BACKGROUND Acoustic radiation force impulse(ARFI)is used to measure liver fibrosis and predict outcomes.The performance of elastography in assessment of fibrosis is poorer in hepatitis B virus(HBV)than in other etiolo...BACKGROUND Acoustic radiation force impulse(ARFI)is used to measure liver fibrosis and predict outcomes.The performance of elastography in assessment of fibrosis is poorer in hepatitis B virus(HBV)than in other etiologies of chronic liver disease.AIM To evaluate the performance of ARFI in long-term outcome prediction among different etiologies of chronic liver disease.METHODS Consecutive patients who received an ARFI study between 2011 and 2018 were enrolled.After excluding dual infection,alcoholism,autoimmune hepatitis,and others with incomplete data,this retrospective cohort were divided into hepatitis B(HBV,n=1064),hepatitis C(HCV,n=507),and non-HBV,non-HCV(NBNC,n=391)groups.The indexed cases were linked to cancer registration(1987-2020)and national mortality databases.The differences in morbidity and mortality among the groups were analyzed.RESULTS At the enrollment,the HBV group showed more males(77.5%),a higher prevalence of prediagnosed hepatocellular carcinoma(HCC),and a lower prevalence of comorbidities than the other groups(P<0.001).The HCV group was older and had a lower platelet count and higher ARFI score than the other groups(P<0.001).The NBNC group showed a higher body mass index and platelet count,a higher prevalence of pre-diagnosed non-HCC cancers(P<0.001),especially breast cancer,and a lower prevalence of cirrhosis.Male gender,ARFI score,and HBV were independent predictors of HCC.The 5-year risk of HCC was 5.9%and 9.8%for those ARFI-graded with severe fibrosis and cirrhosis.ARFI alone had an area under the receiver operating characteristic curve(AUROC)of 0.742 for prediction of HCC in 5 years.AUROC increased to 0.828 after adding etiology,gender,age,and platelet score.No difference was found in mortality rate among the groups.CONCLUSION The HBV group showed a higher prevalence of HCC but lower comorbidity that made mortality similar among the groups.Those patients with ARFI-graded severe fibrosis or cirrhosis should receive regular surveillance.展开更多
AIM To compare the clinical outcomes of patients with portal hypertension(PH) who underwent treatment with splenectomy plus simplified pericardial devascularisation(SSPD) or splenectomy plus traditional pericardial de...AIM To compare the clinical outcomes of patients with portal hypertension(PH) who underwent treatment with splenectomy plus simplified pericardial devascularisation(SSPD) or splenectomy plus traditional pericardial devascularisation(STPD).METHODS We conducted a single-centre retrospective study of 1045 PH patients treated with either SSPD(S Group, 357 patients) or STPD(T Group, 688 patients) between January 2002 and February 2017. In all, 37 clinical indicators were compared to evaluate the efficacy of SSPD.RESULTS Perioperative indicators in the S Group were significantly better than those in the T Group(P < 0.05). In both groups, the postoperative long-term portal vein diameter and Model for End-Stage Liver Disease score were significantly lower than those in the preoperative and postoperative short-term groups(P< 0.05). The incidence of complications in the S Group was significantly lower than that in the T Group(P < 0.05). Compared to the T Group, postoperative shortterm WBC(white blood cell) and platelet counts were significantly lower and the short-term Hb(haemoglobin) level was significantly higher in the S Group(P < 0.05). In the S Group, postoperative long-term total bilirubin, direct bilirubin, alanine transaminase, and aspartate transaminase and postoperative serum creatinine and cystatin C levels were significantly lower than those in the T Group(P < 0.05), and postoperative albumin was significantly higher than that in the T Group(P < 0.05).CONCLUSION Compared to STPD, SSPD is a simple and easy procedure resulting in less tissue damage. Patients recovered smoothly and steadily with fewer complications. Short-term liver and kidney function damage was less severe, and long-term liver function recovery was better. Therefore, SSPD is worthy of clinical promotion and application for the treatment of PH.展开更多
AIM: To study whether transfer of blood between the right gastroepiploic artery and gastroduodenal artery could lessens the damage to bile canaliculi.METHODS: Forty male Bama miniature pigs were divided into four grou...AIM: To study whether transfer of blood between the right gastroepiploic artery and gastroduodenal artery could lessens the damage to bile canaliculi.METHODS: Forty male Bama miniature pigs were divided into four groups as follows: a control group, two hepatic artery ischemia groups(1 h and 2 h), and a hepatic artery bridging group. The hemodynamics of the hepatic artery in the hepatic artery bridging group was measured using color Doppler ultrasound. Morphological changes in the bile canaliculus were observed by transmission electron microscopy. Cofilin, heat shock protein 27 and F-actin expression was detected by immunohistochemistry, Western blot, and real-time polymerase chain reaction. Terminal deoxynucleotidyl transferase-mediated nick end-labeling method was used to evaluate liver injury. RESULTS: The hemodynamics was not changed in the hepatic artery bridging group. The microvilli in the bile canaliculus were impaired in the two hepatic artery ischemia groups. The down-regulation of cofilin and F-actin and up-regulation of heat shock protein 27 were observed in the two hepatic artery ischemia groups, while there were no significant differences between thecontrol group and hepatic artery bridging group.CONCLUSION: Hepatic artery ischemia aggravates damage to bile canaliculi, and this damage can be diminished by a hepatic artery bridging duct.展开更多
Objective:Several reports have proposed that lnc RNAs,as potential biomarkers,participate in the progression and growth of malignant tumors.HIF1 A-AS2 is a novel lnc RNA and potential biomarker,involved in the genesis...Objective:Several reports have proposed that lnc RNAs,as potential biomarkers,participate in the progression and growth of malignant tumors.HIF1 A-AS2 is a novel lnc RNA and potential biomarker,involved in the genesis and development of carcinomas.However,the molecular mechanism of HIF1 A-AS2 in renal carcinoma is unclear.Methods:The relative expression levels of HIF1 A-AS2 and miR-30 a-5 p were detected using RT-qPCR in renal carcinoma tissues and cell lines.Using loss-of-function and overexpression,the biological effects of HIF1 A-AS2 and miR-30 a-5 p in kidney carcinoma progression were characterized.Dual luciferase reporter gene analysis and Western blot were used to detect the potential mechanism of HIF1 A-AS2 in renal carcinomas.Results:HIF1 A-AS2 was upregulated in kidney carcinoma tissues when compared with para-carcinoma tissues(P<0.05).In addition,tumor size,tumor node mestastasis stage and differentiation were identified as being closely associated with HIF1 A-AS2 expression(P<0.05).Knockdown or overexpression of HIF1 A-AS2 either restrained or promoted the malignant phenotype and WNT/β-catenin signaling in renal carcinoma cells(P<0.05).Mi R-30 a-5 p was downregulated in renal cancers and partially reversed HIF1 A-AS2 functions in malignant renal tumor cells.HIF1 A-AS2 acted as a micro RNA sponge that actively regulated the relative expression of SOX4 in sponging miR-30 a-5 p and subsequently increased the malignant phenotypes of renal carcinomas.HIF1 A-AS2 showed a carcinogenic effect and miR-30 a-5 p acted as an antagonist of the anti-oncogene effects in the pathogenesis of renal carcinomas.Conclusions:The HIF1 A-AS2-miR-30 a-5 p-SOX4 axis was associated with the malignant progression and development of renal carcinoma.The relative expression of HIF1 A-AS2 was negatively correlated with the expression of miR-30 a-5 p,and was closely correlated with SOX4 mRNA levels in renal cancers.展开更多
Flash sintering(FS)is a novel technique for rapidly densifying silicon carbide(SiC)ceramics.This work achieved a rapid sintering of SiC ceramics by the utilization of ultra-high temperature flash sintering within 60 s...Flash sintering(FS)is a novel technique for rapidly densifying silicon carbide(SiC)ceramics.This work achieved a rapid sintering of SiC ceramics by the utilization of ultra-high temperature flash sintering within 60 s.Pyrolysis carbon(PyC)“bridges”were constructed between SiC particles through the carbonisation of phenolic resin,providing a large number of current channels.The incubation time of the flash sintering process was significantly reduced,and the sintering difference between the centre and the edge regions of the ceramics was minimized,with an average particle size of the centre region and edge region being 12.31 and 9.02μm,respectively.The results showed that the porosity of the SiC ceramics after the flash sintering was reduced to 14.79% with PyC“bridges”introduced,and the Vickers hardness reached 19.62 GPa.PyC“bridges”gradually evolved from amorphous eddy current carbon to oriented graphite carbon,indicating that the ultra-high temperature environment in which the sample was located during the flash sintering was successfully constructed.Ultra-high temperature flash sintering of SiC is expected to be applied to the local repair of matrix damage in SiC ceramic matrix composites.展开更多
AIM To analyse the postoperative survival of patients with portal hypertension and determine the factors that influence survival and construct nomograms.METHODS We retrospectively followed 1045 patients who underwent ...AIM To analyse the postoperative survival of patients with portal hypertension and determine the factors that influence survival and construct nomograms.METHODS We retrospectively followed 1045 patients who underwent splenectomy plus pericardial devascularisation(SPD) between January 2002 and December 2017. Two SPD types are used in our department: splenectomy plus simplified pericardial devascularisation(SSPD) and splenectomy plus traditional pericardial devascularisation(STPD). The Kaplan-Meier method and Cox regression analysis were used to evaluate the prognostic effects of multiple parameters on overall survival(OS), diseasespecific survival(DSS) and bleeding-free survival(BFS). Significant prognostic factors were combined to build nomograms to predict the survival rate of individual patients.RESULTS Five hundred and fifty-seven(53.30%) patients weresuccessfully followed with 192 in the SSPD group and 365 in the STPD group; 93(16.70%) patients died, of whom 42(7.54%) died due to bleeding. Postoperative bleeding was observed in 84(15.10%) patients. The 5-and 10-year OS, DSS and BFS rates in the group of patients who underwent SSPD were not significantly different from those in patients who underwent STPD. Independent prognostic factors for OS were age, operative time, alanine transaminase level and albumin-bilirubin score. Independent prognostic factors for BFS were male sex, age, intraoperative blood loss and time to first flatus. Independent prognostic factors for DSS were the Comprehensive Complication Index and age. These characteristics were used to establish nomograms, which showed good accuracy in predicting 1-, 3-and 5-year OS and BFS.CONCLUSION SSPD achieves or surpasses the long-term survival effect of traditional pericardial devascularisation and is worthy of clinical promotion and application. Nomograms are effective at predicting prognosis.展开更多
AIM: We undertook this meta-analysis to investigate the relationship between revascularization and outcomes after liver transplantation.METHODS: A literature search was performed using MeSH and key words. The quality ...AIM: We undertook this meta-analysis to investigate the relationship between revascularization and outcomes after liver transplantation.METHODS: A literature search was performed using MeSH and key words. The quality of the included studies was assessed using the Jadad Score and the NewcastleOttawa Scale. Heterogeneity was evaluated by the χ 2and I 2 tests. The risk of publication bias was assessed using a funnel plot and Egger's test, and the risk of bias was assessed using a domain-based assessment tool.A sensitivity analysis was conducted by reanalyzing the data using different statistical approaches.RESULTS: Six studies with a total of 467 patients were included. Ischemic-type biliary lesions were significantly reduced in the simultaneous revascularization group compared with the sequential revascularization group(OR = 4.97, 95%CI: 2.45-10.07; P < 0.00001),and intensive care unit(ICU) days were decreased(MD = 2.00, 95%CI: 0.55-3.45; P = 0.007) in the simultaneous revascularization group. Although warm ischemia time was prolonged in simultaneous revascularization group(MD =-25.84, 95%CI:-29.28-22.40; P < 0.00001), there were no significant differences in other outcomes between sequential and simultaneous revascularization groups. Assessment of the risk of bias showed that the methods of random sequence generation and blinding might have been a source of bias. The sensitivity analysis strengthened the reliability of the results of this meta-analysis.CONCLUSION: The results of this study indicate that simultaneous revascularization in liver transplantation may reduce the incidence of ischemic-type biliary lesions and length of stay of patients in the ICU.展开更多
基金Supported by the Chang Gung Memorial Hospital and PAII Inc.(a United States subsidiary company of Ping An Insurance Group),No.SMRPG3I0011.
文摘BACKGROUND Acoustic radiation force impulse(ARFI)is used to measure liver fibrosis and predict outcomes.The performance of elastography in assessment of fibrosis is poorer in hepatitis B virus(HBV)than in other etiologies of chronic liver disease.AIM To evaluate the performance of ARFI in long-term outcome prediction among different etiologies of chronic liver disease.METHODS Consecutive patients who received an ARFI study between 2011 and 2018 were enrolled.After excluding dual infection,alcoholism,autoimmune hepatitis,and others with incomplete data,this retrospective cohort were divided into hepatitis B(HBV,n=1064),hepatitis C(HCV,n=507),and non-HBV,non-HCV(NBNC,n=391)groups.The indexed cases were linked to cancer registration(1987-2020)and national mortality databases.The differences in morbidity and mortality among the groups were analyzed.RESULTS At the enrollment,the HBV group showed more males(77.5%),a higher prevalence of prediagnosed hepatocellular carcinoma(HCC),and a lower prevalence of comorbidities than the other groups(P<0.001).The HCV group was older and had a lower platelet count and higher ARFI score than the other groups(P<0.001).The NBNC group showed a higher body mass index and platelet count,a higher prevalence of pre-diagnosed non-HCC cancers(P<0.001),especially breast cancer,and a lower prevalence of cirrhosis.Male gender,ARFI score,and HBV were independent predictors of HCC.The 5-year risk of HCC was 5.9%and 9.8%for those ARFI-graded with severe fibrosis and cirrhosis.ARFI alone had an area under the receiver operating characteristic curve(AUROC)of 0.742 for prediction of HCC in 5 years.AUROC increased to 0.828 after adding etiology,gender,age,and platelet score.No difference was found in mortality rate among the groups.CONCLUSION The HBV group showed a higher prevalence of HCC but lower comorbidity that made mortality similar among the groups.Those patients with ARFI-graded severe fibrosis or cirrhosis should receive regular surveillance.
基金Supported by National Natural Science Foundation of China,No.81170454
文摘AIM To compare the clinical outcomes of patients with portal hypertension(PH) who underwent treatment with splenectomy plus simplified pericardial devascularisation(SSPD) or splenectomy plus traditional pericardial devascularisation(STPD).METHODS We conducted a single-centre retrospective study of 1045 PH patients treated with either SSPD(S Group, 357 patients) or STPD(T Group, 688 patients) between January 2002 and February 2017. In all, 37 clinical indicators were compared to evaluate the efficacy of SSPD.RESULTS Perioperative indicators in the S Group were significantly better than those in the T Group(P < 0.05). In both groups, the postoperative long-term portal vein diameter and Model for End-Stage Liver Disease score were significantly lower than those in the preoperative and postoperative short-term groups(P< 0.05). The incidence of complications in the S Group was significantly lower than that in the T Group(P < 0.05). Compared to the T Group, postoperative shortterm WBC(white blood cell) and platelet counts were significantly lower and the short-term Hb(haemoglobin) level was significantly higher in the S Group(P < 0.05). In the S Group, postoperative long-term total bilirubin, direct bilirubin, alanine transaminase, and aspartate transaminase and postoperative serum creatinine and cystatin C levels were significantly lower than those in the T Group(P < 0.05), and postoperative albumin was significantly higher than that in the T Group(P < 0.05).CONCLUSION Compared to STPD, SSPD is a simple and easy procedure resulting in less tissue damage. Patients recovered smoothly and steadily with fewer complications. Short-term liver and kidney function damage was less severe, and long-term liver function recovery was better. Therefore, SSPD is worthy of clinical promotion and application for the treatment of PH.
基金Supported by National Natural Science Foundation of China,No.81170454
文摘AIM: To study whether transfer of blood between the right gastroepiploic artery and gastroduodenal artery could lessens the damage to bile canaliculi.METHODS: Forty male Bama miniature pigs were divided into four groups as follows: a control group, two hepatic artery ischemia groups(1 h and 2 h), and a hepatic artery bridging group. The hemodynamics of the hepatic artery in the hepatic artery bridging group was measured using color Doppler ultrasound. Morphological changes in the bile canaliculus were observed by transmission electron microscopy. Cofilin, heat shock protein 27 and F-actin expression was detected by immunohistochemistry, Western blot, and real-time polymerase chain reaction. Terminal deoxynucleotidyl transferase-mediated nick end-labeling method was used to evaluate liver injury. RESULTS: The hemodynamics was not changed in the hepatic artery bridging group. The microvilli in the bile canaliculus were impaired in the two hepatic artery ischemia groups. The down-regulation of cofilin and F-actin and up-regulation of heat shock protein 27 were observed in the two hepatic artery ischemia groups, while there were no significant differences between thecontrol group and hepatic artery bridging group.CONCLUSION: Hepatic artery ischemia aggravates damage to bile canaliculi, and this damage can be diminished by a hepatic artery bridging duct.
基金supported by grants from the National Natural Science Foundations of China(Grant Nos.81702511,81472401,81772708,and 2016YFA0201204)the Jiangsu Provincial Key Medical Discipline(Grant No.ZDXKA2016012)+1 种基金the Clinical Medicine Center of Suzhou(Grant No.SZZXJ201501)programs for Recruitment of Clinical Medical Top Team of Suzhou。
文摘Objective:Several reports have proposed that lnc RNAs,as potential biomarkers,participate in the progression and growth of malignant tumors.HIF1 A-AS2 is a novel lnc RNA and potential biomarker,involved in the genesis and development of carcinomas.However,the molecular mechanism of HIF1 A-AS2 in renal carcinoma is unclear.Methods:The relative expression levels of HIF1 A-AS2 and miR-30 a-5 p were detected using RT-qPCR in renal carcinoma tissues and cell lines.Using loss-of-function and overexpression,the biological effects of HIF1 A-AS2 and miR-30 a-5 p in kidney carcinoma progression were characterized.Dual luciferase reporter gene analysis and Western blot were used to detect the potential mechanism of HIF1 A-AS2 in renal carcinomas.Results:HIF1 A-AS2 was upregulated in kidney carcinoma tissues when compared with para-carcinoma tissues(P<0.05).In addition,tumor size,tumor node mestastasis stage and differentiation were identified as being closely associated with HIF1 A-AS2 expression(P<0.05).Knockdown or overexpression of HIF1 A-AS2 either restrained or promoted the malignant phenotype and WNT/β-catenin signaling in renal carcinoma cells(P<0.05).Mi R-30 a-5 p was downregulated in renal cancers and partially reversed HIF1 A-AS2 functions in malignant renal tumor cells.HIF1 A-AS2 acted as a micro RNA sponge that actively regulated the relative expression of SOX4 in sponging miR-30 a-5 p and subsequently increased the malignant phenotypes of renal carcinomas.HIF1 A-AS2 showed a carcinogenic effect and miR-30 a-5 p acted as an antagonist of the anti-oncogene effects in the pathogenesis of renal carcinomas.Conclusions:The HIF1 A-AS2-miR-30 a-5 p-SOX4 axis was associated with the malignant progression and development of renal carcinoma.The relative expression of HIF1 A-AS2 was negatively correlated with the expression of miR-30 a-5 p,and was closely correlated with SOX4 mRNA levels in renal cancers.
基金supported by the National Natural Science Foundation of China(No.92160202)the National Natural Science Foundation of China(No.52375188)+1 种基金the National Key R&D Program of China(No.2021YFB3703100)the Ningbo Key Technology Research and Development(No.2023T007).
文摘Flash sintering(FS)is a novel technique for rapidly densifying silicon carbide(SiC)ceramics.This work achieved a rapid sintering of SiC ceramics by the utilization of ultra-high temperature flash sintering within 60 s.Pyrolysis carbon(PyC)“bridges”were constructed between SiC particles through the carbonisation of phenolic resin,providing a large number of current channels.The incubation time of the flash sintering process was significantly reduced,and the sintering difference between the centre and the edge regions of the ceramics was minimized,with an average particle size of the centre region and edge region being 12.31 and 9.02μm,respectively.The results showed that the porosity of the SiC ceramics after the flash sintering was reduced to 14.79% with PyC“bridges”introduced,and the Vickers hardness reached 19.62 GPa.PyC“bridges”gradually evolved from amorphous eddy current carbon to oriented graphite carbon,indicating that the ultra-high temperature environment in which the sample was located during the flash sintering was successfully constructed.Ultra-high temperature flash sintering of SiC is expected to be applied to the local repair of matrix damage in SiC ceramic matrix composites.
基金Supported by the National Natural Science Foundation of China,No.81170454,No.30772049 and No.30571765
文摘AIM To analyse the postoperative survival of patients with portal hypertension and determine the factors that influence survival and construct nomograms.METHODS We retrospectively followed 1045 patients who underwent splenectomy plus pericardial devascularisation(SPD) between January 2002 and December 2017. Two SPD types are used in our department: splenectomy plus simplified pericardial devascularisation(SSPD) and splenectomy plus traditional pericardial devascularisation(STPD). The Kaplan-Meier method and Cox regression analysis were used to evaluate the prognostic effects of multiple parameters on overall survival(OS), diseasespecific survival(DSS) and bleeding-free survival(BFS). Significant prognostic factors were combined to build nomograms to predict the survival rate of individual patients.RESULTS Five hundred and fifty-seven(53.30%) patients weresuccessfully followed with 192 in the SSPD group and 365 in the STPD group; 93(16.70%) patients died, of whom 42(7.54%) died due to bleeding. Postoperative bleeding was observed in 84(15.10%) patients. The 5-and 10-year OS, DSS and BFS rates in the group of patients who underwent SSPD were not significantly different from those in patients who underwent STPD. Independent prognostic factors for OS were age, operative time, alanine transaminase level and albumin-bilirubin score. Independent prognostic factors for BFS were male sex, age, intraoperative blood loss and time to first flatus. Independent prognostic factors for DSS were the Comprehensive Complication Index and age. These characteristics were used to establish nomograms, which showed good accuracy in predicting 1-, 3-and 5-year OS and BFS.CONCLUSION SSPD achieves or surpasses the long-term survival effect of traditional pericardial devascularisation and is worthy of clinical promotion and application. Nomograms are effective at predicting prognosis.
基金Supported by National Natural Science Foundation of China,No.81170454
文摘AIM: We undertook this meta-analysis to investigate the relationship between revascularization and outcomes after liver transplantation.METHODS: A literature search was performed using MeSH and key words. The quality of the included studies was assessed using the Jadad Score and the NewcastleOttawa Scale. Heterogeneity was evaluated by the χ 2and I 2 tests. The risk of publication bias was assessed using a funnel plot and Egger's test, and the risk of bias was assessed using a domain-based assessment tool.A sensitivity analysis was conducted by reanalyzing the data using different statistical approaches.RESULTS: Six studies with a total of 467 patients were included. Ischemic-type biliary lesions were significantly reduced in the simultaneous revascularization group compared with the sequential revascularization group(OR = 4.97, 95%CI: 2.45-10.07; P < 0.00001),and intensive care unit(ICU) days were decreased(MD = 2.00, 95%CI: 0.55-3.45; P = 0.007) in the simultaneous revascularization group. Although warm ischemia time was prolonged in simultaneous revascularization group(MD =-25.84, 95%CI:-29.28-22.40; P < 0.00001), there were no significant differences in other outcomes between sequential and simultaneous revascularization groups. Assessment of the risk of bias showed that the methods of random sequence generation and blinding might have been a source of bias. The sensitivity analysis strengthened the reliability of the results of this meta-analysis.CONCLUSION: The results of this study indicate that simultaneous revascularization in liver transplantation may reduce the incidence of ischemic-type biliary lesions and length of stay of patients in the ICU.
