Treatment of hepatocellular carcinoma(HCC)in the caudate lobe is technically challenging.This retrospective study was designed to evaluate the clinical outcome of both superselective transcatheter arterial chemoemboli...Treatment of hepatocellular carcinoma(HCC)in the caudate lobe is technically challenging.This retrospective study was designed to evaluate the clinical outcome of both superselective transcatheter arterial chemoembolization(TACE)and liver resection(LR)for HCC occurring exclusively in the caudate lobe.From January 2008 to September 2021,a total of 129 patients were diagnosed with HCC of the caudate lobe.The Cox proportional hazard model was used to analyze the potential clinical factors and established prognostic nomograms with interval validation.Of the total number of patients,78 received TACE and 51 received LR.The overall survival(OS)rates(TACE vs.LR)at 1,2,3,4,and 5 years were 83.9%vs.71.0%;74.2%vs.61.3%;58.1%vs.48.4%;45.2%vs.45.2%;and 32.3%vs.25.0%,respectively.However,subgroup analysis revealed that TACE was superior to LR for treating patients with stage IIb Chinese liver cancer(CNLC-IIb)in the entire cohort(p=0.002).Interestingly,no difference was found between TACE and LR in the treatment outcomes of CNLC-IIa HCC(p=0.6).Based on Child-Pugh A and B calculations,TACE tended to lead to a better OS than LR(p=0.081 and 0.16,respectively).Multivariate analysis showed that Child-Pugh score,CNLC stage,ascites,alpha fetoprotein(AFP),tumor size,and anti-HCV are related to OS.Predictive nomograms for 1,2,and 3 years were performed.Based on this study,TACE may provide a longer OS than liver resection for patients with CNLC-IIb HCC of the caudate lobe.Because this suggestion is limited by the study design and relatively small sample size,additional randomized controlled trials are needed.展开更多
Major depressive disorder(MDD)is a chronic,generally episodic and debilitating disease that affects an estimated 300 million people worldwide,but its pathogenesis is poorly understood.The heritability estimate of MDD ...Major depressive disorder(MDD)is a chronic,generally episodic and debilitating disease that affects an estimated 300 million people worldwide,but its pathogenesis is poorly understood.The heritability estimate of MDD is 30–40%,suggesting that genetics alone do not account for most of the risk of major depression.Another factor known to associate with MDD involves environmental stressors such as childhood adversity and recent life stress.Recent studies have emerged to show that the biological impact of environmental factors in MDD and other stress-related disorders is mediated by a variety of epigenetic modifications.These epigenetic modification alterations contribute to abnormal neuroendocrine responses,neuroplasticity impairment,neurotransmission and neuroglia dysfunction,which are involved in the pathophysiology of MDD.Furthermore,epigenetic marks have been associated with the diagnosis and treatment of MDD.The evaluation of epigenetic modifications holds promise for further understanding of the heterogeneous etiology and complex phenotypes of MDD,and may identify new therapeutic targets.Here,we review preclinical and clinical epigenetic findings,including DNA methylation,histone modification,noncoding RNA,RNA modification,and chromatin remodeling factor in MDD.In addition,we elaborate on the contribution of these epigenetic mechanisms to the pathological trait variability in depression and discuss how such mechanisms can be exploited for therapeutic purposes.展开更多
基金funding by National Natural Science Foundation of China(82200695)Post-Doctor Research Project,West China Hospital,Sichuan University(2021HXBH023)Sichuan Science and Technology Program of China(2021YJ0429).
文摘Treatment of hepatocellular carcinoma(HCC)in the caudate lobe is technically challenging.This retrospective study was designed to evaluate the clinical outcome of both superselective transcatheter arterial chemoembolization(TACE)and liver resection(LR)for HCC occurring exclusively in the caudate lobe.From January 2008 to September 2021,a total of 129 patients were diagnosed with HCC of the caudate lobe.The Cox proportional hazard model was used to analyze the potential clinical factors and established prognostic nomograms with interval validation.Of the total number of patients,78 received TACE and 51 received LR.The overall survival(OS)rates(TACE vs.LR)at 1,2,3,4,and 5 years were 83.9%vs.71.0%;74.2%vs.61.3%;58.1%vs.48.4%;45.2%vs.45.2%;and 32.3%vs.25.0%,respectively.However,subgroup analysis revealed that TACE was superior to LR for treating patients with stage IIb Chinese liver cancer(CNLC-IIb)in the entire cohort(p=0.002).Interestingly,no difference was found between TACE and LR in the treatment outcomes of CNLC-IIa HCC(p=0.6).Based on Child-Pugh A and B calculations,TACE tended to lead to a better OS than LR(p=0.081 and 0.16,respectively).Multivariate analysis showed that Child-Pugh score,CNLC stage,ascites,alpha fetoprotein(AFP),tumor size,and anti-HCV are related to OS.Predictive nomograms for 1,2,and 3 years were performed.Based on this study,TACE may provide a longer OS than liver resection for patients with CNLC-IIb HCC of the caudate lobe.Because this suggestion is limited by the study design and relatively small sample size,additional randomized controlled trials are needed.
基金This work was supported by grants from the Ministry of Science and Technology of the People’s Republic of China(2021ZD0201900)1·3·5 project for disciplines of excellence,West China Hospital,Sichuan University(ZYJC21004,ZYGD22007)+2 种基金the National Natural Science Foundation of China(82120108002,81821002,82171527,82200695)Distinguished Young Scholar of Zhejiang(LR20H090001 to C.W.)Municipal Key R&D Program of Ningbo(2022Z127).
文摘Major depressive disorder(MDD)is a chronic,generally episodic and debilitating disease that affects an estimated 300 million people worldwide,but its pathogenesis is poorly understood.The heritability estimate of MDD is 30–40%,suggesting that genetics alone do not account for most of the risk of major depression.Another factor known to associate with MDD involves environmental stressors such as childhood adversity and recent life stress.Recent studies have emerged to show that the biological impact of environmental factors in MDD and other stress-related disorders is mediated by a variety of epigenetic modifications.These epigenetic modification alterations contribute to abnormal neuroendocrine responses,neuroplasticity impairment,neurotransmission and neuroglia dysfunction,which are involved in the pathophysiology of MDD.Furthermore,epigenetic marks have been associated with the diagnosis and treatment of MDD.The evaluation of epigenetic modifications holds promise for further understanding of the heterogeneous etiology and complex phenotypes of MDD,and may identify new therapeutic targets.Here,we review preclinical and clinical epigenetic findings,including DNA methylation,histone modification,noncoding RNA,RNA modification,and chromatin remodeling factor in MDD.In addition,we elaborate on the contribution of these epigenetic mechanisms to the pathological trait variability in depression and discuss how such mechanisms can be exploited for therapeutic purposes.
