Zhen- Li

Theranostic nanomedicine by surface nanopore engineering

Theranostic nanomedicine that integrates diagnostic and therapeutic agents into one nanosystem has gained considerable momentum in the field of cancer treatment. Among diverse strategies for achieving theranostic capabilities, surface-nanopore engineering based on mesoporous silica coating has attracted great interest because of their negligible cytotoxicity and chemically active surface that can be easily modified to introduce various functional groups (e.g., −COOH, −NH2, −SH, etc.) via silanization, which can satisfy various requirements of conjugating biological molecules or functional nanoparticles. In addition, the nanopore-engineered biomaterials possess large surface area and high pore volume, ensuring desirable loading of therapeutic guest molecules. In this review, we comprehensively summarize the synthetic procedure/paradigm of nanopore engineering and further broad theranostic applications. Such nanopore-engineering strategy endows the biocompatible nanocomposites (e.g., Au, Ag, graphene, upconversion nanoparticles, Fe3O4, MXene, etc.) with versatile functional moieties, which enables the development of multifunctional nanoplatforms for multimodal diagnostic bio-imaging, photothermal therapy, photodynamic therapy, targeted drug delivery, synergetic therapy and imaging-guided therapies. Therefore, mesoporous silica-based surface-nanopore engineering integrates intriguing unique features for broadening the biomedical applications of the single mono-functional nanosystem, facilitating the development and further clinical translation of theranostic nanomedicine.

Protein induced by vitamin K absence or antagonist-II versus alpha-fetoprotein in the diagnosis of hepatocellular carcinoma: A systematic review with meta-analysis

BACKGROUND As a promising biomarker of hepatocellular carcinoma (HCC), protein induced by vitamin K absence or antagonist-II (PIVKA-II) has been studied extensively. However, its diagnostic capability varies across HCC studies. This study aimed to compare the performance of PIVKA-II with alpha-fetoprotein (AFP) in the diagnosis of HCC. DATA SOURCES A systematic literature search was conducted to identify the studies from MEDLINE, Embase and Cochrane Library Databases, which were published up to December 20, 2017 to compare the diagnostic capability of PIVKA-II and AFP for HCC. The data were pooled using random effects model. Pooled sensitivity and specificity were calculated. Summary receiver operating characteristic curve (ROC) was employed to evaluate the diagnostic accuracy of each marker. RESULTS Thirty-one studies were included. The pooled sensitivity (95% CI) of PIVKA-II and AFP was 0.66 (0.65-0.68) and 0.66 (0.65-0.67), respectively in diagnosis of HCC; and the corresponding pooled specificity (95% CI) was 0.89 (0.88-0.90) and 0.84 (0.83-0.85), respectively. The area under the ROC curve (AUC) of PIVKA-II and AFP was 0.856 (0.817-0.895) and 0.770 (0.728-0.811), respectively. Subgroup analysis showed that PIVKA-II was superior to AFP in terms of the AUC for both small HCC (< 3 cm) [0.863 (0.825-0.901) vs 0.717 (0.658-0.776)] and large HCC (≥ 3 cm) [0.854 (0.811-0.897) vs 0.729 (0.682-0.776)]; for American [0.926 (0.897-0.955) vs 0.698 (0.594-0.662)], European [0.772 (0.743-0.801) vs 0.628 (0.594-0.662)], Asian [0.838 (0.812-0.864) vs 0.785 (0.764-0.806)] and African [0.812 (0.794-0.840) vs 0.721 (0.675-0.767)] HCC patients; and for HBV-related [0.909 (0.866-0.951) vs 0.714 (0.673-0.755)] and mixed-etiology [0.847 (0.821-0.873) vs 0.794 (0.772-0.816)] HCC. CONCLUSION This meta-analysis indicates that PIVKA-II is better than AFP in terms of the accuracy for diagnosing HCC, regardless of tumor size, patient ethnic group, or HCC etiology.

Surgical site infections following pancreaticoduodenectomy

We read with interest the article by Richard A. Burkhart et al. This single-center retrospective study investigated which factors were associated with the occurrence of surgical site infection (SSI) following pancreaticoduodenectomy, and concluded that the use of an incisional negative pressure dressing (iVAC)was an independent protective factor. We would like to raise the following comments: Therewere differences in some variableswhichonly just failed to reach significance when comparing patients inwhom and without the use of an iVAC was or was not employed, including body mass index, preoperative biliary stenting, and estimated blood loss (all p < 0.1), suggesting that there may have been a degree of selection bias in the use of iVAC.Did the authors use iVAC for those patients with obesity, massive blood loss, or preoperative biliary stenting? Propensity score matching analysis could have been usefully adopted in this observational study, to adjust other confounding variables before comparison between the two groups. Since SSI is classified into incisional and organ/space types, it is theoretically possible that the use of an iVAC decreases the incisional SSI rate. However, it is hard to understand that iVAC could also prevent organ/space SSI. So, in this study, clarification of these issues could be addressed by means of subgroup analyses for incisional and organ/space SSI. Only in that way, can we understand how the use of an iVAC could possible prevent a specific type or all types of SSI following pancreaticoduodenectomy.

Comparison of Patterns and Outcomes of Liver Resection for Hepatocellular Carcinoma: East vs West

Surgical resection is the standard option and treatment of choice for localized hepatocellular carcinoma (HCC). Difference in candidate selection and surgical practice of liver resection for HCC has been widely acknowledged between Eastern and Western centers. However, direct comparisons between the 2 regions are still lacking, especially those that identify the differences in their surgical safety and long-term efficacy. This study aimed to compare the patterns and outcomes of liver resection for HCC between 2 large centers in the East and the West.

Dysregulated fatty acid metabolism in hepatocellular carcinoma

Hepatocellular carcinoma (HCC) is one of the most frequent and deadly malignancies worldwide. Studies are urgently needed on its molecular pathogenesis and biological characteristics. Dysregulation of fatty acid (FA) metabolism, in which aberrant activation of oncogenic signaling pathways alters the expression and activity of lipid-metabolizing enzymes, is an emerging hallmark of cancer cells, and it may be involved in HCC development and progression. The current review summarizes what is known about dysregulated FA metabolism in HCC and pathways through which this dysregulation may regulate HCC survival and growth. Our understanding of dysregulated FA metabolism and associated signaling pathways may contribute to the development of novel and efficient antitumor approaches for patients with HCC.