Comment on “Outcomes of curative liver resection for hepatocellular carcinoma in patients with cirrhosis”

The present letter to the editor is in response to the research “Outcomes of curative liver resection for hepatocellular carcinoma in patients with cirrhosis” by Elshaarawy et al in World J Gastroenterol 2021; 13(5): 424–439. The preoperative assessment of the liver reserve function in hepatocellular carcinoma (HCC) patients with cirrhosis is crucial, and there is no universal consensus on how to assess it. Based on a retrospective study, Elshaarawy et al investigated the impact of various classical clinical indicators on liver failure and the prognosis after hepatectomy in HCC patients with cirrhosis. We recommend that we should strive to explore new appraisal indicators, such as the indocyanine green retention rate at 15 min.     

<i>Sinomenium</i> Inhibits the Viability of Hepatoma Carcinoma Cells through Activating IFNA2

Hepatocellular carcinoma (HCC) ranks the sixth place of most common cancers. Meanwhile, it is the tertiary mortality cause of cancer. There is no effective therapeutic method to prevent and treat the liver cancer. Sinomenine is a kind of Chinese traditional medicine herbal, it is reported that it can inhibit the viability of several cancer cells. The study is to explore whether sinomenine is also able to inhibit the cell viability of HCC and its potential mechanism. The IC50 of sinomenine in BEL-7402 cells was 5.351 mmol/L, and the IC50 of sinomenine in SMMC-7721 cells was 6.204 mmol/L. The gene expression results showed the relative expression of FGF2, CCND2, DCN, F3, MMP7, NRG1, HMGB1, TRIM29, HAS2, EHF, CTGF, PLK2 were down-regulated, and the relative expression of VEGF A, CITED2, NUPR1, DDX58, IRF9, NAMPT, MMP1, NDRG1, HMGA2, PPARGC1A, IFIT2, PARP9, HEY1, LOX, ETV1, ISG15, BACH, CYLD were up-regulated. Moreover, the IPA analysis results suggested that IFIT3, IFIT1, OAS1, MX1, IRF9, IFI6, IFITM1, ISG15 were up-regulated in BEL-7402 cells treated with sinomenine by activating IFNA2. The findings presented in this study may provide a promising method for the prevention and treatment of liver cancer.     

碳离子和质子治疗胰腺癌安全性和有效性的系统评价及Meta分析

目的 评价碳离子和质子治疗胰腺癌（PaC）的安全性和有效性。方法 检索数据库纳入碳离子和质子治疗PaC的临床研究，检索时间为自建库至2019年6月。两位研究者独立筛选文献、提取资料。采用STATA 12.0和MetaAnalyst Beta 3.13软件进行Meta分析。结果 共纳入8篇文献，包含459例PaC患者。效应模型Meta分析显示，碳离子和质子治疗PaC的2、3、5级胃肠道溃疡发生率分别为7%、2%、0；2、3、4级厌食症发生率分别为6%、3%、0；1、2年总生存率（OS）分别为77%、45%；2年局部控制率为81%；1年无局部进展率为88%；1年局部复发率为15%。碳离子和质子治疗PaC的2、3、2～3级胃肠道溃疡发生率分别为6.8%、1.5%、9.2%和3.5%、8.3%、6.1%（均P>0.05）；1、2年OS分别为77.1%、44.4%和77.6%、49.7%（P均>0.05）。结论 碳离子和质子治疗PaC安全有效，两者的安全性和有效性相似。     

黑逍遥散对APP/PS1双转基因小鼠海马和脑皮层CaMKⅡα蛋白及其磷酸化表达的影响

目的:观察黑逍遥散对阿尔茨海默症(AD)小鼠海马和脑皮层钙调蛋白依赖性激酶2α(CaMKⅡα)及其磷酸化表达水平的干预效应。方法:30只APP/PS1双转基因雄性小鼠称体质量并按随机原则分为模型组、盐酸多奈哌齐组、黑逍遥散组,每组10只。同月龄、同种系的野生型C57BL/6雄性小鼠10只为空白组。盐酸多奈哌齐组(6 g·kg~(-1))、黑逍遥散组(3. 25 mg·kg~(-1))分别连续给药90 d后,Morris水迷宫检测行为学变化,免疫组化和蛋白免疫印迹法检测小鼠海马区和脑皮层CaMKⅡα蛋白及其磷酸化的表达。结果:干预90 d后,与空白组比较,AD模型组小鼠,逃避潜伏期显著延长,跨原平台和有效区域次数显著减少(P 0. 01),小鼠海马区及脑皮层Ca MKⅡα蛋白表达显著减弱或降低,而p-CaMKⅡα蛋白表达显著升高(P 0. 05,P 0. 01);与模型组比较,盐酸多奈哌齐和黑逍遥散组小鼠的逃避潜伏期均显著缩短、跨原平台次数均显著增加(P 0. 01),小鼠海马区及脑皮层Ca MKⅡα蛋白显著增强或升高,p-CaMKⅡα蛋白表达显著降低(P 0. 05,P 0. 01)。结论:黑逍遥散通过调节AD小鼠不同脑区参与细胞记忆形成机制的关键蛋白Ca MKⅡα及其磷酸化表达,进而发挥改善AD小鼠的学习记忆能力。     

Current standards and future perspectives in adjuvant treatment for biliary tract cancers

Biliary tract cancer, including cholangiocarcinoma (CCA) and gallbladder cancer (GBC) are rare tumours with a rising incidence. Prognosis is poor, since most patients are diagnosed with advanced disease. Only ~20% of patients are diagnosed with early-stage disease, suitable for curative surgery. Despite surgery performed with potentially-curative intent, relapse rates are high, with around 60–70% of patients expected to have disease recurrence. Most relapses occur in the form of distant metastases, with a predominance of liver spread. In view of high tumour recurrence, adjuvant strategies have been explored for many years, in the form of radiotherapy, chemo-radiotherapy and chemotherapy. Historically, few randomised trials were available, which included a variety of additional tumours (e.g. pancreatic and ampullary tumours); most evidence relied on phase II and retrospective studies, with no high-quality evidence available to define the real benefit derived from adjuvant strategies.Since 2017, three randomised phase III clinical trials have been reported; all recruited patients with resected biliary tract cancer (CCA and GBC) who were randomised to observation alone, or chemotherapy in the form of gemcitabine (BCAT study; included patients diagnosed with extrahepatic CCA only), gemcitabine and oxaliplatin (PRODIGE-12/ACCORD-18; included patients diagnosed with CCA and GBC) or capecitabine (BILCAP; included patients diagnosed with CCA and GBC). While gemcitabine-based chemotherapy failed to show an impact on patient outcome (relapse-free survival (RFS) or overall survival (OS)), the BILCAP study showed a benefit from adjuvant capecitabine in terms of OS (pre-planned sensitivity analysis in the intention-to-treat population and in the per-protocol analysis), with confirmed benefit in terms of RFS. Based on the BILCAP trial, international guidelines recommend adjuvant capecitabine for a period of six months following potentially curative resection of CCA as the current standard of care for resected CCA and GBC. However, BILCAP failed to show OS benefit in the intention-to-treat (non-sensitivity analysis) population (primary end-point), and this finding, as well as some inconsistencies between studies has been criticised and has led to confusion in the biliary tract cancer medical community.This review summarises the adjuvant field in biliary tract cancer, with evidence before and after 2017, and comparison between the latest randomised phase III studies. Potential explanations are presented for differential findings, and future steps are explored.     

Safety and efficacy of oral nemonoxacin versus levofloxacin in treatment of community-acquired pneumonia: A phase 3, multicenter,randomized, double-blind,double-dummy,active-controlled,non-inferiority trial

Background/Purpose

Nemonoxacin is a novel nonfluorinated quinolone with excellent in vitro activity against most pathogens in community-acquired pneumonia (CAP), especially Gram-positive isolates. The purpose of this study was to assess the efficacy and safety of nemonoxacin compared with levofloxacin in patients with CAP.

Penetration moxibustion for postpartum subinvolution of uterus: Two case reports and mechanism analysis: 透灸法成功治疗产后子宫复旧不良:两则病例报告及机制分析

This article introduced the application of penetration moxibustion in successfully treating two cases of postpartum subinvolution of uterus. The main complaint of one case was increasing volume of abnormal vaginal bleeding for five days after delivery. The bleeding stopped after the patient received 7 times treatment of warming needle and penetration moxibustion on Zhōngjí (中极CV3), Guānyuán (关元CV4) and Qìhăi (气海CV6). The other case complained about persistent abdominal pain for 15 days, which was worsening for the recent 2 days. The symptom of abdominal pain was relieved after the penetration moxibustion was applied on CV4, CV6 and Zǐgōng (子宫 EX-CA1) for 5 times for the case. Penetration moxibustion can relieve abdominal pain during the postpartum period, accelerate lochia discharge, and recovery of menstrual and uterine cavity. Àiyè (艾叶 Artemisiae Argyi Folium) was proved to have antibacterial, hemostatic, and analgesic effects. The warming function and radiation features of moxibustion can help to alleviate spasm of the smooth muscle in the uterus and enhance the metabolism of the uterine tissue by expanding microvessels and improving the circulations of both blood and lymph. It can also activate cells in the uterine tissue by increased temperature in order to enhance the decomposition and elimination of pathological wastes, such as inflammation and hematoma. In addition, it can also relieve pelvic pain by inhibiting neuronal excitability.     

生殖相关疾病与膳食炎症指数关系的研究进展

炎症参与了多囊卵巢综合征、子宫内膜异位症、妇科肿瘤等多种疾病的发生、发展,同时也可影响男性生殖功能。饮食在调节慢性炎症中发挥重要作用。膳食炎症指数（dietary inflammation index,DII）是一种新的临床膳食评估工具,将饮食分为促炎饮食和抗炎饮食,用于评估个人膳食整体的炎症潜力。研究显示,促炎饮食与生殖相关疾病的发生风险增加有关,抗炎饮食则与生殖相关疾病的发生风险降低有关。促炎饮食及其组分可升高机体内的炎症水平,促使慢性子宫内膜炎、多囊卵巢综合征、卵巢癌及子宫内膜癌等多种疾病的发生,也可对男性精子浓度和总活力等产生影响,从而导致不孕不育。综述DII与生殖相关疾病的关系和临床机制,并从疾病的预防和控制方面提出饮食建议,以期为临床治疗和护理提供参考。     

SARS-CoV-2对生育的影响

近年严重急性呼吸综合征冠状病毒2（severe acute respiratory syndrome corona virus 2,SARS-CoV-2）大流行对人类健康造成了威胁。研究表明,SARS-CoV-2对人类生育能力有潜在影响,对男性生育力的影响远大于女性。目前研究表明接种疫苗可能不会对人类的生育能力存在不利影响。感染SARS-CoV-2会不会发生性传播、垂直传播及母婴传播,从而对下一代产生影响,目前暂不清楚。尚需要从生殖医学科、传染病学科角度探讨SARS-CoV-2及其疫苗对生育的影响,并讨论可能存在的性传播、垂直传播和母婴传播,以提高对SARS-CoV-2及其疫苗的认识。