ObjectiveTo explore the correlation between phosphatase of regenerating liver-3 (PRL-3) and portal vein tumor thrombus in hepatocellular carcinoma (HCC).MethodsClinical data of 248 patients with HCC undergoing hepatectomy in the First People's Hospital of Foshan between December 2003 and December 2008 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval had been received. Among the 248 patients, 193 were males and 55 were females with the age ranging from 18 to 75 years old and the median of 48 years old. Forty-ifve cases were complicated with portal vein tumor thrombus. The expression of PRL-3 in HCC and portal vein tumor thrombus were observed by immunohistochemistry. The correlation between the expression of PRL-3 and the clinicopathological parameters of HCC patients and its signiifcance in portal vein tumor thrombus formation were analyzed. The analysis on the correlation between the expression of PRL-3 and the clinicopathological parameters of HCC was conducted usingχ2 test and the analysis on the risk factors associated with portal vein tumor thrombus formation was conducted using Logistic regression analysis.ResultsThe positive expression rate of PRL-3 in HCC and portal vein tumor thrombus was 70% (174/249) and 98% (44/45) respectively, and the positive expression rate in portal vein tumor thrombus was signiifcantly higher than that in HCC (χ2=15.253,P<0.05). The positive expression of PRL-3 was associated with the serum AFP, tumor diameter, histological differentiation of tumor, portal vein tumor thrombus formation, tumor TNM staging and early recurrence (χ2=4.836, 7.186, 4.226, 5.357, 13.862, 10.824;P<0.05). The positive expression of PRL-3 was the risk factor for portal vein tumor thrombus formation (OR=2.674,P<0.05).ConclusionsPRL-3 expression increases in HCC portal vein tumor thrombus and positive expression of PRL-3 may be closely associated with the invasion and metastasis of HCC.

Objective To evaluate the role of multi-disciplinary team (MDT) in improving the diagnosis and treatment of human herpes virus-6B (HHV-6B) encephalitis after liver transplantation. Methods MDT consultation was delivered for one rare case of HHV-6B encephalitis after liver transplantation to establish an effective individualized treatment regime. Results On the 16 d after liver transplantation, the patient developed headache, and suddenly presented with unresponsiveness, unconsciousness, coma complicated with involuntary limb twitching on the 18 d. Blood ammonia level was increased. Brain CT scan showed cerebral ischemic changes. Electroencephalography prompted the epileptic seizure. After MDT consultation, the possibility of nervous system infection after liver transplantation was considered, and medication therapy was given to control the epileptic seizure. Cerebrospinal fluid examination via lumbar puncture hinted increased intracranial pressure. Real-time fluorescent quantitative polymerase chain reaction (RT-qPCR) of the cerebrospinal fluid demonstrated that the patient was tested positive for HHV-6B nucleic acid, which confirmed the diagnosis of HHV-6B encephalitis. The immunosuppressant regime was adjusted, intravenous ganciclovir was given for antiviral treatment, and active interventions were delivered to prevent and treat relevant complications. Epileptic seizure disappeared after 4 d, and neurological symptoms were significantly alleviated after 2 weeks. After 4-week antiviral treatment, the patient was tested negative for virology testing, and the neurological function was restored to normal. Conclusions HHV-6B encephalitis rarely occurs after adult liver transplantation, which is primarily associated with the virus reactivation after use of immunosuppressant. MDT pattern may be employed to deepen the understanding of the patient's condition, formulate more effective individualized treatment regime, and enhance the clinical efficacy and safety.

BACKGROUND:Intervertebral disk degeneration is a pathological change caused by a series of complex molecular mechanisms that result in the aging and damage of intervertebral discs,ultimately leading to severe clinical symptoms.Traditional Chinese medicine has unique advantages in the treatment of intervertebral disk degeneration due to its low cost,non-addictive nature,multi-target effects,minimally toxic and side effects,and high patient acceptance. OBJECTIVE:To review the latest research results of traditional Chinese medicine monomer intervention-related signaling pathways in the treatment of intervertebral disk degeneration,describe and analyze the action mechanism of traditional Chinese medicine monomer on intervertebral disk degeneration,and provide a new approach and theoretical basis for future basic research and clinical treatment. METHODS:The first author searched for relevant literature from January 2018 to February 2023 in CNKI,PubMed,VIP,and WanFang using the search terms"intervertebral disc,signal pathway".The articles that did not meet the criteria were excluded after preliminary screening of the titles and abstracts.Finally,72 articles were selected for review and analysis. RESULTS AND CONCLUSION:Traditional Chinese medicine monomers can regulate multiple classical signaling pathways such as Wnt/β-catenin,PI3K/Akt,mTOR,NF-κB,and MAPK.They achieve this by regulating oxidative stress,adjusting the expression of pro/anti-apoptotic proteins in cells,stimulating cellular autophagy function,reducing stimulation of cell inflammatory factors,increasing the expression of extracellular matrix markers,reducing the production of matrix-degrading enzymes,maintaining the synthesis and stability of extracellular matrix,inducing differentiation of mesenchymal stem cells in the nucleus pulposus into nucleus pulposus cells,promoting endogenous repair and reconstruction,controlling apoptosis and aging of nucleus pulposus cells,and increasing the activity of nucleus pulposus cells.These actions improve the microenvironment within the intervertebral disc,maintain the normal physiological function of the intervertebral disc,and delay intervertebral disc degeneration.