Left jackknife position:a novel position for laparoscopic hepatectomy

Background: Laparoscopic hepatectomy for hepatocellular carcinoma(HCC) located in segment Ⅵ, Ⅶ, or Ⅷ of the liver is usually difficult because of poor operative exposure, due to the unique anatomical structure. In this study, we evaluated the practice of laparoscopic hepatectomy with the left jackknife position for patients with HCC located in segment Ⅵ, Ⅶ, or Ⅷ.Methods: A total of 10 patients were enrolled to undergo laparoscopic hepatectomy with the left jackknife position.Tumors located in segment Ⅵ, Ⅶ, or Ⅷ were assessed by preoperative dynamic computed tomography or magnetic resonance imaging. Operation time, intraoperative blood loss, postoperative fasting time, postoperative drainage time, major postoperative complications, and duration of postoperative hospital stay were recorded.Results: All surgeries were successfully completed. None of the patients required conversion to open surgery during the procedure, and no serious postoperative complications were observed.The median tumor size was 31 mm(range 23-41 mm) in diameter, the mean operation time was 166 ± 38 min, the mean intraoperative blood loss was220 ± 135 mL, and the median postoperative hospital stay was 4 days(range 2-7 days).Conclusions: For HCC located in segment Ⅵ, Ⅶ, or Ⅷ, laparoscopic hepatectomy with this novel position—the left jackknife position—is safe and effective during tumor resection by exposing a sufficient operating field.Trial registration ClinicalTrials.gov ID:

Indoleamine-2,3-dioxygenase 1/cyclooxygenase 2 expression prediction for adverse prognosis in colorectal cancer

AIM To evaluate indoleamine-2,3-dioxygenase 1/cyclooxygenase 2(IDO1/COX2) expression as an independent prognostic biomarker for colorectal cancer(CRC) patients.METHODS We retrospectively studied the medical records of 95 patients who received surgical resection from August 2008 to January 2010. All patients were randomly assigned to adjuvant treatment with or without celecoxib groups after surgery. We performed standard immunohistochemistry to assess the expression levels of IDO1/COX2 and evaluated the correlation of IDO1/COX2 with clinicopathological factors and overall survival(OS) outcomes.RESULTS The expression of nuclear IDO1 was significantly correlated with body mass index(P < 0.001), and IDO1 expression displayed no association with sex, age, tumor differentiation, T stage, N stage, carcinoembryonic antigen, cancer antigen 19-9, CD3+ and CD8+ tumor infiltrating lymphocytes, and COX2. In univariate analysis, we found that nuclear IDO1(P = 0.039), nuclear/cytoplasmic IDO1 [hazard ratio(HR) = 2.044, 95% confidence interval(CI): 0.871-4.798, P = 0.039], nuclear IDO1/COX2(HR = 3.048, 95%CI: 0.868-10.7, P = 0.0049) and cytoplasmic IDO1/COX2(HR = 2.109, 95%CI: 0.976-4.558, P = 0.022) all yielded significantly poor OS outcomes. Nuclear IDO1(P = 0.041), nuclear/cytoplasmic IDO1(HR = 3.023, 95%CI: 0.585-15.61, P = 0.041) and cytoplasmic IDO1/COX2(HR = 2.740, 95%CI: 0.764-9.831, P = 0.038) have significantly poor OS outcomes for the CRC celecoxib subgroup. In our multivariate Cox model, high coexpression of cytoplasmic IDO1/COX2 was found to be an independent predictor of poor outcome in CRC(HR = 2.218, 95%CI: 1.011-4.48, P = 0.047) and celecoxib subgroup patients(HR = 3.210, 95%CI: 1.074-9.590, P = 0.037).CONCLUSION Our results showed that cytoplasmic IDO1/COX2 coexpression could be used as an independent poor predictor for OS in CRC.

Machine Learning Models in Type 2 Diabetes Risk Prediction:Results from a Cross-sectional Retrospective Study in Chinese Adults

Type 2 diabetes mellitus (T2DM) has become a prevalent health problem in China,especially in urban areas.Early prevention strategies are needed to reduce the associated mortality and morbidity.We applied the combination of rules and different machine learning techniques to assess the risk of development of T2DM in an urban Chinese adult population.A retrospective analysis was performed on 8000 people with non-diabetes and 3845 people with T2DM in Nanjing.Multilayer Perceptron (MLP),AdaBoost (AD),Trees Random Forest (TRF),Support Vector Machine (SVM),and Gradient Tree Boosting (GTB) machine learning techniques with 10 cross validation methods were used with the proposed model for the prediction of the risk of development of T2DM.The performance of these models was evaluated with accuracy,precision,sensitivity,specificity,and area under receiver operating characteristic (ROC) curve (AUC).After comparison,the prediction accuracy of the different five machine models was 0.87,0.86,0.86,0.86 and 0.86 respectively.The combination model using the same voting weight of each component was built on T2DM,which was performed better than individual models.The findings indicate that,combining machine learning models could provide an accurate assessment model for T2DM risk prediction.

左侧折刀体位在腹腔镜肝切除术中的新应用

背景与目的由于独特的解剖结构和手术显露不佳,通过腹腔镜肝切除术治疗位于肝脏Ⅵ、Ⅶ或Ⅷ段的肝细胞癌(hepatocellular carcinoma,HCC)通常是比较困难的。在本研究中,我们评价了左侧折刀体位腹腔镜肝切除术对治疗位于Ⅵ、Ⅶ或Ⅷ段的HCC患者的临床疗效。方法共10例患者进行了左侧折刀体位腹腔镜肝切除术。通过术前动态计算机断层扫描或磁共振成像来评估位于Ⅵ、Ⅶ或Ⅷ段的肿瘤。记录了手术时间、术中出血量、术后开始进食时间、术后引流时间、术后主要并发症及术后住院时间。结果所有手术均顺利完成。在手术过程中没有患者需要转为开腹手术,且术后无严重并发症发生。肿瘤直径的中位数为31 mm(23–41 mm),平均手术时间为166±38 min,术中平均出血量为220±135 mL,术后住院时间中位数为4 d(2–7 d)。结论左侧折刀体位在肿瘤切除术中可以展示出足够的术野显露,在这种新的体位下对位于Ⅵ、Ⅶ或Ⅷ段的HCC进行腹腔镜肝切除术是安全有效的。

Underwater video transceiver designs based on channel state information and video content

Underwater hostile channel conditions challenge video transmission designs. The current designs often treat video coding and transmission schemes as individual modules. In this study, we develop an adaptive transceiver with channel state information(CSI) by taking into account the importance of video components and channel conditions. The design is more effective than the traditional ones. However, in practical systems, perfect CSI may not be available. Therefore, we compare the imperfect CSI case with existing schemes, and validate the effectiveness of our design through simulations and measured channels in terms of a better peak signal-to-noise ratio and a higher video structural similarity index.

Tescalcin is an unfavorable prognosis factor that regulats cell proliferation and survival in hepatocellular carcinoma patients

Background:Hepatocellular carcinoma(HCC)is a major health problem and a primary cause of cancer-related death worldwide.Although great advances have achieved recently by large-scale high-throughput analysis,the precise molecular mechanism underlying HCC progression remains to be clearly elucidated.We investigated the relationship between Tescalcin(TESC),a candidate oncogene,and clinicopathological features of HCC patients and explored the role of TECS in HCC development.Methods:To identify new genes involved in HCC development,we analyzed The Cancer Genome Atlas liver cancer database,and TESC was selected for further investigation.HCC tissue microarray analysis for TESC and its association with clinicopathological features were performed to investigate its clinical significance.TESC was knocked down by using short-hairpin RNAs.Cell proliferation was analyzed by WST-1 assay and cell counting.Cell apoptosis was tested by fluorescence-activated cell sorting.A subcutaneous xenograft tumor model in nude mice was established to determine the in vivo function of TESC.Affymetrix microarray was used to identify its molecular mechanism.Results:TESC was significantly increased in HCC tissues compared with the adjacent normal liver tissues.High expression of TESC was detected in 61 of 172 HCC patients by tissue microarray.Large tumor(>5 cm)and elevated total bilirubin were associated with high TESC expression(both P<0.050).In multivariate analysis,TESC was identified as an independent prognostic factor for short overall survival of HCC patients.TESC knockdown impaired HCC cell growth in vitro and in vivo.TESC knockdown significantly increased cell apoptosis in HCC cell lines.Furthermore,Affymetrix microarray analysis revealed that TESC knockdown inhibited tumor proliferation-related pathways while activated cell death-related pathways.Conclusion:TESC was identified as an independent prognostic factor for short overall survival of HCC patients,and was critical for HCC cell proliferation and survival.