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Ten-year survival and recurrence of hepatocellular cancer

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Hepatoma Research 2019年第10期5卷 32-41页

作者： Tomoki Sempokuya linda l.Wong Department of Medicine John A.Burns School of MedicineUniversity of Hawaii at ManoaHonoluluHawaiiHI 96813USA Division of Gastroenterology and Hepatology University of Nebraska Medical CenterOmahaNebraskaNE 68198USA Department of Surgery John A.Burns School of MedicineUniversity of Hawaii at ManoaHonoluluHawaiiHI 96813USA.

Aim:long-term survival after hepatocellular cancer(HCC)is difficult to achieve likely related to *** study aimed to identify factors that were predictive of 10-year survival after the diagnosis of ***:In a prospectively collected database of 1374 HCC cases(1993-2019),we identified 70 patients who survived over 10 years regardless of *** then identified 164 patients in the entire cohort who either had liver resection or transplant,and died before 10 ***,tumor characteristics,treatment,recurrence and treatment of recurrence were ***:Of the 10-year survivors,36 underwent transplant,27 had liver resection and 7 patients had only locoregional *** to the non-survivors,the 10-year survivors were younger and had fewer comorbidities or recurrence,smaller tumor size,lower AST,AlT,AFP,platelets,neutrophil-to-lymphocyte *** analysis showed only age and diabetes to be negative *** occurred in 24 survivors(34.3%)with mean time to recurrence with standard deviation 57.1±42.6 months compared to 80 non-survivors(48.7%)with mean time to recurrence of 15.3±14.8 *** hepatic resection,10-year survivors had longer time to recurrence compared to non-survivors(median:31.3 months).Conclusion:long-term survivors mostly occur after resection or transplant,but 10%of our cohort survived 10 years with only locoregional *** health status maybe an important predictor of 10-year survival for ;patients receiving liver *** of HCC occurs in both 10-year survivors and non-survivors,but later recurrence with aggressive treatment of the recurrence may allow for 10-year survival.

关键词： Hepatocellular cancer 10-year survival liver transplantation hepatic resection

Hepatocellular Carcinoma in Micronesians, a Growing Pacific Islander Population in the U.S.

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Open Journal of Gastroenterology 2018年第6期8卷 223-233页

作者： Eric M. Wu Brenda Y. Hernandez linda l. Wong Department of Surgery University of Hawaii John A. Burns School of Medicine Honolulu USA Cancer Center University of Hawaii Honolulu USA

Background: Micronesians are a rapidly growing population in Hawaii and the continental U.S. Hepatitis B is prevalent in Micronesia, but the consequences in those migrating to the U.S. are unclear. This study characterizes hepatocellular carcinoma in Micronesians with comparisons to other Pacific Islanders. Methods: A retrospective evaluation was undertaken of 40 Micronesian and 142 Non-Micronesian Pacific hepatocellular carcinoma patients diagnosed in a large clinical practice in Hawaii from 1993-2017. Results: All Micronesians were born outside of the U.S. Micronesians were younger at diagnosis (52.0 vs. 60.2 years), had higher rates of hepatitis B (80% vs. 31.2%), a family history of hepatocellular carcinoma (17.5% vs. 4.4%) and more tumors landers had higher rates of Hepatitis C (48.6% vs. 22.5%) and hypertension (61.7% vs. 32.4%). There was no difference in the proportions of screen-detected tumors, those meeting Milan criteria, tumor stage, or liver function. Micronesians had better 5-year survival rates (48% vs. 16.7%). Conclusion: Hepatocellular carcinoma in Micronesians is primarily Hepatitis B-related. Micronesians were equally likely to have hepatocellular carcinoma found with screening, undergo transplant and had better survival. Our study emphasizes the need for hepatitis B screening and hepatocellular carcinoma surveillance in Micronesians.

关键词： Hepatocellular Carcinoma Micronesians Hepatitis B Screening

Operative Time as a Measure of Quality in Pancreaticoduodenectomy: Is Faster Better? A Retrospective Review Using the ACS NSQIP Database

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Surgical Science 2015年第9期6卷 418-426页

作者： Gwendolyn M. Garnett lynne Wilkens Whitney limm linda l. Wong Department of Surgery John A. Burns School of Medicine University of Hawaii Honolulu USA Department of Surgery Queens Medical Center Honolulu USA

Objective: To determine if pancreaticoduodenectomy operative time can provide insight into surgeon performance and thus be considered for use as a quality indicator. Background: Case volume is the traditional quality metric for complex pancreatic surgery, with studies showing better outcomes for high-volume providers. However, there are surgeons performing fewer cases with good quality who are overlooked for referrals directed to high-volume “centers of excellence”. Additional quality metrics are needed. Methods: The ACS NSQIP database (2005-2011) was used to identify 4805 pancreaticoduodenectomy patients. Cases were divided at the mean operative time (ORtime) into those ≤373 (n = 2638, 54.9%) vs ≥373 minutes in duration. Complications and outcome measures were compared and predictors of 30-day mortality were assessed. Results: Age ≤ 65 years, male sex, prior chemotherapy, prior radiation, disseminated cancer, diabetes, recent MI, no prior TIA, lower bilirubin and platelet count, and higher prothrombin time were associated with ORtime > 373 minutes. Patients with ORtime > 373 minutes demonstrated more intra-abdominal and superficial infections, wound dehiscence, bleeding requiring transfusion, need for reintubation, septic shock, and returns to OR. ORtime > 373 minutes was associated with longer hospital stay and increased 30-day mortality. ORtime > 373 minutes was a significant and independent predictor in a stepwise model of 30-day mortality. Conclusions: Shorter pancreaticoduodenectomy operative time is associated with fewer complications, shorter hospital stays and lower 30-day mortality after adjusting for patient factors. This may imply that shorter operative time is associated with superior surgical outcome. Operative time may provide insight into surgeon performance and be considered for use as a quality metric.

关键词： Pancreaticoduodenectomy Operative Time

Hepatitis B Virus Screening Patterns amongst Physicians in Hawaii: Changes in a Decade

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Open Journal of Gastroenterology 2015年第10期5卷 139-145页

作者： Chuong T. Tran Krista K. Kiyosaki linda l. Wong california Pacific Medical Center San Francisco CA USA Department of Surgery John A. Burns School of Medicine University of Hawaii Honolulu HI USA University of Hawaii Cancer Center Honolulu HI USA

Purpose: Hawaii had the highest incidence of liver cancer in the US and had a unique patient population with many immigrants from the Pacific and Asia where Hepatitis B virus (HBV) was endemic. HBV screening in high risk populations was a recommended measure of preventative medicine, thus we sought to examine physician screening patterns for HBV in Hawaii. Methods: We retrospectively analyzed billing claims from 1999 to 2009 from the largest healthcare coverage provider in the state of Hawaii. We identified all patients (>18 years) who underwent HBV screening based on Current Procedural Terminology (CPT) billing codes. We collected data on age, gender and specialty of physicians ordering the screening tests. Analysis was done in 2013 and 2014. Results: Of an estimated 700,000 covered lives, 125,576 patients underwent HBV screening. We stratified the patients into two eras from 1999-2004 (N = 52,245) and 2005-2009 (N = 73,331) to examine temporal trends. In the first era, 30,975 women (59.3%) underwent HBV screening, compared to 49,950 women (69.1%) screened in the 2005-2009 era. There absolute number of tests increased, but the proportion done by primary care MDs decreased from 55.6% to 44.9%. OB/GYN screened 15.6% in the early era and 26.9% in later era. Conclusions: There was an increase in women aged 18 - 40 years screened in the 2005-2009 era compared to 1999-2004, most likely due to OB/GYN physicians’ screening of prenatal women. Physician education on HBV vaccination/treatment or appropriate referral should include OB/GYN as well as primary care physicians.

关键词： CPT Codes Hepatitis B HBV Screening Patterns Hawaii

Advances in nanomaterials for brain microscopy

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Nano Research 2018年第10期11卷 5144-5172页

作者： Jackson T. Del Bonis-O'Donnell linda Chio Gabriel F. Dorlhiac lan R. McFarlane Markita P. landry Department of Chemical and Biomolecular Engineering University of California Berkeley CA 94720 USA Biophysics Graduate Group University of California Berkeley CA 94720 USA Innovative Genomics Institute (IGI) Berkeley CA 94720 USA california Institute for Quantitative Biosciences QB3 University of California Berkeley CA 94720 USA Chan-Zuckerberg Biohub San Francisco CA 94158 USA

Microscopic imaging of the brain continues to reveal details of its structure, connectivity, and function. To further improve our understanding of the emergent properties and functions of neural circuits, we need to directly visualize the relationship between brain structure, neuron activity, and neurochemistry. Advances in the chemical and optical properties of nanomaterials, and developments in deep-tissue microscopy, may help to overcome the current challenges of in-vivo brain imaging, particularly when imaging the brain through optically-dense brain tissue, skull, and scalp. Developments in nanomaterials may enable the implementation of tunable chemical functionality for neurochemical targeting and sensing, and fluorescence stability for long-term imaging. In this review, we summarize the current methods used for brain microscopy and describe the diverse classes of nanomaterials recently offered as contrast agents and functional probes for microscopic optical imaging of the brain.

关键词： nanomaterials neuroscience imaging microscopy

Effects of environmental variability on superspreading transmission events in stochastic epidemic models

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Infectious Disease Modelling 2021年第1期6卷 560-583页

作者： Nika Shakiba Christina J.Edholm Blessing O.Emerenini Anarina l.Murillo Angela Peace Omar Saucedo Xueying Wang linda J.S.Allen School of Biomedical Engineering University of British ColumbiaVancouverBCCanada Department of Mathematics Scripps CollegeClaremontCAUSA Department of Mathematics Oregon State UniversityCorvallisORUSA Department of Pediatrics and Center for Statistical Sciences Brown UniversityProvidenceRIUSA Department of Mathematics and Statistics Texas Tech UniversityLubbockTXUSA Department of Mathematics Virginia Polytechnic Institute and State UniversityBlacksburgVAUSA Department of Mathematics and Statistics Washington State UniversityPullmanWAUSA School of Mathematical Sciences Rochester Institute of TechnologyRochesterNYUSA

Superspreaders(individuals with a high propensity for disease spread)have played a pivotal role in recent emerging and re-emerging *** disease outbreak studies,host heterogeneity based on demographic(***,sex,vaccination status)and environmental(***,urban/rural residence,clinics)factors are critical for the spread of infectious diseases,such as Ebola and Middle East Respiratory Syndrome(MERS).Transmission rates can vary as demographic and environmental factors are altered naturally or due to modified behaviors in response to the implementation of public health *** this work,we develop stochastic models to explore the effects of demographic and environmental variability on human-to-human disease transmission rates among superspreaders in the case of Ebola and *** show that the addition of environmental variability results in reduced probability of outbreak occurrence,however the severity of outbreaks that do occur *** observations have implications for public health strategies that aim to control environmental variables.

关键词： Superspreader MERS Ebola Environmental variability Stochastic models

lingguizhugan Decoction, a Chinese herbal formula, improves insulin resistance in overweight/obese subjects with non-alcoholic fatty liver disease: a translational approach

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Frontiers of Medicine 2022年第5期16卷 745-759页

作者： liang Dai Jingjuan Xu Baocheng liu Yanqi Dang Ruirui Wang lijie Zhuang Dong li lulu Jiao Jianying Wang lei Zhang linda lDZhong Wenjun Zhou Guang Ji Institute of Digestive Diseases Longhua HospitalShanghai University of Traditional Chinese MedicineShanghai 200032China Clinical Research Academy Peking University Shenzhen HospitalShenzhen 518032China Department of Integrated Traditional and Western Medicine Jinling HospitalMedical School of Nanjing UniversityNanjing 210002China Shanghai Innovation Centre of TCM Health Service Shanghai University of Traditional Chinese MedicineShanghai 201203China Sanlin Health Centre of Pudong New District Shanghai 200120China Zhangjiang Health Centre of Pudong New District Shanghai 201203China Beicai Health Centre of Pudong New District Shanghai 201204China Hong Kong Chinese Medicine Study Centre Hong Kong Baptist UniversityHong Kong 999077China

lingguizhugan Decoction(lGZG)has been investigated in basic studies,with satisfactory effects on insulin resistance in non-alcoholic fatty liver disease(NAFlD).This translational approach aimed to explore the effect and underlying mechanism of lGZG in clinical setting.A randomized,double-blinded,placebo-controlled trial was performed.A total of 243 eligible participants with NAFlD were equally allocated to receive lGZG(two groups:standard dose and low dose)or placebo for 12 weeks on the basis of lifestyle *** primary efficacy variable was homeostasis model assessment of insulin resistance(HOMA-IR).Analyses were performed in two populations in accordance with body mass index(BMI;overweight/obese,BMI 24 kg/m^(2);lean,BMIlow-dose lGZG significantly decreased their HOMA-IR level compared with placebo(0.19(1.47)versus 0.08(1.99),P=0.038).For lean subjects,neither dose of lGZG showed a superior effect compared with *** DNA immunoprecipitation sequencing and real-time qPCR found that the DNA N6-methyladenine modification levels of protein phosphatase 1 regulatory subunit 3A(PPP1R3A)and autophagy related 3(ATG3)significantly increased after lGZG intervention in overweight/obese ***-dose lGZG effectively improved insulin resistance in overweight/obese subjects with *** underlying mechanism may be related to the regulation of DNA N6-methyladenine modification of PPP1R3A and *** subjects may not be a targeted population for lGZG.

关键词： insulin resistance non-alcoholic fatty liver disease Chinese herbal medicine randomized controlled trial DNA N6-methyladenine modification

A bio-instructive parylene-based conformal coating suppresses thrombosis and intimal hyperplasia of implantable vascular devices

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Bioactive Materials 2023年第10期28卷 467-479页

作者： Dake Hao Jonathan lin Ruiwu liu Christopher Pivetti Kaeli Yamashiro linda M.Schutzman Junichiro Sageshima Mimmie Kwong Nataliya Bahatyrevich Diana l.Farmer Misty D.Humphries Kit S.lam Alyssa Panitch Aijun Wang Department of Surgery School of MedicineUniversity of California DavisSacramentoCA95817United States Institute for Pediatric Regenerative Medicine Shriners Hospitals for ChildrenSacramentoCA95817United States Department of Biochemistry and Molecular Medicine School of MedicineUniversity of California DavisSacramentoCA95817United States Wallace H.Coulter Department of Biomedical Engineering Georgia Institute of Technology and Emory UniversityAtlant1GA30332United States Department of Biomedical Engineering University of California DavisDavisCA95616United States

Implantable vascular devices are widely used in clinical treatments for various vascular diseases. However, current approved clinical implantable vascular devices generally have high failure rates primarily due to their surface lacking inherent functional endothelium. Here, inspired by the pathological mechanisms of vascular device failure and physiological functions of native endothelium, we developed a new generation of bioactive parylene (poly(p-xylylene))-based conformal coating to address these challenges of the vascular devices. This coating used a polyethylene glycol (PEG) linker to introduce an endothelial progenitor cell (EPC) specific binding ligand lXW7 (cGRGDdvc) onto the vascular devices for preventing platelet adhesion and selectively capturing endogenous EPCs. Also, we confirmed the long-term stability and function of this coating in human serum. Using two vascular disease-related large animal models, a porcine carotid artery interposition model and a porcine carotid artery-jugular vein arteriovenous graft model, we demonstrated that this coating enabled rapid generation of self-renewable “living” endothelium on the blood contacting surface of the expanded polytetrafluoroethylene (ePTFE) grafts after implantation. We expect this easy-to-apply conformal coating will present a promising avenue to engineer surface properties of “off-the-shelf” implantable vascular devices for long-lasting performance in the clinical settings.

关键词： Parylene coating Integrin ligand Thrombosis Intimal hyperplasia Implantable vascular devices

Bph30confers resistance to brown planthopperby fortifying sclerenchyma in rice leaf sheaths

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Molecular Plant 2021年第10期14卷 1714-1732页

作者： Shaojie Shi Huiying Wang lingyun Nie Di Tan Cong Zhou Qian Zhang Yili Bo Du Jianping Guo Jin Huang DiWu Xiaohong Zheng Wei Guan Junhan Shan lili Zhu Rongzhi Chen longjian Xue linda l.Walling Guangcun He State Key laboratory of Hybrid Rice College of Life SciencesWuhan UniversityWuhan 430072China The Institute of Technological Science School of Power and Mechanical EngineeringWuhan UniversityWuhan 430072China Department of Botany and Plant Sciences University of CaliforniaARiversideCA 92521USA

Phloem-feeding insects cause massive losses in agriculture and *** plant resistance to phloem-feeding insects is often mediated by changes in phloem composition,which deter insect settling and feeding and decrease ***,we report that rice plant resistance to the phloem-feeding brown planthopper(BPH)is associated with fortification of the sclerenchyma tissue,which is located just beneath the epidermis and a cell layer or two away from the vascular bundle in the rice leaf *** found that BPHs prefer to feed on the smooth and soft region on the surface of rice leaf sheaths called the long-cell *** identified Bph30 as a rice BPH resistance gene that prevents BPH stylets from reaching the phloem due to the fortified ***30 is strongly expressed in sclerenchyma cells and enhances cellulose and hemicellulose synthesis,making the cell walls stiffer and sclerenchyma *** structurally fortified sclerenchyma is a formidable barrier preventing BPH stylets from penetrating the leaf sheath tissues and arriving at the phloem to ***30 belongs to a novel gene family,encoding a protein with two leucine-rich *** member of the family,Bph40,also conferred resistance to ***,the fortified sclerenchyma-mediated resistance mechanism revealed in this study expands our understanding of plant-insect interactions and opens a new path for controlling planthoppers in rice.

关键词： rice brown planthopper fortified sclerenchyma-mediated resistance cell wall leaf sheath breeding