Surgical vs percutaneous radiofrequency ablation for hepatocellular carcinoma in dangerous locations

AIM:To compare the long-term outcome of percutaneous vs surgical radiofrequency ablation(RFA) for hepatocellular carcinoma(HCC) in dangerous locations.METHODS:One hundred and sixty-two patients with HCC in dangerous locations treated with percutaneous or surgical RFA were enrolled in this study.The patients were divided into percutaneous RFA group and surgical RFA group.After the patients were regularly followed up for a long time,their curative rate,hospital stay time,postoperative complications and 5-year local tumor progression were compared and analyzed.RESULTS:No significant difference was observed in curative rate between the two groups(91.3% vs 96.8%,P = 0.841).The hospital stay time was longer and more analgesics were required while the incidence of bile duct injury and RFA-related hemorrhage was lower in surgical RFA group than in percutaneous RFA group(P < 0.05).The local progression rate of HCC in dangerous locations was significantly lower in surgical RFA group than in percutaneous RFA group(P = 0.05).The relative risk of local tumor progression was 14.315 in percutaneous RFA group.CONCLUSION:The incidence of severe postoperative complications and local tumor progression is lower after surgical RFA than after percutaneous RFA.

Successful liver resection in a giant hemangioma with intestinal obstruction after embolization

Hepatic hemangiomas are the most common benign tumor of the liver.Most hepatic hemangiomas remain asymptomatic and require no treatment.Giant hepatic hemangiomas with established complications,diagnostic uncertainty and incapacitating symptoms,however,are generally considered an absolute indication for surgical resection.We present a case of a giant hemangioma with intestinal obstruction following transcatheter arterial embolization,by which the volume of the hemangioma was significantly reduced,and it was completely resected by a left hepatectomy.A 21-yearold Asian man visited our hospital for left upper quadrant pain.Examinations at the first visit revealed a left liver hemangioma occupying the abdominal cavity,with a maximum diameter of 31.5 cm.Embolization of the left hepatic artery was performed and confirmed a decrease in its size.However,the patient was readmitted to our hospital one month after embolization for intestinal obstruction.A left hepatectomy was completed through a herringbone incision,and safely removed a giant hemangioma of 26.5 cm × 19.5 cm × 12.0 cm in size and 3690 g in weight.Pre-operative arterial embolization is effective for reducing tumor size,but a close follow-up to decide the time for hepatectomy is important.

Indirubin suppresses 4T1 murine breast cancer in vitro and in vivo by induction of ferroptosis

Objective Indirubin,isolated from Indigo Naturals,has been reported to have the inhibitory activity of MCF-7 human breast cancer cells in vitro.However,studies on its anti-breast cancer activity in vivo and the underlying mechanism are insufficient.We explored whether indirubin could trigger ferroptosis of breast cancer cells to exert anti-tumor activity.Methods Bioinformatical analysis was performed to detect the expression of prostaglandin-endoperoxide synthase 2(Ptgs2)in breast cancer tissues and Ptgs2-related prognosis for patients with breast cancer.The inhibitory effects of indirubin on 4T1 cells were assessed using MTT assay and LDH activity detection.The levels of 4-HNE,GPX4,PTGS2 and GSK-3βproteins were detected by Western blotting,and the mRNA of Ptgs2 was tested by qPCR.The contents of GSH and MDA were determined by commercial kits.Molecular docking was employed to study the interaction between indirubin and GSK-3β.A 4T1 murine breast cancer was adopted to evaluate the in vivo antitumor activity of indirubin.Results Indirubin promoted ferroptosis of 4T1 breast cancer cells with depleting of GSH,increased MDA and 4-HNE levels,as well as decreased GPX4 expression.Indirubin suppressed 4T1 breast tumor in vivo.The mechanism study showed indirubin up-regulated Ptgs2 expression by promoting phosphorylation(Ser 9)of GSK-3β.Conclusion Indirubin suppresses 4T1 murine breast cancer in vitro and in vivo by induction of ferroptosis.

The impact of the COVID-19 pandemic on erectile function in Chinese CP/CPPS patients

This study aimed to investigate the impact of the coronavirus disease 2019(COVID-19)pandemic on erectile function in Chinese patients with chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS).A retrospective study was conducted on 657 CP/CPPS patients who visited The Third Xiangya Hospital of Central South University(Changsha,China)from November 2018 to November 2022.Patients were divided into two groups based on the timeline before and after the COVID-19 outbreak in China.The severity of CP/CPPS,penile erection status,anxiety,and depression was evaluated using the National Institutes of Health-Chronic Prostatitis Symptom Index(NIH-CPSI),International Index of Erectile Function-5(IIEF-5),Generalized Anxiety Disorder-7(GAD-7),and Patient Health Questionnaire-9(PHQ-9)scales,respectively.Compared with patients before the COVID-19 outbreak,more CP/CPPS patients developed severe erectile dysfunction(ED)due to depression and anxiety caused by the pandemic.After developing moderateto-severe ED,mild and moderate-to-severe CP/CPPS patients exhibited more apparent symptoms of anxiety and depression(P<0.001 and P=0.001,respectively),forming a vicious cycle.The COVID-19 pandemic has adversely affected the psychological status of CP/CPPS patients,exacerbating their clinical symptoms and complicating ED.The exacerbation of clinical symptoms further worsens the anxiety and depression status of patients,forming a vicious cycle.During the COVID-19 pandemic,paying more attention to the mental health of CP/CPPS patients,strengthening psychological interventions,and achieving better treatment outcomes are necessary.