on BHJ composite thin film.

Inhibition of Acetylcholine Expression in the Tumor Microenvironment by Mustard Oil: A Potential Strategy to Retard Colon Cancer Progression.

Objective: This study aims to investigate the potential of mustard oil-induced reduction in acetylcholine expression as a means to delay the progression of colon cancer within the internal environment. Methods: The study design in this research involved both in vitro cellular experiments and in vivo animal experiments to employ mustard oil to modulate acetylcholine expression levels and evaluate its impact on colon cancer. Cellular experiments involved the introduction of six concentrations of acetylcholine (10-2, 10-3, 10-4, 10-5, 10-6, and 10-7 mol/L) into colon cancer cell cultures to monitor cell proliferation. Animal experiments encompassed the subcutaneous CT26 colon cancer cells implantation into 28 Balb/c mice, divided into experimental and control groups. After tumor establishment, both groups were fed standard diets for two weeks. Serum acetylcholine concentrations were measured from eye blood samples. Additionally, Balb/c mice were inoculated with CT26-derived colon cancer cells and further categorized into experimental and control groups. A total of 14 mice comprised each group, with experimental mice fed mustard oil and control mice fed soybean oil. Post two weeks, serum acetylcholine expression in both groups was assessed. After sacrifice, subcutaneous tumors were excised, and tumor dimensions were measured using a Vernier scale. Results: Acetylcholine concentration augmentation in the culture medium corresponded to gradual cell proliferation escalation, peaking at 10-5 mol/L, exhibiting statistical significance. Comparative analysis revealed significantly elevated relative acetylcholine expression levels in Balb/c mice with tumor-bearing colon cancers compared to normal Balb/c mice. Experimental group mice exhibited substantially lower serum acetylcholine concentrations than control group mice. Mustard oil administration effectively curtailed acetylcholine expression in normal Balb/c mice, consequently retarding tumor growth. These findings underscore mustard oil's potential to diminish serum acetylcholine expression, thereby delaying colon cancer progression. Conclusions: This study suggests that mustard oil's modulation of acetylcholine expression within the internal environment holds the potential for impeding colon cancer growth.

Development and validation of a nomogram for prediction of cervical lymph node metastasis in middle and lower thoracic esophageal squamous cell carcinoma.

BACKGROUND: Estimates of cervical lymph node (LN) metastasis in patients with middle and lower thoracic esophageal squamous cell carcinoma (ESCC) are important. A nomogram is a useful tool for individualized prediction. METHODS: A total of 235 patients were enrolled in this study. Univariate and multivariate analyses were performed to screen for independent risk factors and construct a nomogram to predict the risk of cervical LN metastasis. The nomogram performance was assessed by discrimination, calibration, and clinical use. RESULTS: Totally, four independent predictors, including the maximum diameter of tumor, paraesophageal lymph node status, recurrent laryngeal nerve lymph node status, and the CT-reported cervical LN status, were enrolled in the nomogram. The AUC of the nomogram model in the training and validation dataset were 0.833 (95% CI 0.762-0.905), 0.808 (95% CI 0.696-0.920), respectively. The calibration curve demonstrated a strong consistency between nomogram and clinical findings in predicting cervical LN metastasis. Decision curve analysis demonstrated that the nomogram was clinically useful. CONCLUSION: We developed a nomogram that could be conveniently used to predict the individualized risk of cervical LN metastasis in patients with middle and lower thoracic ESCC.

Dynamics of the threshold model on hypergraphs.

The threshold model has been widely adopted as a prototype for studying contagion processes on social networks. In this paper, we consider individual interactions in groups of three or more vertices and study the threshold model on hypergraphs. To understand how high-order interactions affect the breakdown of the system, we develop a theoretical framework based on generating function technology to derive the cascade condition and the giant component of vulnerable vertices, which depend on both hyperedges and hyperdegrees. First, we find a dual role of the hyperedge in propagation: when the average hyperdegree is small, increasing the size of the hyperedges may make the system fragile, while the average hyperdegree is relatively large, the increase of the hyperedges causes the system to be robust. Then, we identify the effects of threshold, hyperdegree, and hyperedge heterogeneities. The heterogeneity of individual thresholds causes the system to be more fragile, while the heterogeneity of individual hyperdegrees or hyperedges increases the robustness of the system. Finally, we show that the higher hyperdegree a vertex has, the larger possibility and faster speed it will get activated. We verify these results by simulating meme spreading on both random hypergraph models and hypergraphs constructed from empirical data.

Computed tomography-guided coil localization for scapular-blocked lung nodules.

PURPOSE: To investigate the clinical efficacy, feasibility, and safety of the preoperative computed tomography (CT)-guided coil localization (CL) approach for scapula-blocked lung nodules (SBLNs). MATERIAL AND METHODS: A total of 123 patients with LNs were treated via CT-guided CL and subsequent VATS-guided wedge resection from January 2015 to June 2020. Of these patients, 12 (9.8%) exhibited SBLNs and underwent CT-guided CL. Technical success of localization and video-assisted thoracoscopic surgery (VATS)-guided wedge resection, and localization-related complications were recorded and analyzed. RESULTS: The technical success rate of CT-guided CL was 100%. Each patient was placed with one coil. The mean duration of CT-guided CL was 14.7 ± 2.7 min. One patient (8.3%) developed asymptomatic pneumothorax, which has not impacted the subsequent VATS procedure. Successful VATS-guided wedge resection of these SBLNs was achieved in all patients, with no instances of conversion to thoracotomy. Additional lobectomy was performed in three patients. The mean duration of the VATS procedure and blood loss were 143.8 ± 95.5 min and 110.0 ± 82.0 ml, respectively. CONCLUSIONS: The approach of CT-guided CL could be safely and easily utilized to facilitate high rates of success when conducting the VATS-guided wedge resection of SBLNs.

An updated meta-analysis of partial splenic embolization versus splenectomy in the treatment of hypersplenism due to cirrhosis.

OBJECTIVE: To evaluate the efficacy and safety of partial splenic embolization (PSE) versus splenectomy (SP) for hypersplenism. MATERIAL AND METHODS: Pubmed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang, and Chinese Science and Technology Periodical Database (VIP) databases were systematically searched to identify all relevant studies. Stratified meta-analysis was also conducted to control the influence of confounding factors on the research results. RESULTS: Twenty-three studies comparing PSE with SP involving a total of 1849 hypersplenism patients were selected. Postoperative increased level of platelet (PLT) [mean difference (MD) = -65.51; 95% confidence interval (CI), -81.33 to -41.69; p < .00001] were better in SP than in PSE; however, PSE was associated with less operation time (MD = -53.47; 95% CI, -65.01 to -41.94; p < .00001), less intraoperative blood loss (MD = -61.58; 95% CI, -80.35 to -42.82; p < .00001), shorter hospital stay (MD = -2.98;95% CI, -4.07 to -1.88; p < .00001) and lower complication rate [odds ratio (OR) = 0.53; 95% CI, 0.32 to 0.90; p = .02] compared with the SP. Meanwhile, there was no significant difference in postoperative increased level of white blood cells (WBC) (MD = -1.02; 95% CI, -2.16 to 0.11; p = .08) and postoperative increased level of hemoglobin (HB) (MD = -4.09; 95% CI, -14.06 to 5.88; p = .42) between PSE and SP group. CONCLUSION: PSE had similar efficacy with SP in improving postoperative PLT, WBC, and HB levels. Moreover, PSE had the advantages of less trauma and fewer complications as well as faster recovery when compared with SP. Therefore, we tended to be cautious about SP and considered that patients with hypersplenism might benefit more from PSE.

Evolution of computed tomography manifestations of eleven patients with severe coronavirus disease 2019 (COVID-19) pneumonia.

PURPOSE: Severe coronavirus disease 2019 (COVID-19) pneumonia is associated with high mortality. However, the evolution of computed tomography (CT) manifestations of severe COVID-19 pneumonia remains unclear, more evidence regarding its evolution process is urgently needed. METHOD: The clinical, laboratory and imaging data of eleven patients with severe COVID-19 pneumonia were collected to investigate the evolution process of severe COVID-19 cases. RESULTS: The main initial CT manifestations of severe COVID-19 pneumonia were multiple ground-glass opacities and/or consolidation. The evolution of CT manifestations showed that acute exudative lesions of severe COVID-19 pneumonia could be gradually resolved after the active intervention. CONCLUSIONS: Most of patients with severe COVID-19 pneumonia showed marked improvement of acute exudative lesions on chest imagings and satisfactory prognosis of severe COVID-19 pneumonia could be achieved after active treatment.

Echinococcus multilocularis induces surface high expression of inhibitory killer immunoglobulin-like receptor on natural killer cells.

Alveolar echinococcosis (AE) is a malignant and fatal parasitic disease caused by the larvae of Echinococcus multilocularis (E. multilocularis), which inhibits the activity and proliferation of natural killer (NK) cells. In this study, the functional alteration of hepatic NK cells and their related molecules were studied. The AE-infected patient's tissue was fixed with formalin, embedded in paraffin, and stained with Masson's trichrome or hematoxylin and eosin (H&E). Single cells from AE-infected patient or E. multilocularis-infected mice were blocked with Fc-receptor (FcR), and stained with monoclonal antibodies, including CD16, CD56, CD3, KIR2DL1, granzyme B, perforin, Interferon gamma (IFN-γ), and tumor necrosis factor-α (TNFα) or isotype control, to measure molecules and cytokines of NK cells and analyzed by flow cytometry. The Sirius red staining was used to quantitate hepatic fibrosis by calculating quantitative collagen deposition. AE can adjust both the number of hepatic CD56+ NK cells and its KIR2DL1 expression processes. Moreover, the overexpression of KIR2DL1 in NK cells could downregulate the functioning of immune cells in the liver area close to parasitic lesions. The number and dysfunction of NK cells in E. multilocularis infection could be related to the molecule dynamics of cell surface inhibitory receptor Ly49A, leading to hepatic damage and progression of fibrosis. This study illustrated significant increase in hepatic fibrogenesis and apparent upregulation of hepatic CD56+ NK cell population and its KIR2DL1 expression in AE-infected patients. This opposite variation might be related to the impaired NK cells functioning, such as granzyme B, IFN-γ, and TNF-α secretion. In addition, the cell surface inhibitory receptor Ly49A was related to the intracellular cytokine secretion functions of NK cells.

Incidence and risk factors of surgical site infection following colorectal surgery in China: a national cross-sectional study.

PURPOSES: Surgical site infection (SSI) after colorectal surgery is a frequent complication associated with the increase in morbidity, medical expenses, and mortality. To date, there is no nationwide large-scale database of SSI after colorectal surgery in China. The aim of this study was to determine the incidence of SSI after colorectal surgery in China and to further evaluate the related risk factors. METHODS: Two multicenter, prospective, cross-sectional studies covering 55 hospitals in China and enrolling adult patients undergoing colorectal surgery were conducted from May 1 to June 30 of 2018 and the same time of 2019. The demographic and perioperative characteristics were collected, and the main outcome was SSI within postoperative 30 days. Multivariable logistic regressions were conducted to predict risk factors of SSI after colorectal surgery. RESULTS: In total, 1046 patients were enrolled and SSI occurred in 74 patients (7.1%). In the multivariate analysis with adjustments, significant factors associated with SSI were the prior diagnosis of hypertension (OR, 1.903; 95% confidence interval [CI], 1.088-3.327, P = 0.025), national nosocomial infection surveillance risk index score of 2 or 3 (OR, 3.840; 95% CI, 1.926-7.658, P < 0.001), laparoscopic or robotic surgery (OR, 0.363; 95% CI, 0.200-0.659, P < 0.001), and adhesive incise drapes (OR, 0.400; 95% CI, 0.187-0.855, P = 0.018). In addition, SSI group had remarkably increased length of postoperative stays (median, 15.0 d versus 9.0d, P < 0.001), medical expenses (median, 74,620 yuan versus 57,827 yuan, P < 0.001), and the mortality (4.1% versus 0.3%, P = 0.006), compared with those of non-SSI group. CONCLUSION: This study provides the newest data of SSI after colorectal surgery in China and finds some predictors of SSI. The data presented in our study can be a tool to develop optimal preventive measures and improve surgical quality in China.

An Enhanced Detection System of Drill Rod Bending Degree Based on Two-Dimensional Laser.

Drill rod straightness has to be strictly controlled and the maximum bending degree detection needs to be used in the straightening process. The mechanical bending degree measurement depends on machinery instruments and workers' experience, often with low efficiency and precision. While the optical inspection, as a non-contact detection method, with higher precision and lower installation accuracy requirements, is frequently applied in the online detection system. Based on this, an enhanced bending degree detection system for a drill rod is proposed in this paper. Compared to the existing detection system, the main progress is to use a two-dimensional laser to quickly obtain arc profile data and fit with ellipse. Segment inspection idea is also utilized is this system as the camera that could obtain the whole drill rod in one shot needs extremely high resolution and price. A specialized algorithm is designed to fit the cross-section shape and whole centerline displacement based on the least square method. Some laboratory tests are conducted to verify this detection system, findings of which are compared to manual measured results. The maximum bending degree error is 2.14 mm and the maximum position error is 8.21 mm, which are both within the tolerance of error. Those results show the feasibility and precision of this enhanced detection system.

Life-threatening hemorrhage from the corona mortis treated with balloon-assisted coiling technique.

Isolated pubic ramus fractures are common and generally uncomplicated injuries in the elderly. However, pubic ramus fractures are closely related to important vascular structures. The corona mortis, located in the retropubis, has an important anastomotic value, as it serves as a communication between the internal and external iliac vessels. The following case report describes an 88-year-old male who was diagnosed with a right superior pubic ramus fracture, which led to a severe picture of hemodynamic instability. Emergent angiography demonstrated injury of the corona mortis. After super-selective embolization of the corona mortis artery with a balloon-assisted coiling technique, the patient progressed satisfactorily and was discharged after 7days.

Contribution of DNA repair xeroderma pigmentosum group D genotypes to pancreatic cancer risk in the Chinese Han population.

This study aimed to determine the association between the polymorphisms and haplotypes in the xeroderma pigmentosum group D (XPD) gene and the risk of pancreatic cancer in the Chinese Han population. SNaPshot was used for genotyping six SNP sites of the XPD gene. Comparisons of the correlations between different genotypes in combination with smoking and the susceptibility to pancreatic cancer were performed. Individual pancreatic cancer risk in patients who carry mutant C alleles (AC, CC, and AC+CC) at rs13181 increased (p < 0.05). Taking non-smoking individuals who carry the AA genotype as a reference, and non-smoking individuals who carry mutant allele C (AC+CC), the risk of pancreatic cancer increased by 3.343 times in individuals who smoked ≥ 20 cigarettes daily, 3.309 times in individuals who smoked ≥ 14 packs per year, 5.011 times in individuals who smoked ≥ 24 packs per year, and 4.013 times in the individuals who smoked ≥ 37 packs per year (P < 0.05). In addition, haplotype analysis revealed that haplotype AGG, which comprised rs13181, rs3916874 and rs238415, was associated with a 1.401-fold increase in pancreatic cancer risk (p < 0.05). We conclude that the polymorphism of XPD Lys751Gln (rs13181) in combination with smoking contributes to increased risk of pancreatic cancer in the Chinese Han population. Haplotype AGG might be a susceptibility haplotype for pancreatic cancer.

PPIM: A Protein-Protein Interaction Database for Maize.

Maize (Zea mays) is one of the most important crops worldwide. To understand the biological processes underlying various traits of the crop (e.g. yield and response to stress), a detailed protein-protein interaction (PPI) network is highly demanded. Unfortunately, there are very few such PPIs available in the literature. Therefore, in this work, we present the Protein-Protein Interaction Database for Maize (PPIM), which covers 2,762,560 interactions among 14,000 proteins. The PPIM contains not only accurately predicted PPIs but also those molecular interactions collected from the literature. The database is freely available at http://comp-sysbio.org/ppim with a user-friendly powerful interface. We believe that the PPIM resource can help biologists better understand the maize crop.

Targeting protein for Xenopus kinesin-like protein 2 knockdown enhances radiation sensitivity of human lung squamous carcinoma cell.

The targeting protein for Xenopus kinesin-like protein 2 (TPX2) has been demonstrated to be associated with the tumourigenesis of many cancers. In the present study, we investigated the role and preliminary mechanism of TPX2 in the resistance of lung squamous carcinoma to radiation therapy. The results showed that SK-MES-1R and NCI-H226R cells were more resistant to X-ray irradiation than the parental cells (SK-MES-1 and NCI-H226). Moreover, TPX2 was upregulated in the radioresistant cells compared with the parental cells. TPX2 knockdown significantly decreased TPX2 expression in SK-MES-1 cells, while TPX2 overexpression increased TPX2 expression in NCI-H226 cells compared with the corresponding control cells. TPX2 knockdown enhanced the radiosensitivity of SK-MES-1 and promoted cell apoptosis following exposure to irradiation, whereas TPX2 overexpression decreased the radiosensitivity of NCI-H226 and inhibited cell apoptosis. In in vivo studies, the combination of TPX2 knockdown and irradiation significantly inhibited tumour growth, decreased tumour weight, downregulated TPX2 expression in tumour tissue and induced cell apoptosis in nude mice, while TPX2 overexpression exerted an opposite effect. Our results indicated that TPX2 was correlated with cell radioresistance and it might be served as a therapeutic target to enhance cell radiosensitivity in the radiation therapy of lung squamous carcinoma.

Prevention of infectious diseases by public vaccination and individual protection.

In the face of serious infectious diseases, governments endeavour to implement containment measures such as public vaccination at a macroscopic level. Meanwhile, individuals tend to protect themselves by avoiding contacts with infections at a microscopic level. However, a comprehensive understanding of how such combined strategy influences epidemic dynamics is still lacking. We study a susceptible-infected-susceptible epidemic model with imperfect vaccination on dynamic contact networks, where the macroscopic intervention is represented by random vaccination of the population and the microscopic protection is characterised by susceptible individuals rewiring contacts from infective neighbours. In particular, the model is formulated both in populations without and then with demographic effects (births, deaths, and migration). Using the pairwise approximation and the probability generating function approach, we investigate both dynamics of the epidemic and the underlying network. For populations without demography, the emerging degree correlations, bistable states, and oscillations demonstrate the combined effects of the public vaccination program and individual protective behavior. Compared to either strategy in isolation, the combination of public vaccination and individual protection is more effective in preventing and controlling the spread of infectious diseases by increasing both the invasion threshold and the persistence threshold. For populations with additional demographic factors, we investigate temporal evolution of infected individuals and infectious contacts, as well as degree distributions of nodes in each class. It is found that the disease spreads faster but is more restricted in scale-free networks than in the Erdös-Rényi ones. The integration between vaccination intervention and individual rewiring may promote epidemic spreading due to the birth effect. Moreover, the degree distributions of both networks in the steady state is closely related to the degree distribution of newborns, which leads to uncorrelated connectivity. All the results demonstrate the importance of both local protection and global intervention, as well as the demographic effects. Our work thus offers a more comprehensive description of disease containment.

[Clinical feature of gallbladder cancer in Northwestern China: a report of 2 379 cases from 17 institutions].

OBJECTIVE: To analyze the clinical features of patients with gallbladder cancer from 17 hospitals in 5 Northwestern provinces (autonomous region) of China from 2009 to 2013. METHODS: A total of 2 379 cases with gallbladder cancer in 17 tertiary hospitals from 5 Northwestern provinces of China from January 2009 to December 2013 were reviewed retrospectively. The clinical data was collected by standardized "Questionnaire for Clinical Survey of Gallbladder Cancer in Northwestern Area of China". χ² test was used to analyze the data. RESULTS: (1) Gallbladder cancer from 17 hospitals accounted for 1.6%-6.8% of all bile tract diseases from 2009 to 2013 in Northwestern China, average was 2.7%. Gallbladder cancer accounted for 0.4%-0.9% of abdominal surgery, average was 0.7%. (2) The incidence of gallbladder cancer was higher in the aged females, the ration of female to male was 1.0 to 2.1. The average age of gallbladder cancer was (64 ± 11) years. The occupation of patients was mainly farmers (χ² = 147.10, P < 0.01). (3) 57.2% of the gallbladder cancers were associated with gallstones. (4) The main pathological patterns of gallbladder cancer were moderate and poor differentiated adenocarcinoma, showing an aggressive malignancy. TNM stage IV accounted for 55.1% of all cases, which was associated with the poor prognosis. (5) The curative resection rate was 30.4%. CONCLUSIONS: Gallbladder cancer is common in the aged females and mainly at advanced stage. The screening and follow-up of high-risk groups with ultrasound and other methods regularly could increase the early diagnosis rate of gallbladder cancer, aggressive surgical resection combined with other comprehensive treatment could improve the prognosis of patients.

Transarterial embolization followed by staged hepatectomy versus emergency hepatectomy for ruptured HCC: a meta-analysis.

BACKGROUND: To compare the efficacy and safety between emergency hepatectomy (EH) and emergency transarterial embolization (TAE) followed by staged hepatectomy (SH) in the treatment of spontaneous ruptured hepatocellular carcinoma (rHCC). METHODS: Databases (PubMed, EMBASE, Web of science, Cochrane Library, ClinicalTrial.gov, CNKI, Wanfang and VIP) were searched for all relevant comparative studies from January 2000 to October 2020. Odds ratio (OR) and mean difference (MD) with 95% confidence interval (CI) were pooled for dichotomous and continuous variables, respectively. Subgroup analyses based on the kind of embolization were conducted. RevMan 5.3 software was adopted for meta-analysis. RESULTS: Eighteen studies with 871 patients were finally included in this meta-analysis, 448 in EH group and 423 in TAE + SH group. No significant difference was observed in successful hemostasis (P = 0.42), postoperative hospital stay (P = 0.12), complication rate (P = 0.08) between EH and TAE + SH group. However, TAE + SH group was associated with shorter operating time (P < 0.00001), fewer perioperative blood loss (P = 0.007), fewer blood transfusion (P = 0.003), lower in-hospital mortality (P < 0.00001) and higher 1-year survival as well as 3-year survival (P < 0.0001; P = 0.003) compared with EH group. CONCLUSION: Compared with EH, TAE + SH could reduce perioperative operating time, blood loss, blood transfusion, mortality rate and increase the long-term survival rate of the rHCC patients, which may be a better treatment for resectable rHCC.