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L-GrAFT_(7) has High Accuracy in Predicting Early Allograft Failure after Liver Transplantation: A Multicenter Cohort Study in China

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Journal of Clinical and Translational Hepatology 2024年第1期12卷 62-69页

作者： Songming Li Qijie Luo Shirui Chen Zehua Jia Tielong Wang Xinyu Yu Wenjing Wang YuyiZhang Jiaxing Zhu Feiwen Deng Qiang Sun Zhiyong Guo Xiaoshun He Organ Transplant Center The First Affiliated HospitalSun Yat-sen UniversityGuangzhouGuangdongChina Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology GuangzhouGuangdongChina Guangdong Provincial International Cooperation Base of Science and Technology GuangzhouGuangdongChina NHC Key Laboratory of Assisted Circulation(Sun Yat-sen University) GuangzhouGuangdongChina General surgery dept.1 Zhongshan People’s HospitalZhongshan Hospital of Sun Yat-Sen UniversityZhongshanGuangdongChina Department of Hepatobiliary surgery The First People’s Hospital of FoshanFoshanGuangdongChina

Background and Aims:Increasing utilization of extended criteria donor leads to an increasing rate of early allograft failure after liver ***,consensus of definition of early allograft failure is ***:A retrospective,multicenter study was performed to validate the Liver Graft Assessment Following Transplantation(L-GrAFT)risk model in a Chinese cohort of 942 adult patients undergoing primary liver transplantation at three Chinese centers.L-GrAFT(L-GrAFT7 and L-GrAFT10)was compared with existing models:the Early Allograft Failure Simplified Estimation(EASE)score,the model of early allograft function(MEAF),and the Early Allograft Dysfunction(EAD)*** and multivariate logistic regression were used to find risk factors of L-GrAFT high-risk ***:L-GrAFT7 had an area under the curve of 0.85 in predicting 90-day graft survival,significantly superior to MEAF[area under the curve(AUC=0.78,p=0.044)]and EAD(AUC=0.78,p=0.006),while there was no statistical significance between the predicting abilities of L-GrAFT7 and EASE(AUC=0.84,p>0.05).Furthermore,L-GrAFT7 maintains good predicting ability in the subgroup of high-donor risk index(DRI)cases(AUC=0.83 ***,p=0.007 ***,p=0.014)and recipients of donors after cardiac death(AUC=0.92 ***,p<0.001).Through multivariate analysis,pretransplant bilirubin level,units of packed red blood cells,and the DRI score were selected as independent risk factors of a L-GrAFT7 high-risk ***:The accuracy of L-GrAFT7 in predicting early allograft failure was validated in a Chinese multicenter cohort,indicating that it has the potential to become an accurate endpoint of clinical practice and transitional study of machine perfusion.

关键词： Early allograft failure Graft survival Liver transplantation Risk prediction model Multicenter study

Inhalation of taraxasterol loaded mixed micelles for the treatment of idiopathic pulmonary fibrosis

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Chinese Chemical Letters 2024年第8期35卷 475-480页

作者： Tong Zhang Chao Sun Shubin Yang Zimin Cai Sifeng Zhu Wendian Liu Yun Luan Cheng Wang Key Laboratory of Marine Drugs Chinese Ministry of EducationSchool of Medicine and PharmacyOcean University of ChinaQingdao 266003China Central Research Laboratory Department of General Surgerythe Second Hospital of Shandong UniversityJi’nan 250033China Laboratory for Marine Drugs and Bioproducts Pilot National Laboratory for Marine Science and TechnologyQingdao 266237China Orthopedics dept.1 Rushan people’s hospitalRushan 264500China Department of Cardiology the Second Hospital of Shandong UniversityJi’nan 250033China

Idiopathic pulmonary fibrosis(IPF)is a chronic and fatal lung disease characterized by pulmonary inflam-mation,oxidative stress,and excessive extracellular matrix(ECM)*** anti-fibrotic drugs for IPF treatment in the clinic lack selectivity and demonstrate unsatisfactory efficacy,highlighting the urgent necessity for a novel therapeutic ***(TA),which has biological activities against lung injury induced by various factors,is a potential anti-IPF drug due to its anti-inflammatory,antiox-idant and lung-protective ***,the protective effect of TA on IPF has not been confirmed,and its clinical application is limited due to its poor aqueous *** this study,we demonstrated that TA could inhibit epithelial-mesenchymal transition(EMT)and migration of A549 cells by inhibiting the transforming growth factor-β1(TGF-β1)/Smad signaling *** improve the aqueous solubility and pulmonary administration performance of TA,we prepared TA loaded methoxy poly(ethylene glycol)-poly(d,l-lactide)(mPEG-PLA)/d-α-tocopheryl polyethylene glycol succinate(TPGS)mixed polymeric mi-celles(TA-PM).Then a MicroSprayer^(R) Aerosolizer was used to deliver TA-PM once every two days for three weeks to evaluate their therapeutic effects on bleomycin(BLM)-induced IPF *** results demonstrated that inhaled TA-PM significantly inhibited BLM-induced inflammation,oxidative stress and fibrosis in lung ***,TA-PM exhibited high pulmonary deposition and retention by pul-monary administration,along with a favorable safety ***,this study emphasizes the potential of inhaled TA-PM as a promising treatment for IPF,providing a new opportunity for their clinical appli-cation.

关键词： Taraxasterol Idiopathic pulmonary fibrosis Mixed polymeric micelles Pulmonary administration Bleomycin

Milling of wheat, maize and rice: Effects on fibre and lipid content and health

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World Journal of Gastroenterology 2004年第12期10卷 1695-1696页

作者： FI Tovey Hon.Research Fellow M Hobsley Professor Emeritus Dept.of SurgeryUCLUK

During the last thirty years the main interest in the medical consequences of milling of staple carbohydrate foods, particularly wheat and maize, has been in its effect on the fibre content as a result of the milling. The late nineteenth and early twentieth centuries in the West saw great changes in milling processes, from stone milling using water or wind power, to increasingly sophisticated roller milling, with an

关键词： Dietary Fiber Food Handling Lipids Cereals Dietary Carbohydrates Humans Oryza sativa Triticum Zea mays

INTERVENTIONAL OR SEMI-INTERVENTIONAL TREATMENT FOR BUDD-CHIARI SYNDROME

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Chinese Medical Sciences Journal 2003年第2期18卷 111-115页

作者：张小明汪忠镐 dept.of Vascular surgery People Hospital of Beijing UniversityBeijing 100044 dept.of Vascular surgery the First Affiliated Hospital of Zhejiang UniversityHangzhou 310003

Objective. Report the results of interventional or semi-interventional techniques for 173 patients with Budd-Chiari syndrome.Method. This group included 120 males and 53 females. The pathologic lesions composed of localized complete occlusion of inferior vena cava (IVC) (78), IVC stenosis (49), IVC membrane with a hole (37), membrane of hepatic vein (HV) (3), IVC thrombosis (4), IVC membrane with thrombosis (2) and IVC lesion with occlusion of HV (32). Treatment methods included that I: Percutaneous transinferior vena cava angioplasty (PTA) (76); II: IVC PTA with stent (59); III: Percutaneous transhepatic vein recanalization (3); IV: IVC thrombolysis through a catheter (4); V; Combined transcardiac and trans-femoral venous membranotomy and balloon dilation (22); VI: V and stent (17); VII; Stenting during radical surgery (3); VIII: Additional operation after intervention (23).Results. The immediate technique success rate for intervention was 90.1%, for the semi-intervention was 100%. The IVC pressure was reduced from 3 to 29 cmH20. Complications occurred in 8 cases. The death rate was 2.9%. A follow-up study showed the recurrence rates were 14.5% in IVC PTA group, 1.7% in IVC PTA with stent, 18.2% in combined technique without stent and no recurrence was found in other groups.Conclusion. The PTA is the first choice for localized lesions. When elastic recoil occurs, immediate stenting is suggested. The semi-interventional approach is advised for PTA failure and more complicated cases. For those with both IVC lesion and occlusion of HV, the additional operation is needed after IVC intervention.

关键词： interventional semi-interventional Budd-Chiari syndrome

The translabyrinthine approach in residency training.“Step by step”surgical anatomy from the dissection laboratory to the operative room

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Journal of Otology 2021年第2期16卷 99-108页

作者： Fabio Roberti Joshua J.Wind Rosa Perez Anthony J.Caputy dept.of Neurological surgery The George Washington UniversityWashington DCUSA

Surgical anatomy training in a dedicated research laboratory and attendance to focused“hands-on”dissection courses are of high educational importance in order to acquire and maintain surgical expertise in skull base surgery,both for young and more experienced ***,transitioning surgical skills and anatomic knowledge from the laboratory to the operative room it is not free of challenges,especially during skull base approaches where the three-dimensional surgical orientation can be quite *** present a“step-by-step”and“side-by-side”surgical anatomy report on a translabyrinthine approach that was practiced in the laboratory then performed in the operative room by the surgical team,and we compare surgical anatomy exposures while discussing intraoperative techniques,nuances and challenges,both in the laboratory and the operative room.

关键词： Skull base surgery Translabyrinthine approach Vestibular schwannomas

Multiscale mechanobiology modeling for surgery assessment

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Acta Mechanica Sinica 2012年第4期28卷 1186-1202页

作者： M. Garbey B. L. Bass S. Berceli dept. of Computer Science University of Houston USA The Methodist Institute for TechnologyInnovation and Education Houston TX USA dept. of surgery The Methodist Hospital Houston TX USA The Methodist Institute for TechnologyInnovation and Education Houston TX USA dept. of surgery University of Florida

This paper discusses some of the concept of modeling surgery outcome. It is also an attempt to offer a road map for progress. This paper may serve as a common ground of discussion for both communities i.e surgeons and computational scientist in its broadest sense. Predicting surgery outcome is a very difficult task. All patients are different, and multiple factors such as genetic, or environment conditions plays a role. The difficulty is to construct models that are complex enough to address some of these significant multiscale elements and simple enough to be used in clinical conditions and calibrated on patient data. We will pro- vide a multilevel progressive approach inspired by two applications in surgery that we have been working on. One is about vein graft adaptation after a transplantation, the other is the recovery of cosmesis outcome after a breast lumpectomy. This work, that is still very much in progress, may teach us some lessons. We are convinced that the digital revolution that is transforming the working environment of the surgeon makes closer collaboration between surgeons and computational scientist unavoidable. We believe that ＂computational surgery＂ will allow the community to develop predictive model of the surgery outcome and greatprogresses in surgery procedures that goes far beyond the operating room procedural aspect.

关键词： Multiscale mechanobiology surgery assessment Breast cancer Vascular Adaptation

The key role of the hepatic veins collaterals in the modern liver surgery

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Hepatobiliary surgery and Nutrition 2023年第5期12卷 643-644页

作者： Fabrizio Panaro Boris Guiu Astrid Herrero Division of HBP surgery&Transplantation Dept.of SurgerySt.Eloi HospitalMontpellier University Hospital-School of MedicineMontpellierFrance

Currently,the terminology for liver anatomy and resection was based on the updates of the Brisbane 2000 system(1).In this setting,Couinaud’s anatomical description serves as the backbone for the classification of resection(2).Based on this classification,an anatomic liver resection was defined as the complete removal of the liver parenchyma confined within the responsible portal *** subsegmentectomy is defined as the removal of the liver parenchyma within the portal territory of less than a Couinaud’s *** are also defined as cone units,and their areas can be intraoperatively assessed by using ischemic demarcation,indocyanine green(ICG)staining,or both.

关键词： anatomy surgery hepatic

Defensin expression in chronic pouchitis in patients with ulcerative colitis or familial adenomatous polyposis coli

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World Journal of Gastroenterology 2006年第7期12卷 1056-1062页

作者： Karlheinz Kiehne Gabriele Brunke Franziska Wegner Tomas Banasiewicz Ulrich R F lsch Karl-Heinz Herzig Department of Internal Medicine Universit tsklinikum Schleswig HolsteinSchittenhelmstr.12Kiel 24105Germany Department of surgery Karol Marcinowski UniversityPoznanPoland A.I.Virtanen Institute for Molecular Sciences Dept.of SurgeryKuopio University HospitalUniversity of KuopioFinland

AIM. Pouchitis develops in ileoanal pouches in up to 50% of patients with ulcerative colitis during the first 10 years after pouch surgery while being rare in patients after proctocolectomy for familial adenomatous polyposis coil （FAP） syndrome. Defensins are major components of the innate immune system and play a significant role in gastrointestinal microbial homeostasis. Pouch defensin and cytokine expression were correlated with states of pouch inflammation to study their role in pouchitis.METHODS： Patients with ulcerative colitis and FAP syndrome were stratified into groups with pouches after surgery, pouches without or with pouchitis. Biopsies from terminal ileum from a healthy intestine or from normal terminal ileum of patients with ulcerative colitis served as controls, mRNA from pouches and controls was analysed for defensin and cytokine expression.RESULTS： Expression of defensins was increased in all pouches immediately after surgery, compared to ileum of controls. Initially, pouches in ulcerative colitis revealed higher defensin expression than FAP pouches. Defensin expression declined in both patient groups and increased again slightly in pouchitis in patients with ulcerative colitis. FAP pouches without pouchitis had strong expression of β-defensin hBD-1, while all other defensins remained at low levels. Cytokine expression in ulcerative colitis pouches was high, while FAP pouches showed moderately elevated cytokines only after surgery.CONCLUSION： Development of pouchitis correlates with decreased defensin expression in ulcerative colitis in addition to high expression of cytokines. The low incidence of pouchitis in FAP pouches correlates with increased expression of hBD-1 β- defensin in association with low cytokine levels.

关键词： Innate immunity Ulcerative colitis Defensins Pouchitis Cytokines

Endoscope-Assisted Cerebellopontine Angle surgery

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Journal of Otology 2009年第1期4卷 44-49页

作者： YANG Shi-ming,YU Li-Mei,ZOU Yi-hui,YU Li-Ming,JI Fei,YANG Wei-yan,HAN Dong-yi dept.Otolaryngology Head and Neck surgery,Institute of Otolaryngology,Chinese PLA General Hospital,Beijing 100853 dept. Otolaryngology Head and Neck surgery Institute of Otolaryngology Chinese PLA General Hospital Beijing 100853

Objective To report experiences with use of otoendoscopy in cerebellopontine angle(CPA) *** Twenty five cases of CPA surgeries performed between November 2002 and December 2008 in which microscope enabled otoendoscopy was used were *** 25 cases included 19 cases of acoustic neuroma,3 cases of CPA facial nerve tumors,1 case of trigeminal neurinoma,a case of glossopharyngeal neuralgia and 1 case of hemifacial *** was used in all cases together with monitoring of brainstem auditory responses and facial *** hearing and facial nerve function were evaluated and compared to pre-operative *** Endoscopy provided improved visualization of local anatomy,revealed hidden lesions and reduced unnecessary anatomical *** resection was achieved in 18 of the 19 acoustic neuroma cases,Facial nerve anatomical integrity was preserved in all 19 *** week postoperative House-Brackmann grading was I in 3 cases,Ⅱ in 10 cases and Ⅲ in 6 *** nerve function continued to improve in some cases at 3 *** tumor resection was achieved in all 3 patients with facial *** facial nerve was sacrificed in 2 of the 3 cases with primary faciohypoglossal nerve *** nerve function was Grade Ⅱ and Grade III one year after surgery,*** the case with anatomically preserved facial nerve,postoperative facial nerve function was initially Grade Ⅲ and improved to Ⅱ at 3 *** tumor was completely resected in the trigeminal neurinoma patient with a Grade Ⅲ postoperative facial nerve function which improved Grade II three months *** of the 19 patients with acoustic neuroma retained hearing postoperatively,of these 12 maintained preoperative levels of *** hearing capacity was preserved in 2 of the 3 patients with facial nerve tumors,but lost in patients with other tumor *** neurotomy(n=1) and microvascular decompression(n=1) re

关键词： CPA endoscope retrosigmoid approach