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Progress in bioreactors of bioartificial livers

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Hepatobiliary & Pancreatic Diseases International 2009年第2期8卷 134-140页

作者： Yu, Cheng-Bo Pan, Xiao-Ping li, lan-juan Zhejiang Univ Sch Med Affiliated Hosp 1 State Key Lab Diag & Treatment Infect Dis Hangzhou 310003 Zhejiang Peoples R China

BACKGROUND: Bioartificial liver support systems are becoming an effective therapy for hepatic failure. Bioreactors, as key devices in these systems, can provide a favorable growth and metabolic environment, mass exchange, and immunological isolation as a platform. Currently, stagnancy in bioreactor research is the main factor restricting the development of bioartificial liver support systems. DATA SOURCES: A PubMed database search of English-language literature was performed to identify relevant articles using the keywords 'bioreactor', 'bioartificial liver', 'hepatocyte', and 'liver failure'. More than 40 articles related to the bioreactors of bioartificial livers were reviewed. RESULTS: Some progress has been made in the improvement of structures, functions, and modified macromolecular materials related to bioreactors in recent years. The current data on the improvement of bioreactor configurations for bioartificial livers or on the potential of the use of certain scaffold materials in bioreactors, combined with the clinical efficacy and safety evaluation of cultured hepatocytes in vitro, indicate that the AMC (Academic Medical Center) BAL bioreactor and MELS (modular extracorporeal liver support) BAL bioreactor system can partly replace the synthetic and metabolic functions of the liver in phase I clinical studies. In addition, it has been indicated that the microfluidic PDMS (polydimethylsiloxane) bioreactor, or SlideBioreactor, and the microfabricated grooved bioreactor are appropriate for hepatocyte culture, which is also promising for bioartificial livers. Similarly, modified scaffolds can promote the adhesion, growth, and function of hepatocytes, and provide reliable materials for bioreactors. CONCLUSIONS: Bioreactors, as key devices in bioartificial livers, play an important role in the therapy for liver failure both now and in the future. Bioreactor configurations are indispensable for the development of bioartificial livers used for liver failure, just as

关键词： bioreactor bioartificial liver hepatocyte liver failure

Transformation of the Chinese medical and health development： from the perspective of the public hospital reform

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Chinese Medical Journal 2012年第16期125卷 2933-2941页

作者： ZHOU Yi li lan-juan School of Medicine Zhejiang UniversityHangzhouZhejiang 310058China

The mistakes of ＂Old healthcare reform＂ lead to bad consequences： the contradiction between the reducing government investment and the rising costs of medical treatment, the contradiction between the nature of the public welfare and the marketization of hospitals, and the contradiction between the unlimited demand growth for medical services and the scarcity of qualified medical resources. The causes of the failure of ＂old healthcare reform＂ are the loss of market-oriented reform and the decadence of medical tenet.

关键词： healthcare reform," public hospital," transformation policy

New medical reform and the sustainable development of the pharmaceutical industry in China

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Chinese Medical Journal 2013年第4期126卷 775-782页

作者： ZHOU Yi li lan-juan State Key Laboratory for Diagnosis and Treatment of Infectious Diseases First Affiliated Hospital School of Medicine Zhejiang University Hangzhou Zhejiang 310003 China

The national economy development and the demanding of the drugs request the pharmaceutical industry in China to keep sustainable development especially under the background of the new medical reform. According to the status of industry development and drug consumption in China, the trend and the driving factors for pharmaceutical industry in the future were estimated. Based on the analysis of the background and conditions for pharmaceutical industry sustainable development in China, the problems and challenges, the goal as well as the main measures for the sustainable development of pharmaceutical industry were put forward.

关键词： sustainable development pharmaceutical industry new medical reform policy environment

Enlightenment of German social health insurance system reform on China

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Chinese Medical Journal 2013年第14期126卷 2780-2785页

作者： ZHOU Yi li lan-juan State Key Laboratory for Diagnosis and Treatment of Infectious Diseases the First Affiliated Hospital School of Medicine Zhejiang University Hangzhou Zhejiang 310003 China

According to the latest Chinese Healthcare Reform .Plan, the medical insurance system is one ofthe four components of the healthcare sector. The Healthcare financing and payment in China are mainly based on medical insurance. So it is important to learn the experiences of the developed countries. This paper examines the key issues of the German Healthcare system and reforms, with a particular emphasis on basic social medical insurance, which has the broadest coverage in Germany. It reviews the evolution of the background of the German social medical insurance system, describes how the system functions, and analyzes the existing and emerging problems with the system which push the Germany government to adapt a series of reforms.

关键词： German health insurance system medical reform finance competition Chinese health insurance system

Sepsis resulting from Enterobacter aerogenes resistant to carbapenems after liver transplantation

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Hepatobiliary & Pancreatic Diseases International 2009年第3期8卷 320-322页

作者： Chen, Hao Zhang, Ying Chen, Ya-Gang Yu, Yun-Song Zheng, Shu-Sen li, lan-juan Zhejiang Univ Sch Med Dept Hepatobiliary & Pancreat Surg Affiliated Hosp 1 Hangzhou 310003 Peoples R China Zhejiang Univ Sch Med Key Lab Infect Dis Affiliated Hosp 1Publ Hlth Minist Hangzhou 310003 Peoples R China

BACKGROUND: Sepsis due to Enterobacter aerogenes (E. aerogenes) is rare after liver transplantation but is also a serious infection that may cause liver abscess. The purpose of this case report is to relate an unusual presentation of liver transplantation to show how successive treatment can be an appropriate option in septic patients after liver transplantation. METHOD: We report on a patient with liver transplantation who developed sepsis due to extended spectrum beta-lactamases and AmpC-producing E. aerogenes. RESULTS: A 39-year-old man had a biliary fistula and then was found to have multiple liver abscesses through abdominal ultrasound and an abdominal computed tomography scan, and carbapenem-sensitive E. aerogenes infection was confirmed. The patient was not successfully treated with conservative treatment consisting of intravenous carbapenems, percutaneous transhepatic cholangial drainage, and biliary stent placement by endoscopic retrograde cholangiopancreatography, so a second liver transplantation followed. Carbapenem-resistant E. aerogenes was detected in bile and blood after a five-week course of carbapenem therapy. The patient developed septic shock and multiple organ dysfunction syndrome. CONCLUSIONS: We first report an unusual case of sepsis caused by E. aerogenes after liver transplantation in China. Carbapenem-resistant E. aerogenes finally leads to uncontrolled sepsis with current antibiotics. We hypothesize that the infection developed as a result of biliary fistula and predisposing immunosuppressive agent therapy. Further research is progressing on the aspect of immunomodulation therapy. (Hepatobiliary Pancreat Dis Int 2009; 8: 320-322)

关键词： sepsis Enterobacter aerogenes carbapenem therapy

The role of intestinal microbiota,bile acids,and Th17/IL17 axis in hepatitis B virus-related liver fibrosis

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Chinese Medical Journal 2020年第24期133卷 2902-2904页

作者： Yan-Fei Chen Jiu Chen lan-juan li State Key Laboratory for Diagnosis and Treatment of Infectious Diseases National Clinical Research Center for Infectious DiseasesCollaborative Innovation Center for Diagnosis and Treatment of Infectious DiseasesDepartment of Infectious DiseasesThe First Affiliated HospitalCollege of MedicineZhejiang UniversityHangzhouZhejiang 310003China Department of Traditional Chinese Medicine The First Affiliated HospitalCollege of MedicineZhejiang UniversityHangzhouZhejiang 310003China

Hepatitis B virus(HBV)infection,which affects 90 million people in China,remains a prominent cause of liver cancer and liver cirrhosis.[1]Chronic HBV infection has a complicated course,which is a dynamic process formed by the interaction between the virus and the immune system.[2,3]Hepatic fibrosis is the basis of liver cirrhosis and liver cancer.[4]In recent years,accumulating studies have indicated potential roles of intestinal microbiota,bile acids,and T helper(Th)17/interleukin(IL)-17 axis in the process of HBV-related liver *** microbiota actively communicates with bile acids and plays an important role in the pathogenesis of HBV-related liver *** the following content,we are going to summarize current evidence of the role of intestinal microbiota,bile acids,and Th17/IL-17 axis in HBV-related liver fibrosis.

关键词： Th17 bile IL17

Safety and efficacy of omalizumab for antihistamine-resistant chronic urticaria in children:a case series and literature review

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World Journal of Pediatrics 2024年第3期20卷 294-298页

作者： Wei-Fang Zhu Chen Wang Jian-Jun Qiao lan-juan li Department of Dermatology First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China State Key Laboratory for Diagnosis and Treatment of Infectious Diseases National Clinical Research Center for Infectious DiseasesCollaborative Innovation Center for Diagnosis and Treatment of Infectious DiseasesThe First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China

Chronic urticaria(CU)is a common skin disease characterized by the occurrence of wheals,with or without angioedema,lasting more than 6 *** prevalence of CU is about 0.7%[1],but higher in children,with an incidence of 1.38%[1].The occurrence of severe pruritus and unpredictable wheals may severely impact patients'quality of life,cause psychological problems,including sleep disorders and depression,and lead to economic burden due to limitation on daily life and work[2,3].

关键词： edema prevalence children

Effects of plasma from patients with acute on chronic liver failure on function of cytochrome P450 in immortalized human hepatocytes

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Hepatobiliary & Pancreatic Diseases International 2010年第6期9卷 611-614页

作者： Du, Wei-Bo Pan, Xiao-Ping Yu, Xiao-Peng Yu, Cheng-Bo Lv, Guo-liang Chen, Yu li, lan-juan Zhejiang Univ Sch Med Affiliated Hosp 1 State Key Lab Diag & Treatment Infect Dis Hangzhou 310003 Zhejiang Peoples R China

BACKGROUND: The bioartificial liver is anticipated to be a promising alternative choice for patients with liver failure. Toxic substances which accumulate in the patients' plasma exert deleterious effects on hepatocytes in the bioreactor, and potentially reduce the efficacy of bioartificial liver devices. This study was designed to investigate the effects of plasma from patients with acute on chronic liver failure (AoCLF) on immortalized human hepatocytes in terms of cytochrome P450 gene expression, drug metabolism activity and detoxification capability. METHODS: Immortalized human hepatocytes (Hepli-2 cells) were cultured in medium containing fetal calf serum or human plasma from three patients with AoCLF. The cytochrome P450 (CYP3A5, CYP2E1, CYP3A4) expression, drug metabolism activity and detoxification capability of Hepli-2 cells were assessed by RT-PCR, lidocaine clearance and ammonia elimination assay. RESULTS: After incubation in medium containing AoCLF plasma for 24 hours, the cytochrome P450 mRNA expression of Hepli-2 cells was not significantly decreased compared with control culture. Ammonia elimination and lidocaine clearance assay showed that the ability of ammonia removal and drug metabolism remained stable. CONCLUSIONS: Immortalized human hepatocytes can be exposed to AoCLF plasma for at least 24 hours with no significant reduction in the function of cytochrome P450. Hepli-2 cells appear to be effective in metabolism and detoxification and can be potentially used in the development of bioartificial liver. (Hepatobiliary Pancreat Dis Int 2010; 9:611-614)

关键词： acute on chronic liver failure bioartificial liver immortalized human hepatocyte cytochrome P450 cell culture

Evaluation of the clinical effects of atropine in combination with remifentanil in children undergoing surgery for acute appendicitis

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World Journal of Gastrointestinal Surgery 2024年第7期16卷 2065-2072页

作者： Yu-juan li Yong-Yan Chen Xia-lan lin Wei-Zhi Zhang Department of Anesthesiology Shanxi Provincial Children’s HospitalTaiyuan 030013Shanxi ProvinceChina

BACKGROUND Acute appendicitis(AA)is the most common cause of acute abdomen in *** significantly influences the surgical treatment of AA in children,making the scientific and effective selection of anesthetics *** To assess the clinical effect of atropine(ATR)in combination with remifentanil(REMI)in children undergoing surgery for *** In total,108 cases of pediatric AA treated between May 2020 and May 2023 were selected,58 of which received ATR+REMI[research group(RG)]and 50 who received REMI[control group(CG)].Comparative analyses were conducted on the time to loss of eyelash reflex,pain resolution time,recovery time from anesthesia,incidence of adverse events(AEs;respiratory depression,hypoxemia,bradycardia,nausea and vomiting,and hypotension),intraoperative responses(head shaking,limb activity,orientation recovery,safe departure time from the operating room),hemodynamic parameters[oxygen saturation(SPO2),mean arterial pressure,heart rate,and respiratory rate],postoperative sedation score(Ramsay score),and pain level[the Face,Legs,Activity,Cry,Consolability(FLACC)Behavioral Scale].RESULTS Compared with the CG,the RG showed significantly shorter time to loss of eyelash reflex,pain resolution,recovery from anesthesia,and safe departure from the operating ***,the incidence rates of overall AEs(head shaking,limb activity,etc.)were lower,and influences on intraoperative hemodynamic parameters and stress response indexes were *** Ramsay score at 30 min after extubation and the FLACC score at 60 min after extubation were significantly lower in the RG than in the *** ATR+REMI is superior to REMI alone in children undergoing AA surgery,with a lower incidence of AEs,fewer influences on hemodynamics and stress responses,and better post-anesthesia recovery.

关键词： Atropine Remifentanil Pediatric acute appendicitis Surgery Clinical efficacy