Primary hepatic neuroendocrine tumor case with a preoperative course of 26 years: A case report and literature review

Primary hepatic neuroendocrine tumor(PHNET) is an extremely rare liver tumor. Patients often have no clinical symptoms or have only non-specific symptoms, such as abdominal pain and abdominal mass. The clinical manifestations, disease development, treatment methods, and treatment outcomes of PHNET vary greatly among cases. Here we report a case of PHNET with a confirmed 26-year survival before surgery. The patient was a 56-year-old female. A large right hepatic mass was detected when the patient was 30 years old. The tumor could not be removed during exploratory laparotomy, and constriction of the right hepatic artery and biopsy were conducted. Pathological results indicated a diagnosis of benign tumor, but a confirmed diagnosis was not reached. Twenty-six years after the patient had been living with the tumor, she sought treatment again because of tumor progression. After systematic evaluation of the resectability, the tumor was resected. Based on the examination results of the gastrointestinal tract and lungs, intraoperative examination results, pathological findings, and long-term follow-up results, the diagnosis of PHNET was confirmed. This case represents the longest reported survival time for a PHNET patient before removal of the tumor.

Safety validation of decision trees for hepatocellular carcinoma

AIM: To evaluate a different decision tree for safe liver resection and verify its efficiency.METHODS: A total of 2457 patients underwent hepatic resection between January 2004 and December 2010 at the Chinese PLA General Hospital,and 634 hepatocellular carcinoma(HCC) patients were eligible for the final analyses. Post-hepatectomy liver failure(PHLF) was identified by the association of prothrombin time < 50% and serum bilirubin > 50 μmol/L(the "50-50" criteria),which were assessed at day 5 postoperatively or later. The Swiss-Clavien decision tree,Tokyo University-Makuuchi decision tree,and Chinese consensus decision tree were adopted to divide patients into two groups based on those decision trees in sequence,and the PHLF rates were recorded.RESULTS: The overall mortality and PHLF rate were 0.16% and 3.0%. A total of 19 patients experienced PHLF. The numbers of patients to whom the SwissClavien,Tokyo University-Makuuchi,and Chinese consensus decision trees were applied were 581,573,and 622,and the PHLF rates were 2.75%,2.62%,and 2.73%,respectively. Significantly more cases satisfied the Chinese consensus decision tree than the Swiss-Clavien decision tree and Tokyo University-Makuuchi decision tree(P < 0.01,P < 0.01); nevertheless,the latter two shared no difference(P = 0.147). The PHLF rate exhibited no significant difference with respect to the three decision trees.CONCLUSION: The Chinese consensus decision tree expands the indications for hepatic resection for HCC patients and does not increase the PHLF rate compared to the Swiss-Clavien and Tokyo UniversityMakuuchi decision trees. It would be a safe and effective algorithm for hepatectomy in patients with hepatocellular carcinoma.

Computationally predicting spin semiconductors and half metals from doped phosphorene monolayers

First-principles computations are performed to investigate phosphorene monolayers doped with 30 metal and nonmetal atoms. The binding energies indicate the stability of all doped configurations. Interestingly, the magnetic atom Co doping induces the absence of the magnetism while the magnetism is realized in phosphorene with substitutional doping of nonmagnetic atoms (O, S, Se, Si, Br, and Cl). The magnetic moment of transition metal (TM)-doped systems is suppressed in the range of 1.0-3.97μB.The electronic properties of the doped systems are modulated differently;O, S, Se, Ni, and Ti doped systems become spin semiconductors, while V doping makes the system a half metal. These results demonstrate potential applications of functionalized phosphorene with external atoms, in particular to spintronics and dilute magnetic semiconductors.

Genetic association between the polymorphism of cytosolicPLA2 gene family and schizophrenia

Abnormal phospholipid metabolism in the brain plays an important role in neuropsychiatric diseases.Phospholipase A2(PLA2)is a crucial element for normal neuro-physiological function.This study aims to investi-gate the genetic association between the polymorphism of cytosolic phospholipase A2(cPLA2)family genes and schizophrenia among Han Chinese in the northern part of China.The polymerase chain reaction-based ligase detec-tion reaction(PCR-LDR)was applied to detect the genotype ten single nucleotide polymorphisms(SNPs)of cPLA2 family genes among 201 pedigrees consisting of fathers,mothers and affected offsprings with schizophre-nia.The pedigrees were collected from 2000 to 2006.Haplotype relative risk(HRR)test,transmission disequili-brium test(TDT),haplotype transmission analysis and multiple locus analysis were conducted to analyze the genotyping data.The genotypic frequency of cPLA2 gene did not deviate from Hardy-Weinberg equilibrium either in case or control group.HRR and TDT showed that the ten SNPs were not associated with schizophrenia(P>0.05).Analysis for haplotype transmission showed that no haplotype system was associated with schizophrenia(P>0.05).The conditioning on allele(COA)and conditioning on gene(COG)tests showed disease associations with the haplotype of rs2162886-rs1668589,rs891014-rs1668589 and rs2307279-rs7542180(χ2=6.913,P=0.032;χ2=8.393,P=0.015;χ2=8.447,P=0.038).Our data suggest that many loci in the cPLA2 family genes may be associated with schizophrenia.