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Details determining the success in establishing a mouse orthotopic liver transplantation model

World Journal of Gastroenterology 2020年第27期26卷 3889-3898页

作者： Ting Li Zheng Hu Lei Wang guo-yue lv Department of Hepatobiliary and Pancreatic Surgery The First Hospital of Jilin UniversityChangchun 130021Jilin ProvinceChina Key Laboratory of Organ Regeneration and Transplantation of Ministry of Education The First Hospital of Jilin UniversityChangchun 130061Jilin ProvinceChina National-Local Joint Engineering Laboratory of Animal Models for Human Diseases Changchun 130061Jilin ProvinceChina Department of Gastrointestinal Surgery The First Hospital of Jilin UniversityChangchun 130021Jilin ProvinceChina

Liver transplantation(LT)is currently the only effective treatment option for endstage liver *** importance of animal models in transplantation is widely recognized among *** of the well-characterized mouse genome and the greater diversity and availability of both genetically modified animals and research reagents,mouse orthotopic LT(MOLT)has become an ideal model for the investigation of liver biology,tissue injury,regulation of alloimmunity and tolerance induction,and the pathogenesis of specific liver ***,due to its complicated and technically demanding procedure,the model has merely been used by only a few research groups in the world for *** a new learner,training lasting at least a couple of months or even years is *** of the investigators have emphasized the importance of elaborate techniques and dedicated instruments in establishing a MOLT model,but some details are often *** nontechnical details are also significant,especially for researchers who have little experience in mouse ***,we review and summarize the crucial technical and nontechnical details in establishing the model of MOLT based on scientific articles and our experience in six aspects:animal selection,anesthesia,perioperative management,organ procurement,back-table preparation,and implantation *** aim to enable research groups to shorten the learning curve and implement the mouse LT procedure with high technical success.

关键词： Mouse orthotopic liver transplantation Animal selection Anesthesia Perioperative management Organ procurement Back-table preparation Implantation surgery

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Intra-arterial thrombolysis for early hepatic artery thrombosis after liver transplantation

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World Journal of Clinical Cases 2021年第7期9卷 1592-1599页

作者： Ting Li Xiao-Dong Sun Ying Yu guo-yue lv Department of Hepatobiliary and Pancreatic Surgery The First Hospital of Jilin UniversityChangchun 130021Jilin ProvinceChina

BACKGROUND Early hepatic artery thrombosis(E-HAT)is a serious complication after liver transplantation(LT),which often results in graft failure and can lead to patient *** such as re-transplantation and re-anastomosis are conventional therapeutic methods which are restricted by the shortage of donors and the patient’s postoperative intolerance to *** to the advances in interventional techniques and thrombolytics,endovascular treatments are increasingly being selected by more and more *** study reviews and reports our single-center experience with intra-arterial thrombolysis as the first choice therapy for E-HAT after deceased donor *** To evaluate the feasibility and reasonability of intra-arterial thrombolysis for EHAT after deceased donor *** A total of 147 patients who underwent deceased donor LT were retrospectively reviewed in our hospital between September 2011 and December *** patients were diagnosed with *** of these patients underwent intraarterial thrombolysis with alteplase as the first choice therapy after *** method of arterial anastomosis and details of the diagnosis and treatment of EHAT were *** long-term prognosis of E-HAT patients was also *** median follow-up period was 26 mo(range:23 to 30 mo).RESULTS The incidence of E-HAT was 2.7%(4/147).E-HAT was considered when Doppler ultrasonography showed no blood flow signals and a definite diagnosis was confirmed by immediate hepatic arterial angiography when complete occlusion of the hepatic artery was *** patients were given temporary thrombolytics(mainly alteplase)via a 5-Fr catheter which was placed in the proximal part of the thrombosed hepatic artery followed by continuous alteplase using an infusion *** dose was adjusted according to activated clotting *** recanalization rate of intra-arterial thrombolysis in our study was 100%(4/4)and no thrombolysis-related mortality was *** the f

关键词： Early hepatic artery thrombosis Liver transplantation Intra-arterial thrombolysis Thrombolytics Hepatic arterial angiography Prognosis

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Conversion therapy in liver transplantation for hepatocellular carcinoma:What's new in the era of molecular and immune therapy?

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Hepatobiliary & Pancreatic Diseases International 2023年第1期22卷 7-13页

作者： Chao Jiang Xiao-Dong Sun Wei Qiu Yu-guo Chen Da-Wei Sun guo-yue lv General Surgery Center Department of Hepatobiliary and Pancreatic Surgerythe First Hospital of Jilin UniversityChangchun 130021China

Background:Hepatocellular carcinoma(HCC)is the sixth most common cancer globally,with limited therapies and unsatisfactory prognosis once in the advanced *** promising advances in locoregional and systematic treatments,fast development of targeted drugs,the success of immunotherapy,as well as the emergence of the therapeutic alliance,conversion therapy has recently become more well developed and an effective therapeutic *** article aimed to review recent developments in conversion therapy in liver transplantation(LT)for *** sources:We searched for relevant publications on Pub Med before September 2022,using the terms“HCC”,“liver transplantation”,“downstaging”,“bridging treatment”and“conversion therapy.”Results:Conversion therapy was frequently represented as a combination of multiple treatment modalities to downstage HCC and make patients eligible for *** combining various local and systematic treatments in conversion therapy is still controversial,growing evidence has suggested that multimodal combined treatment strategies downstage HCC in a shorter time,which ultimately increases the opportunities for ***,the recent breakthrough of immunotherapy and targeted therapy for HCC also benefit patients with advanced-stage ***:In the era of targeted therapy and immunotherapy,applying the thinking of transplant oncology to benefit HCC patients receiving LT is a new topic that has shed light on advanced-stage *** the expansion of conversion therapy concepts,further investigation and research is required to realize the full potential of conversion treatment strategies,including accurately selecting candidates,determining the timing of surgery,improving the conversion rate,and guaranteeing the safety and long-term efficacy of treatment.

关键词： Liver transplantation Hepatocellular carcinoma Conversion therapy Targeted therapy Immunotherapy Combination therapy

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Sclerosing angiomatoid nodular transformation of the spleen: A case report and literature review

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World Journal of Clinical Cases 2021年第1期9卷 211-217页

作者： Shu-Xuan Li Ye-Hui Fan Hao Wu guo-yue lv Department of Hepatobiliary and Pancreatic Surgery First Hospital of Jilin UniversityChangchun 130021Jilin ProvinceChina Department of The First Operation Room First Hospital of Jilin UniversityChangchun 130021Jilin ProvinceChina

BACKGROUND Sclerosing angiomatoid nodular transformation(SANT)is a rare disease of the *** has unique pathological features and mimics splenic tumor on radiological *** SUMMARY A 47-year-old woman was incidentally found to have a splenic mass on abdominal *** had a 10-cm postoperative scar in the lower abdomen due to previous cesarean *** patient had a past history of anemia of unknown etiology for 20 *** patient underwent laparoscopic *** postoperative course was uneventful,with a hospital stay of 7 *** histopathological examination of the spleen revealed *** the 6-mo followup,the patient remained *** SANT is a rare benign disease mimicking a malignant tumor.A definitive diagnosis can be made only on histopathology.

关键词： Splenic neoplasms Sclerosing angiomatoid nodular transformation Spleen Case report

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Pediatric living donor liver transplantation using liver allograft after ex vivo backtable resection of hemangioma: A case report

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World Journal of Clinical Cases 2022年第12期10卷 3834-3841页

作者： Shu-Xuan Li He-Nan Tang guo-yue lv Xuan Chen Department of Hepatobiliary and Pancreatic Surgery the First Hospital of Jilin UniversityChangchun 130021Jilin ProvinceChina Department of Neurosurgery the First Hospital of Jilin UniversityChangchun 130021Jilin ProvinceChina

BACKGROUND Use of liver allograft with hepatic hemangioma after in vivo resection of hemangioma in living donor liver transplantation(LDLT)has been previously ***,there are few reports describing ex vivo backtable resection of hemangioma from liver allografts in *** SUMMARY A 55-year-old male was evaluated as a donor for an 8-month-year old patient with acute hepatic failure due to biliary ***-operative contrast enhanced computed tomography revealed a 9 cm hemangioma in segment 4 with vascular variations in the *** LDLT,an intra-operative intrahepatic cholangiography was performed to ensure no variation in the anatomy of the intrahepatic bile *** intra-operative pathological diagnosis,ex vivo backtable resection of the hemangioma was performed and the liver allograft was transplanted into the *** donor’s and recipient’s post-operative course were *** the 2-year follow-up,the liver allograft showed good regeneration without any recurrence of *** Liver allografts with hemangiomas are an acceptable alternative strategy for *** vivo backtable resection of hemangioma from the donor liver during pediatric LDLT is safe and feasible,and can effectively reduce the operative time and intra-operative bleeding for the donor.

关键词： Hemangioma Liver allograft ex vivo resection Backtable resection Pediatric living donor liver transplantation Case report

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Surgical treatment of abnormal systemic artery to the left lower lobe: A case report

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World Journal of Clinical Cases 2021年第27期9卷 8192-8198页

作者： Yi-Yuan Zhang Xiao-Ying Gu Jia-Lin Li Zhao Liu guo-yue lv Department of Thoracic Surgery The First Hospital of Jilin UniversityChangchun 130021Jilin ProvinceChina Department of Anesthesiology The First Hospital of Jilin UniversityChangchun 130021Jilin ProvinceChina Department of Hepatobiliary and Pancreatic Surgery The First Hospital of Jilin UniversityChangchun 130021Jilin ProvinceChina

BACKGROUND Abnormal systemic artery to the left lower lobe is a rare congenital abnormality characterized by anomalous communication between the systemic and pulmonary *** to its rarity,there is limited clinical experience with respect to the diagnosis and treatment of this *** SUMMARY We report a 60-year-old man who presented with a history of hemoptysis for 20 ***-enhanced computed tomography of the chest confirmed the diagnosis of abnormal systemic artery to the left lower lobe,and surgical treatment was *** aberrant artery arising from the descending thoracic aorta was ligated,followed by removal of the left lower *** patient showed good recovery and was discharged 6 d after the *** the 1-year follow-up,the patient had recovered completely,and lung CT showed no abnormal *** We present a case of abnormal systemic artery to the left lower lobe that was successfully managed by surgical resection of the aberrant artery and the left lower *** case report adds to the clinical experience of diagnosing and treating this rare entity.

关键词： Abnormal systemic artery to the left lower lobe Diagnosis and treatment Surgery Rare disease Computed tomography Case report

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Feasible management of median arcuate ligament syndrome in orthotopic liver transplantation recipients

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World Journal of Gastrointestinal Surgery 2022年第9期14卷 976-985页

作者： Shu-Xuan Li Ye-Hui Fan Guang-Yao Tian guo-yue lv Department of Hepatobiliary and Pancreatic Surgery The First Hospital of Jilin UniversityChangchun 130021Jilin ProvinceChina Department of The First Operation Room The First Hospital of Jilin UniversityChangchun 130021Jilin ProvinceChina

BACKGROUND In orthotopic liver transplantation(OLT)recipients,median arcuate ligament syndrome(MALS)is considered a risk factor for hepatic arterial thrombosis(HAT),which is dreadful for OLT *** alternative surgical procedures have been proposed to overcome the impact of MALS on transplantation,but clinical evidence is still *** To evaluate the feasible surgical management of MALS to reduce complications in OLT *** Data for 288 consecutive patients who underwent OLT at The First Hospital of Jilin University between January 2017 and July 2020 were retrospectively *** surgical management of median arcuate ligament(MAL)and modifications to the arterial anastomosis were *** perioperative and long-term prognosis of MALS recipients were *** preoperative and postoperative data of patients were analyzed in a descriptive *** Eight patients with MALS were included in this *** first patient with MALS received no intervention during the primary surgery and developed postoperative *** liver transplantation with MAL division was successfully *** artery(GDA)preservation with splenic artery ligation was performed on three patients,only GDA preservation was performed on two patients,and no intervention was performed on two *** patient developed HAT after surgery and postoperative recovery was *** The preservation of collateral circulation between the superior mesenteric artery and celiac trunk via the GDA with or without splenic artery ligation is a safe and feasible alternative to MAL division.

关键词： Orthotopic liver transplantation Median arcuate ligament syndrome Surgical complications Surgical management Hepatic artery thrombosis

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Hepatic epithelioid hemangioendothelioma:Update on diagnosis and therapy

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World Journal of Clinical Cases 2020年第18期8卷 3978-3987页

作者： Kai Kou Yu-guo Chen Jian-Peng Zhou Xiao-Dong Sun Da-Wei Sun Shu-Xuan Li guo-yue lv Department of Hepatobiliary and Pancreatic Surgery The First Hospital of Jilin UniversityChangchun 130021Jilin ProvinceChina

With an estimated incidence of only 1-2 cases in every 1 million people,hepatic epithelioid hemangioendothelioma(HEHE)is a rare vascular endothelial cell tumor occurring in the liver and consisting of epithelioid and histiocyte-like vascular endothelial cells in mucus or a fibrotic *** is characterized as a low-to-moderate grade malignant tumor and is classified into three types:solitary,multiple,and *** the etiology and characteristic clinical manifestations of HEHE are ***,HEHE has a characteristic appearance on imaging including ultrasound,magnetic resonance imaging,and positron emission tomography/computerized ***,its diagnosis depends mainly on pathological findings,with immunohistochemical detection of endothelial markers cluster of differentiation 31(CD31),CD34,CD10,vimentin,and factor VIII antigen as the basis of *** and/or liver transplantation are the first choice for treatment,but various chemotherapeutic drugs are reportedly effective,providing a promising treatment *** this review,we summarize the literature related to the diagnosis and treatment of HEHE,which provides future perspectives for the clinical management of HEHE.

关键词： Hepatic epithelioid hemangioendothelioma Diagnosis Differential diagnosis Therapy Prognosis Imaging

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Drainage fluid and serum amylase levels accurately predict development of postoperative pancreatic fistula

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World Journal of Gastroenterology 2017年第34期23卷 6357-6364页

作者： Shuo Jin Xiao-Ju Shi Si-Yuan Wang Ping Zhang guo-yue lv Xiao-Hong Du Guang-Yi Wang School of Clinical Medicine Tsinghua University Department of Hepatobiliary and Pancreatic Surgery Beijing Tsinghua Changgung Hospital Medical CenterTsinghua University Department of Hepatobiliary and Pancreatic Surgery Bethune First Hospital of Jilin University Department of Respiratory and Critical Care Medicine Beijing Chao-yang Hospital Affiliated to Capital Medical University

AIM To investigate potential biomarkers for predicting postoperative pancreatic fistula( POPF) after pancreaticoduodenectomy(PD).METHODS We prospectively recruited 83 patients to this study. All patients underwent PD(Child's procedure) at the Division of Hepatobiliary and Pancreas Surgery at the First Bethune Hospital of Jilin University between June 2011 and April 2015. Data pertaining to demographic variables, clinical characteristics, texture of pancreas, surgical approach, histopathological results, white blood cell count, amylase and choline levels in the serum, pancreatic/gastric drainage fluid, and choline and amylase levels in abdominal drainage fluid were included in the analysis. Potential correlations between these parameters and postoperative complications such as, POPF, acute pancreatitis, hemorrhage, delayed gastric emptying, and biliary fistula, were assessed. RESULTS Twenty-eight out of the 83(33.7%) patients developed POPF. The severity of POPF was classified as Grade A in 8(28%) patients, grade B in 16(58%), and grade C in4(14%), according to the pancreatic fistula criteria. On univariate and multivariate logistic regression analyses, higher amylase level in the abdominal drainage fluid on postoperative day(POD)1 and higher serum amylase levels on POD4 showed a significant correlation with POPF(P < 0.05). On receiver operating characteristic curve analysis, amylase cut-off level of 2365.5 U/L in the abdominal drainage fluid was associated with a 78.6% sensitivity and 80% specificity [area under the curve(AUC): 0.844; P = 0.009]. A cut-off serum amylase level of 44.2 U/L was associated with a 78.6% sensitivity and 70.9% specificity(AUC: 0.784; P = 0.05).CONCLUSION Amylase level in the abdominal drainage fluid on POD1 and serum amylase level on POD4 represent novel biomarkers associated with POPF development.

关键词： Pancreaticoduodenectomy Complication Amylase Pancreatic fistula

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Cone-beam computed tomography noise reduction method based on U-Net with convolutional block attention module in proton therapy

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Nuclear Science and Techniques 2024年第7期35卷 89-100页

作者： Xing-yue Ruan Xiu-Fang Li Meng-Ya guo Mei Chen Ming lv Rui Li Zhi-Ling Chen Shanghai Institute of Applied Physics Chinese Academy of SciencesShanghai201800China University of Chinese Academy of Sciences Beijing100049China Shanghai Advanced Research Institute Chinese Academy of SciencesShanghai201210China Department of Radiation Oncology Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghai200025China Shanghai Key Laboratory of Proton therapy Shanghai201801China

Cone-beam computed tomography(CBCT) is mostly used for position verification during the treatment process. However,severe image artifacts in CBCT hinder its direct use in dose calculation and adaptive radiation therapy re-planning for proton therapy. In this study, an improved U-Net neural network named CBAM-U-Net was proposed for CBCT noise reduction in proton therapy, which is a CBCT denoised U-Net network with convolutional block attention modules. The datasets contained 20 groups of head and neck images. The CT images were registered to CBCT images as ground truth. The original CBCT denoised U-Net network, sCTU-Net, was trained for model performance comparison. The synthetic CT(SCT) images generated by CBAM-U-Net and the original sCTU-Net are called CBAM-SCT and U-Net-SCT images, respectively. The HU accuracies of the CT, CBCT, and SCT images were compared using four metrics: mean absolute error(MAE), root mean square error(RMSE), peak signal-to-noise ratio(PSNR), and structure similarity index measure(SSIM). The mean values of the MAE, RMSE, PSNR, and SSIM of CBAM-SCT images were 23.80 HU, 64.63 HU, 52.27 dB, and 0.9919, respectively,which were superior to those of the U-Net-SCT images. To evaluate dosimetric accuracy, the range accuracy was compared for a single-energy proton beam. The γ-index pass rates of a 4 cm × 4 cm scanned field and simple plan were calculated to compare the effects of the noise reduction capabilities of the original U-Net and CBAM-U-Net on the dose calculation results. CBAM-U-Net reduced noise more effectively than sCTU-Net, particularly in high-density tissues. We proposed a CBAM-U-Net model for CBCT noise reduction in proton therapy. Owing to the excellent noise reduction capabilities of CBAM-U-Net, the proposed model provided relatively explicit information regarding patient tissues. Moreover, it maybe be used in dose calculation and adaptive treatment planning in the future.

关键词： Proton therapy Cone-beam CT CBAM-U-Net γ-index

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