Objective To summarize the strategies of treatment and investigate the risk factors affecting the survival of patients with hepatic cancer recurrence and metastasis after liver transplantation.Methods The clinical data of 99 patients with hepatic cancer recurrence and metastasis after liver transplantation who were admitted to the Southwest Hospital of Third Military Medical University from January 1999 to September 2011 were retrospectively analyzed.Of the 99 patients,7 patients who did not meet the criteria were excluded from the study,and 92 patients were enrolled in the study.All patients were divided into single therapy group (18 patients) and combined therapy group (74 patients).The study was reviewed by the ethics committee,and all the patients signed the informed consent form.The survival time of the 2 groups was compared,and the risk factors affecting the survival time was analyzed.All data were analyzed using the t test,chi-square test or by calculating the Fisher exact probability.The survival curve was drawn using the Kaplan-Meier method,and the survival time was compared by the Log-rank test.Factors influencing the prognosis were analyzed using the multivariate linear regression analysis.Results The survival time of patients in the single therapy group and the combined therapy group after hepatic cancer recurrence and metastasis were (5.5 ± 1.1) months and (8.5 ± 1.6) months,respectively,with a significant difference between the 2 groups (Log-rank value =7.489,P ＜ 0.05).The survival time were (7.9 ± 1.5) months for patients in TNM Ⅱ and Ⅲ A,and (7.0 ± 1.3) months for patients in TNM Ⅲ B and ⅣA,with significant difference between the 2 groups (Log-rank value =2.567,P ＜0.05).The survival time of patients with moderately or well differentiated tumors after tumor recurrence and metastasis was (8.1 ± 1.5) months,which was significantly longer than (7.2 ± 1.4)months of patients with poorly differentiated tumor (Log-rank value =2.749,P ＜ 0.05).TNM stage,tumor differentiation,Milan criteria,great vessel invasion were independent factors affecting the survival of patients with hepatic cancer recurrence and metastasis (t =2.610,3.132,4.378,2.258,P ＜ 0.05).Conclusions Combined therapy can significantly prolong the survival time of patients with hepatic cancer recurrence and metastasis.Earlier hepatic cancer recurrence and metastasis after liver transplantation result in a shorter survival time.TNM stage,tumor differentiation,great vessel invasion and Milan criteria are risk factors affecting the survival of patients with hepatic cancer recurrence and metastasis after liver transplantation.

Objective To investigate the survival condition of the liver transplant recipients and determine the factors which influence the long time survival. Methods Retrospective study of the follow-up data of the orthotopic liver transplantation recipients during 1999-2009 was performed.The survival rate of different primary disease was analyzed respectively. The recurrence of the primary disease, mortality and morbidity was also analyzed. Results 331 recipients were follwed up. The follow-up duration ranged from 8-120 months. The 1-, 3-, 5-, and 10-year survival rate of patients with benign end-stage liver disease was 86 %, 85 %, 83 %, and 83 %, respectively. There was no difference in the long- term survival rate between the patients with hepatitis B virus (HBV)-related cirrhosis and severe liver failure. The 1-, 3-, 5-, and 10-year survival rate of patients with HCC matching Millan criteria was 96 %, 87 %, 87 %, and 87 0%, while those of HCC exceeding Millan criteria were 42 % ,26 % ,24 % ,24 % resepectively. There was significant difference between them at the same period (P＜0. 01). The total recurrent rate of HCC recipient was 54. 3 %, and that of HCC matching and exceeding Millan criteria was 4.3 % and 72. 7 0% respectively (P＜0. 01 ). Tumor recurrence was the main cause of death of the malignancy. The HBV recurrent rate was 6. 0 0%, and all the cases were controlled by changing the antivirus regimen. The morbidity of billiary complication was 11.8 %, and intrahepatic biliary stricture was the most common type. CNIs-related renal impairment morbidity was 8. 2 % and the damage was reversible in condition of early diagnosis and treatment. Conclusion Orthotopic liver transplantation is an effective and safe treatment for end stage liver disease. The LTx recipients can get long time survival with perfect quallity life under proper medical supervision.

Objective To investigate the long-term survival of the recipients with liver malignant tumors receiving liver transplantation and determine the risk factors of tumor recurrence after liver transplantation.Methods The follow-up data of the orthotopic liver transplantation for liver malignant tumors during 1999-2010 were retrospectively analyzed.The survival rate of different pathological tumor types was analyzed respectively.The tumor recurrence rate,mortality and morbidity,and the risk factors of the tumor recurrence were also analyzed.Results 170 recipients were followed up.The follow-up duration ranged from 8-132 months.The general 1-,3-,5-,10-year survival rate was 52 %,38 %,36 %,and 36 % respectively.The 1-,3-,5-,10-year survival rate of HCC matching Millan Criteria was 96 %,87 %,87 %,87 %,while that of HCC exceeding Millan Criteria was 42 %,26 %,24 %,24 % respectively(P<0.05).Tumor recurrence was the main course of the death during follow-up period(92.5 %).The recurrence rate of HCC matching and exceeding Millan Criteria was 10.2 %,and 68.4 % respectively(P<0.05).Among the recipients exceeding Millan Criteria,the recurrence rate of HCC with and without blood vessel invasion was 95.3 %,55.9 % respectively(P<0.05).Radiofrequency ablation before transplantation could decrease the risk of tumor recurrence post-transplantation(P=0.039,OR=0.293),while the high HBV-DNA load (>104 copy/L)was the risk factor of tumor recurrence.Conclusion Orthotopic liver transplantation is an effective and safe treatment for hepatocellular carcinoma matching Millan criteria.Blood vessel invasion is regarded as the contraindication of the liver transplantation of HCC.RF is an effective bridging therapy for the HCC patients,and anti-virus therapy is important during transplant waiting period.

Objective To explore the effects of interstitial cells of liver cancer and normal liver cells co‐cultured on the biological function of liver cancer malignancy so as to understand the signal pathway involved by the interaction between these cells and confirm the role of interstitial cells in cancer progression in tumor microenvironment .Methods We co‐cultured interstitial cells or hepatocyte growth factor (HGF ) and human normal liver cell L‐02 ,and then detected the expressions of the tumor‐suppressing gene PTEN and the oncogene K‐RAS and changes of cell proliferation .The downstream signaling pathways were detected by Real‐time PCR and Western blot .Results The expression of PTEN was downregulated at the transcription level by 1 .15 times and translation level by 10 times (P<0 .05) ,while the transcription level and translation level of K‐RAS increased by 1 .4 times and more than 9 times , respectively ( P< 0 .05 ) in normal liver cells co‐cultured with liver cancer mesenchymal cells .The proliferation ability was increased by more than 2 times .ELISA experiment results showed that the medium from co‐culture contained HGF over 3 times more than the control group ( P<0 .05 ,1 085+108 vs .387+23) .At the same time ,cells in the experimental group expressed more than four times of cMET than the control group cells (P< 0 .05) .Exogenous HGF consistently promoted liver cell proliferation and viability (P<0 .05) .Conclusion Our study shows that liver cancer interstitial cells activate the HGF/cMET signaling pathway by secreting HGF and promote the proliferation of normal liver cells ,suggesting a new way to explore the molecular mechanism of tumor microenvironment in tumor development and treatment of hepatocellular carcinoma .

OBJECTIVETo observe the effect of dexamethasone on the proliferation and apoptosis of embryonic palatal mesenchymal (EPM) cells, and chose a proper concentration of dexamethasone which can effect the ordinary growth of embryonic palatal mesenchymal cells.

METHODSThe primary EPM cells were isolated and cultured in vitro, then we did biological assay. EPM cells were treated with different concentration dexamethasone (1 x 10(-9), 1 x 10(-8), 1 x 10(-7) and 1 x 10(-6) mol x L(-1)) respectively. The proliferation of EPM cells was evaluated using MTT method. Apoptosis was examined quantitatively with fluorescein stain.

RESULTSIn the condition of blood serum's concentration at 10%, optical density step down following the raise of dexamethasone's concentration. The effect of dexamethasone got to a summit at 3 days. Inhibition rate of dexamethasone at 1 x 10(-6) mol x L(-1) was the highest.

CONCLUSIONDexamethasone at 1 x 10(-6) mol x L(-1) can not only inhibit the growth of the EPM cells, but also will not lead to a large number of cells death. Therefore, this concentration can be used as a reference standard in future research. The most significant drug action time of dexamethason appears at the third day after administration, then the effect became weaken following the drug metabolism.

OBJECTIVETo obtain the self-concept psychological feature of cleft lip and palate (CLP) adolescents further and accurately, and offer reasons for timely and pointed psychological intervention.

METHODSBased on the procedure and criteria of development of psychological questionnaire, a psychological questionnaire for CLP adolescents was designed. 93 CLP and 88 healthy adolescents were studied by using it and their half-quantified score raging 0-9 were analyzed statistically.

RESULTS(1) There was no statistical difference between CLP and normal adolescents, scored 5.91 and 5.66 respectively, which demonstrated that the self-concept of CLP adolescents was at a normal level without obvious passive tendency. (2) There was no significant difference between genders, but boys were more extroversion while girls did better on being unyielding and releasing strain. (3) CLP adolescents had a higher ability of psychological regulation and could face failure more bravely. CLP patients were in a tendency of protective behavior inhibition, companied less, and maximized delight mood unconsciously to decrease harm from enviroment. (4) CLP adolescents had a good parentage. (5) A majority of patients had low expectation of life-quality. (6) Much of CLP patients considered that speech was more important than appearance.

CONCLUSIONSelf-concept of CLP adolescents have normal self-concept and do better in psychological regulation and dependence than normal ones.

Objective To investigate the clinicopathological features and immunohistochemical phenotypes of brain metastatic carcinoma in Tibetan patients. Methods The clinical and pathological data of all patients with brain metastases from 2014 to 2020 in Tibet Autonomous Region People's Hospital were retrospectively analyzed,including 13 cases of brain metastatic carcinoma.All cases were diagnosed and classified by immunohistochemical staining. Results 13 cases(9 males and 4 females)of brain metastatic carcinoma,aged 26-62 years old,present with headache,dizziness,nausea and vomiting clinically.Four patients had a medical history of tumor,and among the 9 patients with no history of tumor,7 present space occupying lesions in both the brain and other organs.Imaging data could be found in 10 cases,including 4 cases of single lesion and 6 cases of multiple lesions.Primary tumors were identified in 11 cases(8 located in the lung,including 4 cases of adenocarcinoma,3 cases of small cell carcinoma,and 1 case of squamous cell carcinoma;1 case of urothelial carcinoma of the renal pelvis;1 case of thyroid papillary carcinoma;1 case of uterine choriocarcinoma),whereas the primary tumor was unknown for the other 2 cases(1 case of small cell carcinoma and 1 case of adenocarcinoma). Conclusions Brain metastatic carcinoma are more common among middle-aged and elderly people in Tibet.Most of the cases have no history of tumor,with the initial site at the brain metastatic lesions.The most common primary site is the lung,and the primary site of some cases is unknown.Multiple lesions are common in brain metastatic carcinoma,especially in the cerebral hemisphere.For older patients with multiple brain space occupying lesions,the possibility of brain metastatic carcinoma increases.
Adult ; Aged ; Brain ; Brain Neoplasms/diagnostic imaging* ; Carcinoma, Transitional Cell ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Thyroid Neoplasms ; Tibet ; Urinary Bladder Neoplasms

Objective To analyze the clinicopathological features and immunohistochemical expression of meningiomas in the Tibetan population in Tibet,and improve the understanding of meningiomas. Methods The clinical and pathological data of all the meningiomas diagnosed by pathology in Tibet Autonomous Region People's Hospital from April 2013 to March 2021 were analyzed retrospectively.All the cases underwent immunohistochemical staining of trimethylation of lysine 27 on histone H3 (H3K27me3),mucin 4 (MUC4),somatostatin receptor 2 (SSTR2),progesterone receptor,epithelial membrane antigen,glial fibrillary acidic protein,vimentin,S-100,P53,and Ki-67.The histopathological features and the staining results were observed under a light microscope. Results A total of 116 cases of meningiomas were included in this study,with the male-to-female ratio of 1.0∶2.6 and the age of 4-73 years.The main clinical symptom was headache.The imaging examination showed that 114 cases had single lesions and 2 cases had multiple lesions.The tumors were located in the cranium (108 cases) and spinal canal (8 cases).The maximum diameter of the tumors ranged from 0.3 cm to 10.0 cm,with a mean of (5.7±2.2) cm.In terms of microscopic grading and histological types,the 116 cases included 111 cases of WHO grade Ⅰ (including 53 cases of fibrous type,20 cases of meningothelial type,24 cases of transitional type,10 cases of psammomatous type,etc.),4 cases of WHO grade Ⅱ (3 cases of atypical type and 1 case of clear cell type),and 1 case of WHO grade Ⅲ (papillary type).The immunohistochemical staining showed H3K27me3 expression absent in 9 cases (9/116,7.8%),MUC4 positive in 64 cases (64/116,55.2%),SSTR2 positive in 101 cases (101/116,87.1%).Eighty cases had follow-up results,among which 71 cases had no recurrence,while 9 cases recurred. Conclusions Meningioma is the most common tumor in the central nervous system in the pathological file of Tibet.It mainly attacks the middle-aged female patients,occupying the parasagittal sinus,falx,and convex surface of the brain.Fibrous meningioma of WHO grade Ⅰ is common,while the meningiomas of WHO grades Ⅱ and Ⅲ are rare.The expression degree of MUC4 is higher in meningothelial and transitional meningiomas but lower in fibrous meningiomas.There may be no correlation between the absence of H3K27me3 expression and prognosis.
Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Female ; Histones ; Humans ; Male ; Meningeal Neoplasms/diagnosis* ; Meningioma/diagnosis* ; Middle Aged ; Retrospective Studies ; Tibet ; Young Adult

Objective To investigate the status of exclusive breastfeeding and bottle feeding in remote rural areas of Sichuan province and explore the relationship between negative emotions of mothers and feeding patterns of infants.Methods Multistage cluster sampling was employed to select the infants aged 0-6 months and their mothers in remote rural areas of Sichuan province.A self-designed questionnaire was used to collect the demographic characteristics of mothers and infants and the basic family information.The Chinese version of Depression Anxiety Stress scale was used to evaluate mothers' negative emotions,and the Breastfeeding Self-efficacy scale to assess the confidence level of mothers' behavior of adhering to exclusive breastfeeding.Results Totally 723 pairs of infants and their mothers were included.The exclusive breastfeeding and bottle feeding rates were 34.16% (247/723) and 57.54% (416/723),respectively.Mothers with depression tendency were less likely to adopt exclusive breastfeeding (OR=0.532,95%CI=0.291-0.974,P=0.041) and more likely to adopt bottle feeding (OR=1.877,95%CI=1.054-3.344,P=0.033).Further subgroup analysis of breastfeeding self-efficacy showed that in the group of low self-efficacy,the mothers with depression tendency were less likely to adopt exclusive breastfeeding (OR=0.461,95%CI=0.236-0.902,P=0.024) and more likely to adopt bottle feeding (OR=1.968,95%CI=1.047-3.701,P=0.036) than the mothers without depression tendency.In the group of high self-efficacy,mothers' depression,anxiety,and stress tendency had no significant correlation with infant feeding patterns (all P>0.05).Conclusions The mothers in the remote rural areas of Sichuan province are more likely to employ bottle feeding than exclusive breastfeeding.The mothers with stronger depression tendency demonstrate lower possibility of exclusive breastfeeding and higher possibility of bottle feeding.Breastfeeding self-efficacy may affect the association between maternal depression and infant feeding patterns.
Humans ; Infant ; Anxiety ; China ; Feeding Behavior ; Self Efficacy ; East Asian People ; Mothers/psychology* ; Depression/epidemiology*

Objective To explore the spatial and temporal distribution characteristics of cases with newly diagnosed echinococcosis in Sichuan Province from 2007 to 2017, so as to provide reference for the formulation of echinococcosis prevention and control strategies and for the identification of key areas. Methods The spatial distribution maps of detection of cases with newly diagnosed echinococcosis were plotted in Sichuan Province from 2007 to 2017, and the spatial distribution characteristics and epidemic trends were analyzed. Results From 2007 to 2017, the detection rate of cases with newly diagnosed echinococcosis appeared a decline in Sichuan Province year by year, and the areas with a high detection rate of cases with newly diagnosed echinococcosis were mainly located in western, northwestern and northern parts of Sichuan Province, while the areas with a low detection rate were predominantly found in the southern and eastern parts of the province. The global Moran’s I values were 0.19, 0.22, 0.17, 0.44, 0.48, 0.31 and 0.16 for the detection rate of cases with newly diagnosed echinococcosis in Sichuan Province from 2010 to 2016 (all Z scores > 1.96, all P values < 0.05), suggesting spatial aggregation distribution during this period. Local spatial autocorrelation analysis revealed that the“high-high”areas and“low-low”areas for the detection rate of cases with newly diagnosed echinococcosis all showed an aggregation tendency. Conclusions The detection rate of cases with newly diagnosed echinococcosis decreases in Sichuan Province from 2007 to 2017 year by year, and shows a spatial aggregation. The echinococcosis control activities should be intensified in Shiqu, Seda, Dege, Ganzi and Baiyu counties.