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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

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

Bispectral index-guided sedation in transfemoral transcatheter aortic valve implantation:a retrospective control study

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2017年第4期18卷 353-359页

作者： Wei HE Rong-rong HUANG Qing-yu SHI xian-bao liu Jian-an WANG Min YAN Department of Anesthesia the Second Affiliated Hospital School of Medicine Zhejiang University Hangzhou 310003 China Department of Cardiology the Second Affiliated Hospital School of Medicine Zhejiang University Hangzhou 310003 China

Objective： Transcatheter aortic valve implantation （TAVI） is a minimally invasive therapy for elderly patients with severe aortic valve stenosis who were refused surgical aortic valve replacement because of the high perioperative risk. Traditionally, this procedure has been done under general anesthesia, but more recently local anesthesia and sedation have become popular. This research assessed the effectiveness of transfemoral TAVI under bispectral index （BIS）-guided sedation. Methods： In this single-center retrospective control analysis, clinical data, including demographic characteristics, echocardiography, periprocedural data, and main complications, were collected and assessed in 113 patients undergoing TAVI through the femoral artery under general anesthesia （GA group, n=36） and under BIS-guided sedation （SED group, n=77）. Results： The demographic characteristics and echocardi-ographic parameters between the two groups were similar （P〉0.05）. Two （2.6%） of patients were moved from BIS-guided sedation to general anesthesia for surgical reasons. Procedures were significantly shorter in the SED group than in the GA group （（127.10±44.43） min vs. （165.90±71.62） min, P=0.004）. Patients in the SED group lost less blood and received significantly fewer red blood cells and catecholamines than those in the GA group （5.19% vs. 22.22%, P=0.017 and 67.53% vs. 97.22%, P〈0.001）. The length of hospital stay was significantly shorter and there were fewer pulmonary complications in the SED group than in the GA group. Thirty-day mortality was similar between the two groups. Conclusions： BIS-guided sedation is a feasible and safe approach for transfemoral TAVl. The anes- thesiologist should choose the best anesthetic method according to the team＇s experience.

关键词： Transcatheter aortic valve implantation Sedation Bispectral index

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

Effect of corticosteroids on atrial fibrillation after catheter ablation: a meta-analysis

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2018年第1期19卷 57-64页

作者： Sanjay JAISWAL xian-bao liu Qu-cheng WEI Ying-hao SUN Li-han WANG liu-guang SONG Dan-dan YANG Jian-an WANG Department of Cardiology the Second Affiliated Hospital School of Medicine Zhejiang University

Objective： The purpose of this meta-analysis was to explore the effect of corticosteroids on atrial fibrillation（AF） following catheter ablation. Methods： We searched Pub Med, Embase, and the Cochrane Central Register of Controlled Trials for published articles describing the effect of corticosteroids in preventing AF recurrence after catheter ablation. Data on study and patient were extracted. Risk ratios（RRs） and 95% confidence intervals（CIs） were calculated by use of a random-effect model, and P values of 〈0.05 were considered significant. Results： Two randomized controlled trials（RCTs） and three cohort studies involving 846 patients were included in this meta-analysis. Within one month of catheter ablation, corticosteroid use was associated with a declined risk of recurrence of AF in RCT（RR 0.57, 95% CI 0.39 to 0.85, P=0.005）, but without significant effect in cohort studies（RR 1.01, 95% CI 0.79 to 1.30, P=0.94）. After three months of catheter ablation, corticosteroids did not have a significant effect in the prevention of late recurrence of AF in either RCT（RR 0.78, 95% CI 0.38 to 1.59, P=0.49） or cohort studies（RR 0.96, 95% CI 0.70 to 1.31, P=0.78）. Conclusions： Our meta-analysis suggested that periprocedural administration of corticosteroids of catheter ablation was associated with reduction of early but not late recurrence of AF.

关键词： Atrial fibrillation Corticosteroids Catheter ablation Meta-analysis

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

Meta-analysis of C242T polymorphism in CYBA genes: risk of acute coronary syndrome is lower in Asians but not in Caucasians

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2015年第5期16卷 370-379页

作者： Po HU Ming-yuan HUANG Xin-yang HU Xiao-jie XIE Mei-xiang xianG xian-bao liu Jian-an WANG Key Laboratory for Diagnosis and Treatment of Cardiovascular Disease of Zhejiang Province the Second Affiliated HospitalSchool of Medicine Zhejiang University Department of Cardiology the Second Affiliated Hospital School of Medicine Zhejiang University

Background：A lot of studies have demonstrated that C242T polymorphism in CYBA genes may play an important role in the pathological process of acute coronary syndrome （ACS）. However, the results are not consistent. To further evaluate this debate, we performed a meta-analysis to determine the relationship between C242T poly-morphism and ACS. Methods and results：We screened PubMed/MEDLINE, EBSCIO, and EMBASE research reports until Mar. 2014 and extracted data from 10 studies involving 6102 ACS patients and 8669 controls. Subgroup analysis by ethnicity documented a significant decreased risk of ACS for C242T polymorphism in the Asian population under al elic comparison （odd ratio （OR） 0.73;95%confidence intervals （CI） 0.64–0.83）, dominant model （OR 0.71;95%CI 0.62–0.82）, and homozygote comparison （OR 0.57;95%CI 0.35–0.92）. However, in the overal population and es-pecial y with Caucasians, no significant association was uncovered. Further meta-regression analysis revealed that the heterogeneity among studies was largely attributed to ethnicity. No publication bias was detected through a funnel plot and an Egger’s linear regression test. Conclusions： Taken together, our results suggest that the C242T poly-morphism might be a protective factor against developing ACS in the Asian population. Further researches wil be needed to identify the confounding factors which modified the protective effect of T al ele among Caucasians.

关键词： CYBA C242T polymorphism Acute coronary syndrome