The prognostic significance of clinical and pathological features in hepatocellular carcinoma

The prognosis of patients with HCC still remains dismal. The life expectancy of HCC patients is hard to predict because of the high possibility of postoperative recurrence. Many factors, such as patient's general conditions, macroscopic tumor morphology, as well as tumor histopathology features, have been proven of prognostic significance. Female HCC patient often has a better prognosis than male patient, which might be due to the receptor of sex hormones. Younger patients often have tumors with higher invasiveness and metastatic potentials, and their survival and prognosis are worse than the older ones. Co-existing hepatitis status and hepatic functional reserve have been confirmed as risk factors for recurrence. Serum alpha-fetoprotein (AFP) is useful not only for diagnosis, but also as a prognostic indicator for HCC patients. AFP mRNA has been proposed as a predictive marker of HCC cells disseminated into the circulation and for metastatic recurrence. Many pathologic features, such as tumor size, number, capsule state, cell differentiation, venous invasion, intrahepatic spreading, and advanced pTNM stage, are the best-established risk factors for recurrence and important aspects affecting the prognosis of patients with HCC. Marked inflammatory cell infiltration in the tumor could predict a better prognosis. Clinical stage is still the most important factor influencing on the prognosis. Extratumor spreading and lymph nodal metastasis are independent predictors for poor outcome. Some new predictive systems have recently been proposed. Different strategies of treatment might have significant different effects on the patients' prognosis. To date, surgical resection is still the only potentially curative treatment for HCC, including localized postoperative recurrences. Extent of resection, blood transfusion, occlusion of porta hepatis, and blood loss affect the survival and prognosis of HCC patients. Regional therapies provide alternative ways to improve the prognosis of HCC patients who have no opportunity to receive surgical treatment or postoperative recurrence. The combination of these treatment modalities is hopeful to further improve the prognosis. The efficacies of neoadjuvant (preoperative) or adjuvant (postoperative) chemotherapy or chemoembolization in preventing recurrence and on the HCC prognosis still remain great controversy, and deserve further evaluation. Biotherapy, including IFN-alpha therapy, will play more important role in preventing recurrence and metastasis of HCC after operation.

Gender difference of transmural heterogeneity of calcium current in rabbit ventricle

Objective: To study the distribution of I_ Ca,L in endomyocardium(Endo), mid-myocardium(Mid) and epicardium(Epi) in female and male rabbit ventricle and to elucidate the mechanism of sex difference in drug-associated torsade de pointes. Methods: Whole-cell patch clamp technique was used to record action potential and I_Ca,L. Results: Action potential duration ofMidinfemale rabbit heart waslonger thanthat in male and transmural dispersion of repolarization in female was largerthan thatinmale. The densities of I_ Ca,L in Endo, Mid and Epi of female rabbits were (7.1±0.6), (10.4±0.9) and (9.6±1.1) pA/pF and they were (9.1±0.9), (10.5±1.0) and (9.8±0.9) pA/pF in male respectively. Transmural heterogeneity of I_ Ca,L in female ventricle was more significant than that in male rabbit.Conclusion:Female rabbitspossessmoresignificant transmural heterogeneityof I_Ca,L,whichmaybe responsiblefor largertransmuraldispersion of repolarization and more drug-associated torsade de pointes in female.

Prevalence rate of osteoporosis in the mid-aged and elderly in selected parts of China

OBJECTIVE: To understand the distribution of prevalence rate of osteoporosis in the middle - aged and elderly in parts of China. METHODS: Bone mineral density (BMD) was measured and questionnaires were taken for 5593 people aged above 40 years in five administrative areas in China selected by the stratified - multi - steps - cluster sampling method. RESULTS: The total prevalence rate of osteoporosis was 16.1%. The prevalence rate among males was 11.5% and among females was 19.9% (P

Histopathological classification and location of consecutively operated meningiomas at a single institution in China from 2001 to 2010

Background Meningioma is one of the most common primary tumors of the central nervous system, but there are not many detailed studies on the sex, age, subtypes and locations of large series. This study was a retrospective analysis of the characteristics of meningioma cases consecutively operated on at a single institution in China from 2001 to 2010. Methods This study investigated the demographic background of 7084 meningioma cases, and the subtypes and locations of the tumors. Sex and age distributions were analyzed, and the pathological subtypes were classified according to the World Health Organization （WHO） classification. The location of the meningiomas was also categorized. Results The female：male ratio of the 7084 cases was 2.34：1. The mean age was 51.4 years （range, 11 months-86 years）. The mean age of cases of WHO grade I meningioma was significantly older than that of grade II or III meningiomas （P 〈0.001, Fisher＇s Least Significant Digit test）. There was a significantly higher female：male ratio in WHO grade I meningiomas than in grade II or grade III meningiomas （2.57, 1.03 and 0.76, respectively; P 〈0.001, X^2 test）. Meningothelial （n=2061） and fibrous meningiomas （n=3556） were the most common subtypes, comprising 79.3% of all meningiomas. All meningioma cases were classified into 23 locations in this study, with the cerebral convexity the most common site （38.33%, n=2722）. Cases with uncommon locations such as extra-cranial and sylvian fissure meningiomas were also present in this series. Conclusions Female predominance was found for benign meningiomas, while malignant subtypes showed male predominance. The mean age of patients with WHO grade Ⅰ meningiomas was older than that of patients with higher-grade tumors. Meningothelial and fibrous meningiomas were the most common subtypes. The cerebral convexity was the most common menin.qioma location.

Gender difference on five-year outcomes of EXCEL biodegradable polymer-coated sirolimus-eluting stents implantation： results from the CREATE study

Background The gender difference on long-term outcome in unselected patients after percutaneous coronary intervention （PCI） has not yet been fully investigated. This study aimed to evaluate the gender difference on five-year outcomes following EXCEL biodegradable polymer-coated sirolimus-eluting stenting in patients with coronary disease. Methods A total of 2077 ＂all comers＂, consisting of 1528 （73.6%） men and 549 （26.4%） women, who were exclusively treated with EXCEL coronary stents were enrolled in the prospective CREATE study at 59 centers from four countries. After propensity score matching, the baseline characteristics of the two groups were well matched. Recommended antiplatelet regimen was clopidogrel and aspirin for six months followed by chronic aspirin therapy. The primary outcome that was the rate of major adverse cardiac events （MACE）, defined as a composite of cardiac mortality, non-fatal myocardial infarction （MI） and target lesion revascularization （TLR）, and stent thrombosis （ST） at five years were compared between the two gender groups. Results In the two groups, women had higher proportions of clinical risk factors, such as being elderly, diabetes mellitus, hypertension and hyperlipidemia, compared to men. Besides, the mean target vessel number per patient was higher and the mean reference vessel diameter smaller for women. Men had higher risks of cardiac death （3.7% vs. 1.6%, P=-0.021） and MACE （8.4% vs. 4.7%, P=-0.004） at five years compared with women. However, the cumulative hazards of non-fatal MI and TLR were similar between men and women. The incidence of Academic Research Consortium （ARC） definite or probable stent thrombosis was similar between the two groups （1.3% vs. 1.0%, P=0.639）. Prolonged clopidogrel therapy （〉6 months） did not reduce the cumulative hazards of ST from six months to five years in both men （X^2=0.098, log rank P=0.754） and women （X2=2.043, log rank P=-0.153） patients. Conclusions Women had a lower MACE and cardiac death rate than men after biodegradable polymer-coated sirolimus-eluting stenting in long term follow-up. Effects of prolonged dual antiplatelet therapy （DAPT） in preventing stent thrombosis was similar with six-month DAPT after EXCEL stent implantation in both men and women groups.