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Ablative strategies for recurrent hepatocellular carcinoma

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World Journal of Hepatology 2023年第4期15卷 515-524页

作者： Lin Wang bao-xian liu Hai-Yi Long Department of Medical Ultrasound Institute of Diagnostic and Interventional UltrasoundThe First Affiliated Hospital of Sun Yat-sen UniversityGuangzhou 510080Guangdong ProvinceChina

Hepatocellular carcinoma(HCC)is the most common primary liver cancer and is the fifth leading cause of cancer death worldwide and the third leading cause of all diseases *** transplantation,surgical resection and ablation are the three main curative treatments for *** transplantation is the optimal treatment option for HCC,but its usage is limited by the shortage of liver *** resection is considered the first choice for early-stage HCC,but it does not apply to patients with poor liver ***,more and more doctors choose ablation for ***,intrahepatic recurrence occurs in up to 70%patients within 5 years after initial *** patients with oligo recurrence after primary treatment,repeated resection and local ablation are both *** 20%patients with recurrent HCC(rHCC)indicate repeated surgical resection because of limitations in liver function,tumor location and intraperitoneal *** ablation has become an option for the waiting period when liver transplantation is *** patients with intrahepatic recurrence after liver transplantation,local ablation can reduce the tumor burden and prepare them for liver *** review systematically describes the various ablation treatments for rHCC,including radiofrequency ablation,microwave ablation,laser ablation,high-intensity focused ultrasound ablation,cryablation,irreversible electroporation,percutaneous ethanol injection,and the combination of ablation and other treatment modalities.

关键词： Hepatocellular carcinoma Recurrence Ablative therapy Thermal ablation

Dexmedetomidine mitigates isoflurane-induced neurodegeneration in fetal rats during the second trimester of pregnancy

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Neural Regeneration Research 2017年第8期12卷 1329-1337页

作者： Zhi-yuan Su Qing Ye xian-bao liu Yu-zhong Chen Hong Zhan Shi-yuan Xu Department of Anesthesia The Third Affiliated Hospital of Guangzhou Medical University Department of Anesthesia Zhujiang Hospital of Southern Medical University

Dexmedetomidine has significant neuroprotective effects. However, whether its protective effects can reduce neurotoxicity caused by isoflurane in fetal brain during the second trimester of pregnancy remains unclear. In this study, timed-pregnancy rats at gestational day 14 spontaneously inhaled 1.5% isoflurane for 4 hours, and were intraperitoneally injected with dexmedetomidine at dosages of 5, 10, 20, and 20 μg/kg 15 minutes before inhalation and after inhalation for 2 hours. Our results demonstrate that 4 hours after inhaling isoflurane, 20 μg/kg dexmedetomidine visibly mitigated isoflurane-induced neuronal apoptosis, reversed downregulation of brain-derived neurotrophic factor expression, and lessened decreased spatial learning and memory ability in adulthood in the fetal rats. Altogether, these findings indicate that dexmedetomidine can reduce neurodegeneration induced by isoflurane in fetal rats during the second trimester of pregnancy. Further, brain-derived neurotrophic factor participates in this process.

关键词： nerve regeneration dexmedetornidine isoflurane fetal rat apoptosis brain-derived neurotrophic factor behavior neuroprotection neurodegeneration neural regeneration

Anemia and risk of periprocedural cerebral injury detected by diffusion-weighted magnetic resonance imaging in patients undergoing transcatheter aortic valve replacement

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World Journal of Emergency Medicine 2022年第1期13卷 32-39页

作者： Stella Ng Qi-feng Zhu Ju-bo Jiang Chun-hui liu Jia-qi Fan Ye-ming Xu xian-bao liu Jian-an Wang Department of Cardiology the Second Affi liated Hospital of Zhejiang University School of MedicineHangzhou 310009China Zhejiang University School of Medicine Hangzhou 310058China

BACKGROUND: Anemia is prevalent in patients undergoing transcatheter aortic valve replacement(TAVR) and has been linked to impaired outcomes after the procedure. Few studies have evaluated the impact of anemia and new ischemic lesions post ***: We prospectively enrolled 158 patients who received TAVR in our center. Anemia was defined according to the World Health Organization criteria as hemoglobin <12 g/dL in women and <13 g/dL in men. All patients underwent diffusion-weighted magnetic resonance imaging(DW-MRI) procedure before and within 4–7 days after TAVR. RESULTS: Anemia was present in 85(53.8%) patients who underwent TAVR, and 126(79.7%) patients had 718 new DW-MRI positive lesions with a mean of 4.54±5.26 lesions per patient. The incidence of new ischemic lesions was 81.2% in patients with anemia versus 78.1% in patients without anemia(P=0.629). Moreover, anemic patients had bigger total volume/lesions in the anterior cerebral artery/middle cerebral artery(ACA/MCA) and MCA regions compared to the non-anemic patients(31.89±55.78 mm^(3) vs. 17.08±37.39 mm^(3), P=0.049;and 54.54±74.72 mm^(3) vs. 33.75±46.03 mm^(3), P=0.034). Anemia was independently associated with the volume/lesion in the ACA/MCA(β=16.796, 95% confidence interval [95% CI] 2.001 to 31.591, P=0.026) and in the MCA zone(β=0.020, 95% CI 0.001 to 0.040, P=0.041). CONCLUSIONS: Patients with pre-procedural anemia may have bigger total volume/lesions in the ACA/MCA and MCA regions compared to the non-anemic patients. Whether the consequences of bigger total volume/lesions impact neurological and cognitive outcomes remains to be investigated.

关键词： Aortic stenosis Anemia Cerebral ischemic lesions Transcatheter aortic valve replacement

Treatment strategies for hepatocellular carcinoma with extrahepatic metastasis

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World Journal of Clinical Cases 2021年第21期9卷 5754-5768页

作者： Hai-Yi Long Tong-Yi Huang Xiao-Yan Xie Jian-Ting Long bao-xian liu Department of Medical Ultrasonics Institute of Diagnostic and Interventional Ultrasoundthe First Affiliated Hospital of Sun Yat-Sen UniversityGuangzhou 510080Guangdong ProvinceChina Department of Medical Oncology The First Affiliated Hospital of Sun Yat-sen UniversityGuangzhou 510080Guangdong ProvinceChina

Extrahepatic metastasis(EHM)of hepatocellular carcinoma(HCC)has increasingly been seen due to improved survival with effective management of intrahepatic *** presence of EHM indicates an advanced stage of HCC,for which systemic therapy serves as the standard treatment *** the approval of Sorafenib as the first systemic agent in 2007,it took almost a decade to show its efficacy in both first and further lines of setting until the landscape of systemic drugs was finally ***,with inspiring results from immunotherapy trials in HCC,it appears that the introduction of immunotherapy may lead to an evolution in the portfolio of HCC *** the locoregional approach in the management of EHM is not recommended for advancedstage HCC,efforts have been made to demonstrate its efficacy in symptom relief and potential benefit for overall *** review provides a summary of recent updates of the systemic agents in the treatment of advanced HCC,with an emphasis on aggressive locoregional management of EHM by various treatment modalities.

关键词： Hepatocellular carcinoma Extrahepatic metastasis Systemic therapy Targeted therapy Immunotherapy Locoregional therapy

Complex coronary lesions and rotational atherectomy:one hospital's experience

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2012年第8期13卷 645-651页

作者： Jun JIANG Yong SUN Mei-xiang xianG Liang DONG xian-bao liu Xin-yang HU Yan FENG Jian-an WANG Department of Cardiology the Second Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhou 310009China Cardiovascular Key Lab of Zhejiang Province the Second Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhou 310009China

Objective:To evaluate the safety and effectiveness of rotational atherectomy followed by drug eluting stent (DES) implantation in patients with complex coronary lesions. Methods:From August 2006 to August 2012, 253 consecutive patients with 289 lesions and who underwent rotational atherectomy in our center were enrolled in this study. Results:The overall procedure success rate was 98% with the cost of two (0.8%) coronary perforations, three (1.2%) dissections, five (2.0%) slow flows or no flows, three (1.2%) peri-procedure myocardial infarctions, and two (0.8%) in hospital deaths. During follow-up (mean three years), one (0.4%) patient died, two (0.8%) patients had acute myocardial infarction, 14 (5.5%) had restenosis, and target lesion revascularization occurred in eight patients (3.2%). Conclusions:Rotational atherectomy followed by DES implantation is a safe and effective technique for patients with complex coronary lesions, especially calcified and non-dilatable lesions.

关键词： Complex coronary lesions Calcified coronary lesions Rotational atherectomy Drug eluting stents

Myocardial infarction detected by a smartwatch after transcatheter aortic valve replacement during the COVID-19 pandemic

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World Journal of Emergency Medicine 2021年第3期12卷 247-248页

作者： xian-bao liu Jia-qi Fan Ye-ming Xu Yu-chao Guo Cheng Li Jian-guo Xu Jian-an Wang Department of Cardiology the Second Affi liated Hospital Zhejiang University School of MedicineHangzhou 310009China Zhejiang University School of Medicine Hangzhou 310058China Department of Electrocardiography the Second Affi liated Hospital Zhejiang University School of MedicineHangzhou 310009China

Dear editor,Transcatheter aortic valve replacement(TAVR)is a safe and effective first-line therapeutic management for patients with severe aortic *** evidence of multiple randomized clinical trials proves the safety and efficacy of TAVR in patients.[1-2]However,new-onset conduction disorders,atrial fi brillation,and acute coronary syndrome are still common complications after TAVR *** life-threatening complications such as myocardial infarction may result in fatal clinical *** COVID-19 pandemic makes periodic and timely follow-ups for patients after TAVR more diffi *** ambulatory electrocardiogram(AECG)monitoring system by a smart wearable device has recently emerged as a tool to monitor cardiac events before and after TAVR.[3]Smartwatches can monitor and record multiple biometric parameters,like heart rate,step counts,sleep cycles,oxygen saturation,and analyze QRS complexes and P waves after triggering incidences。

关键词： infarction smart editor

Heat shock protein 90 protects rat mesenchymal stem cells against hypoxia and serum deprivation-induced apoptosis via the PI3K/Akt and ERK1/2 pathways

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2010年第8期11卷 608-617页

作者： Feng GAO Xin-yang HU Xiao-jie XIE Qi-yuan XU Ya-ping WANG xian-bao liu Mei-xiang xianG Yong SUN Jian-an WANG Department of Cardiology Hangzhou 310009 China Cardiovascular Key Lab of Zhejiang Province the Second~ffiliated Hospital School of Medicine Zhejiang University Hangzhou 310009 China

Mesenchymal stem cell （MSC） transplantation has shown a therapeutic potential to repair the ischemic and infracted myocardium, but the effects are limited by the apoptosis and loss of donor cells in host cardiac microenvironment. The aim of this study is to explore the cytoprotection of heat shock protein 90 （Hsp90） against hypoxia and serum deprivation-induced apoptosis and the possible mechanisms in rat MSCs. Cell viability was determined by 3-（4,5-dimethylthiazol-2-yl）-2,5-diphenyltetrazolium bromide （MTT） assay. Apoptosis was assessed by Hoechst 33258 nuclear staining and flow cytometric analysis with annexin V/PI staining. The gene expression of Toll-like receptor-4 （TLR-4） and V-erb-b2 erythroblastic leukemia viral oncogene homolog 2 （ErbB2） was detected by real-time poly- merase chain reaction （PCR）. The protein levels of cleaved caspase-3, Bcl-2, Bcl-xL, Bax, totaI-ERK, phospho-ERK, totaI-Akt, phospho-Akt, and Hsp90 were detected by Western blot. The production of nitric oxide was measured by spectrophotometric assay. Hsp90 improves MSC viability and protects MSCs against apoptosis induced by serum deprivation and hypoxia. The protective role of Hsp90 not only elevates Bcl-2/Bax and Bcl-xL/Bax expression and attenuates cleaved caspase-3 expression via down-regulating membrane TLR-4 and ErbB2 receptors and then ac- tivating their downstream PI3K/Akt and ERK1/2 pathways, but also enhances the paracrine effect of MSCs. These findings demonstrated a novel and effective treatment strategy against MSC apoptosis in cell transplantation.

关键词： Heat shock protein Apoptosis Stem cell Hypoxia Phosphoinositide-3-kinase/protein kinase B (PI3K/Akt) Extracellular-signal-regulate kinase (ERK)

Roles of SIRT3 in heart failure: from bench to bedside

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2016年第11期17卷 821-830页

作者： De-xing HU xian-bao liu Wen-chao SONG Jian-an WANG Department of Cardiology the Second Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhou 310009China Provincial Key Laboratory of Cardiovascular Research of Zhejiang Province Hangzhou 310009China Department of Cardiology Ningbo Medical Center Lihuili Eastern HospitalNingbo 315100China

Heart failure （HF） represents the most common endpoint of most cardiovascular diseases （CVDs） which are the leading causes of death around the world. Despite the advances in treating CVDs, the prevalence of HF con- tinues to increase. It is believed that better results of prognosis are obtained from prevention rather than additional treatment for HF. Therefore, it is reasonable to prevent the development of CVDs or other complications to HF. Most types of HF are attributed to contractile dysfunction, cardiac hypertrophy or remodeling, and ischemic injuries. SIRT3 is a mitochondrial nicotinamide adenine dinucleotide （NAD＊）-dependent deacetylase whose substrates vary from met- abolic biogenesis-associated proteins to stress-responsive proteins. In recent years, a number of studies have high- lighted the cardio-protective role of SIRT3 and, as such, efforts have been made to induce over-expression or in- creased activity of this protein. In this review, we provide an overview of the roles of SIRT3 in cardiac hypertrophy induced by pressure overload or agonists and cardiomyocytes ischemic injuries. Moreover, we will introduce the application of SIRT3 agonists in the prevention of cardiac hypertrophy and ischemia reperfusion injury.

关键词： SIRT3 Heart failure Hypertrophy Ischemia reperfusion

Ascending aortic dilatation rate after transcatheter aortic valve replacement in patients with bicuspid and tricuspid aortic stenosis: A multidetector computed tomography follow-up study

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World Journal of Emergency Medicine 2019年第4期10卷 197-204页

作者： Yu-xin He Jia-qi Fan Qi-feng Zhu Qi-jing Zhou Ju-bo Jiang Li-han Wang Stella Ng xian-bao liu Jian-an Wang Department of Cardiology the Second Affiliated HospitalZhejiang University School of MedicineHangzhou 310009China Department of Radiology the Second Affiliated HospitalZhejiang University School of MedicineHangzhou 310009China

BACKGROUND: Current data is lacking about the progression of ascending aortic dilatation after transcatheter aortic valve replacement(TAVR) in aortic stenosis(AS) patients with bicuspid aortic valve(BAV) and tricuspid aortic valve(TAV). This study aims to assess the ascending aortic dilatation rate(mm/year) after TAVR in patients with BAV versus TAV using a multidetector computed tomography(MDCT) fol ow-up and to determine the predictors of ascending aortic dilatation ***: Severe AS patients undergoing TAVR from March 2013 to March 2018 at our center with MDCT follow-ups were included. BAV and TAV were identified using baseline MDCT. Baseline and follow-up MDCT images were analyzed,and the diameters of ascending aorta were measured. Study end point is ascending aortic dilatation rate(mm/year). Furthermore,factors predicting ascending aortic dilatation rate were also ***: Two hundred and eight patients were included,comprised of 86 BAV and 122 TAV patients. Five,4,3,2,and 1-year MDCT follow-ups were achieved in 7,9,30,46,and 116 patients. The ascending aortic diameter was significantly increased after TAVR in both BAV group(43.7±4.4 mm vs. 44.0±4.5 mm;P<0.001) and TAV group(39.1±4.8 mm vs. 39.7±5.1 mm;P<0.001). However,no difference of ascending aortic dilatation rate was found between BAV and TAV group(0.2±0.8 mm/year vs. 0.3±0.8 mm/year,P=0.592). Multivariate linear regression revealed paravalvular leakage(PVL) grade was independently associated with ascending aortic dilatation rate in the whole population and BAV group,but not TAV group. No aortic events occurred during ***: Ascending aortic size continues to grow after TAVR in BAV patients,but the dilatation rate is mild and comparable to that of TAV patients. PVL grade is associated with ascending aortic dilatation rate in BAV patients post-TAVR.

关键词： Transcatheter aortic valve replacement Aortic dilatation Bicuspid aortic valve