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Alliance of Chinese Expert Consensus on Neoadjuvant Therapy for Hepatocellular Carcinoma, Committee of Digestive Surgery of Chinese Research Hospital Association, Committee of Liver Cancer, Chinese Anti-Cancer Association. [Chinese expert consensus on neoadjuvant therapy for hepatocellular carcinoma (2023 edition)]. Zhonghua Wai Ke Za Zhi 2023; 61:1035-45. [PMID: 37932138 DOI: 10.3760/cma.j.cn112139-20230914-00121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
Recurrence of hepatocellular carcinoma (HCC) after surgery is a major factor affecting the efficacy of the treatment of patients. Neoadjuvant treatment is an effective therapeutic method to reduce postoperative recurrence and prolong patient survival. However,there is no generally accepted neoadjuvant treatment regimen that has been proven to be effective so far. Recently,with the progress in systemic antitumor therapies,represented by targeted molecular agents and immune checkpoint inhibitors,and the improvement in local regional therapies,these treatment approaches have shown promising efficacy and safety in the field of neoadjuvant treatment for HCC. Under the organizational leadership of Committee of Digestive Surgery of Chinese Research Hospital Association and Committee of Liver Cancer of Chinese Anti-Cancer Association,Alliance of Chinese Expert Consensus on Neoadjuvant Therapy for Hepatocellular Carcinoma has discussed and revised several times and finally formulated the Chinese expert consensus on neoadjuvant therapy for hepatocellular carcinoma (2023 edition). This consensus aimed to review the Chinese characteristics of the diagnosis and treatment of HCC,to provide specific guidance and suggestions for preoperative treatment strategies for HCC,and further promote the management of the clinical pathway for neoadjuvant treatment of HCC.
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Peng SY, Liu YB, Qin RY, Hong DF, Li JT, Tan ZJ, Yu YQ, Zhong XS, Wang M, Wang XA. [The clinical value of radical resection of retroperitoneal lipo-lymphatic layer for pancreatic head cancer]. Zhonghua Wai Ke Za Zhi 2023; 61:989-994. [PMID: 37767665 DOI: 10.3760/cma.j.cn112139-20230504-00191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Abstract
Objective: To investigate the clinical value of the novel approach,radical resection of the retroperitoneal lipo-lymphatic layer (RRRLLL),in the surgical treatment of resectable pancreatic head cancer. Methods: Between June 2020 and June 2022,a total of 221 patients with pancreatic head cancer underwent surgical treatment using the RRRLLL approach(RRRLLL group),while 107 patients received traditional surgical treatment(traditional group) in five high-volume pancreatic centers in China. Data from surgical technique and clinical perioperative outcomes,including lymph node harvested,surgical time,and complications,were analyzed. The RRRLLL group consisted of 144 males and 77 females with an age of (67.5±9.0) years(range:41.3 to 81.1 years). The traditional group included 71 males and 36 females,with an age of (66.3±8.1) years(range:45.1 to 79.2 years). Statistical analysis was performed using the K-S test,Z test,or χ2 test. Results: Pancreaticoduodenectomy was performed successfully in all patients,achieving R0 resection. RRRLLL group surgery required mobilization of retroperitoneal adipose and lymphatic tissues starting from the right edge of the inferior vena cava and extending to the left side,up to the superior mesenteric artery,down to the inferior mesenteric artery,and left to the left side of the aorta,including the perineural and lymphatic tissues around the superior mesenteric artery and the sheath of the mesenteric artery. However,the traditional group did not include the areas mentioned above in the scope of clearance. There were no statistically significant differences between the RRRLLL group and the traditional group in terms of age,sex,tumor size,T stage,and vascular invasion (all P>0.05). However,the number of lymph nodes harvested in the RRRLLL group was significantly higher at 28.7±9.0 (range: 18 to 39) compared to 18.2±8.0 (range: 12 to 21) in the traditional group (Z=-10.691,P<0.05). There were no statistically significant differences in the number of positive lymph nodes,N staging,and postoperative complications between the two groups. Conclusion: The RRRLLL approach improved lymph node dissection compared to the traditional approach,potentially leading to reduced recurrence rates.
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Affiliation(s)
- S Y Peng
- Department of Hepato-Biliary-Pancreatic Surgery,the Second Affiliated Hospital, Zhejiang University School of Medicine,Hangzhou 310006,China
| | - Y B Liu
- Department of Pancreatic-Biliary Surgery,Renji Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200127,China
| | - R Y Qin
- Department of Pancreatic-Biliary Surgery,Tongji Hospital,Tongji Medical College,Huazhong University of Science & Technology,Wuhan 430030,China
| | - D F Hong
- Department of Hepato-biliary-pancreatic Surgery,Sir Run Run Shaw Hospital,Zhejiang University School of Medicine,Hangzhou 310016,China
| | - J T Li
- Department of Hepato-Biliary-Pancreatic Surgery,the Second Affiliated Hospital, Zhejiang University School of Medicine,Hangzhou 310006,China
| | - Z J Tan
- Department of Hepato-Biliary-Pancreatic Surgery,Guangdong Provincial Hospital of Traditional Chinese Medicine,Guangzhou 510120,China
| | - Y Q Yu
- Department of Hepato-Biliary-Pancreatic Surgery,the Second Affiliated Hospital, Zhejiang University School of Medicine,Hangzhou 310006,China
| | - X S Zhong
- Department of Hepato-Biliary-Pancreatic Surgery,Guangdong Provincial Hospital of Traditional Chinese Medicine,Guangzhou 510120,China
| | - M Wang
- Department of Pancreatic-Biliary Surgery,Tongji Hospital,Tongji Medical College,Huazhong University of Science & Technology,Wuhan 430030,China
| | - X A Wang
- Department of Pancreatic-Biliary Surgery,Renji Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200127,China
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Zhao J, Ye L, Liu Z, Wu J, Deng D, An L, Bai S, Yang L, Liu B, Shi Y, Liu Z, Zhang R. The Effects of Early-Life Stress on Liver Transcriptomics and the Protective Role of EPA in a Mouse Model of Early-Life-Stress-Induced Adolescent Depression. Int J Mol Sci 2023; 24:13131. [PMID: 37685937 PMCID: PMC10487865 DOI: 10.3390/ijms241713131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/29/2023] [Accepted: 08/22/2023] [Indexed: 09/10/2023] Open
Abstract
Early-life stress (ELS) was found to increase the risk of adolescent depression, and clinical evidence indicated that eicosapentaenoic acid (EPA) was decreased in patients with adolescent depression, but the underlying mechanisms are unclear. Here, we utilized an ELS model of maternal separation with early weaning to explore the protective role of EPA in adolescent depression. We found that that ELS induced depression-like behavior rather than anxiety-like behavior in adolescent mice. RNA-sequencing results showed that ELS changed the transcription pattern in the liver, including 863 upregulated genes and 971 downregulated genes, especially those related to the biosynthesis of unsaturated fatty acids metabolism in the liver. Moreover, ELS decreased the expression of the rate-limiting enzymes, fatty acid desaturases 1/2 (FADS1/2), involved in the biosynthesis of EPA in the liver. Additionally, ELS reduced the levels of EPA in the liver, serum, and hippocampus, and EPA administration improved depression-like behavior-induced by ELS. Our results provide transcriptomic evidence that ELS increases the risk of adolescent depression by reducing the synthesis of unsaturated fatty acids in the liver, especially EPA, and suggest that supplementation with EPA should be investigated as a potential treatment for adolescent depression.
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Affiliation(s)
- Jinlan Zhao
- Guangdong Provincial Key Laboratory of Translational Cancer Research of Chinese Medicines, Joint International Research Laboratory of Translational Cancer Research of Chinese Medicines, International Institute for Translational Chinese Medicine, School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou 510006, China; (J.Z.); (L.Y.); (Z.L.); (D.D.); (L.A.); (S.B.); (L.Y.); (B.L.)
| | - Lihong Ye
- Guangdong Provincial Key Laboratory of Translational Cancer Research of Chinese Medicines, Joint International Research Laboratory of Translational Cancer Research of Chinese Medicines, International Institute for Translational Chinese Medicine, School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou 510006, China; (J.Z.); (L.Y.); (Z.L.); (D.D.); (L.A.); (S.B.); (L.Y.); (B.L.)
| | - Zuyi Liu
- Guangdong Provincial Key Laboratory of Translational Cancer Research of Chinese Medicines, Joint International Research Laboratory of Translational Cancer Research of Chinese Medicines, International Institute for Translational Chinese Medicine, School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou 510006, China; (J.Z.); (L.Y.); (Z.L.); (D.D.); (L.A.); (S.B.); (L.Y.); (B.L.)
| | - Jiayi Wu
- School of Fundamental Medical Science, Guangzhou University of Chinese Medicine, Guangzhou 510006, China; (J.W.); (Y.S.)
| | - Di Deng
- Guangdong Provincial Key Laboratory of Translational Cancer Research of Chinese Medicines, Joint International Research Laboratory of Translational Cancer Research of Chinese Medicines, International Institute for Translational Chinese Medicine, School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou 510006, China; (J.Z.); (L.Y.); (Z.L.); (D.D.); (L.A.); (S.B.); (L.Y.); (B.L.)
| | - Lin An
- Guangdong Provincial Key Laboratory of Translational Cancer Research of Chinese Medicines, Joint International Research Laboratory of Translational Cancer Research of Chinese Medicines, International Institute for Translational Chinese Medicine, School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou 510006, China; (J.Z.); (L.Y.); (Z.L.); (D.D.); (L.A.); (S.B.); (L.Y.); (B.L.)
| | - Shasha Bai
- Guangdong Provincial Key Laboratory of Translational Cancer Research of Chinese Medicines, Joint International Research Laboratory of Translational Cancer Research of Chinese Medicines, International Institute for Translational Chinese Medicine, School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou 510006, China; (J.Z.); (L.Y.); (Z.L.); (D.D.); (L.A.); (S.B.); (L.Y.); (B.L.)
| | - Lei Yang
- Guangdong Provincial Key Laboratory of Translational Cancer Research of Chinese Medicines, Joint International Research Laboratory of Translational Cancer Research of Chinese Medicines, International Institute for Translational Chinese Medicine, School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou 510006, China; (J.Z.); (L.Y.); (Z.L.); (D.D.); (L.A.); (S.B.); (L.Y.); (B.L.)
| | - Binjie Liu
- Guangdong Provincial Key Laboratory of Translational Cancer Research of Chinese Medicines, Joint International Research Laboratory of Translational Cancer Research of Chinese Medicines, International Institute for Translational Chinese Medicine, School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou 510006, China; (J.Z.); (L.Y.); (Z.L.); (D.D.); (L.A.); (S.B.); (L.Y.); (B.L.)
| | - Yafei Shi
- School of Fundamental Medical Science, Guangzhou University of Chinese Medicine, Guangzhou 510006, China; (J.W.); (Y.S.)
| | - Zhongqiu Liu
- Guangdong Provincial Key Laboratory of Translational Cancer Research of Chinese Medicines, Joint International Research Laboratory of Translational Cancer Research of Chinese Medicines, International Institute for Translational Chinese Medicine, School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou 510006, China; (J.Z.); (L.Y.); (Z.L.); (D.D.); (L.A.); (S.B.); (L.Y.); (B.L.)
| | - Rong Zhang
- Guangdong Provincial Key Laboratory of Translational Cancer Research of Chinese Medicines, Joint International Research Laboratory of Translational Cancer Research of Chinese Medicines, International Institute for Translational Chinese Medicine, School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou 510006, China; (J.Z.); (L.Y.); (Z.L.); (D.D.); (L.A.); (S.B.); (L.Y.); (B.L.)
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