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Assessment of liver volume variation to evaluate liver function

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Frontiers of Medicine 2012年第4期6卷 421-427页

作者： Cong Tong xinsen xu Chang Liu Tianzheng Zhang Kai Qu Department of Hepatobiliary Surgery the First Affiliated HospitalSchool of MedicineXi’an Jiaotong UniversityXi’an 710061China Department of Surgery Shaanxi Xianyang 215 HospitalXianyang 712000China

In order to assess the value of liver volumetry in cirrhosis and acute liver failure(ALF)patients,we explored the correlation between hepatic volume and severity of the hepatic *** clinical data of 48 cirrhosis patients with 60 normal controls and 39 ALF patients were *** tomography-derived liver volume(CTLV)and body surface area(BSA)of normal controls were calculated to get a regression formula for standard liver volume(SLV)and *** CTLV and SLV of all patients were calculated and grouped by Child-Turcotte-Pugh classification for cirrhosis patients and assigned according to prognosis of ALF patients for further *** turned out that the mean liver volume of the control group was 1058±337 cm^(3).SLV was correlated with BSA according to the regression *** hepatic volume of cirrhosis patients in Child A,B level was not reduced,but in Child C level it was significantly reduced with the lowest liver volume index(CTLV/SLV).Likewise,in the death group of ALF patients,the volume index was significantly lower than that of the survival *** on volumetric study,we proposed an ROC(receiver operating characteristic)analysis to predict the prognosis of ALF patients that CTLV/SLV<83.9% indicates a poor *** conclusion,the CTLV/SLV ratio,which reflects liver volume variations,correlates well with the liver function and progression of cirrhosis and *** is also a very useful marker for predicting the prognosis of ALF.

关键词： liver volume variation cirrhosis acute liver failure(ALF)

Transcriptional modules related to hepatocellular carcinoma survival： coexpression network analysis

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Frontiers of Medicine 2016年第2期10卷 183-190页

作者： xinsen xu Yanyan Zhou Runchen Miao Wei Chen Kai Qu Qing Pang Chang Liu Department of Hepatobiliary Surgery the First Affiliated Hospital School of Medicine Xi'an Jiaotong University Xi 'an 710061 China

We performed weighted gene coexpression network analysis （WGCNA） to gain insights into the molecular aspects of hepatocellular carcinoma （HCC）. Raw microarray datasets （including 488 samples） were downloaded from the Gene Expression Omnibus （GEO） website. Data were normalized using the RMA algorithm. We utilized the WGCNA to identify the coexpressed genes （modules） after non-specific filtering. Correlation and survival analyses were conducted using the modules, and gene ontology （GO） enrichment was applied to explore the possible mechanisms. Eight distinct modules were identified by the WGCNA. Pink and red modules were associated with liver function, whereas turquoise and black modules were inversely correlated with tumor staging. Poor outcomes were found in the low expression group in the turquoise module and in the high expression group in the red module. In addition, GO enrichment analysis suggested that inflammation, immune, virus-related, and interferon-mediated pathways were enriched in the turquoise module. Several potential biomarkers, such as cyclin-dependent kinase 1 （CDK1）, topoisomerase 2α （TOP2A）, and serpin peptidase inhibitor clade C （antithrombin） member 1 （SERPINC1）, were also identified. In conclusion, gene signatures identified from the genome-based assays could contribute to HCC stratification. WGCNA was able to identify significant groups of genes associated with cancer prognosis.

关键词： hepatocellular carcinoma coexpression module microarray prognosis

Sclerosing cholangitis in critically ill patients： an important and easily ignored problem based on a German experience

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Frontiers of Medicine 2014年第1期8卷 118-126页

作者： Ting Lin Kai Qu xinsen xu Min Tian Jie Gao Chun Zhang Ying Di Yuelang Zhang Chang Liu Department of Hepatobiliary Surgery Surgical Intensive Care Unit Department of Imaging the First Affiliated Hospital School ofMedicine Xi 'an Jiaotong University Xi 'an 710061 China

Intensive care unit （ICU） is important in the rehabilitation of critically ill patients. In the past decades, many patients who received aggressive treatment in ICU developed sclerosing cholangitis in multiple centers. Sclerosing cholangitis in critically ill patients （SC-CIP） is a relatively new issue. To investigate the causes, clinical manifestation, treatment, and prognosis of SC-CIP, we searched for published cases in the databases of PubMed, Highwire, and Elsevier from 2001 to 2012. Data were extracted using a standard form and retrospectively analyzed. Twelve eligible studies covering 88 patients, with 64 men and 24 women, were mainly reported by German centers. The mean age was 49.8 years. All of the patients recovered from critical illnesses, such as trauma, infection, burn, and major surgeries. High pressure positive end-expiratory pressure （PEEP, peak level at 12.8 cm H20） was utilized for all patients, with the average duration of 36.3 d. In addition, vasopressor agents were administered in approximately 60% of SC-CIE A rapid increase in cholestasis and irregular strictures in the intrahepatic bile ducts was observed in the following months. With an average follow-up period of 17.9 months, poor outcomes were observed in 54 patients, including 34 deaths. In conclusion, ischemic injury of the biliary tree, which may be affected by PEEP and/or vasopressor administration, affects cholangiopathic procedure. As a newly discovered type of secondary sclerosing cholangitis, SC-CIP is a severe progressive complication of patients in ICU and should be carefully monitored by clinicians.

关键词： intensive care unit sclerosing cholangitis ischemic injury prognosis systemic review

Epidemiological study of a von Hippel-Lindau family in northwest China

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Frontiers of Medicine 2013年第3期7卷 378-385页

作者： Jingyao Zhang Dapeng Wu Hong Ai Jigang Bai Shunbin Dong Qinling Yang Kai Qu Lei Zhou xinsen xu Chang Liu Department of Hepatobiliary Surgery the First Affiliated HospitalSchool of MedicineXi’an Jiaotong UniversityXi’an 710061China Department of Urology Surgery the First Affiliated HospitalSchool of MedicineXi’an Jiaotong UniversityXi’an 710061China Department of Ultrasound the First Affiliated HospitalSchool of MedicineXi’an Jiaotong UniversityXi’an 710061China

von Hippel-Lindau(VHL)disease is a rare,inherited neoplastic disease characterized by hemangioblastomas(HBL)of the central nervous system(CNS),retinal angiomas,renal cell carcinomas(RCC),pancreatic endocrine tumors(PETs),pheochromocytomas,paragangliomas,and visceral *** encountered a large VHL family in northwest China and conducted a systematic screening of the family members based on their epidemiological and clinical characteristics.A self-designed questionnaire was used to collect the general sociodemographic and health information of the family *** the preliminary family screening,physical examination and abdomen B ultrasonography were *** suspected patients were subjected to cranial computerized tomography and fundus *** clinical data of the patients with confirmed VHL disease were collected from hospital records.A total of 63 lineal descendants in six generations were observed in the family(generations O,A,B,C,D,E),including 9 dead suspected cases(6 males,3 females)and 10 living cases(2 males,8 females).Among the 10 living cases,4,2,1,3,4,8,and 2 manifested HBLs of the CNS,PETs,RCC,pancreatic cysts,renal cysts,pheochromocytomas(4 hemi and 4 bilateral),and paragangliomas,*** showed that the morbidity of VHL disease in generation C was lower than that in generation B,but the age of onset was *** study is the first to report VHL disease in northwest China and VHL-associated PET cases in ***,follow-up checkups of the family should be focused on younger *** family screening protocols should be followed for the treatment of patients with VHL disease.

关键词： von Hippel-Lindau disease epidemiology family screening pancreatic endocrine tumor

Exploring the diagnosis markers for gallbladder cancer based on clinical data

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Frontiers of Medicine 2015年第3期9卷 350-355页

作者： Lingqiang Zhang Runchen Miao Xiude Zhang Wei Chen Yanyan Zhou Ruitao Wang Ruiyao Zhang Qing Pang xinsen xu Chang Liu Department of Hepatobiliary Surgery the First Affiliated Hospital School of Medicine Xi 'an Jiaotong University Xi 'an 710061 China Department of Endocrinology Xian Yang Center Hospital Xianyang 712000 China

Presently, no effective markers are available to facilitate gallbladder cancer （GBC） diagnosis. This study aims to explore available markers for GBC diagnosis. Clinical data of 144 GBC and 116 cholelithiasis patients were retrospectively reviewed. Logistic regression analysis was performed to evaluate GBC risk factors. A receiver operating characteristic （ROC） curve was used to assess the diagnosis value of the risk factors. By comparing the characteristic of GBC and cholelithiasis patients, the following factors exhibited statistical difference： age, gender, gallstones, total bilirubin （TB）, alkaline phosphatase （ALP）, aspartate aminotransferase （AST）, alanine aminotransferase （ALT）, platelet count （PLT）, CA125 （carcinoembryonic antigen 125）, and CA199 （carbohydrate antigen 199）. Logistic regression analysis indicated that age [odds ratio （OR）, 1.032; 95% confidence interval （95~o CI）, 1.004 to 1.061; P = 0.024], gender （OR, 0.346; 95% CI, 0.167 to 0.716; P = 0.004）, gallstones （OR, 0.027; 95~ CI, 0.007 to 0.095; P 〈 0.001）, ALP （OR, 1.003; 95~ CI, 1.000 to 1.006; P = 0.032）, TB （OR, 1.004; 95% CI, 1.000 to 1.009; P = 0.042）, and CA125 （OR, 1.007; 95% CI, 1.002 to 1.013; P = 0.011） were independent risk factors for GBC. According to the ROC curve, CA125 [area under curve （AUC）, 0.720], ALP （AUC, 0.713）, TB （AUC, 0.636）, and age （AUC, 0.573） were valuable diagnosis markers. Additionally, based on the independent risk factors, the GBC diagnosis model was established. Age, TB, ALP, and CA125 can be used as auxiliary diagnosis factors of GBC. The diagnosis model provides a quantitative tool for GBC diagnosis when comprehensively considering various risk factors.

关键词： gallbladder cancer diagnosis marker

Reactive oxygen species generation is essential for cisplatininduced accelerated senescence in hepatocellular carcinoma

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Frontiers of Medicine 2014年第2期8卷 227-235页

作者： Kai Qu Ting Lin Zhixin Wang Sinan Liu Hulin Chang xinsen xu Fandi Meng Lei Zhou Jichao Wei Minghui Tai Yafeng Dong Chang Liu Department of Hepatobiliary Surgery Surgical Intensive Care Unit the First Affiliated Hospital School of Medicine Xi'an Jiaotong University Xi 'an 710061 China Department of Obstetrics and Gynecology Kansas University Kansas City KS 66160 USA

Accelerated senescence is important because this process is involved in tumor suppression and has been induced by many chemotherapeutic agents. The platinum-based chemotherapeutic agent cisplatin displays a wide range of antitumor activities. However, the molecular mechanism of cisplatin-induced accelerated senescence in hepatocellular carcinoma （HCC） remains unclear. In the present study, the growth inhibitory effect of cisplatin on HepG2 and SMMC-7721 cells was detected by 3-（4,5-dimethylthiazol-2-yl）-2,5-diphenyltetrazolium bromide assay. Cellular senescence was then assessed by I^-galactosidase assay. Senescence-related factors, including p53, p21, and p16, were evaluated by quantitative reverse transcription-polymerase chain reaction. Reactive oxygen species （ROS） was analyzed by flow cytometry. Our results revealed that cisplatin reduced the proliferation of HepG2 and SMMC-7721 cells in a dose- and time-dependent manner. Senescent phenotype observed in cisplatin- treated hepatoma cells was dependent on p53 and p21 activation but not on pl 6 activation. Furthermore, cisplatininduced accelerated senescence depended on intracellular ROS generation. The ROS scavenger N-acetyl-Lcysteine also significantly suppressed the cisplatin-induced senescence of HepG2 and SMMC-7721 cells. In conclusion, our results revealed a functional link between intracellular ROS generation and cisplatin-indnced accelerated senescence, and this link may be used as a potential target of HCC.

关键词： reactive oxygen species senescence cisplatin hepatocellular carcinoma

Peptide tyrosine-tyrosine combined with its receptors exhibits an anti-cancer potential in pancreatic cancer MiaPaCa-2 cell

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Chinese Medical Journal 2014年第24期127卷 4235-4242页

作者： Li Hongxia Wang Zhixin Dong Lei Jiang Jiong xu xinsen Zhou Lei Wan Yong Department of Gastroenterology Department of Hepatobiliary Surgery the First Affiliated Hospital of Xi'an Jiaotong University College of Medicine Xi'an Shaanxi 710061 China

Background Pancreatic cancer is a common malignant tumor of the digestive system. It is the fourth major cause of tumor-related death and its morbidity is increasing, and hence it is imperative to develop effective forms of therapy for pancreatic cancer. Peptide tyrosine-tyrosine （PYY） is an important gastrointestinal peptide hormone. According to previous literatures, PYY has been shown to inhibit tumor proliferation in cellular and animal models, but there has been limited research on the detailed mechanism of PYY in pancreatic cancer. This study was to observe the effects of PYY on pancreatic cancer cell and investigate the possible mechanism. Methods The expression of Y1, Y2, and Y5 receptors on pancreatic cancer cell lines were detected by reverse transcription quantitative polymerase chain reaction （RT-qPCR）. The cytotoxicity of PYY toward the MiaPaCa-2 cell was evaluated by 3-（4,5-dimethylthiazol-2-yl）-2,5-diphenyltetrazolium bromide （MTT） assay; the cell morphology and structure changes were observed under inverted microscope and transmission electron microscope respectively. Apoptosis and cell cycle were evaluated by flow cytometry. The activity of caspase-3 was determined by activity assay kits and Western blotting. The expression of survivin, vascular endothelial growth factor （VEGF）, and cyclooxygenase-2 （COX-2） were determined by RT-qPCR and Western blotting. Results Expression of Y2 receptor is the most abundant PYY receptor on pancreatic cancer cell. PYY inhibited MiaPaCa-2 cell proliferation, blocked it in G0/G1 phase, increased the proportion of apoptosis cells and caspase-3 activity, and reduced the expression of survivin, VEGF, and COX-2. Conclusions PYY weakened the ability of the pancreatic MiaPaCa-2 cell viability through cell cycle blocking and apoptosis inducing. The inhibition effect of PYY may be mediated by the Y2 receptor. The increased caspase-3 activity and reduced expression of survivin, VEGF, and COX-2 may serve as a novel mechanism i

关键词： peptide tyrosine-tyrosine (PYY) pancreatic cancer MiaPaCa-2 cell anti-cancer

Prognostic significance of neutrophil to lymphocyte ratio in patients with hepatocellular carcinoma after transcatheter arterial chemoembolization

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Chinese Medical Journal 2014年第24期127卷 4204-4209页

作者： xu xinsen Chen Wei Zhang Lingqiang Miao Runchen Zhou Yanyan Wan Yong Dong Yafeng Liu Chang Department of Hepatobiliary Surgery First Affiliated Hospital of Medical College Xi'an Jiaotong University Xi'an Shaanxi 710061 China Department of Obstetrics and Gynecology University of Kansas School of Medicine Kansas 66160 USA

Background Accumulating evidence indicates that systemic inflammation response is associated with the prognosis of various cancers. The aim of this study was to investigate the neutrophil-lymphocyte ratio （NLR）, which is one of the systemic inflammation markers, in the prognosis of hepatocellular carcinoma （HCC） after treatment of transcatheter arterial chemoembolization （TACE）. Methods The clinical data of 178 HCC patients who received TACE were retrospectively analyzed. The optimal NLR cutoff was determined according to the receiver operating characteristic （ROC） analysis. All patients were divided into NLR-normal group and NLR-elevated group according to the cutoff, and the clinical features of these two groups were comparatively analyzed. Meanwhile, the overall survival and disease free survival （DFS） were analyzed using the Kaplan- Meier method. The risk factors of postoperative survival were investigated using univariate and multivariate Cox regression analyses. Results The optimal NLR cutoff was defined at 1.85 and 42 （23.6%） patients had an elevated NLR （NLR〉1.85）. The median survival time was 9.5 months （range 1-99 months）. The clinical data between the two groups were comparable, except for a-fetoprotein. Follow-up results showed that the median survival of patients with normal NLR was 17.5 months （range： 1-99 months） compared with 8 months （range： 8-68 months） of patients with elevated NLR. The 1, 3 and 5-year overall survival of patients in the NLR-normal group and NLR-elevated group were 57.3%, 44.1%, and 27.2% and 42.1%, 19.6%, and 9.5% respectively 0（2=194.2, P 〈0.001）. Similarly, the disease free survival also has a significant difference 0（2=39.3, P 〈0.001）. Multivariate Cox regression analysis showed that a high NLR was an independent factor affecting the survival rate of HCC after TACE （P=0.04）. Conclusion Preoperative NLR was an important prognostic factor to predict the prognosis of patients with intermediate HCC treated with TACE.

关键词： neutrophil to lymphocyte ratio hepatocellular carcinoma transcatheter arterial chemoembolization prognosis

考虑组合效应的梁腹板开圆孔型钢框架的静力弹塑性分析

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北京交通大学学报 2014年第6期38卷 82-87,92页

作者：许鑫森杨娜北京交通大学土木建筑工程学院北京100044 悉地(北京)国际建筑设计顾问有限公司北京100013

利用静力弹塑性的分析方法,对考虑组合效应的梁腹板开圆孔型钢框架进行分析.为了便于对比,分别根据有无混凝土楼板和有无开孔削弱,选取了四个类型的框架,采用SAP2000进行建模计算;利用已有的研究成果,定义了节点的塑性铰模型.通过两种... 详细信息

利用静力弹塑性的分析方法,对考虑组合效应的梁腹板开圆孔型钢框架进行分析.为了便于对比,分别根据有无混凝土楼板和有无开孔削弱,选取了四个类型的框架,采用SAP2000进行建模计算;利用已有的研究成果,定义了节点的塑性铰模型.通过两种侧向荷载分布模式的计算得到了不同结构的Pushover曲线、结构的位移和塑性铰的分布情况.研究表明:考虑混凝土楼板的组合效应后,结构的刚度和承载力增加;腹板开圆孔削弱则对结构整体性能的影响非常小.

关键词：腹板开圆孔组合效应静力弹塑性分析 SAP2000 塑性铰