Objective To explore the relationship of the preoperative serum alanine aminotransferase(ALT)/aspartate aminotransferase(AST)ratio and imaging features to the prognosis of patients with hepatocellular carcinoma(HCC)after receiving transarterial chemoembolization(TACE),and to develop a nomogram model used for predicting the patient's overall survival(OS).Methods A total of 211 patients,who were diagnosed as HCC and were treated with TACE as the initial therapy at the Guangci Branch of the First Affiliated Hospital of Soochow University of China between July 2016 and July 2020,were enrolled in this study.The patients were randomly divided into the modeling group(n=139)and validation group(n=72).The receiver operating characteristic(ROC)curve was used to determine the optimal cutoff value of AST/ALT ratio.The univariate and multivariate Cox regression analyses were conducted in the modeling group to screen out the independent predictors affecting HCC patient's OS and to establish a prognostic model.Harrell consistency index(C-index)was used to evaluate the predictive ability of the nomogram model for OS in HCC patients,and the calibration curves were plotted to assess the predictive accuracy of the nomogram model.Results No statistically significant difference in the baseline feature distribution existed between the modeling group and validation group(P＞0.05).The median OS of the modeling group and validation group was 28.5 months(95％CI:22.1-34.9)and 25.1 months(95％CI:19.2-29.0)respectively,the difference was not statistically significant(x2=1.395,P=0.322).The optimal cutoff value of AST/ALT ratio for predicting OS was 1.10,and the area under curve(AUC)value was 0.674(95％CI:0.604-0.753).The Cox regression analysis indicated that the tumor number(HR=2.080,95％CI=1.245-3.475,P=0.005),tumor capsule(HR=1.771,95％CI=1.128-2.780,P=0.013),irregular marginal enhancement(HR=1.884,95％CI=1.190-2.984,P=0.007),and AST/ALT ratio(HR=2.450,95％CI=1.506-3.987,P＜0.01)were the independent prognostic factors for HCC patients receiving TACE treatment.Based on the above variables,a nomogram model for predicting OS was established,and the C-index values in the modeling group and validation group were 0.733(95％CI:0.650-0.826)and 0.770(95％CI:0.688-0.862)respectively.The calibration curves showed that no significant deviations existed between the predictive curves of the prognostic model and the ideal reference curves for one-,2-and 3-year OS.Conclusion The nomogram model,which is established based on the tumor number,imaging features and preoperative AST/ALT ratio,has an excellent value in predicting the prognosis of HCC patients treated with TACE.

Objective:To compare the clinical outcomes of the Laennec’s approach versus the two-step separation stylized approach in laparoscopic left lateral sectionectomy (LLLS).Methods:A total of 60 patients who underwent LLLS at the Department of Hepatobiliary and Pancreatic Surgery, the Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University from March 2019 to April 2022 were prospectively entered into this study. There were 40 males and 20 females, aged (49.1±9.3) years, with 31 patients suffering from liver cancer, 14 patients hepatic hemangioma and 15 patients hepatolithiasis. A randomized number table was used to assign the patients into two groups: the Laennec’s approach group ( n=30) and the two-step separation stylized approach group ( n=30). The age, gender, liver function, operation time, intraoperative blood loss, abdominal drainage amount, drainage tube retention time, postoperative hospital stay, total hospital costs and postoperative complications were compared between the two groups. Results:There were no significant differences between the two groups in gender, age and Child-Pugh grading of liver function (all P>0.05). Comparison of intraoperative bleeding, postoperative hospital stay, postoperative complications, postoperative recurrence between the two groups showed there were no significant differences between the two groups (all P>0.05). The operative time [(85.6±24.5) min vs (99.1±30.7) min, P<0.05] was significantly less in the stylized group than the Laennec’s group, while the Laennec’s group were superior to the stylized group in the amount of draining [(144.1±38.3) ml vs (290.9±59.5) ml], drainage tube retention time [(2.7±1.5) d vs (4.3±1.9) d] and total hospital costs [(35 100.7±13 200.6) yuan vs (44 700.1±11 800.8) yuan](all P<0.05). Conclusions:Both the Laennec’s and stylized approaches for LLLS were safe and feasible. The stylized approach for LLLS could be performed more quickly, while the Laennec’s approach could more accurately dissect and handle intrahepatic and extrahepatic ducts, thus resulting in decreased postoperative exudation and treatment costs.

Objective To explore the value of high-resolution MRI in in the preoperative evaluation of children with type Ⅰ focal cortical dysplasia (FCD). Methods The MRI and related clinical data of 52 children with FCD Ⅰ confirmed by pathology were retrospectively analyzed,Compare the detection rates of major MRI signs of type Ⅰ FCD (focal demarcation of gray and white matter,focal cortical structure abnormalities,abnormal white matter signal lesions,and local atrophy / hypoplasia) of high-resolution imaging and conventional MRI sequences,and comparisons in the assessment of lesion extent,borders,and completeness were perfomed. Results The detection rate of high-resolution imaging for blurring of gray-white matter boundaries,focal cortical structural abnormalities,and abnormal white matter abnormalities was higher than that of conventional sequences (P<0.05),there was no significant difference in the detection rate of local atrophy/dysplasia (P>0.05). 3D-T1WI showed the range and boundary of the lesion better than the conventional T1WI sequence,3D-T2FLAIR was more complete than the conventional T2FLAIR sequence. Conclusion The high-resolution MRI could improve the detection rate of various major signs of type Ⅰ FCD,could more fully display the lesion and accurately assess the scope and boundary of the lesion,and was the preferred MRI imaging sequence before surgery.

Objective To investigate the expression change of RACK1 ,Src and Bcl‐2 in gastric carcinoma tissue and adjacent carcinomatous tissue .Methods Eighty specimens of gastric carcinoma and adjacent carcinomatous tissues in our hospital from Au‐gust 1 ,2011 to February 1 ,2014 were collected .The immunohistochemistry staining and Western blotting methods were adopted to detect the expression of RACK1 ,Src and Bcl‐2 protein in gastric carcinoma and adjacent carcinomatous tissues ,and their correlation was analyzed and performed the statistical analysis by combining with the clinicopathological data .Results The immunohistochem‐istry staining and Western blotting detection displayed that the expression positive rate and expression level of RACK 1 in gastric carcinoma tissue were obviously lower than those in the adjacent carcinomatous tissue ,while the expression positive rate and ex‐pression level of Src and Bcl‐2 in gastric carcinoma tissue were obviously higher than those in the adjacent carcinomatous tissue ,the differences were statistically significant (P<0 .05) .The RACK1 expression in gastric carcinoma tissue was negatively correlated with the Src and Bcl‐2 expression(r= -0 .632 ,-0 .754 ,P<0 .01) ,while Src had no obvious correlation with Bcl‐2 protein(r=0 .217 ,P>0 .05) .Conclusion The expression of RACK1 in gastric carcinoma tissue is significantly decreased ,while the expres‐sions of Src and Bcl‐2 are increased .

OBJECTIVE To explore the outcomes of CO2 laser assisted stapedotomy with artificial stapes prostheses in the treatment of advanced otosclerosis. METHODS Between January 2010 and January 2014, 15 patients (16 ears) diagnosed as advanced otosclerosis accepted CO2 laser assisted stapedotomy with artificial stapes implantation in our department. The averaged preoperative air conduction threshold of the speech frequency was 70.21 dB HL, the averaged bone conduction threshold was 38.49 dB HL, the averaged air-bone gap (ABG) was 31.72 dB HL. All cases were followed up for more than 6 months after operation. RESULTS All cases accepted auditory follow up after 6 months postoperatively. The speech frequency average air conduction threshold was 43.7 dB HL, the average bone conduction threshold was 28.95 dB HL, the average ABG was 14.75 dB HL. The ABG≤20 dB was achieved in 9 ears (56.3%) and ABG closure (≤10 dB) was achieved in 6 ears (37.5%). No cases appeared intractable vertigo, sensorineural hearing loss, secondary facial paralysis and other serious complications. CONCLUSION CO2 laser assisted technique reduced the probability of serious complications of stapedotomy, most patients with hearing level improved significantly. It's a safe, practical, relatively economical choice for advanced otosclerosis.

OBJECTIVETo investigate the mechanisms underlying the ability ofheparin-treated dendritic cells (DCs) to promote Th0 to Th1 differentiation in chronic hepatitis B (CHB).

METHODSPeripheral blood mononuclear cells (PBMCs) were isolated from CHB patients and cultured in RPMI-1640 with recombinant GM-CSF and IL-4 with or without heparin to obtain DCs for study. The levels of Toll-like receptors (TLRs) on the DCs were measured using FACS and qPCR techniques.DC subsets with high expression of TLRs were selected for analysis of functional changes by treatment with the corresponding TLR-siRNA. The CD4+ T cell subpopulation was purified from peripheral blood by Dynal immunomagnetic beads, and then the production of IL-12 by DCs in the presence of poly(I:C) or R848 and ofIFN and IL-4 by Th cells co-cultured with DCs was evaluated by ELISA. The t-test was used for statistical analysis.

RESULTSTLR3 expression, and not expression of TLR 7 or TLR8,was significantly increased in heparin-treated DCs as compared to levels detected in the DCs without heparin treatment (t =2.849,P less than 0.05;t =3.027,P less than 0.05). The level of IL-12 produced by heparin-treated DCs stimulated with poly(I:C) was obviously higher than that produced by DCs without heparin treatment and stimulated with poly(I: C) (t =8.68,P less than 0.01) or with R848 (t =19.01,P less than 0.01). However, the IL-12 production by TLR3-siRNA transfected-DCs was significantly reduced (t =31.49, P less than 0.01).When Th cells from allogenic patients with CHB were co-cultured with the TLR3-siRNA transfectedDCs, the frequency ofCD4+ IFN+ cells was significantly reduced (1.64+/-0.57% vs.6.31+/-0.88%,P less than 0.01),as was the capability of Thl to generate IFNg (t =20.83,Pless than 0.01).

CONCLUSIONHeparin may have up-regulated the TLR3 expression level of DCs, and sequentially promoted Th0 to Th1 differentiation.

CD4-Positive T-Lymphocytes ; cytology ; Cell Differentiation ; Coculture Techniques ; Dendritic Cells ; cytology ; Granulocyte-Macrophage Colony-Stimulating Factor ; pharmacology ; Heparin ; pharmacology ; Hepatitis B, Chronic ; immunology ; Humans ; Interferon-gamma ; metabolism ; Interleukin-12 ; metabolism ; Interleukin-4 ; pharmacology ; Monocytes ; cytology ; Recombinant Proteins ; pharmacology ; Toll-Like Receptor 3 ; metabolism

Objective This study is to study the age related changes of the expression of caspase-3 and the apoptosis states of neurons in primary auditory cortex of 15 young C57BL/6J mice(2 months, 15～20 g) and 15 old C57BL/6J mice(10 months, 50～60 g) and to determine probable physical effects underlying these changes. This paper also discusses the relationship of caspase-3 and apotosis states in primary auditory cortex, the possible role of caspase-3 in primary auditory cortex and the pathogenesis of presbycusis. Methods The immunohistochemical methods were applied to explore the differences of the expression of caspase-3 and the apoptosis states determined by TUNEI. method in the primary auditory cortex between young and old C57BL/6J mice. Results The expression of caspase-3 and apoptosis in Al of old C57BL/6J mice was significantly higher than that in the counterpart of young C57BL/6J mice. Conclusion The results presented a direct morphological evidence for the strengthening of caspase-3 in the primary auditory cortex in old C57BL/6J mice. This method has an important role in the formation and development of presbycusis. The expression of caspase-3 participated in the regulatory procedure of apoptosis and may be a possible factor of the etiologies of presbycusis.

OBJECTIVE: To explore the effects of c-Met-siRNA on the proliferation, movement and invasion of laryngeal carcinoma Hep-2 cells in vitro. METHOD: Firstly, the pSilencer 2.0/c-Met-shRNA recombinant plasmid was transfected into laryngeal carcinoma Hep-2 cells with transfecting agent of cationic liposome Lipofectamine 2000. Secondly,the transfection efficacy was tested by RT-PCR and Western-Blot, then the most inhibitive c-Met-siRNA sequence was elected. Cell proliferation, movement and invasion were detected with MTT, cell migration assay and cell invasion assay, respectively. RESULT: After the transfection of pSilencer 2.0/c-Met-shRNA recombinant plasmid into laryngeal carcinoma Hep-2 cells, the expression of mRNA and protein of c-Met decreased significantly in Hep-2 cells, and ability of the proliferation, movement and invasion of laryngeal carcinoma Hep-2 cells were also inhibited. CONCLUSION The results indicated that c-Met-siRNA can down-regulated the expression of c-Met and markedly inhibited laryngeal carcinoma Hep-2 cell proliferation, movement and invasion. It may have the potential as a therapeutic modality to treat human laryngeal carcinoma.
Apoptosis ; genetics ; Carcinoma, Squamous Cell ; genetics ; pathology ; Cell Line, Tumor ; Cell Proliferation ; Humans ; Laryngeal Neoplasms ; genetics ; pathology ; Liposomes ; Proto-Oncogene Proteins c-met ; genetics ; RNA, Messenger ; genetics ; RNA, Small Interfering ; genetics ; Transfection

BACKGROUND: Hepatocyte/polymer interface with good biocompatibility is the key factor in bioreactor design andconstruction, however, bioreactor used in the clinical practice currently is not an ideal one.OBJECTIVE: To establish human hepatocyte compatible polypropylene interface and to lay a foundation for establishingbioartificial liver reactor with polypropylene hollow fiber.DESIGN, TIME AND SETTING: The comparative observation, cell compatibility experiment was performed betweenFebruary and October 2003 at Shanghai Jiao Tong University, Shanghai, China.MATERIALS: Polypropylene Photochemical graft polymerization modification technique was used to graft hydrophilicacrylamide groups on the surface of polypropylene membrane by chemical bonds to form modified polypropylenemembrane.METHODS: L02 human hepatoeytes were seeded on polypropylene membrane, modified polypropylene membrane andpolystyrene membrane, and polystyrene membrane was used as normal control.MAIN OUTCOME MEASURES: Static water contact angle of polypropylene membrane before and after graftmodification; morphology, adherent rate and proliferation activity of L02 human hepatocytes on different material surfaces.RESULTS: Static water contact angle after polypropylene membrane graft modification was smaller than that before graftmodification (P < 0.05). The adherent rate of L02 human hepatocytes on the surface of modified polypropylene membranewas 0, and the proliferation activity of them, which grew as spherical aggregates, was markedly higher than that of cells onpolystyrene membrane and polypropylene membrane without graft modification.CONCLUSION: Grafting polyacrylamide on the surface of polypropylene can establish good interface of L02 humanhepatocytes/polypropylene and form hepatocyte spherical aggregates through simple static culture.

Objective To investigate the cellular immune state and pathological mechanism of HBV chronic infection by analyzing the cytokines produced by peripheral blood mononuclear cells(PBMCs) of asymptomatic HBV carriers.Methods PBMCs were prepared from diagnosed chronic asymptomatic HBV individuals and cultured in the presence of different antigens and antibodies.The levels of IFN-?,IL-12,TNF-?,TGF-? and IL-10 in the culture supernatants were respectively detected by ELISA.Results The levels of IFN-?,IL-12 were significantly lower than in the counterparts from healthy controls;meanwhile,those of TGF-? and IL-10 were elevated markedly.Neutralization of TGF-? and IL-10 simultaneously restore the IFN-? production from PBMCs of HBV carriers,and exogenous IL-12 in low dose combined with specific HBV antigens promoted IFN-? production.Conclusion Reduction of IL-12 from PBMCs may be the fundamental reason of viral persistence in HBV chronic carriers,combined IL-12 and specific HBV antigen promoted the celluar immunity of PBMCs from HBV carriers.