1.Clinical efficacy of escitalopram combined with transcutaneous cervical vagus nerve stimulation therapy for patients with major depressive disorder and its effect on plasma IL-6 and IL-10 levels
Jin LI ; Jinbo SUN ; Di WU ; Wenjun WU ; Runzhu SUN ; Shanshan XUE ; Yapeng CUI ; Huaning WANG ; Yihuan CHEN
Sichuan Mental Health 2025;38(1):7-13
BackgroundInvasive vagus nerve stimulation therapy has been approved for the adjunctive treatment of treatment-resistant depression, which may contribute to the anti-inflammatory properties of vagus nerve stimulation (VNS), whereas the efficacy of non-invasive transcutaneous cervical vagus nerve stimulation (tcVNS) in treating major depressive disorder (MDD) and its impact on plasma inflammatory factors remain unclear. ObjectiveTo observe the effect of escitaloprom combined with tcVNS on the status of depression, anxiety and sleep quality as well as the plasma levels of interleukin-6 (IL-6) and interleukin-10 (IL-10) in MDD patients, in order to provide references for the recovery and treatment of MDD patients. MethodsFrom August 21, 2019 to April 17, 2024, 45 patients who met the diagnostic criteria for MDD in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) were recruited from the psychosomatic outpatient clinic of the First Affiliated Hospital of Air Force Military Medical University. Subjects were divided into study group (n=23) and control group (n=22) using random number table method. All patients were treated with escitalopram. On this basis, study group added a 30-minute tcVNS therapy once a day for 4 weeks. While control group was given corresponding sham stimulation, and the duration of each stimulation lasted 30 seconds. Before and after 4 weeks of treatment, Hamilton Depression Scale-17 item (HAMD-17) was used to assess depressive symptoms, and HAMD-17 anxiety/somatization subfactor and insomnia subfactor were used to assess patients' anxiety/somatization symptoms and sleep quality. Levels of plasma IL-6 and IL-10 were measured by enzyme-linked immunosorbent assay (ELISA). ResultsThe generalized estimating equation model yielded a significant time effect for HAMD-17 total score, anxiety/somatization subfactor score and insomnia subfactor score in both groups (Wald χ2=315.226, 495.481, 82.420, P<0.01). After 4 weeks of treatment, HAMD-17 total score and anxiety/somatization subfactor score of study group were lower than those of control group, with statistically significant differences (Wald χ2=4.967, 32.543, P<0.05 or 0.01), while no statistically significant difference was found in the insomnia subfactor score between two groups (Wald χ2=0.819, P=0.366). Significant time effects were reported on plasma IL-6 and IL-10 levels in both groups (Wald χ2=21.792, 5.242, P<0.05 or 0.01). Compared with baseline data, a reduction in plasma IL-6 levels was detected in both groups (Wald χ2=22.015, 6.803, P<0.01), and an increase in plasma IL-10 levels was reported in study group (Wald χ2=5.118, P=0.024) after 4 weeks of treatment. ConclusionEscitalopram combined with tcVNS therapy is effective in improving depressive symptoms, anxiety/somatization symptoms and sleep quality in patients with MDD. Additionally, it helps reduce plasma IL-6 levels and increase IL-10 levels. [Funded by Shaanxi Provincial Key Research and Development Program-General Project (number, 2023-YBSF-185), www.clinicaltrials.gov number, NCT04037111]
2.Quality Evaluation of Atractylodis Macrocephalae Rhizoma in Different Production Methods Based on Traditional Traits
Jinxiu QIAN ; Yihan WANG ; Yapeng WANG ; Guoliang YU ; Qiuxiang PAN ; Jiawei SHI ; Meiping CHEN ; Yangqing LIU ; Lun LU ; Yanmeng LIU ; Tiegui NAN ; Liping KANG ; Zhilai ZHAN
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(1):43-52
ObjectiveBased on the experience of traditional quality evaluation, the quality of Atractylodis Macrocephalae Rhizoma(AMR) with different production methods such as direct seeding, transplanting after seedling raising, topping and non-topping, and difference in growth years was compared. MethodVernier caliper was used to measure the trait data of AMR in different production methods. Paraffin sections of AMR with different production methods were made by saffron solid green staining, and the microstructure was observed. The contents of water-soluble and alcohol-soluble extracts in AMR with different production methods were determined according to the 2020 edition of Chinese Pharmacopoeia. The content of water-soluble total polysaccharides in AMR with different production methods was detected by sulfuric acid-anthrone method. Fiber analyzer was used to detect the content of fiber components in AMR with different production methods. The contents of monosaccharides, oligosaccharides and some secondary metabolites in AMR with different production methods were detected by ultra performance liquid chromatography(UPLC), and the differences of chemical components were compared by multivariate statistical analysis methods such as principal component analysis(PCA) and partial least squares-discriminant analysis(PLS-DA). ResultIn terms of traits, the 3-year-old AMR with direct seeding and without topping was close to the high-quality AMR with "phoenix-head and crane-neck, strong sweetness and clear aroma" recorded in ancient materia medica, followed by the 3-year-old AMR with topping after transplanting, while the 2-year-old AMR with topping after transplanting with high market circulation rate was generally fat and strong with mild odor. In the microscopic aspect, the arrangement of xylem vessels and fiber bundles in the 3-year-old samples formed two obvious rings. Compared with the 2-year-old samples cultivated in Bozhou and Zhejiang, the 3-year-old samples without topping after transplanting had more wood fibers. In terms of chemical composition, the contents of 70% ethanol extract, fructose, glucose, sucrose, 1-kestose, atractylenolide Ⅰ, chlorogenic acid, neochlorogenic acid, cryptochlorogenic acid and other components in 3-year-old AMR with direct seeding and without topping were significantly higher than those in the other three samples(P<0.05). The contents of cellulose, 70% ethanol extract, sucrose, atractylenolide Ⅰ, atractylone and other components in 3-year-old AMR with topping after transplanting were significantly higher than those in the 2-year-old AMR with high market circulation rate(P<0.05), while the contents of water-soluble extract and water-soluble total polysaccharides in 2-year-old samples with topping after transplanting were significantly higher than those in the 3-year-old AMR with topping after transplanting, direct seeding and without topping(P<0.05). ConclusionUnder the current mainstream production mode, too much manual intervention makes AMR heavily enriched in polysaccharides and increased the yield, but the accumulation of sweet substances, fragrant substances and fiber substances is insufficient, which affects its quality. The current quality standard of AMR has some shortcomings in guiding the high quality production of it, it is suggested to revise the quality standard of AMR, supplement the quantitative analysis of secondary metabolites, and strengthen the production of imitation wild AMR.
3.Effects of circular RNA-SEC31A on the invasion and migration of pancreatic cancer cells and molecular mechanism
Yina YIN ; Min SU ; Zihang LIN ; Yapeng CHEN ; Rufu CHEN ; Zhihua LI
Chinese Journal of Pancreatology 2023;23(2):99-107
Objective:To determine the expression of circular RNA-SEC31A(circSEC31A) in pancreatic cancer and investigate the effects on the invasion and migration of pancreatic cancer cells and the underlying molecular mechanism.Methods:Differentially expressed circRNAs between pancreatic cancer cells (BXPC-3, PANC1, CaPan-2, SW1990) and human normal pancreatic cells (HPDE) were identified by qRT-PCR. Then, two cell lines with high circSEC31A expression were selected to conduct next experiments. According to the sequence of the back-splicing site in circSEC31A, siRNAs for downregulation of circSEC31A were designed and transfected by liposome to silence circSEC31A in pancreatic cancer cells, and grouped as followed siR-circSEC31A#1 and siR-circSEC31A#2. Meanwhile, siR-NC group transfected with non-specific siRNA served as control. Transwell assays and wound healing assays were operated to evaluate the functional role of circSEC31A on the invasion and migration of pancreatic cancer cells. RNA Pull-down assay with circSEC31A probe and oligo control probe was used to screen the miRNA combining with circSEC31A and the effects of miRNA on cell invasion and migration of pancreatic cancer cells were validated. The effect of miR-200c-3p and circSEC31A silencing on the expression of PDK1 mRNA was identified by qRT-PCR. The protein expression of PDK1, downstream Akt and p-Akt after circSEC31A silencing was verified by Western blotting assays.Results:The relative expression level of circSEC31A in HPDE (1.000±0.120) was obviously lower than that in BXPC-3 (1.920±0.130), SW1990 (2.93±0.528), PANC1 (4.557±0.692) and CaPan-2 (5.247±0.194), and all the differences were statistically significant ( P<0.001). Compared with the PANC1 siR-NC group (1301.3±94.6) and CaPan-2 siR-NC group (1835.0±70.1) per 100 high power field, transwell assays showed that the numbers of invasive pancreatic cancer cells was highly decreased in PANC1 siR-circSEC31A#1 group (727.3±92.9), siR-circSEC31A#2 group (792.0±18.1), CaPan-2 siR-circSEC31A#1 group (718.0±90.6), siR-circSEC31A#2 group (692.7±84.8). Wound healing assays showed that silencing circSEC31A decreased the wound healing rate of pancreatic cancer cells in PANC1 siR-circSEC31A#1 group (20.667±3.215)%, siR-circSEC31A#2 group (20.000±4.583)%, CaPan-2 siR-circSEC31A#1 group (28.000±8.185)%, siR-circSEC31A#2 group (29.667±5.686)%, compared with the PANC1 siR-NC group (55.000±4.359)% and CaPan-2 siR-NC group (69.000±3.606)%. RNA Pull-down assays showed that compared with PANC1 oligo probe group (1.000±0.091) and CaPan-2 oligo probe group (1.000±0.153), miR-200c-3p was significantly enriched in the PANC1 circSEC31A probe group (2.237±0.175) and CaPan-2 circSEC31A probe group (2.166±0.156). Compared with PANC1 siR-NC group (939.3±57.0) and CaPan-2 siR-NC group (786.7±51.5) per 100 high power field, the numbers of invasive pancreatic cancer cells were up-regulated in PANC1 siR-miR-200c-3p group (1206.0±99.1) and CaPan-2 siR-miR-200c-3p group (1838.0±105.7), while the low numbers of invasive pancreatic cancer cells were observed in PANC1 siR-miR-200c-3p+ siR-circSEC31A group (932.7±116.4) and CaPan-2 siR-miR-200c-3p+ siR-circSEC31A group (785.3±58.8). Compared with PANC1 siR-NC group (1.000±0.103) and CaPan-2 siR-NC group (1.000±0.107), the relative expression of PDK1 mRNA in PANC1 siR-miR-200c-3p group (1.898±0.159) and CaPan-2 siR-miR-200c-3p group (2.102±0.337) was upregulated. Furthermore, the expression of PDK1 mRNA was decreased in the siR-miR-200c-3p+ siR-circSEC31A group (0.980±0.070, 1.015±0.079). Western blot assays showed that the expression of PDK1 protein in PANC1 siR-NC group, siR-circSEC31A#1 group, siR-circSEC31A#2 group was 0.767±0.086, 0.281±0.191, 0.333±0.062 and in CaPan-2 siR-NC group, siR-circSEC31A#1 group, siR-circSEC31A#2 group was 0.712±0.038, 0.353±0.061, 0.308±0.018. The expression of p-Akt protein in PANC1 siR-NC group and siR-circSEC31A group was 0.741±0.050, 0.114±0.027, 0.139±0.041. In addition, p-Akt protein expression in CaPan-2 siR-NC group and siR-circSEC31A group was 0.823±0.052, 0.141±0.045, 0.280±0.089. PDK1 and p Akt expression in siR circSEC31A group was obviously lower than those in sir NC group. All the differences between either groups above were statistically significant ( P<0.05). Conclusions:circSEC31A is upregulated in pancreatic cancer cells, which facilitates the invasion and metastasis of pancreatic cancer cells via miR-200c-3p/PDK1/Akt signaling pathway, supporting that circSEC31A may function as a new diagnostic and therapeutic target for pancreatic cancer patients.
4.Efficacy and safety of ropivacaine combined with alfentanil for analgesia after knee arthroscopic surgery
Yapeng HE ; Zong YE ; Lei LI ; Hui QIN ; Hao WU ; Jia CHEN ; Xianlin ZHU
China Pharmacy 2023;34(8):974-977
OBJECTIVE To explore the efficacy and safety of intra-articular injection of ropivacaine combined with alfentanil for postoperative analgesia in patients who underwent knee arthroscopic surgery. METHODS A total of 60 patients who underwent knee arthroscopic surgery were collected from the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture from March to September in 2022, and then divided into trial group and control group with random number table method, with 30 cases in each group. The control group received intra-articular injection of 0.25% ropivacaine 50 mg, and the trial group received intra-articular injection of 0.25% ropivacaine 50 mg+alfentanil 0.15 μg/kg.The first postoperative remedial analgesia time, the total amount of postoperative remedial drugs, numerical rating scale at rest (NRS-R) scores, numerical rating scale at movement (NRS-M) scores, heart rate, mean arterial blood pressure, and pulse oxygen saturation during exercise at different monitoring time points after surgery, the incidence of adverse drug reactions such as hypotension, respiratory depression, nausea, and vomiting after surgery were compared between 2 groups. RESULTS Compared with the control group, the first postoperative remedial analgesia time was significantly longer in the trial group, and the total amount of postoperative remedial drugs was significantly reduced (P<0.001). The trial group had lower NRS-R and NRS-M scores at each monitoring time point, with statistically significant differences (P<0.001), and there was an interactive effect between time and groups (P<0.001). The changes in heart rate, mean arterial blood pressure, and pulse oxygen saturation of patients in the trial group were relatively small, with no statistically significant differences (P>0.05), and there was no interactive effect between time and groups (P>0.05). There was no statistical significance in the incidence of adverse drug reactions between 2 groups, such as postoperative hypotension, respiratory depression, nausea, vomiting (P>0.05). CONCLUSIONS The intra- articular injection of ropivacaine combined with alfentanil shows good efficacy and safety for post-knee arthroscopic analgesia, and significantly prolongs the analgesic duration of ropivacaine.
5.Effect of catheterin-related antimicrobial peptides on the high glucose induced cardiac microvascular endothelial cell injury
Zhengwei ZHANG ; Yapeng LI ; Yuhua DANG ; Kui CHEN
Chinese Journal of Geriatrics 2022;41(8):975-980
Objective:To investigate the effect of catheterin-related antimicrobial peptides(CRAMP)on the damage of cardiac microvascular endothelial cells induced by high glucose.Methods:Adult mouse heart microvascular endothelial cells were isolated and cultured.A model of microvascular endothelial cell injury was established by high glucose culture.The endothelial cells were randomly divided into 4 groups as the following.In the control group, 27.5 mmol/L mannitol was given as isoosmotic control as compared with the high glucose group.In the high glucose group(HG group), cells were cultured with 33.3 mmol/L high glucose for 48 h, and then treated without CRAMP.In 0.15 mg/L CRAMP treatment group, cells were cultured with 33.3 mmol/L high glucose for 48 h, followed by 0.15 mg/L CRAMP treatmen for 24 h. In the 0.5 mg/L CRAMP treatment group, cells were cultured with 33.3 mmol/L high glucose treatment for 48 h, and then treated with 0.5 mg/L CRAMP for 24 h. Cell proliferation was examined by staining with CKK-8 cell counting kit.The secretion of inflammatory factors in microvascular endothelial cells was detected by ELISA kit.Reactive oxygen species assay kit detects the level of reactive oxygen species in cells.Cell apoptosis was detected by apoptosis kit.Tubule formation and tubule number were measured by cells cultured on the matrix glue membrane, then detected by microscopic observation.The nitric oxide(NO)test kit measures levels of NO.The expression of nitric oxide synthase(eNOS)was detected by western blotting.Results:The cell proliferation activity was significant lower in the HG group than in control group[(52.2±5.4)% vs.(100.0±7.3)%]. The cell proliferation activity was higher in the 0.15 and 0.5 mg/L CRAMP groups than in the HG group[(72.0±3.4)% vs.(52.2±5.4)%; and(84.2±5.8)% vs.(52.2±5.4)%( F=75.300, P<0.001)]. The expression of tumor necrosis factor-α was significantly higher in the HG group than in the control group and in 0.5 mg/L CRAMP group[HG group of(239.1±32.1)μg/L, the control of(22.1±3.7)μg/L, 0.5 mg/L CRAMP of(84.6±9.4)μg/L]( F=197.300, P<0.001). The level of reactive oxygen species was significantly higher in the HG group than in control group and in 0.5 mg/L CRAMP group[(20.8±2.4)in HG group, (4.8±1.7)in control group, (10.2±1.5)in CRAMP group]( F=105.700, P<0.001). The number of apoptotic cells was significantly higher in the HG group than in control group and in 0.5 mg/L CRAMP group[(21.2±3.1)% in HG group, (2.2±0.6)% in control group(9.5±1.2)% in CRAMP group]( F=141.900, P<0.001). The length and number of tubules were lower in the HG group than in control group and in CRAMP group[for the length: (87.8±9.1)μm in HG group, (337.0±37.2)μm in control group(206.5±16.3)μm in CRAMP group( F=160.800, P<0.001); for the number: (9.1±1.9)in HG group, (22.0±3.4)in control group, (16.8±2.2)]in CRAMP group( F=36.200, P<0.001)]. The level of NO was lower in the HG group than in control group and in CRAMP group[(0.25±0.05)in HG group, (1.05±0.16)in control group, (0.75±0.06)in CRAMP group( F=83.200, P<0.001)]. The protein expression and mRNA levels of endothelial nitric oxide synthase(eNOS)were lower in the HG group than in the control group and in CRAMP group[for eNOS protein: (0.07±0.03)in HG group, (0.81±0.05)in control group, (0.54±0.07)in CRAMP group, F=275.700, P<0.001; and for eNOS mRNA: (0.11±0.07)in HG group, (1.00±0.22)in control group, (0.57±0.12)in CRAMP group, F=50.600, P<0.001]. Conclusions:CRAMP protein can inhibit the damage of cardiac microvascular endothelial cells by increasing eNOS-mediated NO signal pathway.
6.Diameter of ductus venous and angle between ductus venous and sagittal part of left portal vein associated with success rate of neonatal umbilical venous catheterization
Guanchu CHEN ; Yapeng YAO ; Bin MA ; Wenyuan WANG ; Tingting YIN ; Jianming TANG ; Hongxia GAO
Chinese Journal of Perinatal Medicine 2021;24(11):823-827
Objective:To explore the effect of the angle between sagittal part of left portal vein and ductus venous(AsLPVDV), and the diameter of ductus venous(DDV) on the success rate of umbilical venous catheterization (UVC) in neonates.Methods:This was a retrospective study including 80 neonates requireing UVC in Gansu Provincial Women and Child-care Hospital from April 2020 to January 2021. According to the results of UVC, they were grouped into the success group(successful insertion of catheter, n=76) and failure group(failed to insert, n=4), or one-time success group (successful after first insertion attempt, n=43) and non-one-time success group(successful after several attempts or failed to insert, n=37). The AsLPVDV and the DDV were measured before UVC by bedside ultrasound. For those with obstruction of catheterization were guided by pressing the abdomen in right side recumbent position under real-time ultrasound monitoring. The success rate of UVC and the differences of AsLPVDV and DDV among different groups were compared. Chi-square test, t test, or U test were adopted for the comparison among groups. Receiver operating characteristic (ROC) curve was used to evaluate the sensitivity and specificity of the AsLPVDV and the DDV in predicting the one-time success of UVC. Results:The total success rate of UVC was 95%(76/80) and the one-time success rate was 53.8%(43/80). A larger AsLPVDV and DDV were observed in the success group compared with the failure group [(142.2±8.3)° vs (133.6±3.2)°, (3.0±0.4) vs(1.8±0.4) mm, t=6.284 and 2.064, both P<0.05] as well as in one-time success group compared with the non-one-time success group [(147.5±6.2)° vs (135.2±4.7)°, (3.1±0.3) vs (2.8±0.6) mm, t=9.956 and 2.939, both P<0.05]. Area under the curve of AsLPVDV and DDV in predicting one-time success of UVC were 0.944(95% CI:0.869-0.983) and 0.811 (95% CI:0.708-0.890), respectively. The cut-off value was 140.4° for AsLPVDV and 2.9 mm for DDV, with the sensitivity of 93.0% and 90.7%, and specificity of 91.9% and 64.9%, respectively. Conclusions:The success rate of UVC is related to AsLPVDV and DDV. AsLPVDV is of high value in predicting the one-time success of UVC.
7.Prognostic scoring system in hepatocellular carcinoma patients with portal vein tumor thrombus to predict the prognosis of hepatic resection
Changzhi CHEN ; Yapeng QI ; Liang LIU ; Kezhang QIN ; Yujie ZHOU ; Jianhong ZHONG ; Liang MA ; Weiping YUAN ; Bangde XIANG
Chinese Journal of Hepatobiliary Surgery 2021;27(4):257-261
Objective:To investigate the risk factors for overall survival in operable hepatocellular carcinoma with portal vein tumor thrombus (PVTT-HCC) patients and establish a scoring system.Methods:Survival data in 253 PVTT-HCC patients were retrospectively analyzed in Guangxi Medical University Affiliated Tumor Hospital. Survival curves were analyzed using the Kaplan-Meier method and log-rank test. Cox stepwise regression analysis was used to identify independent preoperative risk factors affecting overall survival. A prognostic scoring system based on independent risk factors and their relative coefficients was established to screen patients with greater hepatic resection benefits, and the identification ability of the model was based on ROC.Results:A total of 253 patients with PVTT-HCC were enrolled in this study, there were 222 males and 31 females, with a median age 44 years. The median survival time in all patients was (13.00±2.15) months. Rate of overall survival was 51.8% at 1 year, 25.0% at 3 years and 17.7% at 5 years. Multivariable Cox regression analyses showed four risk factors including: AST≥40 U/L, ALP (≥80 U/L), tumor number (>1), and incomplete tumor capsule. A prognostic scoring system was established based on these variables. The area under curve of the scoring system was 0.780 (95% CI: 0.715-0.845). Patients were classified as low- or high-risk group for hepatic resection depending on whether their score was <3 ( n=77) or ≥3 ( n=176), respectively. High-risk patients had a median survival of 10 months, compared to 29 months in low-risk patients. Low-risk patients also had better survival rates at 1 year (75.3% vs 41.5%), 3 years (47.6% vs 15.2%), and 5 years (34.7% vs 10.5%), P<0.05. Conclusion:A prognostic scoring system for hepatic resection in PVTT-HCC patients has been developed based entirely on preoperative variables. Using this system, patients belong to the low risk group have better prognosis after surgery, which can provide a basis for surgical treatment of PVTT-HCC patients.
8.Type Ⅰ collagen combined titanium dioxide nanotube composite coating modified titanium surface improves osteoblast adhesion and osseointegration
Ying LI ; Yapeng YOU ; Baoe LI ; Yunjia SONG ; Aobo MA ; Bo CHEN ; Wen HAN ; Changyi LI
Chinese Journal of Tissue Engineering Research 2019;23(14):2169-2176
BACKGROUND: Simple nanotube surface modification of titanium implant has been shown to promote adhesion, proliferation and differentiation of osteoblasts. Collagen coating can promote osteoblast adhesion and osseointegration in vivo. OBJECTⅠVE: To observe the effects of type collagen combined titanium dioxide nanotube composite coating modified titanium surface on osteoblast adhesion in vitro and osseointegration in vivo. METHODS: The titanium dioxide nanotube was fabricated on the pure titanium surface, then type Ⅰ collagen was combined with the nanotube structure to form composite coating. Scanning electron microscope observation was used to characterize the surface topography of the pure titanium, titanium dioxide nanotube and type Ⅰ collagen combined titanium dioxide nanotube surfaces. Contact angle test was employed to evaluate the hydrophilicity of different samples. MC3 T3-E1 murine preosteoblasts were seeded on the three kinds of materials for 4 hours. Cell adhesion morphology was examined by scanning electron microscope. Adherent cell counting was detected under inverted fluorescence microscope. Expression of actin cytoskeleton and vinculin was observed under laser scanning confocal microscope. The gene expression of vinculin and osteoprotegerin mRNA was detected by real-time quantitative PCR. The three kinds of samples were implanted into the tibia of Sprague-Dawley rats (provided by Laboratory Animal Center, Ⅰnstitute of Radiation Medicine, Chinese Academy of Medical Sciences) , and tibia samples were removed after 4 weeks of implantation for biological push-out test and histological observation. RESULTS AND CONCLUSⅠON: (1) Scanning electron microscope: There was mechanical scratch on the pure titanium surface. There was controllable, and uniform vertical arrangement of nanotubular structures with a diameter of approximately 70 nm on the titanium dioxide nanotube surface, and collagen adhered surrounding the nanotubular structures on the type Ⅰ collagen combined titanium dioxide nanotube substrate, and partial tubule orifices were closed. (2) The hydrophicility of type Ⅰ collagen combined titanium dioxide nanotube was significantly larger than those of the other two materials (P < 0.05) . (3) Compared with the pure titanium and titanium dioxide nanotube surfaces, the type Ⅰ collagen combined titanium dioxide nanotube substrate displayed increased adherent cell number, much well-organized cytoskeleton, enhanced immunofluorescence intensity of vinculin protein staining, and increased expression levels of vinculin and osteoprotegerin mRNA levels (all P < 0.05) . (4) Ⅰn vivo test revealed that the maximum push-out force in the type Ⅰ collagen combined titanium dioxide nanotube group was significantly higher than that in the pure titanium and titanium dioxide nanotube groups (P < 0.05) . Hematoxylin-eosin staining results showed that there were few bones, but many fibrous connective tissue surrounding the implant in the pure titanium group; there were more newly-born bones, and less fibrous connective tissue surrounding the implant in the titanium dioxide nanotube group; there were dense newly-born bones, and few thin fibrous connective tissue surrounding the implant in the type Ⅰ collagen combined titanium dioxide nanotube group. (5) These results indicate that type Ⅰ collagen combined titanium dioxide nanotube surface can facilitate osteoblast cell adhesion and promote osseointegration in vivo.
9. Clinical efficacy of radiofrequency ablation for postoperative recurrent and primary hepatocellular carcinoma
Tao HUANG ; Jianhong ZHONG ; Yapeng QI ; Zhiyin LIANG ; Jie ZHANG ; Changzhi CHEN ; Weiping YUAN ; Liang MA ; Bangde XIANG ; Lequn LI
Chinese Journal of General Surgery 2019;34(11):936-939
Objective:
To compare the prognosis of radiofrequency ablation (RFA) for postoperative recurrent hepatocellular carcinoma and primary hepatocellular carcinoma(HCC).
Methods:
The clinical data of 179 patients with recurrent HCC (recurrent group) and primary HCC (primary group) treated by RFA from 2009 to 2015 were retrospectively analyzed. Overall survival rate (OS) and disease-free survival rate (DFS) were analyzed by Kaplan-meier log-rank test. The prognostic factors of RFA for recurrent HCC were analyzed by COX proportional hazard regression.
Results:
The 1, 3 and 5year′s OS of the recurrent group were 93%, 73%, 61%, respectively and 85%, 75%, 61% for the primary group(χ2=0.017,
10.The establishment and application of a preoperative predictive nomogram for hepatocellular carcinoma with microvascular invasion
Zhiyin LIANG ; Changzhi CHEN ; Tao HUANG ; Yapeng QI ; Jie ZHANG ; Weiping YUAN ; Bangde XIANG ; Lequn LI
Chinese Journal of Hepatobiliary Surgery 2019;25(5):344-348
Objective To establish a preoperative nomogram model in predicting microvascular invasion (MVI) and to test its predictive effectiveness in hepatocellular carcinoma (HCC).Methods This retrospective study was conducted on 798 patients with HCC,including 690 males and 108 females,aged (49.8± 10.9) years old who underwent curative hepatectomy in the Guangxi Medical University Affiliated Tumor Hospital between January 2014 and December 2017 were retrospectively analyzed.The patients were divided into the model group (n=579) and the validation group (n=219) according to the periods of the operation time.Independent risk factors of MVI were identified by univariate and multivariate logistic regression analysis in the model group,and a nomogram model was established according to the independent risk factors.The accuracy of the nomogram model in predicting MVI was detected in the two groups by the computer consistency coefficient (C-index) and calibration graph method.The predictive value was evaluated by receiver operating characteristic curve.Results Histopathological diagnosis revealed 278 patients with MVI and no MVI in the 301 patients of HCC out of the 579 patients in the model group.In the validation group,there were 119 patients with MVI and 100 patients with no MVI out of the 219 patients.Total bilirubin >15 μmol/L(OR=1.519,95% CI:1.041 ~ 2.217),alkaline phosphatase >60 U/L(OR =1.681,95%CI:1.059~2.670),alpha-fetoprotein >200 ng/L (OR=2.192,95%CI:1.531 ~3.134) and tumor maximum diameter (OR =1.120,95%CI:1.057 ~ 1.187) were the independent risk factors of MVI on multivariate analysis.After establishment of the nomogram model using the independent risk factors,the C-indexes were 0.680 and 0.773 respectively in the model group and the validation group.In the calibration graph,the standard curve properly fitted with the predicting calibration curve.The predicted value of MVI obtained was in good agreement with the observed value.The ROC curve analysis nomogram model predicted the low performance of MVI.Conclusion The nomogram model in predicting MVI in patients with HCC was successfully established.The model offered certain guiding significance in the clinical treatment of HCC.

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