PurposeThe systemic inflammation biomarker, Neutrophil-to-Lymphocyte Ratio (NLR), has been reported as one of the adverse prognostic factors for hepatocellular carcinoma (HCC) patient. The purpose of this study was to evaluate whether NLR could predict the risk of recurrence and death for the HCC patient, according to Milan criteria after hepatectomy.Materials and MethodsRetrospective analysis was performed on a database of HCC patients who underwent hepatectomy between March 2001 and December 2011. The cutoff value of NLR was decided by receiver operating characteristic (ROC) curve analysis. Univariate and multivariate regression analyses were performed to identify predictive factors of recurrence and death.ResultsA total of 213 patients were included in the present study. The median follow-up period was 48 months. One hundred and seven patients were experienced tumor recurrence; forty of them recurred within 12 months (early recurrence). NLR ≥1.505, albumin ≤3.75 g/dL, microvascular invasion and high grade of cirrhosis were found to be independent factors for adverse recurrence-free survival in multivariate regression analysis. And NLR ≥1.945 was also found as a prognosis factor for early recurrence by univariate regression analysis.ConclusionElevated preoperative NLR can be easily obtained and reliable biomarker for assessing the tumor recurrence and early recurrence of Milan criteria HCC after the initial hepatectomy.
PurposeAlthough many staging systems have been proposed for hepatocellular carcinoma (HCC), there is no globally accepted system due to the extreme heterogeneity of the disease. We aimed to compare the results of the 7th/8th American Joint Committee on Cancer (AJCC) and the modified Union for International Cancer Control (mUICC) staging systems in patients with HCC.Materials and MethodsWe collected data from 792 patients who underwent hepatic resection at our center. The Kaplan-Meier method was used to determine disease-free survival and overall survival. To evaluate homogeneity, ‘-2 log likelihood’ was calculated using Cox proportional hazards regression. To measure discriminatory ability, the linear trend chi method and the Cochran-Armitage test for trend were used. The ability to accurately predict survival was verified by cross-validation analysis.ResultsKaplan-Meier curves for disease-free survival and overall survival showed mUICC to be superior to the 7th/8th AJCC. The homogeneity test indicated that mUICC was the best for both disease-free survival and overall survival. In the discriminatory ability test, the chi-square value of mUICC was the best for disease-free survival, while the 7th AJCC had the best value for overall survival. In the cross-validation analysis, all three staging systems had significant predictive power.ConclusionmUICC seemed to be superior to the 7th/8th AJCC after analyzing the data of our surgical patients, although the geographic heterogeneity of HCC might result in differences between the staging systems. We believe that, while the three staging systems allow for the clear stratification of patients into prognostic groups, mUICC may be more appropriate in HCC.
Magnolol (MAG), 5,5-Di-2-propenyl-[1,1-biphenyl]-2,2-diol ( Fig. 1), is the major phenolic compound purified from the medical plant Cortex magnoliae officinalis, 1) which has been used for lower gastrointestinal disorders (e.g., diarrhea, constipation) in Traditional Chinese Medicine for long time.2) Major findings about the pharmacological activity of MAG involved: 1) inhibition of the respiratory burst in formylmethionyl-leucyl-phenylalanine activated neutrophils 3); 2) suppression of the overproduction of nitric oxide and tumor necrosis factor (TNF)-a in lipopolysaccharide activated macrophages ; and 5) antioxidative effect on neutrophil adhesion in vitro and in vivo in rats, [7][8][9] Furthermore, MAG has previously been reported to inhibit smooth muscle contraction in porcine trachea, with possible mechanism of blockade of calcium influx through voltage dependent Ca 2ϩ channels. 10) Recently, one study reported that MAG can inhibit contractility of the upper gastrointestinal tract smooth muscles of isolated gastric fundus strips of rats and isolated ileum of guinea pigs with a calcium-antagonistic effect, 11) but no research have been done about MAG on the lower gastrointestinal tract. The characteristics of different parts of the gastrointestinal tract are not the same, especially in terms of motility, 12) permeability, 13) and response to calcium manipulation.14) Thus, it is necessary to study the effect of MAG on colon, in order to understand the pharmacological action of MAG in lower gastrointestinal disorder.In this study, pharmacological effects of MAG on muscle strips isolated from distal colon of guinea pig were investigated with the presence of activators and inhibitors of muscle contraction, and isolated colon segments of guinea pig were used to test the effect of MAG on the velocity of artificial pellet propulsion. MATERIALS AND METHODS Tissue PreparationMale guinea pigs (200-250 g) were fasted for 24 h, and then sacrificed by stunning and cervical dislocation, and 2-cm pieces of the colon were dissected from the colon segment 1.5 to 2 cm from anus. Luminal contents were washed out with Krebs-bicarbonate buffer. The segments were then opened along the mesenteric border, cut into 10 mmϫ4 mm strips approximately along the circular and longitudinal axis individually and transferred into cold Krebs-bicarbonate buffer. The mucosa was carefully dissected away to expose the muscularis externa. Tissues were mounted for tension recording and allowed to equilibrate for 1-2 h in 10-ml chambers containing Krebs-bicarbonate buffer (118 mM NaCl, 4.8 mM KCl, 1.2 mM KH 2 PO 4 , 1.2 mM MgSO 4 , 2.5 mM CaCl 2 , 25 mM NaHCO 3 and 11 mM Glucose, pH 7.4, at 37°C), and saturated with 95%O 2 and 5%CO 2 . The colonic longitudinal muscle strips (LMS) and circular muscle strips (CMS) were initially maintained at 0.5 g tension and equilibrated for 60 min. The bath solution was replaced every 20 min to keep the solution fresh during equilibration. Measurement of Contractile ActivityThe mechanical responses in preparations w...
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