OBJECTIVETo compare the predictive values of eight staging systems for primary liver cancer in the prognosis of combined hepatocellular-cholangiocellular carcinoma (cHCC-CC) patients after surgery.

METHODSThe clinical data of 54 cHCC-CC patients who underwent hepatectomy or liver transplantation from May 2005 to Augest 2013 in Chinese PLA General Hospital were collected. We evaluated the prognostic value of the Okuda staging system, Cancer of the Liver Italian Program (CLIP) score, French staging system, Barcelona Clinic Liver Cancer (BCLC) staging system, 7th edition of tumour-node-metastasis (TNM) staging system for hepatocellular carcinoma and intrahepatic cholangiocarcinoma (ICC), Japan Integrated Staging (JIS) score, and Chinese University Prognostic Index. The distribution, Kaplan-Meier method, Log-rank test, and area under a receiver operating characteristic curve were used to compare the prognosis-predicting ability of these different staging systems in 54 cHCC-CC patients after surgery.

RESULTSThe TNM staging system for ICC and JIS score had a better distribution of cases. The 12-and 24-month survivals of the entire cohort were 65.5% and 56.3%, respectively. A Log-rank test showed that there was a significant difference existing in the cumulative survival rates of different stage patients when using TNM staging system for ICC (stage 1 vs. stage 2, P=0.012; stage 2 vs. stage 3-4, P=0.002), Okuda staging system (stage 1 vs. stage 2, P=0.025), and French staging system (stage A and stage B, P=0.045). The 12-and 24-month area under curve of TNM staging system for ICC, BCLC staging system, JIS score, and CLIP score were 0.836 and 0.847, 0.744 and 0.780, 0.723 and 0.764, and 0.710 and 0.786, respectively.

CONCLUSIONThe 7th edition of TNM staging system for ICC has superior prognostic value to other seven staging systems in cHCC-CC patients undergoing surgical treatment.

Bile Duct Neoplasms ; diagnosis ; surgery ; Carcinoma, Hepatocellular ; diagnosis ; surgery ; Cholangiocarcinoma ; diagnosis ; surgery ; Hepatectomy ; Humans ; Liver Neoplasms ; diagnosis ; surgery ; Neoplasm Staging ; methods ; Predictive Value of Tests ; Prognosis ; ROC Curve ; Survival Rate

OBJECTIVETo study the role of NY-ESO-1 and LAGE-1 cancer-testis antigens as targets for immunotherapy and the relationship between corresponding gene expression and biologic behavior of hepatocellular carcinoma (HCC).

METHODSThe expression of NY-ESO-1 and LAGE-1 was studied in frozen tumor tissues from 30 cases of HCC by reverse transcriptase-polymerase chain reaction and immunohistochemistry. NY-ESO-1 expression and its distribution were further studied by immunohistochemistry in a tissue array contained 191 cases of HCC.

RESULTSNY-ESO-1 and LAGE-1 mRNAs were expressed in 33.3% (10/30) and 16.7% (5/30) of HCC respectively. Either NY-ESO-1 or LAGE-1 was expressed in 36.7% (11/30) cases. NY-ESO-1 was expressed mainly in the cytoplasm of tumor cells. It was positive in 13.8% (24/174) cases of HCC. There was an increased expression of NY-ESO-1 from 6.8%, 3/44 in small HCC, 16.2%, 21/130 in advanced HCC and 23.1%, 12/52 in metastatic HCC. The expression in the non-metastatic group was 9.8% (12/122). The differences between the metastatic group and non-metastatic group (< 0.05) and between normal liver tissue and HCC (< 0.01) were statistically significant. There was no relationship between NY-ESO-1 expression and tumor size. NY-ESO-1 and LAGE-1 were not detected in adjacent normal liver tissue.

CONCLUSIONSNY-ESO-1 and LAGE-1 are expressed in a high percentage of HCC, especially in cases with metastasis. It is thus possible that NY-ESO-1/LAGE-1 can serve as targets for antigen-specific immunotherapy in HCC and NY-ESO-1 peptide vaccination may be of use for patients with advanced HCC.

Adult ; Aged ; Antigens, Neoplasm ; biosynthesis ; genetics ; Antigens, Surface ; biosynthesis ; genetics ; Carcinoma, Hepatocellular ; metabolism ; pathology ; Female ; Gene Expression Regulation, Neoplastic ; Humans ; Liver ; metabolism ; pathology ; Liver Neoplasms ; metabolism ; pathology ; Male ; Membrane Proteins ; biosynthesis ; genetics ; Middle Aged ; Neoplasm Metastasis ; Neoplasm Staging ; RNA, Messenger ; biosynthesis ; genetics

Objective To study the epidemiological significance of community-structural difference regarding both small mammal and flea communities on Rattus ftavipectus in Dehong and Baoshan areas,Yunnan province,during 1982 to 1996.Methods Methodologies as cluster analysis,communities dominated constitution and species diversity were used for data analysis.Results 75 490 small mammals of 27 species could be divided into three types:Ⅰ.Ruili habitat-communities dominated bv R.flavipectus (54.41%)and Suncus murinus(33.37%): Ⅱ.Longchuan and Yingiiang habitat-communities dominated by R.flavipectus(62.99%),S.murinus(23.25%)and Mus musculus(10.06%);Ⅲ.Baoshan habitat-community dominated by R.flavipectus(48.07%),S.murinus(19.56%)and Crocidura attenuats(14.37%).The captured 61 122 fleas of 11 species on R.flavipectus could be divided into three types: i.Ruili habitat-communities dominated by Xenopsylla cheopis(83.51%)and Lentistivslius ferinus(13.86%);ii.Longchuan and Yingjiang habitats X.cheopis(74.42%)and L.segnis(22.94%); iii.Baoshan habitat-communities dominated by L.segnis(70.62%)and X.cheopis(22.70%).There had been 1471 strains of Y.pestis isolated from the hosts of 7 species and vectors of 5 species in Dehong areas for the ten year period.36 strains of Y.pestis were isolated from host of one species and vectors of 2 species in Baoshan area for ten years.The constitution ratio of R.flavipectus and X.cheopis was higher in Dehong area with average as 58.70%and 78.97%respectively.However.the diversities of species among host and vector communities were low,with average as 1.010 and 0.625.On the contrary,the constitution ratios of R.flavipectus and X.cheopis were lower in Baoshan area.with an average as 48.07%and 22.70%respectively but the diversities of species among host and vector community were higher with the averages as 1.471 and 0.829 respectively.The main dominative flea species from 'group ii'to 'group iii'in the flea community had changed from X.cheopis to L.segnis.Conclusion The species diversity index of host and vector community was higher in Baoshan area,while the constitution ratio of main host and vector community was lower.This findings seemed to be the important factor of the decrease of plague prevalence in Baoshan area.

Objective To evaluate the efficacy and safety of isotretinoin and viaminate for the treatment of moderate to severe acne vulgaris.Methods A multiple-centre,double-blind,double-analog comparative clinical trial was conducted.Patients diagnosed with moderate to severe acne by GAGS (global acne grading system) were randomly divided into isotretinoin group (10 mg,bid) and viaminate group (50 mg,tid);treatment was done for a total of 6 weeks.All subjects were evaluated before treatment,and at 2,4,6 weeks after the initiation of treatment,for evaluation of lesion count,and for observation of thera- peutic effects and side effects.Results A total of 217 patients were enrolled this trial,of which,213 could be evaluated in a FAS (Full Analysis Set) analysis and 200 in a PPS (per protocol) analysis.There was no significant difference in the efficacy at 2,4,6 weeks after the initiation of treatment between the isotretinoin group and viaminate group (6.0% vs 5.0%,29.0% vs 20.0%,57.0 % vs 51.0 %,respectively). However,the inflammatory papules and pustules decreased more rapidly in the isotretinoin group than in the viaminate group at each of the follow up evaluations (all P＜0.05).There was no obvious difference in the rate of clearance of comedones and nodules between the two groups.Both the occurrence rate (68.81% vs 36.53%,P＜0.001) and severity (P＜0.05) of side effects were higher in the isotretinoin group than in the viaminate group.The main adverse events included mouth dryness,dizziness,etc,occurred more fre- quently in the isotretinoin group than in the viaminate group.Conclusion For the treatment of moderate to severe acne,the efficacy of isotretinoin is similar to that of viaminate;however,isotretinoin has more imme- diate effect with more side effects than viaminate.

OBJECTIVETo establish a database and to understand the molecular epidemiological features of non-O157 Shiga toxin-producing Escherichia coli (STEC) isolates from different animal reservoirs and patients.

METHODSPulsed-field gel electrophoresis (PFGE) was performed according to the PulseNet protocol with minor modifications. A dendrogram was constructed using the BioNumerics.

RESULTSUnder the PulseNet protocol, 62 PFGE patterns were obtained from 76 non-O157 STEC isolates and then divided into A to M groups. Isolates from different sources were widely distributed in different groups, but were predominant seen in certain groups.

CONCLUSIONThe non-O157 STEC isolates in China were highly polymorphic. PulseNet protocol seemed to be suitable for the typing of Chinese non-O157 STEC isolates.

Animals ; China ; epidemiology ; DNA, Bacterial ; Electrophoresis, Gel, Pulsed-Field ; Escherichia coli Infections ; epidemiology ; microbiology ; Escherichia coli O157 ; genetics ; isolation & purification ; Feces ; microbiology ; Genotype ; Humans ; Shiga-Toxigenic Escherichia coli

OBJECTIVEGenetic factors are thought to be involved in the development of vitiligo. The aim of this study is to explore the possible genetic model of vitiligo by analyzing the genetic characteristics of 815 patients from Zhejiang province.

METHODSData for 815 patients with vitiligo together with their first- and second-degree relatives were obtained using a standardized questionnaire. All these information was requested to confirm the answers about family history in order to reduce the possibility of 'recall' bias. The 815 probands would include 411 (50.43%) males and 404 (49.57%) females with a varied age from 2 months to 71 years old. Since the information on general prevalence of vitiligo in this area was absent, a control group was set up to facilitate the calculations of heritability degree. 468 persons of the control group were from non-vitiligo population with a sex ratio of 241(male): 227(female) with varied age of 4 months to 80 years old. Both gender and age were comparable between the vitiligo and the control population. The inheritance pattern estimation, heritability calculation and complex segregation analysis were performed with Penrose method, Falconer regression method and SAGE-REGTL program.

RESULTSIn 815 vitiligo probands, 128 had and 687 had not family histories, with a heritability rate of 15.7%. The vitiligo prevalence in proband's first degree relatives was 2.580%, higher than the prevalence of 0.618% in second degree relatives, and both of them were higher than general prevalence: 0.192%. By Penrose method, the rates on different catagories were as follows: sibling prevalence rates s = 0.080 18; population prevalence rate q = 0.001 92; s/q = 41.76. The ratio of s/q did not approach 1/2q (260.42) or 1/4q (130.21), but approached 1/square root of q(22.82), suggesting vitiligo was consistent with a mode of polygenic inheritance. Using Falconer's method, heritabilities of vitiligo in first-and second degree relatives of probands were 59.61% (95% confidence interval 65.37-53.84) and 55.20% (95% confidence interval 43.88-66.52), respectively. The weighted average of heritability in all relatives was 58.7% (95% confidence interval 53.56-63.83). The results of complex segregation analysis suggested that major gene model including the Mendelian dominant, recessive and additive hypotheses were not rejected (P > 0.05). Purely environmental model and no transmission model were rejected at a 0. 001 significance level. According to AIC, Mendelian dominant inheritance was the best-fitted hypothesis.

CONCLUSIONGenetic factors played an important role in the occurrence of vitiligo, and the genetic model of vitiligo could serve as the polygenetic or multifactorial inheritance with major gene trait.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Infant ; Male ; Middle Aged ; Models, Genetic ; Vitiligo ; epidemiology ; genetics ; Young Adult

OBJECTIVETo study and improve the tissue culture technology of Panax notoginseng.

METHODUsing the callus of leaf blade and leafstalk of P. notogingseng as explants, MS + 2, 4-D 1.5 mg x L(-1) as basal medium, the formation of asexual embryos was induced by added LFS, BA, KT or ZT 0.5 mg x L(-1), and cultured in dark. It cultured then in 2000 lx of illumination for 10-12 h x d(-1) to induce the asexual embryos germinating and developing to be the regenerated-plantlet.

RESULT AND CONCLUSIONOnly the medium added with LFS could induce the formation of asexual embryos, and made it developed to be regenerated-plantlet. The inducing ratio of asexual embryos reached about 85%, and 30% of asexual embryos could grow and develop as robust regenerated-plantlets.

Culture Media ; pharmacology ; Panax notoginseng ; embryology ; physiology ; Plant Growth Regulators ; pharmacology ; Plant Leaves ; embryology ; physiology ; Plants, Medicinal ; embryology ; physiology ; Regeneration ; drug effects ; physiology ; Tissue Culture Techniques

Objective To understand the situation of depression and its related influencing factors among medical staff in Hunan province.Methods Data were collected through random sampling with multi-stage stratified cluster.Wilcoxon rank sum test,Kruskal-Wallis H test and Ordinal regression analysis were used for data analysis by SPSS 17.0 software.Results This survey was including 16 000 medical personnel with 14 988 valid questionnaires and the effective rate was 93.68％.Results from the single factor analysis showed that factors as:level of the hospital grading,gender,education background,age,occupation,title,departments,the number of continue education,income,working overtime every week,the frequency of night work,the number of patients treated in the emergency room etc.,had statistical significances (P＜0.05).Data from ordinal regression showed that the probabilities related to depression that clinicians and nurses suffering from were 1.58 times more than the pharmacists (OR=1.58,95％ CI:1.30-1.92).The probability among those whose income was less than 2000 Yuan/month was 2.19 times of the ones whose earned more than 3000 Yuan/month (OR=2.19,95％CI:2.05-2.35).The higher the numbers of days with working overtime every week,the frequencies of night work,and the numbers of patients being treated at the emergency room,with more probabilities of the people with depression seen in our study.Conclusion Depression seemed to be common among doctors and nurses.We suggested that the government need to increase the monthly income and to reduce the workload and intensity,lessen the overworking time,etc.

Objective: To improve the knowledge and experience of ibrutinib combined with CAR-T cells in the treatment of high-risk chronic lymphoblastic leukemia (CLL) patients or small lymphocytic lymphoma (SLL) with TP53 gene aberration. Methods: One case of del (17p) CLL patients with BCL-2 inhibitor resistance was treated with ibrutinib combined with CAR-T cells, successfully bridged to allogeneic hematopoietic stem cell transplantation (allo-HSCT) , and the relative literatures were reviewed. Results: The patient was a young female with superficial lymph node enlarging at the beginning of the onset. Lymph node biopsy was confirmed as small lymphocytic lymphoma (SLL) without del (17p) . The disease progressed rapidly to CLL/SLL with del (17p) and bone marrow hematopoietic failure 2 years later. Firstly, the patient was treated with BCL-2 inhibitor (Venetoclax) , and the enlarged lymph nodes shrank significantly 2 months later. After 3 months, the disease progressed rapidly. The spleen was enlarged to 16 cm below the ribs, the neck lymph nodes was rapidly enlarged, and the superior vena cava syndrome appeared, which were mainly attributed to venetoclax resistance; so BTK inhibitor (ibrutinib) was used continuously after venetoclax discontinuation. Partial remission (PR) was achieved without lymphocytosis after 2 months, then ibrutinib was combined with CAR-T cells targeting CD19 antigen. Grade 1 of cytokine release syndrome (CRS) appeared after CAR-T cells infusion, and the complete remission (CR) was achieved after 1 month both in bone marrow and peripheral blood, with minimal residual disease (MRD) negative, then bridging allo-HSCT after 2 months of combined therapy. Conclusion: CLL/SLL patients with TP53 aberration have poor prognosis because of rapid progression, drug resistance, etc. Ibrutinib combined with CAR-T cell therapy can quickly achieved complete remission.
Adenine/analogs & derivatives* ; Female ; Humans ; Leukemia, Lymphocytic, Chronic, B-Cell/therapy* ; Piperidines ; Proto-Oncogene Proteins c-bcl-2 ; Pyrazoles/therapeutic use* ; Pyrimidines/therapeutic use* ; Recoverin ; T-Lymphocytes

Objective To explore the effect of hydrogen sulfide (H2S) on the expression of survivin in PC12 cells and the neuroprotective function of H2S on PC12 cells.Methods Different concentrations of sodium hydrosulfide (NaHS) were used to treat the PC12 cells at different times.Dose-effect (50-800 μmol/L) and time-effect (0-180 min) on the expression of survivin were evaluated by Western blotting.Cell viability was tested by using cell counter kit-8.Results NariS treatment at the concentrations from 50 to 200 μmol/L for 30 min could up-regulate the expression of survivin in a dose dependent manner,however,when the concentration of NariS was above that,the expression of survivin decreased gradually;when the concentration of NariS reached 800 μmoi/L,the expression level of survivin was lower than the normal level.Treatment with 400 μmol/L NariS within the range of 0-60 min could promote the expression of survivin in a time dependent manner,but with the extension of time,the expression of survivin was declined.On the other hand,400 μmol/L NaHS preconditioning could enhance the expression of survivin promoted by CoCl2 and reduce the injuries of PC12 cells induced by CoCl2 to increase the cell viability.Conclusion H2S increases the expression ofsurvivin in a dose and time dependent manners at certain degree,which may be related to the protection of PC12 cells against chemical hypoxic damage.