Diagnostic value of gamma-glutamyltransferase/aspartate aminotransferase ratio, protein induced by vitamin K absence or antagonist II, and alpha-fetoprotein in hepatitis B virus-related hepatocellular carcinoma

BACKGROUND Researchers have investigated the diagnostic value of protein induced by vitamin K absence or antagonist II (PIVKA-II) and alpha-fetoprotein (AFP) in hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC), and obtained abundant clinical diagnostic data. However, PIVKA-II and AFP have unsatisfactory specificity and sensitivity in the diagnosis of early-stage HBV-related HCC. Gamma-glutamyltransferase (γ-GT) and aspartate aminotransferase (AST) are common biomarkers for evaluating liver function, and we hypothesized that the γ-GT/AST ratio in combination with PIVKA-II and AFP would improve the diagnosis of early-stage HBV-related HCC. AIM To evaluate the diagnostic value of γ-GT/AST ratio alone or in combination with PIVKA-II and AFP in HBV-related HCC. METHODS Serum levels of γ-GT, AST, PIVKA-II, and AFP were detected and analysed in 176 patients with HBV-related HCC and in 359 patients with chronic hepatitis B. According to tumour size and serum level of HBV DNA, HBV-related HCC patients were divided into the following categories: Early-stage HCC patients, HCC patients, HBV DNA positive (HBV DNA+) HCC patients, and HBV DNA negative (HBV DNA-) HCC patients. Receiver-operating characteristic (ROC) curves were used to analyse and compare the diagnostic value of the single and combined detection of various biomarkers in different types of HBV-related HCC. RESULTS Tumour size was positively correlated with serum levels of PIVKA-II and AFP in HCC patients (r = 0.529, aP < 0.001 and r = 0.270, bP < 0.001, respectively), but there was no correlation between tumour size and the γ-GT/AST ratio (r = 0.073, P = 0.336). The areas under the receiver-operating characteristic curves (AUROCs) of the γ-GT/AST ratio in early-stage HCC patients, HBV DNA+ HCC patients and HBV DNA- HCC patients were not significantly different from that in the total HCC patients (0.754, 0.802, and 0.705 vs 0.779, respectively;P > 0.05). When PIVKA-II was combined with the γ-GT/AST ratio in the diagnosis of earlystage HCC, HCC, and HBV DNA+ HCC, the AUROCs of PIVKA-II increased, with values of 0.857 vs 0.835, 0.925 vs 0.913, and 0.958 vs 0.954, respectively. When AFP was combined with the γ-GT/AST ratio in the diagnosis of early-stage HCC, HCC, HBV DNA+ HCC, and HBV DNA- HCC, the AUROCs of AFP increased, with values of 0.757 vs 0.621, 0.837 vs 0.744, 0.868 vs 0.757, and 0.840 vs 0.828, respectively. CONCLUSION The γ-GT/AST ratio may be better than PIVKA-II and AFP in the diagnosis of early-stage HBV-related HCC, and its combination with PIVKA-II and AFP can improve the diagnostic value for HBV-related HCC.

3D conformal radiotherapy combined with transcatheter arterial chemoembolization for hepatocellular carcinoma

AIM:To compare transcatheter arterial chemoembolization(TACE)and 3D conformal radiotherapy(3D-CRT)with TACE monotherapy in hepatocellular carcinoma(HCC).METHODS:We searched all the eligible studies from the Cochrane Library,Pub Med,Medline,Embase,and CNKI.The meta-analysis was performed to assess the survival benefit,tumor response,and the decline inα-fetoprotein(AFP)level.According to the heterogeneity of the studies,pooled OR with 95%CI were calculated using the fixed-effects or random-effects model.An observed OR>1 indicated that the addition of 3D-CRT to TACE offered survival benefits to patients that could be considered statistically significant.Statistical analyses were performed using Review Manager Software.RESULTS:Ten studies met the criteria to perform a meta-analysis including 908 HCC participants,with 400patients in the TACE/3D-CRT combination group and508 in the TACE alone group.TACE combined with 3DCRT significantly improved 1-,2-and 3-year overall survival compared with TACE monotherapy(OR=1.87,95%CI:1.37-2.55,P<0.0001),(OR=2.38,95%CI:1.78-3.17,P<0.00001)and(OR=2.97,95%CI:2.10-4.21,P<0.00001).In addition,TACE plus 3DCRT was associated with a higher tumor response(complete remission and partial remission)(OR=3.81;95%CI:2.70-5.37;P<0.00001),and decline rates of AFP level(OR=3.24,95%CI:2.09-5.02,P<0.00001).CONCLUSION:This meta-analysis demonstrated that TACE combined with 3D-CRT was better than TACE monotherapy for patients with HCC,which needs to be confirmed by large multicenter trials.

Correlation of serum MR-ProANP and NT-ProBNP content with pump function and ventricular remodeling in patients with left heart failure

Objective:To study the correlation of serum MR-ProANP and NT-ProBNP content with pump function and ventricular remodeling in patients with left heart failure.Methods:A total of 104 patients with chronic heart failure treated in our hospital between May 2013 and May 2016 were selected as the heart failure group of the research and 95 healthy volunteers receiving physical examination in our hospital over the same period were selected as the control group of the research. Serum was collected to detect the content of MR-ProANP, NT-ProBNP as well as ventricular remodeling-related molecules, and cardiac color Doppler ultrasonography was conducted to determine the heart pump function- and myocardial remodeling-related parameters.Results:Serum MR-ProANP, NT-ProBNP, MMP2, MMP9, MMP10, PICP and PIIINP content as well as ultrasound parameters IVSd, PWT, LVMI, MWS levels of heart failure group were significantly higher than those of control group, ultrasound parameters LAEF, LAPEF and LAAEF levels were significantly lower than those of control group;serum MR-ProANP and NT-ProBNP content were positively correlated with ultrasound parameters IVSd, PWT, LVMI, MWS as well as serum MMP2, MMP9, MMP10, PICP and PIIINP content, negatively correlated with ultrasound parameters LAEF, LAPEF and LAAEF, and the correlation coefficients of MR-ProANP with these indexes were all higher than those of NT-ProBNP.Conclusion:Serum MR-ProANP and NT-ProBNP content in patients with left heart failure are closely related to the pump function and ventricular remodeling, and MR-ProANP is more valuable for evaluating pump function decrease and ventricular remodeling increase.

Increasing the Solubility of a Hydrophobic Molecule with Thymine-like Face by DNA via Supramolecular Interaction

Poor water-solubility of hydrophobic drugs greatly hampers drug design and creats delivery problems.The traditional way to improve the solubility is to add hydrotropes or excipients to supress aggregations.Here,a novel mechanisim has been proposed based on supramolecular interactions and demonstrated with a small molecule,pvromellitic diimide(PD).This compound contains thymine-like ‘face’ and can interact with adenines through Wat-son-Crick and Hoogsteen hydrogen-bonding.Given the high water solubility of poly adenines[poly(A)],it is expectec that poly(A)will greatly increase the PD solubility.Indeed,such an increased solubility was confirmed by ultraviolet-visible spectroscopy(UV-Vis)and polyacrylamide gel electrophoresis(PAGE)analysis.We believe that this strategy could be used to improve the solubility of other similar hydrophobic molecules.

Microcluster colloidosomes for hemostat delivery into complex wounds:A platform inspired by the attack action of torpedoes

Complex yet lethal wounds with uncontrollable bleeding hinder conventional hemostats from clotting blood at the source or deep sites of injury vasculature,thereby causing massive blood loss and significantly increased mortality.Inspired by the attack action of torpedoes,we synthesized microcluster(MC)colloidosomes equipped with magnetic-mediated navigation and“blast”systems to deliver hemostats into the cavity of vase-type wounds.CaCO_(3)/Fe_(2)O_(3)(CF)microparticles functionalized with Arg-Gly-Asp(RGD)modified polyelectrolyte multilayers were co-assembled with oppositely charged zwitterionic carbon dots(CDs)to form MC colloidosomes,which were loaded with thrombin and protonated tranexamic acid(TXA-NH_(3)^(+)).The composite microparticles moved against blood flow under magnetic mediation and simultaneously disassembled for the burst release of thrombin stimulated by TXA-NH_(3)^(+).The CO_(2) bubbles generated during disassembly produced a“blast”that propelled thrombin into the wound cavity.Severe bleeding in a vase-type hemorrhage model in the rabbit liver was rapidly controlled within~60 s.Furthermore,in vivo subcutaneous muscle and liver implantation models demonstrated excellent biodegradability of MC colloidosomes.This study is the first to propose a novel strategy based on the principle of torpedoes for transporting hemostats into vase-type wounds to achieve rapid hemostasis,creating a new paradigm for combating trauma treatment.

Magnetic field-mediated Janus particles with sustained driving capability for severe bleeding control in perforating and inflected wounds

Severe bleeding in perforating and inflected wounds with forky cavities or fine voids encountered during prehospital treatments and surgical procedures is a complex challenge.Therefore,we present a novel hemostatic strategy based on magnetic field-mediated guidance.The biphasic Janus magnetic particle(MSS@Fe2O3-T)comprised aggregates ofα-Fe2O3 nanoparticles(Fe_(2)O_(3) NPs)as the motion actuator,negatively modified microporous starch(MSS)as the base hemostatic substrate,and thrombin as the loaded hemostatic drug.Before application,the particles were first wrapped using NaHCO_(3) and then doped with protonated tranexamic acid(TXA-NH_(3)^(+)),which ensured their high self-dispersibility in liquids.During application,the particles promptly self-diffused in blood by bubble propulsion and travelled to deep bleeding sites against reverse rushing blood flow under magnetic guidance.In vivo tests confirmed the superior hemostatic performance of the particles in perforating and inflected wounds(“V”-shaped femoral artery and“J”-shaped liver bleeding models).The present strategy,for the first time,extends the range of magnetically guided drug carriers to address the challenges in the hemorrhage control of perforating and inflected wounds.

Correction to:Conformer Analysis of a Biological G-Quadruplex Element in the Human c-MYC Promoter by Native Polyacrylamide Gel Electrophoresis

Correction to:Journal of Analysis and Testing(2021)5:188-194 https://doi.org/10.1007/s41664-021-00181-0 In the original publication of the article,the first author’s first name has been incorrectly published.The correct author name is Xiao-Li Hu.The original article was corrected.