Objective:To investigate the influencing of portal vein embolization (PVE) and PVE combined with transcatheter arterial chemoembolization (TACE) on secondary hepatectomy and prognosis of patients with initially unresectable hepatocellular carcinoma (HCC).Methods:The retrospective cohort study was conducted. The clinicopathological data of 102 patients with initially unresectable HCC who were admitted to the Third Affiliated Hospital of Naval Medical University from October 26,2015 to December 31,2022 were collected. There were 82 males and 20 females, aged 52(range,25?73)years. Of 102 patients, 72 cases undergoing PVE combined with TACE were set as the PVE+TACE group, and 30 cases undergoing PVE were set as the PVE group. Observation indicators: (1) surgical resection rate of secondary hepatectomy and increase of future liver remnant (FLR); (2) situations of secondary hepatectomy; (3) follow-up. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the independent sample t test. Measurement data with skewed distribution were represented as M(range), and comparison between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test or Fisher exact probability. Comparison of ordinal data was conducted using the Mann-Whitney U test. The Kaplan-Meier method was used to calculate survival rate and draw survival curve, and Log-Rank test was used for survival analysis. Results:(1) Surgical resection rate of secondary hepatectomy and increase of FLR. The surgical resection rate of secondary hepatectomy in the PVE+TACE group and the PVE group were 72.2%(52/72) and 53.3%(16/30), respectively, showing no significant difference between the two groups ( χ2=3.400, P>0.05). The surgical waiting time, increasing volume of FLR, growth rate of FLR in the 52 patients of PVE+TACE group receiving secon-dary hepatectomy were 20(range, 14?140)days, 140(range, 62?424)mL, 9.8(range, 1.5?26.5)mL/day, respectively. The above indicators in the 16 patients of PVE group receiving secondary hepatectomy were 16(range, 12?35)days, 160(range, 95?408)mL, 10.5(range, 1.2?28.0)mL/day, respectively. There was no significant difference in the above indicators between the 52 patients of PVE+TACE group and the 16 patients of PVE group ( Z=1.830, 1.498, 1.266, P>0.05). (2) Situations of secondary hepatectomy. The operation time, rate of tumor necrosis (>90%, 60%?90%,<60%), cases with complications ≥ grade Ⅲa in the 52 patients of PVE+TACE group receiving secondary hepatectomy were 200(range, 125?420)minutes, 8, 4, 40, 28, respectively. The above indicators in the 16 patients of PVE group receiving secondary hepatectomy were 170(range, 105?320)minutes, 0, 0, 16, 4, respectively. There were significant differences in the above indicators between the 52 patients of PVE+TACE group and the 16 patients of PVE group ( Z=2.132, ?2.093, χ2=4.087, P<0.05). (3) Follow-up. Sixty-eight patients who completed the surgery were followed up for 40(range, 10?84)months. The 1-, 3-, 5-year recurrence free survival rate in the 52 patients of PVE+TACE group receiving secondary hepatectomy were 73.0%, 53.3%, 35.4%, respectively. The above indicators in the 16 patients of PVE group were 62.5%, 37.5%, 18.8%, respectively. There was a significant difference in the recurrence free survival rate between the 52 patients of PVE+TACE group and the 16 patients of PVE group ( χ2=4.035, P<0.05). The 1-, 3-, 5-year overall survival rate in the 52 patients of PVE+TACE group receiving secondary hepatectomy were 82.5%, 61.2%, 36.6%, respectively. The above indica-tors in the 16 patients of PVE group receiving secondary hepatectomy were 68.8%, 41.7%,20.8%, respectively. There was a significant difference in the overall survival rate between the 52 patients of PVE+TACE group and the 16 patients of PVE group ( χ2=4.767, P<0.05). Conclusion:Compared with PVE, PVE+TACE as stage Ⅰ surgery can increase the surgical resection rate of secondary hepatec-tomy and the recurrence free survival rate of patients with initially unresectable HCC, prolong the long-term survival time, but not influence the growth rate of FLR.

Objective·To explore the heterogeneity in single-cell genomics between human-induced pluripotent stem cell(iPSC)-derived macrophages(IPSDM)and human peripheral blood-derived macrophages(PBDM).Methods·iPSCs were differentiated into IPSDMs in vitro using a feeder-free and serum-free protocol.The expression of cluster of differentiation antigen 14(CD14)and monocyte-macrophage marker genes in IPSDMs was analyzed using flow cytometry and real-time reverse transcription quantitative polymerase chain reaction(RT-qPCR),respectively.Single-cell sequencing was then performed on IPSDMs.Simultaneously,the single-cell sequencing dataset GSE126085 was downloaded from the Gene Expression Omnibus database as a reference dataset for PBDMs.Sequencing data for both IPSDMs and PBDMs were processed and analyzed using the seurat package in R software,with PBDMs annotated using the singleR package.A reference dataset was constructed with highly variable genes from PBDMs,and the highly variable genes of IPSDMs were projected onto the PBDM dataset using the scmap package to infer IPSDMs cell identities based on variable gene similarity.IPSDMs were annotated using cell-type annotation tools and referenced against relevant studies.The expression distribution of macrophage marker genes was compared between IPSDMs and PBDMs.Differentially expressed genes(DEGs)between IPSDMs and PBDMs were identified using the seurat package,and their potential biological functions were explored through Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analyses.Results·Suspended IPSDMs were obtained after 29 d of in vitro differentiation.Flow cytometry and RT-qPCR confirmed that approximately 23.1%of IPSDMs expressed CD14,and IPSDMs exhibited higher expression of monocyte-macrophage marker genes compared to the U-937 cell line.All cells in the PBDM dataset were annotated as macrophages.After constructing a scmap reference dataset using PBDMs,59.8%of IPSDMs were annotated as macrophages through mapping their highly variable genes to the PBDM dataset.The remaining 40.2%of IPSDM cells could not be matched to the variable genes of PBDMs.Further manual annotation of IPSDMs revealed a composition of 97.15%macrophages,2.71%hematopoietic precursor cell-like cells,and 0.14%dendritic cells.When comparing the expression of macrophage markers,both IPSDMs and PBDMs highly expressed the classical macrophage marker CD68 gene,while IPSDMs exhibited higher expression of markers associated with tissue-resident macrophages.GO analysis of DEGs showed enrichment in the molecular functions such as ubiquitin-like protein ligase binding,cellular components such as the nuclear speck and nuclear envelope,and biological processes such as the regulation of translation.KEGG pathway enrichment indicated that the DEGs between IPSDMs and PBDMs might be related to various intracellular pathogen infections.Conclusion·Human IPSDMs and PBDMs exhibit certain similarities and heterogeneity at the single-cell transcriptional level.Transcriptomic analysis indicates that IPSDMs display more characteristics of tissue-resident macrophages.The DEGs between IPSDMs and PBDMs are potentially associated with intracellular infection immunity.

Objective·To explore the heterogeneity in single-cell genomics between human-induced pluripotent stem cell(iPSC)-derived macrophages(IPSDM)and human peripheral blood-derived macrophages(PBDM).Methods·iPSCs were differentiated into IPSDMs in vitro using a feeder-free and serum-free protocol.The expression of cluster of differentiation antigen 14(CD14)and monocyte-macrophage marker genes in IPSDMs was analyzed using flow cytometry and real-time reverse transcription quantitative polymerase chain reaction(RT-qPCR),respectively.Single-cell sequencing was then performed on IPSDMs.Simultaneously,the single-cell sequencing dataset GSE126085 was downloaded from the Gene Expression Omnibus database as a reference dataset for PBDMs.Sequencing data for both IPSDMs and PBDMs were processed and analyzed using the seurat package in R software,with PBDMs annotated using the singleR package.A reference dataset was constructed with highly variable genes from PBDMs,and the highly variable genes of IPSDMs were projected onto the PBDM dataset using the scmap package to infer IPSDMs cell identities based on variable gene similarity.IPSDMs were annotated using cell-type annotation tools and referenced against relevant studies.The expression distribution of macrophage marker genes was compared between IPSDMs and PBDMs.Differentially expressed genes(DEGs)between IPSDMs and PBDMs were identified using the seurat package,and their potential biological functions were explored through Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analyses.Results·Suspended IPSDMs were obtained after 29 d of in vitro differentiation.Flow cytometry and RT-qPCR confirmed that approximately 23.1%of IPSDMs expressed CD14,and IPSDMs exhibited higher expression of monocyte-macrophage marker genes compared to the U-937 cell line.All cells in the PBDM dataset were annotated as macrophages.After constructing a scmap reference dataset using PBDMs,59.8%of IPSDMs were annotated as macrophages through mapping their highly variable genes to the PBDM dataset.The remaining 40.2%of IPSDM cells could not be matched to the variable genes of PBDMs.Further manual annotation of IPSDMs revealed a composition of 97.15%macrophages,2.71%hematopoietic precursor cell-like cells,and 0.14%dendritic cells.When comparing the expression of macrophage markers,both IPSDMs and PBDMs highly expressed the classical macrophage marker CD68 gene,while IPSDMs exhibited higher expression of markers associated with tissue-resident macrophages.GO analysis of DEGs showed enrichment in the molecular functions such as ubiquitin-like protein ligase binding,cellular components such as the nuclear speck and nuclear envelope,and biological processes such as the regulation of translation.KEGG pathway enrichment indicated that the DEGs between IPSDMs and PBDMs might be related to various intracellular pathogen infections.Conclusion·Human IPSDMs and PBDMs exhibit certain similarities and heterogeneity at the single-cell transcriptional level.Transcriptomic analysis indicates that IPSDMs display more characteristics of tissue-resident macrophages.The DEGs between IPSDMs and PBDMs are potentially associated with intracellular infection immunity.

Objective:To study the clinical effects of portal vein embolization (PVE) with N-butyl cyanoacrylate copolymer (NBCA) and with gelatin sponge (GS) as embolization materials in patients with initially unresectable hepatocellular carcinoma (HCC).Methods:Clinical data of 90 patients with initial unresectable HCC who underwent PVE treatment at the Third Affiliated Hospital of Naval Medical University from November 2014 to April 2020 were included. There were 77 males and 13 females, aged 48 (25, 67) years old. Patients were divided into two groups according to the embolization materials selected in PVE: NBCA group ( n=60) and GS group ( n=30). Forty-eight and 18 patients finally underwent secondary hepatectomy in NBCA group (resectable NBCA group) and GS group (resectable GS group), respectively. Clinical data including future liver remnant (FLR) growth rate and secondary hepatectomy rate were analyzed. Survivals after hepatectomy was followed up by telephone, WeChat, and outpatient review. Results:The secondary hepatectomy rate in NBCA group was higher than that in GS group [80%(48/60) vs. 60%(18/30), P=0.043]. The waiting time from primary intervention to secondary hepatectomy in resectable NBCA group was 15 (7, 96) d, which was shorter than that in resectable GS group [40 (28, 118) d, P<0.001]. The FLR growth rate of resectable NBCA group was 9.03 (1.24, 29.64) ml/d, which was faster than that in resectable GS group [3.76 (0.08, 8.03) ml/d, P<0.001]. The recurrence-free survival (RFS) rates of patients in resectable NBCA group were 69.1%, 62.0% and 44.7% at 1, 2 and 3 years after surgery, and the overall survival (OS) rates were 76.4%, 69.5% and 59.6%, respectively. The RFS rates of patients in resectable GS group were 60.6%, 48.5% and 35.4% at 1, 2 and 3 years after surgery, and the OS rates were 66.7%, 60.6% and 42.4%, respectively. There were no significant differences in RFS and OS between two groups (all P>0.05). Conclusions:PVE with NBCA and GS as embolization material showed good efficacy in patients with initially unresectable HCC. The FLR growth rate and secondary hepatectomy rate of patients using NBCA were better than those of patients using GS.

Objective:To investigate the prognostic factors of renal function after nephron sparing surgery (NSS) in renal tumor patients.Methods:The data of 115 patients who underwent NSS in our hospital from December 2016 to December 2018 were retrospectively analyzed. There were 75 males and 40 females, aged (49.50±12.94) years. The body mass index was (24.59±3.59) kg/m 2. The maximum diameter of the tumor was (3.66±1.32) cm. The R. E.N.A.L. score was (6.43±1.60). Laparoscopic partial nephrectomy was performed in 61 cases and robot-assisted laparoscopic partial nephrectomy was performed in 54 cases, and all of which were successfully completed. Operative time, WIT and postoperative pathological results were recorded. Blood creatinine value, GFR of affected kidney, GFR of healthy kidney, total GFR, GFR preserving rate (the ratio of postoperative GFR to preoperative GFR), functioning parenchymal volume (FPV) of the affected kidneys, and FPV preserving rate of the affected kidneys (the ratio of postoperative FPV and preoperative FPV) were recorded 6 months after surgery. FPV was measured by the ellipsoid approximation on CT images before and after surgery. Paired sample t test was used to compare GFR and FPV before and after surgery. Spearman rank correlation analysis was used to evaluate the correlation between the study factors and GFR preserving rate of the affected kidneys. Multivariate linear regression models were used to analyze independent predictors of renal function of the affected kidneys. Independent sample t test was used for comparison between group of WIT≤25 min and group of WIT>25 min. Results:All of the 115 patients in this study underwent successfully operations, with the median operation time of 135(75-245) min, and WIT(24.57±5.51) min. Postoperative GFR of the affected kidneys(35.50±7.81)ml/(min·1.73 m 2) was significantly different from preoperative GFR( P<0.001). The FPV preserving rate of the affected kidneys was (84.28±4.37)%, which was significantly lower than that preoperative FPV of the affected kidneys ( P<0.001). Spearman rank correlation analysis showed that there was a strong positive correlation between the FPV preserving rate of the affected kidneys and the GFR preserving rate of the affected kidneys ( r=0.802), WIT was negatively correlated with the GFR preserving rate of the affected kidneys ( r=-0.503). Multiple linear regression analysis showed that preoperative GFR of the affected kidneys ( b=-0.150, P=0.008), WIT ( b=-0.443, P<0.001) and the FPV preserving rate of the affected kidneys ( b=1.638, P<0.001) were independent predictors of the GFR preserving rate of the affected kidneys. WIT>25 min group had a significantly lower GFR preserving rate of the affected kidneys than WIT≤25 min group [(68.77±10.88)% vs.(79.34±8.88)%, P<0.001]. Conclusions:In the case of short WIT (<30 min), the reservation of normal renal tissue is the most important variable prognostic factor of renal function after NSS, and short WIT plays a secondary role. Under the premise of complete tumor resection, normal renal tissue should be reserved as much as possible and WIT should be controlled within 25 min.

Objective:To determine effects of BEZ235,an inhibitor of phosphoionsitol-3-kinase (PI3K)/ mTOR,on the cell proliferation and migration in human prostate carcinoma lines including RWPE-1,PC3,and DU 145 cells.Methods:Viability of RWPE-1,PC3,and DU145 cells was detected by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay,while cell migration was analyzed by wound healing assay.Western blot and immunofluorescence were used to examine the changes of relevant protein expression.Results:The proliferation of PC3 and DU145 cells was effectively inhibited by BEZ235 (P<0.01),whereas RWPE-1 was not obviously inhibited.Invasion and migration of PC3 and DU145 cells were attenuated by BEZ235 via EMT pathway.Conclusion:The PI3K/mTOR dual inhibitor BEZ235 shows substantial anti-tumor activity in human prostate carcinoma lines of PC3 and DU145 cells,which may be involved in the EMT pathway.

Neuromyelitis optica spectrum disorder (NMOSD) is a kind of immune mediated inflammatory demyelinating disease of the central nervous system manifesting with optic neuritis and acute transverse myelitis,which takes a relapsing or progression course.The exact etiology and pathogenesis are not clear.There are a lot of researches on immune pathogenesis;in addition,the pathogenesis also involves genetic,environmental,oxidative stress and other factors.

Objective To analyze the perioperative conditions and long-term survival of patients with non-small cell lung cancer (NSCLC) after thoracoscopic lobectomy. Methods 119 patients with NSCLC underwent thoracoscopic lobectomy from January 2006 to December 2012 were enrolled in the study, then collecting and analyzing their perioperative indicators, pathological results and follow-up data. Results 9 patients converted to thoracotomy with a conversion rate of 7.0 %. The median operation time, the median intraoperative blood loss and off-bed activity time were 170 min (65~440 min), 90 ml (15~3 000 ml) and (32.9 ± 16.3) h after operation respectively. The time and amount of postoperative drainage, the length of hospital stay were (6.7 ± 3.2) d, (1 690.0 ± 410.5) ml, (9.2 ± 4.0) d respectively. The incidence of perioperative mortality and postoperative complications were 0.8 %, 13.4 % respectively. For postoperative pathological type, 96 cases of adenocarcinoma, 19 cases of squamous carcinoma, 2 cases of adenosquamous carcinoma and 2 cases of large cell carcinoma. For discharge patients, the median follow-up time was 34.5 months (0 ~ 102 months). The incidence of local recurrence and distant metastasis in observation group were 5.0 % and 17.6 % respectively. 1-year overall survival (OS) and disease free survival (DFS) were 85.3 % and 79.5 %, 3-year OS and DFS were 69.8 % and 64.8 %, 5-year OS and DFS were 60.8 %and 58.6 % respectively. There was no significant difference in 1-year, 3-year and 5-year OS and DFS between adenocarcinoma and squamous carcinoma (P > 0.05) while there were significant difference in local recurrence and distant metastasis among different stages (P < 0.05). In addition to slightly low OS, DFS of Ⅲ a , Ⅲ b and Ⅳ DFS and OS, the overall living conditions among all stage were similar. Conclusions The long-term survival condition of thoracoscopic lobectomy for NSCLC is ideal, and it’s a safe and effective operation, worthy of clinical promoting.