RESUMEN

OBJECTIVE: To assess the effect of the intraoperative application of the Aquamantys® system to treat the hepatic resection margin on local and overall recurrence of HCC. METHODS: We retrospectively analyzed 101 patients admitted from November 2016 to June 2018 who underwent hepatectomy using the Aquamantys® as hemostatic device, who were matched with 101 patients (control group) using conventional hemostatic devices through PSM. Univariate and multivariate analyses of recurrence-free survival (RFS) and local recurrence-free survival (LRFS) were performed using the Cox proportional hazard model. RESULTS: There were no significant differences in baseline data and surgical procedures between the two groups. The Aquamantys® group showed less blood loss (P = 0.005) and a lower blood transfusion rate (P = 0.036), while the incidences of postoperative complications of the two groups showed no difference (P = 0.266). OS rates of the Aquamantys® group and the control group were 82.6% and 84.2%, respectively (P = 0. 446), and RFS rates were 65.5% and 58.2%, respectively (P = 0.153), with no significant differences. The Aquamantys® group and the control group had two cases and 11 cases of local recurrence, respectively, with LRFS rates of 98% and 87.9%, respectively, in the follow-up period, corresponding to a significant difference (P = 0.011). Multivariate analysis showed that microvascular invasion (MVI), tumor diameter > 5 cm, and the control group were independent risk factors for LRFS. CONCLUSION: Our results indicate that application of the Aquamantys® system in hepatectomy can reduce local recurrence, but it can neither reduce overall recurrence nor improve OS.

Asunto(s)

Carcinoma Hepatocelular/cirugía , Electrocirugia/instrumentación , Hemostasis Quirúrgica/instrumentación , Hepatectomía , Neoplasias Hepáticas/cirugía , Recurrencia Local de Neoplasia , Pérdida de Sangre Quirúrgica/prevención & control , Transfusión Sanguínea/estadística & datos numéricos , Carcinoma Hepatocelular/prevención & control , Estudios de Casos y Controles , Supervivencia sin Enfermedad , Femenino , Hemostasis Quirúrgica/métodos , Humanos , Neoplasias Hepáticas/prevención & control , Masculino , Márgenes de Escisión , Persona de Mediana Edad , Recurrencia Local de Neoplasia/prevención & control , Puntaje de Propensión , Modelos de Riesgos Proporcionales , Análisis de Regresión , Estudios Retrospectivos

RESUMEN

Tumor necrosis factor-α (TNF-α) promoter polymorphisms has been reported to be associated with obesity and insulin resistance and gained widespread attention. However, results obtained so far are quite conf||licting. We therefore performed a meta-analysis to address this issue, basing on 17 studies from electronic databases (MEDLINE and EMBASE). No evidence of significant effect of TNF-αG-308A polymorphism on body mass index (BMI) or obesity risk was detected (BMI: WMDRE = 0.05, 95%CI: -0.62 to 0.73; risk of obesity: ORFE = 1.09, 95%CI: 0.87 to 1.35). G-308A variant was significantly associated with increased insulin levels in the overall (SMDFE = 0.12, 95%CI: 0.03 to 0.20) and obese subgroup analysis (SMDFE = 0.16, 95%CI: 0.03 to 0.29). In total, no significant result was observed for the association between TNF-α G-308A variant and HOMA-IR index. Nevertheless, subgroup analysis showed G-308A polymorphism was significantly associated with increased HOMA-IR in Caucasians (WMDFE = 0.49, 95%CI: 0.03 to 0.94). Our results indicate that TNF-αG-308A polymorphism has a significant effect on insulin resistance. However, it is unlikely that G-308A variant contributes to obesity.

Asunto(s)

Estudios de Asociación Genética , Predisposición Genética a la Enfermedad , Resistencia a la Insulina/genética , Polimorfismo de Nucleótido Simple/genética , Factor de Necrosis Tumoral alfa/genética , Adulto , Anciano , Índice de Masa Corporal , Femenino , Humanos , Insulina/sangre , Masculino , Persona de Mediana Edad , Obesidad/sangre , Obesidad/genética , Sesgo de Publicación , Factores de Riesgo , Adulto Joven

RESUMEN

Our previous studies have shown that tandem Alu repeats inhibit green fluorescent protein (GFP) gene expression when inserted downstream of the GFP gene in the pEGFP-C1 vector. We found that the 22R sequence (5'-GTGAAAAAAATGCTTTATTTGT-3') from the antisense PolyA (240 bp polyadenylation signal) of simian virus 40, eliminated repression of GFP gene expression when inserted between the GFP gene and the Alu repeats. The 22R sequence contains an imperfect palindrome; based on RNA structure software prediction, it forms an unstable stem-loop structure, including a loop, a first stem, a bulge, and a second stem. Analysis of mutations of the loop length of the 22R sequence showed that the three-nucleotide loop (wild-type, 22R) induced much stronger GFP expression than did other loop lengths. Two mutations, 4TMI (A7→T, A17→T) and 5AMI (A6→T, T18→A), which caused the base type changes in the bulge and in the second stem in the 22R sequence, induced stronger GFP gene expression than 22R itself. Mutation of the bulge base (A17→T), leading to complete complementation of the stem, caused weaker GFP gene expression. Sequences without a palindrome (7pieA, 5'-GTGAAAAAAATG CAAAAAAAGT-3', 7pieT, 5'-GTGTTTTTTTTGCTTTTTTTGT-3') did not activate GFP gene expression. We conclude that an imperfect palindrome affects and can increase GFP gene expression.

Asunto(s)

Regulación Viral de la Expresión Génica , Proteínas Fluorescentes Verdes/genética , Señales de Poliadenilación de ARN 3' , Virus 40 de los Simios/genética , Proteínas Virales/genética , Elementos Alu/genética , Secuencia de Bases , Línea Celular Tumoral , Cartilla de ADN , Genes Reporteros , Vectores Genéticos , Proteínas Fluorescentes Verdes/biosíntesis , Células HeLa , Humanos , Secuencias Invertidas Repetidas , Plásmidos , Poli A/genética , ARN Viral/genética , ARN Viral/metabolismo , Análisis de Secuencia de ADN , Virus 40 de los Simios/metabolismo

RESUMEN

We examined the effect of polymorphisms in the endothelial nitric oxide synthase gene on the risk for essential hypertension in a Han Chinese population through a meta-analysis of data from 15 studies. Associations between increased risk for essential hypertension and 4b/a were obtained in a dominant model and allele contrast (aa + ab vs bb: odds ratio (OR)(FE) = 1.26, 95% confidence interval (CI) = 1.10-1.44; a vs b allele: OR(FE) = 1.23, 95%CI: 1.09-1.40). Four studies with sample sizes over 500 produced similar results. No evidence of publication bias was found. Also, no significant heterogeneity was observed among these studies. When we examined the G894T polymorphism, we found a marginally significant association for allele contrast and the recessive model when all the eligible studies were pooled together. However, there was no evidence for a significant association after the exclusion of two studies deviating from Hardy-Weinberg equilibrium in the control group. Heterogeneity among studies was observed. Results of cumulative and recursive cumulative meta-analysis indicated that more studies are needed to objectively determine the effects of these two polymorphisms.

Asunto(s)

Hipertensión/genética , Óxido Nítrico Sintasa de Tipo III/genética , Polimorfismo Genético/genética , Adulto , Anciano , Pueblo Asiatico/genética , Femenino , Predisposición Genética a la Enfermedad , Humanos , Masculino , Persona de Mediana Edad