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Hepatocellular carcinoma (HCC) is a high-incidence, poor-prognosis malignancy worldwide, requiring new strategies for treatment. Ubiquitination, especially ubiquitination through E3 ubiquitin ligases, plays an indispensable role in the development and progression of HCC. E3 ubiquitin ligases are crucial enzymes in ubiquitination, controlling the degradation of specific substrate proteins and influencing various cellular functions, such as tumor cell proliferation, apoptosis, migration, and immune evasion. In this review, we systematically summarize the mechanisms of E3 ubiquitin ligases in HCC, with a focus on the significance of RING, HECT, and RBR types in HCC progression. The review also looks at the potential for targeting E3 ligases to modulate the tumor microenvironment (TME) and increase immunotherapy efficacy. Future studies will optimize HCC treatment by formulating specific inhibitors or approaches that will be based on gene therapy targeting E3 ligases in order to overcome resistance issues with present treatments and create optimism in the journey of treatment for HCC patients. [ABSTRACT FROM AUTHOR]

BackgroundUrinary stones are a common and frequently-occurring disease of the urinary system, among which upper urinary tract stones are the most common, imposing a heavy burden on patients. The causes of upper urinary tract stones are complex, which are closely associated with gender, age, geographic condition, climate, diet, and so on. However, it is still unclear whether upper urinary stone constituents vary by geographical conditions.ObjectiveTo analyze the constituents of upper urinary tract stones among adults in different geographic regions of Hebei, providing evidence for clinical treatment and prevention of upper urinary tract stones.MethodsOutpatients and inpatients (n=1 192, ≥18 years old) with upper urinary calculis who were from three geographical regions (mountainous, plain and coastal) of Hebei were selected from the Second Hospital of Hebei Medical University in 2019. Upper urinary tract stones of the outpatients removed by extracorporeal shock wave lithotripsy, and those of the inpatients removed by surgery were collected for quantitative and qualitative constituent analyses by geographical region using infrared spectrometry.ResultsUpper urinary tract stones were more often found in those 30 to 70 years old, with a male to female ratio about 1.75∶1. Kidney stones and ureteral stones accounted for similar proportions (about 1.1∶1) , and the mixed stones were more common (61.5%) . Calcium-containing stones were the major type of upper urinary tract stones in participants from each geographic regions, with calcium oxalate monohydrate being the most. The prevalence of infectious stones showed no significant differences across participants from three regions (P>0.05) . The prevalence of uric acid-containing stones in participants from plain was significantly different from that of participants from mountainous or coastal region (P

Objective To investigate the effect of wide surgical margin on the prognosis of patients with single intrahepatic cholangiocarcinoma (ICC) undergoing hepatectomy and the effect of microvascular invasion (MVI) on the treatment of hepatectomy with both wide surgical margin and narrow surgical margin. Methods From December 2011 to December 2017, the clinicopathological data of 302 patients with single ICC who underwent radical resection were retrospectively studied in 13 medical centers. According to the width of surgical margin, there were 126 patients (41.7%) in wide surgical margin group (≥1 cm) and 176 patients (58.3%) in narrow surgical margin group (0.05). Disease-free survival rate in wide surgical margin group before PSM was significantly higher than that in narrow surgical margin group (P=0.005), while overall survival rate showed no statistically significant difference (P=0.053). After PSM, both overall survival rate and disease-free survival rate in wide surgical margin group were significantly higher than those in narrow surgical margin group (P0.05). In MVI negative group, however both overall survival rate and disease-free survival rate were significantly higher in the patients with wide surgical margin hepatectomy than in those with narrow surgical margin (P

Background: With advances in techniques and technologies, laparoscopic radical resection of hilar cholangiocarcinoma (HCCA) has gradually been carried out in major medical centers in China. Its feasibility and safety have been accepted by a group of Chinese surgical experts.Methods: To standardize perioperative management of HCCA by using laparoscopic resectional approach, to ensure safety of the patient with standardized management, improve prognosis of the patient, and enable proper application and refinement of this surgical approach, the expert group on specifications for laparoscopic radical resection of HCCA in China organized a consensus meeting.Results: Laparoscopic radical resection of HCCA is difficult and associated with high risks. Appropriate patients should be carefully selected and this surgical approach should be promoted gradually. The experts met and arrived at 16 recommendations on perioperative management of HCCA by using laparoscopic surgery. There were three recommendations on preoperative diagnosis and evaluation; one recommendation on surgical principles of treatment; one recommendation on indications and contraindications; one recommendation on credentialing, staffing, and equipment; nine recommendations on laparoscopic techniques in different stages of operation; and one recommendation on indications for conversion to open surgery.Conclusion: Laparoscopic surgery for HCCA is still in the early phase of development. This consensus provides a clinical reference with the aim to promote and to facilitate its further development.

This paper investigated the discomfort caused by vertical whole-body vibration (WBV) over 20 minutes using data recorded at the front, middle, and rear seats of the passenger cabin in civil aviation during a cruising flight. Twenty-four subjects experienced each stimulus at 0.5 ms−2 r.m.s. and judged discomfort at various moments (i.e. 1/6, 5, 10, 15, and 20 min) using a category-ratio method. The difference in discomfort due to high-frequency vibration components vanished after 10 min. Based on Stevens' power law, a method is developed to estimate long-term vertical WBV discomfort by considering the static discomfort and an interaction coefficient between vibration and static discomfort as parameters. The proposed estimation method showed high accuracy with determination coefficients (R2) higher than 0.97 and good linearity with values of growth rates 0.95, 1, and 0.95 for the vertical WBV discomfort at the front, middle, and rear seat positions in the aircraft cabin. Practitioner summary: An estimation method for the discomfort caused by vertical WBV considering the duration and static sitting discomfort is developed. This method can provide accurate discomfort estimating for long-term vibration exposure, e.g. in civil aviation during a cruising flight, by introducing an 'interaction term' between static and dynamic discomfort. [ABSTRACT FROM AUTHOR]