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Validation and performance of three scoring systems for predicting primary non-function and early allograft failure after liver transplantation

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hepatobiliary & pancreatic Diseases International 2024年第5期23卷 463-471页

作者： Yu Nie Jin-Bo Huang Shu-Jiao He Hua-Di Chen Jun-Jun Jia Jing-Jing Li Xiao-Shun He Qiang Zhao General surgery Center Department of Hepatobiliary Surgery IIResearch Center for Artificial Organ and Tissue EngineeringGuangzhou Clinical Research and Transformation Center for Artificial LiverInstitute of Regenerative MedicineZhujiang HospitalSouthern Medical UniversityGuangzhou 510515China organ Transplant Center the First Affiliated HospitalSun Yat-sen UniversityGuangzhou 510080China Guangdong Provincial key laboratory of organ Donation and Transplant Immunology Guangzhou 510080China Guangdong Provincial International Cooperation Base of Science and Technology Guangzhou 510080China Division of hepatobiliary pancreatic surgery the First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China

Background: Primary non-function(PNF) and early allograft failure(EAF) after liver transplantation(LT) seriously affect patient outcomes. In clinical practice, effective prognostic tools for early identifying recipients at high risk of PNF and EAF were urgently needed. Recently, the Model for Early Allograft Function(MEAF), PNF score by King's College(King-PNF) and Balance-and-Risk-Lactate(BAR-Lac) score were developed to assess the risks of PNF and EAF. This study aimed to externally validate and compare the prognostic performance of these three scores for predicting PNF and EAF. Methods: A retrospective study included 720 patients with primary LT between January 2015 and December 2020. MEAF, King-PNF and BAR-Lac scores were compared using receiver operating characteristic(ROC) and the net reclassification improvement(NRI) and integrated discrimination improvement(IDI) analyses. Results: Of all 720 patients, 28(3.9%) developed PNF and 67(9.3%) developed EAF in 3 months. The overall early allograft dysfunction(EAD) rate was 39.0%. The 3-month patient mortality was 8.6% while 1-year graft-failure-free survival was 89.2%. The median MEAF, King-PNF and BAR-Lac scores were 5.0(3.5–6.3),-2.1(-2.6 to-1.2), and 5.0(2.0–11.0), respectively. For predicting PNF, MEAF and King-PNF scores had excellent area under curves(AUCs) of 0.872 and 0.891, superior to BAR-Lac(AUC = 0.830). The NRI and IDI analyses confirmed that King-PNF score had the best performance in predicting PNF while MEAF served as a better predictor of EAD. The EAF risk curve and 1-year graft-failure-free survival curve showed that King-PNF was superior to MEAF and BAR-Lac scores for stratifying the risk of EAF. Conclusions: MEAF, King-PNF and BAR-Lac were validated as practical and effective risk assessment tools of PNF. King-PNF score outperformed MEAF and BAR-Lac in predicting PNF and EAF within 6 months. BAR-Lac score had a huge advantage in the prediction for PNF without post-transplant variables. Proper use

关键词： Primary non-function Early allograft failure Risk predicting model Liver transplantation

Relationship between autophagy and perineural invasion, clinicopathological features, and prognosis in pancreatic cancer

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World Journal of Gastroenterology 2017年第40期23卷 7232-7241页

作者： Yan-Hui Yang Jiang-Bo Liu Yang Gui Liang-Liang Lei Shui-Jun Zhang Department of hepatobiliary and pancreatic surgery the First Affiliated Hospital of Zhengzhou University Department of hepatobiliary surgery First Affiliated Hospital College of Clinical Medicine Henan University of Science and Technology Department of General surgery First Affiliated Hospital College of Clinical Medicine Henan University of Science and Technology henan key laboratory of digestive organ transplantation Open and Key Laboratory of Hepatobiliary and Pancreatic Surgery and Digestive Organ Transplantation at Henan Universities Zhengzhou Key Laboratory of Hepatobiliary Pancreatic Diseases and Organ Transplantation

AIM To investigate the relationship between autophagy and perineural invasion(PNI), clinical features, and prognosis in patients with pancreatic cancer. METHODS Clinical and pathological data were retrospectively collected from 109 patients with pancreatic ductal adenocarcinoma who underwent radical resection at the First Affiliated Hospital of Zhengzhou University from January 2011 to August 2016. Expression levels of the autophagy-related protein microtubuleassociated protein 1 A/1 B-light chain 3(LC3) and PNI marker ubiquitin carboxy-terminal hydrolase(UCH) in pancreatic cancer tissues were detected by immunohistochemistry. The correlations among LC3 expression, PNI, and clinical pathological features in pancreatic cancer were analyzed. The patients were followed for further survival analysis. RESULTS In 109 cases of pancreatic cancer, 68.8%(75/109) had evidence of PNI and 61.5%(67/109) had high LC3 expression. PNI was associated with lymph node metastasis, pancreatitis, and CA19-9 levels(P pancreatic cancer patients(P pancreatic cancer(P pancreatic cancer is positively related to autophagy. Neural invasion and LC3 expression are independent risk factors for pancreatic cancer with a poor prognosis.

关键词： pancreatic cancer Perineural invasion Autophagy Clinical pathological features Prognosis

Reassessment of palliative surgery in conversion therapy of previously unresectable hepatocellular carcinoma: Two case reports and review of literature

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World Journal of Gastrointestinal surgery 2024年第10期16卷 3312-3320页

作者： Yang-Bo Zhu Jia-Yi Qin Ting-Ting Zhang Wen-Jin Zhang Qi Ling Division of hepatobiliary and pancreatic surgery Department of SurgeryThe First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003Zhejiang ProvinceChina key Lab of Combined Multi-organ transplantation Ministry of Public HealthThe First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003Zhejiang ProvinceChina Department of Clinical Pharmacy The First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003Zhejiang ProvinceChina Department of Medical Imaging The First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003Zhejiang ProvinceChina

BACKGROUND Most patients with hepatocellular carcinoma(HCC)have lost the opportunity for direct surgery at the time of *** chemoembolization(TACE)combined with immune checkpoint inhibitors or tyrosine kinase inhibitors(TKI)can partially transform some unresectable HCC and improve the prognosis ***,based on the promising prospects of combined targeted and immunotherapy for the effective treatment of HCC,the positive role of palliative surgery in the conversion treatment of advanced HCC urgently needs further in-tensive *** SUMMARY In this study,we describe two successful cases of"conversion therapy for un-resectable HCC"achieved mainly by palliative surgery combined with TACE plus immunotherapy and TKIs.A 48-year-old patient with newly diagnosed HCC,presenting with a 6-cm mass in the segment VII/VIII of the right liver with mul-tiple intrahepatic metastases,could not undergo one-stage radical surgical *** underwent palliative surgery with radiofrequency of metastatic lesions and the palliative resection of the primary mass,and received subsequent TACE treatments twice in the early postoperative period(2 weeks and 6 weeks),in addition to targeted and immune combination therapy with sintilimab injection and oral *** evidence of recurrence was observed during the 11-month follow-up period after *** other patient was a 47-year-old patient with massive HCC(18 cm×15 cm×4.5 cm)in the left liver with severe *** left portal branch was occluded and a tumor thrombus formed,and the tumor partly involved the middle hepatic *** patient underwent palliative surgery of left hemihepatectomy(including resection of the middle hepatic vein)for HCC,followed by three TACE procedures and oral TKIs 2 weeks after *** months later,the re-examination via computed tomography revealed no tumour activity in the remaining right liver,while magnetic resonance imaging revealed slight local tumor enh

关键词： Hepatocellular carcinoma Transarterial chemoembolization Immunotherapy Conversion Therapy Tyrosine kinase inhibitors Case report

hMex-3A is associated with poor prognosis and contributes to the progression of hepatocellular carcinoma

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hepatobiliary & pancreatic Diseases International 2021年第2期20卷 147-153页

作者： Yi-Fan Liu Xiao-Yan Sun Jia-Kai Zhang Zhi-Hui Wang Zhi-Gang Ren Jie Li Wen-Zhi Guo Shui-Jun Zhang Zhengzhou key laboratory of hepatobiliary and pancreatic Diseases and organ transplantation Zhengzhou 450052China henan key laboratory of digestive organ transplantation Zhengzhou 450052China Department of hepatobiliary and pancreatic surgery the First Affiliated Hospital of Zhengzhou UniversityZhengzhou 450052China open and key laboratory of hepatobiliary and pancreatic surgery and digestive organ transplantation at henan Universities the First Affiliated Hospital of Zhengzhou UniversityZhengzhou 450052China Department of Infectious Diseases the First Affiliated Hospital of Zhengzhou UniversityZhengzhou 450052China

Background:HMex-3A,an RNA-binding protein,was found to be associated with ***,the roles of h Mex-3A in hepatocellular carcinoma(HCC)progression remained ***:The different expression of h Mex-3A between HCC tissues and non-tumor tissues was evaluated using The Cancer Genome Atlas ***,the h Mex-3A expression was evaluated in HCC tissues using Western blotting and q *** was performed to investigate the association between h Mex-3 A level and clinicopathological features including prognosis in HCC *** addition,we used si-h Mex-3A to knockdown h Mex-3A in HCC cells to test Cell Counting Kit-8,colony formation,cell migration and ***:The h Mex-3A expression was significantly elevated in HCC *** of the clinicopathological parameters suggested that h Mex-3A expression was significantly associated with pathological grade(P=0.019)and TNM stage(P=0.001)in ***,univariate and multivariate Coxregression analyses revealed that high h Mex-3A expression(HR=1.491,95%CI:1.107–2.007;P=0.009)was an independent risk factor for overall survival in HCC ***,we confirmed that si-h Mex-3A could significantly inhibit HCC cell proliferation,migration,and invasion in ***:HMex-3A may contribute to the progression of HCC and might be used as a novel therapeutic target and prognostic marker in HCC.

关键词： Hepatocellular carcinoma hMex-3A Targeted therapy

Fully umbilical cord-derived adhesive materials enable to recruit and segregate immune cells for the reversal of acute liver failure

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Engineered Regeneration 2024年第1期5卷 70-79页

作者： Xiao Yi Feng Chen Kunjie Gao Huayan Li Yuan Xie Shao Li Jiajun Zhang Qing Peng Weijie Zhou Shutao Wang Jun-Bing Fan Yi Gao Research Centre for Artificial organ and Tissue Engineering&Institute of Regenerative Medicine Department of hepatobiliary surgery II Zhujiang Hospital Cancer Research InstituteSchool of Basic Medical SciencesSouthern Medical UniversityGuangzhouGuangdong Province 510515P R China Department of Gynecology Zhujiang HospitalSouthern Medical UniversityGuangzhou 510515P R China CAS key laboratory of Bio-inspired Materials and Interfacial Science CAS Center for Excellence in NanoscienceTechnical Institute of Physics and ChemistryChinese Academy of SciencesBeijing 100190P R China Department of Hepato-Biliary-pancreatic and Hernia surgery The First People’s Hospital of ZhaoqingZhaoqingGuangdong 526000P R China Department of Pathology School of Basic Medical SciencesSouthern Medical UniversityGuangzhou 510515P R China

Inflammatory cytokine storms can trigger disease exacerbation and even death and have reached a consensus in the clinical treatment of acute organ ***,the existing strategies remain a great challenge to efficiently suppress inflammatory cytokine storms for promoting organ repair and ***,fully human umbilical cord(UC)-derived adhesive materials(UCAM)that integrate decellularized extracellular matrix(ECM)nanofiber hydrogel and homologous mesenchymal stem cells(MSCs)are demonstrated to greatly suppress inflammatory cytokine storms,demonstrating high efficacy in treating acute liver failure(ALF)in rats with 90%*** UC-derived adhesive materials have the capacity to secrete a significant quantity of cytokines by MSCs to recruit activated immune cells to migrate into their ECM nanofiber networks,segregating them away from the infection area and thereby greatly suppressing the inflammatory cytokine *** expected,the UC-derived adhesive materials can significantly promote hepatocyte proliferation to achieve functional recovery and regeneration of the liver,significantly improving the survival rate in *** fully human UC-derived adhesive materials provide a new avenue in suppressing inflammatory cytokine storms for promoting organ regeneration that would be really utility in clinical organ transplantation-related treatment.

关键词： Interfacial adhesive materials Extracellular matrix nanofibers Hydrogel Mesenchymal stem cells Acute liver failure

Gene knockout or inhibition of macrophage migration inhibitory factor alleviates lipopolysaccharide-induced liver injury via inhibiting inflammatory response

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hepatobiliary & pancreatic Diseases International 2021年第5期20卷 469-477页

作者： Yu-Lei Gu Li-Li Xiao De-Jian Li Yan-Na Liu Chang-Ju Zhu Shui-Jun Zhang Emergency Department the First Affiliated Hospital of Zhengzhou UniversityZhengzhou 450052China Department of Cardiology the First Affiliated Hospital of Zhengzhou UniversityZhengzhou 450052China Department of hepatobiliary and pancreatic surgery the First Affiliated Hospital of Zhengzhou UniversityZhengzhou 450052China open and key laboratory of hepatobiliary&pancreatic surgery and digestive organ transplantation at henan province Zhengzhou 450052China Zhengzhou Engineering laboratory of organ transplantation Technique and Application Zhengzhou 450052China

Background:Liver injury is one of the most common complications during *** migration inhibitory factor(MIF)is an important proinflammatory *** study explored the role of MIF in the lipopolysaccharide(LPS)-induced liver injury through genetically manipulated mouse ***:The model of LPS-induced liver injury was established in wild-type and Mif-knockout C57/BL6 *** levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),and total bilirubin(TBil)were detected,and the expressions of MIF,tumor necrosis factor-α(TNF-α)and interleukin-1β(IL-1β)were *** histopathology was conducted to assess liver ***,the inhibitions of MIF with(S,R)-3-(4-hydroxyphenyl)-4,5-dihydro-5-isoxazole acetic acid methyl ester(ISO-1)and 4-iodo-6-phenylpyrimidine(4-IPP)were used to evaluate their therapeutic potential of liver ***:Compared with wild-type mice,the liver function indices and inflammation factors presented no significant difference in the Mif-/-*** 72 h of the LPS-induced liver injury,serum levels of ALT,AST,and TBil as well as TNF-αand IL-1βwere significantly increased,but the knockout of Mif attenuated liver injury and inflammatory *** liver tissue,m RNA levels of TNF-α,IL-1βand NF-κB p65 were remarkably elevated in LPS-induced liver injury,while the knockout of Mif reduced these ***,in LPS-induced liver injury,the inhibitions of MIF with ISO-1 and 4-IPP alleviated liver injury and slightly attenuated inflammatory ***,compared to mice with LPS-induced liver injury,Mif knockout or MIF inhibitions significantly prolonged the survival of the ***:In LPS-induced liver injury,the knockout of Mif or MIF inhibitions alleviated liver injury and slightly attenuated inflammatory response,thereby prolonged the survival of the *** MIF may be an important strategy to protect the liver from injury during sepsis.

关键词： Sepsis Liver injury Migration inhibitory factor Gene knockout Inflammation

Calycosin attenuates severe acute pancreatitis-associated acute lung injury by curtailing high mobility group box 1-induced inflammation

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World Journal of Gastroenterology 2021年第44期27卷 7669-7686页

作者： Chang-Ju Zhu Wan-Guang Yang De-Jian Li Yao-Dong Song San-Yang Chen Qiao-Fang Wang Yan-Na Liu Yan Zhang Bo Cheng Zhong-Wei Wu Zong-Chao Cui henan Medical key laboratory of Emergency and Trauma Research The First Affiliated Hospital of Zhengzhou UniversityZhengzhou 450052Henan ProvinceChina key laboratory of hepatobiliary and pancreatic surgery and digestive organ transplantation of henan province The First Affiliated Hospital of Zhengzhou UniversityZhengzhou 450052Henan ProvinceChina

BACKGROUND Acute lung injury(ALI)is a common and life-threatening complication of severe acute pancreatitis(SAP).There are currently limited effective treatment options for SAP and associated ***(Cal),a bioactive constituent extracted from the medicinal herb Radix Astragali exhibits potent anti-inflammatory properties,but its effect on SAP and associated ALI has yet to be *** To identify the roles of Cal in SAP-ALI and the underlying *** SAP was induced via two intraperitoneal injections of L-arg(4 g/kg)and Cal(25 or 50 mg/kg)were injected 1 h prior to the first L-arg *** were sacrificed 72 h after the induction of SAP and associated ALI was examined histologically and *** in vitro model of lipopolysaccharide(LPS)-induced ALI was established using A549 *** analysis and western blot were evaluated in *** docking analyses were conducted to examine the interaction of Cal with *** Cal treatment substantially reduced the serum amylase levels and alleviated histopathological injury associated with SAP and *** infiltration and lung tissue levels of neutrophil mediator myeloperoxidase were reduced in line with protective effects of Cal against ALI in *** treatment also attenuated the serum levels and mRNA expression of pro-inflammatory cytokines tumor necrosis factor-α,interleukin-6,IL-1β,HMGB1 and chemokine(CXC motif)ligand 1 in lung *** and western blot analyses showed that Cal treatment markedly suppressed the expression of HMGB1 and phosphorylated nuclear factor-kappa B(NF-κB)p65 in lung tissues and an in vitro model of LPSinduced ALI in A549 cells suggesting a role for HGMB1 in the pathogenesis of ***,molecular docking analysis provided evidence for the direct interaction of Cal with *** Cal protects mice against L-arg-induced SAP and associated ALI by attenuating local and systemic neutrophil infiltration a

关键词： Severe acute pancreatitis Acute lung injury Calycosin Mouse model Highmobility group box 1 Nuclear factor-kappa B

Lack of association between genetic polymorphisms in cytokine genes and tumor recurrence in patients with hepatocellular carcinoma undergoing transplantation

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hepatobiliary & pancreatic Diseases International 2013年第1期12卷 54-59页

作者： Li-Ming Wu Lin Zhou Jun Xu Ba-Jin Wei Jun Cheng Xiao Xu Bin Xi Hai-Yang Xie Shu-Sen Zheng key laboratory of Combined Multi-organ transplantation Ministry of Public Health key laboratory of organ transplantation Zhejiang Province and Division of hepatobiliary and pancreatic surgery First Affiliated HospitalZhejiang University School of Medicine

BACKGROUND:Recurrence of hepatocellular carcinoma(HCC) after liver transplantation(LT) remains one of the most common causes of poor long-term ***,the host genetic factors affecting increased risk of tumor recurrence after transplantation have not been thoroughly *** present study was designed to investigate the association of cytokine gene polymorphisms with the risk of tumor recurrence in LT patients for ***:Eleven single-nucleotide polymorphisms within the promoter regions of 7 cytokine genes,i.e.,the IL-1 family(IL-1α and IL-1β),IL-6,IL-8,IL-10,TNF-α,and TGF-β1,were genotyped in 93 HCC patients treated with LT using DNA *** association between these polymorphisms and the risk of tumor recurrence was evaluated while controlling confounding clinical ***:The genotype frequency of IL-10-1082 A/G in patients with and without recurrence of HCC was AA 83.3%,GA 16.7% and AA 97.6%,GA 2.4%,*** association between IL-10-1082 GA and recurrence was significant(P=0.033).No other single-nucleotide polymorphism in the cytokine gene was found to be associated with ***-Meier survival curves showed that the homozygous AA patients had a significantly longer mean recurrence-free survival than heterozygous GA patients(23.5 vs 5.7 months,P=0.001).However,multivariate analysis failed to reveal that the GA genotype of IL-10-1082 A/G was an independent indicator of ***:This study suggests the lack of association of selected cytokine gene polymorphisms with HCC recurrence after LT in the Han Chinese *** finding does not exclude the idea that other cytokine polymorphisms could act as candidate biomarkers of disease prognosis.

关键词： hepatocellular carcinoma cytokine polymorphism recurrence

Risk factors of choledocholithiasis formation after liver transplantation

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hepatobiliary & pancreatic Diseases International 2013年第2期12卷 215-217页

作者： Zhi-Yong Yu Min Zhang Yun-Sheng Qin Xiao-Ping Zhou Ming-Yue Cai Song-Feng Yu Qing-Hong Ke Shu-Sen Zheng Division of hepatobiliary and pancreatic surgery key laboratory of Combined Multi-organ transplantation Ministry of Public Health and key laboratory of organ transplantation Zhejiang province First Affiliated Hospital Zhejiang University School of Medicine

Systematic study of risk factors for biliary stone post-liver transplantation is rarely performed. To investigate the risk factor of choledocholithiasis formation after liver transplantation, we c onducted a case-control study. Fourteen patients were selected into a study group. The stones of the bile duct of the patients were confirmed and treated successfully by endoscopic retrograde cholangiopancreatography. For univariate analysis, we selected carefully some potential risk factors such as cold ischemia time, warm ischemia time, and biliary stricture. The results revealed that cold ischemia time and biliary stenosis were significant predictors. But multivariate analysis revealed that only biliary stenosis was a significant risk factor. In conclusion, biliary stenosis is a risk factor of bile duct stones formation after liver transplantation. Endoscopic retrograde cholangiopancreatography is effective and safe in the diagnosis or treatment of bile duct stones after liver transplantation.

关键词： liver transplantation endoscopic retrograde cholangiopancreatography choledocholithiasis biliary tract diseases common bile duct stone gallstones