ObjectiveTo do a brief introduction and prospects for simultaneous pancreas and kidney transplanta-tion from aspects of recipient screening, choice of operative method, prognosis, quality of life, and complications. MethodDomestic and international literatures were collected to summary the effect, prognosis, and the latest progress of simultaneous pancreas and kidney transplantation in the treatment of diabetes. ResultsAs a kind of mature treatment of diabetic with end-stage renal disease, simultaneous pancreas and kidney transplantation had been carried out in most transplantation centers around the world, it had the definite therapeutic effect and controllable side effects, the life quality of posttransplantation patients would be improved notably. However, the screen of transplantation patient, the selection of transplantation operation, and the postoperative immunosuppressive protocols had not yet been reached a consensus. ConclusionsSimultaneous pancreas and kidney transplantation is the most effective treatment for type 1 diabetes patients with end-stage renal disease, it provides a more feasible and more physiological way for the secretion of insulin. Although the patient has to undergo a major operation and take some risk, simultaneous pancreas and kidney transplantation still improves the patient's survival rate and the quality of life, and reduces the incidence of complications related to diabetes. Based on the above reasons, simultaneous pancreas and kidney transplantation should be a preferred treatment for all eligible patients.
Objective To review generation, distribution of microRNA-203 (miR-203) and it’s relation with tumors. Method Domestic and international literatures were collected to summarize the generation, distribution of miR-203 and it’s relation with tumors. Result Although the previous studies of miR-203 have shown an encouraging result, but only a small portion of miR-203 biological functions are identified, the regulatory mechanism of downstream target genes also has not been fully elucidated. Conclusion With deepening of research, miR-203 might play an active role in classification, categorizing, diagnosis, treatment, and prognosis of tumors.
Objective To compare the positive rate of zinc finger protein A20， NF-κB p65 protein， and P-glyco- protein between primary hepatocellular carcinoma （HCC） tissues and paratumor tissues， and to explore the relationship between the 3 kinds of proteins and pathological features of HCC. Methods Thirty-two HCC tissues and 26 paratumor tissues resected from patients with HCC treated in our hospital from Feb. 2009 to Aug. 2010 were enrolled. Clinical data were also collected from files. The expressions of zinc finger protein A20， NF-κB p65 protein， and P-glycoprotein were tested by immunohistochemistry. Results The positive rate of zinc finger protein A20， NF-κB p65 protein， and P-glycoprotein in HCC tissues were 87.5%（28/32）， 81.3%（26/32）， and 65.6%（21/32）， respectively， which were higher than that in paratumor tissues〔61.5%（16/26）， 34.6%（9/26）， and 30.8%（8/26）， respectively〕， P＜0.05. The three kinds of proteins were all closely related with HbsAg， and zinc finger protein A20 was related with cirrhosis in addition （P＜0.05）. Conclusions The positive rate of zinc protein A20， NF-κB p65 protein， and P-glycoprotein are much higher in primary HCC tissues than that in paratumor tissus， and they may play an important role in preoperative determination of hepatic tumors.
ObjectiveTo evaluate the effect and safety of sorafenib in patients with advanced hepatocellular carcinoma(HCC). MethodsThe computer-based search in Pubmed, Embase, Science Citation Index, and Cochrane for phaseⅡandⅢclinical trial related to sorafeinib in advanced HCC were conducted. Data abstraction and quality assessment were conducted according to enrolled criteria. Meta-analysis was performed by REVMAN 5.2 version, evidence recommendation was conducted by GRADE 3.6 version, which classify evidence level into:extremely low quality evidence, low quality evidence, moderate quality evidence, and high quality evidence. ResultsFive studies were included, 4 randomization control trial(RCT), 1 prospective no-randomization control clinical trial. Meta-analysis indicated that overall survival, time to progression, and disease control rate in sorafenib treatment group were higher than those in control group(P < 0.05). In addition, the incidence of hand-foot skin reaction, rash/desquamation, hypertention, and dirrahea in soafeinib treatment group were higher than those in control group(P < 0.05). ConclusionSorafeinib can prolong the overall survival, time to progression, and disease control rate in patients with advanced HCC, but there is still no evidence that sorafenib can improve tumor response in these patients.
Objective The aim of this study is to review the relationship between microRNA (miR)-200a and the proliferation, metastasis, and prognosis of hepatocellular carcinoma (HCC) based on the previous relevant studies. Methods A systematic literature search was performed to identify the related studies. We summarized the expression level of miR-200a in HCC, its roles and mechanisms in proliferation, metastasis, and prognosis of HCC. Results The expressions of miR-200a were down-regulated in HCC tissue, cell, and patients’ serum. The normal expression or the overexpression of miR-200a could significantly inhibite the proliferation, invision, and metastasis of HCC. Moreover, the differentially expressed miR-200a in the tumor tissue or the patient’ serum was potentially valuable for the early diagnosis and prognostic predicting of HCC. Although there had been many advances on miR-200a in HCC, only a few biological functions had been identified. The underlying regulating mechanisms and more targeted genes of miR-200a still needed to be further studied. Conclusion miR-200a not only has an inhibitory effect on the proliferation, invasion, and metastasis of HCC, but also has a certain clinical application value in the early diagnosis and prognosis of HCC.
ObjectiveTo summarize the research progress in the study of the diagnostic function of humoral circular RNAs in human diseases.MethodsThe research progress was summarized by reading relevant literatures on the diagnostic function of humoral circular RNAs in human disease at home and abroad.ResultsAs endogenous circular RNA molecules, circular RNAs were found to be related to a variety of diseases due to their stable structures, conserved sequences, diverse functions, and tissue cell specificity. Recent studies had found that circular RNAs could be secreted into body fluids, such as blood, saliva, urine, gastric juice, seminal plasma, and so on. They could also exist in body fluids stably. In addition, circular RNAs were found that was related to the diagnosis of various diseases, including cardiovascular diseases, nervous system diseases, autoimmune diseases, various carcinomas and metabolic diseases, and so on. As a consequence, circular RNAs might be important biomarkers for non-invasive detection of human diseases.ConclusionsRecent researches have found that circular RNA is related to the diagnosis of various diseases. Therefore, the in-depth study of the relationship between humoral circular RNAs and the diagnosis of diseases is conducive to the development of non-invasive diagnostic markers of clinical diseases, which is of great significance for the non-invasive diagnosis of diseases.
ObjectiveTo understand the research progress of treatment of hyperkalemia after simultaneous pancreas and kidney transplantation (SPK), and to provide the basis for the prevention and treatment of hyperkalemia after SPK.MethodThe relevant literatures about hyperkalemia after SPK in recent years were reviewed.ResultsThe pancreas and kidney that maintained the stability of serum potassium in different ways had been confirmed in current studies. The newly transplanted organ dysfunction after SPK and the use of drugs after SPK both caused hyperkalemia. The treatment principle of hyperkalemia after SPK was to take corresponding prevention and treatment measures according to different reasons.ConclusionsSPK is the best treatment for diabetic renal failure. Postoperative hyperkalemia is one of the most common complications, and timely and correct management is of great significance to the survival and prognosis of patients.
ObjectiveTo find out the risk factors affecting the prognoses and microvascular invasion (MVI) of patients with China Liver Cancer Staging-stageⅠ a (CNLC Ⅰ a) hepatocellular carcinoma (HCC). MethodsBased on the established inclusion and exclusion criteria, the clinicopathologic information and follow-up data of patients with CNLC Ⅰ a HCC were retrospectively collected, who underwent radical resection in the West China Hospital of Sichuan University from Jan. 2012 to Dec. 2016. The Cox proportional hazards regression was utilized to analyze the risk factors affecting the prognosis of patients with CNLC Ⅰ a HCC, and the non-conditional logistic regression was utilized to analyze the preoperative clinical indicators associating with MVI. ResultsA total of 300 patients with CNLC Ⅰ a HCC were included in this study, among which 51 (17.0%) cases accompanied with MVI. The follow-up period ranged from 2 to 104 months (median 39 months), with a recurrence time ranging from 2 to 104 months (median 52 months), and an overall survival time ranging from 3 to 104 months (median 98 months). During the follow-up period, postoperative recurrence occurred in 145 (48.3%) cases. The Cox proportional hazards regression analysis revealed that: tumor diameter >3 cm, presences of MVI and satellite nodules increased the risk of shortened recurrence time for the patients with CNLC Ⅰ a HCC (P<0.05); Factors including gamma-glutamyltranspeptidase level >60 U/L, tumor low differentiation, presences of MVI and satellite nodules were associated with shortened overall survival time for the patients with CNLC Ⅰ a HCC (P<0.05). The preoperative alpha-fetoprotein level ≥400 μg/L and tumor diameter >3 cm increased the risk of presence of MVI for the patients with CNLC Ⅰ a HCC [χ2=3.059, OR(95%CI)=2.357(1.047, 5.306), P=0.038; χ2=3.002, OR(95%CI)=2.301(1.026, 5.162), P=0.043]. ConclusionThe results of this study suggest that adopting corresponding strategies to address the risk factors affecting prognosis of patients with CNLC Ⅰ a HCC and the risk factors associated with MVI can have a significant clinical impact on improving surgical treatment outcomes for these patients.