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World Journal of Clinical Cases 2019年第2期7卷 130-136页

作者： fu-liang he Chuan Li fu-Quan Liu Xing-Shun Qi Department of Interventional Therapy Beijing Shijitan HospitalCapital Medical University Liver Cirrhosis Study Group Department of GastroenterologyGeneral Hospital of Shenyang Military Area Section of Medical Services General Hospital of Shenyang Military Area

BACKGROUND Collagen proportionate area(CPA) is an important index for assessing the severity of liver fibrosis. Budd-Chiari syndrome can frequently progress to liver fibrosis and cirrhosis. CPA might play an important role in the pathological progress of Budd-Chiari *** To explore the role of CPA in predicting the outcomes of patients with BuddChiari *** Nine patients with Budd-Chiari syndrome undergoing transjugular intrahepatic portosystemic shunt(TIPS) were included. The median CPA level and correlation of CPA and prognosis of TIPS were *** Median CPA was 23.07%(range: 0%-40.20%). Pearson's χ2 test demonstrated a significant correlation of CPA with history of gastrointestinal bleeding(Pearson's coefficient: 0.832, P = 0.005), alanine aminotransferase(Pearson's coefficient:-0.694, P = 0.038), and prothrombin time(Pearson's coefficient: 0.68, P = 0.044).Although CPA was not significantly correlated with shunt dysfunction or hepatic encephalopathy after TIPS, the absolute CPA was relatively larger in patients who developed shunt dysfunction or hepatic encephalopathy after *** This preliminary clinicopathological study found a marginal effect of CPA on the outcomes of Budd-Chiari syndrome patients treated with TIPS.

关键词： Budd-Chiari syndrome hepatic vein Occlusion Thrombosis Fibrosis

hepatic amyloidosis leading to hepatic venular occlusive disease and Budd-Chiari syndrome: A case report

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World Journal of Clinical Cases 2019年第20期7卷 3282-3288页

作者： Ting-Ting Li Yi-Fan Wu fu-Quan Liu fu-liang he Department of Interventional Therapy Beijing Shijitan Hospital Capital Medical University The 9th Affiliated Hospital of Peking University

BACKGROUND Systemic amyloidosis in which multiple systems can be involved has become a common clinical *** the liver is affected,symptoms such as abdominal distension,fatigue,edema,liver,and jaundice could *** date,hepatic amyloidosis combined with hepatic venular occlusive disease and Budd-Chiari syndrome has not been *** SUMMARY A 54-year-old female patient was admitted to the Beijing Shijitan Hospital with hepatic amyloidosis leading to hepatic venular occlusion and Budd-Chiari syndrome in *** patient underwent surgery 1 mo previously for liver rupture and hemorrhage after Budd-Chiari syndrome was *** was diagnosed with hepatic venular occlusion,liver amyloidosis,and Budd-Chiari syndrome(*** hepatic vein occlusion).Transjugular intrahepatic portosystem shunt was *** the treatment,the clinical symptoms improved markedly with increase in urine *** hepatic amyloidosis with hepatic venous occlusion and Budd-Chiari syndrome is relatively rare clinically,and transjugular intrahepatic portosystem shunt is an effective treatment for this disease.

关键词： hepatic venular occlusion Liver amyloidosis Budd-Chiari syndrome Portal hypertension Case report

Establishment of a hepatic cirrhosis and portal hypertension model by hepatic arterial perfusion with 80% alcohol

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World Journal of Gastroenterology 2015年第32期21卷 9544-9553页

作者： Lei Wang fu-liang he fu-Quan Liu Zhen-Dong Yue Hong-Wei Zhao Department of Interventional Therapy Beijing Shijitan Hospital Capital Medical University

AIM: To determine the feasibility and safety of establishing a porcine hepatic cirrhosis and portal hypertension model by hepatic arterial perfusion with 80% ***: Twenty-one healthy Guizhou miniature pigs were randomly divided into three experimental groups and three control groups. The pigs in the three experimental groups were subjected to hepatic arterial perfusion with 7, 12 and 17 m L of 80% alcohol, respectively, while those in the three control groups underwent hepatic arterial perfusion with 7, 12 and 17 m L of saline, respectively. hepatic arteriography and direct portal phlebography were performed on all animals before and after perfusion, and the portal venous pressure and diameter were measured before perfusion, immediately after perfusion, and at 2, 4 and 6 wk after perfusion. The following procedures were performed at different time points: routine blood sampling, blood biochemistry, blood coagulation and blood ammonia tests before surgery, and at 2, 4 and 6 wk after surgery; hepatic biopsy before surgery, within 6 h after surgery, and at 1, 2, 3, 4 and 5 wk after surgery; abdominal enhanced computed tomography examination before surgery and at 6 wk after surgery; autopsy and multi-point sampling of various liver lobes for histological examination at 6 wk after surgery. RESULTS: In experimental group 1, different degrees of hepatic fibrosis were observed, and one pig developed hepatic cirrhosis. In experimental group 2, there were cases of hepatic cirrhosis, different degrees of increased portal venous pressure, and intrahepatic portal venous bypass, but neither extrahepatic portalsystemic bypass circulation nor death occurred. In experimental group 3, two animals died and threeanimals developed hepatic cirrhosis, and different degrees of increased portal venous pressure and intrahepatic portal venous bypass were also observed, but there was no extrahepatic portal-systemic bypass circulation. CONCLUSION: It is feasible to establish an anima

关键词： Alcohol hepatic arterial perfusion hepatic cirrhos

Parallel transjugular intrahepatic portosystemic shunt for controlling portal hypertension complications in cirrhotic patients

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World Journal of Gastroenterology 2014年第33期20卷 11835-11839页

作者： fu-liang he Lei Wang Zhen-Dong Yue Hong-Wei Zhao fu-Quan Liu Department of Interventional Therapy Beijing Shijitan Hospital Capital Medical University

AIM: To evaluate the feasibility of a second parallel transjugular intrahepatic portosystemic shunt (TIPS) to reduce portal venous pressure and control complications of portal hypertension.

关键词： Transjugular intrahepatic portosystemic shunt Portal hypertension Portosystemic pressure gradient

Safety and efficacy of transfemoral intrahepatic portosystemic shunt for portal hypertension: A single-center retrospective study

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World Journal of Clinical Cases 2019年第12期7卷 1410-1420页

作者： Yu Zhang fu-Quan Liu Zhen-Dong Yue Hong-Wei Zhao Lei Wang Zhen-Hua Fan fu-liang he Department of Interventional Therapy Peking University Ninth School of Clinical MedicineBeijing Shijitan Hospital and Capital Medical University

BACKGROUND Transfemoral intrahepatic portosystemic shunt (TFIPS) can be performed to treat portal hypertension. However, few studies have evaluated the safety and efficacy of this technique. AIM To retrospectively evaluate the safety and clinical outcomes of TFIPS and compare them with those of typical transjugular intrahepatic portosystemic shunt (TIPS). METHODS This retrospective study was approved by our hospital ethics committee. From November 2012 to November 2015, 19 patients who underwent successful TFIPS placement were included. In addition, 21 patients treated with TIPS during the same period were selected as controls. Data collected included the success rate and complications of TIPS and TFIPS. Continuous data were expressed as the mean ± SD and were compared using the Student’s t test. All categorical data were expressed as count (percentage) and were compared using the χ2 test or Fisher’s exact test. The Kaplan–Meier method was used to calculate cumulative survival rate and survival curves. RESULTS Baseline characteristics were comparable between the two groups. The success rate of TFIPS and TIPS was 95%(19/20) and 100%(21/21), respectively. Effective portal decompression and free antegrade shunt flow was completed in all patients. The portal pressure gradient prior to TIPS and TFIPS placement was 23.91 ± 4.64 mmHg and 22.61 ± 5.39 mmHg, respectively, and it was significantly decreased to 10.85 ± 3.33 mmHg and 10.84 ± 3.33 mmHg after stent placement, respectively. Time–to-event calculated rates of shunt patency at one and two years in the TFIPS and TIPS groups were not statistically different (94.7% vs 95.2% and 94.7% vs 90.5%, respectively). De nova hepatic encephalopathy was 27.5%(11/40) with five patients in the TFIPS group (26.3%) and six patients (28.6%) in the TIPS group experiencing it (P = 0.873). The cumulative survival rates were similar between the two groups: 94.7% and 94.7% at 1 and 2 years, respectively, in the TFIPS group vs 100% and 95.2%

关键词： Transjugular intraheptic portosystemic shunt Transfemoral intraheptic portosystemic shunt Portal hypertension Variceal bleeding

Transjugular intrahepatic portosystemic shunt for severe jaundice in patients with acute Budd-Chiari syndrome

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World Journal of Gastroenterology 2015年第8期21卷 2413-2418页

作者： fu-liang he Lei Wang Hong-Wei Zhao Zhen-Hua Fan Meng-Fei Zhao Shan Dai Zhen-Dong Yue fu-Quan Liu Department of Interventional Therapy Beijing Shijitan Hospital Capital Medical University

AIM:To evaluate the feasibility of transjugular intrahepatic portosystemic shunt(TIPS)for severe jaundice secondary to acute Budd-Chiari syndrome(BCS).METHODS:From February 2009 to March 2013,37patients with severe jaundice secondary to acute BCS were *** patients without hepatic venule,hepatic veins(HV)obstruction underwent percutaneous angioplasty of the inferior vena cava(IVC)and/or ***-one patients with HV occlusion underwent *** bilirubin,liver function,demographic data and operative data of the two groups of patients were ***:Twenty-one patients underwent TIPS and the technical success rate was 100%,with no technical *** patients underwent recanalization of the IVC and/or HVs and the technical success rate was 100%.The mean procedure time for TIPS was 84.0±12.11 min and angioplasty was44.11±5.12 min(Phe mean portosystemic pressure in the TIPS group decreased significantly from 40.50±4.32 to 16.05±3.50 mm Hg(Phe mean portosystemic pressure gradient decreased significantly from 33.60±2.62 to 7.30±2.21 mm Hg(Phe procedures,in the TIPS group,total bilirubin(TBIL)decreased significantly from 266.24±122.03 before surgery to 40.11±3.52μmol/L(Phe angioplasty group,bilirubin returned to the normal range,with TBIL decreased significantly from 258.22±72.71μmol/L to 13.33±3.54μmol/L(Pfunction improved faster than *** 2 wk,in the TIPS group,alanine aminotransferase(ALT)decreased significantly from 50.33±40.61 U/L to 28.67±7.02U/L(Phe angioplasty group,ALT decreased significantly from 51.56±27.90 to 14.22±2.59μmol/L(P<0.01)and AST from 60.66±39.89μmol/L to 8.18±1.89μmol/L(P<0.01).After mean follow-up of 12.6 m

关键词： Budd-Chiari syndrome Jaundice Transjugular intrahe

Stents combined with iodine-125 implantation to treat main portal vein tumor thrombus

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World Journal of Gastrointestinal Oncology 2018年第12期10卷 496-504页

作者： Yi-Fan Wu Tao Wang Zhen-Dong Yue Hong-Wei Zhao Lei Wang Zhen-Hua Fan fu-liang he fu-Quan Liu Department of Interventional Therapy Beijing Shijitan HospitalCapital Medical University Department of Interventional Therapy The Affiliated Yantai Yuhuangding Hospital of Qingdao University

AIM To evaluate the efficacy of main portal vein stents combined with iodine-125(^(125)Ⅰ) to treat main portal vein tumor *** From January 1, 2010 to January 1, 2015, 111 patients were diagnosed with liver cancer combined with main portal vein tumor thrombus. They were non-randomly assigned to undergo treatment with transarterial chemoembolization(TACE)/transarterial embolization(TAE) + portal vein stents combined with ^(125)Ⅰ implantation(Group A) and TACE/TAE + portal vein stents only(Group B). After the operation, scheduled follow-up was performed at 6, 12 and 24 mo. The recorded information included clinical manifestations, survival rate, and stent restenosis rate. Kaplan–Meier curves, log-rank test and Cox regression were used for data analyses. RESULTS From January 1, 2010 to January 1, 2015, 54 and 57 patients were allocated to Groups A and B, respectively. The survival rates at 6, 12 and 24 mo were 85.2%, 42.6% and 22.2% in Group A and 50.9%, 10.5% and 0% in Group B. The differences were significant [log rank P he rates of stent restenosis were 18.5%, 55.6% and 83.3% in Group A and 43.9%, 82.5% and 96.5% in Group B. The differences were significant(log rank P he only factor affecting survival rate in this *** Main portal vein stents combined with ^(125)Ⅰ can significantly improve survival rate and reduce the rate of stent restenosis.

关键词： Iodine-125 Liver cancer Stent Main portal vein tumor thrombus Transarterial chemoembolization/ transarterial embolization

AAV for Gene Therapy in Ocular Diseases:Progress and Prospects

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Research 2024年第3期2023卷 651-670页

作者： Xiaoyu he Yidian fu liang Ma Yizheng Yao Shengfang Ge Zhi Yang Xianqun Fan Department of Ophthalmology Ninth People’s HospitalShanghai JiaoTong University School of MedicineShanghaiChina Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology ShanghaiChina Jiangsu Key Laboratory of Neuropsychiatric Diseases and Institute of Neuroscience Soochow UniversityClinical Research Center of Neurological DiseaseThe Second Affiliated Hospital of Soochow UniversitySuzhouChina

Owing to the promising therapeutic effect and one-time treatment advantage, gene therapy may completely change the management of eye diseases, especially retinal diseases. Adeno-associated virus (AAV) is considered one of the most promising viral gene delivery tools because it can infect various types of tissues and is considered as a relatively safe gene delivery vector. The eye is one of the most popular organs for gene therapy, since its limited volume is suitable for small doses of AAV stably transduction. Recently, an increasing number of clinical trials of AAV-mediated gene therapy are underway. This review summarizes the biological functions of AAV and its application in the treatment of various ocular diseases, as well as the characteristics of different AAV delivery routes in clinical applications. here, the latest research progresses in AAV-mediated gene editing and silencing strategies to modify that the genetic ocular diseases are systematically outlined, especially by base editing and prime editing. We discuss the progress of AAV in ocular optogenetic therapy. We also summarize the application of AAV-mediated gene therapy in animal models and the difficulties in its clinical transformation.

关键词： AAV organs treatment

Iodine-125 implantation with transjugular intrahepatic portosystemic shunt for main portal vein tumor thrombus

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World Journal of Gastrointestinal Oncology 2019年第4期11卷 310-321页

作者： Yue Zhang Yi-Fan Wu Zhen-Dong Yue Hong-Wei Zhao Lei Wang Zhen-Hua Fan fu-liang he Tao Wang fu-Quan Liu Department of Interventional Therapy Peking University Ninth School of Clinical Medicine Beijing Shijitan Hospital and Capital Medical University Department of Interventional Therapy Beijing Shijitan Hospital and Capital Medical University Department of Interventional Therapy The affiliated Yantai Yuhuangding Hospitalof Qingdao University

BACKGROUND Main portal vein tumor thrombus(MPVTT), which has a high incidence, is the major complication of terminal liver cancer. The occurrence of MPVTT is always a negative prognostic factor for patients with hepatocellular carcinoma(HCC).Therefore, attention should be paid to the treatment of MPVTT and its *** To evaluate the efficacy of transarterial chemoembolization/transarterial embolization(TACE/TAE)+^(125)I seeds implantation with transjugular intrahepatic portosystemic shunt(TIPS) in treating MPVTT and its *** From January 2007 to March 2015, 85 consecutive patients with MPVTT were nonrandomly assigned to undergo treatment with TACE/TAE + TIPS and ^(125)I implantation(TIPS-^(125)I group) or TACE/TAE + TIPS only(TIPS only group) in Beijing Shijitan Hospital, and all clinical data were collected. During 24 mo follow-up, the incidence of overall survival, stent stenosis and symptom recurrence was analyzed to evaluate the efficacy of TIPS-^(125)*** During 24 mo follow-up of all patients, we collected data at 6, 12 and 24 mo. The rates of survival were 80%, 45%, and 20%, respectively, in the TIPS-^(125)I group,whereas those in the TIPS only group were 64.4%, 24.4%, and 4.4%, respectively(P he rates of symptom recurrence were 7.5%, 22.5%, and 35%,respectively, in the TIPS-^(125)I group, whereas those in the TIPS only group were31.1%, 62.2%, and 82.2%(P he rates of stent restenosis were 12.5%,27.5%, and 42.5%, respectively, in the TIPS-^(125)I group, and 42.2%, 68.9%, and84.4%, respectively, in the TIPS only group(P < 0.05). TIPS-^(125)I was found to be significantly favorable in treating MPVTT and its complications in patients with *** TACE/TAE+^(125)I combined with TIPS is effective in treating MPVTT and its complications, improving quality of life of patients and reducing mortality.

关键词： Iodine-125 Transjugular intrahepatic portosystemic shunt Main portal vein tumor thrombus Metastasis Portal hypertension

Transjugular intrahepatic portosystemic shunt and splenectomy are more effective than endoscopic therapy for recurrent variceal bleeding in patients with idiopathic noncirrhotic portal hypertension

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World Journal of Clinical Cases 2020年第10期8卷 1871-1877页

作者： fu-liang he Rui-Zhao Qi Yue-Ning Zhang Ke Zhang Yu-Zheng Zhu-Ge Min Wang Yu Wang Ji-Dong Jia fu-Quan Liu Department of hepatology Beijing Friendship HospitalCapital Medical UniversityBeijing 100050China Department of General Surgery Fifth Medical Center of PLA General HospitalBeijing 100039China Department of Gastroenterology Beijing You’an HospitalCapital Medical UniversityBeijing 100069China Department of General Surgery Beijing Ditan HospitalCapital Medical UniversityBeijing 100102China Department of Gastroenterology Nanjing Drum Tower Hospitalthe Affiliated Hospital of Nanjing University Medical SchoolNanjing 210008Jiangsu ProvinceChina Department of Interventional Therapy Beijing Shijitan HospitalCapital Medical UniversityBeijing 100038China

BACKGROUND Transjugular intrahepatic portosystemic shunt(TIPS),splenectomy plus esophagogastric devascularization(SED)and endoscopic therapy+non-selectiveβ-blockers(ET+NSBB)are widely applied in secondary prevention of recurrent gastroesophageal variceal bleeding in patients with liver *** different treatments,however,have not been compared in patients with idiopathic noncirrhotic portal hypertension(INCPH).AIM To compare the outcomes of TIPS,SED and ET+NSBB in the control of variceal rebleeding in patients with *** This retrospective study recruited patients from six centers across *** characteristics,baseline profiles and follow-up clinical outcomes were ***-procedural clinical outcomes,including incidence of rebleeding,hepatic encephalopathy(he),portal vein thrombosis(PVT)and mortality rates,were compared in the different *** In total,81 patients were recruited,with 28 receiving TIPS,26 SED,and 27 ET+*** significant differences in demographic and baseline characteristics were found among these three groups before the *** treatment,blood ammonia was significantly higher in the TIPS group;hemoglobin level and platelet count were significantly higher in the SED group(Pher in the ET+NSBB group(Phe TIPS,SED and ET+NSBB groups,respectively,with no significant differences(P=0.082).Logistic regression analysis showed that mortality was significantly correlated with rebleeding,he,portal thrombosis and superior mesenteric vein thrombosis(Phe three *** was significantly correlated with rebleeding,he and PVT.

关键词： Idiopathic non-cirrhotic portal hypertension Transjugular intrahepatic portosystemic shunt Splenectomy plus esophagogastric devascularization Endoscopic therapy Survival