Background It is still controversial that whether hepatocellular carcinoma (HCC) patients with lymph node invasion should receive surgery treatment. This study aimed to evaluate the efficacy of surgery (liver resection and local tumor destruction treatments[l陈1] ) in HCC patients with regional lymph node metastasis.Methods The study utilized data from the Surveillance, Epidemiology, and End Results-18 (SEER-18) cancer registry. Patients for whom the treatment type was not clear or those with distant metastasis or without regional lymph nodules invasion were excluded. For survival analysis, patients with the survival months coded as 0 and 999 were excluded. [l陈2] All 1434 patients were included in the analysis. Among them, 168 patients were treated surgically and the other 1266 received non-surgery therapy. Propensity Score Matching (PSM) model was used to reduce selection bias.Results Before PSM, the median overall survival (mOS) and median cancer-specific survival (mCSS) of patients treated surgically were longer than that of receiving non-surgery treatment (mOS: 20 months, 95%CI: 15.3-24.7 vs. 7 months, 95%CI: 6.4-7.6, P<0.001; mCSS: 21 months, 95%CI: 115.5-26.5 vs. 6 months, 95%CI: 5.3-6.7, P<0.001). Subgroup analysis found no significant differences in mOS and mCSS between liver resection and non-liver resection surgery cohorts (P=0.886 and P=0.813, respectively).[l陈3] Similar results were obtained in the PSM analysis. The mOS and mCSS in the surgery group were longer than in the non-surgery group (mOS: 20 months vs. 7 months, P<0.001; mCSS: 20 months vs. 6 months, P<0.001). The multivariate analysis documented that surgery was an independent predictor for OS and CSS before and after PSM.Conclusions HCC patients with invasion of regional lymph nodules may get more survival benefit from surgery than other types of treatment.

BackgroundRadiotherapy has been used in the treatment of hepatocellular carcinoma (HCC) more widely. However, little research focus on comparing the efficacy of patients with liver resection combined with radiotherapy with that received liver resection alone. The study was conducted to evaluate whether the efficacy of liver resection combined with radiotherapy in the treatment of patients with HCC is better than liver resection alone.MethodsThe study utilized the data from the Surveillance, Epidemiology, and End Results 18 registry (SEER-18). Patients diagnosed with HCC between 2004 and 2015 who received liver resection or the combination of liver resection and radiotherapy were included in the analysis. The propensity score matching model (PSM) was used to reduce selection bias and potential confounding factors.ResultsBefore PSM, the median overall survival (mOS) and median cancer-specific survival (mCSS) of patients treated with liver resection alone were longer than in patients treated with the combination of liver resection and radiotherapy (P<0.001). However, there was no statistically significant difference in mOS and mCSS between the groups after PSM (P>0.05). The subgroup analysis after PSM documented that patients with American Joint Committee on Cancer (AJCC) stage I and II who were treated with liver resection and radiotherapy had no longer mOS and mCSS than patients subjected to the combination of liver resection alone (P=0.151 and P=0.185). Similar results were obtained in the subgroup group of patients with a single tumor smaller than 5 cm. Univariate analysis showed that patients undergoing liver resection combined with radiotherapy did not have an increased all-cause mortality risk (HR:1.214, 95%CI: 0.950-1.553; P=0.122) and cancer-specific mortality risk (HR:1.132, 95%CI: 0.848-1.510; P=0.401) when compared to patients treated with liver resection alone after PSM.ConclusionThe combination of liver resection and radiotherapy does not prolong the survival of HCC patients more than liver resection alone.

BackgroundOsteoporosis (OP) is a systemic skeletal disease marked by bone mass reduction and bone tissue destruction. Hormone replacement therapy is an effective treatment for post-menopausal OP, but estrogen has poor tissue selectivity and severe side effects.ResultsIn this study, we constructed a poly(lactic-co-glycolic acid) (PLGA) nanoparticles (NPs)-based drug delivery system to co-load 17β estradiol (E2) and iron oxide (Fe3O4) together, modified with alendronate (AL) to achieve bone targeting and realize a magnetically remote-controllable drug release. The NPs were fabricated through the emulsion solvent diffusion method. The particle size was approximately 200 nm while the encapsulation efficiency of E2 was 58.34 ± 9.21%. The NPs were found to be spherical with a homogenous distribution of particle size. The NPs showed good stability, good biocompatibility, high encapsulation ability of E2 and excellent magnetic properties. The NPs could be effectively taken up by Raw 264.7 cells and were effective in enriching drugs in bone tissue. The co-loaded NPs exposed to an external magnetic field ameliorated OVX-induced bone loss through increased BV/TV, decreased Tb.N and Tb.Sp, improved bone strength, increased PINP and OC, and downregulated CTX and TRAP-5b. The haematological index and histopathological analyses displayed the NPs had less side effects on non-skeletal tissues.ConclusionsThis study presented a remote-controlled release system based on bone-targeted multifunctional NPs and a new potential approach to bone-targeted therapy of OP.

BackgroundOperation for the treatment of hepatocellular carcinoma (HCC) is limited. Recently, the possibility was advanced that operation (including surgery, transplantation, and ablation et, al) could be applied in HCC patients more widely. To address this issue, the trend in the use of operation and surgery for the treatment of HCC with time was analyzed. Additionally, whether patients gain a better survival benefit from surgery than other treatments was also evaluated.MethodsData from SEER registries were used to analyze the trends in the use operation and surgery for HCC and the survival benefits of these procedures. The study included patients between the ages of 35 and 84 years diagnosed as HCC between 2004 and 2015 (n=64019). Propensity score matching (PSM) analysis was used to reduce selection bias.Results From 2004 to 2015, the rate of operation for HCC decreased in the localized group (P<0.001), the regional and distant group (P<0.001). Surgery rate in the localized, regional, and distant group also declined (P=0.016, P=0.009, and P=0.018, respectively). Non-operation rate increased in the localized, regional, and distant group (all P<0.001). The median overall survival (mOS) of patients in the localized, regional group who underwent surgery was longer than that of patients with non-surgery operation and non-operation. Similar survival results were obtained in the analysis of patients with single tumor larger than 5 cm and 2-3 tumors larger than 3 cm. ConclusionAlthough surgery rate declined from 2004 to 2015 in all HCC patients, it might be used more widely in patients with localized and regional tumors. And the treatment of surgery in patients with single tumor larger than 5 cm or patients with 2-3 tumors larger than 3 cm was worth trying.