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Heme oxygenase system in hepatic ischemia-reperfusion injury

World journal of Gastroenterology 2010年第48期16卷 6068-6078页

作者： james A Richards stephen j wigmore Luke R Devey Centre for Inflammation Research The University of EdinburghThe Queen's Medical Research Institute

Hepatic ischemia-reperfusion injury (IRI) limits access to transplantation. Heme oxygenase-1 (HO-1) is a powerful antioxidant enzyme which degrades free heme into biliverdin,free iron and carbon monoxide. HO-1 and its metabolites have the ability to modulate a wide variety of inflammatory disorders including hepatic IRI. Mechanisms of this protective effect include reduction of oxygen free radicals,alteration of macrophage and T cell phenotype. Further work is required to understand the physiological importance of the many actions of HO-1 identified experimentally,and to harness the protective effect of HO-1 for therapeutic potential.

关键词： Ischemia-reperfusion injury Heme oxygenase Transplantation Ischemic pre-conditioning

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Synchronous colorectal Iiver metastases: timing of resection and patterns of referral

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Hepatobiliary Surgery and Nutrition 2020年第2期9卷 242-243页

作者： Fiona Hand stephen j.wigmore Department of Clinical Surgery Royal Infirmary of EdinburghEdinburghUK

There remain no consensus guidelines on the optimum surgical strategy for the management of synchronous colorectal liver metastases in spite of a number of published reviews and meta-analyses(1,2).In their paper,Howard et *** the‘real world’referral patterns and resection pathways of Canadian surgeons for this challenging patient cohort(3).This is a timely and interesting area for *** was generated from an online survey sent out to all surgeons in *** were received from 58 surgeons but 6 responses were inadequate for analysis leaving 52 surgeon responses included for *** study does not indicate the total number of surgeons who were invited to participate and so the proportional response rate is *** all survey based-studies,the small number of respondents included does raise the question of inherent selection bias which cannot be *** addition,almost all included surgeons had access to hepatobiliary services,with over half reporting access to hepatobiliary surgeons within their own institutions,such availability would undoubtedly affect decision making in this *** information around the nature and scope of general surgical and surgical oncology training in Canada would have been useful in understanding the likely experience of *** this paper raises some interesting points in the management of patients with synchronous colorectal liver metastases.

关键词： Canada colorectal doubt

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Duplicate publication bias weakens the validity of metaanalysis of immunosuppression after transplantation

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World journal of Gastroenterology 2017年第39期23卷 7198-7200页

作者： Cameron j Fairfield Ewen M Harrison stephen j wigmore Department of Clinical Surgery University of Edinburgh Royal Infirmary of Edinburgh

Duplicate publication can introduce significant bias into a meta-analysis if studies are inadvertently included more than once. Many studies are published in more than one journal to maximize readership and impact of the study findings. Inclusion of multiple publications of the same study within a meta-analysis affords inappropriate weight to the duplicated data if reports of the same study are not linked together. As studies which have positive findings are more likely to be published in multiple journals this leads to a potential overestimate of the benefits of an intervention. Recent advances in immunosuppression strategies following liver transplantation have led to many studies investigating immunosuppressive regimes including immunosuppression monotherapy. In this letter we focus on a recently published meta-analysis by Lan et al investigating studies assessing immunosuppression monotherapy for liver transplantation. The authors claim to have identified fourteen separate randomised studies investigating immunosuppression monotherapy. Seven of the references appear to relate to only three studies which have been subject to duplicate publication. Several similarities can be identified in each of the duplicate publications including similar authorship, identical immunosuppression regimes, identical dates of enrolment and citation of the original publication in the subsequent manuscripts. We discuss the evidence of the duplicate publication inclusion in the meta-analysis.

关键词： Liver transplantation Immunosuppression Meta-analysis Duplicate publication Bias

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以肝脏大部切除术后剩余肝脏体积预测肝功能不全及感染的应用价值

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世界核心医学期刊文摘（胃肠病学分册） 2005年第6期1卷 47-48页

作者： Schindl M.j. Redhead D.N. Fearon K.C.H. S.j.wigmore 雒向宁 Dept. of Clin./Surg. Sci. (Surgery) Royal Infirmary Edinburgh 51 Little France Crescent Edinburgh EH16 4SA United Kingdom

Background and aims: Major liver resection incurs a risk of postoperative liver dysfunction and infection and there is a lack of objective evidence relating residual liver volume to these complications. Patients and methods: Liver volumetry was performed on computer models derived from computed tomography (CT) angioportograms of 104 patients with normal synthetic liver function scheduled for liver resection. Relative residual liver volume (%RLV) was calculated as the relation of residual to total functional liver volume and related to postoperative hepatic dysfunction and infection. Receiver operator characteristic curve analysis was undertaken to determine the critical %RLV predicting severe hepatic dysfunction and infection. Univariate analysis and multivariate logistic regression analysis were performed to delineate perioperative predictors of severe hepatic dysfunction and infection. Results: The incidence of severe hepatic dysfunction and infection following liver resection increased significantly with smaller %RLV. A critical %RLV of 26.6%was identified as associated with severe hepatic dysfunction (pjor liver resection, infection was significantly more common in those who developed postoperative severe hepatic dysfunction compared with those who did not (p = 0.030). Conclusions: The likelihood of severe hepatic dysfunction following liver resection can be predicted by a small %RLV and a high BMI whereas postoperative infection is more related to liver dysfunction than precise residual liver volume. Understanding the relationship between liver volume and synthetic and immune function is the key to improving the safety of major liver resection.

关键词：肝功能不全肝脏体积切除术术后肝功能术中失血量预测术手术安全性静脉血管造影围手术期单变量分析

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历史、科学、法律与真实:史学、科学和法学领域事实认定的反思

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证据科学 2021年第3期29卷 360-370页

作者： [美]罗纳德·j·艾伦满运龙(译) 美国西北大学法学院中国政法大学证据科学院外国专家咨询委员会北京大学国际法学院中国政法大学证据科学院

除了最注重内省的领域之外,几乎所有的文化领域都运用真实和知识的拙朴概念,探究外部世界的知识。既使是纯粹内省的领域(如果这类领域存在的话),对从事思想活动个人的思维和情感状况,也做同样的研究。根据真实和知识的拙朴概念,真实由... 详细信息

除了最注重内省的领域之外,几乎所有的文化领域都运用真实和知识的拙朴概念,探究外部世界的知识。既使是纯粹内省的领域(如果这类领域存在的话),对从事思想活动个人的思维和情感状况,也做同样的研究。根据真实和知识的拙朴概念,真实由各类准确描述其任何指称对象的命题所涵盖;知识指各类信念,其内容实际是准确反映外部世界的真实命题。所有领域方法趋同,原因在于任何其他研究方法毫无意义。如果外部世界不可认知,或者可以认知,但不运用系统探究方法去认知,我们都不过是象形意义上的(甚或是字面意义上的)“缸中之脑”1。若此,我们不如就此罢手,退到后院饮酒自娱。诚然,任何有理智的人都不会这样认为,既使是那些就怀疑主义和就无法获知外部世界直接知识等问题发布了许多愚蠢至极的哲学废话的人们,以及对“葛梯尔例证”2的深刻内涵苦思冥想的人们,也不会这样认为。经常不为人察觉的一个具有至为讽刺意味的现象,是最极端的主观主义者、最顽固的怀疑主义者、最坚信无法认知世界的人们,一直在试图说服我们其他人他(她)的观点是正确的,在现实生活中是真实的,而其观点又说人们不可能知晓真实世界是否存在,也不可能对真实世界做任何了解。

关键词：事实认定外部世界讽刺意味探究方法怀疑主义指称对象现实生活毫无意义

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