AIM： To detect the DNA binding activity of nuclear factor-kappaB （NF-KB） in rat hepatocyte and to investigate the effects of NF-KB on rat hepatocyte regeneration and apoptosis after 70% portal branch Iigation. METH...AIM： To detect the DNA binding activity of nuclear factor-kappaB （NF-KB） in rat hepatocyte and to investigate the effects of NF-KB on rat hepatocyte regeneration and apoptosis after 70% portal branch Iigation. METHODS： Sixty Wistar rats were randomly divided into control group and portal branch ligation group. The animals were killed 12 h, 1, 2, 3, 7, and 14 d after surgery to determine the contents of plasma ALT. Hepatocytes were isolated and nuclear protein was extracted. DNA binding activity of NF-KB was measured by ENSA. Hepatocyte regeneration and apoptosis were observed under microscope by TUNEL staining. The ultrastructural changes of liver were observed under electron microscope. RESULTS： Seventy percent portal branch ligation produced atrophy of the ligated lobes and the perfused lobes underwent compensatory regeneration, the total liver weight and plasma ALT levels were maintained at the level of sham-operated animals throughout the experiment. After 2 d of portal branch ligation, DNA binding activity of NF-KB in hepatocyte increased and reached its peak, the number of apoptotic hepatocyte in the ligated lobes and the number of mitotic hepatocyte in the perfused lobes also reached their peak. Typical apoptotic changes and evident fibrotic changes in the ligated lobes were observed under electron microscope. CONCLUSION： After 70% portal branch ligation, DNA binding activity of NF-KB in hepatocyte is significantly increased and NF-KB plays an important role in hepatocyte regeneration and apoptosis.展开更多
Background and Objective: Allogeneic hematopoietic cell transplantation (allo-HSCT) is a potent procedure for the treatment of hematologic diseases, yet it is associated with high risks of treatment-related complicati...Background and Objective: Allogeneic hematopoietic cell transplantation (allo-HSCT) is a potent procedure for the treatment of hematologic diseases, yet it is associated with high risks of treatment-related complications. Except for transplant-related organ toxicities, renal insufficiencies which emerge earlier significantly limit patients' long survival. To analyze risk factors for acute kidney injury (AKI), we conducted a retrospective cohort study of 96 patients undergoing HSCT. Methods: During the first 100 days after allo-HSCT, all patients were evaluated for renal function by measuring serum creatinine clearance and glomerular filtration rate (GFR) with a classification below: Grade 0 (< 25%, decline in creatinine clearance), Grade 1 ( ≥25% decline in creatinine clearance but < 2-fold increase in serum creatinine), Grade 2 ( ≥2-fold rise in serum creatinine but no need for dialysis), and Grade 3 ( ≥2-fold rise in serum creatinine and need for dialysis). Cox regression model was used to calculate the hazard ratios (HRs) of demographic data, clinical variables, and risk factors for AKI. Results: Twenty-eight (29.2%) patients occurred Grades 1-3 renal dysfunction (Grade 1, 14 patients; Grade 2, 12 patients; Grade 3, 2 patients), and ratios of early kidney injury increased in high-risk malignancy group (HR = 2.945, 95% confidence interval (CI) = 1.293-6.421), patients treated with myeloablative conditioning regimen ( HR = 2.463, 95% CI = 1.757-4.320), and patients with acute GVHD (HR = 3.553, 95% CI = 1.809-6.978), sepsis (HR = 3.215, 95% CI = 1.189-6.333 ), or hepatic veno-occlusive disease (VOD) (HR = 3.487, 95% CI = 1.392-6.524). Whereas, HLA histocompatibility showed no striking increased risk for acute renal injury (HR = 1.684, 95% CI = 0.648-4.378). The survival rate was lower in patients with severe nephrotoxicity (21.4%) than in patients without nephrotoxicity (70.6%) (P = 0.001). Conclusions: Nephrotoxicity is the primary risk factor for AKI, severely impacting on survival. Sorts of risk factors mentioned will be useful for evaluation for kidney function of patients undergoing allo-HSCT.展开更多
BACKGROUND Diffuse reduction of spleen density(DROSD)is related to cancer prognosis;however,its role in intrahepatic cholangiocarcinoma(ICC)remains unclear.AIM To assess the predictive value of DROSD in the prognosis ...BACKGROUND Diffuse reduction of spleen density(DROSD)is related to cancer prognosis;however,its role in intrahepatic cholangiocarcinoma(ICC)remains unclear.AIM To assess the predictive value of DROSD in the prognosis of ICC after curative resection.METHODS In this multicenter retrospective cohort study,we enrolled patients with ICC who underwent curative hepatectomy between 2012 and 2019.Preoperative spleen density was measured using computed tomography.Overall survival(OS)and recurrence-free survival(RFS)rates were calculated and compared utilizing the Kaplan-Meier method.Univariable and multivariable Cox regression analyses were applied to identify independent factors for OS and RFS.A nomogram was created with independent risk factors to predict prognosis of patients with ICC.RESULTS One hundred and sixty-seven ICC patients were enrolled.Based on the diagnostic cut-off values(spleen density≤45.5 Hounsfield units),55(32.9%)patients had DROSD.Kaplan-Meier analysis indicated that patients with DROSD had worse OS and RFS than those without DROSD(P<0.05).Cox regression analysis revealed that DROSD,carcinoembryonic antigen level,carbohydrate antigen 19-9 level,length of hospital stay,lymph node metastasis,and postoperative complications were independent predictors for OS(P<0.05).The nomogram created with these factors was able to predict the prognosis of patients with ICC with good reliability(OS C-index=0.733).The area under the curve for OS was 0.79.CONCLUSION ICC patients with DROSD have worse OS and RFS.The nomogram is a simple and practical method to identify high-risk ICC patients with poor prognosis.展开更多
文摘AIM： To detect the DNA binding activity of nuclear factor-kappaB （NF-KB） in rat hepatocyte and to investigate the effects of NF-KB on rat hepatocyte regeneration and apoptosis after 70% portal branch Iigation. METHODS： Sixty Wistar rats were randomly divided into control group and portal branch ligation group. The animals were killed 12 h, 1, 2, 3, 7, and 14 d after surgery to determine the contents of plasma ALT. Hepatocytes were isolated and nuclear protein was extracted. DNA binding activity of NF-KB was measured by ENSA. Hepatocyte regeneration and apoptosis were observed under microscope by TUNEL staining. The ultrastructural changes of liver were observed under electron microscope. RESULTS： Seventy percent portal branch ligation produced atrophy of the ligated lobes and the perfused lobes underwent compensatory regeneration, the total liver weight and plasma ALT levels were maintained at the level of sham-operated animals throughout the experiment. After 2 d of portal branch ligation, DNA binding activity of NF-KB in hepatocyte increased and reached its peak, the number of apoptotic hepatocyte in the ligated lobes and the number of mitotic hepatocyte in the perfused lobes also reached their peak. Typical apoptotic changes and evident fibrotic changes in the ligated lobes were observed under electron microscope. CONCLUSION： After 70% portal branch ligation, DNA binding activity of NF-KB in hepatocyte is significantly increased and NF-KB plays an important role in hepatocyte regeneration and apoptosis.
文摘Background and Objective: Allogeneic hematopoietic cell transplantation (allo-HSCT) is a potent procedure for the treatment of hematologic diseases, yet it is associated with high risks of treatment-related complications. Except for transplant-related organ toxicities, renal insufficiencies which emerge earlier significantly limit patients' long survival. To analyze risk factors for acute kidney injury (AKI), we conducted a retrospective cohort study of 96 patients undergoing HSCT. Methods: During the first 100 days after allo-HSCT, all patients were evaluated for renal function by measuring serum creatinine clearance and glomerular filtration rate (GFR) with a classification below: Grade 0 (< 25%, decline in creatinine clearance), Grade 1 ( ≥25% decline in creatinine clearance but < 2-fold increase in serum creatinine), Grade 2 ( ≥2-fold rise in serum creatinine but no need for dialysis), and Grade 3 ( ≥2-fold rise in serum creatinine and need for dialysis). Cox regression model was used to calculate the hazard ratios (HRs) of demographic data, clinical variables, and risk factors for AKI. Results: Twenty-eight (29.2%) patients occurred Grades 1-3 renal dysfunction (Grade 1, 14 patients; Grade 2, 12 patients; Grade 3, 2 patients), and ratios of early kidney injury increased in high-risk malignancy group (HR = 2.945, 95% confidence interval (CI) = 1.293-6.421), patients treated with myeloablative conditioning regimen ( HR = 2.463, 95% CI = 1.757-4.320), and patients with acute GVHD (HR = 3.553, 95% CI = 1.809-6.978), sepsis (HR = 3.215, 95% CI = 1.189-6.333 ), or hepatic veno-occlusive disease (VOD) (HR = 3.487, 95% CI = 1.392-6.524). Whereas, HLA histocompatibility showed no striking increased risk for acute renal injury (HR = 1.684, 95% CI = 0.648-4.378). The survival rate was lower in patients with severe nephrotoxicity (21.4%) than in patients without nephrotoxicity (70.6%) (P = 0.001). Conclusions: Nephrotoxicity is the primary risk factor for AKI, severely impacting on survival. Sorts of risk factors mentioned will be useful for evaluation for kidney function of patients undergoing allo-HSCT.
基金Supported by National Natural Science Foundation of China,No.82072685the Science and Technology Innovation Program for College Students in Zhejiang Province,No.2020R413022.
文摘BACKGROUND Diffuse reduction of spleen density(DROSD)is related to cancer prognosis;however,its role in intrahepatic cholangiocarcinoma(ICC)remains unclear.AIM To assess the predictive value of DROSD in the prognosis of ICC after curative resection.METHODS In this multicenter retrospective cohort study,we enrolled patients with ICC who underwent curative hepatectomy between 2012 and 2019.Preoperative spleen density was measured using computed tomography.Overall survival(OS)and recurrence-free survival(RFS)rates were calculated and compared utilizing the Kaplan-Meier method.Univariable and multivariable Cox regression analyses were applied to identify independent factors for OS and RFS.A nomogram was created with independent risk factors to predict prognosis of patients with ICC.RESULTS One hundred and sixty-seven ICC patients were enrolled.Based on the diagnostic cut-off values(spleen density≤45.5 Hounsfield units),55(32.9%)patients had DROSD.Kaplan-Meier analysis indicated that patients with DROSD had worse OS and RFS than those without DROSD(P<0.05).Cox regression analysis revealed that DROSD,carcinoembryonic antigen level,carbohydrate antigen 19-9 level,length of hospital stay,lymph node metastasis,and postoperative complications were independent predictors for OS(P<0.05).The nomogram created with these factors was able to predict the prognosis of patients with ICC with good reliability(OS C-index=0.733).The area under the curve for OS was 0.79.CONCLUSION ICC patients with DROSD have worse OS and RFS.The nomogram is a simple and practical method to identify high-risk ICC patients with poor prognosis.
