Development of a nomogram for predicting liver transplantation prognosis in hepatocellular carcinoma

BACKGROUND At present,liver transplantation(LT)is one of the best treatments for hepatocellular carcinoma(HCC).Accurately predicting the survival status after LT can significantly improve the survival rate after LT,and ensure the best way to make rational use of liver organs.AIM To develop a model for predicting prognosis after LT in patients with HCC.METHODS Clinical data and follow-up information of 160 patients with HCC who underwent LT were collected and evaluated.The expression levels of alphafetoprotein(AFP),des-gamma-carboxy prothrombin,Golgi protein 73,cytokeratin-18 epitopes M30 and M65 were measured using a fully automated chemiluminescence analyzer.The best cutoff value of biomarkers was determined using the Youden index.Cox regression analysis was used to identify the independent risk factors.A forest model was constructed using the random forest method.We evaluated the accuracy of the nomogram using the area under the curve,using the calibration curve to assess consistency.A decision curve analysis(DCA)was used to evaluate the clinical utility of the nomograms.RESULTS The total tumor diameter(TTD),vascular invasion(VI),AFP,and cytokeratin-18 epitopes M30(CK18-M30)were identified as important risk factors for outcome after LT.The nomogram had a higher predictive accuracy than the Milan,University of California,San Francisco,and Hangzhou criteria.The calibration curve analyses indicated a good fit.The survival and recurrence-free survival(RFS)of high-risk groups were significantly lower than those of low-and middle-risk groups(P<0.001).The DCA shows that the model has better clinical practicability.CONCLUSION The study developed a predictive nomogram based on TTD,VI,AFP,and CK18-M30 that could accurately predict overall survival and RFS after LT.It can screen for patients with better postoperative prognosis,and improve longterm survival for LT patients.

Development of a diagnostic nomogram for alpha-fetoproteinnegative hepatocellular carcinoma based on serological biomarkers

BACKGROUND Hepatocellular carcinoma(HCC)is the third leading cause of cancer-related death worldwide.Serum biomarkers play an important role in the early diagnosis and prognosis of HCC.Because a certain percentage of HCC patients are negative for alpha-fetoprotein(AFP),the diagnosis of AFP-negative HCC is essential to improve the detection rate of HCC.AIM To establish an effective model for diagnosing AFP-negative HCC based on serum tumour biomarkers.METHODS A total of 180 HCC patients were enrolled in this study.The expression levels of GP73,des-γ-carboxyprothrombin(DCP),CK18-M65,and CK18-M30 were detected by a fully automated chemiluminescence analyser.The variables were selected by logistic regression analysis.Several models were constructed using stepwise backward logistic regression.The performance of the models was compared using the C statistic,integrated discrimination improvement,net reclassification improvement,and calibration curves.The clinical utility of the nomogram was assessed using decision curve analysis(DCA).RESULTS The results showed that the expression levels of GP73,DCP,CK18-M65,and CK18-M30 were significantly greater in AFP-negative HCC patients than in healthy controls(P<0.001).Multivariate logistic regression analysis revealed that GP73,DCP,and CK18-M65 were independent factors for diagnosing AFP-negative HCC.By comparing the diagnostic performance of multiple models,we included GP73 and CK18-M65 as the model variables,and the model had good discrimination ability(area under the curve=0.946)and good goodness of fit.The DCA curves indicated the good clinical utility of the nomogram.CONCLUSION Our study identified GP73 and CK18-M65 as serum biomarkers with certain application value in the diagnosis of AFP-negative HCC.The diagnostic nomogram based on CK18-M65 combined with GP73 demonstrated good performance and effectively identified high-risk groups of patients with HCC.

Synthesis of MnO2/N-doped ultramicroporous carbon nanospheres for high-performance supercapacitor electrodes

We demonstrate a simple and highly efficient strategy to synthesize MnO2/nitrogen-doped ultramicroporous carbon nanospheres（MnO2/N-UCNs） for supercapacitor application.MnO2/N-UCNs were fabricated via a template-free polymerization of resorcinol/formaldehyde on the surface of phloroglucinol/terephthalaldehyde colloids in the presence of hexamethylenetetramine,followed by carbonization and then a redox reaction between carbons and KMnO4.As-prepared MnO2/N-UCNs exhibits regular ultramicropores,high surface area,nitrogen heteroatom,and high content of MnO2.A typical MnO2/N-UCNs with 57 wt.%MnO2 doping content（denoted as MnO2（57%）/N-UCNs） makes the most use of the synergistic effect between carbons and metal oxides.MnO2（57%）/N-UCNs as a supercapacitor electrode exhibits excellent electrochemical performance such as a high specific capacitance（401 F/g at 1.0 A/g） and excellent charge/discharge stability（86.3%of the initial capacitance after 10,000 cycles at 2.0 A/g） in 1.0 mol/L Na2SO4 electrolyte.The well-designed and high-performance MnO2/N-UCNs highlight the great potential for advanced supercapacitor applications.

A report on the congenital hepatic diaphragmatic hernia

To the Editor:The author found a suspected congenital hepatic diaphragmatic hernia in a middle-aged male specimen about 170 cm in height.The specific report is as follows.The specimen was laid flat and the thoracic cavity and abdominal cavity were opened with conventional anatomical method.Then it was surprisingly found that most of the right lobe of the liver passed through the aortic hiatus in the diaphragm and passed through the oblique fissure hernia of the right lung into the thoracic cavity,causing the lower lobe of the right lung severely squeezed and deformed,followed by dysplasia.Gallbladder and dark green bile was also visible around it,and the left lobe of the liver was still in the abdominal cavity[Figure 1].The project followed the principle of respecting life and voluntariness,and it had passed the review of the Ethics Committee(Approval No.JZFY201620).