Objective:To investigate the impact of elevated glucose-induced RNA oxidation on pancreatic β-cell function, activity, and underlying molecular mechanisms.Methods:Rat pancreatic islet β-cell tumour INS-1 cells were cultured in vitro and subjected to nucleic acid oxidation assessment using isotope dilution ultra-high performance liquid tandem mass spectrometry(ID LC MS/MS)following high glucose exposure.In vitro simulation of increased RNA oxidation in INS-1 cells was achieved using 8-oxoguanosine-5'-triphosphate(8-oxoGTP).Cell proliferation was evaluated through CCK-8 assay, apoptosis was measured via flow cytometry, and gene expression of insulin(INS), pancreatic-duodenal homologous cassette 1(PDX1), cysteine-aspartate proteinase 3(Casp3), and cysteine aspartate protease 6(Casp6)was analyzed at the mRNA level.Additionally, whole transcriptome sequencing was performed to elucidate the molecular mechanisms underlying the impact of RNA oxidation on INS-1 cells.Results:Elevated glucose levels induced an increase in RNA oxidation within INS-1 cells.This heightened RNA oxidation led to the inhibition of INS-1 cell proliferation, a reduction in mRNA levels of INS and PDX1 genes, and the promotion of apoptosis-related casp3 and casp6 gene mRNA synthesis.Transcriptome sequencing analysis unveiled that the elevated RNA oxidation caused differential expression of mRNA, lncRNA, miRNA, and circRNA in INS-1 cells.This included a significant down-regulation of transcription factors such as Mafa, Pdx1, Pax6, and Mnx1, alongside an up-regulation of various miRNAs like rno-miR-124-3p, rno-miR-133a-3p, rno-miR-3120, rno-miR-212-3p, and rno-miR-7a-2-3p.These molecular changes contributed to the altered expression of associated lncRNAs, ultimately hindering insulin synthesis and secretion, as well as β-cell proliferation.Conclusions:Increased RNA oxidation down-regulates the levels of key β-cell transcription factor mRNAs, contributes to the differential expression of related non-coding RNAs(ncRNAs), particularly lncRNAs, impacts β-cell insulin synthesis and secretion, hinders cell proliferation, and serves as a significant factor in β-cell dysfunction and decreased activity in type 2 diabetes mellitus(T2DM).

Objective: To compare the short-term clinical efficacy and feasibilities between complete mesocolic excision (CME) and tra-ditional radical resection in emergency surgery for patients with colon cancer. Methods: Clinical data for 53 cases of colon cancer treat-ed by emergency surgery between January 2011 and December 2017 in Civil Aviation General Hospital were analyzed. On the basis of the entry time and various operation procedures, the 53 patients were assigned into two groups: the CME group (n=25) that under-went CME in May 2014 or later and the traditional operative group (n=28) that underwent traditional radical resection before May 2014. Distal and proximal colonic and intestinal lavage were performed in all patients. The short-term clinical effects of these different methods were analyzed. Results: The number of excised lymph nodes in the CME group and traditional group was 31.7±2.9 and 19.5± 4.2, respectively, and the difference between the groups was statistically significant (P<0.05). The operation time of the two groups was (176.0±42.3) min and (157.5±33.5) min and the blood loss was (148.7±74.0) mL and (128.9±50.0) mL, respectively. The length of hospital stay of the two groups was (27.2±10.4) days and (23.1±6.3) days and the first flatus time was (75.0±3.3) h and (75.3±3.7) h, re-spectively. The difference between the two groups in these parameters was not statistically significant (P>0.05). In addition, there was no significant differences in pathological staging, postoperative complications, or mortality between the CME group and traditional op-erative group (P>0.05). Conclusions: The short-term clinical efficacy of CME is similar to that of traditional radical cancer surgery with the advantage of more extensive lymph node dissection. CME can be used safely in patients with colon cancer undergoing an emergen-cy operation.

Objective: To investigate the clinical effectiveness of postoperative nutritional support in patients undergoing hepatectomy for hepatocellular carcinoma (HCC). Methods: A total of 379 HCC patients who received partial hepatectomy from January 2010 to December 2013 in Department of Hepatobiliary Surgery of Cancer Hospital, Chinese Academy of Medical Sciences were selected. Based on the nutritional method, all of the enrolled patients were divided into two group: 142 patients who received early enteral nutrition (EEN) combined with parenteral nutrition (PN) were identified as EEN+ PN group; 237 patients who received total parenteral nutrition (TPN) were identified as TPN group. These two groups were even divided into two subgroups, centrally located HCC (cl-HCC) and non-centrally located HCC (ncl-HCC). The clinical effectiveness of different groups was assessed and compared. Results: The age, gender, body mass index (BMI), the maximum diameter of the tumor, the amount of operative bleeding and postoperative infective rate did not show statistically significant differences between EEN+ PN group and TPN group (P>0.05). On the seventh postoperative day (7^th POD), aspartate transaminase (AST) of EEN+ PN group and TPN group were (41.6±2.0) IU/L and (50.4±3.2) IU/L respectively, and the difference was statistically significant (P<0.05). Alkaline phosphatase (ALP) of these two groups were (80.8±2.4) IU/L and (90.2±2.3) IU/L, respectively, and the difference was statistically significant (P<0.05). Total bilirubin (TBIL) of these two groups were (15.8±0.7) μmol/L and (19.1±0.7) μmol/L, respectively, and the difference was statistically significant (P<0.05). On the 7^th POD, AST in cl-HCC subgroups of EEN+ PN group and TPN group were (39.6±2.6) IU/L and (61.0±7.0) IU/L, respectively, and the difference was statistically significant (P<0.05). TBIL in cl-HCC subgroups of these two groups were (14.4±0.9) μmol/L and (20.7±1.3) μmol/L, respectively, and the difference was statistically significant (P<0.05). On the 7^th POD, ALP in ncl-HCC subgroups of these two groups were (79.3±3.0) IU/L and (89.9±3.1) IU/L, respectively, and the difference was statistically significant (P<0.05). The total length of stay (t-LOS) of these two groups were (15.8±0.4) days and (17.1±0.4) days, respectively, and the difference was statistically significant (P<0.05). Postoperative LOS (postop-LOS) of these two groups were (8.6±0.2) days and (10.1±0.3) days, respectively, and the difference was statistically significant (P<0.05). Total length of stay (t-LOS) in ncl-HCC subgroups of these two groups were (15.1±0.5) days and (16.6±0.3) days, respectively, and the difference was statistically significant (P<0.05). Postoperative LOS (postop-LOS) in ncl-HCC subgroups of these two groups were (8.4±0.2) days and (9.5±0.2) days, respectively, and the difference was statistically significant (P<0.05). Postoperative LOS (postop-LOS) in cl-HCC subgroups of these two groups were (8.7±0.2) days and (11.0±0.8) days, respectively, and the difference was statistically significant (P<0.05). Postoperative hospitalization expenses of these two groups were (20 855.0±549.8) yuan and (23 373.0±715.5) yuan, respectively, and the difference was statistically significant (P<0.05). Postoperative hospitalization expenses in cl-HCC subgroups of these two groups were (21 012.0±748.5) yuan and (24 697.0±1 409.0) yuan, respectively, and the difference was statistically significant (P<0.05). Conclusion EEN+ PN can improve the liver function, shorten the postoperative hospitalization time and reduce the postoperative hospitalization expenses of HCC patients in need of nutritional support.

Based on a description of the positioning and characteristics of the hospital and its development roadblocks and mission,the authors studied practical experiences in building a research hospital.The hospital has achieved a leap-forward development thanks to its pursuit of quality as lifeline,innovative research and translation,enhancement of its role in rescue medicine innovation,and leveraging branding effect of rescue medicine.

OBJECTIVETo explore the significance of resection margin and tumor number on survival of patients with small liver cancer after hepatectomy.

METHODSWe collected 219 cases with small liver cancer undergoing hepatectomy in Cancer Hospital, Chinese Academy of Medical Sciences between December 2003 to July 2013. The survival rates were compared by log-rank test between two resection margin groups (≥ 1 cm vs. <1 cm), different tumor number groups (single tumor vs. multiple tumors). We also performed a multifactor analysis by Cox model.

RESULTSThe 1-, 3-, 5- and 10- year overall survival rates were 95.9%, 85.3%, 67.8% and 53.3%, respectively, in all patients. The median survival time was 28 months in the group of <1 cm resection margin and 36 months in the group of ≥ 1 cm resection margin (P=0.249). The median survival time was 36 months in the group of single tumor and 26 months in the group of multiple tumors (P=0.448). The multifactor analysis also did not show significant effect of resection margin and tumor number on the patients' survival.

CONCLUSIONSFor small liver cancer, the resection margin of 1 cm might be advised. Increasing resection margin in further could probably not improve therapeutic effect. Standardized operation and combined treatment will decrease the negative influence of multiple tumors on overall survival.

Combined Modality Therapy ; Hepatectomy ; Humans ; Liver Neoplasms ; mortality ; pathology ; surgery ; Survival Rate ; Time Factors

OBJECTIVETo investigate the differences between clinicopathological features and prognosis of alpha-fetoprotein (AFP) negative (AFP < 20 ng/ml) and positive (AFP ≥ 20 ng/ml) hepatocellular carcinoma (HCC) patients.

METHODSClinicopathological data of 142 AFP-negative and 109 AFP-positive HCC patients who underwent RO radical hepatectomy in the Cancer Hospital of Chinese Academy of Medical Sciences between January 2006 and December 2011 were retrospectively reviewed and analyzed in this study.

RESULTSCompared with the AFP-negative patients, a higher female to male sex ratio, the later Barcelona Clinic Liver Cancer ( BCLC) stage, more liver capsule invasion and poorer Edmondson-Steiner grade were in the AFP-positive cases (P < 0.05 for all). Furthermore, the 1-, 3-, and 5- year overall survival rates were 94.4%, 82.4% and 61.0% in the AFP-negative group and 87.2%, 61.1% and 40.2%, respectively, in the AFP-positive group (P < 0.001). The multivariate analysis with Cox's proportional hazards model showed that AFP status, tumor size and Edmondson-Steiner grade are independent risk factors for survival of all the patients (P < 0.05) , and large tumor and Edmondson-Steiner grades III/IV are independent risk factors for worse survival in AFP-negative patients (P < 0.05). However, large tumor diameter was proved to be an independent risk factor leading to poor prognosis of AFP-positive cases (P < 0.05).

CONCLUSIONHigh levels of AFP indicate that the tumors are more malignant and with unfavorable prognosis.

Asian Continental Ancestry Group ; Carcinoma, Hepatocellular ; chemistry ; mortality ; pathology ; surgery ; Female ; Hepatectomy ; Humans ; Liver Neoplasms ; chemistry ; mortality ; pathology ; surgery ; Male ; Multivariate Analysis ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors ; Survival Rate ; alpha-Fetoproteins ; analysis

OBJECTIVETo evaluate preliminarily the clinical efficacy of two types of hepatic inflow occlusion in hepatectomy for hepatocellular carcinoma (HCC).

METHODSA total of 54 patients with HCC who underwent hepatectomy were divided into two groups: RIP group (regional ischemic preconditioning with continuous clamping, n=15) and HHV group (hemi-hepatic vascular inflow occlusion, n=39). HHV was performed by placing a clamp on the right hepatic artery and right portal vein, and was maintained until the liver resection was completed. In the RIP group, HHV was preceded by a 5-min period of ischemia followed by 5 min of reperfusion. The clinical indicators of the two groups were compared.

RESULTSThe volume of intraoperative blood loss had significant difference between the two groups (P=0.039). One case (6.7%) in the RIP group and 17 cases (43.6%) in the HHV group received postoperative blood transfusion, showing a significant difference (P=0.010). No postoperative 30-day mortality happened in all patients. No significant differences were found between the two groups in hospital stay or postoperative morbidity, including hepatic insufficiency, infection, ascites, pleural effusion, cardiopulmonary complications and intestinal ventilation time (P>0.05 for all).The RIP group had a significantly higher PTA level at postoperative days 3 and 5 (P<0.001). Although no significant differences were found between the two groups regarding total bilirubin, albumin, prealbumin and aminotransferase (P>0.05) during any postoperative stage, the ALT recovered to normal level in 5 patients (33.3%) of the RIP group and only in one case (2.7%) of the HHV group, with a significant difference between the two groups (P=0.006).

CONCLUSIONThe results of this study indicate that regional ischemic preconditioning may have better hemostatic effect on hepatectomy, can reduce postoperative blood transfusion and promote early recovery of liver function than hemi-hepatic vascular inflow occlusion.

Ascites ; Bilirubin ; Blood Loss, Surgical ; Blood Transfusion ; Carcinoma, Hepatocellular ; surgery ; Constriction ; Hepatectomy ; Hepatic Artery ; Humans ; Ischemic Preconditioning ; Length of Stay ; Liver Neoplasms ; surgery ; Portal Vein ; Postoperative Period

OBJECTIVETo explore the surgical risk, perioperative outcome and the response of patients with hepatocellular carcinoma (HCC) after preoperative transcatheter arterial chemoembolization (TACE).

METHODSA retrospective case-matched study was conducted to compare the characteristics and corresponding measures of patients in the preoperative TACE group and the control group without TACE. A total of 105 patients (82 patients with selective and dynamic region-specific vascular occlusion to perform hepatectomy for patients with complex hepatocellular carcinoma) was included in this study, in which 35 patients underwent TACE therapy, and a 1:2 matched control group of 70 subjects.

RESULTSThe patients of preoperative TACE therapy group had a higher level of γ-glutamyl transpeptidase before operation (119.52±98.83) U/L vs. (67.39±61.25) U/L (P=0.040). The operation time was longer in the TACE group than that in the control group but with a non-significant difference (232.60±95.43) min vs. (218.70±75.13) min (P=0.052). The postoperative recovery of liver function and severe complications in the preoperative TACE group were similar to that in the control group (P>0.05). There were no massive hemorrhage, biliary fistula and 30-d death neither in the treatment group and matched control group.

CONCLUSIONSPreoperative TACE therapy has certain negative effect on liver function. It is preferable to use selective and dynamic region-specific vascular occlusion technique during hepatectomy and combine with reasonable perioperative treatment for this group of patients, that can ensure safety of patients and promote their rapid recovery.

Carcinoma, Hepatocellular ; blood supply ; therapy ; Case-Control Studies ; Chemoembolization, Therapeutic ; adverse effects ; methods ; Hepatectomy ; methods ; Humans ; Liver ; physiopathology ; Liver Neoplasms ; blood supply ; therapy ; Operative Time ; Preoperative Period ; Recovery of Function ; Retrospective Studies ; gamma-Glutamyltransferase ; analysis

Objective To evaluate preliminarily the clinical efficacy of two types of hepatic inflow occlusion in hepatectomy for hepatocellular carcinoma ( HCC) .Methods A total of 54 patients with HCC who underwent hepatectomy were divided into two groups:RIP group ( regional ischemic preconditioning with continuous clamping,n=15) and HHV group(hemi-hepatic vascular inflow occlusion, n=39).HHV was performed by placing a clamp on the right hepatic artery and right portal vein, and was maintained until the liver resection was completed.In the RIP group, HHV was preceded by a 5-min period of ischemia followed by 5 min of reperfusion.The clinical indicators of the two groups were compared.Results The volume of intraoperative blood loss had significant difference between the two groups (P=0.039).One case (6.7%) in the RIP group and 17 cases ( 43.6%) in the HHV group received postoperative blood transfusion, showing a significant difference (P=0.010).No postoperative 30-day mortality happened in all patients. No significant differences were found between the two groups in hospital stay or postoperative morbidity, including hepatic insufficiency, infection, ascites, pleural effusion, cardiopulmonary complications and intestinal ventilation time ( P >0.05 for all).The RIP group had a significantly higher PTA level at postoperative days 3 and 5 (P<0.001).Although no significant differences were found between the two groups regarding total bilirubin, albumin, prealbumin and aminotransferase ( P >0.05 ) during any postoperative stage, the ALT recovered to normal level in 5 patients (33.3%) of the RIP group and only in one case (2.7%) of the HHV group, with a significant difference between the two groups (P=0.006). Conclusion The results of this study indicate that regional ischemic preconditioning may have better hemostatic effect on hepatectomy, can reduce postoperative blood transfusion and promote early recovery of liver function than hemi-hepatic vascular inflow occlusion.

Objective To investigate the differences between clinicopathological features and prognosis of alpha-fetoprotein ( AFP ) negative ( AFP<20 ng/ml ) and positive ( AFP≥20 ng/ml ) hepatocellular carcinoma ( HCC) patients.Methods Clinicopathological data of 142 AFP-negative and 109 AFP-positive HCC patients who underwent R0 radical hepatectomy in the Cancer Hospital of Chinese Academy of Medical Sciences between January 2006 and December 2011 were retrospectively reviewed and analyzed in this study.Results Compared with the AFP-negative patients, a higher female to male sex ratio, the later Barcelona Clinic Liver Cancer ( BCLC ) stage, more liver capsule invasion and poorer Edmondson-Steiner grade were in the AFP-positive cases (P<0.05 for all).Furthermore, the 1-, 3-, and 5-year overall survival rates were 94.4%, 82.4%and 61.0%in the AFP-negative group and 87.2%, 61.1%and 40.2%, respectively, in the AFP-positive group ( P<0.001 ) .The multivariate analysis with Cox′s proportional hazards model showed that AFP status, tumor size and Edmondson-Steiner grade are independent risk factors for survival of all the patients ( P<0.05) , and large tumor and Edmondson-Steiner gradesⅢ/Ⅳare independent risk factors for worse survival in AFP-negative patients ( P<0.05) .However, large tumor diameter was proved to be an independent risk factor leading to poor prognosis of AFP-positive cases (P<0.05).Conclusion High levels of AFP indicate that the tumors are more malignant and with unfavorable prognosis.