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Heparin is an effective treatment for preventing liver failure after hepatectomy

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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

Pathologic assessment of hepatocellular carcinoma in the era of immunotherapy:a narrative review

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Hepatobiliary Surgery and Nutrition 2024年第3期13卷 472-493页

作者： Han Wang You-Wen Qian Hui Dong Wen-Ming Cong Department of Pathology Shanghai Eastern Hepatobiliary Surgery HospitalNaval Medical UniversityShanghaiChina

Background and Objective:Immune checkpoint inhibitor(ICI)-based therapy has achieved impressive success in various cancer *** ICIs have been unprecedentedly approved as the treatment regimens for advanced hepatocellular carcinoma(HCC)in recent ***,numerous clinical trials are being performed to exploit more ICIs into initially unresectable HCC and postoperative HCC to expectantly induce adequate tumor downstaging for further resection or implement adjuvant treatment for relapse-free survival,*** this review,we aim to summarize some pragmatic histomorphologic,immunohistochemical,and molecular pathologic parameters which promisingly indicate the response of neoadjuvant/conversion ICI-related therapy and predict the efficacy of adjuvant/therapeutic ICI-related therapy for ***:We searched PubMed using the terms hepatocellular carcinoma,immunotherapy,immune checkpoint inhibitor,immune checkpoint blockade,conversion therapy,neoadjuvant therapy,adjuvant therapy,biomarker,pathologic evaluation,pathologic assessment till February *** Content and Findings:Although there is no consensus regarding the pathologic evaluation of relevant HCC specimens,it is encouraging that a few of studies have concentrated on this field,and moreover,the methods and parameters noted on other cancer types are also worthy of *** the pathologic assessment of HCC specimens underwent immunotherapy,a suitable sampling scheme,identifying immunotherapy-related pathologic response,and quantification of pathologic response rate should be *** the patients of HCC who are scheduled to receive immunotherapy,tumor-infiltrating lymphocyte,intratumoral tertiary lymphoid structure,programmed cell death ligand 1,Wnt/β-catenin,microsatellite instability and mismatch repair,tumor mutational burden and tumor neoantigen,as well as some other signaling pathways are the potential predictive biomarkers of treatment response of ***:The managem

关键词： Hepatocellular carcinoma(HCC) immune checkpoint blockade pathologic evaluation neoadjuvant therapy conversion therapy adjuvant therapy

Update on the Diagnosis and Treatment of Combined Hepatocellular Cholangiocarcinoma

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Journal of Clinical and Translational Hepatology 2024年第2期12卷 210-217页

作者： Kai-Jian Chu Yoshikuni Kawaguchi Han Wang Xiao-Qing Jiang Kiyoshi Hasegawa Biliary Surgical Department No.1 Eastern Hepatobiliary Surgical HospitalThe Naval Medical UniversityShanghaiChina Hepato-Biliary-Pancreatic Surgery Division Department of SurgeryGraduate School of MedicineThe University of TokyoTokyoJapan Department of Pathology Eastern Hepatobiliary Surgical HospitalThe Naval Medical UniversityShanghaiChina

Combined hepatocellular-cholangiocarcinoma(cHCC-CCA)is a unique type of liver tumor that contains both hepatocellular carcinoma and cholangiocarcinoma components within a single *** fifth edition of the World Health Organization classification provides a definition and diagnostic criteria for ***,the heterogeneous histomorphology and presentation resulting from variation of the proportion of each component poses challenges for clinical diagnosis and treatment.A diagnosis of cHCC-CCA may be suggested by the synchronous elevation of serum tumor markers for hepatocellular carcinoma and cholangiocarcinoma,a mixed enhancement pattern on imaging,and a discrepancy between the elevation of tumor marker and the imaging enhancement *** examination using hematoxylin and eosin staining is considered the gold standard for diagnosing cHCC-CCA,and comprehensive examination of resection or biopsy specimens is crucial for an accurate ***,there is no standard treatment for cHCC-CCA,and surgery is the *** hepatectomy with lymphadenectomy is among the recommended surgical *** role of liver transplantation in the management of cHCC-CCA is still *** chemoembolization may be effective for unresectable cHCC-CCA,particularly for hypervascular ***,the available evidence does not support systemic therapy for advanced *** prognosis of cHCC-CCA is generally poor,and there is no established staging *** research is needed to better understand the histogenesis and clinical management of *** review provides an overview of the current literature on cHCC-CCA with a focus on its clinical characteristics,pathological diagnosis,and management.

关键词： Combined hepatocellular-cholangiocarcinoma Clinical characteristics Imaging characteristics Pathological diagnosis Treatment

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

Minimally invasive liver resection in metabolic syndrome: insights and future directions

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Hepatobiliary Surgery and Nutrition 2024年第4期13卷 703-705页

作者： Kechun Wang Yifan Li Jinbo Gong Mingda Wang Tian Yang Department of Hepatobiliary Surgery Eastern Hepatobiliary Surgery HospitalSecond Military Medical University(Naval Medical University)ShanghaiChina Department of Hepatobiliary Surgery Affiliated Hospital of Nantong UniversityNantongChina

Hepatocellular carcinoma(HCC)has emerged as a formidable global health challenge since it ranks the sixth most common malignant tumor and the third most common cause of cancer-related death(1).One of the most important factors in the creation of the increased incidence of HCC is the increasing rate of metabolic syndrome(MS),which is a complex interaction of metabolic abnormalities represented by obesity,insulin resistance,dyslipidemia,and *** was believed that chronic hepatitis B and C were one of the major etiologies of HCC,but additionally,the changed landscape of etiology now points toward MS and its comorbidities,such as non-alcoholic fatty liver disease,as major contributors in promotion of development and progress of HCC(2,3).

关键词： Minimally invasive surgery hepatectomy metabolic syndrome(MS) survival

Immune Regulatory Networks and Therapy of yδT Cells in Liver Cancer:Recent Trends and Advancements

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Journal of Clinical and Translational Hepatology 2024年第3期12卷 287-297页

作者： Kun-Li Yin Kai-Jian Chu Ming Li Yu-Xin Duan Yan-Xi Yu Mei-Qing Kang Da Fu Rui Liao Department of Hepatobiliary Surgery the First Affiliated Hospital of Chongqing Medical UniversityChongqingChina Biliary Surgical Department I the Eastern Hepatobiliary Surgical HospitalNaval Medical UniversityShanghaiChina General Surgery Institute of Pancreatic DiseasesRuijin HospitalShanghai Jiaotong University School of MedicineShanghaiChina

The roles of γδ T cells in liver cancer,especially in the poten-tial function of immunotherapy due to their direct cytotoxic effects on tumor cells and secretion of important cytokines and chemokines,have aroused research *** re-view briefly describes the basic characteristics of γδ T cells,focusing on their diverse effects on liver *** particular,different subtypes of γδ T cells have diverse or even opposite effects on liver *** provide a detailed description of the immune regulatory network of γδ T cells in liver can-cer from two aspects:immune components and nonimmune *** interactions between various components in this immune regulatory network are dynamic and pluralis-tic,ultimately determining the biological effects of γδ T cells in liver *** also integrate the current knowledge of γδ T-cell immunotherapy for liver cancer treatment,emphasiz-ing the potential of these cells in liver cancer immunotherapy.

关键词： Liver cancer γδT cells Immunotherapy Tumor microenvironment

Oleanonic acid inhibits glioma growth by inactivating STAT3 via upregulating SIRT6 in nude mice

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Food Science and Human Wellness 2024年

作者： Jiancun Wang Yuanyuan Wang Hui Gao Qin Sun Wen Li Neurosurgery Department of the First Affiliated hospital of Soochow University Department of Neurosurgery， the Third Affiliated hospital of Naval Medical University Department of anesthesiology， General hospital Of eastern Theater Command Department of Pharmacology， School of Medicine， Shaoxing University

Patients with glioma have a very high mortality rate， thus improving the poor prognosis of glioma has been the goal in the therapeutic field. Searching for more effective drugs for gliomas from natural compounds is a promising strategy. In this study， both oleanonic acid and oleanolic acid inhibited proliferation of glioma cells and reduced expression of cyclin D1 and E1， but the former has a lower IC50 than the latter. Oleanonic acid reduced the expression of p-STAT3 but not p-STAT1 and 5， and also reducing the expression of STAT3 in the nucleus and its transcriptional activity in glioma cells. Furthermore， knockdown of STAT3 expression inhibited proliferation and migration of glioma cells. Next， the expressions of the upstream regulators such as SIRT6 and p-JAK2 but not SIRT1， p-ERK1/2， p300 were increased by oleanonic acid. The overexpression of SIRT6 not only reduced the expression of p-STAT3 and its transcriptional activity but also inhibited the proliferation and migration of glioma cells. In addition， the effects that oleanonic acid reduced the expression of p-STAT3 and its transcriptional activity and inhibited the proliferation and migration were attenuated by the knockdown of SIRT6. Furthermore， oleanonic acid effectively suppressed glioma growth and extended survival in nude mice bearing intracerebral U87 xenografts， but not in nude mice bearing intracerebral SIRT6-knockdown U87 xenografts. In conclusion， oleanonic acid upregulates the expression of SIRT6 to inactivates STAT3 and then inhibits glioma growth.

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Incidence of acute infectious conjunctivitis across the pre-and post COVID era:a 7-year-result from a tertiary acute hospital in Hong Kong

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Journal of Acute Disease 2024年第2期13卷 85-86页

作者： Sunny Chi Lik Au Department Ophthalmology Tung Wah Eastern HospitalHong KongChina

Acute infectious conjunctivitis(AIC)is one of the most common communicable diseases encountered in acute hospital *** exists long before *** showed COVID-19 infections were associated with AIC,as the most common ocular manifestations[1].Thus,an increase in AIC during COVID-19 is expected[2].However,personal hygiene practices and public health measures throughout COVID-19 negatively impacted the incidence of influenza and other upper respiratory tract infections,as for AIC[3].Our retrospective study extracted the data between July 2016 to June 2023,from the hospital communicable ocular diseases *** aim to reveal the incidence of AIC across the pre-and post-COVID era in a local regional acute hospital.A total of 1512 patients with AIC were identified in the last 7 years across the pre-and post-COVID *** incidences of AIC over the past 7 years were plotted as a line chart(Figure 1A).

关键词： acute diseases Acute

Pearls of meta-analyses and systematic review in scientific evidence

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World Journal of Clinical Cases 2024年第16期12卷 2701-2703页

作者： Sunny Chi Lik Au Department of Ophthalmology Tung Wah Eastern HospitalHong KongChina

Scientific evidence develops bit by bit from case reports,case series;to larger casecontrol,case-cohort;and further escalate to randomized controlled *** echoed the importance of continue publishing World journal of Clinical Cases,where novel and advancing discoveries start from a single *** contrast,at the other end of the realm of evidence synthesis,systematic review and meta-analysis represent distinct yet interconnected *** in epidural labor analgesia has long been studied since 1989,and with 70 publications from MEDLINE ***,there was no meta-analysis,nor any systematic review published so *** latest in-press article published by Tang et *** the protocol for the systematic review and meta-analysis on the safety and effectiveness of butorphanol in epidural labor analgesia is *** believe the findings of this study will be valuable for clinical practice as well as for future research.

关键词： Meta-analysis Systematic review Methodology Research Journal Academic