Transarterial chemoembolization with hepatic arterial infusion chemotherapy plus S-1 for hepatocellular carcinoma

BACKGROUND Transarterial chemoembolization(TACE) and hepatic arterial infusion chemotherapy(HAIC) have shown promising local benefits for advanced hepatocellular carcinoma(HCC). S-1, a composite preparation of a 5-fluorouracil prodrug, has proven to be a convenient oral chemotherapeutic agent with definite efficacy against advanced HCC.AIM To evaluate the efficacy and safety of TACE followed by HAIC with or without oral S-1 for treating advanced HCC.METHODS In this single-center, open-label, prospective, randomized controlled trial, 117 participants with advanced HCC were randomized to receive TACE followed by oxaliplatin-based HAIC either with(TACE/HAIC + S-1, n = 56) or without(TACE/HAIC, n = 61) oral S-1 between December 2013 and September 2017. Two participants were excluded from final analysis for withdrawing consent. The primary endpoint was progression-free survival(PFS) and secondary endpoints included overall survival(OS), objective response rate, disease control rate and safety.RESULTS In total, 115 participants(100 males and 15 females; mean age, 57.7 years ± 11.9) were analyzed. The median PFS and OS were 5.0 mo(0.4–58.6 mo)(95% confidence interval(CI): 3.82 to 6.18) vs 4.4 mo(1.1–54.4 mo)(95%CI: 2.54 to 6.26; P = 0.585) and 8.4 mo(0.4–58.6 mo)(95%CI: 6.88 to 9.92) vs 8.3 mo(1.4–54.4 m)(95%CI: 5.71 to 10.96; P = 0.985) in the TACE/HAIC + S-1 and TACE/HAIC groups, respectively. The objective response rate and disease control rate were 30.9% vs 18.4% and 72.7% vs 56.7% in the TACE/HAIC + S-1 and TACE/HAIC groups, respectively. Grade 3/4 adverse events had a similar frequency in both treatment groups.CONCLUSION No improvements in tumor response rates, PFS or OS were observed with the addition of S-1 to TACE/HAIC in advanced HCC. Both treatment regimens had a similar safety profile.     

The harmonic scalpel versus electrocautery for parotidectomy: A meta - analysis

ObjectiveParotidectomy is the most classic and unequivocal intervention for parotid neoplasm. The operative outcomes and postoperative complications of parotidectomy between harmonic scalpel and electrocautery gained more prominence in physician. In spite of much research work within the past years, there was an obvious lack of randomized controlled trial to resolve this question. Hence, a quantitative and qualitative meta-analysis was essential to evaluate the differences in these two types of hemostasis method.MethodThe major electronic databases, including Pubmed, Embase, Cochrane library, Google Scholar, China National Knowledge Infrastructure and Chinese Scientific and Technological Journal databases were using the key words “electrocautery”, “electrocoagulation”, “harmonic scalpel”, “ultrasonic scalpel”, “ultrasonic dissector”, “parotidectomy” and “parotid surgery”. 9 articles were included in our systematic review and meta-analysis. The operative time, intraoperative blood loss, hospital stay, salivary fistula and transient facial nerve paralysis were the outcome measures. Odds ratios (ORs) with 95% confidence intervals (CIs) were employed to evaluate the effect size for categorical outcomes and mean differences (MDs) with 95% confidence intervals (CIs) for continuous outcomes.ResultsIn our meta-analysis, there was a significant reduction in operation time [mean difference: ?20.97; 95%CI=(?24.02,?17.92); P < 0.00001], intraoperative blood loss [mean difference: ?20.75, 95%CI=(?22.32,?19.18); P < 0.00001], hospital stay [mean difference: ?0.83; 95%CI=(?1.10,?0.57); P < 0.00001], salivary fistula [ORs: 0.30, 95%CI=(0.08,1.14)] and transient facial nerve paralysis [OR:0.33, 95%CI=(0.19,0.58),P = 0.0001] in harmonic scalpel group compared with electrocautery group.ConclusionThis meta-analysis indicated that compared with electrocautery, harmonic scalpel (HS)was transcendent in the aspects of operative time, intraoperative blood loss, hospital stay, salivary fistula and transient facial nerve paralysis. The harmonic scalpel, as an efficient and useful instrument, was advocated in parotidectomy.     

Coexpression of SGLT1 and EGFR is associated with tumor differentiation in oral squamous cell carcinoma

Overexpression of epidermal growth factor receptor (EGFR) is associated with resistance to chemotherapy and radiotherapy, advanced tumor stage, invasion, metastasis and poor prognosis in malignant tumors. EGFR, therefore, has been an attractive molecular target for chemotherapy. However, the results of clinical studies using inhibitors of its kinase activity have not been promising because the response rates were at most 20%. Sodium-glucose co-transporter 1 (SGLT1) is a membrane protein that mediates the transport of glucose across cellular membranes. EGFR physically associates with and stabilizes SGLT1 to promote glucose uptake into cancer cells through a kinase-independent process. The purpose of this study was to investigate the coexpression of SGLT1 and EGFR and its relationships with clinicopathological features in oral squamous cell carcinoma (OSCC). SGLT1 and EGFR were detected in all OSCC cell lines, and the expression levels of SGLT1 were significantly correlated with those of EGFR. Pearson product?Cmoment correlation coefficient of SGLT1 and EGFR was 0.89 (P?=?0.016). The immunohistochemical study using the surgical specimens in 52 patients with tongue SCC also showed a significant correlation between SGLT1 and EGFR. Moreover, SGLT1/EGFR expression was inversely related to tumor differentiation among the 5 clinicopathological factors (P?=?0.004). SGLT1/EGFR coexpression might be required in the de-differentiation of OSCC, but further study is needed to clarify the implication of these proteins in the manifestation of malignancy and clinical significance.     

Decreased frontal lobe function in people with Internet addiction disorder

In our previous studies, we showed that frontal lobe and brainstem functions were abnormal in online game addicts. In this study, 14 students with Internet addiction disorder and 14 matched healthy controls underwent proton-magnetic resonance spectroscopy to measure cerebral function. Results demonstrated that the ratio of N-acetylaspartate to creatine decreased, but the ratio of cho- line-containing compounds to creatine increased in the bilateral frontal lobe white matter in people with Internet addiction disorder. However, these ratios were mostly unaltered in the brainstem, suggesting that frontal lobe function decreases in people with Internet addiction disorder.     

生理学课中加入诺贝尔生理医学奖的教育推进器

诺贝尔生理学或医学奖是生物医学奖中的最高奖项,在生理学教学中加入诺贝尔生理学或医学奖的教育推进器能提高教学质量,及培养学生的综合素质和科研创新能力。     

Determining early gastric cancer lesions appropriate for endoscopic submucosal dissection trainees: a proposal related to curability

Endoscopic submucosal dissection (ESD) was introduced worldwide as a new treatment option for early gastric cancer. Our objective was to discuss the limited ESD reports available and to determine the lesions suitable for use in training endoscopists on which lesions are appropriate for ESD. We reviewed a series of ESD reports that have been written on various risk factors related to the resectability or curability of a variety of lesions. These published studies show that certain risk factors such as tumor size and location and the presence of ulceration are closely related to both resectability and curability. Because the combination of these risk factors resulted in a much higher risk than did any single factor, we recently established a 'risk assessment chart' to determine an individual's total risk of treatment failure for early gastric cancer that has been treated using ESD. This risk chart provides a clear indication that small, non-ulcerated lesions located in the lower third of the stomach have a high rate of curative resection and are technically less challenging if ESD is used. We suggest that trainees should gain ESD experience with such lesions before they start to perform ESD on more difficult lesion types that have a lower probability of curative resection. In addition, we suggest that this risk assessment chart is suitable for the pretreatment assessment of curability and the likelihood of successful en bloc resection.     

瓜蒌皮提取物对PDGF-BB所致血管平滑肌细胞增殖周期的影响

目的 研究瓜蒌皮提取物对血小板源生长因子BB所致血管平滑肌细胞增殖周期的影响并探讨其可能机制.方法 组织块贴块法培养SD大鼠胸主动脉平滑肌细胞,3H-TdR掺入观察瓜蒌皮提取物(10、20和30mg/L)对血小板源生长因子BB(20 μg/L)所致血管平滑肌细胞DNA合成的影响;流式细胞仪分析细胞增殖周期;real time RT-PCR检测血管平滑肌细胞中c-fos、c-myc mRNA表达.结果 血小板源生长因子BB可明显升高细胞每分钟脉冲数(P＜0.01),并增加S期细胞比例而降低G0/G1期细胞比例(P＜0.01),并上调c-fos、c-myc mRNA表达(P＜0.01).瓜蒌皮提取物各浓度组均明显抑制血小板源生长因子BB诱导的每分钟脉冲数升高(P＜0.01),降低S期细胞比例而升高G0/G1期细胞比例,明显下调血小板源生长因子BB所致的c-fos、c-myc mRNA高表达(P＜0.01).结论 瓜蒌皮提取物通过阻止血管平滑肌细胞由G0/G1期进入S期而抑制血小板源生长因子BB所致的增殖,其作用机制可能与降低细胞内c-fos、c-myc mRNA高表达有关.     

Properties and mechanism for selective adsorption of Au(iii) on an ionic liquid adsorbent by grafting N-methyl imidazole onto chloromethylated polystyrene beads

To recover Au(iii) from an acidic chloride-containing solution efficiently, an ionic liquid absorbent (CMPS-IL) was synthesized by grafting N-methyl imidazole onto chloromethylated polystyrene beads (CMPS). The adsorption capacity, selectivity, and reusability were systematically evaluated by a series of adsorption experiments. The maximum adsorption capacity reached up to 516.5 mg g⁻¹ at 318 K. The adsorbent can selectively recover Au(iii) from binary system solutions with a higher separation factor β_Au/M (10⁴–10⁶). Moreover, the adsorption–desorption cycles (7 cycles) showed that the CMPS-IL maintained a stable adsorption performance and high adsorption efficiency. Finally, the adsorption mechanism of CMPS-IL for Au(iii) was investigated by SEM, TEM, XPS, and FT-IR, then proposed with a combination of electrostatic interactions and d–π interaction between imidazolium and AuCl₄⁻. This study provides an easily-prepared and economical adsorbent for Au(iii) with high selectivity and large adsorption capacity to boost its practical applications.

The synthesis and adsorption properties for Au(iii) of CMPS-IL synthesized by grafting N-methyl imidazole onto chloromethylated polystyrene beads (CMPS).