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中华检验医学杂志 2024年第4期47卷 413-418页

作者：黄勇恒谢婵胡波王辉奉源林楠中山大学附属第三医院肝胆外科广州510000

目的探究联合检测血浆中游离BMPR1A、PLAC8基因甲基化预测肝细胞癌术后复发的作用。方法病例系列研究。选取2022年1月至2023年7月中山大学附属第三医院治疗的Ⅰ~Ⅳ期肝细胞癌患者, 入组的所有患者在治疗后1、3、6、9和12个月进行甲胎蛋... 详细信息

目的探究联合检测血浆中游离BMPR1A、PLAC8基因甲基化预测肝细胞癌术后复发的作用。方法病例系列研究。选取2022年1月至2023年7月中山大学附属第三医院治疗的Ⅰ~Ⅳ期肝细胞癌患者, 入组的所有患者在治疗后1、3、6、9和12个月进行甲胎蛋白(AFP)以及影像学评估检查;同时抽取患者外周血进行血浆循环肿瘤DNA(ctDNA)甲基化检测, 比较患者治疗后血浆中游离BMPR1A和PLAC8基因甲基化检测结果以及传统肿瘤标志物AFP检测的阳性率。采用受试者工作特征(ROC)曲线分析该方法对肝细胞癌复发的预测效能, 并根据游离DNA甲基化结果阳性和阴性, 以及AFP是否大于7 μg/L, 分别将肝细胞癌患者划分为甲基化高风险组(12例)、甲基化低风险组(21例)、AFP高风险组(15例)和AFP低风险组(18例), 进行Kaplan-Meier生存分析。结果联合检测血浆中游离BMPR1A、PLAC8基因甲基化对肝癌复发预测的敏感度为66.7%, 特异度为88.9%, ROC曲线分析BMPR1A、PLAC8基因甲基化检测肝癌复发的曲线下面积为0.770和0.778, AFP为0.522;相比影像学检查, 游离DNA甲基化检测平均可以提前58.3 d检测出肝细胞癌的复发(53.8 d比112.1d)。基于游离DNA甲基化预测的高风险组400 d的无进展生存率为22.2%, 低于低风险组(76.2%, P<0.001)。结论相比于AFP, 检测BMPR1A、PLAC8基因甲基化能更准确地预测肝细胞癌的复发, 可成为一种实用的监测肝癌复发的方法。

关键词： DNA甲基化循环肿瘤DNA 肝肿瘤复发

Multi-omics combined test performance effectiveness on opportunistic screening of high-risk liver cancer population

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China Medical Abstracts(Internal Medicine) 2024年第2期41卷 110-110页

作者：谢婵 Dept Infect Dis 3rd Affil HospSun Yat-Sen UnivGuangzhou 510630

Objective To validate the performance of a multiomics combined test for early screening of high-risk liver cancer *** 173 high-risk patients with liver cancer were prospectively screened in a real-world setting,and 164 cases were finally enrolled.B-ultrasound,alpha-fetoprotein(AFP),and HCC screens were conducted in all the patients.A multi-omics early screeninggtestwas performed for liver cancer in combination with multi-gene methylation,TP53/TERT/CTNNB1 mutations,AFP,and abnormal prothrombin(PIVKA-II).Differences in rates were compared using the chi-square test,adjusted chi-square test,or Fisher's exact probabilityymethod forcount data.

关键词： cancer liver performance

多组学联合检测可对肝癌高危人群进行有效机会性筛查

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中华肝脏病杂志 2024年第2期32卷 140-147页

作者：谢婵林炳亮邓洪张晓红赵绮毅高志良中山大学附属第三医院感染性疾病科中山大学附属第三医院肝脏病医院广州510630 广东省肝脏疾病研究重点实验室广州川510630

目的拟验证一项多组学联合检测在肝癌高危人群进行肝癌早筛的性能。方法在真实世界环境下前瞻性筛选173例肝癌高危患者,最后入组164例患者。所有患者均行B超、甲胎蛋白(AFP)和HCCscreen检测。HCCscreen检测是一项合并多基因甲基化、TP53... 详细信息

目的拟验证一项多组学联合检测在肝癌高危人群进行肝癌早筛的性能。方法在真实世界环境下前瞻性筛选173例肝癌高危患者,最后入组164例患者。所有患者均行B超、甲胎蛋白(AFP)和HCCscreen检测。HCCscreen检测是一项合并多基因甲基化、TP53/TERT/CTNNB1突变、AFP和异常凝血酶原(PIVKA-Ⅱ)的多组学肝癌早筛检测。计数资料使用χ^(2)检验、校正χ^(2)检验或Fisher精确概率法比较率的差异;等级资料使用非参数检验(Mann-Whitney)法比较两组数据间的差异。结果HCCscreen检测对肝癌的筛查灵敏度为100%,对肝癌及癌前疾病的筛查灵敏度为93.8%,阳性预测值34.1%,阴性预测值99.2%,曲线下面积(AUC)为0.89。平行检测的AFP、AFP+B超和甲基化+突变的灵敏度/特异度及AUC分别为31.3%/88.5%(AUC=0.78)、56.3%/88.2%(AUC=0.86)和81.3%/82.4%(AUC=0.84)。同时,疾病严重程度与甲基化+突变评分、HCCscreen评分或阳性检出率存在显著相关性。虽然AFP血清水平与甲基化+突变或HCCscreen评分之间没有显著相关性,但甲基化+突变评分与HCCscreen评分之间存在显著的线性相关性(r=0.73,P<0.001)。结论在真实世界机会性筛查条件下,HCCscreen显示出对肝癌高危人群筛查高灵敏度,可有效发现肝癌及癌前疾病,其表现优于AFP及AFP+B超。HCCscreen有潜力成为优于现有筛查方法的肝癌高危人群的有效筛查工具。

关键词：肝细胞癌基因突变筛查肿瘤生物标志物 DNA甲基化早期诊断

乙型肝炎病毒DNA载量对晚期肝细胞癌系统治疗安全性及预后的影响

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中华医学杂志 2024年第14期104卷 1160-1167页

作者：郑杏容彭建新宋欣刘波钟崇陈希瑶张博翔彭亮朱康顺谢婵中山大学附属第三医院感染性疾病科，广州510630 广州中医药大学第二附属医院肝胆外科，广州510120 中山大学附属第三医院普外科，广州510630 广州中医药大学第一附属医院肝胆外科，广州510405 广州医科大学附属第二医院微创介入科介入放射学实验室，广州510260

目的观察乙型肝炎(乙肝)病毒(HBV)阳性对接受系统治疗的晚期肝细胞癌(肝癌)患者发生肝损害、HBV再激活(HBVr)及HBVr对系统治疗预后的影响。方法回顾性收集2018年7月至2020年12月中山大学附属第三医院等4家医院403例乙肝相关肝癌患者的... 详细信息

目的观察乙型肝炎(乙肝)病毒(HBV)阳性对接受系统治疗的晚期肝细胞癌(肝癌)患者发生肝损害、HBV再激活(HBVr)及HBVr对系统治疗预后的影响。方法回顾性收集2018年7月至2020年12月中山大学附属第三医院等4家医院403例乙肝相关肝癌患者的临床资料,分析系统治疗期间肝损害及HBVr发生率,并分析HBVr对生存预后的影响。结果共纳入403例患者,359例(89.1%)为男性,年龄(51.5±12.1)岁。进行倾向性评分匹配(PSM)前,高HBV-DNA(基线HBV-DNA>1000 U/ml,n=147)组与低HBV-DNA(基线HBV DNA≤1000 U/ml,n=256)组相比,肝硬化、TNM及巴塞罗那分期(BCLC)晚期患者比例较高(P0.05)。对169例有生存数据的患者进行生存分析,发现高HBV-DNA组和低HBV-DNA组的中位总生存期(OS)分别为11.49个月(95%CI:7.77~12.89)和16.65个月(95%CI:10.54~21.99,P=0.008),中位无进展生存期(PFS)分别为7.41个月(95%CI:5.06~8.67)和10.55个月(95%CI:6.72~13.54,P=0.038),差异均有统计学意义,但有无HBVr、有无肝损害的患者OS和PFS差异均无统计学意义(均P>0.05)。结论系统治疗前HBV-DNA>1000 U/ml并不增加乙肝相关肝癌患者系统治疗时肝损害或HBVr的风险,该类患者可以安全地接受系统治疗。

关键词：免疫治疗肝细胞癌慢性乙型病毒性肝炎安全性

Interplay of laser power and pore characteristics in selective laser melting of ZK60 magnesium alloys:A study based on in-situ monitoring and image analysis

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Journal of Magnesium and Alloys 2024年第4期12卷 1346-1366页

作者： Weijie xie Hau-Chung Man Chi-Wai chan Department of Industrial and Systems Engineering The Hong Kong Polytechnic UniversityHong KongChina School of Mechanical and Aerospace Engineering Queen’s UniversityBelfast BT95AHUK Research Institute for Advanced Manufacturing The Hong Kong Polytechnic UniversityHong KongChina

This study offers significant insights into the multi-physics phenomena of the SLM process and the subsequent porosity characteristics of ZK60 Magnesium(Mg)***-speed in-situ monitoring was employed to visualise process signals in real-time,elucidating the dynamics of melt pools and vapour plumes under varying laser power conditions specifically between 40 W and 60 *** morphological analysis was performed using Scanning-Electron Microscopy(SEM),demonstrating a critical correlation between laser power and pore *** laser power led to increased pore coverage,whereas a denser structure was observed at higher laser *** laser power influence on porosity was further confirmed via Optical Microscopy(OM)conducted on both top and cross-sectional surfaces of the *** increase in laser power resulted in a decrease in pore coverage and pore size,potentially leading to a denser printed part of Mg alloy.X-ray Computed Tomography(XCT)augmented these findings by providing a 3D volumetric representation of the sample internal structure,revealing an inverse relationship between laser power and overall pore *** laser power appeared to favour the formation of interconnected pores,while a reduction in interconnected pores and an increase in isolated pores were observed at higher *** interplay between melt pool size,vapour plume effects,and laser power was found to significantly influence the resulting porosity,indicating a need for effective management of these factors to optimise the SLM process of Mg alloys.

关键词： Selective laser melting(SLM) Magnesium(Mg)alloys Biodegradable implants Porosity In-situ monitoring

Serum from Acute-on-chronic Liver Failure Patients May Affect Mesenchymal Stem Cells Transplantation by Impairing the Immunosuppressive Function of Cells

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Journal of Clinical and Translational Hepatology 2021年第4期9卷 503-513页

作者： Yongyuan Zheng Shu Zhu Xingrong Zheng Wenxiong Xu Xuejun Li Jianguo Li Zhiliang Gao chan xie Liang Peng Department of Infectious Diseases The Third Affiliated Hospital of Sun Yat-sen UniversityGuangzhouGuangdongChina Guangdong Province Key Laboratory of Liver Disease Research The Third Affiliated Hospital of Sun Yat-sen UniversityGuangzhouGuangdongChina

Background and Aims:The safety and efficacy of mesenchymal stem cells(MSCs)in the treatment of acute-onchronic liver failure(ACLF)have been ***,the impact of the pathological ACLF microenvironment on MSCs is less well *** study was designed to explore the changes in the functional properties of MSCs exposed to ACLF ***:MSCs were cultured in the presence of 10%,30%and 50%serum concentrations from ACLF patients and healthy ***,the cell morphology,phenotype,apoptosis and proliferation of MSCs were evaluated,including the immunosuppressive ***,mRNA sequencing analysis was used to identify the molecules and pathways involved in MSC functional changes in the context of ***:In the presence of ACLF serum,MSC morphology significantly changed but phenotype did ***,MSC proliferation activity was weakened,while the apoptosis rate was lightly *** importantly,the immunosuppressive function of MSCs was enhanced in a lowconcentration serum environment but transformed into a proinflammatory response in a high-concentration serum *** sequencing indicated that 10%serum concentration from ACLF patients mediated the PI3K-Akt pathway to enhance the anti-inflammatory effect of MSCs,while the 50%serum concentration from ACLF patients promoted the conversion of MSCs into a proinflammatory function by affecting the cell ***:The 50%ACLF serum concentration is more similar to the environment in the human body,which means that direct peripheral blood intravenous infusion of MSCs may reduce the effect of *** treatments of plasma exchange to reduce harmful substances in serum may promote MSCs to exert a stronger anti-inflammatory effect.

关键词： Mesenchymal stem cells Acute-on-chronic liver failure Immu-nomodulatory Cell therapy Microenvironment

Key Technologies and Prospects for Electric Vehicles Within Emerging Power Systems: Insights from Five Aspects

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CSEE Journal of Power and Energy Systems 2024年第2期10卷 439-447页

作者： Yalun Li Minggao Ouyang C.C.chan Xueliang Sun Yonghua Song Wei Cai Yilin xie Yuqiong Mao Department of Electrical Engineering and School of Vehicle and MobilityTsinghua UniversityBeijing 100084China School of Vehicle and Mobility Tsinghua UniversityBeijing 100084China Department of Electrical and Electronic Engineering The University of Hong KongHong Kong 999077China Department of Mechanical and Materials Engineering University of Western OntarioLondonON N6A 3K7Canada State Key Laboratory of Internet of Things for Smart City University of MacaoTaipaMacao 999078China Department of Electrical Engineering Tsinghua UniversityBeijing 100084China School of Electrical and Electronic Engineering Harbin University of Science and TechnologyHarbin 150080China

The energy revolution requires coordination in energy consumption, supply, storage and institutional *** energy generation technologies, along with their associated costs, are already fully equipped for large-scale ***, energy storage remains a bottleneck, and solutions areneeded through the use of electric vehicles, which traditionallyplay the role of energy consumption in power systems. Toclarify the key technologies and institutions that support EVsas terminals for energy use, storage, and feedback, the CSEEJPES forum assembled renowned experts and scholars in relevantfields to deliver keynote reports and engage in discussions ontopics such as vehicle–grid integration technology, advancedsolid-state battery technology, high-performance electric motortechnology, and institutional innovation in the industry *** experts also provided prospects for energy storage andutilization technologies capable of decarbonizing new powersystems.

关键词： Electric vehicles engineering philosophy highpower density motor new power system solid state batteries vehicle grid integration.

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终末期肝病肌少症及其营养干预研究进展

西南医科大学学报 2024年第1期47卷 15-19页

作者：李智鹏朱姝罗秋敏许文雄张烨琼郑杏容谢婵彭亮中山大学附属第三医院感染性疾病科广州510630 广东省肝脏病重点实验室广州510630

近几十年,肌少症一直是医学研究的热点。由于营养不良和肝-肌轴中多种代谢介质变化等因素,肌少症常见于终末期肝病患者,与肝硬化失代偿、死亡及移植后不良事件等结局相关。CT检查是评估终末期肝病患者肌肉含量减少的金标准。目前,运动... 详细信息

近几十年,肌少症一直是医学研究的热点。由于营养不良和肝-肌轴中多种代谢介质变化等因素,肌少症常见于终末期肝病患者,与肝硬化失代偿、死亡及移植后不良事件等结局相关。CT检查是评估终末期肝病患者肌肉含量减少的金标准。目前,运动训练及营养干预是肌少症的主要治疗措施。相比于运动训练,营养干预对晚期肝病患者更切实可行。因此,本文对肌少症的定义、机制、诊断以及营养干预进行评述,以期为终末期肝病患者肌少症营养干预提供借鉴和参考。

关键词：终末期肝病肌少症营养干预

Double Plasma Molecular Adsorption System with Sequential Low-dose Plasma Exchange in Patients with Hepatitis B Virus-related Acute-on-chronic Liver Failure:A Prospective Study

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Journal of Clinical and Translational Hepatology 2023年第4期11卷 908-917页

作者： Lu Wang Wenxiong Xu Shu Zhu Guoli Lin Jing Lai Yufeng Zhang Ying Liu Lihua Zheng Qiumin Luo Zhiliang Gao chan xie Liang Peng Second School of Clinical Medicine Binzhou Medical UniversityYantaiShandongChina Department of Infectious Diseases Third Affiliated Hospital of Sun Yat-Sen UniversityGuangzhouGuangdongChina Key Laboratory of Tropical Disease Control(Sun Yat-sen University) Ministry of EducationGuangzhouGuangdongChina

Background and Aims:To investigate the safety and efficacy of double plasma molecular adsorption system(DPMAS)with sequential low-dose plasma exchange(LPE)in treating early hepatitis B virus-related acute-on-chronic liver failure(HBV-ACLF).Methods:Clinical data of patients with HBVACLF were prospectively collected,including patients in a DPMAS with sequential LPE(DPMAS+LPE)group and those in a standard medical treatment(SMT)*** primary endpoint was death or liver transplantation(LT)at 12 weeks of ***-score matching was performed to control the effects of confounding factors on prognosis between the two ***:After 2 weeks,total bilirubin,alanine aminotransferase,blood urea nitrogen levels,and Chinese Group on the Study of Severe Hepatitis B score,were significantly lower in the DPMAS+LPE group than those in the SMT group(p<0.05).After 4 weeks,laboratory parameters of the two groups were *** cumulative survival rate of the DPMAS+LPE group was significantly higher than that of the SMT group at 4 weeks(97.9%vs.85.4%,p=0.027),but not at 12 weeks(85.4%vs.83.3%,p=0.687).Cytokine levels were significantly lower in 12-week survival group than in the death-or-LT group(p<0.05).Functional enrichment analysis showed that downregulated cytokines were mainly involved in positive regulation of proliferation and activation of lymphocytes and monocytes,regulation of immune effect response,regulation of endotoxin response,and glial cell ***:DPMAS+LPE significantly improved the 4-week cumulative survival rate,and ameliorated the inflammatory response in ***+LPE may be a promising modality for patients with early HBV-ACLF.

关键词： Plasma exchange Double plasma molecular adsorption system Acute-on-chronic liver failure Prognosis