AIM:To explore a prophylactic procedure to prevent splenic artery steal syndrome(SASS),as well as a therapeutic intervention to correct it.METHODS:Forty-three liver transplant patients were enrolled in a non-randomize...AIM:To explore a prophylactic procedure to prevent splenic artery steal syndrome(SASS),as well as a therapeutic intervention to correct it.METHODS:Forty-three liver transplant patients were enrolled in a non-randomized controlled trial,with the eligible criterion that the diameter of the splenic artery is more than 5 mm and/or 1.5 times of the diameter of the hepatic artery.The procedure of splenic artery banding was performed in 28 of the 43 patients,with the other 15 patients studied as a control group.SASS and other complications were compared between these two groups.A new therapeutic intervention,temporary incomplete blockade of the splenic artery with a balloon,was performed to treat SASS in this study.RESULTS:The incidence of SASS was decreased by banding the splenic artery(0/28 vs 5/15,P = 0.006),and the same result was observed in total complications associated with prophylactic procedures(2/28 vs 6/15,P = 0.014).Five patients in the control group developed SASS within 5 d after OLT,2 of whom were treated by coil embolization of the splenic artery,whereas the other 3 by temporary blockade of the splenic artery.Reappeared or better hepatic arteries with improved systolic amplitude and increased diastolic flow were detected by Doppler ultrasonography in all the 5 patients.Local splenic ischemic necrosis and nonanastomotic biliary stricture were diagnosed respectively in one patient treated by coil embolization,and no collateral complication was detected in patients treated by temporary blockade of the splenic artery.CONCLUSION:SASS should be avoided during the operation by banding the splenic artery.Temporary blockade of the splenic artery is a new safe and effective intervention for SASS.展开更多
New nucleos(t)ide analogues(NAs) with high genetic barrier to hepatitis B virus(HBV) resistance(such as entecavir, tenofovir) have improved the prognosis of patients with HBV decompensated cirrhosis and have prevented...New nucleos(t)ide analogues(NAs) with high genetic barrier to hepatitis B virus(HBV) resistance(such as entecavir, tenofovir) have improved the prognosis of patients with HBV decompensated cirrhosis and have prevented HBV recurrence after liver transplantation(LT). NAs are considered the most proper approach for HBV infection in patients under renal replacement therapy but their doses should be adjusted according to the patient's creatinine clearance. In addition, physi-cians should be aware of the potential nephrotoxicity. However, patients with chronic hepatitis C and decom-pensated cirrhosis can receive only one therapeutic option before LT, as well as for Hepatitis C virus(HCV) recurrence after LT, which is the combination of sub-cutaneous Peg-IFN and ribavirin. Generally, therapy for HCV after renal transplantation should be avoided. Although the optimal antiviral therapy for HCV infec-tion has not been established, attention has turned to a new, oral direct acting antiviral treatment which marks a promising strategy in prognosis and in amelioration of these diseases.展开更多
Hepatocellular carcinoma(HCC) is an aggressive tumor that often occurs in the setting of chronic liver disease.Many patients do not initially manifest any symptoms of HCC and present late when cure with surgical resec...Hepatocellular carcinoma(HCC) is an aggressive tumor that often occurs in the setting of chronic liver disease.Many patients do not initially manifest any symptoms of HCC and present late when cure with surgical resection or transplantation is no longer possible.For this reason,patients at high risk for developing HCC are subjected to frequent screening processes.The surgical management of HCC is complex and requires an inter-disciplinary approach.Hepatic resection is the treatment of choice for HCC in patients without cirrhosis and is indicated in some patients with early cirrhosis(Child-Pugh A).Liver transplantation has emerged in the past decade as the standard of care for patients with cirrhosis and HCC meeting Milan criteria and in select patients with HCC beyond Milan criteria.Loco-regional therapy with transarterial chemoembolization,transarterial embolization,radiofrequency ablation and other similar local treatments can be used as neo-adjuvant therapy to downstage HCC to within Milan criteria or as a bridge to transplantation in patients on transplant wait list.展开更多
目的:探讨晚期糖基化终末产物受体(RAGE)是否能促进子宫内膜癌裸鼠皮下移植瘤的生长。方法:利用腺病毒介导的RNAi干扰技术下调HEC-1A细胞中RAGE的表达,将干扰前后的HEC-1A细胞接种到裸鼠皮下构建移植瘤模型,观察RAGE对裸鼠皮下移植的子...目的:探讨晚期糖基化终末产物受体(RAGE)是否能促进子宫内膜癌裸鼠皮下移植瘤的生长。方法:利用腺病毒介导的RNAi干扰技术下调HEC-1A细胞中RAGE的表达,将干扰前后的HEC-1A细胞接种到裸鼠皮下构建移植瘤模型,观察RAGE对裸鼠皮下移植的子宫内膜癌细胞生长的影响。结果:RAGE sh RNAi腺病毒干扰的HEC-1A细胞不再表达RAGE蛋白,干扰后的HEC-1A细胞形成的移植瘤体积及质量显著小于干扰前细胞形成的肿瘤(P<0.01)。结论:RAGE促进子宫内膜癌裸鼠皮下移植瘤的生长。展开更多
文摘AIM:To explore a prophylactic procedure to prevent splenic artery steal syndrome(SASS),as well as a therapeutic intervention to correct it.METHODS:Forty-three liver transplant patients were enrolled in a non-randomized controlled trial,with the eligible criterion that the diameter of the splenic artery is more than 5 mm and/or 1.5 times of the diameter of the hepatic artery.The procedure of splenic artery banding was performed in 28 of the 43 patients,with the other 15 patients studied as a control group.SASS and other complications were compared between these two groups.A new therapeutic intervention,temporary incomplete blockade of the splenic artery with a balloon,was performed to treat SASS in this study.RESULTS:The incidence of SASS was decreased by banding the splenic artery(0/28 vs 5/15,P = 0.006),and the same result was observed in total complications associated with prophylactic procedures(2/28 vs 6/15,P = 0.014).Five patients in the control group developed SASS within 5 d after OLT,2 of whom were treated by coil embolization of the splenic artery,whereas the other 3 by temporary blockade of the splenic artery.Reappeared or better hepatic arteries with improved systolic amplitude and increased diastolic flow were detected by Doppler ultrasonography in all the 5 patients.Local splenic ischemic necrosis and nonanastomotic biliary stricture were diagnosed respectively in one patient treated by coil embolization,and no collateral complication was detected in patients treated by temporary blockade of the splenic artery.CONCLUSION:SASS should be avoided during the operation by banding the splenic artery.Temporary blockade of the splenic artery is a new safe and effective intervention for SASS.
文摘New nucleos(t)ide analogues(NAs) with high genetic barrier to hepatitis B virus(HBV) resistance(such as entecavir, tenofovir) have improved the prognosis of patients with HBV decompensated cirrhosis and have prevented HBV recurrence after liver transplantation(LT). NAs are considered the most proper approach for HBV infection in patients under renal replacement therapy but their doses should be adjusted according to the patient's creatinine clearance. In addition, physi-cians should be aware of the potential nephrotoxicity. However, patients with chronic hepatitis C and decom-pensated cirrhosis can receive only one therapeutic option before LT, as well as for Hepatitis C virus(HCV) recurrence after LT, which is the combination of sub-cutaneous Peg-IFN and ribavirin. Generally, therapy for HCV after renal transplantation should be avoided. Although the optimal antiviral therapy for HCV infec-tion has not been established, attention has turned to a new, oral direct acting antiviral treatment which marks a promising strategy in prognosis and in amelioration of these diseases.
文摘Hepatocellular carcinoma(HCC) is an aggressive tumor that often occurs in the setting of chronic liver disease.Many patients do not initially manifest any symptoms of HCC and present late when cure with surgical resection or transplantation is no longer possible.For this reason,patients at high risk for developing HCC are subjected to frequent screening processes.The surgical management of HCC is complex and requires an inter-disciplinary approach.Hepatic resection is the treatment of choice for HCC in patients without cirrhosis and is indicated in some patients with early cirrhosis(Child-Pugh A).Liver transplantation has emerged in the past decade as the standard of care for patients with cirrhosis and HCC meeting Milan criteria and in select patients with HCC beyond Milan criteria.Loco-regional therapy with transarterial chemoembolization,transarterial embolization,radiofrequency ablation and other similar local treatments can be used as neo-adjuvant therapy to downstage HCC to within Milan criteria or as a bridge to transplantation in patients on transplant wait list.
文摘目的:探讨晚期糖基化终末产物受体(RAGE)是否能促进子宫内膜癌裸鼠皮下移植瘤的生长。方法:利用腺病毒介导的RNAi干扰技术下调HEC-1A细胞中RAGE的表达,将干扰前后的HEC-1A细胞接种到裸鼠皮下构建移植瘤模型,观察RAGE对裸鼠皮下移植的子宫内膜癌细胞生长的影响。结果:RAGE sh RNAi腺病毒干扰的HEC-1A细胞不再表达RAGE蛋白,干扰后的HEC-1A细胞形成的移植瘤体积及质量显著小于干扰前细胞形成的肿瘤(P<0.01)。结论:RAGE促进子宫内膜癌裸鼠皮下移植瘤的生长。
