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Transplantation of bone marrow-derived endothelial progenitor cells and hepatocyte stem cells from liver fibrosis rats ameliorates liver fibrosis

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World Journal of Gastroenterology 2018年第2期24卷 237-247页

作者： Ling Lan Ran Liu Ling-Yun Qin Peng Cheng Bo-Wei Liu Bing-Yong Zhang Song-Ze Ding Xiu-Ling Li Department of Gastroenterology and Hepatology the People's Hospital of Zhengzhou University(the Henan Provincial People’s Hospital) Department of Oncology Henan Provincial Rongjun Hospital Department of Gastroenterology and Hepatology the Children’s Hospital of Zhengzhou intensive Care unit the Second Affiliated Hospitalof Luohe Medical College

AIM To explore the effectiveness for treating liver fibrosisby combined transplantation of bone marrow-derived endothelial progenitor cells(BM-EPCs) and bone marrow-derived hepatocyte stem cells(BDHSCs) from the liver fibrosis *** The liver fibrosis rat models were induced with carbon tetrachloride injections for 6 wk. BM-EPCs from rats with liver fibrosis were obtained by different rates of adherence and culture induction. BDHSCs from rats with liver fibrosis were isolated by magnetic bead cell sorting. Tracing analysis was conducted by labeling EPCs with PKH26 in vitro to show EPC location in the liver. Finally, BM-EPCs and/or BDHSCs transplantation into rats with liver fibrosis were performed to evaluate the effectiveness of BM-EPCs and/or BDHSCs on liver *** Normal functional BM-EPCs from liver fibrosis rats were successfully obtained. The co-expression level of CD133 and VEGFR2 was 63.9% ± 2.15%. Transplanted BM-EPCs were located primarily in/near hepatic sinusoids. The combined transplantation of BM-EPCs and BDHSCs promoted hepatic neovascularization, liver regeneration and liver function, and decreased collagen formation and liver fibrosis degree. The VEGF levels were increased in the BM-EPCs(707.10 ± 54.32) and BM-EPCs/BDHSCs group(615.42 ± 42.96), compared with those in the model group and BDHSCs group(P 0.05) compared with those in the BDHSC(AST, TBIL and PT, P liver fibrosis(staging score of 1.75 ± 0.25 vs BDHSCs 2.88 ± 0.23 or

关键词： Bone marrow Endothelial progenitor cells liver stem cell Cell transplantation liver fibrosis

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Early respiratory complications after liver transplantation

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World Journal of Gastroenterology 2013年第48期19卷 9271-9281页

作者： Paolo Feltracco Cristiana Carollo Stefania Barbieri Tommaso Pettenuzzo Carlo Ori Department of Medicine Anesthesia and Intensive Care Unit Padova University Hospital35128 Padova Italy

The poor clinical conditions associated with end-stage cirrhosis,pre-existing pulmonary abnormalities,and high comorbidity rates in patients with high Model for End-Stage liver Disease scores are all well-recognized factors that increase the risk of pulmonary complications after orthotopic liver transplantation(OLT)*** intraoperative and postoperative events,such as fluid overload,massive transfusion of blood products,hemodynamic instability,unexpected coagulation abnormalities,renal dysfunction,and serious adverse effects of reperfusion syndrome,are other factors that predispose an individual to postoperative respiratory *** advances in surgical techniques and anesthesiological management,the lung may still suffer throughout the perioperative period from various types of injury and ventilatory impairment,with different clinical *** complications after OLT can be classified as infectious or *** effusion,atelectasis,pulmonary edema,respiratory distress syndrome,and pneumonia may contribute considerably to early morbidity and mortality in liver transplant *** is of paramount importance to accurately identify lung disorders because infectious pulmonary complications warrant speedy and aggressive treatment to prevent diffuse lung injury and the risk of evolution into multisystem organ *** review discusses the most common perioperative factors that predispose an individual to postoperative pulmonary complications and these complications’early clinical manifestations after OLT and influence on patient outcome.

关键词： Respiratory complications Postoperative respiratory failure liver transplantation Postoperative edema Post-transplant pneumonia

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DNA and RNA oxidative damage in hepatocellular carcinoma patients and mortality during the first year of liver transplantation

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World Journal of Hepatology 2022年第6期14卷 1182-1189页

作者： Leonardo Lorente Sergio T Rodriguez Pablo Sanz Agustín F González-Rivero Antonia Pérez-Cejas Javier Padilla Dácil Díaz Antonio González María M Martín Alejandro Jiménez Purificación Cerro Julián Portero Manuel A Barrera Department ofintensive Care Hospital Universitario de CanariasLa Laguna 38320TenerifeSpain intensive Care unit Hospital Universitario Nuestra Señora CandelariaSanta Cruz de Tenerife 38010Spain Department of Surgery Hospital Universitario Nuestra Señora de CandelariaSanta Cruz de Tenerife 38010Spain Department of Laboratory Hospital Universitario de CanariasLa Laguna 38320Spain Department of Digestive Hospital Universitario Nuestra Señora de CandelariaSanta Cruz de Tenerife 38010Spain Research unit Hospital Universitario de CanariasLa Laguna 38320Spain Transplant unit Hospital Universitario Nuestra Señora CandelariaSanta Cruz de Tenerife 38010Spain Department of Radiology Hospital Universitario Nuestra Señora CandelariaSanta Cruz de Tenerife 38010Spain

BACKGROUND Oxidative damage of DNA and RNA has been associated with mortality of patients with different ***,there is no published data on the potential use of DNA and RNA oxidative damage to predict the prognosis of patients with hepatocellular carcinoma(HCC)undergoing liver transplantation(LT).AIM To determine whether patients with increased DNA and RNA oxidative damage prior to LT for HCC have a poor LT *** Patients with HCC who underwent LT were included in this observational and retrospective *** levels of all three oxidized guanine species(OGS)were measured prior to LT since guanine is the nucleobase that forms DNA and RNA most prone to *** mortality at 1 year was the end-point *** Surviving patients(n=101)showed lower serum OGS levels(P=0.01)and lower age of the liver donor(P=0.03)than non-surviving patients(n=13).An association between serum OGS levels prior to LT and 1-year LT(odds ratio=2.079;95%confidence interval=1.356-3.189;P=0.001)was found in the logistic regression *** The main new finding was that high serum OGS concentration prior to LT was associated with the mortality 1 year after LT in HCC patients.

关键词： DNA oxidative damage Hepatocellular carcinoma liver transplantation Mortality Oxidized guanine species

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Chinese expert consensus on the diagnosis and treatment of severely and critically ill patients with coronavirus disease 2019

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Chinese Medical Journal 2020年第24期133卷 2963-2965页

作者： Tong-Wen Sun Xi-Jing Zhang Zhui Yu You Shang General intensive Care unit The First Affiliated Hospital of Zhengzhou UniversityHenan Key Laboratory of Critical Care MedicineZhengzhou Key Laboratory of SepsisHenan Engineering Research Center for Critical Care MedicineZhengzhouHenan 450052China intensive Care unit The First Affiliated Hospital of Air Force Military Medical UniversityXi’anShaanxi 710032China Department of Critical Care Medicine Renmin Hospital of Wuhan UniversityWuhanHubei 430060China Department of Critical Care Medicine Union Hospital Affiliated to Huazhong University of Science and TechnologyWuhanHubei 430022China

The coronavirus disease 2019(COVID-19)threatens the health of humans worldwide,and at the time of this writing,there is no specifically targeted effective drug for *** major initial symptoms of patients with COVID-19 are fever,dry cough,and fatigue,although some patients mainly experience vomiting,diarrhea,and other gastrointestinal *** severe symptoms,namely chest tightness,dyspnea,and respiratory distress,usually appear one week later,with some patients rapidly developing acute respiratory distress syndrome(ARDS),septic shock,and possibly even death.A retrospective study of critically ill patients with COVID-19 has recently reported that 67.3%of patients presented with ARDS,28.9%with acute kidney injury,23.1%with heart injury,and 28.9%with abnormality in liver *** addition,the 28-day mortality rate was up to 61.5%.[1]

关键词： patients distress diagnosis

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Targeting late SV40 factor: Is the achilles heel of hepatocarcinogenesis revealed?

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World Journal of Gastroenterology 2012年第46期18卷 6709-6711页

作者： Amir Shlomai Institute of Gastroenterology and liver Diseases Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine Tel-Aviv University

Hepatocellular carcinoma (HCC) is a dreadful cancer and a major cause of death among patients with chronic liver disease and cirrhosis. The apparent alterations in a diversity of intracellular pathways found in HCC has set the rational for developing molecular-directed drugs that simultaneously inhibit multiple pathways, such as the multi-kinase inhibitor Sorafenib. However, recently this concept has been challenged by showing that HCC is heavily dependent on a single oncogene designated late SV-40 factor (LSF), a transcription factor that is over-expressed in liver cancer cells and that its expression is strongly correlated with tumor grade and aggressiveness. Furthermore, using an intensive screening for drugs that inhibit LSF activity, Grant et al have found a molecule designated factor quinolinone inhibitor 1 that can specifically block the ability of LSF to bind its target promoters, resulting in a massive death of HCC cells both in vitro and in vivo. The innovative findings of HCC representing "oncogene addiction" to LSF and the ability of a single molecule to block the activity of this oncogene resulting in tumor abolishment are encouraging and provide us with the hope that the "Achilles heel" of HCC has been found.

关键词：肝癌细胞 SV40 后期转录因子单个分子原癌基因导向药物酶抑制剂

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Comprehensive treatment of acute-on-chronic liver failure in a patient with hepatitis B： a case report

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Frontiers of Medicine 2014年第2期8卷 250-253页

作者： Lei Li Yimei Liu Tiancheng Luo Jian Zhou Yingyong Hou Xizhong Shen Jiyao Wang Department of Gastroenterology Zhongshan Hospital Fudan University Shanghai 200032 China Department of liver Surgery Zhongshan Hospital Fudan University Shanghai 200032 China Department of Pathology Zhongshan Hospital Fudan University Shanghai 200032 China Shanghai Institute of liver Diseases Shanghai 200032 China

The clinical data of a patient with acute-on-chronic liver failure were analyzed retrospectively. The patient has suffered from hepatitis B for 30 years. His liver function deteriorated, yielding Child-Pugh grade C and reaching a model for end-stage liver disease score of 33 points within a short period; this condition was complicated with highly active variceal bleeding and coagulation system failure （PT 〉 100 s）. The patient also presented hepatocellular carcinoma. Comprehensive treatments included effective inhibition of hepatitis B virus replication and intensive care support. Piggyback orthotopic liver transplantation was performed as the final treatment. The patient recovered uneventfully and was discharged after surgery.

关键词： acute-on-chronic liver failure submassive necrosis viral hepatitis B esophageal variceal bleeding liver transplantation

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Enhanced recovery after surgery in liver transplantation:Challenges and feasibility

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World Journal of Transplantation 2022年第7期12卷 195-203页

作者： Georgios Katsanos Konstantina-Eleni Karakasi Nikolaos Antoniadis Stella Vasileiadou Athanasios Kofinas Antonios Morsi-Yeroyannis Evangelia Michailidou Ioannis Goulis Emmanouil Sinakos Olga Giouleme Ilias Marios Oikonomou George Evlavis Georgios Tsakiris Eleni Massa Eleni Mouloudi Georgios Tsoulfas Department of Transplantation Medical SchoolAristotle University of ThessalonikiHippokration General HospitalThessaloniki 54642Greece intensive Care unit National Health SystemHippokration General HospitalThessaloniki 54642Greece Fourth Department of Internal Medicine Hippokration General HospitalMedical School of Aristotle UniversityThessaloniki 54642Greece Second Propaedeutic Department of Internal Medicine Hippokratio General HospitalAristotle University ThessalonikiThessaloniki 54642Greece Nursing Department National Health SystemDepartment of TransplantationHippokration General HospitalThessaloniki 54642Greece

BACKGROUND Enhanced recovery after surgery(ERAS)started a revolution that changed age-old surgical stereotypical practices regarding the overall management of the surgical *** the last decade,ERAS has gained significant acceptance in the community of general surgery,in addition to several other surgical specialties,as the evidence of its advantages continues to *** of the last remaining fields,given its significant complexity and intricate nature,is liver transplantation(LT).AIM To investigate the existing efforts at implementing ERAS in *** We conducted a systematic review of the existing studies that evaluate ERAS in orthotopic LT,with a multimodal approach and focusing on measurable clinical primary endpoints,namely length of hospital *** All studies demonstrated a considerable decrease in length of hospital stay,with no readmission or negative impact of the ERAS protocol applied to the postoperative *** ERAS is a well-validated multimodal approach for almost all types of surgical procedures,and its future in selected LT patients seems promising,as the preliminary results advocate for the safety and efficacy of ERAS in the field of LT.

关键词： Enhanced recovery Enhanced recovery after surgery Recovery liver transplantation liver

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Aggressive surgical approach in patients with adrenal-only metastases from hepatocellular carcinoma enables higher survival rates than standard systemic therapy

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Hepatobiliary & Pancreatic Diseases International 2021年第1期20卷 28-33页

作者： Sorin T Alexandrescu Adina E Croitoru Razvan T Grigorie Dana R Tomescu Gabriela Droc Mugur C Grasu Irinel Popescu Dan Setlacec Centre of General Surgery and liver Transplantation Fundeni Clinical InstituteBucharest 022328Romania Carol Davila University of Medicine and Pharmacy Bucharest 020021Romania Department of Oncology Fundeni Clinical InstituteBucharest 022328Romania Faculty of Medicine Titu Maiorescu UniversityBucharest 031593Romania Dan Tulbure Centre of Anesteziology and intensive Care Fundeni Clinical InstituteBucharest 022328Romania Department of Radiology Fundeni Clinical InstituteBucharest 022328Romania

Background:Although guidelines recommend systemic therapy even in patients with limited extrahepatic metastases from hepatocellular carcinoma(HCC),a few recent studies suggested a potential benefit for resection of extrahepatic ***,the benefit of adrenal resection(AR)for adrenal-only metastases(AOM)from HCC was not proved *** is the first study to compare long-term outcomes of AR to those of sorafenib in patients with AOM from ***:The patients with adrenal metastases(AM)from HCC were identified from the electronic records of the institution between January 2002 and December *** who presented AM and other sites of extrahepatic disease were ***,the patients with AOM who received other therapies than AR or sorafenib were ***:A total of 34 patients with AM from HCC were *** of these,22 patients had AOM,6 receiving other treatment than AR or ***,8 patients with AOM underwent AR(AR group),while 8 patients were treated with sorafenib(SOR group).The baseline characteristics of the two groups were not significantly different in terms of age,sex,number and size of the primary tumor,timing of AM diagnosis,Child-Pugh and ECOG *** a median follow-up of 15.5 months,in the AR group,the 1-,3-,and 5-year overall survival rates(85.7%,42.9%,and 0%,respectively)were significantly higher than those achieved in the SOR group(62.5%,0%and 0%at 1-,3-and 5-year,respectively)(P=0.009).The median progression-free survival after AR(14 months)was significantly longer than that after sorafenib therapy(6 months,P=0.002).Conclusions:In patients with AOM from HCC,AR was associated with significantly higher overall and progression-free survival rates than systemic therapy with *** results could represent a starting-point for future phase II/III clinical trials.

关键词： Adrenal metastases Hepatocellular carcinoma Adrenal resection Sorafenib Survival

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Approach to persistent ascites after liver transplantation

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World Journal of Hepatology 2022年第9期14卷 1739-1746页

作者： Ana Ostojic Igor Petrovic Hrvoje Silovski Iva Kosuta Maja Sremac Anna Mrzljak Department of Gastroenterology and Hepatology University Hospital Center ZagrebZagreb 10000Croatia Department of Hepatobiliary Surgery and Transplantation University Hospital Center ZagrebZagreb 10000Croatia Department of intensive Care Medicine University Hospital Center ZagrebZagreb 10000Croatia

Persistent ascites(PA)after liver transplantation(LT),commonly defined as ascites lasting more than 4 wk after LT,can be expected in up to 7%of *** being relatively rare,it is associated with worse clinical outcomes,including higher 1-year *** cause of PA can be divided into vascular,hepatic,or *** causes of PA include hepatic outflow and inflow obstructions,which are usually successfully *** modifiable hepatic causes,recurrent hepatitis C and acute cellular rejection are the leading *** predictors for PA,the presence of ascites,refractory ascites,hepatorenal syndrome type 1,spontaneous bacterial peritonitis,hepatic encephalopathy,and prolonged ischemic time significantly influence the development of PA after *** initial approach to patients with PA should be to diagnose the treatable cause of *** stepwise approach in evaluating PA includes diagnostic paracentesis,ultrasound with Doppler,and an echocardiogram when a cardiac cause is ***,a percutaneous or transjugular liver biopsy should be performed in cases where the diagnosis is *** of unknown cause should be treated with diuretics and paracentesis,while transjugular intrahepatic portosystemic shunt and splenic artery embolization are treatment methods in patients with refractory ascites after LT.

关键词： liver transplantation liver transplantation complications,Ascites Hepatic graft inflow obstructions Hepatic graft outflow obstructions Acute cellular rejection

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High levels of circulating GM-CSF^(+) CD4^(+) T cells are predictive of poor outcomes in sepsis patients: a prospective cohort study

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Cellular & Molecular Immunology 2019年第6期16卷 602-610页

作者： Huihuang Huang Siyu Wang Tianjun Jiang Rong Fan Zheng Zhang Jinsong Mu Ke Li Yonggang Wang Lei Jin Fang Lin Jie Xia Lijian Sun Biao Xu Chengcheng Ji Jing Chen Juan Chang Bo Tu Bing Song Chao Zhang Fu-Sheng Wang Ruonan Xu Treatment and Research Center for Infectious Disease Beijing 302 HospitalBeijingChina Clinical Research and Management Center Beijing 302 HospitalBeijingChina intensive Care Center Beijing 302 HospitalBeijingChina Treatment and Research Center for liver Failure Beijing 302 HospitalBeijingChina Department of Infectious Diseases The Affiliated Southwest Hospital of the Third Military Medical UniversityChongqingChina Medical Department Army General Hospital of PLABeijingChina

Granulocyte colony-stimulating factor(GM-CSF),produced by CD4^(+)T cells,has recently been implicated in the pathogenesis of inflammatory diseases,such as multiple sclerosis and juvenile ***,the role of GM-CSF-producing CD4^(+)T cells in sepsis remains *** study reports peripheral changes in GM-CSF-producing CD4^(+)T cells in septic patients and the possible underlying mechanism by which GM-CSF influences the outcome of ***-three septic patients,20 SIRS patients,and 20 healthy controls were enrolled in this study and followed for 28 days to assess *** measured the peripheral frequency of GM-CSF^(+)CD4^(+)T cells and recorded their associated relationship with disease *** data demonstrated that peripheral GM-CSF-producing CD4^(+)T cells were significantly higher in septic patients than in both SIRS patients and healthy *** cells exhibit a memory phenotype and impaired IFN-γ-secreting capacity in sepsis *** a receiver operating curve analysis with 8.01%as a cut-off point,the percentage of GM-CSF^(+)CD4^(+)T cells could predict the outcome of septic *** with the increase in GM-CSF-producing CD4^(+)T cells,inflammatory cytokines IL-1βand IL-6 were also *** an in vitro neutrophil model,we found that GM-CSF inhibited C3aR expression,while inducing IL-8 ***,this effect was transferrable in plasma from sepsis patients and was attenuated by inhibition of GM-CSF using an anti-GM-CSF *** results indicate that GM-CSF-producing CD4^(+)T cells may serve as a marker of sepsis ***,targeting GM-CSF overproduction may benefit sepsis patients.

关键词： GM-CSF CD4^(+)T cells sepsis SIRS

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