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World Journal of Gastrointestinal Surgery 2024年第5期16卷 1470-1473页

作者： Thibault Vieille Melissa Crotet Celia Turco Paul Monasterolo Hadrien Winiszewski Gael Piton Medical intensive Care unit Besancon University HospitalBesancon 25000France intensive Care unit Vesoul HospitalVesoul 70000France Department of Digestive Surgical Oncology-liver Transplantation unit Besancon University HospitalBesancon 25000France Inserm UMRS-938 Centre de Recherche Saint-Antoine(CRSA)Sorbonne UniversitéParis 10041NY212France intensive Care unit Nord Franche Comte HospitalTrevenans 90400France

We suggest that during severe acute pancreatitis(SAP)with intra-abdominal hypertension,practitioners should consider decompressive laparotomy,even with intra-abdominal pressure(IAP)below 25 ***,in this setting,non-occlusive mesenteric ischemia(NOMI)may occur even with IAP below this cutoff and lead to transmural necrosis if abdominal perfusion pressure is not promptly *** report our experience of 18 critically ill patients with SAP having undergone decompressive laparotomy of which one third had NOMI while IAP was mostly below 25 mmHg.

关键词： Acute pancreatitis Abdominal compartment syndrome Decompressive laparotomy Mesenteric ischemia Intra-abdominal pressure Abdominal perfusion pressure

Early plasma exchange and continuous renal replacement therapy improve puerperal prognosis in hepatitis B virus-related acute-on-chronic liver failure in pregnancy

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Mechanisms of liver injuries caused by traditional Chinese medicines

肝脏研究（英文） 2024年第2期8卷 118-126页

作者： Lijuan Li Mingming Fan Mi Zhou Pinglan Lu Jianrong Liu Huimin Yi Xuxia Wei Surgical intensive Care unit The Third Affiliated Hospital of Sun Yat-sen UniversityGuangzhouGuangdongChina

Background and aim:Hepatitis B virus(HBV)-related gestational acute-on-chronic liver failure(ACLF)is a severe condition with limited treatment *** study aimed to evaluate the efficacy and ideal timing of plasma exchange and continuous renal replacement therapy(CRRT)in managing pregnant women with HBV-related ACLF.Methods:This study retrospectively analyzed 51 eligible patients with HBV-related gestational ACLF between 2009 and *** admitted to the study were divided into a conventional treatment group and a new treatment group according to whether they received the new management protocol,which included more aggressive plasma exchange(PE)and CRRT *** 19 pregnant women with hepatic encephalopathy(HE)were divided into an early treatment group and a non-early treatment group according to whether PE therapy was initiated within three *** study had two primary ***,we aimed to evaluate the impact of PE and CRRT on puerperal ***,we sought to assess the effects of early PE and CRRT regimens on puerperal survival in women with HE.Results:The levels of total bilirubin on the second day postpartum(D3),the third day postpartum(D4),and the fifth day postpartum(D6)were significantly lower in the new treatment group compared to the conventional treatment group(P=0.02,0.01,and 0.02,respectively).The ALT of D3 was significantly elevated in the new treatment group compared to the conventional treatment group(P=0.02).The incidence of HE overall increased from prenatal to postpartum D4,peaked on D4,and then gradually decreased from the fourth day postpartum(D5)(P=0.027).The first week after delivery revealed a significant difference in survival rate between the two groups,the conventional treatment group had statistically higher mortality rates compared to the new treatment group(P=0.002).Similarly,the entire puerperal period mortality rate of the conventional treatment group was statistically higher than the new treatm

关键词： Acute-on-chronic liver failure (ACLF) liver disease in pregnancy Hepatitis B virus (HBV) Plasma exchange (PE) Continuous renal replacement therapy (CRRT) Hepatic encephalopathy (HE)

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Hepatobiliary & Pancreatic Diseases International 2024年第3期23卷 310-312页

作者： Shui-Fang Jin Qi Pan Jin-Peng Zhou Xiao-Ping Pan intensive Care unit The First Affiliated Hospital of Zhejiang Chinese Medical University(Zhejiang Provincial Hospital of Chinese Medicine)Hangzhou 310006China Institute of liver Diseases College of Basic Medical SciencesZhejiang Chinese Medical UniversityHangzhou 310053China The Second Clinical Medical College of Zhejiang Chinese Medical University Hangzhou 310056China

Drug-induced liver injury(DILI)is a common adverse drug reaction,which can even result in liver failure[1,2].The Chinese Medical Association issued the Guidelines for the Diagnosis and Treatment of DILI based on the Roussel Uclaf Causality Assessment Method(RUCAM)in 2015[3].A previous study reported that traditional Chinese medicines(TCMs),herbal and dietary supplements,and antituberculosis drugs were the main causes of DILI in China[4].Herb-induced liver injury(HILI)refers to liver injury caused by TCMs,natural drugs,and their related preparations[5].

关键词： drugs tuberculosis TCM

Identification prognostic features related to sphingolipid metabolism and experimental validation of TRIM47 in hepatocellular carcinoma

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BIOCELL 2024年第4期48卷 639-651页

作者： JIAN TANG CHENQIANG ZHU YUN CHEN YUNLONG WU MING HE YI ZHOU MINGHUA XIE Department of intensive Care unit The First People’s Hospital of Linping DistrictHangzhouChina Department of Pharmacy The First People’s Hospital of Linping DistrictHangzhouChina

Background:The speciﬁc impact of sphingolipid metabolism on developing hepatocellular Carcinoma(HCC)remains *** study aims to explore the relationship between sphingolipid metabolism and HCC prognosis,immune response,and drug ***:Data were obtained from The Cancer Genome Atlas(TCGA)-Hepatocellular Carcinoma(LIHC)and Gene Expression Omnibus(GEO,GSE14520 datasets).47 sphingolipid metabolism genes were obtained from the Kyoto Encyclopedia of Genes and Genomes(KEGG)*** classifying HCC samples using the Non-negative Matrix Factorization(NMF)clustering method,differentially expressed genes were ***,8 risk genes were obtained by univariate analysis,survival random forest reduction and lasso *** expression of 8 risk genes was veriﬁed in ***:8 risk genes were used to construct the Sphingolipid score ***-Sphingolipid score predicted poor prognosis of HCC *** score was associated with immune checkpoints(IL-1B,TLR4,TGFB1,and IL-10),immune cells(Th2,Treg,MDSC,Neutrophil,Fibroblasts and macrophage),and MAPK *** the High-Sphingolipid score group,a signiﬁcantly higher proportion of patients with TP53(p53)mutations was signiﬁcantly higher(56%).Furthermore,patients with a high-Sphingolipid score were predicted to have a higher sensitivity to chemotherapy *** vitro validation showed that compared with normal liver cells LX-2,TRIM47,and S100A9 signiﬁcantly increased in liver cancer cells Hep G2,MHCC-97H,and Hep3B2.1-7,while SLC1A7,LPCAT1,and CFHR4 signiﬁcantly *** TRIM47 reduced the proliferation and promoted *** levels of ceramide synthesis-related indexes(CERS1,CERS6,CERS5,and SPTLC2)increased,and the ACER3 related to catalytic hydrolysis ***:We constructed a sphingolipid metabolism-related prognostic signature(Sphingolipid score)based on 8 risk ***47 may affect the development of liver cancer by regulating the relevant indicators of

关键词： Hepatocellular carcinoma Sphingolipid metabolism TRIM47 Prognosis

Hippo(YAP)-autophagy axis protects against hepatic ischemia-reperfusion injury through JNK signaling

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Chinese Medical Journal 2024年第6期137卷 657-668页

作者： Shuguang Zhu Xiaowen Wang Haoqi Chen Wenfeng Zhu Xuejiao Li Ruiwen Cui Xiaomeng Yi Xiaolong Chen Hua Li Genshu Wang Department of Hepatic Surgery Liver TransplantationThe Third Affiliated Hospital of Sun Yat-sen UniversityGuangzhouGuangdong 510630China Department of Hepatology lab The Third Affiliated Hospital of Sun Yat-sen UniversityGuangzhouGuangdong 510630China Department of General Surgery The Third Affiliated Hospital of Sun Yat-sen UniversityGuangzhouGuangdong 510630China Department of Organ Transplantation The Third Affiliated Hospital of Sun Yat-sen UniversityGuangzhouGuangdong 510630China Department of Renal Transplantation Guangdong Provincial Hospital of Chinese MedicineGuangzhouGuangdong 510630China Department of Surgical intensive Care unit The Third Affiliated Hospital of Sun Yat-sen UniversityGuangzhouGuangdong 510630China Department of Hepatic Surgery Liver TransplantationGuangdong Provincial Hospital of Chinese MedicineGuangzhouGuangdong 510630China

Background:Hepatic ischemia-reperfusion injury(HIRI)remains a common complication during liver transplantation(LT)in *** a key downstream effector of the Hippo pathway,Yes-associated protein(YAP)has been reported to be involved in various physiological and pathological ***,it remains elusive whether and how YAP may control autophagy activation during ***:Human liver tissues from patients who had undergone LT were obtained to evaluate the correlation between YAP and autophagy *** an in vitro hepatocyte cell line and in vivo liver-specific YAP knockdown mice were used to establish the hepatic ischemia-reperfusion models to determine the role of YAP in the activation of autophagy and the mechanism of ***:Autophagy was activated in the post-perfusion liver grafts during LT in patients,and the expression of YAP positively correlated with the autophagic level of ***-specific knockdown of YAP inhibited hepatocytes autophagy upon hypoxia-reoxygenation and HIRI(P<0.05).YAP deficiency aggravated HIRI by promoting the apoptosis of hepatocytes both in the in vitro and in vivo models(P<0.05).Attenuated HIRI by overexpression of YAP was diminished after the inhibition of autophagy with *** addition,inhibiting autophagy activation by YAP knockdown exacerbated mitochondrial damage through increasing reactive oxygen species(P<0.05).Moreover,the regulation of autophagy by YAP during HIRI was mediated by AP1(c-Jun)N-terminal kinase(JNK)signaling through binding to the transcriptional enhanced associate domain(TEAD).Conclusions:YAP protects against HIRI by inducing autophagy via JNK signaling that suppresses the apoptosis of *** Hippo(YAP)-JNK-autophagy axis may provide a novel strategy for the prevention and treatment of HIRI.

关键词： YAP-signaling proteins Autophagy c-Jun N-terminal kinase Ischemia-reperfusion injury liver transplantation

Natural long-chain saturated fatty acids doped LNPs enabling spleen selective mRNA translation and potent cancer immunotherapy

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Nano Research 2024年第3期17卷 1804-1817页

作者： Fazhan Wang Meng Zhang Meiling Tian Jia Lou Longze Pan Xiaoke Gao Lijing Zhang Xiaohan Lou Linyu Zhu Yuqiao Sheng Ming Wang Rui Xue Wenjing Deng Shuai Shao Zhihai Qin Medical Research Center The First Affiliated Hospital of Zhengzhou UniversityZhengzhou UniversityZhengzhou 450052China Translational Medical Center The First Affiliated Hospital of Zhengzhou UniversityZhengzhou UniversityZhengzhou 450052China Department of Neuro-intensive Care unit The First Affiliated Hospital of Zhengzhou UniversityZhengzhou 450052China Academy of Medical Sciences Zhengzhou UniversityZhengzhou 450052China

Rationally tailored lipid nanoparticles(LNPs)with efficient and tunable delivery of mRNA in vivo are crucial for mRNA *** expression of antigenic protein in lymphoid tissues/organs could improve the immunostimulatory efficacy and safety of LNPs-based mRNA *** by the metabolic behavior that long-chain saturated fatty acids tending to enter lymphoid tissue rather than the liver,we developed fatty acid-doped LNPs capable of mediating differential protein expressions in the liver and spleen when administered *** the molar ratio of saturated fatty acid located 60%–70%,the doped LNPs achieved the spleen selective mRNA *** mechanism could be attributed to the different cellular uptake behaviors of saturated fatty acids in *** with a model antigen(ovalbumin)mRNA-loaded spleen selective LNPs,we observed enhanced antigen-specific T cell immune responses,and potent immunotherapeutic and immunoprophylactic efficacy in the mouse lymphoma *** natural long-chain saturated fatty acids metabolic characteristics-inspired design of LNPs for spleen-selective mRNA vaccines delivery will provide references for designing mRNA vaccines with high efficacy and safety for tumor immunotherapy.

关键词： mRNA vaccine lipid nanoparticles spleen long-chain saturated fatty acid cancer immunotherapy

Extracorporeal organ support for critically ill patients:Overcoming the past,achieving the maximum at present,and redefining the future

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World Journal of Critical Care Medicine 2024年第2期13卷 19-28页

作者： Panagiotis Papamichalis Katerina G Oikonomou Maria Xanthoudaki Asimina Valsamaki Apostolia-Lemonia Skoura Sophia K Papathanasiou Achilleas Chovas intensive Care unit General Hospital of LarissaLarissa 41221Greece Department of Transfusion Medicine University Hospital of LarissaLarissa 41110Greece Department of Internal Medicine General Hospital of LarissaLarissa 41221Greece

Extracorporeal organ support(ECOS)has made remarkable progress over the last few *** replacement therapy,introduced a few decades ago,was the first available application of *** subsequent evolution of ECOS enabled the enhanced support to many other organs,including the heart[veno-arterial extracorporeal membrane oxygenation(ECMO),slow continuous ultrafiltration],the lungs(veno-venous ECMO,extracorporeal carbon dioxide removal),and the liver(blood purification techniques for the detoxification of liver toxins).Moreover,additional indications of these methods,including the suppression of excessive inflammatory response occurring in severe disorders such as sepsis,coronavirus disease 2019,pancreatitis,and trauma(blood purification techniques for the removal of exotoxins,endotoxins,or cytokines),have *** organ support therapy is crucial since a vast majority of critically ill patients present not with a single but with multiple organ failure(MOF),whereas,traditional therapeutic approaches(mechanical ventilation for acute respiratory failure,antibiotics for sepsis,and inotropes for cardiac dysfunction)have reached the maximum efficacy and cannot be improved ***,several issues remain to be clarified,such as the complexity and cost of ECOS systems,standardization of indications,therapeutic protocols and initiation time,choice of the patients who will benefit most from these interventions,while evidence from randomized controlled trials supporting their use is still ***,these methods are currently a part of routine clinical practice in intensive care *** editorial presents the past,present,and future considerations,as well as perspectives regarding these *** better understanding of these methods,the pathophysiology of MOF,the crosstalk between native organs resulting in MOF,and the crosstalk between native organs and artificial organ support systems when applied sequentially or simultaneously,will lead t

关键词： Kidney-liver replacement therapy Heart-lung support Blood purification Native–artificial organ crosstalk Multiple organ support therapy Extracorporeal organ support

Hypoxia-preconditioned bone marrow-derived mesenchymal stem cells protect neurons from cardiac arrest-induced pyroptosis

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Neural Regeneration Research 2025年第4期20卷 1103-1123页

作者： Xiahong Tang Nan Zheng Qingming Lin Yan You Zheng Gong Yangping Zhuang Jiali Wu Yu Wang Hanlin Huang Jun Ke Feng Chen Shengli Clinical Medical College of Fujian Medical University Fujian Medical UniversityFuzhouFujian ProvinceChina Department of Emergency Fujian Provincial HospitalFuzhouFujian ProvinceChina Fujian Provincial Key Laboratory of Emergency Medicine FuzhouFujian ProvinceChina The Second Department of intensive Care unit Fujian Provincial Hospital South BranchFuzhouFujian ProvinceChina

Cardiac arrest can lead to severe neurological impairment as a result of inflammation,mitochondrial dysfunction,and post-cardiopulmonary resuscitation neurological *** preconditioning has been shown to improve migration and survival of bone marrow–derived mesenchymal stem cells and reduce pyroptosis after cardiac arrest,but the specific mechanisms by which hypoxia-preconditioned bone marrow–derived mesenchymal stem cells protect against brain injury after cardiac arrest are *** this end,we established an in vitro co-culture model of bone marrow–derived mesenchymal stem cells and oxygen–glucose deprived primary neurons and found that hypoxic preconditioning enhanced the protective effect of bone marrow stromal stem cells against neuronal pyroptosis,possibly through inhibition of the MAPK and nuclear factor κB ***,we transplanted hypoxia-preconditioned bone marrow–derived mesenchymal stem cells into the lateral ventricle after the return of spontaneous circulation in an 8-minute cardiac arrest rat model induced by *** results showed that hypoxia-preconditioned bone marrow–derived mesenchymal stem cells significantly reduced cardiac arrest–induced neuronal pyroptosis,oxidative stress,and mitochondrial damage,whereas knockdown of the liver isoform of phosphofructokinase in bone marrow–derived mesenchymal stem cells inhibited these *** conclude,hypoxia-preconditioned bone marrow–derived mesenchymal stem cells offer a promising therapeutic approach for neuronal injury following cardiac arrest,and their beneficial effects are potentially associated with increased expression of the liver isoform of phosphofructokinase following hypoxic preconditioning.

关键词： bone marrow–derived mesenchymal stem cells cardiac arrest cardiac resuscitation hypoxic preconditioning liver isoform of phosphofructokinase mitochondria neuroinflammation oxidative stress pyroptosis reactive oxygen species

Tumor budding is a meaningful prognostic marker in patients with hepatocellular carcinoma after curative hepatectomy

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Portal Hypertension & Cirrhosis 2024年第2期3卷 86-95页

作者： Kaibo Yang Kunjin Wu Zitong Lei Tong Liu Xing Zhang Jing Li Kun Yang Qiuting Peng Ting Lin Chang Liu Kai Qu Department of Hepatobiliary Surgery and liver Transplantation The Second Affiliated Hospital of Xi'an Jiaotong UniversityXi'anShaanxiChina Key Laboratory of Surgical Critical Care and Life Support(Xi'an Jiaotong University) Ministry of EducationXi'anShaanxiChina Department of Critical Care Nephrology and Blood Purification The First Affiliated Hospital of Xi'an Jiaotong UniversityXi'anShaanxiChina Hangzhou Institute of National Extremelyweak Magnetic Field Infrastructure HangzhouZhejiangChina Department of Surgical intensive Care units The First Affiliated Hospital of Xi'an Jiaotong UniversityXi'anShaanxiChina

Aim:Tumor budding(TB)has excellent prognostic value in many solid tumors,but there is little research on it in hepatocellular carcinoma(HCC).This study assessed the prognostic value of TB in patients with HCC who received ***:This retrospective study included 210 patients with HCC who received curative hepatectomy at the First Affiliated Hospital of Xi'an Jiaotong University,between 2016 and *** was evaluated on hematoxylin-and eosin-stained slides according to the criteria established by the 2016 International Tumor Budding Consensus Conference.t-tests,Chi-squared tests,and rank-sum tests were used to correlate the extent of TB with clinicopathological *** analysis was performed using Cox regression models and the Kaplan–Meier ***:The positive detection rate of TB was 45.2%(95/210)in 210 patients with *** positive for TB always exhibit lower tumor differentiation,higher hepatitis B virus DNA levels,and more severe liver *** Cox analysis identified TB(hazard ratio[HR]:2.232,95%confidence interval[CI]:1.479–3.368,p<0.001)as an independent prognostic factor for patients'recurrence-free survival(RFS),similar to tumor size(HR:1.070,95%CI:1.070–1.142,p=0.042)and satellite nodule(HR:2.266,95%CI:1.298–3.956,p=0.004).Kaplan–Meier analysis also demonstrated that TB-positive patients had a significantly worse ***,subgroup analysis revealed that among HCC patients with negative microvascular invasion(MVI),TB was also strongly associated with RFS(HR:3.206,95%CI:1.667–6.168,p<0.001).These findings suggest that TB may serve as a supplemental prognostic biomarker for HCC-negative ***:TB is an adverse prognostic biomarker for HCC,particularly in patients negative for *** evaluation should be considered in the postoperative pathological examination of HCC in clinical practice.

关键词： hepatocellular carcinoma microvascular invasion prognosis tumor budding

Association of donor hepatectomy time with liver transplantation outcomes: A multicenter retrospective study

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World Journal of Transplantation 2024年第1期14卷 130-140页

作者： Geisiane Custodio Andrew Maykon Massutti Aline Caramori Taynara Gonçalves Pereira Augusto Dalazen Gabriela Scheidt Ludmilla Thomazini Cristiane Bauermann Leitão Tatiana Helena Rech Department of intensive Care unit Hospital Santa IsabelBlumenau-Santa Catarina CEP-89010906Brazil Transplant Division Hospital Santa IsabelBlumenau-Santa Catarina CEP-89010906Brazil School of Medicine Universidade Regional de Blumenau(FURB)Blumenau-Santa Catarina CEP-89010906Brazil School of Medicine Universidade Federal do Rio Grande do SulPorto Alegre 90035-903Brazil Departement of Endocrinology Hospital de Clínicas de Porto Alegre/Universidade Federal do Rio Grande do SulPorto Alegre 90035-903Rio Grande do SulBrazil Department of Internal Medicine Hospital de Clínicas de Porto AlegreDivision of Intensive Care MedicinePorto Alegre 90035-903Brazil

BACKGROUND Prolonged donor hepatectomy time may be implicated in early and late complications of liver *** To evaluate the impact of donor hepatectomy time on outcomes of liver transplant recipients,mainly early allograft *** This multicenter retrospective study included brain-dead donors and adult liver graft ***-recipient matching was obtained through a crossover *** and laboratory data were recorded for both donors and *** hepatectomy,cold ischemia,and warm ischemia times were *** outcome was early allograft *** outcomes included need for retransplantation,length of intensive care unit and hospital stay,and patient and graft survival at 12 *** From January 2019 to December 2021,a total of 243 patients underwent a liver transplant from a brain-dead *** these,57(25%)developed early allograft *** median donor hepatectomy time was 29(23–40)*** with early allograft dysfunction had a median hepatectomy time of 25(22–38)min,whereas those without it had a median time of 30(24–40)min(P=0.126).CONCLUSION Donor hepatectomy time was not associated with early allograft dysfunction,graft survival,or patient survival following liver transplantation.

关键词： Brain death Hepatectomy liver transplantation Early allograft dysfunction Graft survival