Objective To evaluate the effect and safety of combined treatment by laparoscopic cholecystectomy and subsequent ablation in patients with HCC adjacent to the gallbladder. Methods From June 2005 to June 2009,13 patients with HCC nodules( less than 3 cm) adjacent to the gallbladder were treated by ablation after laparoscopic cholecystectomy. The rate of complete necrosis as well as postoperative complications were also analyzed. Results All the patients showed complete necrosis of their tumor lesions after treatment by ablation subsequence of laparoscopic cholecystectomy. During the follow-up period( nearly 2 years), recurrent nodules appeared in other subsegments but not at the original site treated by ablation. Of note, no fatal complications were observed in all the ablation treated patients. Conclusion Combined treatment by laparoscopic cholecystectomy and subsequent PMCT was an effective and safe method for patients with small HCC which was adjacent to gallhladder.

Objective To evaluate the clinical efifcacy of sorafenib in preventing the recurrence of primary liver cancer after radical surgery. Methods Seventy patients with primary liver cancer undergoing radical surgery in the Third Affiliated Hospital of Sun Yat-sen University between June 2009 and June 2012 were enrolled in this prospective study. The informed consents of all patients were obtained and the local ethical committee approval had been received. According to different postoperative therapies, the patients were divided into the sorafenib group (n=24) and control group (n=46). In the sorafenib group, there were 22 males and 2 females with a mean age of (48±10) years. A dose of 400 mg sorafenib was orally administered twice daily for consecutive 6 months. In the control group, there were 40 males and 6 females with a mean age of (48±11) years. The patients were orally administered with placebo. All patients received postoperative follow-up. Postoperative recurrence rate, survival rate and drug-induced adverse reactions were observed. Postoperative recurrence rate and incidence of adverse reactions of two groups were compared using Chi-square test or Fisher exact probability test. Postoperative survival rate was analyzed by Kaplan-Meier plot and Log-rank test. Results In the sorafenib group, the 1-, 2-and 3-year recurrence rates were 25%(6/24), 42%(10/24), 50%(12/24) respectively, and 28%(13/46), 46%(21/46), 53%(25/46) respectively in the control group. No signiifcant difference was observed between two groups (χ2=0.020, 0.102, 0.120;P>0.05). The 1-, 2-and 3-year cumulative survival rates in the sorafenib group were 95.83%, 87.50%and 70.83%, and no signiifcant difference was observed compared with 91.30%, 82.61%and 63.04%in the control group (χ2=0.078, P>0.05). In the sorafenib group, the incidence of hand-foot skin reaction, diarrhea, hypertension and erythema were 42%(10/24), 29%(7/24), 21%(5/24) and 25%(6/24), which were signiifcantly higher compared with 7%(3/46), 7%(3/46), 2%(1/46) and 4%(2/46) in the control group (χ2=10.663, 4.885, 4.828, 4.762;P<0.05). Conclusion Sorafenib can neither decrease postoperative recurrence of peimary liver cancer after radical surgery nor enhance the overall survival rate.

ObjectiveTo investigate the mechanism of activated hepatic stellate cells (aHSC) promote the angiogenesis of hepatocellular carcinoma (HCC).MethodsaHSCs were collected after being cultured for 1, 3, 5, 7 d respectively . The relative expression of aHSC angiopoietin-1 (Ang-1) messenger ribonucleic acid (mRNA) was detected by real-time fluorescence quantitative polymerase chain reaction (PCR). The expression of aHSC Ang-1 protein was observed by immunolfuorescence staining. The impact of aHSC on the proliferation of hepatic vascular endothelial cells (HVEC) was observed by Transwell chamber. The impact of aHSC on HVEC tube formation was observed by tube formation assay. The experimental data were compared using one-way analysis of variance and LSD-t test.ResultsAfter aHSC were cultured for 1, 3, 5, 7 d, the relative expression of aHSC Ang-1 mRNA was respectively 1.000±0.024, 1.920±0.080, 6.230±0.320 and 7.820±0.380, which gradually increased as the culture time went on (LSD-t=7.32, 13.68, 8.34;P<0.05). The immunolfuorescence staining showed that Ang-1 and smooth muscle actin antibody (aSMA) were co-expressed in the aHSC. Transwell chamber indirect co-culture showed that aHSC could promote the proliferation of HVEC, and the effect weakened after Ang-1 antibody was added. Tube formation assay showed that HVEC could polymerize and gradually developed tubular structure in the aHSC conditioned medium, and the effect signiifcantly weakened after Ang-1 antibody was added. ConclusionaHSC may promote the proliferation and angiogenesis of HVEC in HCC by secreting Ang-1.

BACKGROUND:Knee osteoarthritis is a common disease in middle-aged and elderly people.It is a kind of disease that seriously affects the quality of life of patients and even has the risk of disability.Therefore,the pathogenesis and treatment of knee osteoarthritis have become the focus of research.In Chinese medicine,knee osteoarthritis is often treated as"biness,"which is closely related to"biness"caused by blood stasis and blood vessels blocking collaterals in the theory of"blood stasis"in traditional Chinese medicine.Iron overload is a kind of pathological state caused by iron metabolism disorder,which highly coincides with the pathogenic characteristics and clinical manifestations of the"blood stasis"theory of traditional Chinese medicine,and is a risk factor that promotes the development of knee osteoarthritis. OBJECTIVE:Based on the"blood stasis"theory,to summarize the effects of iron overload on cartilage metabolism and subchondral bone reconstruction,to lay a new theoretical foundation for the treatment of knee osteoarthritis with traditional Chinese medicine,and to explore the therapeutic effect of traditional Chinese medicine for promoting blood circulation after interfering with bone tissue. METHODS:CNKI,WanFang database,PubMed and Web of Science databases were searched for relevant literature.The Chinese search terms were"ferroptosis,iron,iron overload,osteoarthritis,blood stasis"and the English search terms were"ferroptosis,iron,iron overload,osteoarthritis,TCM."In the end,76 articles were included for further review. RESULTS AND CONCLUSION:First of all,we explored the potential of the"blood stasis"theory in treating knee osteoarthritis,and found that"blood stasis"is a crucial part in the progress of knee osteoarthritis,indicating that the"blood stasis"theory is the key to the treatment of knee osteoarthritis in traditional Chinese medicine.Secondly,"blood stasis"and iron overload have a high degree of similarity in pathogenic factors,clinical manifestations,and pathogenic characteristics,suggesting the possibility of"blood stasis"theory in treating iron overload.This finding reminds us that iron overload may be an important mechanistic basis for the"blood stasis"theory in the treatment of knee osteoarthritis.The extracts of blood-activating drugs can relieve iron overload and treat knee osteoarthritis,but the specific mechanism is still unclear.Therefore,we believe that the relationship between"blood stasis"theory and iron overload and related mechanisms are important research directions for knee osteoarthritis in the future.The related mechanism of"blood stasis"theory to alleviate iron overload and then treat knee osteoarthritis also provides a theoretical basis for the modernization of traditional Chinese medicine,such as the development of new drugs and innovative usage,and has certain guiding significance for clinical practice.

Loganin(LOG),a bioactive compound derived from Cornus officinalis Siebold & Zucc,has been understudied in the context of osteoarthritis(OA)treatment.In this study,we induced an inflammatory response in chondrocytes using lipopolysaccharide(LPS)and subsequently treated these cells with LOG.We employed fluorescence analysis to quantify reactive oxygen species(ROS)levels and measured the expression of NLRP3 and nuclear factor erythropoietin-2-related factor 2(NRF2)using real-time quantitative polymerase chain reaction(qRT-PCR),Western blotting,and immunofluorescence(IF)techniques.Additionally,we developed an OA mouse model by performing medial meniscus destabilization(DMM)surgery and monitored disease progression through micro-com-puted tomography(micro-CT),hematoxylin and eosin(H&E)staining,safranin O and fast green(S&F)staining,and immunohisto-chemical(IHC)analysis.Our results indicate that LOG significantly reduced LPS-induced ROS levels in chondrocytes,inhibited the activation of the NLRP3 inflammasome,and enhanced NRF2/heme oxygenase 1(HO-1)signaling.In vivo,LOG treatment mitigated cartilage degradation and osteophyte formation triggered by DMM surgery,decreased NLRP3 expression,and increased NRF2 expres-sion.These findings suggest that LOG has a protective effect against OA,potentially delaying disease progression by inhibiting the ROS-NLRP3-IL-1β axis and activating the NRF2/HO-1 pathway.