1.Long-term outcomes and prognostic factors of surgical resection of hepatitis B virus-related solitary large hepatocellular carcinoma
Shilei BAI ; Hongjun XIANG ; Yong XIA ; Jun LI ; Pinghua YANG ; Feng SHEN
Chinese Journal of Digestive Surgery 2017;16(2):151-158
Objective To investigate the prognosis of patients with solitary large hepatocellular carcinoma (SLHCC) and with small hepatocellular carcinoma (SHCC),and analyze the risk factors affecting the prognosis of patients with SLHCC.Methods The retrospective case-control study was conducted.The clinicopathological data of 856 patients with hepatitis B virus (HBV)-related HCC who were admitted to the Eastern Hepatobiliary Surgery Hospital of the Second Military Medical University from January 2008 to December 2008 were collected.Of 856 patients,693 HCC patients with tumor diameter ≤5 cm were allocated into the SHCC group and 163 HCC patients with tumor diameter > 5 cm and with solitary,expansive growth and complete capsule tumors were allocated into the SLHCC group.Patients underwent preoperative antiviral therapy,laboratory and imaging examinations,and then surgical planning was determined based on the preoperative results.Observation indicators:(1) comparisons of clinicopathological features between the 2 groups:sex,age,Child-Pugh grade,HBeAg,serum level of HBV-DNA,platelet (PLT),albumin (Alb),total bilirubin (TBil),alpha-fetoprotein (AFP),tumor diameter,microvascular invasion,Edmondson-Steiner grade and liver cirrhosis;(2) treatment situations between the 2 groups:surgical procedures,operation time,volume of intraoperative blood loss,number of patients with blood transfusion and time of hepatic inflow occlusion;(3) survival analysis between the 2 groups;(4) prognostic analysis of patients with SLHCC.Follow-up using telephone interview and outpatient examination was performed once every 3 months within 2 years postoperatively and once every 6 months after 2 years postoperatively up to June 23,2014.Follow-up included tumor marker,liver function,serum level of HBV-DNA and abdominal B-ultrasound examination.The patients received reexamination of computed tomography (CT) or magnetic resonance imaging (MRI) once every 6 months or when there was suspicion of tumor recurrence or metastasis.Tumor recurrence or metastasis was confirmed through typical HCC imaging findings of CT and MRI,and PET/CT examination was conducted if necessary.Tumor-free survival time was from operation time to time of tumor recurrence,and overall survival time was from operation time to death or the last follow-up.Measurement data with normal distribution were represented as-x±s,and continuous variables were analyzed by the t test or Mann-Whitney U test.Measurement data with skewed distribution were described as M (range).Categorical variables were represented as count (percentage) and analyzed by the chi-square test or calibration chi-square test.The survival curve and survival rate were respectively drawn and calculated by the Kaplan-Meier method and Log-rank test.COX regression model was used for prognostic analysis.Results (1) Comparisons of clinicopathological features between the 2 groups:number of patients with PLT< 100× 109/L,with positive microvascular invasion and with liver cirrhosis and tumor diameter were 197,133,447,(3.1±1.1)cm in the SHCC group and 28,53,79,(8.9±3.3) cm in the SLHCC group,respectively,with significant differences between the 2 groups (x2=28.618,t =37.286,x2 =213.773,214.325,P < 0.05).(2) Treatment situations between the 2 groups:all the 856 patients underwent hepatectomy,including 326 with hepatic segments of resection ≥ 3 and 530 with hepatic segments of resection < 3.Operation time,volume of intraoperative blood loss,number of patients with intraoperative blood transfusion and with time of hepatic inflow occlusion > 20 minutes were 90 minutes (range,60-200 minutes),200 mL (range,20-5 200 mL),47,125 in the SHCC group and 110 minutes (range,60-230 min),300 mL (range,50-3 200 mL),31,58 in the SLHCC group,respectively.(3) Survival analysis between the 2 groups:all the 856 patients were followed up for 32.5 months (range,1.O-72.3 months).The median survival time,median tumor-free survival time,1-,3-,5-year overall survival rates and 1-,3-,5-year tumor-free survival rates were 56.2 months (range,1.6-75.8 months),39.5 months(range,1.0-75.0 months),90%,71%,58%,70%,48%,38% in the SHCC and 50.3 months (range,1.1-76.0 months),30.7 months (range,1.0-72.0 months),87%,59%,47%,65%,46%,33% in the SLHCC group,respectively,with no significant difference in tumor-free survival between the 2 groups (x2=0.514,P>0.05) and with a significant difference in overall survival between the 2 groups (x2=10.067,P<0.05).Stratified analysis:there were 117 SLHCC patients with 5 cm < tumor diameter < 10 cm and 46 SLHCC patients with tumor diameter > 10 cm.The 1-,3-,5-year overall survival rates and 1-,3-,5-year tumor-free survival rates were 91%,65%,53%,70%,48%,35% in 117 SLHCC patients with 5 cm < tumor diameter < 10 cm,respectively,with no significant difference compared with SHCC group (x2=1.832,0.042,P>0.05).The 1-,3-,5-year overall survival rates and 1-,3-,5-year tumor-free survival rates were 78%,46%,31%,49%,39%,30% in 46 SLHCC patients with tumor diameter > 10 cm,respectively,with significant differences compared with SHCC group (x2=21.136,4.097,P<0.05).(4) Prognostic analysis of patients with SLHCC:results of univariate analysis showed that serum level of HBV-DNA,tumor diameter and microvascular invasion were risk factors affecting postoperative 5-year tumor-free survival rate of SLHCC patients (x2 =5.193,3.377,5.509,P<0.05);sex,serum level of HBV-DNA,tumor diameter and microvascular invasion were risk factors affecting postoperative 5-year overall survival rate of SLHCC patients (x2=4.546,18.053,7.780,10.569,P<0.05).Results of multivariate analysis showed that serum level of HBV-DNA ≥ 104 U/mL,tumor diameter > 10 cm and positive microvascular invasion were independent risk factors affecting postoperative 5-year tumor-free survival rate of SLHCC patients [HR =2.77,1.85,1.86,95% confidence interval (CI):1.74-4.40,1.16-2.94,1.17-2.96,P< 0.05] and affecting postoperative 5-year overall survival rate of SLHCC patients (HR=2.73,1.98,1.69,95%CI:1.72-4.33,1.23-3.17,1.04-2.72,P<0.05).Conclusions There are similar prognosis between SLHCC patients with 5 cm < tumor diameter < 10 cm and SHCC patients,however,prognosis of SLHCC patients with tumor diameter > 10 cm is worse than that of SHCC patients.Serum level of HBV-DNA ≥ 104 U/mL,tumor diameter > 10 cm and positive microvascular invasion are independent risk factors affecting prognosis of SLHCC patients.
2.Effect of p120 catenin silencing on biological behaviors of PANC-1 cells.
Zhangjun, CHENG ; Volker, ASSFAG ; Xin, SHI ; Shibo, LIN ; Jiangyan, XIA ; Pinghua, YANG ; Norbert, HÜSER ; Feng, SHEN
Journal of Huazhong University of Science and Technology (Medical Sciences) 2012;32(5):707-12
This study examined the possible role of p120ctn in the pathogenesis and development of pancreatic cancer. PANC-1 cells, a kind of human pancreatic carcinoma cell line, were cultured in this study. p120ctn was immunocytochemically detected in PANC-1 cells. The recombinant lentivirus vector was constructed to knock down the p120ctn expression of PANC-1 cells. Real-time quantitative PCR (RQ-PCR) and Western blotting were used to determine the expression of p120ctn and E-cadherin in PANC-1 cells after p120ctn knockdown. The adhesion, invasion and migration capacity of PANC-1 cells after p120ctn knockdown was detected by cell adhesion, invasion and migration assays. Cell growth was measured by the MTT method. Cell cycle and apoptosis were analyzed by fluorescence-activated cell sorting. The results showed that p120ctn knockdown led to significantly down-regulated E-cadherin and a reduced cell-to-cell adhesion ability in PANC-1 cells. shRNA-mediated knockdown of p120ctn reduced invasion and migration capacity of PANC-1 cells, inhibited cell growth, caused a significant decrease in the percentage of cells in G(1), an increase in S, and promoted apoptosis of PANC-1 cells. It was concluded that p120ctn plays a pivotal role in the proliferation and metastasis of pancreatic carcinoma, suggesting that p120ctn is a novel target for pancreatic carcinoma treatment.
3.Study of anti-fatigue effect of methylphenidate hydrochloride oral fast dissolving films and its mechanism
Lihong ZHANG ; Pinghua XU ; Na WU ; Chengying SHEN ; Hailong YUAN ; Jin HAN
Journal of Pharmaceutical Practice 2015;(6):522-524
Objective To study the anti-fatigue effect of methylphenidate hydrochloride oral fast dissolving films (MPH-OFDF) and its mechanism .Methods 60 mice were randomly divided into 6 groups as:normal control group (physiological sa-line) ,model group (physiological saline) ,Yiqiyangxue oral liquids positive group (7 .00 mg/kg) ,MPH-OFDF high-dose group (5 .20 mg/kg) ,MPH-OFDF middle-dose group (2 .60 mg/kg) and MPH-OFDF low-dose group (1 .30 mg/kg) .Besides the normal control group ,model group and positive group were orally administered ,the other groups are administered with the drug once daily sublingually daily for consecutive 15 days .The mice were put in the load-weighted swimming test 30 min after the last oral administration ,then the anti-fatigue effect was assessed based on recording exhausting swimming time and detec-ting the levels of serum lactale dehydrogenase (LDH) ,creatine kinase (CK) ,triglycerides (TG) in mice .Results Compared with control group ,the middle-dose and the high-dose MPH could prolong the exhausting swimming time (P<0 .05 ,P<0 .01) and decrease the activity of LDH and CK significantly (P<0 .05 ,P<0 .01);in addition the middle-dose MPH could decrease the content of TG (P<0 .05) .Conclusion The MPH had marked anti-fatigue effect that may be associated with reduced ser-um LDH ,CK and TG .
4.Effect of p120 catenin silencing on biological behaviors of PANC-1 cells.
Zhangjun CHENG ; Volker ASSFAG ; Xin SHI ; Shibo LIN ; Jiangyan XIA ; Pinghua YANG ; Norbert HÜSER ; Feng SHEN
Journal of Huazhong University of Science and Technology (Medical Sciences) 2012;32(5):707-712
This study examined the possible role of p120ctn in the pathogenesis and development of pancreatic cancer. PANC-1 cells, a kind of human pancreatic carcinoma cell line, were cultured in this study. p120ctn was immunocytochemically detected in PANC-1 cells. The recombinant lentivirus vector was constructed to knock down the p120ctn expression of PANC-1 cells. Real-time quantitative PCR (RQ-PCR) and Western blotting were used to determine the expression of p120ctn and E-cadherin in PANC-1 cells after p120ctn knockdown. The adhesion, invasion and migration capacity of PANC-1 cells after p120ctn knockdown was detected by cell adhesion, invasion and migration assays. Cell growth was measured by the MTT method. Cell cycle and apoptosis were analyzed by fluorescence-activated cell sorting. The results showed that p120ctn knockdown led to significantly down-regulated E-cadherin and a reduced cell-to-cell adhesion ability in PANC-1 cells. shRNA-mediated knockdown of p120ctn reduced invasion and migration capacity of PANC-1 cells, inhibited cell growth, caused a significant decrease in the percentage of cells in G(1), an increase in S, and promoted apoptosis of PANC-1 cells. It was concluded that p120ctn plays a pivotal role in the proliferation and metastasis of pancreatic carcinoma, suggesting that p120ctn is a novel target for pancreatic carcinoma treatment.
Catenins
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genetics
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Cell Line, Tumor
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Gene Silencing
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Humans
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Pancreatic Neoplasms
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genetics
5.The clinical value of Multi-mode ultrasound in evaluating cerebral hemorrhage with intracranial pressure
Lianhua PIAO ; Hongwei RAN ; Pinghua SHEN
Journal of Apoplexy and Nervous Diseases 2022;39(1):22-24
To explore The clinical value of Multimode ultrasound in evaluating cerebral hemorrhage with intracranial pressure(ICP). Methods A total of 17 patients with cerebral hemorrhage who received lumbar puncture according to their medical necessity in the ICU of the Affiliated Hospital of Yanbian University from September 2019 to June 2021 were enrolled. The diameter of optic nerve sheath (ONSD) and transcranial Doppler ultrasound (TCD) were performed before lumbar puncture. The patients were divided into elevated intracranial pressure group (9 cases) and normal intracranial pressure group (8 cases),according to the results of lumbar puncture pressure (more than 200 mmH2O was defined as elevated intracranial pressure,and 80~200 mmH2O was defined as normal intracranial pressure). The Systolic blood pressure,diastolic blood pressure,partial pressure of carbon dioxide,GCS,ONSD and TCD parameters (such as peak systolic velocity,end diastolic velocity,mean blood flow velocity and pulse index of bilateral middle cerebral artery) were compared between the two groups,and the correlation between ICP and ONSD,pulse index(PI) was analyzed. Results (1)The systolic blood pressure,diastolic blood pressure,partial pressure of carbon dioxide (P CO2) and GCS scores between the two groups were not significantly different (all P> 0.05);(2)The ONSD was significantly higher in the elevated intracranial pressure group[(5.15±0.24) mm vs. (3.97±0.22) mm,t=10.69,P<0.001)];(3)The systolic peak flow velocity (PSV),end diastolic flow velocity (EDV) and mean flow velocity (MV) between the two groups were not significantly different(all P> 0.05),while the PI was significantly higher in the elevated intracranial pressure group[Right(1.20±0.19) vs.(0.95±0.12),t=3.148,P=0.007);Left(1.20±0.17) vs. (0.92±0.10),t=3.893,P=0.001)].(4)ICP was significantly associated with PI (r=0.52,P<0.02) and ONSD(r=0.64,P<0.01). Conclusion Combine with Ultrasonographic ONSD measurement and TCD can effectively assess intracranial hypertension in patients with intracerebral hemorrhage.