AIM:To investigate whether central obesity is associated with nonalcoholic fatty liver disease(NAFLD) formation after adjusting for general obesity.METHODS:The online databases Pub Med,EMBASE,and ISI Web of Science we...AIM:To investigate whether central obesity is associated with nonalcoholic fatty liver disease(NAFLD) formation after adjusting for general obesity.METHODS:The online databases Pub Med,EMBASE,and ISI Web of Science were searched for studies estimating the influence of central obesity on NAFLD occurrence published through April 2014.Studies that did not adjust for body mass index(BMI) were excluded.In addition,the independent effect of BMI was also assessed with the included studies.The pooled effect sizes and 95% confidence intervals(CIs) were calculated using random- or fixed-effects models based on the degree of heterogeneity.Furthermore,subgroup analyses,meta-regression,sensitivity analyses,and publication bias were performed.RESULTS:Twenty eligible studies were identified.The summary odds ratio(OR) values per-unit increase in waist circumference(WC) and BMI for NAFLD formation were 1.07(95%CI:1.03-1.10,I2 = 73.9%,n = 11 studies) and 1.25(95%CI:1.13-1.38,I2 = 88.7%,n = 11 studies),respectively.When the indices were expressed as binary variables(with the non-obesity group as reference),the pooled OR in WC,waist-tohip ratio,and BMI were 2.34(95%CI:1.83-3.00,I2 = 41.8%,n = 7 studies),4.06(95%CI:1.53-10.79,I2 = 65.7%,n = 3 studies),and 2.85(95%CI:1.60-5.08,I2 = 57.8%,n = 5 studies),respectively.Using the same studies as the latter(n = 5),pooled OR in WC was 3.14(95%CI:2.07-4.77),which is greater than that in BMI.CONCLUSION:Central obesity may pose a greater threat to national health than general obesity,although both are independently associated with increased risk of NAFLD.展开更多
AIM: To elaborate the clinicopathologic features of colorectal cancer-related pyogenic liver abscess (PLA). METHODS: Reported cases of colorectal cancer-related PLAs were collected from the literature published up to ...AIM: To elaborate the clinicopathologic features of colorectal cancer-related pyogenic liver abscess (PLA). METHODS: Reported cases of colorectal cancer-related PLAs were collected from the literature published up to October 2011 and evaluated for their clinicopathologic features. Data of collected cases included demographics, clinical presentation, microbial findings and treatment. Categorical variables were compared by 2 analysis and continuous variables were evaluated using Student's t test. RESULTS: A total 96 cases of colorectal cancer-related PLA were collected from the previous literature. Most patients (60%) were male and 40% cases occurred in the age group of 61-70 years. Apart from some special types of PLA, there were significant differences in the microbiological spectrum between Eastern Asia and non-Eastern Asian countries, which implied different risk factors and courses of the disease. Gram negative bacteria especially Klebsiella pneumoniae (K. pneu- moniae ) PLA was predominant in Eastern Asia (80.0%) in contrast to non-Eastern Asian countries (P < 0.01). Meanwhile, most of the Eastern Asian patients exhibited smaller size of liver abscess and atypical presentation. Sigmoid colon and rectum (72.73%) were the main sites of tumor in Eastern Asian patients, whereas tumor sites were uneven among most of the non-Easter Asian PLA patients. CONCLUSION:K. pneumoniae PLA was strongly associated with colorectal cancer, especially those occurring in sigmoid colon and rectum, in elderly Eastern Asian male patients.展开更多
AIM:To preliminarily investigate the prognostic significance of the platelet to lymphocyte ratio(PLR) in patients with gallbladder carcinoma(GBC).METHODS:Clinical data of 316 surgical GBC patients were analyzed retros...AIM:To preliminarily investigate the prognostic significance of the platelet to lymphocyte ratio(PLR) in patients with gallbladder carcinoma(GBC).METHODS:Clinical data of 316 surgical GBC patients were analyzed retrospectively,and preoperative serum platelet and lymphocyte counts were used to calculate the PLR.The optimal cut-off value of the PLR for detecting death was determined by the receiver operating characteristic(ROC) curve.The primary outcome was overall survival,which was estimated by the Kaplan-Meier method.The log-rank test was used to compare the differences in survival.Then,we conducted multivariate Cox analysis to assess the independent effect of the PLR on the survival of GBC patients.RESULTS:For the PLR,the area under the ROC curve was 0.620(95%CI:0.542-0.698,P = 0.040) in detecting death.The cut-off value for the PLR was determined to be 117.7,with 73.6% sensitivity and 53.2% specificity.The PLR was found to be significantlypositively correlated with CA125 serum level,tumornode-metastasis(TNM) stage,and tumor differentiation.Univariate analysis identified carcinoembryonic antigen(CEA),CA125 and CA199 levels,PLR,TNM stage,and the degree of differentiation as significant prognostic factors for GBC when they were expressed as binary data.Multivariate analysis showed that CA125 > 35 U/mL,CA199 > 39 U/mL,PLR ≥ 117.7,and TNM stage Ⅳ were independently associated with poor survival in GBC.When expressed as a continuous variable,the PLR was still an independent predictor for survival,with a hazard ratio of 1.018(95%CI:1.001-1.037 per 10-unit increase,P = 0.043).CONCLUSION:The PLR could be used as a simple,inexpensive,and valuable tool for predicting the prognosis of GBC patients.展开更多
AIM: To investigate the prognostic significance of estrogen receptor 1(ER1) and vascular endothelial growth factor A(VEGF-A) expression in primary gallbladder carcinoma(GBC) to identify new prognostic markers for this...AIM: To investigate the prognostic significance of estrogen receptor 1(ER1) and vascular endothelial growth factor A(VEGF-A) expression in primary gallbladder carcinoma(GBC) to identify new prognostic markers for this malignancy.METHODS: Using immunohistochemistry, we investigated ER1 and VEGF-A expression in 78 GBC and 78 cholelithiasis(CS) tissues. The results were correlated with clinicopathological features. Univariate and multivariate analyses were performed to evaluate the relationship between ER1 and VEGF-A expression and patients' prognosis. Further Kaplan-Meier survival analysis was also performed. RESULTS: ER1 and VEGF-A expression was significantly higher in GBC compared with CS(47/78 vs 28/78, P < 0.05; 51/78 vs 33/78, P < 0.05). ER1 expression was correlated with gender(P < 0.05) and VEGF-A expression was correlated with tumor differentiation in GBC patients(P < 0.05). In univariate analysis, age and tumor node metastasis(TNM) stage were factors associated with GBC prognosis(P < 0.05). Although there was no statistical difference between the expression of ER1 or VEGF-A and overall survival, the high expression of ER1 combined with VEGF-A predicted a poor prognosis for GBC patients(16.30 ± 1.87 vs 24.97 ± 2.09, log-rank P < 0.05). In multivariate analysis, combined expression of ER1 and VEGF-A and TNM stage were independent prognostic factors for GBC patients(P < 0.05).CONCLUSION: Combined expression of ER1 and VEGF-A is a potential prognostic marker for GBC patients. Clinical detection of ER1 and VEGF-A in surgically resected GBC tissues would provide animportant reference for decision-making of postoperative treatment programs.展开更多
AIM:To investigate the prognostic value of preoperative platelet count(PLT) in patients with primary gallbladder cancer(GBC).METHODS:The clinical data of 223 GBC patients after surgery was retrospectively reviewed.A r...AIM:To investigate the prognostic value of preoperative platelet count(PLT) in patients with primary gallbladder cancer(GBC).METHODS:The clinical data of 223 GBC patients after surgery was retrospectively reviewed.A receiver operating characteristic(ROC) curve was plotted to verify the optimum cutoff point for PLT.Univariate and multivariate survival analyses were performed to identify the factors associated with the prognosis.RESULTS:The ROC curve showed that the optimum cutoff point for PLT was 178 × 109/L,and the entire cohort was stratified into group A with PLT > 178 × 109/L and group B with PLT ≤ 178 × 109/L.Group A had a better survival than group B(P < 0.001).There was an obvious difference between the two groups in terms of the differentiation degree,advanced tumor stage,lymph node metastasis(P < 0.001) and pathological type(P < 0.05).The univariate analysis demonstrated that tumor location,differentiation degree,TNM stage,Nevin stage,lymph node metastasis and PLT were associated with overall survival(P < 0.001).In the multivariate analysis,PLT(P = 0.032),lymph node metastasis(P = 0.007),tumor location(P < 0.001) and TNM stage(P = 0.005) were independent prognostic factors.CONCLUSION:PLT is closely correlated with GBC prognosis and could be used to identify the population with a poorer prognosis after surgery.展开更多
Background： To compare the clinicopathological features and prognosis between younger and aged patients with hepatocellular carcinoma （HCC）. Methods： We analyzed the outcome of 451 HCC patients underwent liver res...Background： To compare the clinicopathological features and prognosis between younger and aged patients with hepatocellular carcinoma （HCC）. Methods： We analyzed the outcome of 451 HCC patients underwent liver resection, transcatheter arterial chemoembolization and radiofrequency ablation, respectively. Then risk factors for aged and younger patients＇ survival were evaluated by multivariate analysis, respectively. Results： The patients who were older lhan 55 years old were defined as the older group. The overall survival for aged patients was significantly worse than those younger patients. The younger patients had similar liver fhnctional reserve but more aggressive tumor Paclors than aged patients. Cox regression analysis showed that tile elevated levels ofaspartate aminotransferase （AST） （Waldx2= 3.963, P = 0.047, hazard ratio [HR] -1.453, 95% confidence interval [CI]： 1.006-2.098）, lower albumin （Wald X2 = 12.213, P 〈 0.001, HR 1.982, q5% CI： 1.351 2.910）, tumor size （Wald X2 = 8.179, P- 0,004, HR - 1.841,95% CI： 1.212-2.797）, and higher alpha-fetoprotein level （Wald X2=4.044, P = 0.044, HR = 1,465, 95% （CI： 1.010 2.126） were independent prognostic factors for aged patients, while only elevated levelsofAST（WaldZ= 14.491,P〈0.001,HR 2.285, 95%CI： 1.493-3.496）andtumorsize（WaldX2= 21.662, P〈0.001,HR= 2.928, 95% CI： 1.863-4.604） were independent prognostic factors for younger patients. Conclusions： Age is a risk factor to determine the prognosis of patients with HCC. Aged patients who have good liver lhnctional reserve are still encouraged to receive curative therapy.展开更多
Splenic hamartoma(SH)is a rare benign tumor usually detected accidentally,which is composed of an aberrant mixture of normal splenic elements.Here,we report a case of 54-year-old man who presented with symptomatic mul...Splenic hamartoma(SH)is a rare benign tumor usually detected accidentally,which is composed of an aberrant mixture of normal splenic elements.Here,we report a case of 54-year-old man who presented with symptomatic multinodular SH and was admitted initially for thrombocytopenia and anemia.Physical examination revealed that the patients had an anemic appearance and palpable spleen,extending 10 cm below the costal margin.Preoperative ultrasound and computed tomography(CT)indicated splenomegaly with multinodular lesions.On enhanced CT scanning,during the arterial phase,the lesions demonstrated inhomogeneous enhancement,and in the portal phase the lesions were more hyperdense than the splenic parenchyma.The images were highly suggestive of a metastatic tumor.Splenectomy was performed 1 wk later.The tumor was eventually diagnosed as SH according to the morphological features and immunohistochemical detection,by which CD34 was positive in lining cells and some spindle cells,vimentin was positive in the tumor,factor-Ⅷ-related antigen was positive multifocally in lining cells,and smooth muscle actin was positive in some spindle cells.Thrombocytopenia and anemia were cured after splenectomy.展开更多
AIM: To investigate the effect of knockdown of Forkhead box M1 (FoxM1) on the proliferation and invasion capacities of human gallbladder carcinoma (GBC)-SD cells.
The dry root and rhizome of Panax ginseng C. A. Mey has garnered much interest owing to its medicinal properties against diabetes and cardiovascular diseases. In this study, an ultra-high performance liquid chromatogr...The dry root and rhizome of Panax ginseng C. A. Mey has garnered much interest owing to its medicinal properties against diabetes and cardiovascular diseases. In this study, an ultra-high performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry (UHPLC-Q-TOF-MS)-based metabolomics approach was used to illustrate the therapeutic mechanisms of ginseng extract on the serum and urinary metabolic profiles in streptozotocin-induced type 1 diabetes mellitus (T1DM) rats. Pharmacological and renal parameters in response to the administration of ginseng were also evaluated. In total, 16 serum endogenous metabolites and 14 urine endogenous metabolites, including pyruvic acid, indoleacetic acid, and phenylacetylglycine, were identified as potential biomarkers for diabetes. Pathway enrichment and network analysis revealed that the biomarkers modulated by ginseng were primarily involved in phenylalanine and pyruvate metabolism, as well as in arginine biosynthesis. Moreover, the levels of several renal injury-related biomarkers in T1DM rats were significantly restored following treatment with ginseng. The administration of the extract helped maintain tissue structure integrity and ameliorated renal injury. The findings suggest that the regulatory effect of ginseng extract on T1DM involves metabolic management of diabetic rats, which subsequently attenuates T1DM-induced early renal dysfunction.展开更多
BACKGROUND: Liver transplantation(LT) and liver resection(LR) are currently considered the standard treatment of patients with hepatocellular carcinoma(HCC). However, the outcomes of LT and LR are still inconclusive.D...BACKGROUND: Liver transplantation(LT) and liver resection(LR) are currently considered the standard treatment of patients with hepatocellular carcinoma(HCC). However, the outcomes of LT and LR are still inconclusive.DATA SOURCES: MEDLINE, EMBASE, and Cochrane Library were searched for relevant studies. Surgical safety indices such as treatment-related morbidity and mortality, and efficacy indices such as overall and tumor-free survival outcomes were evaluated. Weighted mean differences and odds ratios(ORs)were calculated using a random-effects model.RESULTS: Seventeen studies were included in this metaanalysis.LT achieved significantly higher rates of surgeryrelated morbidity(OR=1.47; 95% CI: 1.02-2.13) and mortality(OR=2.12; 95% CI: 1.11-4.05). Likewise, the 1-year survival rate was lower in LT(OR=0.86; 95% CI: 0.61-1.20). However, the 3-and 5-year survival rates were significantly higher in LT than in LR and the ORs were 1.12(95% CI: 0.96-1.30) in 3 years and1.84(95% CI: 1.49-2.28) in 5 years. Furthermore, the tumorfree survival rate in LT was significantly higher than that in LR in 1, 3, 5 years after surgery, with the ORs of 1.72(95% CI:1.24-2.41), 3.75(95% CI: 2.94-4.78) and 5.64(95% CI: 4.35-7.31),respectively.CONCLUSIONS: One-year morbidity and mortality are higher in LT than in LR for patients with HCC. However, long-term survival and tumor-free survival rates are higher in patients treated with LT than those treated with LR.展开更多
AIM: To investigate the association between thrombocytopenia and relapse after treatment for hepatocellular carcinoma(HCC).METHODS: We searched the Pub Med, EMBASE, and Web of Science databases to obtain eligible stud...AIM: To investigate the association between thrombocytopenia and relapse after treatment for hepatocellular carcinoma(HCC).METHODS: We searched the Pub Med, EMBASE, and Web of Science databases to obtain eligible studies. The hazard ratios(HRs) values and 95% confidence intervals(CIs) were pooled by random effects model. Subsequently, we estimated the heterogeneity, performed a sensitivity analysis, determined the publication bias, and performed subgroup and meta-regression analyses. Study quality was assessed by using the Oxford Center for Evidence Based Medicine tool.RESULTS: We identified 18 eligible studies by retrieval(published during 2000-2014). Out of the 4163 patients with HCC who were recruited, 2746(66.0%) experienced recurrence. In general, our meta-analysis suggested that low platelet count(PLT) before therapy significantly increased the probability of postoperative recurrence(HR = 1.53, 95%CI: 1.29-1.81). PLT was also valuable in the prediction of intrahepatic distant recurrence(HR = 1.49, 95%CI: 1.25-1.77). Subgroupand meta-regression analyses identified various therapeutic modalities as the source of a high degree of heterogeneity. The pooled HR values showed no obvious change when a single study was removed, but otherwise, an opposite-effects model was used. In addition, no significant publication bias was detected.CONCLUSION: Thrombocytopenia before treatment might be an inexpensive and useful predictor of postoperative recurrence in patients with HCC.展开更多
AIM:To explore the effects of platelet count(PLT)and11 platelet-based indices on postoperative recurrence of hepatocellular carcinoma(HCC).METHODS:We retrospectively analyzed 172 HCC patients who were treated by parti...AIM:To explore the effects of platelet count(PLT)and11 platelet-based indices on postoperative recurrence of hepatocellular carcinoma(HCC).METHODS:We retrospectively analyzed 172 HCC patients who were treated by partial hepatectomy.Preoperative data,including laboratory biochemical results,were used to calculate the 11 indices included in the analysis.We performed receiver operating characteristic curve analysis to determine the optimal cut-off values for predicting recurrence.Cumulative rates of HCC recurrence were calculated using KaplanMeier survival curves and differences were analyzed by log-rank tests.Multivariate analyses were performed to identify independent predictors of recurrence,early recurrence(within one year after surgery),and late recurrence in HCC.To obtain better prognostic models,PLT-based indices were analyzed separately after being expressed as binary and continuous variables.Two platelet-unrelated,validated HCC prognostic models were included in the analyses as reference indices.Additional analyses were performed after patients were stratified based on hepatitis B virus infection status,cirrhosis,and tumor size to investigate the significance of platelets in different subgroups.RESULTS:In the study cohort,44.2%(76/172)of patients experienced HCC recurrence,and 50.6%(87/172)died during a median follow-up time of 46mo.PLT and five of the 11 platelet-related models were significant predisposing factors for recurrence(P<0.05).Multivariate analysis indicated that,among the clinical parameters,presence of ascites,PLT≥148×109/L,alkaline phosphatase≥116 U/L,and tumor size≥5 cm were independently associated with ahigher risk of HCC recurrence(P<0.05).Independent and significant models included the aspartate aminotransferase/PLT index,fibrosis index based on the four factors,fibro-quotient,aspartate aminotransferase/PLT/γ-glutamyl transpeptidase/alpha-fetoprotein index,and the PLT/age/alkaline phosphatase/alphafetoprotein/aspartate aminotransferase index.There were different risk factors betw展开更多
AIM:To explore the prognostic value in the monitoring of treatment efficacy of serial α-fetoprotein(AFP) in hepatocellular carcinoma(HCC) patients.METHODS:We searched MEDLINE,EMBASE and COCHRANE LIBRARY through April...AIM:To explore the prognostic value in the monitoring of treatment efficacy of serial α-fetoprotein(AFP) in hepatocellular carcinoma(HCC) patients.METHODS:We searched MEDLINE,EMBASE and COCHRANE LIBRARY through April 21,2012,to find qualifying articles.Our overall search strategy included terms for HCC,AFP,treatment response,and prognosis.Literature was limited to English-language,human studies.Studies reporting cumulative survival rates were summa-rized qualitatively.For the prognostic meta-analysis,we undertook a series of meta-analyses that summarised the Cox proportional hazard ratios(HRs) by assuming a random effects model.With regards to the correlation of AFP change with radiologic response,the categorical dichotomous variables were assessed using Poisson relative risks(RRs),which were incorporated into the random effects model meta-analysis of accuracy prediction.Between-study heterogeneity was estimated by use of the I2 statistic.Publication bias was evaluated using the Begg funnel plot and Egger plot.Sensitivity analyses were conducted first by separating systemic treatment estimates from locoregional therapy estimates,evaluating different AFP response cut-off point effects,and exploring the impact of different study sizes.RESULTS:Of 142 titles identified in our original search,11 articles(12 clinical studies) met our criteria.Six studies investigated outcome in a total of 464 cases who underwent systemic treatment,and six studies investigated outcome in a total of 510 patients who received locoregional therapy.A random-effects model metaanalysis showed that AFP response was associated with an mortality HR of 0.55(95%CI,0.47-0.65) across HCC in overall survival(OS) and 0.50(95%CI,0.38-0.65) in progression-free survival.Restricting analysis to the six eligible analyses of systemic treatment,the pooled HRs were 0.64(95%CI,0.53-0.77) for OS.Limiting analysis to the six analyses of locoregional therapy,the pooled HRs for OS was 0.39(95%CI,0.29-0.53).We showed a larger pooled HR in the 50% definition studie展开更多
A new heuristics model based on the Voronoi diagram is presented to simulate pedestrian dynamics with the noncrowded state, in which these mechanisms of preference demand evading and surpassing, microscopic anti-deadl...A new heuristics model based on the Voronoi diagram is presented to simulate pedestrian dynamics with the noncrowded state, in which these mechanisms of preference demand evading and surpassing, microscopic anti-deadlock, and site-fine-tuning are considered. The preference demand describes the willingness determination of detouring or following other pedestrians. In the evading and surpassing mechanisms, in order to achieve a balance between avoiding conflicts and minimizing detour distances, a new pair of concepts: "allow-areas and denial-areas" are introduced to divide the feasible region for pedestrians detour behaviors, in which the direction and magnitude of detour velocity are determined.A microscopic anti-deadlock mechanism is inserted to avoid deadlock problem of the counter-directional pedestrian. A site-fine-tuning mechanism is introduced to describe the behavior of avoiding getting too close to the neighbors in pedestrian movement. The presented model is verified through multiple scenarios, including the uni-or bi-direction pedestrian flow in the corridor without obstacles, the uni-direction pedestrian flow in the corridor with obstacles, and the pedestrian evacuation from a room with single-exit. The simulation results show that the velocity–density relationship is consistent with empirical data. Some self-organizing phenomena, such as lanes formation and arching are observed in the simulation.When pedestrians detour an obstacle, the avoiding area before the obstacle and the unoccupied area after the obstacle can be observed. When pedestrians evacuate through a bottleneck without panic, the fan-shaped crowd can be found, which is consistent with the actual observation. It is also found that the behavior of following others in an orderly manner is more conducive to the improvement of the overall movement efficiency when the crowd moves in a limited space.展开更多
AIM: To investigate the effects of single nucleotide polymorphisms(SNPs) in glutathione S-transferase(GST) genes on survival of hepatocellular carcinoma(HCC) patients.METHODS: Twelve tagging SNPs in GST genes(includin...AIM: To investigate the effects of single nucleotide polymorphisms(SNPs) in glutathione S-transferase(GST) genes on survival of hepatocellular carcinoma(HCC) patients.METHODS: Twelve tagging SNPs in GST genes(including GSTA1, GSTA4, GSTM2, GSTM3, GSTO1, GSTO2 and GSTP1) were genotyped using Sequenom Mass ARRAY i PLEX genotyping method in a cohort of 214 Chinese patients with resected HCC.The Cox proportional hazards model and log-rank test were performed to determine the SNPs related to outcome.Additionally, stratified analysis was performed at each level of the demographic and clinical variables.An SNP-gene expression association model was further established to investigate the correlation between SNP and gene expression.RESULTS: Two SNPs(GSTO2 : rs7085725 and GSTP1 : rs4147581) were significantly associated with overall survival in HCC patients(P = 0.035 and 0.042, respectively).In stratified analysis, they were more significantly associated with overall survival in patients with younger age, male gender and cirrhosis.We further investigated cumulative effects of these two SNPs on overall survival in HCC patients.Compared with the patients carrying no unfavorable genotypes, those carrying 2 unfavorable genotypes had a 1.70-fold increased risk of death(P < 0.001).The cumulative effects were more significant in those patients with younger age, male gender and cirrhosis(HR = 2.00, 1.94 and 1.97, respectively; all P < 0.001).Additionally, we found that heavy smoking resulted in a significantly worse overall survival in those patients carrying variantalleles of rs7085725(HR = 2.07, 95%CI: 1.13-3.76, P = 0.018).The distributions of GSTO2 : rs7085725 and GSTP1 : rs4147581 genotypes were associated with altered gene expression and contributed to influences on overall survival.CONCLUSION: Our study provides the first evidence that GSTO2 and GSTP1 gene polymorphisms may serve as independent prognostic markers for HCC patients.展开更多
We corrected the mistake of Figure 3,and replaced the incorrect images with the correct ones.The“adenovirus”was a typographical error in writing,and should be revised to“lentivirus”.
基金Supported by National Natural Science Foundation of China,No.30872482 and No.81072051
文摘AIM:To investigate whether central obesity is associated with nonalcoholic fatty liver disease(NAFLD) formation after adjusting for general obesity.METHODS:The online databases Pub Med,EMBASE,and ISI Web of Science were searched for studies estimating the influence of central obesity on NAFLD occurrence published through April 2014.Studies that did not adjust for body mass index(BMI) were excluded.In addition,the independent effect of BMI was also assessed with the included studies.The pooled effect sizes and 95% confidence intervals(CIs) were calculated using random- or fixed-effects models based on the degree of heterogeneity.Furthermore,subgroup analyses,meta-regression,sensitivity analyses,and publication bias were performed.RESULTS:Twenty eligible studies were identified.The summary odds ratio(OR) values per-unit increase in waist circumference(WC) and BMI for NAFLD formation were 1.07(95%CI:1.03-1.10,I2 = 73.9%,n = 11 studies) and 1.25(95%CI:1.13-1.38,I2 = 88.7%,n = 11 studies),respectively.When the indices were expressed as binary variables(with the non-obesity group as reference),the pooled OR in WC,waist-tohip ratio,and BMI were 2.34(95%CI:1.83-3.00,I2 = 41.8%,n = 7 studies),4.06(95%CI:1.53-10.79,I2 = 65.7%,n = 3 studies),and 2.85(95%CI:1.60-5.08,I2 = 57.8%,n = 5 studies),respectively.Using the same studies as the latter(n = 5),pooled OR in WC was 3.14(95%CI:2.07-4.77),which is greater than that in BMI.CONCLUSION:Central obesity may pose a greater threat to national health than general obesity,although both are independently associated with increased risk of NAFLD.
基金Supported by The National Natural Science Foundation of China, No. 30872482 and No. 81072051
文摘AIM: To elaborate the clinicopathologic features of colorectal cancer-related pyogenic liver abscess (PLA). METHODS: Reported cases of colorectal cancer-related PLAs were collected from the literature published up to October 2011 and evaluated for their clinicopathologic features. Data of collected cases included demographics, clinical presentation, microbial findings and treatment. Categorical variables were compared by 2 analysis and continuous variables were evaluated using Student's t test. RESULTS: A total 96 cases of colorectal cancer-related PLA were collected from the previous literature. Most patients (60%) were male and 40% cases occurred in the age group of 61-70 years. Apart from some special types of PLA, there were significant differences in the microbiological spectrum between Eastern Asia and non-Eastern Asian countries, which implied different risk factors and courses of the disease. Gram negative bacteria especially Klebsiella pneumoniae (K. pneu- moniae ) PLA was predominant in Eastern Asia (80.0%) in contrast to non-Eastern Asian countries (P < 0.01). Meanwhile, most of the Eastern Asian patients exhibited smaller size of liver abscess and atypical presentation. Sigmoid colon and rectum (72.73%) were the main sites of tumor in Eastern Asian patients, whereas tumor sites were uneven among most of the non-Easter Asian PLA patients. CONCLUSION:K. pneumoniae PLA was strongly associated with colorectal cancer, especially those occurring in sigmoid colon and rectum, in elderly Eastern Asian male patients.
基金Supported by Hospital Foundation of the First Affiliated Hospital of Xi’an Jiaotong University College of Medicine(Xi’an,China),No.2013YK36National Natural Science Foundation of China,No.81272644 and No.81072051(to Liu C)
文摘AIM:To preliminarily investigate the prognostic significance of the platelet to lymphocyte ratio(PLR) in patients with gallbladder carcinoma(GBC).METHODS:Clinical data of 316 surgical GBC patients were analyzed retrospectively,and preoperative serum platelet and lymphocyte counts were used to calculate the PLR.The optimal cut-off value of the PLR for detecting death was determined by the receiver operating characteristic(ROC) curve.The primary outcome was overall survival,which was estimated by the Kaplan-Meier method.The log-rank test was used to compare the differences in survival.Then,we conducted multivariate Cox analysis to assess the independent effect of the PLR on the survival of GBC patients.RESULTS:For the PLR,the area under the ROC curve was 0.620(95%CI:0.542-0.698,P = 0.040) in detecting death.The cut-off value for the PLR was determined to be 117.7,with 73.6% sensitivity and 53.2% specificity.The PLR was found to be significantlypositively correlated with CA125 serum level,tumornode-metastasis(TNM) stage,and tumor differentiation.Univariate analysis identified carcinoembryonic antigen(CEA),CA125 and CA199 levels,PLR,TNM stage,and the degree of differentiation as significant prognostic factors for GBC when they were expressed as binary data.Multivariate analysis showed that CA125 > 35 U/mL,CA199 > 39 U/mL,PLR ≥ 117.7,and TNM stage Ⅳ were independently associated with poor survival in GBC.When expressed as a continuous variable,the PLR was still an independent predictor for survival,with a hazard ratio of 1.018(95%CI:1.001-1.037 per 10-unit increase,P = 0.043).CONCLUSION:The PLR could be used as a simple,inexpensive,and valuable tool for predicting the prognosis of GBC patients.
基金Supported by National Natural Science Foundation of China,No.81272644 and No.81201549
文摘AIM: To investigate the prognostic significance of estrogen receptor 1(ER1) and vascular endothelial growth factor A(VEGF-A) expression in primary gallbladder carcinoma(GBC) to identify new prognostic markers for this malignancy.METHODS: Using immunohistochemistry, we investigated ER1 and VEGF-A expression in 78 GBC and 78 cholelithiasis(CS) tissues. The results were correlated with clinicopathological features. Univariate and multivariate analyses were performed to evaluate the relationship between ER1 and VEGF-A expression and patients' prognosis. Further Kaplan-Meier survival analysis was also performed. RESULTS: ER1 and VEGF-A expression was significantly higher in GBC compared with CS(47/78 vs 28/78, P < 0.05; 51/78 vs 33/78, P < 0.05). ER1 expression was correlated with gender(P < 0.05) and VEGF-A expression was correlated with tumor differentiation in GBC patients(P < 0.05). In univariate analysis, age and tumor node metastasis(TNM) stage were factors associated with GBC prognosis(P < 0.05). Although there was no statistical difference between the expression of ER1 or VEGF-A and overall survival, the high expression of ER1 combined with VEGF-A predicted a poor prognosis for GBC patients(16.30 ± 1.87 vs 24.97 ± 2.09, log-rank P < 0.05). In multivariate analysis, combined expression of ER1 and VEGF-A and TNM stage were independent prognostic factors for GBC patients(P < 0.05).CONCLUSION: Combined expression of ER1 and VEGF-A is a potential prognostic marker for GBC patients. Clinical detection of ER1 and VEGF-A in surgically resected GBC tissues would provide animportant reference for decision-making of postoperative treatment programs.
基金Hospital Foundation of the First Affiliated Hospital of Xi’an Jiaotong University College of Medicine(Xi’an,China),No.2013YK36
文摘AIM:To investigate the prognostic value of preoperative platelet count(PLT) in patients with primary gallbladder cancer(GBC).METHODS:The clinical data of 223 GBC patients after surgery was retrospectively reviewed.A receiver operating characteristic(ROC) curve was plotted to verify the optimum cutoff point for PLT.Univariate and multivariate survival analyses were performed to identify the factors associated with the prognosis.RESULTS:The ROC curve showed that the optimum cutoff point for PLT was 178 × 109/L,and the entire cohort was stratified into group A with PLT > 178 × 109/L and group B with PLT ≤ 178 × 109/L.Group A had a better survival than group B(P < 0.001).There was an obvious difference between the two groups in terms of the differentiation degree,advanced tumor stage,lymph node metastasis(P < 0.001) and pathological type(P < 0.05).The univariate analysis demonstrated that tumor location,differentiation degree,TNM stage,Nevin stage,lymph node metastasis and PLT were associated with overall survival(P < 0.001).In the multivariate analysis,PLT(P = 0.032),lymph node metastasis(P = 0.007),tumor location(P < 0.001) and TNM stage(P = 0.005) were independent prognostic factors.CONCLUSION:PLT is closely correlated with GBC prognosis and could be used to identify the population with a poorer prognosis after surgery.
基金This research was supported by The National Natural Science Foundation of China
文摘Background： To compare the clinicopathological features and prognosis between younger and aged patients with hepatocellular carcinoma （HCC）. Methods： We analyzed the outcome of 451 HCC patients underwent liver resection, transcatheter arterial chemoembolization and radiofrequency ablation, respectively. Then risk factors for aged and younger patients＇ survival were evaluated by multivariate analysis, respectively. Results： The patients who were older lhan 55 years old were defined as the older group. The overall survival for aged patients was significantly worse than those younger patients. The younger patients had similar liver fhnctional reserve but more aggressive tumor Paclors than aged patients. Cox regression analysis showed that tile elevated levels ofaspartate aminotransferase （AST） （Waldx2= 3.963, P = 0.047, hazard ratio [HR] -1.453, 95% confidence interval [CI]： 1.006-2.098）, lower albumin （Wald X2 = 12.213, P 〈 0.001, HR 1.982, q5% CI： 1.351 2.910）, tumor size （Wald X2 = 8.179, P- 0,004, HR - 1.841,95% CI： 1.212-2.797）, and higher alpha-fetoprotein level （Wald X2=4.044, P = 0.044, HR = 1,465, 95% （CI： 1.010 2.126） were independent prognostic factors for aged patients, while only elevated levelsofAST（WaldZ= 14.491,P〈0.001,HR 2.285, 95%CI： 1.493-3.496）andtumorsize（WaldX2= 21.662, P〈0.001,HR= 2.928, 95% CI： 1.863-4.604） were independent prognostic factors for younger patients. Conclusions： Age is a risk factor to determine the prognosis of patients with HCC. Aged patients who have good liver lhnctional reserve are still encouraged to receive curative therapy.
文摘Splenic hamartoma(SH)is a rare benign tumor usually detected accidentally,which is composed of an aberrant mixture of normal splenic elements.Here,we report a case of 54-year-old man who presented with symptomatic multinodular SH and was admitted initially for thrombocytopenia and anemia.Physical examination revealed that the patients had an anemic appearance and palpable spleen,extending 10 cm below the costal margin.Preoperative ultrasound and computed tomography(CT)indicated splenomegaly with multinodular lesions.On enhanced CT scanning,during the arterial phase,the lesions demonstrated inhomogeneous enhancement,and in the portal phase the lesions were more hyperdense than the splenic parenchyma.The images were highly suggestive of a metastatic tumor.Splenectomy was performed 1 wk later.The tumor was eventually diagnosed as SH according to the morphological features and immunohistochemical detection,by which CD34 was positive in lining cells and some spindle cells,vimentin was positive in the tumor,factor-Ⅷ-related antigen was positive multifocally in lining cells,and smooth muscle actin was positive in some spindle cells.Thrombocytopenia and anemia were cured after splenectomy.
基金supported by Science Foundation of the First Affiliated Hospital of Medical College,Xi’an Jiaotong University,No.2010YK1
文摘AIM: To investigate the effect of knockdown of Forkhead box M1 (FoxM1) on the proliferation and invasion capacities of human gallbladder carcinoma (GBC)-SD cells.
基金supported by the National Key Research and Development Project(No.2017YFC1702105)Education Department of Jilin Province Project(No.JJKH20201033KJ).
文摘The dry root and rhizome of Panax ginseng C. A. Mey has garnered much interest owing to its medicinal properties against diabetes and cardiovascular diseases. In this study, an ultra-high performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry (UHPLC-Q-TOF-MS)-based metabolomics approach was used to illustrate the therapeutic mechanisms of ginseng extract on the serum and urinary metabolic profiles in streptozotocin-induced type 1 diabetes mellitus (T1DM) rats. Pharmacological and renal parameters in response to the administration of ginseng were also evaluated. In total, 16 serum endogenous metabolites and 14 urine endogenous metabolites, including pyruvic acid, indoleacetic acid, and phenylacetylglycine, were identified as potential biomarkers for diabetes. Pathway enrichment and network analysis revealed that the biomarkers modulated by ginseng were primarily involved in phenylalanine and pyruvate metabolism, as well as in arginine biosynthesis. Moreover, the levels of several renal injury-related biomarkers in T1DM rats were significantly restored following treatment with ginseng. The administration of the extract helped maintain tissue structure integrity and ameliorated renal injury. The findings suggest that the regulatory effect of ginseng extract on T1DM involves metabolic management of diabetic rats, which subsequently attenuates T1DM-induced early renal dysfunction.
基金supported by grants from the National Natural Science Foundation of China(30872482 and 81072051)
文摘BACKGROUND: Liver transplantation(LT) and liver resection(LR) are currently considered the standard treatment of patients with hepatocellular carcinoma(HCC). However, the outcomes of LT and LR are still inconclusive.DATA SOURCES: MEDLINE, EMBASE, and Cochrane Library were searched for relevant studies. Surgical safety indices such as treatment-related morbidity and mortality, and efficacy indices such as overall and tumor-free survival outcomes were evaluated. Weighted mean differences and odds ratios(ORs)were calculated using a random-effects model.RESULTS: Seventeen studies were included in this metaanalysis.LT achieved significantly higher rates of surgeryrelated morbidity(OR=1.47; 95% CI: 1.02-2.13) and mortality(OR=2.12; 95% CI: 1.11-4.05). Likewise, the 1-year survival rate was lower in LT(OR=0.86; 95% CI: 0.61-1.20). However, the 3-and 5-year survival rates were significantly higher in LT than in LR and the ORs were 1.12(95% CI: 0.96-1.30) in 3 years and1.84(95% CI: 1.49-2.28) in 5 years. Furthermore, the tumorfree survival rate in LT was significantly higher than that in LR in 1, 3, 5 years after surgery, with the ORs of 1.72(95% CI:1.24-2.41), 3.75(95% CI: 2.94-4.78) and 5.64(95% CI: 4.35-7.31),respectively.CONCLUSIONS: One-year morbidity and mortality are higher in LT than in LR for patients with HCC. However, long-term survival and tumor-free survival rates are higher in patients treated with LT than those treated with LR.
基金Supported by National Natural Science Foundation of China,No.81272644 and No.81072051
文摘AIM: To investigate the association between thrombocytopenia and relapse after treatment for hepatocellular carcinoma(HCC).METHODS: We searched the Pub Med, EMBASE, and Web of Science databases to obtain eligible studies. The hazard ratios(HRs) values and 95% confidence intervals(CIs) were pooled by random effects model. Subsequently, we estimated the heterogeneity, performed a sensitivity analysis, determined the publication bias, and performed subgroup and meta-regression analyses. Study quality was assessed by using the Oxford Center for Evidence Based Medicine tool.RESULTS: We identified 18 eligible studies by retrieval(published during 2000-2014). Out of the 4163 patients with HCC who were recruited, 2746(66.0%) experienced recurrence. In general, our meta-analysis suggested that low platelet count(PLT) before therapy significantly increased the probability of postoperative recurrence(HR = 1.53, 95%CI: 1.29-1.81). PLT was also valuable in the prediction of intrahepatic distant recurrence(HR = 1.49, 95%CI: 1.25-1.77). Subgroupand meta-regression analyses identified various therapeutic modalities as the source of a high degree of heterogeneity. The pooled HR values showed no obvious change when a single study was removed, but otherwise, an opposite-effects model was used. In addition, no significant publication bias was detected.CONCLUSION: Thrombocytopenia before treatment might be an inexpensive and useful predictor of postoperative recurrence in patients with HCC.
基金Supported by National Natural Science Foundation of China,No.30872482 and No.81072051
文摘AIM:To explore the effects of platelet count(PLT)and11 platelet-based indices on postoperative recurrence of hepatocellular carcinoma(HCC).METHODS:We retrospectively analyzed 172 HCC patients who were treated by partial hepatectomy.Preoperative data,including laboratory biochemical results,were used to calculate the 11 indices included in the analysis.We performed receiver operating characteristic curve analysis to determine the optimal cut-off values for predicting recurrence.Cumulative rates of HCC recurrence were calculated using KaplanMeier survival curves and differences were analyzed by log-rank tests.Multivariate analyses were performed to identify independent predictors of recurrence,early recurrence(within one year after surgery),and late recurrence in HCC.To obtain better prognostic models,PLT-based indices were analyzed separately after being expressed as binary and continuous variables.Two platelet-unrelated,validated HCC prognostic models were included in the analyses as reference indices.Additional analyses were performed after patients were stratified based on hepatitis B virus infection status,cirrhosis,and tumor size to investigate the significance of platelets in different subgroups.RESULTS:In the study cohort,44.2%(76/172)of patients experienced HCC recurrence,and 50.6%(87/172)died during a median follow-up time of 46mo.PLT and five of the 11 platelet-related models were significant predisposing factors for recurrence(P<0.05).Multivariate analysis indicated that,among the clinical parameters,presence of ascites,PLT≥148×109/L,alkaline phosphatase≥116 U/L,and tumor size≥5 cm were independently associated with ahigher risk of HCC recurrence(P<0.05).Independent and significant models included the aspartate aminotransferase/PLT index,fibrosis index based on the four factors,fibro-quotient,aspartate aminotransferase/PLT/γ-glutamyl transpeptidase/alpha-fetoprotein index,and the PLT/age/alkaline phosphatase/alphafetoprotein/aspartate aminotransferase index.There were different risk factors betw
基金Supported by National Natural Science Foundation of ChinaNo. 30872482 and No. 81072051
文摘AIM:To explore the prognostic value in the monitoring of treatment efficacy of serial α-fetoprotein(AFP) in hepatocellular carcinoma(HCC) patients.METHODS:We searched MEDLINE,EMBASE and COCHRANE LIBRARY through April 21,2012,to find qualifying articles.Our overall search strategy included terms for HCC,AFP,treatment response,and prognosis.Literature was limited to English-language,human studies.Studies reporting cumulative survival rates were summa-rized qualitatively.For the prognostic meta-analysis,we undertook a series of meta-analyses that summarised the Cox proportional hazard ratios(HRs) by assuming a random effects model.With regards to the correlation of AFP change with radiologic response,the categorical dichotomous variables were assessed using Poisson relative risks(RRs),which were incorporated into the random effects model meta-analysis of accuracy prediction.Between-study heterogeneity was estimated by use of the I2 statistic.Publication bias was evaluated using the Begg funnel plot and Egger plot.Sensitivity analyses were conducted first by separating systemic treatment estimates from locoregional therapy estimates,evaluating different AFP response cut-off point effects,and exploring the impact of different study sizes.RESULTS:Of 142 titles identified in our original search,11 articles(12 clinical studies) met our criteria.Six studies investigated outcome in a total of 464 cases who underwent systemic treatment,and six studies investigated outcome in a total of 510 patients who received locoregional therapy.A random-effects model metaanalysis showed that AFP response was associated with an mortality HR of 0.55(95%CI,0.47-0.65) across HCC in overall survival(OS) and 0.50(95%CI,0.38-0.65) in progression-free survival.Restricting analysis to the six eligible analyses of systemic treatment,the pooled HRs were 0.64(95%CI,0.53-0.77) for OS.Limiting analysis to the six analyses of locoregional therapy,the pooled HRs for OS was 0.39(95%CI,0.29-0.53).We showed a larger pooled HR in the 50% definition studie
基金Project supported by the National Natural Science Foundation of China(Grant Nos.71771013 and 71621001)in part by the National Key Research and Development Program of China(Grant No.2019YFF0301403)+1 种基金in part by the Singapore Ministry of Education(MOE)Ac RF Tier 2(Grant No.MOE2016-T2-1-044)in part by the Fundamental Research Funds for the Central Universities,China(Grant NO.2019JBM041)。
文摘A new heuristics model based on the Voronoi diagram is presented to simulate pedestrian dynamics with the noncrowded state, in which these mechanisms of preference demand evading and surpassing, microscopic anti-deadlock, and site-fine-tuning are considered. The preference demand describes the willingness determination of detouring or following other pedestrians. In the evading and surpassing mechanisms, in order to achieve a balance between avoiding conflicts and minimizing detour distances, a new pair of concepts: "allow-areas and denial-areas" are introduced to divide the feasible region for pedestrians detour behaviors, in which the direction and magnitude of detour velocity are determined.A microscopic anti-deadlock mechanism is inserted to avoid deadlock problem of the counter-directional pedestrian. A site-fine-tuning mechanism is introduced to describe the behavior of avoiding getting too close to the neighbors in pedestrian movement. The presented model is verified through multiple scenarios, including the uni-or bi-direction pedestrian flow in the corridor without obstacles, the uni-direction pedestrian flow in the corridor with obstacles, and the pedestrian evacuation from a room with single-exit. The simulation results show that the velocity–density relationship is consistent with empirical data. Some self-organizing phenomena, such as lanes formation and arching are observed in the simulation.When pedestrians detour an obstacle, the avoiding area before the obstacle and the unoccupied area after the obstacle can be observed. When pedestrians evacuate through a bottleneck without panic, the fan-shaped crowd can be found, which is consistent with the actual observation. It is also found that the behavior of following others in an orderly manner is more conducive to the improvement of the overall movement efficiency when the crowd moves in a limited space.
基金Supported by Grants from National Natural Science Foundation of China,No.81201549 and No.81272644the Project of Innovative Research Team for Key Science and Technology in Xi’an Jiaotong University,No.2003KCJ-23
文摘AIM: To investigate the effects of single nucleotide polymorphisms(SNPs) in glutathione S-transferase(GST) genes on survival of hepatocellular carcinoma(HCC) patients.METHODS: Twelve tagging SNPs in GST genes(including GSTA1, GSTA4, GSTM2, GSTM3, GSTO1, GSTO2 and GSTP1) were genotyped using Sequenom Mass ARRAY i PLEX genotyping method in a cohort of 214 Chinese patients with resected HCC.The Cox proportional hazards model and log-rank test were performed to determine the SNPs related to outcome.Additionally, stratified analysis was performed at each level of the demographic and clinical variables.An SNP-gene expression association model was further established to investigate the correlation between SNP and gene expression.RESULTS: Two SNPs(GSTO2 : rs7085725 and GSTP1 : rs4147581) were significantly associated with overall survival in HCC patients(P = 0.035 and 0.042, respectively).In stratified analysis, they were more significantly associated with overall survival in patients with younger age, male gender and cirrhosis.We further investigated cumulative effects of these two SNPs on overall survival in HCC patients.Compared with the patients carrying no unfavorable genotypes, those carrying 2 unfavorable genotypes had a 1.70-fold increased risk of death(P < 0.001).The cumulative effects were more significant in those patients with younger age, male gender and cirrhosis(HR = 2.00, 1.94 and 1.97, respectively; all P < 0.001).Additionally, we found that heavy smoking resulted in a significantly worse overall survival in those patients carrying variantalleles of rs7085725(HR = 2.07, 95%CI: 1.13-3.76, P = 0.018).The distributions of GSTO2 : rs7085725 and GSTP1 : rs4147581 genotypes were associated with altered gene expression and contributed to influences on overall survival.CONCLUSION: Our study provides the first evidence that GSTO2 and GSTP1 gene polymorphisms may serve as independent prognostic markers for HCC patients.
文摘We corrected the mistake of Figure 3,and replaced the incorrect images with the correct ones.The“adenovirus”was a typographical error in writing,and should be revised to“lentivirus”.
