Background
Postoperative complications have a great impact on the postoperative course and oncological outcomes following major cancer surgery. Among them, infective complications play an important ...role. The aim of this study was to evaluate whether postoperative infective complications influence long‐term survival after liver resection for hepatocellular carcinoma (HCC).
Methods
Patients who underwent resection with curative intent for HCC between July 2003 and June 2016 were identified from a multicentre database (8 institutions) and analysed retrospectively. Independent risk factors for postoperative infective complications were identified. After excluding patients who died 90 days or less after surgery, overall survival (OS) and recurrence‐free survival (RFS) were compared between patients with and without postoperative infective complications within 30 days after resection.
Results
Among 2442 patients identified, 332 (13·6 per cent) had postoperative infective complications. Age over 60 years, diabetes mellitus, obesity, cirrhosis, intraoperative blood transfusion, duration of surgery exceeding 180 min and major hepatectomy were identified as independent risk factors for postoperative infective complications. Univariable analysis revealed that median OS and RFS were poorer among patients with postoperative infective complications than among patients without (54·3 versus 86·8 months, and 22·6 versus 43·2 months, respectively; both P < 0·001). After adjustment for other prognostic factors, multivariable Cox regression analyses identified postoperative infective complications as independently associated with decreased OS (hazard ratio (HR) 1·20, 95 per cent c.i. 1·02 to 1·41; P = 0·027) and RFS (HR 1·19, 1·03 to 1·37; P = 0·021).
Conclusion
Postoperative infective complications decreased long‐term OS and RFS in patients treated with liver resection for HCC.
From a multi‐institutional database, 2442 patients who underwent resection with curative intent for hepatocellular carcinoma between 2003 and 2016 were analysed retrospectively. Among them, 332 patients (13·6 per cent) had postoperative infective complications within 30 days after surgery. Multivariable Cox regression revealed that postoperative infective complications decreased long‐term overall and recurrence‐free survival after liver resection for hepatocellular carcinoma.
Complications decrease long‐term overall survival
The design of atomic-scale microstructural traps to limit the diffusion of hydrogen is one key strategy in the development of hydrogen-embrittlement-resistant materials. In the case of bearing ...steels, an effective trapping mechanism may be the incorporation of finely dispersed V-Mo-Nb carbides in a ferrite matrix. First, we charged a ferritic steel with deuterium by means of electrolytic loading to achieve a high hydrogen concentration. We then immobilized it in the microstructure with a cryogenic transfer protocol before atom probe tomography (APT) analysis. Using APT, we show trapping of hydrogen within the core of these carbides with quantitative composition profiles. Furthermore, with this method the experiment can be feasibly replicated in any APT-equipped laboratory by using a simple cold chain.
The long noncoding RNA TINCR shows aberrant expression in human squamous carcinomas. However, its expression and function in gastric cancer remain unclear. We report that TINCR is strongly ...upregulated in human gastric carcinoma (GC), where it was found to contribute to oncogenesis and cancer progression. We also revealed that TINCR overexpression is induced by nuclear transcription factor SP1. Silencing TINCR expression inhibited cell proliferation, colony formation, tumorigenicity and apoptosis promotion, whereas TINCR overexpression promoted cell growth, as documented in the SGC7901 and BGC823 cell lines. Mechanistic analyses indicated that TINCR could bind to STAU1 (staufen1) protein, and influence KLF2 mRNA stability and expression, then KLF2 regulated cyclin-dependent kinase genes CDKN1A/P21 and CDKN2B/P15 transcription and expression, thereby affecting the proliferation and apoptosis of GC cells. Together, our findings suggest that TINCR contributes to the oncogenic potential of GC and may constitute a potential therapeutic target in this disease.
Summary
Recent studies found that hepatitis C virus (HCV) may invade the central nervous system, and both HCV and Parkinson's disease (PD) have in common the overexpression of inflammatory ...biomarkers. We analysed data from a community‐based integrated screening programme based on a total of 62 276 subjects. We used logistic regression models to investigate association between HCV infection and PD. The neurotoxicity of HCV was evaluated in the midbrain neuron–glia coculture system in rats. The cytokine/chemokine array was performed to measure the differences of amounts of cytokines released from midbrain in the presence and absence of HCV. The crude odds ratios (ORs) for having PD were 0.62 95% confidence interval (CI), 0.48–0.81 and 1.91 (95% CI, 1.48–2.47) for hepatitis B virus (HBV) and HCV. After controlling for potential confounders, the association between HCV and PD remained statistically significant (adjusted OR = 1.39; 95% CI, 1.07–1.80), but not significantly different between HBV and PD. The HCV induced 60% dopaminergic neuron death in the midbrain neuron–glia coculture system in rats, similar to that of 1‐methyl‐4‐phenylpyridinium (MPP+) but not caused by HBV. This link was further supported by the finding that HCV infection may release the inflammatory cytokines, which may play a role in the pathogenesis of PD. In conclusion, our study demonstrated a significantly positive epidemiological association between HCV infection and PD and corroborated the dopaminergic toxicity of HCV similar to that of MPP+.
Summary
Background Alopecia areata (AA) may be related to stress and has been reported to be associated with psychiatric disorders. Nevertheless, a nationwide study of the relationship between AA ...and comorbid psychiatric diseases has not been conducted, and the effect of onset age has rarely been reported.
Objectives To analyse the associations between AA and various psychiatric disorders using a nationwide database in Taiwan.
Methods Data were obtained from the National Health Insurance Research Database of Taiwan from 2000 to 2009. In total, 5117 patients with AA and 20 468 age‐ and gender‐matched controls were enrolled.
Results Patients with AA tended to have more coexisting anxiety and less comorbid schizophrenia. Differences in ages of onset revealed differences in comorbidities. An increased risk of depression odds ratio (OR) 2·23; 95% confidence interval (CI) 1·09–4·54 was found in patients with AA aged < 20 years. An increased rate of anxiety (OR 1·43; CI 1·15–1·77) was observed with AA onset between the ages of 20 and 39 years. The highest odds of obsessive–compulsive disorder (OR 3·00; CI 1·11–8·12) and anxiety (OR 2·05; CI 1·56–2·68) were observed in patients with AA aged 40–59 years. Moreover, about 50% of psychiatric disorders occurred earlier than AA.
Conclusions AA is related to various psychiatric disorders. Onset age of AA is an important factor in the association with different comorbid psychiatric diseases. In addition to cosmetic impact, which may bring about anxiety or depression, stress neuroendocrine immunology may play an important role in the pathogenesis of both AA and psychiatric disorders.
The improvement of catalysts for the four-electron oxygen-reduction reaction (ORR; O2+4H++4e−→2H2O) remains a critical challenge for fuel cells and other electrochemical-energy technologies. Recent ...attention in this area has centred on the development of metal alloys with nanostructured compositional gradients (for example, core–shell structure) that exhibit higher activity than supported Pt nanoparticles (Pt–C; refs 1,2,3,4,5,6,7). For instance, with a Pt outer surface and Ni-rich second atomic layer, Pt3Ni(111) is one of the most active surfaces for the ORR (ref. 8), owing to a shift in the d-band centre of the surface Pt atoms that results in a weakened interaction between Pt and intermediate oxide species, freeing more active sites for O2 adsorption. However, enhancements due solely to alloy structure and composition may not be sufficient to reduce the mass activity enough to satisfy the requirements for fuel-cell commercialization, especially as the high activity of particular crystal surface facets may not easily translate to polyfaceted particles. Here we show that a tailored geometric and chemical materials architecture can further improve ORR catalysis by demonstrating that a composite nanoporous Ni–Pt alloy impregnated with a hydrophobic, high-oxygen-solubility and protic ionic liquid has extremely high mass activity. The results are consistent with an engineered chemical bias within a catalytically active nanoporous framework that pushes the ORR towards completion.
Monoclonal gammopathy of undetermined significance (MGUS) was identified in 3.2% of 21 463 residents of Olmsted County, Minnesota, 50 years of age or older. The risk of progression to multiple ...myeloma, Waldenstrom's macroglobulinemia, AL amyloidosis or a lymphoproliferative disorder is approximately 1% per year. Low-risk MGUS is characterized by having an M protein <15 g/l, IgG type and a normal free light chain (FLC) ratio. Patients should be followed with serum protein electrophoresis at six months and, if stable, can be followed every 2-3 years or when symptoms suggestive of a plasma cell malignancy arise. Patients with intermediate and high-risk MGUS should be followed in 6 months and then annually for life. The risk of smoldering (asymptomatic) multiple myeloma (SMM) progressing to multiple myeloma or a related disorder is 10% per year for the first 5 years, 3% per year for the next 5 years and 1-2% per year for the next 10 years. Testing should be done 2-3 months after the initial recognition of SMM. If the results are stable, the patient should be followed every 4-6 months for 1 year and, if stable, every 6-12 months.
Using a newly developed apparatus, swelling pressure tests and saturated hydraulic conductivity tests on the compacted Gao-Miao-Zi (GMZ01) bentonite with an initial dry density of 1.7 Mg/m³ were ...conducted at various temperatures. Based on the test results, the mechanisms of influence of temperature on the swelling pressure and saturated hydraulic conductivity were analyzed. Results indicate that swelling pressure increases with the increase in temperature. The swelling pressures measured at 20 and 40 °C are 3.02 and 3.41 MPa, respectively. For a given temperature, the swelling pressure increases rapidly at the beginning of the infiltration process and then reaches a first peak value followed by an intermediate period characterized by a decrease of swelling pressure, well before the clay reaches its full saturation. The saturated hydraulic conductivity of the GMZ01 bentonite also shows an increase with temperature rise. The temperature changing paths (heating or cooling) have no effect on the saturated hydraulic conductivity. Based on the test results, models for prediction of saturated hydraulic conductivity of the compacted GMZ01 bentonite have been developed and verified. It was observed that the model that only considers the temperature effect on water viscosity gives predictions with large deviation from the measured values, moreover, the deviation increases with temperature rise. When considering both the temperature influence on water viscosity and the effective flow cross-sectional area of porous channels, the model can satisfactorily account for the temperature effects.
Summary
Background Bullous pemphigoid (BP) has been associated with neurological and psychiatric diseases; however, large‐scale population‐based study of different comorbid diseases in patients with ...BP is quite limited.
Objectives We sought to analyse the prevalence of neurological, psychiatric, autoimmune and inflammatory skin diseases prior to the diagnosis of BP and their associations with BP among patients with BP from a nationwide database in Taiwan.
Methods A total of 3485 patients with BP and 17 425 matching controls were identified from the National Health Insurance Database in Taiwan from 1997 to 2008. Conditional logistic regression analyses for a nested case–control study were performed to examine the prevalence of comorbidities prior to the diagnosis of BP between these two groups.
Results Overall, our results showed that stroke odds ratio (OR) 3·30; 95% confidence interval (95% CI) 3·03–3·60, dementia (OR 4·81; 95% CI 4·26–5·42), Parkinson disease (OR 3·49; 95% CI 3·05–3·98), epilepsy (OR 3·97; 95% CI 3·28–4·81), schizophrenia (OR 2·56; 95% CI 1·52–4·30) and psoriasis (OR 2·02; 95% CI 1·54–2·66) were significantly associated with BP. Among them, the association with schizophrenia and psoriasis was predominant in female and male patients, respectively, with BP. It remains for all these comorbid diseases to be independently associated with BP by multivariate analysis.
Conclusions Patients with BP are more likely to have various neurological diseases, schizophrenia and psoriasis prior to the diagnosis of BP, supporting associations found in other studies. Further research is required to elucidate the tentative causal association with BP.
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