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Heparin is an effective treatment for preventing liver failure after hepatectomy

World Journal of Gastroenterology 2024年第22期30卷 2881-2892页

作者： Zhi-Ying Xu Min Peng Ming-Ming Fan Qi-Fei Zou Yi-Ran Li Dong Jiang Hepatic surgery IV Shanghai Eastern Hepatobiliary Surgery HospitalThe Third Affiliated Hospital of Naval Medical UniversityShanghai 200433China Ultrasound Diagnosis PLA Naval Medical CenterShanghai 200437China Department of Ultrasound Eastern Hepatobiliary Surgery HospitalThe Third Affiliated Hospital of Naval Medical UniversityShanghai 200433China

BACKGROUND Posthepatectomy liver failure(PHLF)is one of the most important causes of death following liver ***,an established anticoagulant,can protect liver function through a number of mechanisms,and thus,prevent liver *** To look at the safety and efficacy of heparin in preventing hepatic dysfunction after *** The data was extracted from Multiparameter Intelligent Monitoring in Intensive Care III(MIMIC-III)v1.4 pinpointed patients who had undergone hepatectomy for liver cancer,subdividing them into two cohorts:Those who were injected with heparin and those who were *** statistical evaluations used were unpaired ttests,Mann-Whitney U tests,chi-square tests,and Fisher’s exact tests to assess the effect of heparin administration on PHLF,duration of intensive care unit(ICU)stay,need for mechanical ventilation,use of continuous renal replacement therapy(CRRT),incidence of hypoxemia,development of acute kidney injury,and ICU *** regression was utilized to analyze the factors related to PHLF,with propensity score matching(PSM)aiming to balance the preoperative disparities between the two *** In this study,1388 patients who underwent liver cancer hepatectomy were *** yielded 213 matched pairs from the heparin-treated and control *** univariate analyses indicated that heparin potentially reduces the risk of PHLF in both matched and unmatched *** analysis in the matched cohorts confirmed a significant association,with heparin reducing the risk of PHLF(odds ratio:0.518;95%confidence interval:0.295-0.910;P=0.022).Additionally,heparin treatment correlated with improved short-term postoperative outcomes such as reduced ICU stay durations,diminished requirements for respiratory support and CRRT,and lower incidences of hypoxemia and ICU *** Liver failure is an important hazard following hepatic *** ICU care heparin administration has been proved to decr

关键词： Liver resection Posthepatectomy liver failure Prophylactic treatment Heparin Prognosis of hepatectomy

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Efficacy of ginseng-based Renshenguben oral solution for cancer-related fatigue among patients with advanced-stage hepatocellular carcinoma:A prospective multicenter cohort study

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hepatobiliary & Pancreatic Diseases International 2024年第3期23卷 249-256页

作者： Ming-Da Wang Chen Yuan Ke-Chun Wang Nan-Ya Wang Ying-Jian Liang Hong Zhu Xiang-Min Tong Tian Yang Department of hepatobiliary and Pancreatic surgery General Surgery CenterFirst Hospital of Jilin UniversityChangchun 130021China Department of hepatobiliary surgery Eastern Hepatobiliary Surgery HospitalSecond Military Medical University(Naval Medical University)Shanghai 200438China Department of Clinical Laboratory Laboratory Medicine CenterZhejiang Provincial People’s HospitalHangzhou Medical CollegeHangzhou 310000China Department of hepatobiliary surgery First Affiliated Hospital of Harbin Medical UniversityHarbin 150007China Department of Medical Oncology First Affiliated Hospital of Soochow UniversitySuzhou 215006China fDepartment of Central Laboratory Affiliated Hangzhou First People’s HospitalWestlake University School of MedicineHangzhou 310006China

Background:Cancer-related fatigue(CRF)is a common and debilitating symptom experienced by patients with advanced-stage cancer,especially those undergoing antitumor *** study aimed to evaluate the efficacy and safety of Renshenguben(RSGB)oral solution,a ginseng-based traditional Chinese medicine,in alleviating CRF in patients with advanced hepatocellular carcinoma(HCC)receiving antitumor ***:In this prospective,open-label,controlled,multicenter study,patients with advanced HCC at BCLC stage C and a brief fatigue inventory(BFI)score of≥4 were *** were assigned to the RSGB group(RSGB,10 mL twice daily)or the control group(with supportive care).Primary and secondary endpoints were the change in multidimensional fatigue inventory(MFI)score,and BFI and functional assessment of cancer therapy-hepatobiliary(FACT-Hep)scores at weeks 4 and 8 after *** events(AEs)and toxicities were ***:A total of 409 participants were enrolled,with 206 assigned to the RSGB *** week 4,there was a trend towards improvement,but the differences were not statistically *** week 8,the RSGB group exhibited a significantly lower MFI score(P<0.05)compared to the control group,indicating improved fatigue ***,the RSGB group showed significantly greater decrease in BFI and FACT-Hep scores at week 8(P<0.05).Subgroup analyses among patients receiving various antitumor treatments showed similar *** linear regression analyses revealed that the RSGB group experienced a significantly substantial decrease in MFI,BFI,and FACT-Hep scores at week *** serious drug-related AEs or toxicities were ***:RSGB oral solution effectively reduced CRF in patients with advanced HCC undergoing antitumor therapy over an eight-week period,with no discernible *** findings support the potential of RSGB oral solution as an adjunctive treatment for managing CRF in this patient population.

关键词： Cancer-related fatigue Hepatocellular carcinoma Renshenguben oral solution Efficacy Safety Ginseng

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Predicting hepatocellular carcinoma: A new non-invasive model based on shear wave elastography

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World Journal of Gastroenterology 2024年第25期30卷 3166-3178页

作者： Dong Jiang Yi Qian Yi-Jun Gu Ru Wang Hua Yu Hui Dong Dong-Yu Chen Yan Chen Hao-Zheng Jiang Bi-Bo Tan Min Peng Yi-Ran Li Department of Ultrasound Eastern Hepatobiliary Surgery HospitalThe Third Affiliated Hospital of Naval Medical UniversityShanghai 200433China Department of Pathology Shanghai Eastern Hepatobiliary Surgery HospitalThird Affiliated Hospital of Naval Medical UniversityShanghai 200433China Department of College of Art and Science Case Western Reserve UniversityClevelandOH 44106United States Ultrasound Diagnosis PLA Naval Medical CenterShanghai 200437China

BACKGROUND Integrating conventional ultrasound features with 2D shear wave elastography(2D-SWE)can potentially enhance preoperative hepatocellular carcinoma(HCC)*** To develop a 2D-SWE-based predictive model for preoperative identification of *** A retrospective analysis of 884 patients who underwent liver resection and pathology evaluation from February 2021 to August 2023 was conducted at the Oriental hepatobiliary surgery *** patients were divided into the modeling group(n=720)and the control group(n=164).The study included conventional ultrasound,2D-SWE,and preoperative laboratory *** logistic regression was used to identify independent predictive factors for RESULTS In the modeling group analysis,maximal elasticity(Emax)of tumors and their peripheries,platelet count,cirrhosis,and blood flow were independent risk indicators for *** factors yielded an area under the curve of 0.77(95%confidence interval:0.73-0.81)with 84%sensitivity and 61%*** model demonstrated good calibration in both the construction and validation cohorts,as shown by the calibration graph and Hosmer-Lemeshow test(P=0.683 and P=0.658,respectively).Additionally,the mean elasticity(Emean)of the tumor periphery was identified as a risk factor for microvascular invasion(MVI)in malignant liver tumors(P=0.003).Patients receiving antiviral treatment differed significantly in platelet count(P=0.002),Emax of tumors(P=0.033),Emean of tumors(P=0.042),Emax at tumor periphery(P<0.001),and Emean at tumor periphery(P=0.003).CONCLUSION 2D-SWE’s hardness value serves as a valuable marker for enhancing the preoperative diagnosis of malignant liver lesions,correlating significantly with MVI and antiviral treatment efficacy.

关键词： Shear wave elastography Predicting model Microvascular invasion Antiviral treatment Hepatocellular carcinoma

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Sequential or simultaneous transarterial chemoembolization and radiofrequency ablation for hepatocellular carcinoma within the Milan criteria:A retrospective real-world study

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Portal Hypertension & Cirrhosis 2024年第2期3卷 105-115页

作者： Jianwei Liu Minmin Sun Zhiliang Hu Jie Wang Caixia Lu Ya Gao Cuijuan He Yeye Wu Jian Zhai Yong Xia Xiaorong Pan Kui Wang Department of Hepatic surgery II Third Affiliated Hospital of Naval Medical University(Eastern Hepatobiliary Surgery Hospital)ShanghaiChina Department of Hepatic surgery I Third Affiliated Hospital of Naval Medical University(Eastern Hepatobiliary Surgery Hospital)ShanghaiChina Department of Clinical Research Institute Third Affiliated Hospital of Naval Medical University(Eastern Hepatobiliary Surgery Hospital)ShanghaiChina Department II of Interventional Radiology Third Affiliated Hospital of Naval Medical University(Eastern Hepatobiliary Surgery Hospital)ShanghaiChina Department of Hepatic surgery IV Third Affiliated Hospital of Naval Medical University(Eastern Hepatobiliary Surgery Hospital)ShanghaiChina Shanghai Baoshan District Songnan Town Community Health Service Center ShanghaiChina

Aims:Few studies have investigated differences in sequential transarterial chemoembolization(TACE),radiofrequency ablation(RFA),and simultaneous RFA-TACE for the treatment of hepatocellular carcinoma(HCC)using the Milan *** study explored the differences in safety and prognosis between sequential TACE-RFA and simultaneous ***:This retrospective real-world study included 109 patients with HCC within the Milan criteria who underwent sequential TACE-RFA(n=75)or simultaneous RFA-TACE(n=34)at the eastern hepatobiliary surgery hosp.tal between January 2017 and *** complications,length of hosp.tal stay,and long-term prognosis were *** median follow-up duration of these patients was 39.1 *** survival(OS)and time to tumor recurrence(TTR)curves were plotted using the Kaplan−Meier method and were compared using the logarithmic rank *** risk factors for OS and tumor recurrence(TR)were analyzed using the Cox risk regression ***:Multivariate analysis showed that tumor diameter>3 cm(hazard ratio[HR]:2.201,95%confidence interval[CI]:1.106-4.378,p=0.025;HR:2.236,95%CI:1.271-3.934,p=0.005,respectively)and alphafetoprotein(AFP)>400μg/L(HR:2.362,95%CI:1.195-4.668,p=0.013;HR:1.798,95%CI:1.048-3.086,p=0.033,respectively)were independent risk factors for OS and TTR,whereas the presence of multiple tumors(HR:2.352,95%CI:1.127-4.907,p=0.023)was an independent risk factor for *** RFA-TACE did not have an effect on OS or *** propensity score-matched,comparable results were obtained and RFATACE still had no effect on OS or *** significant differences were observed in grade III/IV complications(2/75[2.7%]vs.1/34[2.9%],p=1.000)between the two ***,the RFA-TACE group had fewer complications than the TACE-RFA group(24/34[70.6%]vs.66/75[88.0%],p=0.026).The RFA-TACE group had a shorter hosp.tal stay and less total cost during hosp.talization compared with the TACE-RFA group(6.0 vs.10.0 da

关键词： complications hepatocellular carcinoma prognosis radiofrequency ablation transarterial chemoembolization

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Genetic landscape and clinical significance of cuproptosis-related genes in liver hepatocellular carcinoma

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Genes & Diseases 2024年第2期11卷 516-519页

作者： Dingtao Hu Yichuan Wang Xu Shen Tiantian Mao Xijun Liang Tengjiao Wang Weifeng Shen Yugang Zhuang Jin Ding Clinical Cancer Institute Center for Translational MedicineNaval Medical UniversityShanghai 200433China Department of Emergency Shanghai Tenth People's HospitalTongji UniversitySchool of MedicineShanghai 200072China Bioinformatics Analysis Laboratory Center for Translational MedicineNaval Medical UniversityShanghai 200433China The Department of Hepatic surgery Eastern Hepatobiliary Surgery HospitalNaval Medical UniversityShanghai 200433China

Recently,Peter et al reported a novel form of cell death(cuproptosis)that was different from other known death mechanisms.1 They found that accumulation of copper ions could induce destabilization of Fe-S cluster proteins and aggregation of mitochondrial lipoylated proteins,ultimately resulting in cuproptosis.1 of note,ten genes were identified as cuproptosis-related genes(CRGs)in copper ion-induced cell death,including PDHB,PDHA1,DLAT,DLD,LIPT1,LIAS,FDX1,CDKN2A,GLS,and MTF1.1 Since dysregulation of copper metabolism is involved in many cancers,cuproptosis and CRGs may play vital roles in cancer development and treatment.1.2 Herein,our pancancer analysis revealed the coordinated upregulation of 9 of 10 CRGs in human liver hepatocellular carcinoma(LIHC)across 33 solid tumors(Fig.S1A;Fig.1A),suggesting the distinct role of CRGs in *** then explored the genetic landscape,biological function,and clinical significance of CRGs in LIHC,and validated our bioinformatic findings by in vitro experiments and clinical *** detailed methods were described in the supplementary material.

关键词： clinical metabolism hepatocellular

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Tumor microenvironment-responsive arsenic-loaded layered double hydroxides film with synergistic anticancer and bactericidal activity

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Rare Metals 2024年第3期43卷 1207-1221页

作者： Shun Xing Dong-Hui Wang Hai-Feng Zhang Li-Dan Liu Cheng-Ce Li Chao Wei Jun-Yu Liu Nai-Jian Ge Xuan-Yong Liu State Key Laboratory of High Performance Ceramics and Superfine Microstructure Shanghai Institute of CeramicsChinese Academy of SciencesShanghai200050China Center of Materials Science and Optoelectronics Engineering University of Chinese Academy of SciencesBeijing100049China Intervention Center Eastern Hepatobiliary Surgery HospitalThe Third Affiliated Hospital of Naval Medical UniversityShanghai200438China School of Health Sciences and Biomedical Engineering Hebei University of TechnologyTianjin300130China

Malignant obstruction makes gallbladder cancer have a high mortality ***-titanium alloy(nitinol)stents are commonly used as a local intervention to maximize patient survival time,but the stents lack antitumor and antibacterial capacity and are vulnerable to secondary ***-based drugs show good therapeutic promise against gallbladder *** meet clinical *** layered double hydroxides(LDHs)film is constructed on the nitinol,whose arsenite loading amounts rose by 60%after simple heat treatment compared with the conventional anion-exchange *** addition,calcination promotes the dissolution of nickel ions from the LDHs lattice,resulting in a powerful synergistic killing effect on tumor cells together with the released *** importantly,the calcined arsenic-loaded LDHs are sensitive to the acidic microenvironment of tumor tissues,which presents a much lower arsenic and nickel release amount in the normal tissues,guaranteeing its ***,the vertically sharp LDHs nanosheets can synergize with arsenic to achieve effective physical cleavage and chemical killing of adherent and planktonic *** short,we attempt to use arsenic drugs for local interventions and reasonably avoid their toxic side effects,which provides a new design idea for nitinol stents applied in the treatment of gallbladder cancer.

关键词： Nitinol Layered double hydroxides Arsenic Gallbladder cancer

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Diverse functions of sox9 in liver development and homeostasis and hepatobiliary diseases

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Genes & Diseases 2024年第4期11卷 170-187页

作者： Taiyu Shang Tianyi Jiang Xiaowen Cui Yufei Pan Xiaofan Feng Liwei Dong Hongyang Wang School of Life Sciences Institute of Metabolism and Integrative BiologyFudan UniversityShanghai 200438China National Center for Liver Cancer The Naval Medical UniversityShanghai 201805China International Cooperation Laboratory on Signal Transduction Eastern Hepatobiliary Surgery InstituteThe Second Military Medical UniversityShanghai 200438China Laboratory of Signaling Regulation and Targeting Therapy of Liver Cancer Second Military Medical University&Ministryof EducationShanghai 200438China

The liver is the central organ for digestion and detoxification and has unique metabolic and regenerative *** hepatobiliary system originates from the foregut endoderm,in which cells undergo multiple events of cell proliferation,migration,and differentiation to form the liver parenchyma and ductal system under the hierarchical regulation of transcription *** on liver development and diseases have revealed that SRY-related high-mobility group box 9(SOx9)plays an important role in liver embryogenesis and the progression of hepatobiliary ***9 is not only a master regulator of cell fate determination and tissue morphogenesis,but also regulates various biological features of cancer,including cancer stemness,invasion,and drug resistance,making Sox9 a potential biomarker for tumor prognosis and *** review systematically summarizes the latest findings of sox9 in hepatobiliary development,homeostasis,and *** also highlight the value of sox9 as a novel biomarker and potential target for the clinical treatment of major liverdiseases.

关键词： Biliary system Cancer Homeostasis Liver diseases SOX9

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METTL14 downregulation drives S100A4^(+)monocyte-derived macrophages via MyD88/NF-κB pathway to promote MAFLD progression

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Signal Transduction and Targeted Therapy 2024年第5期9卷 2176-2192页

作者： Yue-fan Wang Wen-li Zhang Zhi-xuan Li Yue Liu Jian Tan Hao-zan Yin Zhi-chao Zhang Xian-jie Piao Min-hao Ruan Zhi-hui Dai Si-jie Wang Chen-yang Mu Ji-hang Yuan Shu-han Sun Hui Liu Fu Yang The Third Department of Hepatic surgery Eastern Hepatobiliary Surgery Hospital Affiliated to Naval Medical University200438 ShanghaiChina The Department of Medical Genetics Naval Medical University200433 ShanghaiChina Translational Medicine Research Center Medical Innovation Research Division and Fourth Medical Center of the Chinese PLA General Hospital100048 BeijingChina The Department of Pharmaceutical Analysis School of PharmacyNaval Medical University200433 ShanghaiChina Key Laboratory of Biosafety Defense Ministry of Education200433 ShanghaiChina Shanghai Key Laboratory of Medical Biodefense 200433 ShanghaiChina

Without intervention,a considerable proportion of patients with metabolism‐associated fatty liver disease(MAFLD)will progress from simple steatosis to metabolism‐associated steatohepatitis(MASH),liver fibrosis,and even hepatocellular ***,the molecular mechanisms that control progressive MAFLD have yet to be fully ***,we unraveled that the expression of the N6-methyladenosine(m6A)methyltransferase METTL14 is remarkably downregulated in the livers of both patients and several murine models of MAFLD,whereas hepatocyte-specific depletion of this methyltransferase aggravated lipid accumulation,liver injury,and ***,hepatic Mettl14 overexpression alleviated the above pathophysiological changes in mice fed on a high-fat diet(HFD).Notably,in vivo and in vitro mechanistic studies indicated that METTL14 downregulation decreased the level of GLS2 by affecting the translation efficiency mediated by YTHDF1 in an m6A-depedent manner,which might help to form an oxidative stress microenvironment and accordingly recruit Cx3cr1^(+)Ccr2^(+)monocyte-derived macrophages(Mo-macs).In detail,Cx3cr1^(+)Ccr2^(+)Mo-macs can be categorized into M1-like macrophages and S100A4-positive macrophages and then further activate hepatic stellate cells(HSCs)to promote liver *** experiments revealed that CX3CR1 can activate the transcription of S100A4 via CX3CR1/MyD88/NF-κB signaling pathway in Cx3cr1^(+)Ccr2^(+)*** of METTL14 or GLS2,or interfering with this signal transduction pathway such as inhibiting MyD88 could ameliorate liver injuries and *** together,these findings indicate potential therapies for the treatment of MAFLD progression.

关键词： S100A4 MyD88 metabolism

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Role of post-hepatectomy portal hypertension in predicting the outcome of hepatocellular carcinoma after curative resection

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Portal Hypertension & Cirrhosis 2024年第2期3卷 75-85页

作者： Jian Lin Liangrui Chen Xiaodong Shi Fengwei Li Qian Xu Hongzhi Liu Jingfeng Liu Kui Wang Feng Shen Department of Hepatic surgery Eastern Hepatobiliary Surgery HospitalSecond Military Medical UniversityShanghaiChina Department of Public Health Fujian University of Traditional Chinese MedicineCollege of Integrative MedicineFuzhouFujianChina Department of Hepatopancreatobiliary surgery Mengchao Hepatobiliary Hospital of Fujian Medical UniversityFuzhouFujianChina Department of Hepatopancreatobiliary surgery Cancer Hospital of Fujian Medical UniversityFuzhouFujianChina

Aims:Portal venous pressure frequently increases after a major *** aimed to assess the outcomes of patients with hepatocellular carcinoma(HCC)with different post-hepatectomy portal pressure statuses and the predictive factors correlated with prognosis and post-hepatectomy portal hypertension(PHPH).Methods:Data from consecutive patients who underwent curative-intent hepatectomy for HCC at the eastern hepatobiliary surgery hosp.tal and Mengchao hepatobiliary hosp.tal of Fujian Medical University between January 2008 and December 2016 were retrospectively *** were followed up until March 1,*** was defined as new-onset portal hypertension(PH)in patients without preoperative PH within 1 month of *** were classified into two groups according to the presence or absence of PHPH:non-PH and *** clinicopathological characteristics were compared between the two *** and multivariate analyses were used to identify independent risk factors for early and late recurrence of HCC,overall survival(OS),and ***:Disease-free survival rates were significantly higher in the non-PH group(n=1068)than those in the PHPH group(n=423)(62.0%,39.0%,and 31.0%vs.46.2%,24.5%,and 19.3%at 1,3,and 5 years,respectively;all p40 U/L,and major hepatectomy were identified as independent risk factors for ***:PHPH was associated with early recurrence of HCC and poor OS but not with late ***,PHPH may be an attractive target for therapeutic inte

关键词： hepatocellular carcinoma hepatectomy portal hypertension prognosis predictive factors

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Infection with SARS-CoV-2 can cause pancreatic impairment

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Signal Transduction and Targeted Therapy 2024年第5期9卷 2143-2160页

作者： Wei Deng Linlin Bao Zhiqi Song Ling Zhang Pin Yu Yanfeng Xu Jue Wang Wenjie Zhao Xiuqin Zhang Yunlin Han Yanhong Li Jiangning Liu Qi Lv Xujian Liang Fengdi Li Feifei Qi Ran Deng Siyuan Wang Yibai Xiong Ruiping Xiao Hongyang Wang Chuan Qin NHC Key Laboratory of Comparative Medicine Beijing Key Laboratory for Animal Models of Emerging and Remerging Infectious DiseasesInstitute of Laboratory Animal ScienceChinese Academy of Medical Sciences and Comparative Medicine CenterPeking Union Medical CollegeBeijing 100021China Institute of Molecular Medicine College of Future TechnologyPeking UniversityBeijing 100871China Beijing Key Laboratory of Cardiometabolic Molecular Medicine Peking UniversityBeijing 100871China State Key Laboratory of Biomembrane and Membrane Biotechnology Peking-Tsinghua Center for Life SciencesBeijing 100871China Chinese Academy of Engineering Eastern Hepatobiliary Surgery Hospital225 Changhai RoadYangpu DistrictShanghai 200438China International Co-operation Laboratory on Signal Transduction Eastern Hepatobiliary Surgery InstituteSecond Military Medical UniversityShanghai 200438PR China National Laboratory for Oncogenes and Related Genes Cancer Institute of Shanghai Jiao Tong UniversityShanghai 200441PR China Changping National laboratory(CPNL) Beijing 102206China State Key Laboratory of Respiratory Health and Multimorbidity National Health Commission of the People’s Republic of ChinaBeijingPR China

Evidence suggests associations between COVID-19 patients or vaccines and glycometabolic dysfunction and an even higher risk of the occurrence of ***,we retrospectively analyzed pancreatic lesions in autopsy tissues from 67 SARS-CoV-2 infected non-human primates(NHPs)models and 121 vaccinated and infected NHPs from 2020 to 2023 and COVID-19 ***-label immunofluorescence revealed direct infection of both exocrine and endocrine pancreatic cells by the virus in NHPs and *** and limited phenotypic and histopathological changes were observed in adult *** proteomics and metabolomics results indicated metabolic disorders,mainly enriched in insulin resistance pathways,in infected adult NHPs,along with elevated fasting C-peptide and C-peptide/glucose ratio ***,in elder COVID-19 NHPs,SARS-CoV-2 infection causes loss of beta(β)cells and lower expressed-insulin in situ characterized by islet amyloidosis and necrosis,activation ofα-SMA and aggravated fibrosis consisting of lower collagen in serum,an increase of pancreatic inflammation and stress markers,ICAM-1 and G3BP1,along with more severe glycometabolic *** contrast,vaccination maintained glucose homeostasis by activating insulin receptorαand insulin receptorβ.Overall,the cumulative risk of diabetes post-COVID-19 is closely tied to age,suggesting more attention should be paid to blood sugar management in elderly COVID-19 patients.

关键词： infected elevated homeostasis

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