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Peri-operative extracorporeal membrane oxygenation in adult and pediatric living donor liver transplantation:a single-center experience

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Hepatobiliary Surgery and Nutrition 2023年第6期12卷 898-908,I0011页

作者： Itsuko Chih-Yi Chen Leona Bettina PDungca Chee-Chien Yong Wei Ho Jiunn-Jye Sheu Chao-Long Chen liver Transplantation center Department of SurgeryKaohsiung Chang Gung Memorial HospitalKaohsiung Cardiovascular Surgery Kaohsiung Chang Gung Memorial HospitalKaohsiung

Background:Extracorporeal membrane oxygenation(ECMO)is a potential rescue therapy for patients with acute cardiopulmonary dysfunction refractory to conventional *** this study,we described the clinical profiles and outcomes of adult and pediatric living donor liver transplantation(LDLT)patients who received ECMO support during the peri-operative ***:From June 1994 to December 2020,eleven out of the 1,812 LDLTs performed at Kaohsiung Chang Gung Memorial Hospital required ECMO support:six for respiratory failure,three for cardiogenic shock,and two for refractory septic *** between the survivor and non-survivor groups was ***:The survival rate for liver transplantation(LT)patients on ECMO support is 36.4%-40%in adults and 33.3%in pediatrics,while the survival rate per indication is as follows:acute respiratory distress syndrome(ARDS)(50%),cardiogenic shock(33.3%),and sepsis(0%).Shorter durations of LT-to-ECMO and pre-ECMO mechanical ventilation were observed in the survivor *** the other hand,we observed persistently elevated total bilirubin levels in non-survivors,while none of the survivors had aspartate aminotransferase(AST)/alanine aminotransferase(ALT)levels>1,000 U/L.A higher proportion of non-survivors were on concurrent continuous renal replacement therapy(CRRT).Conclusions:Our experience has proven ECMO’s utility during the peri-operative period for both adult and pediatric LDLT patients,more specifically for indications other than septic *** studies are needed to better understand the factors leading to poor outcomes in order to identify patients who will more likely benefit from ECMO.

关键词： Extracorporeal membrane oxygenation(ECMO) living donor liver transplantation(LDLT) respiratory failure cardiogenic shock septic shock

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Early hepatic arterial thrombosis after pediatric living donor liver transplantation:a single-center experience

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Chinese Medical Journal 2021年第5期134卷 602-604页

作者： Zhi-Gui Zeng Liu-Xin Zhou Li-Ying Sun Lin Wei Wei Qu Ying Liu Yu-Le Tan Hai-Ming Zhang Xiao-Jie Chen Zhi-Jun Zhu liver Transplantation center National Clinical Research Center for Digestive DiseasesBeijing Friendship HospitalCapital Medical UniversityBeijing 100050China Clinical center for pediatric liver Transplantation Capital Medical UniversityBeijing 100050China Beijing Key Laboratory of Tolerance Induction and Organ Protection in Transplantation Beijing 100050China

To the Editor:As one of the most severe vascular complications after liver transplantation(LT),early hepatic arterial thrombosis(eHAT)may lead to ischemic liver necrosis and ischemic biliary tract complications such as biliary leakage and eventually graft or patient *** outcome,however,can be signifcantly improved by early diagnosis and intervention.4 Satisfying intervention is achieved by revascularization,when it fails,life-saving retransplantation must be considered.

关键词： arterial diagnosis liver

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Three-dimensional cell-based strategies for liver regeneration

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BIOCELL 2024年第7期48卷 1023-1036页

作者： DAN GUO XI XIA JIAN YANG liver Transplant center Transplant CenterWest China HospitalSichuan UniversityChengdu610041China Frontiers Medical center Tianfu Jincheng LaboratoryChengdu610212China

liver regeneration and the development of effective therapies for liver failure remain formidable challenges in modern *** recent years,the utilization of 3D cell-based strategies has emerged as a promising approach for addressing these urgent clinical *** review provides a thorough analysis of the application of 3D cell-based approaches to liver regeneration and their potential impact on patients with end-stage liver ***,we discuss various 3D culture models that incorporate hepatocytes and stem cells to restore liver function and ameliorate the consequences of liver ***,we explored the challenges in transitioning these innovative strategies from preclinical studies to clinical *** collective insights presented herein highlight the signiﬁcance of 3D cell-based strategies as a transformative paradigm for liver regeneration and improved patient care.

关键词： Three-Dimensional liver regeneration Organoids Stem cells Cell therapy

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Development of a new Cox model for predicting long-term survival in hepatitis cirrhosis patients underwent transjugular intrahepatic portosystemic shunts

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World Journal of Gastrointestinal Surgery 2024年第2期16卷 491-502页

作者： Yi-Fan Lv Bing Zhu Ming-Ming Meng Yi-Fan Wu Cheng-Bin Dong Yu Zhang Bo-Wen Liu Shao-Li You Sa Lv Yong-Ping Yang Fu-Quan Liu liver Disease Minimally Invasive Diagnosis and Treatment center Beijing Shijitan HospitalCapital Medical UniversityBeijing 100038China liver Vascular Disease Diagnosis and Treatment center The Fifth Medical Center of Chinese People's Liberation Army General HospitalBeijing 100039China

BACKGROUND Transjugular intrahepatic portosystemic shunt(TIPS)placement is a procedure that can effectively treat complications of portal hypertension,such as variceal bleeding and refractory ***,there have been no specific studies on predicting long-term survival after TIPS *** To establish a model to predict long-term survival in patients with hepatitis cirrhosis after *** A retrospective analysis was conducted on a cohort of 224 patients who un-derwent TIPS *** univariate and multivariate Cox regression analyses,various factors were examined for their ability to predict survival at 6 years after ***,a composite score was formulated,encompassing the indication,shunt reasonability,portal venous pressure gradient(PPG)after TIPS,percentage decrease in portal venous pressure(PVP),indocyanine green retention rate at 15 min(ICGR15)and total bilirubin(Tbil)***,the performance of the newly developed Cox(NDC)model was evaluated in an in-ternal validation cohort and compared with that of a series of existing *** The indication(variceal bleeding or ascites),shunt reasonability(reasonable or unreasonable),ICGR15,post-operative PPG,percentage of PVP decrease and Tbil were found to be independent factors affecting long-term survival after TIPS *** NDC model incorporated these parameters and successfully identified patients at high risk,exhibiting a notably elevated mortality rate following the TIPS procedure,as observed in both the training and validation ***,in terms of predicting the long-term survival rate,the performance of the NDC model was significantly better than that of the other four models[Child-Pugh,model for end-stage liver disease(MELD),MELD-sodium and the Freiburg index of post-TIPS survival].CONCLUSION The NDC model can accurately predict long-term survival after the TIPS procedure in patients with hepatitis cirrhosis,help identify high-risk patients

关键词： Transjugular intrahepatic portosystemic shunt Long-term survival Predictive model

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A novel structural variant of RET causes familial Hirschsprung's disease via nonsense-mediated mRNA decay

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Genes & Diseases 2024年第1期11卷 7-10页

作者： Qi Wang Siyu Pu Bo Xiang Jing Chen Department of pediatric Surgery and Laboratory of pediatric Surgery Rare Diseases CenterInstitute of Immunology and InflammationFrontiers Science Center for Disease-Related Molecular NetworkWest China HospitalSichuan UniversityChengduSichuan 610041China

Hirschsprung's disease(HsCR)is the most common type of developmental gastrointestinal malformation causing intestinal obstruction in children,with an incidence of 1/5000 in live births.1 it is characterized by the absence of intrinsic ganglion cells in the myenteric and submucosal plexuses of the distal gastrointestinal tract,leading to the dysregulation of smooth muscle contraction/relaxation and resulting in intestinal *** on the length of the aganglionic intestine,HSCR can be categorized into short-segmental HSCR(S-HSCR),which affects up to the sigmoid colon from the anus,and long-segmental HSCR(LHSCR),which affects beyond the sigmoid colon.1 In some rare conditions,aganglionic lesions can affect the full length of the colon or even the whole intestine.

关键词： intestine colon relaxation

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Pulmonary Bacterial Infection and liver Cirrhosis: Current Status and Treatment

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Infectious Microbes & Diseases 2024年第1期6卷 5-10页

作者： Yingying Zhao Song Yang Huichun Xing center of liver Diseases Division 3 Beijing Ditan HospitalCapital Medical UniversityBeijingChina

liver cirrhosis has a higher incidence rate and mortality when complicated with bacterial *** bacterial infections,especially bacterial pneumonia,increase the susceptibility of cirrhotic patients to decompensation,with a higher likelihood of *** pneu-monia is often overlooked in patients with liver cirrhosis,although it can impact the clinical progress and *** diagnosis and inappropriate antibiotic treatments are associated with poor prognosis and increased *** understanding of mechanisms and appropriate antibiotic treatments for cirrhosis-related bacterial pneumonia remain ***,we reviewed the epidemiology,clinical characteristics and treatment of pulmonary bacterial infections in cirrhotic patients to provide suggestions for clinical practice.

关键词： bacterial pneumonia liver cirrhosis epidemiology characteristics treatment

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Differentiation and immunosuppressive function of CD19^(+)CD24^(hi)CD27^(+) regulatory B cells are regulated through the miR-29a-3p/NFAT5 pathway

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Hepatobiliary & Pancreatic Diseases International 2024年第5期23卷 472-480页

作者： Jin-Yang Li Tian-Shuo Feng Ji Gao Xin-Xiang Yang Xiang-Cheng Li Zhen-Hua Deng Yong-Xiang Xia Zheng-Shan Wu Hepatobiliary center the First Affiliated Hospital of Nanjing Medical UniversityNanjing 210029China Key Laboratory of liver Transplantation Chinese Academy of Medical SciencesNanjing 210029China NHC Key Laboratory of Living Donor liver Transplantation Nanjing Medical UniversityNanjing 210029China

Background: Regulatory B cells(Bregs) is an indispensable element in inducing immune tolerance after liver transplantation. As one of the microRNAs(miRNAs), mi R-29a-3p also inhibits translation by degrading the target mRNA, and yet the relationship between Bregs and mi R-29a-3p has not yet been fully explored. This study aimed to investigate the impact of miR-29a-3p on the regulation of differentiation and immunosuppressive functions of memory Bregs(m Bregs) and ultimately provide potentially effective therapies in inducing immune tolerance after liver transplantation. Methods: Flow cytometry was employed to determine the levels of Bregs in peripheral blood mononuclear cells. TaqMan low-density array miRNA assays were used to identify the expression of different miRNAs, electroporation transfection was used to induce mi R-29a-3p overexpression and knockdown, and dual luciferase reporter assay was used to verify the target gene of miR-29a-3p. Results: In patients experiencing acute rejection after liver transplantation, the proportions and immunosuppressive function of m Bregs in the circulating blood were significantly impaired. mi R-29a-3p was found to be a regulator of m Bregs differentiation. Inhibition of miR-29a-3p, which targeted nuclear factor of activated T cells 5(NFAT5), resulted in a conspicuous boost in the differentiation and immunosuppressive function of m Bregs. The inhibition of mi R-29a-3p in CD19~+ B cells was capable of raising the expression levels of NFAT5, thereby promoting B cells to differentiate into m Bregs. In addition, the observed enhancement of differentiation and immunosuppressive function of m Bregs upon mi R-29a-3p inhibition was abolished by the knockdown of NFAT5 in B cells. Conclusions: mi R-29a-3p was found to be a crucial regulator for m Bregs differentiation and immunosuppressive function. Silencing mi R-29a-3p could be a potentially effective therapeutic strategy for inducing immune tolerance after liver transplantation.

关键词： Regulatory B cells miR-29a-3p NFAT5 liver transplantation

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Actin(g) toward a revised understanding of the role of cytoskeletal dynamics in neuronal bioenergetics

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Neural Regeneration Research 2024年第10期19卷 2109-2110页

作者： Sabrina M.Holland Gianluca Gallo Department of Neural Sciences Shriners Pediatric Research CenterLewis Katz School of Medicine at Temple UniversityPhiladelphiaPAUSA

Neurons are energy-demanding *** in energy metabolism can quickly interrupt neuronal function,leading to cell death and *** instance,ischemia rapidly depletes adenosine triphosphate(ATP)thereby disrupting energy-dependent cellular processes crucial for homeostasis,and axon degeneration is preceded by a collapse of axonal ATP levels.

关键词： metabolism homeostasis degeneration

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Lin28 as a therapeutic target for central nervous system regeneration and repair

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Neural Regeneration Research 2024年第2期19卷 397-398页

作者： Shuo Wang Shuxin Li Shriners Hospitals pediatric Research center Department of Neural SciencesLewis Katz School of Medicine at Temple UniversityPhiladelphiaPAUSA

Axon disconnection in the central nervous system(CNS) usually causes signal transduction failure and severe functional deficits in patients with neurological disorders. Currently, there is no cure for patients with CNS axon injury and they usually suffer from life-long neurological defects(e.g., paralysis, loss of sensory function, and autonomic dysfunction) and life-threatening complications(e.g., autonomic dysreflexia).

关键词： paralysis therapeutic system

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Multiomics analysis reveals metabolic subtypes and identifies diacylglycerol kinase α (DGKA) as a potential therapeutic target for intrahepatic cholangiocarcinoma

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Cancer Communications 2024年第2期44卷 226-250页

作者： Weiren Liu Huqiang Wang Qianfu Zhao Chenyang Tao Weifeng Qu Yushan Hou Run Huang Zimei Sun Guiqi Zhu Xifei Jiang Yuan Fang Jun Gao Xiaoling Wu Zhixiang Yang Rongyu Ping Jiafeng Chen Rui Yang Tianhao Chu Jian Zhou Jia Fan Zheng Tang Dong Yang Yinghong Shi Department of liver Surgery and Transplantation Liver Cancer InstituteZhongshan HospitalFudan UniversityKey Laboratory of Carcinogenesis and Cancer Invasion of Ministry of EducationShanghaiP.R.China Research Unit of liver cancer Recurrence and Metastasis Chinese Academy of Medical SciencesBeijingP.R.China State Key Laboratory of Medical Proteomics Beijing Proteome Research CenterNational Center for Protein Sciences(Beijing)Beijing Institute of LifeomicsBeijingP.R.China

Background:Intrahepatic cholangiocarcinoma(iCCA)is a highly heteroge-neous and lethal hepatobiliary tumor with few therapeutic *** metabolic reprogramming of tumor cells plays an essential role in the develop-ment of tumors,while the metabolic molecular classification of iCCA is largely ***,we performed an integrated multiomics analysis and metabolic classification to depict differences in metabolic characteristics of iCCA patients,hoping to provide a novel perspective to understand and treat ***:We performed integrated multiomics analysis in 116 iCCA samples,including whole-exome sequencing,bulk RNA-sequencing and proteome *** on the non-negative matrix factorization method and the protein abundance of metabolic genes in human genome-scale metabolic models,the metabolic subtype of iCCA was *** and prognostic gene analy-ses were used to compare overall survival(OS)differences between metabolic *** proliferation analysis,5-ethynyl-2’-deoxyuridine(EdU)assay,colony formation assay,RNA-sequencing and Western blotting were performed to investigate the molecular mechanisms of diacylglycerol kinaseα(DGKA)in iCCA ***:Three metabolic subtypes(S1-S3)with subtype-specific biomarkers of iCCA were *** metabolic subtypes presented with distinct prog-noses,metabolic features,immune microenvironments,and genetic *** S2 subtype with the worst survival showed the activation of some special metabolic processes,immune-suppressed microenvironment and Kirsten ratsar-coma viral oncogene homolog(KRAS)/AT-rich interactive domain 1A(ARID1A)*** the S2 subtype-specific upregulated proteins,DGKA was further identified as a potential drug target for iCCA,which promoted cell proliferation by enhancing phosphatidic acid(PA)metabolism and activating mitogen-activated protein kinase(MAPK)***:Viamultiomics analyses,we identified three metabolic subtypes of iCCA,revealing

关键词： diacylglycerol kinaseα intrahepatic cholangiocarcinoma MAPK signaling metabolic classifi-cation multiomics analysis phosphatidic acid metabolism

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