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Network meta-analysis of the prognosis of curative treatment strategies for recurrent hepatocellular carcinoma after hepatectomy

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World Journal of Gastrointestinal Surgery 2023年第2期15卷 258-272页

作者： Jen-Lung chen yaw-sen chen chen-Guo Ker Department of General Surgery E-Da HospitalI-Shou UniversityKaohsiung 824Taiwan Department of Surgery School of MedicineI-Shou UniversityKaohsiung 824Taiwan

BACKGROUND Recurrent hepatocellular carcinoma(rHCC)is a common outcome after curative *** for rHCC is recommended,but no guidelines *** To compare curative treatments such as repeated hepatectomy(RH),radiofrequency ablation(RFA),transarterial chemoembolization(TACE)and liver transplantation(LT)for patients with rHCC after primary hepatectomy by conducting a network meta-analysis(NMA).METHODS From 2011 to 2021,30 articles involving patients with rHCC after primary liver resection were retrieved for this *** Q test was used to assess heterogeneity among studies,and Egger’s test was used to assess publication *** efficacy of rHCC treatment was assessed using disease-free survival(DFS)and overall survival(OS).RESULTS From 30 articles,a total of 17,11,8,and 12 arms of RH,RFA,TACE,and LT subgroups were collected for *** plot analysis revealed that the LT subgroup had a better cumulative DFS and 1-year OS than the RH subgroup,with an odds ratio(OR)of 0.96(95%CI:0.31-2.96).However,the RH subgroup had a better 3-year and 5-year OS compared to the LT,RFA,and TACE *** step diagram of different subgroups measured by the Wald test yielded the same results as the forest plot *** had a better 1-year OS(OR:1.04,95%CI:0.34-03.20),and LT was inferior to RH in 3-year OS(OR:10.61,95%CI:0.21-1.73)and 5-year OS(OR:0.95,95%CI:0.39-2.34).According to the predictive P score evaluation,the LT subgroup had a better DFS,and RH had the best ***,meta-regression analysis revealed that LT had a better DFS(P<0.001)as well as 3-year OS(P=0.881)and 5-year OS(P=0.188).The differences in superiority between DFS and OS were due to the different testing methods *** According to this NMA,RH and LT had better DFS and OS for rHCC than RFA and ***,treatment strategies should be determined by the recurrent tumor characteristics,the patient’s general health status,and the care program at each institution.

关键词： Hepatocellular carcinoma Recurrence Network meta-analysis Curative treatment Outcome Survival rate

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Tumor lysis syndrome after transarterial chemoembolization of hepatocellular carcinoma: Case reports and literature review

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World Journal of Gastroenterology 2009年第37期15卷 4726-4728页

作者： Pei-Min Hsieh Kao-chen Hung yaw-sen chen Department of General Surgery E-Da Hospital E-Da Road Yan-Chau Kaohsiung 82445 Taiwan China

Tumor lysis syndrome (TLS) is a potentially lethal complication in cancer therapy. It may occur in highly sensitive tumors, especially in childhood cancer and leukemia, whereas, it is rare in the treatment of solid tumors in adults. TLS results from a sudden and rapid release of nuclear and cytoplasmic degradation products of malignant cells. The release of these can lead to severe alterations in the metabolic prof ile. Here, we present two cases of large hepatocellular carcinoma (HCC) treated by transarterial chemoembolization (TACE) that resulted in TLS. Although TLS rarely happens in the treatment of adult hepatic tumor, only a few cases have been reported. We should keep in mind that all patients with HCC, particularly those with large and rapidly growing tumors, must be closely watched for evidence of TLS after TACE.

关键词： Hepatocellular carcinoma Therapeutic chemoembolization Tumor lysis syndrome

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Expression and prognostic role of molecular markers in 99 KIT-positive gastric stromal tumors in Taiwan Residents

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World Journal of Gastroenterology 2006年第4期12卷 595-602页

作者： Tsung-Hui Hu seng-Kee Chuah Jui-Wei Lin Yi-Chun Chiu Chi-Sin Changchien Chih-Chi Wang yaw-sen chen Li-Na Yi King-Wah Chiu Chuan-Mo Lee Division of Gastroenterology Department of Internal MedicineChanggung Memorial Hospital Kaohsiung Taiwan China Department of Pathology Chang Gung Memorial Hospital Kaohsiung Taiwan China Department of Surgery Chang Gung Memorial Hospital Kaohsiung Taiwan China

AIM： TO elucidate the prognostic role and relationship of three molecular markers such as tumor suppressor gene p53, proliferating cell nuclear antigen （PCNA） and Ki-67 in gastric stromal tumor. METHODS： A total of 108 surgically resected gastric smooth muscle tumor specimens were collected from January 1987 to December 1999. Immunohistochemical studies were performed on the paraffin sections of 99 of 108 CDl17-positive tumors with antibodies of p53, PCNA, and Ki-67. Immunoreactivity of three molecular markers was recorded by labeling index （LI, %） and was analyzed for clinicopathologic and survival correlation. RESULTS： Of the 99 cases, immunostaining revealed that 52 patients （52.5%） had p53, and 37 patients （37.3%） had Ki-67 immunoreactivity （defined as 〉10% of LI）. All patients （100%） had PCNA immunoreactivity ranging from 12% to 93% of LI, divided into high or low by median. Statistics revealed that LI of three markers positively correlate to each other （P〈0.01） and to microscopic tumor mitotic counts （P〈0.001）. By combination, patients with ≥2 markers （positive or high） in tumors had early tumor recurrence （P〈0.001） and unfavorable outcome （P〈0.001）. Univariate analysis indicated that patients with tumor size 〉5 cm （P=0.003）, tumor mitosis 〉5/50 HPF （P〈0.001）, p53 immunoreactivity （P=0.001）, Ki-67 immunoreactivity （P=0.026）, high PCNA LI （P=0.015） and male gender （P=0.036） were six predictors for early disease recurrence. Subsequent multivariate analysis revealed that mitotic counts, tumor size, and p53 immunoreactivity were three independent prognostic factors for both disease free and overall survival of patients. By combination of three independent prognostic factors for grouping, we found higher tumor recurrence rate （P〈0.001） and shorter survival （P〈0.001） existed in groups with increasing factors. CONCLUSION： We first provide the prognostic value and linkage of three molecular markers in GISTs. The combination of three factors （p53, tumor size, and t

关键词： Gastrointestinal stromal tumor GIST p53 PCNA Ki-67 Prognosis

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Clinical characteristics and prognostic factors of splenic abscess:A review of 67 cases in a single medical center of Taiwan

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World Journal of Gastroenterology 2006年第3期12卷 460-464页

作者： Kuo-Chin Chang seng-Kee Chuah Chi-Sin Changchien Tung-Lung Tsai Sheng-Nan Lu Yi-Chun Chiu yaw-sen chen Chih-Chi Wang Jui-Wei Lin Chuan-Mo Lee Tsung-Hui Hu Division of Gastroenterology Department ofInternal Medicine Chang Gung Memorial Hospital KaohsiungTaiwan China Department of surgery ChangGung Memorial Hospital Kaohsiung Taiwan China Department of Pathology Chang Gung Memorial Hospital Kaohsiung Taiwan China

AIM： To analyze 67 cases of splenic abscess in a medica center of Taiwan during a period of 19 years. METHODS： From January 1986 to December 2004, a total of 67 patients with splenic abscess were enrolled for the retrospective study. The clinical characteristics, underlying diseases, organism spectra, therapeutic methods, APACHE Ⅱ scores, and mortality rates were analyzed. RESULTS： There were 41 males and 26 females with the mean age of 54.14-14.1 years. Multiple splenic abscesses （MSA） account for 28.4% and solitary splenic abscess in 71.6% of the patients. Twenty-six of sixtyseven patients （35.8%） had extrasplenic abscesses, with leading site of liver （34.6%）, Microbiological cultures were positive in 58 patients （86.6%）, with 71.8% in blood culture and 93.5% in abscess culture. Gram negative bacillus （GNB） infection predominated （55.2%）, with leading pathogen of Klebslella pneumoniae （22.4%）, followed by gram positive coccus （GPC） infection （31%）. Splenectomy was performed in 26 patients （38.8%）, percutaneous drainage or aspiration in 21 （31.3%）, and antibiotic therapy alone in 20 patients （29.9%）. Eventually, 12 of 67 patients expired （17.9 %）. By statistics, spleen infected with GNB was likely to develop multiple abscesses compared with infection with GPC （P=0.036）. Patients with GNB infection （P=0.009） and multiple abscesses （P=0.011） experienced a higher mortality rate than patients with GPC infection and solitary abscess. The mean APACHE Ⅱ score of 12 ex- pired patients （16.3±3.2） was significantly higher than that of the 55 survivals （7.2 ± 3.8）（P〈 0.001）. CONCLUSION： MSA, GNB infection, and high APACHE Ⅱ scores are poor prognostic factors. Early surgical intervention should be encouraged when these risk factors are present.

关键词： Splenic abscess Prognosis Gram negative bacillus infection APACHE Ⅱ scores

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Effect of autologous blood donation on the central venous pressure, blood loss and blood transfusion during living donor left hepatectomy

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World Journal of Gastroenterology 2005年第27期11卷 4233-4236页

作者： Bruno Jawan Yu-Fan cheng Chia-Chi Tseng yaw-sen chen Chih-Chi Wang Tung-Liang Huang Hock-Liew Eng Po-Ping Liu King-Wah Chiu Shih-Hor Wang Chih-Che Lin Tsan-Shiun Lin Yueh-Wei Liu Chao-Long chen Department of Anesthesiology Chang Gung Memorial Hospital Kaohsiung Medical Center TaiwanChina Liver Transplantation Program Chang Gung Memorial Hospital Kaohsiung Medical Center Taiwan China

AIM： Autologous blood donation （ABD） is mainly used to reduce the use of banked blood. In fact, ABD can be regarded as acute blood loss. Would ABD 2-3 d before operation affect the CVP level and subsequently result in less blood loss during liver resection was to be ***： Eighty-four patients undergoing living donor left hepatectomy were retrospectively divided as group Ⅰ （GⅠ） and group Ⅱ （GⅡ） according to have donated 250-300 mL blood 2-3 d before living donor hepatectomy or not. The changes of the intraoperative CVP, surgical blood loss,blood products used and the changes of perioperative hemoglobin （Hb） between groups were analyzed and compared by using Mann-Whitney ***： The results show that the intraoperative CVP changes between GⅠ （n = 35） and GⅡ （n = 49） up to graft procurement were the same, subsequently the blood loss,but ABD resulted in significantly lower perioperative Hb levels in ***： Since none of the patients required any blood products perioperatively, all the predonated bloods were discarded after the patients were discharged from the hospital. It indicates that ABD in current series had no any beneficial effects, in term of cost, lowering the CVP, blood loss and reduce the use of banked blood products, but resulted in significant lower Hb in perioperative period.

关键词： Blood Transfusion, Autologous Central Venous Pressure Hepatectomy Liver Transplantation Living Donors Adult Blood Loss, Surgical control Female Humans Intraoperative Care Male Retrospective Studies

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Dextrose in the banked blood products does not seem to affect the blood glucose levels in patients undergoing liver transplantation

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World Journal of Gastroenterology 2005年第18期11卷 2789-2791页

作者： Kwok-Wai cheng Chia-Chih Tseng Chih-Hsien Wang yaw-sen chen Chih-Chi Wang Tung-Liang Huang Hock-Liew Eng King-Wah Chiu Shih-Hor Wang Chih-Che Lin Tsan-Shiun Lin Yueh-Wei Liu Bruno Jawan Department of Anesthesiology and Liver Transplantation Program Chang Gung Memorial Hospital Kaohsiung Medical Center Taiwan China Chang Gung University Ta-pei Taiwan China

AIM: Hyperglycemia commonly seen in liver transplantation (LT) has often been attributed to the dextrose in the storage solution of blood transfusion products. The purpose of the study is to compare the changes of the blood glucose levels in transfused and non-transfused patients during LT. METHODS: A retrospective study on 60 biliary pediatric patients and 16 adult patients undergoing LT was carried out. Transfused pediatric patients were included in Group Ⅰ (GⅠ), those not transfused in Group Ⅱ (GⅡ). Twelve adult patients were not given transfusion and assigned to Group Ⅲ(GⅢ); whereas, four adult patients who received massive transfusion were assigned to Group Ⅳ (GⅣ). The blood glucose levels, volume of blood transfused, and the volume of crystalloid infused were recorded, compared and analyzed. RESULTS: Results showed that the changes in blood glucose levels during LT for both non-transfused and minimally transfused pediatric groups and non-transfused and massively-transfused adult groups were almost the same. CONCLUSION: We conclude that blood transfusion does not cause significant changes in the blood glucose levels in this study.

关键词： Organ Liver surgery Transplantation Anesthesia General monitoring Blood glucose transfusion Bank blood component Infusion 5% dextrose in 1/4 saline

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Role of the Greenland Sea ice anomaly in the late-spring drought over Northwest China

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Atmospheric and Oceanic Science Letters 2025年第1期18卷 1-5页

作者： Yang Liu Huopo chen Nansen-Zhu International Research Centre Institute of Atmospheric Physics Chinese Academy of SciencesBeijingChina Collaborative Innovation Center on Forecast and Evaluation of Meteorological Disasters Nanjing University for Information Science and TechnologyNanjingChina

Drought across Northwest China in late spring has exerted a vital effect on the local climate and agricultural production,and has been alleviated during the past *** study explored the influence of the preceding Arctic sea ice on the May drought in Northwest China caused by the precipitation *** analysis indicated that when the Greenland Sea ice concentration is abnormally high during February to April,the dry conditions in Northwest China tend to be *** increase of sea ice in the Greenland Sea can excite a meridional circulation,which causes sea surface temperature(SST)anomalies in the North Atlantic via the sea-air interaction,manifested as significant warm SST anomalies over the south of Greenland and the subtropical North Atlantic,but negative SST anomalies over the west of the *** abnormal SST pattern maintains to May and triggers a zonal wave train from the North Atlantic through Scandinavia and Central Asia to Northwest China,leading to abnormal cyclones in Northwest ***,Northwest China experiences a more humid climate than usual.

关键词： Arctic sea ice Greenland Sea North Atlantic SST Drought Northwest China

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Cell polarization in ischemic stroke: molecular mechanisms and advances

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Neural Regeneration Research 2025年第3期20卷 632-645页

作者： Yuanwei Li Xiaoxiao Xu Xuan Wu Jiarui Li Shiling chen Danyang chen Gaigai Li Zhouping Tang Department of Neurology Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubei ProvinceChina

Ischemic stroke is a cerebrovascular disease associated with high mortality and disability rates. Since the inflammation and immune response play a central role in driving ischemic damage, it becomes essential to modulate excessive inflammatory reactions to promote cell survival and facilitate tissue repair around the injury site. Various cell types are involved in the inflammatory response, including microglia, astrocytes, and neutrophils, each exhibiting distinct phenotypic profiles upon stimulation. They display either proinflammatory or anti-inflammatory states, a phenomenon known as ‘cell polarization.’ There are two cell polarization therapy strategies. The first involves inducing cells into a neuroprotective phenotype in vitro, then reintroducing them autologously. The second approach utilizes small molecular substances to directly affect cells in vivo. In this review, we elucidate the polarization dynamics of the three reactive cell populations(microglia, astrocytes, and neutrophils) in the context of ischemic stroke, and provide a comprehensive summary of the molecular mechanisms involved in their phenotypic switching. By unraveling the complexity of cell polarization, we hope to offer insights for future research on neuroinflammation and novel therapeutic strategies for ischemic stroke.

关键词： astrocyte polarization immune regulation inflammation ischemic injury microglia polarization neutrophil polarization signaling pathways stroke

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Engineering atomic Rb-N configurations to tune radical pathways for highly selective photocatalytic H2O2 synthesis coupled with biomass valorization

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Journal of Energy Chemistry 2025年第1期100卷 215-225页

作者： Jiaye Li Shuang Pan Yihuang chen Qiong Liu College of Chemistry and Materials Engineering Wenzhou University Guangdong Provincial Key Laboratory of Chemical Measurement and Emergency Test Technology (China) Institute of Analysis Guangdong Academy of Sciences (China National Analytical CenterGuangzhou)

Photocatalytic oxygen reduction for hydrogen peroxide （H2O2） synthesis presents a green and costeffective production ***,achieving highly selective H2O2synthesis remains challenging,necessitating precise control over free radical reaction pathways and minimizing undesirable oxidative ***,we report for the visible light-driven simultaneous co-photocatalytic reduction of O2to H2O2and oxidation of biomass using the atomic rubidium-nitride modified carbon nitride（CNRb）.The optimized CNRb catalyst demonstrates a record photoreduction rate of 8.01 mM h-1for H2O2generation and photooxidation rate of 3.75 mM h-1for furfuryl alcohol to furoic acid,achieving a remarkable solar-to-chemical conversion （SCC） efficiency of up to 2.27%.Experimental characterizations and DFT calculation disclosed that the introducing atomic Rb–N configurations allows for the high-selective generation of superoxide radicals while suppressing hydroxyl free radical *** is because the Rb–N serves as the new alternative site to perceive a stronger connection position for O2adsorption and reinforce the capability to extract protons,thereby triggering a high selective redox product *** study holds great potential in precisely regulating reactive radical processes at the atomic level,thereby paving the way for efficient synthesis of H2O2coupled with biomass valorization.

关键词： Atomic economy Radical pathway regulation Rubidium atom coordination Biomass valorization

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Cyano migration-mediated radical-polar crossover cyclopropanation

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Science China Chemistry 2025年第01期 241-248页

作者： Ziqiang Wang Yasu chen Jie Li chen Zhu Key Laboratory of Organic Synthesis of Jiangsu Province College of Chemistry Chemical Engineering and Materials ScienceSoochow University Frontiers Science Center for Transformative Molecules Zhangjiang Institute for Advanced Study and Shanghai Key Laboratory for Molecular Engineering of Chiral Drugs Shanghai Jiao Tong University

We report a novel cyano migration-mediated radical-polar crossover process, whereby both the sulfonylcyanation of aliphatic alkenes and the formation of cyclopropanes are concurrently achieved. This transformation yields a diverse array of multisubstituted cyclopropanes under mild photocatalytic conditions. Mechanistic studies elucidate that the reaction proceeds via intramolecular nucleophilic substitution, leading to the formation of the cyclopropane derivatives.

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