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Functionalized Hydrogels for Articular cartilage Tissue Engineering

Engineering 2022年第6期8卷 71-90页

作者： Liangbin Zhou Peng Guo Matteo d’Este Wenxue Tong Jiankun Xu Hao Yao Martin J.Stoddart Gerjo J.v.M.van Osch Kevin Ki-Wai ho Zhen Li Ling Qin Musculoskeletal Research Laboratory of department of Orthopaedics&Traumatology Faculty of MedicineThe Chinese University of Hong KongHong Kong 999077China Innovative Orthopaedic Biomaterials and drug Translational Research Laboratory Li Ka Shing Institute of Health SciencesFaculty of MedicineThe Chinese University of Hong KongHong Kong 999077China AO Research Institute davos DavosCH 7270Switzerland Innovation Platform of Regeneration and Repair of Spinal Cord and Nerve Injury Department of Orthopaedic SurgeryThe Seventh Affiliated Hospital of Sun Yat-sen UniversityShenzhen 518000China department of Orthopaedics and Sports Medicine&department of Otorhinolaryngology Erasmus MCUniversity Medical CenterRotterdam 3000 CAthe Netherlands f Department of Biomechanical EngineeringDelft University of TechnologyDelft 2600 AAthe Netherlands Centre for Translational Medicine Research and development Shenzhen Institute of Advanced TechnologyThe Chinese Academy of SciencesShenzhen 518000China

Articular cartilage(AC)is an avascular and flexible connective tissue located on the bone surface in the diarthrodial joints.AC defects are common in the knees of young and physically active individuals.Because of the lack of suitable tissue-engineered artificial matrices,current therapies for AC defects,espe-cially full-thickness AC defects and osteochondral interfaces,fail to replace or regenerate damaged carti-lage adequately.With rapid research and development advancements in AC tissue engineering(ACTE),functionalized hydrogels have emerged as promising cartilage matrix substitutes because of their favor-able biomechanical properties,water content,swelling ability,cytocompatibility,biodegradability,and lubricating behaviors.They can be rationally designed and conveniently tuned to simulate the extracel-lular matrix of cartilage.This article briefly introduces the composition,structure,and function of AC and its defects,followed by a comprehensive review of the exquisite(bio)design and(bio)fabrication of func-tionalized hydrogels for AC repair.Finally,we summarize the challenges encountered in functionalized hydrogel-based strategies for ACTE both in vivo and in vitro and the future directions for clinical translation.

关键词： Articular cartilage Functionalized hydrogels cartilage repair cartilage tissue engineering Clinical translation

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luminescent cyclometalated iridium(Ⅲ) dipyridoquinoxaline indole complexes as biological probes

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Science China Chemistry 2010年第10期53卷 2091-2098页

作者： LO Kenneth Kam-Wing LEUNG Arthur ho-hon department of Biology and Chemistry City University of Hong Kong

Four luminescent cyclometalated iridium(Ⅲ) dipyridoquinoxaline complexes appended with an indole moiety [Ir(N^C)2(N^N)] (PF6) (HN^C = 2-phenylpyridine, Hppy; N^N = 2-(N-(2-(indole-3-acetamido)ethyl)aminocarbonyl)dipyrido[3,2-f:2′,3′-h]quinox- aline, dpqC2indole (1a), N^N = 2-(N-(6-(indole-3-acetamido)hexyl)aminocarbonyl)dipyrido[3,2-f:2′,3′-h]quinoxaline, dpqC6indole (1b); HN^C = 7,8-benzoquinoline, Hbzq, N^N = dpqC2indole (2a), N^N = dpqC6indole (2b)) have been synthesized and characterized. Upon irradiation, all the complexes displayed moderately intense and long-lived luminescence under ambient condi-tions and in 77 K glass. On the basis of the photophysical data, the emission of the complexes has been assigned to an excited state of triplet metal-to-ligand charge-transfer (3MLCT) ((dπ(Ir)→π*(N^N)) character. Cyclic voltammetric studies revealed indole-based and iridium-based oxidations at ca. +1.10 v and +1.24 v vs. SCE, respectively, and ligand-based reductions at ca. -1.07 to-2.29 v vs. SCE. The interactions of the complexes with an indole-binding protein, bovine serum albumin (Bsa), have been examined by emission titrations.

关键词： binding indole iridium luminescence probes

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Spontaneous ca2+ oscillations in subcellular compartments of vascular smooth muscle cells rely on different ca2+ pools

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Cell Research 2004年第5期14卷 379-388页

作者： Olesya d. FEdORYAK Yvonne SEARLS Irina v. SMIRNOva douglas M. BURNS Lisa STEHNO-BITTEL departments of Physical Therapy and Rehabilitation Sciences University of Kansas Medical Center Kansas City KS 66160 Usa Usa department of Anatomy and Cell Biology KS 66160 va Medical Center MO 64128

Spontaneous ca2+ oscillations in vascular smooth muscle cells have been modeled using a single ca2+ pool. This report describes spontaneous ca2+ oscillations dependent on two separate ca2+ sources for the nuclear versus cytoplas- mic compartments. Changes in free intracellular ca2+ were monitored with ratiometric ca2+- fluorophores using confo- cal microscopy. On average, spontaneous oscillations developed in 79% of rat aortic smooth muscle cells that were synchronous between the cytoplasm and nucleus. Reduction of extracellular ca2+ (decreased the frequency and amplitude of the cytoplasmic oscillations with 48% of the oscillations asynchronous between the nuclear and cytoplasmic compartments. Similar results were obtained with the ca2+ channel blockers, nimodipine and diltiazem. Arg-vasopressin (AvP) induced a rapid release of intracellular ca2+ stores that was greater in the nuclear compartment (4.20 ± 0.23 ratio units, n = 56) than cytoplasm (2.54 ± 0.28) in cells that had spontaneously developed prior oscillations. Conversely, cells in the same conditions lacking oscillations had a greater AvP-induced ca2+ transient in the cytoplasm (4.99 ± 0.66, n = 17) than in the nucleus (2.67 ± 0.29). Pre-treatment with ca2+ channel blockers depressed the AvP responses in both compartments with the cytoplasmic ca2+ most diminished. depletion of internal ca2+ stores prior to AvP exposure blunted the nuclear response, mimicking the response of cells that lacked prior oscillations. Spontaneous oscillating cells had a greater sarcoplasmic reticulum network than cells that did not oscillate. We propose that sponta- neous nuclear oscillations rely on perinuclear sarcoplasmic reticulum stores, while the cytoplasmic oscillations rely on ca2+ influx.

关键词： oscillations vascular smooth muscle cells nuclear ca2+ vasopressin thapsigargin diltiazem nimodipine.

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Laser Machined Fiber‑Based Microprobe: Application in Microscale Electroporation

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Advanced Fiber Materials 2022年第4期4卷 859-872页

作者： Jongwoon Kim Yajun Zhao Shuo Yang Ziang Feng Anbo Wang Rafael v.davalos Xiaoting Jia Bradley department of Electrical and Computer Engineering Virginia TechBlacksburgVA 24060USA department of Biomedical Engineering and Mechanics Virginia TechBlacksburgVA 24061USA

Microscale electroporation devices are mostly restricted to in vitro experiments(i.e.,microchannel and microcapillary).Novel fiber-based microprobes enable in vivo microscale electroporation and arbitrarily select the cell groups of interest to electroporate.We developed a flexible,fiber-based microscale electroporation device through a thermal drawing process and femtosecond laser micromachining techniques.The fiber consists of four copper electrodes(80μm),one microfluidic channel(30μm),and has an overall diameter of 400μm.The dimensions of the exposed electrodes and channel were customizable through a delicate femtosecond laser setup.The feasibility of the fiber probe was validated through numerical simulations and in vitro experiments.Successful reversible and irreversible microscale electroporation was observed in a 3d collagen scaffold(seeded with U251 human glioma cells)using fluorescent staining.The ablation regions were estimated by performing the covariance error ellipse method and compared with the numerical simulations.The computational and experimental results of the working fiber-based microprobe suggest the feasibility of in vivo microscale electroporation in space-sensitive areas,such as the deep brain.

关键词： Fiber probe Polymer Micromachine Irreversible electroporation Reversible electroporation Microscale electroporation

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Novel Fluorene-thiophene Copolymers and Polymer Blends for Photonic devices

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复旦学报（自然科学版） 2007年第5期46卷 623-页

作者： v.CIMROva P.PvLACKva d.vYPRACHTICKY I.KMINEK J.TOUSEK Institute of Macromolecular Chemistry Academy of Sciences of the Czech RepublicHeyrovského nám. 2CZ-162 06 Praha 6 Czech Republic department of Macromolecular Physics Faculty of Mathematics and PhysicsCharles University V Hole ovikách 2 18000 Prague 8 Czech Republic

1 Results In this contribution we deal with photophysical and photoelectrical study of novel fluorene-thiophene copolymers, and thiophene-based oligomers and polymers, the syntheses of which are reported in our other contributions. Information about electronic structure of the polymers was obtained from cyclic voltammetry and absorption spectroscopy. The absorption of the polymers under study covers the whole visible region; the low band-gap polymer (Eg=1.35 ev) exhibited the long-wavelength absorption ...

关键词： conjugated polymers photophysics electronic structure photovoltaics

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Prediction of van hove singularity systems in ternary borides

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npj Computational Materials 2023年第1期9卷 247-257页

作者： Yang Sun Zhen Zhang Andrew P.Porter Kirill Kovnir Kai-Ming ho vladimir Antropov department of Physics Xiamen University361005 XiamenChina department of Physics and Astronomy Iowa State UniversityAmesIA 50011USA department of Chemistry Iowa State UniversityAmesIA 50011USA Ames National Laboratory U.S.Department of EnergyAmesIA 50011USA

A computational search for stable structures among bothαandβphases of ternary ATB4 borides(A=Mg,ca,Sr,Ba,Al,Ga,and Zn,T is 3d or 4d transition elements)has been performed.We found thatα-ATB4 compounds with A=Mg,ca,Al,and T=v,Cr,Mn,Fe,Ni,and Co form a family of structurally stable or almost stable materials.These systems are metallic in non-magnetic states and characterized by the formation of the localized molecular-like state of 3d transition metal atom dimers,which leads to the appearance of numerous van hove singularities in the electronic spectrum.The closeness of such singularities to the Fermi level can be easily tuned by electron doping.For the atoms in the middle of the 3d row(Cr,Mn,and Fe),these singularities led to magnetic instabilities and magnetic ground states with a weakly metallic or semiconducting nature.Such states appear as non-trivial coexistence of the different spin ladders formed by magnetic dimers of 3d elements.These magnetic states can be characterized as an analog of the spin glass state.Experimental attempts to produce MgFeB4 and associated challenges are discussed,and promising directions for further synthetic studies are formulated.

关键词： metallic ternary magnetic

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Robotic versus laparoscopic liver resection for huge (≥10 cm) liver tumors: an international multicenter propensity-score matched cohort study of 799 cases

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Hepatobiliary Surgery and Nutrition 2023年第2期12卷 205-215,I0005页

作者： Tan-To Cheung Rong Liu Federica Cipriani Xiaoying Wang Mikhail Efanov david Fuks Gi-hong Choi Nicholas L.Syn Charing C.N.Chong Fabrizio di Benedetto Ricardo Robles-campos vincenzo Mazzaferro Fernando Rotellar santiago Lopez-Ben James O.Park Alejandro Mejia Iswanto Sucandy Adrian K.H.Chiow Marco v.Marino Mikel Gastaca Jae hoon Lee TPeter Kingham Mathieu d’hondt Sung hoon Choi Robert P.Sutcliffe ho-Seong Han Chung-Ngai Tang Johann Pratschke Roberto I.Troisi Go Wakabayashi daniel Cherqui Felice Giuliante davit L.Aghayan Bjorn Edwin Olivier Scatton Atsushi Sugioka Tran Cong duy Long Constantino Fondevila Mohammad Abu Hilal Andrea Ruzzenente Alessandro Ferrero Paulo Herman Kuo-Hsin Chen luca Aldrighetti Brian K.P.Goh International robotic and laparoscopic liver resection study group investigators department of Surgery Queen Mary HospitalThe University of Hong KongHong Kong SARChina Faculty of Hepatopancreatobiliary Surgery The First Medical Center of Chinese People’s Liberation Army(PLA)General HospitalBeijingChina Hepatobiliary Surgery division IRCCS San Raffaele HospitalMilanItaly department of Liver Surgery and Transplantation Liver Cancer InstituteZhongshan HospitalFudan UniversityShanghaiChina department of Hepato-Pancreato-Biliary Surgery Moscow Clinical Scientific CenterMoscowRussia department of digestive Oncologic and Metabolic SurgeryInstitute Mutualiste MontsourisUniversite Paris DescartesParisFrance division of Hepatopancreatobiliary Surgery Department of SurgerySeverance HospitalYonsei University College of MedicineSeoulKorea department of Hepatopancreatobiliary and Transplant Surgery Singapore General Hospital and Yong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore division of Hepatobiliary and Pancreatic Surgery Department of SurgeryPrince of Wales HospitalThe Chinese University of Hong KongHong Kong SARChina HPB Surgery and Liver Transplant Unit University of Modena and Reggio EmiliaModenaItaly department of General Visceral and Transplantation SurgeryClinic and University Hospital Virgen de la ArrixacaIMIB-ARRIXACAMurciaSpain HPB Surgery Hepatology and Liver TransplantationFondazione IRCCS Istituto Nazionale Tumori di MilanoMilanItaly HPB and Liver Transplant Unit Department of General SurgeryClinica Universidad de NavarraUniversidad de NavarraPamplonaSpain Institute of Health Research of Navarra(IdisNA) PamplonaSpain Hepatobiliary and Pancreatic Surgery Unit Department of SurgeryDr.Josep Trueta HospitalIdIBGiGironaSpain Hepatobiliary Surgical Oncology Department of SurgeryUniversity of Washington Medical CenterSeattleWAUSA The Liver Institute Methodist Dallas Medical CenterDallasTXUSA AdventHealth Tampa Digestive Health InstituteTampaFLUSA Hepatopancreatobiliary Unit Department of SurgeryChangi General

Background:The use of laparoscopic(LLR)and robotic liver resections(RLR)has been safely performed in many institutions for liver tumours.A large scale international multicenter study would provide stronger evidence and insight into application of these techniques for huge liver tumours≥10 cm.Methods:This was a retrospective review of 971 patients who underwent LLR and RLR for huge(≥10 cm)tumors at 42 international centers between 2002-2020.Results:One hundred RLR and 699 LLR which met study criteria were included.The comparison between the 2 approaches for patients with huge tumors were performed using 1:3 propensity-score matching(PSM)(73 vs.219).Before PSM,LLR was associated with significantly increased frequency of previous abdominal surgery,malignant pathology,liver cirrhosis and increased median blood.After PSM,RLR and LLR was associated with no significant difference in key perioperative outcomes including media operation time(242 vs.290 min,P=0.286),transfusion rate rate(19.2%vs.16.9%,P=0.652),median blood loss(200 vs.300 mL,P=0.694),open conversion rate(8.2%vs.11.0%,P=0.519),morbidity(28.8%vs.21.9%,P=0.221),major morbidity(4.1%vs.9.6%,P=0.152),mortality and postoperative length of stay(6 vs.6 days,P=0.435).Conclusions:RLR and LLR can be performed safely for selected patients with huge liver tumours with excellent outcomes.There was no significant difference in perioperative outcomes after RLR or LLR.

关键词： Laparoscopic liver resection(LLR) robotic liver resection(RLR) hepatocellular carcinoma colorectal liver metastases huge

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Search for two-neutrino double-beta decay of^(136)Xe to the 0^(+)_(1)excited state of 136Ba with the complete EXO-200 dataset

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Chinese Physics C 2023年第10期47卷 1-9页

作者： S.Al Kharusi G.Anton I.Badhrees P.S.Barbeau d.Beck v.Belov T.Bhatta M.Breidenbach T.Brunner G.F.cao W.R.Cen C.Chambers B.Cleveland M.Coon A.Craycraft T.daniels L.darroch S.J.daugherty J.davis S.delaquis A.der Mesrobian-Kabakian R.devoe J.dilling A.dolgolenko M.J.dolinski J.Echevers W.Fairbank Jr. d.Fairbank J.Farine S.Feyzbakhsh P.Fierlinger Y.S.Fu d.Fudenberg P.Gautam R.Gornea G.Gratta C.Hall E.v.Hansen J.hoessl P.Hufschmidt M.Hughes A.Iverson A.Jamil C.Jessiman M.J.Jewell A.Johnson A.Karelin L.J.Kaufman T.Koffas R.Krücken A.Kuchenkov K.S.Kumar Y.Lan A.Larson B.G.Lenardo d.S.Leonard G.S.Li S.Li Z.Li C.Licciardi Y.H.Lin R.MacLellan T.McElroy T.Michel B.Mong d.C.Moore K.Murray O.Njoya O.Nusair A.Odian I.Ostrovskiy A.Perna A.Piepke A.Pocar F.Retière A.L.Robinson P.C.Rowson J.Runge S.Schmidt d.Sinclair K.Skarpaas A.K.Soma v.Stekhanov M.Tarka S.Thibado J.Todd T.Tolba T.I.Totev R.Tsang B.veenstra v.veeraraghavan P.vogel J.-L.vuilleumier M.Wagenpfeil J.Watkins M.Weber L.J.Wen U.Wichoski G.Wrede S.X.Wu Q.Xia d.R.Yahne L.Yang Y.-R.Yen O.Ya.Zeldovich T.Ziegler 无 Physics department McGill UniversityMontrealQuebec H3A 2T8Canada Erlangen Centre for Astroparticle Physics(EcaP) Friedrich-Alexander-University Erlangen-NürnbergErlangen 91058Germany Physics department Carleton UniversityOttawaOntario K1S 5B6Canada department of Physics Duke Universityand Triangle Universities Nuclear Laboratory(TUNL)DurhamNorth Carolina 27708USA Physics department University of IllinoisUrbana-ChampaignIllinois 61801USA Institute for Theoretical and Experimental Physics named by A.I.Alikhanov of National Research Centre“Kurchatov Institute” Moscow 117218Russia department of Physics University of South DakotaVermillionSouth Dakota 57069USA SLAC National Accelerator Laboratory Menlo ParkCalifornia 94025USA TRIUMF VancouverBritish Columbia V6T 2A3Canada Institute of High Energy Physics Beijing 100049China department of Physics Laurentian UniversitySudburyOntario P3E 2C6Canada Physics department Colorado State UniversityFort CollinsColorado 80523USA department of Physics and Physical Oceanography University of North Carolina at WilmingtonWilmingtonNC 28403USA Physics department and CEEM Indiana UniversityBloomingtonIndiana 47405USA Physics department Stanford UniversityStanfordCalifornia 94305USA department of Physics Drexel UniversityPhiladelphiaPennsylvania 19104USA Amherst Center for Fundamental Interactions and Physics department University of MassachusettsAmherstMA 01003USA Technische Universität München Physikdepartment and Excellence Cluster UniverseGarching 80805Germany Physics department University of MarylandCollege ParkMaryland 20742USA department of Physics and Astronomy University of AlabamaTuscaloosaAlabama 35487USA Wright Laboratory Department of PhysicsYale UniversityNew HavenConnecticut 06511USA IBS Center for Underground Physics Daejeon 34126Korea department of Physics and Astronomy Stony Brook UniversitySUNYStony BrookNew York 11794USA Kellogg Lab CaltechPasadenaCalifornia 91125USA LHEP Albert Einstein CenterUniversi

A new search for two-neutrino double-beta(2νββ)decay of^(136)Xe to the 0+1 excited state of 136Ba is performed with the full EXO-200 dataset.A deep learning-based convolutional neural network is used to discriminate signal from background events.Signal detection efficiency is increased relative to previous searches by EXO-200 by more than a factor of two.With the addition of the Phase II dataset taken with an upgraded detector,the median 90%confidence level half-life sensitivity of 2νββdecay to the 0+1 state of 136Ba is 2.9×10^(24)yr using a total^(136)Xe exposure of 234.1 kg yr.No statistically significant evidence for 2νββdecay to the 0^(+)_(1)state is observed,leading to a lower limit of T2ν1/2(0^(+)→0^(+)_(1))>1.4×10^(24)yr at 90%confidence level,improved by 70%relative to the current world's best constraint.

关键词： EXO-200 experiment neutrinoless double beta decay excited state

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Words apart:Standardizing forestry terms and definitions across European biodiversity studies

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森林生态系统:英文版 2023年第4期10卷 459-471页

作者： Giovanni Trentanovi Thomas campagnaro Tommaso Sitzia Francesco Chianucci Giorgio vacchiano Christian Ammer MichałCiach Thomas ANagel Miren del Río Yoan Paillet Silvana Munzi Kris vandekerkhove Andrés Bravo-Oviedo Andrea Cutini Ettore d'Andrea Pallieter de Smedt Inken doerfler dimitris Fotakis Jacob Heilmann-Clausen Jeňýk hofmeister Jan hošek Philippe Janssen Sebastian Kepfer-Rojas Nathalie Korboulewsky Bence Kovács daniel Kozák Thibault Lachat Anders Mårell Radim Matula Martin Mikoláš Björn Nordén PéterÓdor x Marko Perović Elisabeth Pötzelsberger Peter Schall Miroslav Svoboda Flóra Tinya Mariana Ujházyová sabina Burrascano Research Institute on Terrestrial Ecosystems-National Research Council(IRET-CNR) Via Madonna Del Piano 1950019Sesto FiorentinoFIItaly department of Land EnvironmentAgriculture and ForestryUniversitàdegli Studi di PadovaViale Dell’Università1635020LegnaroPDItaly National Biodiversity Future Center Piazza Marina 6190133PalermoItaly CREA Research Centre for Forestry and Wood Viale S.Margherita 8052100ArezzoItaly department of Agricultural and Environmental Sciences(dIsaA) University of MilanVia Celoria 220133MilanItaly Silviculture and Forest Ecology of the Temperate Zones University of GöttingenGermany department of Forest Biodiversity Faculty of ForestryUniversity of Agricultureal.29 Listopada 4631-425KrakówPoland department of Forestry and Renewable Forest Resources Biotechnical FacultyUniversity of LjubljanaVecna pot 831000LjubljanaSlovenia Instituto de Ciencias Forestales(ICIFOR-INIA) CSICCtra.de la Coruña Km 7.528040MadridSpain University Grenoble Alpes LessemINRAE2 Rue de la Papeterie38402 Saint-Martin-d'HèresFrance Centro Interuniversitário de História das Ciências e da Tecnologia Faculdade de CiênciasUniversidade de LisboaPortugal Centre for Ecology Evolution and Environmental ChangesFaculdade de Ciências&CHANGE-Global Change and Sustainability InstituteUniversidade de LisboaPortugal Research Institute for Nature and Forest(INBO) Havenlaan 88 Bus 731000BrusselBelgium department of Biogeography and Global Change National Museum of Natural Sciences-CSICC/Serrano 115bis28006MadridSpain Research Institute on Terrestrial Ecosystems-National Research Council(IRET-CNR) Via G.Marconi N.205010PoranoTRItaly Forest&Nature Lab Department of EnvironmentGhent UniversityGeraardsbergsesteenweg 2679090GontrodeBelgium Institute of Biology and Environmental Science Vegetation Science&Nature ConservationUniversity of OldenburgAmmerländer Heerstraße 114-11826129OldenburgGermany Forest Research Institute Hellenic Agricultural Organization DimitraVassilikaThessal

Forest biodiversity studies conducted across Europe use a multitude of forestry terms,often inconsistently.This hinders the comparability across studies and makes the assessment of the impacts of forest management on biodiversity highly context-dependent.Recent attempts to standardize forestry and stand description terminology mostly used a top-down approach that did not account for the perspectives and approaches of forest biodiversity experts.This work aims to establish common standards for silvicultural and vegetation definitions,creating a shared conceptual framework for a consistent study on the effects of forest management on biodiversity.We have identified both strengths and weaknesses of the silvicultural and vegetation information provided in forest biodiversity studies.While quantitative data on forest biomass and dominant tree species are frequently included,information on silvicultural activities and vegetation composition is often lacking,shallow,or based on broad and heterogeneous classifications.We discuss the existing classifications and their use in European forest biodiversity studies through a novel bottom-up and top-driven review process,and ultimately propose a common framework.This will enhance the comparability of forest biodiversity studies in Europe,and puts the basis for effective implementation and monitoring of sustainable forest management policies.The standards here proposed are potentially adaptable and applicable to other geographical areas and could be extended to other forest interventions.

关键词： Forest management Multi-taxon Terminology Silviculture data harmonization

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Epistaxis in end stage liver disease masquerading as severe upper gastrointestinal hemorrhage

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World Journal of Gastroenterology 2014年第38期20卷 13993-13998页

作者： Marine camus dennis M Jensen Jason d Matthews Gordon v Ohning Thomas O Kovacs Rome Jutabha Kevin A Ghassemi Gustavo A Machicado Gareth S dulai CURE Hemostasis Research Group CURE Digestive Diseases Research CenterDavid Geffen School of Medicine at University of California division of digestive diseases at University of california Los AngelesRonald Reagan Medical Center department of Gastroenterology Lariboisiere Hospital CURE Hemostasis Research Group CURE Digestive Diseases Research CenterDavid Geffen School of Medicine at University of CaliforniaLos AngelesLos AngelesCA 90095United States Gastroenterology division at va Greater Los Angeles Healthcare System Hunterdon Gastrointestinal Associates

AIM:To describe the prevalence,diagnosis,treatment,and outcomes of end stage liver disease(ESLd) patients with severe epistaxis thought to be severe upper gastrointestinal hemorrhage(UGIH).METhodS:This observational single center study included all consecutive patients with ESLd and epistaxis identified from consecutive subjects hospitalized with suspected UGIH and prospectively enrolled in our databases of severe UGIH between 1998 and 2011.RESULTS:A total of 1249 patients were registered for severe UGIH in the data basis,461(36.9%) were cirrhotics. Epistaxis rather than UGIH was the bleeding source in 20 patients. All patients had severe coagulopathy. Epistaxis was initially controlled in all cases. Fifteen(75%) subjects required posterior nasal packing and 2(10%) embolization in addition to correction of coagulopathy. Five(25%) patients died in the hospital,12(60%) received orthotopic liver transplantation(OLT),and 3(15%) were discharged without OLT. The mortality rate was 63% in patients without OLT.CONCluSION:Severe epistaxis in patients with ESLd is(1) a diagnosis of exclusion that requires upper endoscopy to exclude severe UGIH;and(2) associated with a high mortality rate in patients not receiving OLT.

关键词： Epistaxis Upper gastrointestinal bleeding End stag

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