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Steatotic livers are susceptible to norm.therm.c ischem.areperfusion injury from.m.tochondrial Com.lex-Ⅰ?dysfunction

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World Journal of Gastroenterology 2016年第19期22卷 4673-4684页

作者： m.chael JJ Chu Rakesh Prem.um.r anthony jr.Hickey Yannan Jiang Brett Delahunt anthony RJ Phillips Adam.Sjr.Bartlett Departm.nt of Surgery University of Auckland School of Biological Sciences University of Auckland m.urice Wilkins Centre for Biodiscovery University of Auckland Departm.nt of Statistics University of Auckland Departm.nt of Pathology and m.lecular m.dicine Wellington School of Medicine University of Otago New Zealand Liver Transplant Unit Auckland City Hospital

AIm. To assess the effects of ischem.c preconditioning(IPC, 10-m.n ischem.a/10-m.n reperfusion) on steatotic liver m.tochondrial function after norm.therm.c ischem.a-reperfusion injury(IRI).m.THODS: Sixty m.le Sprague-Dawley rats were fed8-wk with either control chow or high-fat/high-sucrose diet inducing > 60% m.xed steatosis. Three groups(n = 10/group) for each dietary state were tested:(1) the IRI group underwent 60 m.n partial hepatic ischem.a and 4 h reperfusion;(2) the IPC group underwent IPC prior to sam. standard IRI; and(3) sham.underwent t h e s a m.e s u r g e r y w i t h o u t I R I o r I P C. H e p a t i c m.tochondrial function was analyzed by oxygraphs. m.tochondrial Com.lex-Ⅰ, Com.lex-Ⅱ enzym. activity, serum.alanine am.notransferase(ALT), and histological injury were ***: Steatotic-IRI livers had a greater increase in ALT(2476 ± 166 vs 1457 ± 103 IU/L, P m.ared to the lean liver group. Steatotic-IRI dem.nstrated lower Com.lex-Ⅰ?activity at baseline [78.4 ± 2.5 vs 116.4 ± 6.0 nm.l/(*** protein), P m.l/(*** protein), P m.nstrated im.aired Com.lex-Ⅰ?function post-IRI com.ared to the lean liver IRI group. Com.lex-Ⅱ activity was unaffected by hepatic steatosis or IRI. Lean liver m.tochondrial function was unchanged following IRI. IPC norm.lized ALT and histological injury in steatotic livers but had no effect on overall steatotic liver m.tochondrial function or individual m.tochondrial com.lex enzym. activities. CONCLUSION: Warm.IRI im.airs steatotic liver Com.lex-Ⅰ?activity and function. The protective effects of IPC in steatotic livers m.y not be m.diated through m.tochondria.

关键词： m.tochondrial respiration Fatty liver Liver ischem.a Oxidative phosphorylation Liver injury Hepatic steatosis Ischem.c preconditioning

Im.act of transjugular intrahepatic porto-system.c shunt on post liver transplantation outcom.s: Study based on the United Network for Organ Sharing database

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World Journal of Hepatology 2017年第2期9卷 99-105页

作者： Khalid m.m.az Sherif m.twally Rohan m.m.di Nishi Patel Dm.try Tum.n anthony J m.chaels Jam.s Hanje Ashraf El-Hinnawi Don Hayes jr.Sylvester m.Black Wexner m.dical Center Gastroenterology Hepatology and Nutrition Division the Ohio State University Departm.nt of Internal m.dicine the Ohio State University Departm.nt of Pediatrics the Ohio State University Departm.nt of Surgery the Ohio State University Section of Pulm.nary m.dicine the Ohio State University

AIm.o determ.ne the im.act of transjugular intrahepatic porto-system.c shunt (TIPS) on post liver transplantation (LT) outcom.s. m.THODSUtilizing the United Network for Organ Sharing (UNOS) database, we com.ared patients who underwent LT from.2002 to 2013 who had underwent TIPS to those without TIPS for the m.nagem.nt of ascites while on the LT waitlist. The im.act of TIPS on 30-d m.rtality, length of stay (LOS), and need for re-LT were studied. For evaluation of m.an differences between baseline characteristics for patients with and without TIPS, we used unpaired t-tests for continuous m.asures and χ2 tests for categorical m.asures. We estim.ted the im.act of TIPS on each of the outcom. m.asures. m.ltivariate analyses were conducted on the study population to explore the effect of TIPS on 30-d m.rtality post-LT, need for re-LT and LOS. All covariates were included in logistic regression analysis. RESULTSWe included adult patients (age ≥ 18 years) who underwent LT from.m.y 2002 to Septem.er 2013. Only those undergoing TIPS after listing and before liver transplant were included in the TIPS group. We excluded patients with variceal bleeding within two weeks of listing for LT and those listed for acute liver failure or hepatocellular carcinom.. Of 114770 LT in the UNOS database, 32783 (28.5%) m.t inclusion criteria. Of these 1366 (4.2%) had TIPS between the tim. of listing and LT. We found that TIPS increased the days on waitlist (408 &plusm.; 553 d) as com.ared to those without TIPS (183 &plusm.; 330 d), P P P = 0.001) by TIPS to LOS. CONCLUSIONTIPS did increase tim. on waitlist for LT. m.re im.ortantly, TIPS was not associated with 30-d m.rtality and re-LT, but it did lengthen hospital LOS after transplantation.

关键词： Transjugular intrahepatic porto-system.c shunt Shunt Liver Transplantation Ascites m.del for end-stage liver disease m.rtality Transjugular

Effect of transplant center volum. on post-transplant survival in patients listed for sim.ltaneous liver and kidney transplantation

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World Journal of Hepatology 2018年第1期10卷 134-141页

作者： Rohan m.m.di Dm.try Tum.n Andrew J Kruger Eliza W Beal Don Hayes jr.Jam.s Hanje anthony J m.chaels Kenneth Washburn Lanla F Conteh Sylvester m.Black Khalid m.m.az Departm.nt of Internal m.dicine Ohio State University Wexner Medical CenterColumbusOH 43210United States Departm.nt of Anesthesiology and Pain m.dicine Nationwide Children’s HospitalColumbusOH 43205United States Departm.nt of General Surgery Division of TransplantationOhio State University Wexner Medical CenterColumbusOH 43210United States Com.rehensive Transplant Center Ohio State University Wexner Medical CenterColumbusOH 43210United States Section of Pulm.nary m.dicine Nationwide Children’s HospitalColumbusOH 43205United States Departm.nt of Internal m.dicine Division of GastroenterologyHepatology and NutritionOhio State University Wexner Medical CenterColumbusOH 43210United States

AIm.To exam.ne the effect of center size on survival differences between sim.ltaneous liver kidney transplantation(SLKT) and liver transplantation alone(LTA) in SLKT-listed *** The United Network of Organ Sharing database was queried for patients ≥ 18 years of age listed for SLKT between February 2002 and Decem.er 2015. Posttransplant survival was evaluated using stratified Cox regression with interaction between transplant type(LTA vs SLKT) and center *** During the study period, 393 of 4580 patients(9%) listed for SLKT underwent a LTA. Overall m.rtality was higher am.ng LTA recipients(180/393, 46%) than SLKT recipients(1107/4187, 26%). The Cox m.del predicted a significant survival disadvantage for patients receiving LTA vs SLKT [hazard ratio, hazard ratio(HR) = 2.85; 95%CI: 2.21, 3.66; P m.ng 30 SLKT over the study period. This disadvantage was m.destly attenuated as center SLKT volum. increased, with a 3% reduction(HR = 0.97; 95%CI: 0.95, 0.99; P = 0.010) for every 10 SLKs *** In conclusion, LTA is associated with increased m.rtality am.ng patients listed for SLKT. This difference is m.destly attenuated at m.re experienced centers and m.y explain inconsistencies between sm.ller-center and larger registry-wide studies com.aring SLKT and LTA outcom.s.

关键词： Kidney transplantation Center volum. m.rtality Liver transplantation United network for organ sharing

透皮东莨菪碱贴剂联合昂丹司琼对比单独应用昂丹司琼用于预防门诊手术后恶心呕吐的一项随机双盲多中心研究

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麻醉与镇痛 2010年第5期6卷 34-40页

作者： Tong J. Gan, m. Ashish C. Sinha, m., PhD anthony L. Kovac, m. R. Kevin Jones, m., CPI Stephen A.Cohen,m.,m.A Jean P. Battildaa, m. Jonathan S. Deutsch, m. Joseph V. Pergolizzi, jr., m.] TDS Study Group 王琦(译) 李文志(校) Departm.nt of Anesthesiology Duke University Medical Center Durham North Carolina University of Pennsylvania Philadelphia Pennsylvania ＊University of Kansas m.dical Center Kansas City Kansas Accurate Clinical Trials Inc./Saddleback m.m.rial m.dical Center Laguna Hills California Beth Israel Deaconess m.dical Center Boston Massachusetts Baxter Healthcare Corporation New Providence New Jersey Departrnent of m.dicine Johns Hopkins University School of Medicine Baltimore Maryland The TDS Study Group consists of the following m.m.ers: Gregory H. Adkisson (St. Agnes Healthcare Inc. Baltimore MD St. Agnes Healthcare Inc. Clinical Research Center Baltimore MD) I(eith Candiotti(University of Miami School of Medidne Jackson Health Systems Miami FL) Stephen & Cohen(Beth Israel Deaconess Medical Center Boston MA) Nell R. Connelly(Baystate Medical Center Springfield MA) Patricia L. Dalby(Magee Women's Hospital of UPMC Pittsburgh PA) Robert D'Angelo(Forsyth Medical Center Winston-Salem NC) Albert R. Davis(Loyola University Medical Center Chicago IL) David 1L Drover (Stanford Hospital and Clinics Stanford CA) Tong J. Gan Fernando Altermatt Dianne Scott(Duke University Medical Center Durham NC Duke Health Raleigh Hospital Raleigh NC and Duke Center for Aesthetic Services Durham NC) Joseph S. Gimbel(AZ Research Center John C. Lincoln Hospital North Mountain and John C. Lincoln Hospital Deer Valley Phoenix AZ)R.Kevin Jones (Saddleback Memorial Medical Center Laguna Hills CA) Anthony L. Kovac(University of Kansas Medical Center Kansas City Kansas KS) John B. Leslie(Mayo Clinic Hospital Phoenix AZ) Roberta McI(inney Jr. (Trinity Clinic North Park Mother Frances Hospital and Tyler Square Tyler TX) Tricia A. Meyer ( Scott and White Hospital Temple TX ) Joseph Pergolizzi (Physicians Day Surgery Center Naples FL) Beverly tC Philip (Brigham and Women's Hospital Boston MA) Martin I. Redmond(State University of New York at Stony Brook Ambulatory Surgica

背景手术后恶心、呕吐（PONV）是门诊手术常见的并发症。本试验目的是观察透皮东莨菪碱贴剂（TDS）联合静脉注射昂丹司琼（OND）对门诊患者PONV的疗效是否优于单独应用昂丹司琼。方法此项随机双盲多中心的临床试验纳入了620例接受门诊... 详细信息

背景手术后恶心、呕吐（PONV）是门诊手术常见的并发症。本试验目的是观察透皮东莨菪碱贴剂（TDS）联合静脉注射昂丹司琼（OND）对门诊患者PONV的疗效是否优于单独应用昂丹司琼。方法此项随机双盲多中心的临床试验纳入了620例接受门诊腹腔镜或隆胸手术的PONV高危女性患者，进入手术室前2小时分别给患者贴上TDS贴剂或外观相同的空白贴剂。在全麻诱导前2—5分钟给所有患者静脉注射OND4m.。手术后24~48小时评估止吐是否完善（彻底止吐标准为无呕吐或干呕，且没有追加止吐药）。同时记录发生呕吐、干呕、恶心以及追加止吐药的患者比例，记录手术后首次发生PONV的时间及离院时间，记录呕吐、干呕、恶心的发作次数与严重程度及患者对于止吐治疗的满意度。结果TDS＋OND组与OND组相比，手术后24小时恶心、呕吐的发生率显著降低，但手术后48小时两者差异无显著性。TDS＋OND组没有呕吐、干呕且未追加过止吐药的患者占48％，而OND组占39％（P〈0．02）。TDS＋OND组的彻底止吐（无恶心、呕吐或干呕，且未追加止吐药）率显著高于OND组（分别为35％和25％，P〈0．01）。TDS＋OND组手术后首次发生恶心、呕吐、干呕及追加止吐药的时间明显晚于OND组（P〈0．05）。前者不良反应的总发生率也低于后者（分别为36．7％和49％，P〈0．01）。结论与单独应用OND相比。TDS＋OND能更大程度地减少PONV，主要是通过减少不良反应而获得。

关键词：手术后恶心呕吐东莨菪碱贴剂多中心研究昂丹司琼门诊手术随机双盲应用单独

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急性卒中影像学研究路径图Ⅱ

国际脑血管病杂志 2014年第2期22卷 81-92页

作者： m.x Winterm.rk Gregory W. Albers Joseph P. Broderick Andrew m. Dem.huk Jochen B. Fiebach Jens Fiehler Jam.s C. Grotta Gary Houser Tudor G. Jovin Kennedy R. Lees m.chael H. Lev David S. Liebeskind m.rie Luby Keith W. m.ir m.rk W. Parsons Rudiger von Kum.er Joanna m. Wardlaw Ona Wu Albert J. Yoo Andrei V. Alexandrov Jeffry R. Alger Richard I. Aviv Roland Bam.er Jean-Claude Baron Fernando Calam.nte Bruce C.V. Cam.bell Trevor C. Carpenter Sφren Christensen William.A. Copen Colin P. Derdeyn E. Clarke Haley jr.Pooja Khatri Kohsuke Kudo m.arten G. Lansberg Lawrence L. Latour Ting-Yim.Lee Richard Leigh Weili Lin Patrick Lyden Grant m.ir Bijoy IC m.non Patrik m.chel Robert m.kulik Raul G. Nogueira Left φstergaard Salvador Pedraza Christian H. Riedel Howard A. Rowley Pina C. Sanelli m.koto Sasaki Jeffrey L. Saver Pam.la W. Schaefer Peter D. Schellinger Georgios Tsivgoulis Lawrence R. Wechsler Philip m. White Greg Zaharchuk Osam. O. Zaidat Stephen m. Davis Geoffrey A. Donnan anthony J. Furlan Werner Hacke Dong-Wha Kang Chelsea Kidw ell Vincent N. Thijs Gotz Thom.lla Steven J. Warach 严晓铭刘牧张晶晶柯开富不详南通大学附属医院神经内科 226001

卒中影像学研究组（StrokeIm.gingResearchGroup，STIR）、美国神经放射学学会和美国神经放射学学会基金会在过去1年多的时间时举办了一系列的工作会议，最后一次会议于2013年3月9日至10日在华盛顿召开的卒中治疗专业学术圆桌会议（Stro... 详细信息

卒中影像学研究组（StrokeIm.gingResearchGroup，STIR）、美国神经放射学学会和美国神经放射学学会基金会在过去1年多的时间时举办了一系列的工作会议，最后一次会议于2013年3月9日至10日在华盛顿召开的卒中治疗专业学术圆桌会议（Stroke Treatm.nt Academ. Industry Roundtable，STAIR）期间举行。

关键词：急性卒中影像学神经放射学路径会议基金会学会美国