1.M1 polarization of macrophage induced by STING signaling promotes T cell immune response
Jianfei Li ; Zhi Duan ; Qian Liu ; Qiyin Zong ; Wanlu Duan ; Futing Liu ; Hao Zhang ; Qiang Zhou ; Qin Wang
Acta Universitatis Medicinalis Anhui 2024;59(11):1974-1981
		                        		
		                        			Objective:
		                        			To investigate the effect of activation of the stimulator of interferon genes(STING) pathway on macrophage polarization function and its role in T-cell response.
		                        		
		                        			Methods:
		                        			Mouse macrophage RAW264.7 cells were used.STING signaling related proteins in RAW264.7 macrophage treated with STING agonist diABZI were analyzed by Western blot,including TANK-binding kinase-1(TBK1),interferon regulatory factor-3(IRF3),STING,p-TBK1,p-IRF3,p-STING.The polarization of macrophage RAW264.7 cells treated with diABZI was analyzed by flow cytometry.Co-culture of diABZI-treated RAW264.7 macrophage and T cells was applied to evaluate the change of T cell response.
		                        		
		                        			Results:
		                        			STING signaling related proteins were upregulated in macrophage RAW264.7 cells treated with diABZI for 3 hours.The expression of CD86 was upregulated on the surface of macrophages after 12 hours of diABZI treatment,and the CD86/CD206 ratio was elevated,which presented the M1 polarization phenotype.When coculturing diABZI-treated macrophage RAW264.7 cells with T cells,the cytokine secretion ability of T cells including CD4+T and CD8+T cells was enhanced and the expression of CD107a in CD8+T cells was upregulated.
		                        		
		                        			Conclusion
		                        			STING signaling induces M1 polarization of macrophages which enhance the function of T cells,especially CD8+T cell immune response.
		                        		
		                        		
		                        		
		                        	
2.Applications of Three Dimensional Printing in Chromatography Separation
Qiang LI ; Hao-Nan LU ; Han-Rong WEN ; Zong-Peng WANG ; Bo ZHANG
Chinese Journal of Analytical Chemistry 2024;52(5):624-633
		                        		
		                        			
		                        			Chromatography is one of the most important separation and analytical techniques in production activity and academic research.With the growing demand for applications,the development of targeted separation devices is costly.However,the difficulty of constructing modeling makes it difficult to validate the theoretical studies of chromatography.Three dimensional(3D)printing,as a technology that can fabricate objects by depositing materials from the bottom to up,can custom print complex structures for specific needs,and shows many advantages such as low cost,low waste,high precision,high flexibility and parallel manufacturing,demonstrating great potential in the field of chromatography separations.In recent years,with the rapid development of 3D printing technology,the printing resolution and speed have progressively improved,and the range of printable materials has largely expanded.This has led to preliminary research and application of 3D printing technology in the field of chromatography separation,resulting in brand new discoveries and technological innovations.This article made a comprehensive overview of the latest advancements in research and application of 3D printing technology in separation science,including 3D printed columns,3D printed stationary phase,and 3D printed solid-phase extraction devices.Finally,The prospects and challenges of 3D printing technology in separation science were discussed.
		                        		
		                        		
		                        		
		                        	
3.Disease spectrum and pathogenic genes of inherited metabolic disorder in Gansu Province of China
Chuan ZHANG ; Ling HUI ; Bing-Bo ZHOU ; Lei ZHENG ; Yu-Pei WANG ; Sheng-Ju HAO ; Zhen-Qiang DA ; Ying MA ; Jin-Xian GUO ; Zong-Fu CAO ; Xu MA
Chinese Journal of Contemporary Pediatrics 2024;26(1):67-71
		                        		
		                        			
		                        			Objective To investigate the disease spectrum and pathogenic genes of inherited metabolic disorder(IMD)among neonates in Gansu Province of China.Methods A retrospective analysis was conducted on the tandem mass spectrometry data of 286 682 neonates who received IMD screening in Gansu Provincial Maternal and Child Health Hospital from January 2018 to December 2021.A genetic analysis was conducted on the neonates with positive results in tandem mass spectrometry during primary screening and reexamination.Results A total of 23 types of IMD caused by 28 pathogenic genes were found in the 286 682 neonates,and the overall prevalence rate of IMD was 0.63‰(1/1 593),among which phenylketonuria showed the highest prevalence rate of 0.32‰(1/3 083),followed by methylmalonic acidemia(0.11‰,1/8 959)and tetrahydrobiopterin deficiency(0.06‰,1/15 927).In this study,166 variants were identified in the 28 pathogenic genes,with 13 novel variants found in 9 genes.According to American College of Medical Genetics and Genomics guidelines,5 novel variants were classified as pathogenic variants,7 were classified as likely pathogenic variants,and 1 was classified as the variant of uncertain significance.Conclusions This study enriches the database of pathogenic gene variants for IMD and provides basic data for establishing an accurate screening and diagnosis system for IMD in this region.
		                        		
		                        		
		                        		
		                        	
4.New model of PIRADS and adjusted prostatespecific antigen density of peripheral zone improves the detection rate of initial prostate biopsy: a diagnostic study.
Chen HUANG ; Zong-Qiang CAI ; Feng QIU ; Jin-Xian PU ; Qi-Lin XI ; Xue-Dong WEI ; Xi-Ming WANG ; Xiao-Jun ZHAO ; Lin-Chuan GUO ; Jian-Quan HOU ; Yu-Hua HUANG
Asian Journal of Andrology 2023;25(1):126-131
		                        		
		                        			
		                        			This study explored a new model of Prostate Imaging Reporting and Data System (PIRADS) and adjusted prostate-specific antigen density of peripheral zone (aPSADPZ) for predicting the occurrence of prostate cancer (PCa) and clinically significant prostate cancer (csPCa). The demographic and clinical characteristics of 853 patients were recorded. Prostate-specific antigen (PSA), PSA density (PSAD), PSAD of peripheral zone (PSADPZ), aPSADPZ, and peripheral zone volume ratio (PZ-ratio) were calculated and subjected to receiver operating characteristic (ROC) curve analysis. The calibration and discrimination abilities of new nomograms were verified with the calibration curve and area under the ROC curve (AUC). The clinical benefits of these models were evaluated by decision curve analysis and clinical impact curves. The AUCs of PSA, PSAD, PSADPZ, aPSADPZ, and PZ-ratio were 0.669, 0.762, 0.659, 0.812, and 0.748 for PCa diagnosis, while 0.713, 0.788, 0.694, 0.828, and 0.735 for csPCa diagnosis, respectively. All nomograms displayed higher net benefit and better overall calibration than the scenarios for predicting the occurrence of PCa or csPCa. The new model significantly improved the diagnostic accuracy of PCa (0.945 vs 0.830, P < 0.01) and csPCa (0.937 vs 0.845, P < 0.01) compared with the base model. In addition, the number of patients with PCa and csPCa predicted by the new model was in good agreement with the actual number of patients with PCa and csPCa in high-risk threshold. This study demonstrates that aPSADPZ has a higher predictive accuracy for PCa diagnosis than the conventional indicators. Combining aPSADPZ with PIRADS can improve PCa diagnosis and avoid unnecessary biopsies.
		                        		
		                        		
		                        		
		                        			Male
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Prostate/pathology*
		                        			;
		                        		
		                        			Prostate-Specific Antigen/analysis*
		                        			;
		                        		
		                        			Prostatic Neoplasms/diagnostic imaging*
		                        			;
		                        		
		                        			Biopsy
		                        			;
		                        		
		                        			Nomograms
		                        			;
		                        		
		                        			Retrospective Studies
		                        			
		                        		
		                        	
5.Campus bullying and associated factors among college and middle school students in Tibet
TAN Liming, PUBU Zhuoma, MA Xiao, WU Fang, YANG Zong, ZHANG Qiang, XIE Borong, ZHANG Dengcheng
Chinese Journal of School Health 2023;44(10):1532-1536
		                        		
		                        			Objective:
		                        			To understand campus bullying in colleges and middle schools in Tibet, and to analyze related influencing factors, so as to provide reliable basis and reference for formulating targeted intervention measures.
		                        		
		                        			Methods:
		                        			A stratified cluster sampling method was used to investigate the status and influencing factors of being bullied by questionnaire among 3 875 college and middle school students in Ngari, Qamdo, Lhasa, Nagqu and Xigaze of Tibet, from September to November 2019.  Chi-square test and Logistic regression method were used for data analysis.
		                        		
		                        			Results:
		                        			The report rate of campus bullying among college and middle school students in Tibet was 5.50%; 4.35% for girls and 6.76% for boys;8.81% for college students, 1.64% for senior high school students and 5.94% for junior high school students. The results of multivariate Logistic regression analysis showed that smoking ( OR =1.71), Internet addiction ( OR =3.82), depression ( OR =3.84), obesity ( OR =2.02), single parent family ( OR = 1.67 ) and reorganized family ( OR =3.74) were positively correlated with campus bullying ( P <0.05). Girls ( OR =0.66) and senior high school ( OR =0.28) were negatively correlated with campus bullying ( P <0.05).
		                        		
		                        			Conclusion
		                        			Campus bullying is related to campus environment, family type, behaviors and life styles, etc. Efforts should be committed to build a caring campus culture and a good family moral education environment, in order to reduce the incidence of campus bullying and associated adverse effects.
		                        		
		                        		
		                        		
		                        	
6.Efficacy of adjuvant programmed cell death 1 (PD-1) monoclonal antibody immunotherapy in Chinese patients with resected stage Ⅱ-Ⅲ melanoma.
Zhao Gan REN ; Yu XU ; Zhan qiang HUA ; Zong Yi MO ; Luo Wen WANG ; Gen Bing SHI ; Wan Lin LIU ; Wei SUN ; Bi Qiang ZHENG ; Chun Meng WANG ; Yong Jia JIN ; Yong CHEN
Chinese Journal of Oncology 2023;45(11):973-980
		                        		
		                        			
		                        			Objective: To explore the efficacy of adjuvant programmed cell death 1 (PD-1) monoclonal antibody immunotherapy in Chinese patients with resected stage Ⅱ-Ⅲ melanoma. Methods: A total of 296 patients who underwent radical surgery for stage Ⅱ-Ⅲ cutaneous orlimb melanoma at Fudan University Shanghai Cancer Center and Shanghai Electric Power Hospital between 2017 and 2021 and received adjuvant PD-1 monoclonal antibody immunotherapy, low-dose interferon (IFN), or observational follow-up were enrolled in this study. Patients were divided into the PD-1 monoclonal antibody group (164 cases) and the IFN or observation group (IFN/OBS group, 132 cases) based on postoperative adjuvant treatment methods. Patients' disease recurrence and survival were observed. Results: Among the 296 patients, 77 had cutaneous melanoma and 219 had limb melanoma; 110 were stage Ⅱ and 186 were stage Ⅲ. Among stage Ⅱ patients, the median recurrence-free survival (RFS) in the PD-1 monoclonal antibody group (46 cases) did not reach, while the median RFS in the IFN/OBS group (64 cases) was 36 months. The 1-year RFS rates were 85.3% and 92.1% and the 2-year RFS rates were 71.9% and 63.7% in the PD-1 monoclonal antibody group and the IFN/OBS group, respectively, with no statistically significant difference (P=0.394). Among stage Ⅲ patients, the median RFS rates in the PD-1 monoclonal antibody group (118 cases) and the IFN/OBS group (68 cases) were 23 and 13 months, respectively. The 1-year RFS rates were 70.0% and 51.8% and the 2-year RFS rates were 51.8% and 35.1%in the PD-1 monoclonal antibody group and the IFN/OBS group, respectively, with a statistically significant difference (P=0.010). Stratified analysis showed that the advantage of PD-1 monoclonal antibody adjuvant therapy in improving RFS persisted in the subgroups of primary ulceration (HR=0.558, 95% CI: 0.348-0.893), lymph node macroscopic metastasis (HR=0.486, 95% CI: 0.285-0.828), stage ⅢC (HR=0.389, 95% CI: 0.24-0.63), and the subgroup without BRAF/c-Kit/NRAS gene mutations (HR=0.347, 95% CI: 0.171-0.706). In terms of recurrence patterns, in stage Ⅱ patients, the recurrence and metastasis rate was 15.2% (7/46) in the PD-1 monoclonal antibody group, significantly lower than the IFN/OBS group [43.8% (28/64), P=0.002]. In stage Ⅲ melanoma patients, the recurrence and metastasis rate was 42.4% (50/118) in the PD-1 monoclonal antibody group, also lower than the IFN/OBS group [63.2% (43/68), P=0.006]. Conclusions: In real-world settings, compared with patients receiving low-dose IFN adjuvant therapy or observational follow-up, PD-1 monoclonal antibody immunotherapy can reduce the recurrence and metastasis rate of cutaneous and limb melanoma, and prolong the postoperative RFS of stage Ⅲ cutaneous and limb melanoma patients. Patients with a heavier tumor burden benefit more from immunotherapy.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Antibodies, Monoclonal/therapeutic use*
		                        			;
		                        		
		                        			Apoptosis
		                        			;
		                        		
		                        			China
		                        			;
		                        		
		                        			Disease-Free Survival
		                        			;
		                        		
		                        			East Asian People
		                        			;
		                        		
		                        			Immunotherapy
		                        			;
		                        		
		                        			Interferon-alpha/therapeutic use*
		                        			;
		                        		
		                        			Lymphatic Metastasis
		                        			;
		                        		
		                        			Melanoma/pathology*
		                        			;
		                        		
		                        			Programmed Cell Death 1 Receptor/therapeutic use*
		                        			;
		                        		
		                        			Skin Neoplasms/pathology*
		                        			;
		                        		
		                        			Melanoma, Cutaneous Malignant
		                        			
		                        		
		                        	
7.Efficacy of adjuvant programmed cell death 1 (PD-1) monoclonal antibody immunotherapy in Chinese patients with resected stage Ⅱ-Ⅲ melanoma.
Zhao Gan REN ; Yu XU ; Zhan qiang HUA ; Zong Yi MO ; Luo Wen WANG ; Gen Bing SHI ; Wan Lin LIU ; Wei SUN ; Bi Qiang ZHENG ; Chun Meng WANG ; Yong Jia JIN ; Yong CHEN
Chinese Journal of Oncology 2023;45(11):973-980
		                        		
		                        			
		                        			Objective: To explore the efficacy of adjuvant programmed cell death 1 (PD-1) monoclonal antibody immunotherapy in Chinese patients with resected stage Ⅱ-Ⅲ melanoma. Methods: A total of 296 patients who underwent radical surgery for stage Ⅱ-Ⅲ cutaneous orlimb melanoma at Fudan University Shanghai Cancer Center and Shanghai Electric Power Hospital between 2017 and 2021 and received adjuvant PD-1 monoclonal antibody immunotherapy, low-dose interferon (IFN), or observational follow-up were enrolled in this study. Patients were divided into the PD-1 monoclonal antibody group (164 cases) and the IFN or observation group (IFN/OBS group, 132 cases) based on postoperative adjuvant treatment methods. Patients' disease recurrence and survival were observed. Results: Among the 296 patients, 77 had cutaneous melanoma and 219 had limb melanoma; 110 were stage Ⅱ and 186 were stage Ⅲ. Among stage Ⅱ patients, the median recurrence-free survival (RFS) in the PD-1 monoclonal antibody group (46 cases) did not reach, while the median RFS in the IFN/OBS group (64 cases) was 36 months. The 1-year RFS rates were 85.3% and 92.1% and the 2-year RFS rates were 71.9% and 63.7% in the PD-1 monoclonal antibody group and the IFN/OBS group, respectively, with no statistically significant difference (P=0.394). Among stage Ⅲ patients, the median RFS rates in the PD-1 monoclonal antibody group (118 cases) and the IFN/OBS group (68 cases) were 23 and 13 months, respectively. The 1-year RFS rates were 70.0% and 51.8% and the 2-year RFS rates were 51.8% and 35.1%in the PD-1 monoclonal antibody group and the IFN/OBS group, respectively, with a statistically significant difference (P=0.010). Stratified analysis showed that the advantage of PD-1 monoclonal antibody adjuvant therapy in improving RFS persisted in the subgroups of primary ulceration (HR=0.558, 95% CI: 0.348-0.893), lymph node macroscopic metastasis (HR=0.486, 95% CI: 0.285-0.828), stage ⅢC (HR=0.389, 95% CI: 0.24-0.63), and the subgroup without BRAF/c-Kit/NRAS gene mutations (HR=0.347, 95% CI: 0.171-0.706). In terms of recurrence patterns, in stage Ⅱ patients, the recurrence and metastasis rate was 15.2% (7/46) in the PD-1 monoclonal antibody group, significantly lower than the IFN/OBS group [43.8% (28/64), P=0.002]. In stage Ⅲ melanoma patients, the recurrence and metastasis rate was 42.4% (50/118) in the PD-1 monoclonal antibody group, also lower than the IFN/OBS group [63.2% (43/68), P=0.006]. Conclusions: In real-world settings, compared with patients receiving low-dose IFN adjuvant therapy or observational follow-up, PD-1 monoclonal antibody immunotherapy can reduce the recurrence and metastasis rate of cutaneous and limb melanoma, and prolong the postoperative RFS of stage Ⅲ cutaneous and limb melanoma patients. Patients with a heavier tumor burden benefit more from immunotherapy.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Antibodies, Monoclonal/therapeutic use*
		                        			;
		                        		
		                        			Apoptosis
		                        			;
		                        		
		                        			China
		                        			;
		                        		
		                        			Disease-Free Survival
		                        			;
		                        		
		                        			East Asian People
		                        			;
		                        		
		                        			Immunotherapy
		                        			;
		                        		
		                        			Interferon-alpha/therapeutic use*
		                        			;
		                        		
		                        			Lymphatic Metastasis
		                        			;
		                        		
		                        			Melanoma/pathology*
		                        			;
		                        		
		                        			Programmed Cell Death 1 Receptor/therapeutic use*
		                        			;
		                        		
		                        			Skin Neoplasms/pathology*
		                        			;
		                        		
		                        			Melanoma, Cutaneous Malignant
		                        			
		                        		
		                        	
8.Comparison of application effects of colonoscopy, fecal immunochemical test and a novel risk-adapted screening approach in colorectal cancer screening in Xuzhou population.
Yun Xin KONG ; Dong DONG ; Hong Da CHEN ; Min DAI ; Lang ZHUO ; Pei An LOU ; Ting CAI ; Si Ting CHEN ; Jian Qiang PAN ; Yi Huan GAO ; Hang LU ; Zong Mei DONG ; Hong Ying ZHAO ; Xiao Hu LUO ; Guohui CHEN
Chinese Journal of Preventive Medicine 2022;56(8):1074-1079
		                        		
		                        			
		                        			Objective: To compare the application effect of the colonoscopy, fecal immunochemical test (FIT) and novel risk-adapted screening approach in colorectal cancer screening in Xuzhou population. Methods: From May 2018 to April 2019, 4 280 subjects aged 50-74 were recruited from Gulou district, Yunlong district and Quanshan district of Xuzhou. They were randomly assigned to the colonoscopy group (n=863), FIT group (n=1 723) and novel risk-adapted screening approach group (n=1 694) according to the ratio of 1∶2∶2. For the novel risk-adapted screening approach group, after the risk assessment, high-risk subjects were invited to undergo colonoscopy and low-risk subjects were invited to undergo FIT examination. All FIT positive subjects were invited to undergo colonoscopy. Colonoscopy participation rate [(the number of colonoscopies completed/the number of colonoscopies invited to participate)×100%], detection rate of colorectal lesions [(the number of diagnosed patients/the number of colonoscopies completed)×100%], colonoscopy resource load (the number of colonoscopies completed/the number of diagnosed advanced tumors) and FIT resource load in each group were calculated and compared. Results: The age of all subjects was (61±6) years old, including 1 816 males (42.43%). There was no statistically significant difference in the socio-demographic characteristics of the subjects in different screening groups. The colonoscopy participation rate was 22.60% (195/863) in the colonoscopy group, 57.04% (77/135) in the FIT group, and 33.94% (149/439) in the novel risk-adapted screening approach group, respectively. The colonoscopy participation rate was higher in the FIT group than in the colonoscopy group and the novel risk-adapted screening approach group (P<0.001). The colonoscopy participation rate of novel risk-adapted screening group was significantly higher than the colonoscopy group (P<0.001). The detection rates of advanced tumors were 6.67% (13/195), 9.09% (7/77) and 8.72% (13/149), respectively, and the difference was not statistically significant (P>0.05). The colonoscopy resource load (95%CI) was 15 (13-17) in the colonoscopy group, 11 (9-14) in the FIT group and 11 (10-13) in the novel risk-adapted screening approach group, respectively. Among them, the colonoscopy resource load of high-risk individuals in the novel risk-adapted screening approach group was 12 (9-15). FIT resource loads (95%CI) were 207 (196-218) and 88 (83-94) in the FIT group and the novel risk-adapted screening approach group. Conclusion: The combined application of risk-adapted screening approach and FIT may have a good application effect in colorectal cancer screening.
		                        		
		                        		
		                        		
		                        			Aged
		                        			;
		                        		
		                        			Colonoscopy
		                        			;
		                        		
		                        			Colorectal Neoplasms/pathology*
		                        			;
		                        		
		                        			Early Detection of Cancer
		                        			;
		                        		
		                        			Feces
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Mass Screening
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Occult Blood
		                        			
		                        		
		                        	
9.Treatment of acetabular fracture involving quadrilateral body by external rectus abdominis incision combined with calcaneal profiled plate internal fixation.
Xin-Hong ZHU ; Ji-Kang MIN ; Qiang-Hua ZHANG ; Song-Hua GUO ; Hai-Dong LI ; Zong-Li ZHU
China Journal of Orthopaedics and Traumatology 2022;35(11):1031-1036
		                        		
		                        			OBJECTIVE:
		                        			To investigate the therapeutic effect of lateral rectus abdominis incision combined with winged calcaneal plate on pelvic and acetabular fractures involving quadrilateral body.
		                        		
		                        			METHODS:
		                        			From January 2017 to April 2021, 21 cases of pelvic and acetabular fractures involving quadrilateral bodies were retrospectively analyzed, including 12 males and 9 females. The age ranged from 21 to 73 years with an average of (43.23±6.45) years. All patients were treated by lateral incision of rectus abdominis combined with open reduction and internal fixation with aerofoil plate, including 12 cases of pelvis with anterior and posterior column fractures, 7 cases of acetabular fractures with quadrilateral involvement, and 2 cases of acetabular fractures with central dislocation.
		                        		
		                        			RESULTS:
		                        			All 21 patients were followed up for 12 to 36 months with an average of (18.60±6.45) months. All fractures healed. According to Matta's image reduction evaluation after operation, 11 cases of pelvic anterior and posterior column fractures were all anatomic reduction, 1 case was satisfactory reduction, 7 cases of acetabular fractures involving quadrilateral were anatomic reduction, 1 case with central dislocation was anatomic reduction, and 1 case was satisfactory reduction. The modified Merle D'Aubigne Postel hip joint score was 13 to 17 points.
		                        		
		                        			CONCLUSION
		                        			Lateral incision approach of rectus abdominis combined with wing-shaped steel plate can obtain good radiological and clinical results in the treatment of complex pelvic and acetabular fractures involving quadrilateral bodies, and has advantages in the treatment of complex pelvic fractures and acetabular quadrilateral fractures.
		                        		
		                        		
		                        		
		                        			Male
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Young Adult
		                        			;
		                        		
		                        			Adult
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Aged
		                        			;
		                        		
		                        			Rectus Abdominis
		                        			;
		                        		
		                        			Retrospective Studies
		                        			;
		                        		
		                        			Acetabulum/injuries*
		                        			;
		                        		
		                        			Bone Plates
		                        			;
		                        		
		                        			Hip Fractures/surgery*
		                        			;
		                        		
		                        			Spinal Fractures
		                        			
		                        		
		                        	
10.Effect of Prolonged Storage of Packed Red Blood Cells on Recurrence-free and Overall Survivals after Curative Resection for Hepatocellular Carcinoma
Rui-feng XUE ; Chong-xi ZHAO ; Pei-zong WANG ; Dong-tai CHEN ; Xiao-hui CHEN ; Wei-an ZENG ; Qiang LI
Journal of Sun Yat-sen University(Medical Sciences) 2022;43(3):449-461
		                        		
		                        			
		                        			ObjectiveProlonged storage of packed red blood cells (PRBC) is reportedly associated with poor clinical outcomes in critically ill, trauma, and cardiac surgery patients. However, the impact of PRBC’s age on long-term oncological outcomes in cancer patients remains poorly defined. Here we retrospectively evaluated the effect of PRBC’s age on overall survival and biochemical recurrence in patients undergoing curative resection of hepatocellular carcinoma. MethodsA total of 1 221 qualified patients undergoing curative hepatectomy for HCC between August 1, 2008 and June 30, 2012 at the Sun Yat-sen University Cancer Center (Guangzhou, PR China) were divided into nontransfused or transfused group. Transfused patients were further divided according to PRBC storage duration (fresh PRBC group, ≤ 14 days; old PRBC group, > 14 days). Overall survival (OS), intrahepatic recurrence-free survival (IRFS), extrahepatic metastasis-free survival (EMFS) were assessed and multivariate analyses were performed to evaluate the association of PRBC storage duration with cancer outcomes. ResultsA total of 251 (20.6%) patients received intraoperative PRBC transfusion. Of these, 112 and 125 patients were grouped in the fresh and the old PRBC groups, respectively. The Kaplan–Meier curves showed that both fresh PRBC group and old PRBC group had worse OS, IRFS, and EMFS than nontransfused group (P<0.001). Cox regression analyses further indicated that old PRBC transfusion was an independent prognostic factor of OS (HR=1.417, P=0.049), IRFS (HR=1.519, P=0.013) for patients with HCC; conversely, new PRBC transfusion was not. ConclusionIn patients undergoing curative hepatectomy, intraoperative transfusions of PRBC that had been stored for more than 2 weeks is independently associated with a significantly increased risk of intrahepatic recurrence and reduced overall survival. 
		                        		
		                        		
		                        		
		                        	
            

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