Search

Background: This study aimed to reveal novel markers for prognostic and diagnostic prediction of hepatocellular carcinoma (HCC)., Methods: We applied The Cancer Genome Atlas (TCGA) data to screen differentially expressed genes (DEGs). We identified hub modules and genes using weighted gene co-expression network analysis (WGCNA). After verification with the GSE36376 dataset, hub genes were further identified. The expression of progestin and adipoQ receptor 4 ( PAQR4 ) was confirmed in HCC by quantitative reverse transcription polymerase chain reaction (qRT-PCR) . The diagnostic and prognosis value of PAQR4 was assessed. The expression of PAQR4 was verified using the GSE76427 dataset., Results: A total of 803 DEGs were obtained between HCC and normal tissue. Through WGCNA, 7 hub modules were screened, among which the blue module was selected to identify the hub genes associated with the HCC. After overlapping all the DEGs with 837 genes of the blue module, we obtained 466 DEGs that were defined as hub genes. Among the hub genes, 239 were related to staging. After verifying with the GSE36376 dataset, PAQR4 was identified as the real hub gene of HCC. The results of qRT-PCR revealed that PAQR4 was upregulated between HCC and normal tissue. Furthermore, PAQR4 was related to the diagnosis and prognosis of patients with HCC. Moreover, the GSE76427 verification results of PAQR4 were consistent with our integration and qRT-PCR results. Ultimately, high expression of PAQR4 was significantly related to cell cycle, DNA replication, and the p53 signaling pathway., Conclusions: The PAQR4 gene may be associated with the prognosis and diagnosis of HCC ., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jgo.amegroups.com/article/view/10.21037/jgo-22-168/coif). The authors have no conflicts of interest to declare., (2022 Journal of Gastrointestinal Oncology. All rights reserved.)

Background: Gynura segetum (GS) is widely used in medical care and in community settings in China as the herbal remedy. It is widely thought to have antiphlogistic properties and pain relief in traditional Chinese medicine. It has been reported that GS can cause chronic drug-induced liver injury (DILI), manifested as hepatic sinusoid obstruction syndrome (HOSO). But case reports of acute DILI developing acute liver failure (ALF) due to GS are extremely rare., Case Presentation: We report a case of a 63-year-old female patient with hepatolithiasis for more than 6 years. There were no deterioration of liver function and no history of viral liver disease, autoimmune liver disease, blood transfusion or surgical allergy before operation. ALF and grade II liver encephalopathy occurred after partial hepatectomy. To follow up the medical history, the patient has been taking GS (Tusanqi) for a year and a half. The causality assessment was done by the updated Roussel Uclaf Causality Assessment Method, and the possibility of DILI caused by GS as highly probable for the score was 6 points. Excluding other causes, a diagnosis of DILI-associated ALF was established. After symptomatic support and artificial liver support system (ALSS) treatment, the clinical symptoms and signs of the patients were significantly improved. After discharge, the liver function of the patients returned to normal., Conclusions: Based on this rare case of severe liver injury, we recommend that timely prevention, identification, and appropriate management of DILI is essential for patients with a history of taking GS and other hepatotoxic drugs, and careful monitoring of liver function for patients with DILI could avoid ALF as far as possible., (© 2022. The Author(s).)

Objective: To explore the molecular mechanism of umbilical cord blood mesenchymal stem cells (UCBMSCs) in the treatment of advanced osteoarthritis pain., Methods: Normal healthy rats were selected to establish advanced osteoarthritis (OA) model, and the rats were randomly divided into control group, intravenous group, intracavitary group and intrathecal group. The intravenous group received intravenous injection of UCBMSCs, intracavitary group received intra-articular injection of UCBMSCs, and intrathecal group received subarachnoid injection of UCBMSCs. The pain behavior and serum pro-inflammatory factor levels were evaluated before and after treatment. microRNA-29a-3p and FOS mRNA in spinal dorsal horn was detected using qPCR, the phosphorylation of c-fos protein and NR1, NR2B, ERK and PKCg was detected using Western blot, and the level of LncRNA H19 was detected using qPCR., Results: LncRNA H19 was enriched in the exosomes of UCBMSCs. microRNA-29a-3p was the target gene of LncRNA H19, while FOS was the downstream target of microRNA-29a-3p. Pain and inflammation of rats in the intrathecal group improved best, and the phosphorylation levels of c-fos and NR1, NR2B, ERK and PKCg in the spinal dorsal horn of the intrathecal group decreased. LncRNA H19 regulated the central sensitization of astrocytes through microRNA-29a-3p/FOS axis., Conclusion: Intrathecal injection of umbilical cord blood mesenchymal stem cells can improve the pain and central sensitization of advanced osteoarthritis through LncRNA H19/microRNA-29a-3p/FOS axis., Competing Interests: None., (AJTR Copyright © 2021.)

Despite the theoretical advantages of laparoscopic hepatectomy, it is still not considered the standard treatment for hepatocellular carcinoma patients because of criticism concerning oncologic stability. This study aimed at examining the short- and long-term follow-up results of laparoscopic hepatectomy versus open hepatectomy for hepatocellular carcinoma and at investigating clinical outcomes, oncologic safety, and any potential advantages of laparoscopic hepatectomy for hepatocellular carcinoma. A series of 53 patients who underwent laparoscopic hepatectomy (Lap group) for hepatocellular carcinoma were matched with 53 patients who underwent open hepatectomy during the same time period (Open group). The short- and long-term outcomes were compared between the two groups of patients. The patients who underwent the laparoscopic procedure showed a significantly faster recovery and less blood loss compared with patients who underwent open surgery. No differences were found in 5-year overall and disease-free survival rates. Our results suggested that the laparoscopic approach was as safe as the open alternative. Laparoscopic hepatectomy has been shown to be a favorable surgical option with better short-term outcomes and similar long-term oncological control compared with open hepatectomy.

Background/aims: To evaluate the effect of high-intensity ultrasound (HIFU) ablation on human hepatocellular carcinoma tissues and apoptotic proteins (bcl-2 and p-53)., Methodology: Patients with hepatocellular carcinoma at stage B were treated with HIFU ablation. Levels of bcl-2 and p53 protein and the apoptosis rate were evaluated both in the pre-treatment and post-treatment tissue specimens using immunochemistry and TUNEL methods, respectively., Results: After HIFU ablation, p53 protein levels were significantly increased around the coagulation necrosis area, whereas, the level of bcl-2 was significantly decreased. More apoptosis cells were found post ablation compared with those in the pretreatment tissues. Additionally, no significant correlation was found between p53/bcl-2 levels and apoptotic index., Conclusions: HIFU ablation may exert promote the apoptosis of hepatocellular carcinoma cells and the effect has a closely association with the change of p53 and bcl-2 expression.

Objective: To investigate whether transplantation of autologous peripheral blood CD34+ stem cells is a viable approach for treating patients with advanced cirrhosis,which is currently hindered by a shortage in liver donors., Methods: A total of 100 patients with advanced cirrhosis and who had failed to respond to conservative therapy were recruited for transplantation of autologous peripheral blood CD34+ stem cells.The success of transplantation was investigated 6-and 12-months later by measuring markers of liver biosynthesis function (coagulation,albumin level,indocyanine green clearance,Child-Pugh score) and assessing pathological changes (Knodell score) and morphologic changes in the liver tissue.Complications were also recorded during follow-up., Results: The 1-year cumulative survival rate was 100%. Fifty-two patients with massive ascites showed gradual reduction and disappearance of the ascites.Four patients experienced upper gastrointestinal bleeding and three patients developed with hepatic encephalopathy (I-II degree) at 3 months post-transplantation.All patients showed significantly improved liver biosynthesis function,liver elasticity and Knodell score after transplantation (P less than 0.05)., Conclusion: Autologous peripheral blood CD34+ stem cell transplantation is a safe and effective treatment for advanced cirrhosis,and has high cost-benefit since it improves liver function,liver histology,and quality of life.

Objective: To evaluate the values of radiology, computed tomography (CT) and magnetic resonance imaging (MRI) in assessing symptomatic osteoporosis vertebral compression fractures in vertebroplasty and kyphoplasty., Methods: Retrospective reviews were conducted for 41 osteoporotic vertebral compression fractures patients with preoperative CT (with 3D reconstruction)/MRI (with fat saturation sequence) and preoperative and postoperative radiological imaging data. All patients underwent percutaneous vertebroplasty (PVP) or balloon kyphoplasty (BKP) when conservative treatment failed to offer pain relief., Results: CT scan showed 52 vertebral fractures while MRI detected a total of 70 lesions of vertebral body, including 44 new fractures, 8 old fractures and 18 bone bruises. Eight old fractures and 2 mild bone bruises were treated conservatively. In conjunctions with MRI, especially fat saturation sequence, 60 therapeutic vertebral bodies were visualized. It was superior to CT. As demonstrated by preoperative and postoperative radiology, vertebral body height improved and Cobb Angle slightly decreased for 60 lesions., Conclusion: For vertebral compression fractures in osteoporosis patients, preoperative CT and MRI examinations have important clinical significance in providing treatment guidance and assessing postoperative outcomes.

Objective: To explore the effects of autotransfusion on intraoperative blood loss and postoperative drainage volume in posterior lumbar spinal surgery., Methods: From June 2010 to January 2012, a total of 183 patients with lumbar disease were enrolled. There were 74 males and 109 females with an average age of 56.6 (31-81) years. There were lumbar disc herniation (n = 80), lumbar stenosis (n = 69), lumbar spondylolisthesis (n = 32) and discogenic pain (n = 2). And one-level (n = 83) and two-level (n = 100) operations were performed. The treatments were non-transfusion (n = 34), auto-blood (n = 109) and allogeneic blood (n = 20) and both (n = 20).Operative duration, operative level, intraoperative autologous blood transfusion, intraoperative allogeneic blood transfusion, intraoperative blood loss, immediate drainage volume, duration of drainage tube and final drainage volume were recorded., Results: The mean intraoperative blood loss was (369.4 ± 284.0) ml and (568.8 ± 398.7) ml for two-level operation, there were significant differences between them(t = 3.94, P < 0.001). The final drainage volume was (186.3 ± 135.6) ml for one-level patients and (301.4 ± 286.8) ml for two-level patients, there were significant differences between them (t = 3.56, P < 0.05). The total intraoperative blood loss was (478.3 ± 364.3) ml and total final drainage volume was (249.2 ± 237.4) ml, there were significant differences between them(P < 0.001). There were significant differences in blood loss between autologous blood transfusion for non-transfusion groups (P < 0.001) .However, there was no difference for immediate drainage and final drainage comparing with other blood transfusion methods (P > 0.05) ., Conclusion: Using autologous blood transfusion alone during operation has significant difference for inoperative blood loss compared with non-transfusion. Yet there is no effect on immediate or final drainage volume.