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Hepatitis B virus reinfection after liver transplan- tation: related risk factors and perspective

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hepatobiliary & pancreatic Diseases International 2005年第4期4卷 502-508页

作者： Li-Ming Wu Xiao Xu Shu-Sen Zheng Department of hepatobiliary and pancreatic Surgery First Affiliated Hospital Zhejiang University School of Medicine Hangzhou 310003 China.

BACKGROUND: In recent years, liver transplantation (LT) has been acknowledged as an acceptable option for patients with hepatitis B virus (HBV) related end-stage liver diseases. However, HBV reinfection is an important event affecting the long-term survival of recipients. This paper was to review the risk factors related to HBV reinfection after LT. DATA SOURCES: English literature was reviewed based on MEDLINE focusing on the potential factors related to HBV reinfection after LT. RESULTS: HBV reinfection attributes to the unfavorable prognosis after LT. Many related factors may be responsible for it, including recipent factors (ethnical background, preoperative HBV replication status, extrahepatic HBV existence status), donor factors (compromised donor liver, HLA-A, -B compatibilities), perioperative treatment (use of antiviral agents, drug resistance, virus mutation, immu-nosuppressants protocol, blood transfusion) and others. CONCLUSIONS: The successful management of HBV reinfection will only be achieved by perfect clarification of its mechanism. The new strategies include new antiviral agents, gene therapy and immune intervention, reliable use of the compromised donor livers, and so on.

关键词： hepatitis B virus reinfection liver transplantation related risk factors

Liver regeneration using decellularized splenic scaffold: a novel approach in tissue engineering

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hepatobiliary & pancreatic Diseases International 2015年第5期14卷 502-508页

作者： Jun-Xi Xiang Xing-Long Zheng Rui Gao Wan-Quan Wu Xu-Long Zhu Jian-Hui Li Yi Lv Department of hepatobiliary Surgery First Affiliated Hospital of Xi'an Jiaotong University Department of surgical Oncology Shaanxi Provincial People's Hospital

BACKGROUND： The potential application of decellularized liver scaffold for liver regeneration is limited by severe shortage of donor organs. Attempt of using heterograft scaffold is accompanied with high risks of zoonosis and immunological rejection. We proposed that the spleen, which procured more extensively than the liver, could be an ideal source of decellularized scaffold for liver regeneration. METHODS： After harvested from donor rat, the spleen was processed by 12-hour freezing/thawing ×2 cycles, then circulation perfusion of 0.02% trypsin and 3% Triton X-100 sequentially through the splenic artery for 32 hours in total to prepare decellularized scaffold. The structure and component characteristics of the scaffold were determined by hematoxylin and eosin and immumohistochemical staining, scanning electron microscope, DNA detection, porosity measurement, biocompatibility and cytocompatibility test. Recellularization of scaffold by 5×106 bone marrow mesenchymal stem cells（BMSCs） was carried out to preliminarily evaluate the feasibility of liver regeneration by BMSCs reseeding and differentiation in decellularized splenic ***： After decellularization, a translucent scaffold, which retained the gross shape of the spleen, was generated. Histological evaluation and residual DNA quantitation revealed the remaining of extracellular matrix without nucleus and cytoplasm residue. Immunohistochemical study proved the existence of collagens I, IV, fibronectin, laminin and elastin in decellularized splenic scaffold, which showed a similarity with decellularized liver. A scanning electron microscope presented the remaining three-dimensional porous structure of extracellular matrix and small blood vessels. The poros-ity of scaffold, aperture of 45.36±4.87 μm and pore rate of 80.14%±2.99% was suitable for cell engraftment. Subcutaneous implantation of decellularized scaffold presented good histocompatibility, and recellularization of the splenic scaffold demonstr

关键词： tissue engineering liver regeneration decellularized scaffold spleen bone marrow mesenchymal stem cells

Middle hepatic vein variation provides a safe path for anterior transection of hepatocellular carcinoma in caudate lobe

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hepatobiliary & pancreatic Diseases International 2024年第4期23卷 438-440页

作者： Bing-Yi Lin Qi-Jun Zhang Zhe Yang Shu-Sen Zheng Department of hepatobiliary and pancreatic Surgery The First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China Department of Thyroid Surgery The First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China Division of hepatobiliary pancreatic Surgery Shulan(Hangzhou)HospitalZhejiang Shuren University School of MedicineHangzhou 310000China

To the Editor:Hepatocellular carcinoma(HCC)is one of the main causes of cancer related death worldwide,and new cases are expected to continue to increase in future[1].surgical resection is still the best way to remove the tumor and improve patient’s ***,resection of caudate lobe often presents a technical challenge,even to accomplished hepatic *** lobe is located anterior to the inferior vena cava(IVC)and posterior to the bifurcation of the portal vein(PV),generally consists of three regions:the paracaval portion,the left Spiegel lobe and the process portion[2].The anatomy of the paracaval portion includes the liver parenchyma ventral to the hepatic IVC and the area between the Spiegel lobe and the right lobe adjacent to the middle hepatic vein(MHV)ventrally,which was classified by Couinaud as segment IX[3].Here,we presented a case of HCC with successful downstaging therapy,as well as variation of MHV,which provides a safe path for anterior transection of segment IX.

关键词： hepatic anatomy Middle

Immune checkpoint inhibitor for hepatocellular carcinoma recurrence after liver transplantation

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hepatobiliary & pancreatic Diseases International 2020年第1期19卷 91-93页

作者： Li Zhuang Hai-Bo Mou Lan-Fang Yu Heng-Kai Zhu Zhe Yang Qin Liao Shu-Sen Zheng Zhejiang University School of Medicine Hangzhou 310000China Department of hepatobiliary pancreatic Surgery Shulan(Hangzhou)HospitalHangzhou 310022China Department of Oncology Shulan(Hangzhou)HospitalHangzhou 310022China Division of hepatobiliary and pancreatic Surgery Department of General Surgerythe First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China

To the Editor:Liver cancer is the fifth most common cancer and the second most frequent cause of cancer-related death *** carcinoma(HCC)accounts for 90%of primary liver cancers with the highest incidence in China(more than 50%of all cases worldwide)[1].Liver transplantation(LT)is regarded as an optimal therapy for selected HCC *** Milan criteria are the benchmark for candidate selection that ensure excellent prognosis for patients with HCC[2].The Hangzhou criteria expand 51.5%more of Milan criteria for LT candidates with comparable posttransplant survivals[3].However,LT recipients fulfilling Milan criteria or Hangzhou criteria are at the risk of up to 13%−18%HCC recurrence rate within five years[4].Only 25%−50%of recurrent HCC patients post-LT are eligible for surgical treatment which have consistently presented favored survival benefit than systemic therapy[5].

关键词： globally Milan Hangzhou

mTORC2 promotes pancreatic cancer progression and parp inhibitor resistance

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Oncology Research 2023年第4期31卷 495-503页

作者： CHIWEN BU LIGANG ZHAO LISHAN WANG ZEQIAN YU JIAHUA ZHOU Department of hepatobiliary and pancreatic Surgery Zhongda HospitalSchool of MedicineSoutheast UniversityNanjing210009China School of Medicine Southeast UniversityNanjing210009China

pancreatic cancer is one of the most aggressive cancers with a median survival time of less than 5 months,and conventional chemotherapeutics are the main treatment ***(ADP-ribose)polymerase(PARP)inhibitors have been recently approved for BRCA1/2-mutant pancreatic cancer,opening a new era for targeted therapy for this ***,most pancreatic cancer patients carry wild-type BRCA1/2 with resistance to PARP ***,we reported that mammalian target of rapamycin complex 2(mTORC2)kinase is overexpressed in pancreatic cancer tissues and promotes pancreatic cancer cell growth and ***,we found that knockdown of the mTORC2 obligate subunit Rictor sensitized pancreatic cancer cells to the PARP inhibitor ***,we showed that mTORC2 positively regulates homologous recombination(HR)repair by modulating BRCA1 recruitment to DNA double-strand breaks(DSBs).In addition,we confirmed that combination treatment with the mTORC2 inhibitor PP242 and the PARP inhibitor olaparib synergistically inhibited pancreatic cancer growth in ***,this study provides a novel target and strategy for optimizing PARP inhibitor efficiency in pancreatic cancers.

关键词： mTORC2 pancreatic cancer PARP inhibitors HR repair DNA damage

Low-concentration sodium hydroxide solution injection in normal liver parenchyma of rabbits

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hepatobiliary & pancreatic Diseases International 2005年第2期4卷 285-290页

作者： Tian-An Jiang, Qi-Yu Zhao, Miao-Yan Chen and Shu-Sen Zheng Hangzhou, China Department of Ultrasonography, First Affiliated Hos- pital , and Distance Education Center , and Department of hepatobiliary and pancreatic Surgery, First Affilia- ted Hospital , Zhejiang University School of Medicine, Hang- zhou 310003, China Department of hepatobiliary and pancreatic Surgery First Affiliated Hospital Zhejiang University School of Medicine Hangzhou 310003 China.

BACKGROUND: Percutaneous ethanol injection has been widely used as a non-surgical therapy for liver cancer, but it has some shortcomings such as local diffusion and une- qual permeation. This study was designed to observe the volume, controllability and completeness of necrosis after injection of low concentration sodium hydroxide in the normal liver parenchyma so as to assess its possibility in treatment of liver cancer instead of ethanol. METHODS: Twenty-seven New Zealand rabbits were di- vided randomly into 9 groups (Aa, Ab, Ac, Ba, Bb, Bc, Ca, Cb, and Cc) by a 3 × 3 (three-by-three) factorial de- sign, each consisting of 3 rabbits. Group A was given sodi- um hydroxide solution at a concentration of 5%, while B at 2.5% and C at 1% in liver parenchyma. Each group re- ceived three doses of the solution: a (0.2 ml), b (0.5 ml) and c (1.0 ml). Then another 3 rabbits as side-effect group were dropped with sodium hydroxide solution in their liver lobe space. Liver and renal function changes in all the rab- bits were compared after injection with pre-injection. RESULTS: All the lesions were localized. At the concentra- tion of 2.5% and 5%, the lesion volume increased with the dose increased from 0.2 ml to 1.0 ml (P < 0. 05). No sig- nificant differences were found in the lesion volume of the groups receiving the same dose but different concentration. Changes in liver and renal function were not significant 7 days after injection, compared with those before injection. CONCLUSIONS: 2.5% and 5% sodium hydroxide solution could control local complete necrosis in normal liver. With regard to safety, 2.5% alkali solution is considered promis- ing as a new agent for intratumoral injection therapy in- stead of ethanol.

关键词： alkali solution liver injection ultrasonography

Associations between obesity and metabolic health with nonalcoholic fatty liver disease in elderly Chinese

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hepatobiliary & pancreatic Diseases International 2020年第3期19卷 252-257页

作者： Li-Ming Wu Hui He Gang Chen Yu Kuang Bing-Yi Lin Xin-Hua Chen Shu-Sen Zheng Department of hepatobiliary and pancreatic Surgery The First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China Department of Internal Medicine Shaoxing Keqiao Women and Children’s HospitalShaoxing 312030China Medical Physics program University of NevadaLas VegasNV 89121USA

Background:Nonalcoholic fatty liver disease(NAFLD)is closely associated with ***,this association could be influenced by the coexisting metabolic *** study aimed to investigate the role of obesity and metabolic abnormalities in NAFLD among elderly ***:A cross-sectional study was performed among elderly residents who took their annual health checkups during 2016 in Keqiao District,Shaoxing,***:A total of 3359 elderly adults were retrospectively included in this *** overall prevalence of NAFLD was 28.7%.The prevalence of NAFLD were 7.14%,27.92%,34.80%,and 61.02%in participants with metabolically healthy normal weight(MHNW),metabolically abnormal normal weight(MANW),metabolically healthy obese(MHO),and metabolically abnormal obese(MAO),*** patients in MHO group had more unfavorable metabolic profiles than those in MHNW *** regression analysis showed that sex,body mass index(BMI),fasting blood glucose,and serum uric acid were the risk factors of ***:Both obesity and metabolic health were significantly associated with NAFLD in elderly *** for obesity and other metabolic abnormalities should be routinely performed for early risk stratification of NAFLD.

关键词： Fatty liver disease Obesity Metabolic health Elderly

''Minimizing tacrolimus' ' strategy and long-term survival after liver transplantation

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World Journal of Gastroenterology 2014年第32期20卷 11363-11369页

作者： Jun-Jun Jia Bin-Yi Lin Jiang-Juan He Lei Geng Dhruba Kadel Li Wang Dong-Dong Yu Tian Shen Zhe Yang Yu-Fu Ye Lin Zhou Shu-Sen Zheng Key Laboratory of Combined Multi-Organ Transplantation Ministry of Public Health Depart-ment of Hepatobiliary and Pancreatic Surgery First Affiliated Hospital of Zhejiang University School of Medicine

AIM: To investigate the effect of the ‘‘minimizing tacrolimus' ' strategy on long-term survival of patients after liver transplantation(LT).METHODS: We conducted a retrospective study of 319 patients who received LT between January 2009 and December 2011 at the First Affiliated Hospital of Zhejiang University School of Medicine. Following elimination of ineligible patients, 235 patients were included in the study. The relationship between early tacrolimus(TAC)exposure and survival period was analyzed by Kaplan Meier curves. Adverse effects related to TAC were eval-uated by the χ2 test. Routine monitoring of blood TAC concentration(TC) was performed using the PRO-TracTM Ⅱ Tacrolimus Elisa Kit(Diasorin, United States). RESULTS: Of 235 subjects enrolled in the study, 124(52.8%) experienced adverse effects due to TAC. When evaluating mean TC, the survival time of patients with a mean TC 4, the survival time was not statistically different. Adverse effects experienced in all three groups were not statistically different. In Cox regression analysis, male patients and those with a primary diagnosis of benign disease, mean TC > 5 ng/mL and TC SD 2-4 had better ***: The early ‘‘minimizing tacrolimus' ' strategy with a mean TC of 5-10 ng/mL and SD of 2-4 was beneficial in terms of long-term survival after LT.

关键词： Tacrolimus Liver transplantation Outcome Minimizing tacrolimus Immunosuppressive drug

pancreatic tumor initiation: the potential role of IL-33

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Signal Transduction and Targeted Therapy 2021年第6期6卷 1636-1637页

作者： Xing Huang Gang Zhang Tingbo Liang Department of hepatobiliary and pancreatic Surgery the First Affiliated HospitalZhejiang University School of MedicineHangzhouZhejiangChina Zhejiang Provincial Key Laboratory of pancreatic Disease the First Affiliated HospitalZhejiang University School of MedicineHangzhouZhejiangChina

A recent report published in Nature by Alonso-Curbelo et al.1 revealed epigenetic reprogramming in pancreatic cancer initiation caused by the cooperative effects of KRAS mutation and environmental damage.

关键词： al. damage KRAS