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Wang X, Zhou ZJ, Zhang XF, Zheng S. A Comparison of Two Different Doses of Rectal Ketamine Added to 0.5 mg.kg-1 Midazolam and 0.02 mg.kg-1 Atropine in Infants and Young Children. Anaesth Intensive Care 2010; 38:900-4. [PMID: 20865876 DOI: 10.1177/0310057x1003800515] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In some circumstances, a high degree of sedation that results in a child being unconscious at the time of parental separation is desirable. We set out to investigate the efficacy and safety of a rectal premedication regimen designed to produce this increased level of sedation. Sixty-seven children aged two to 24 months were randomised into two groups. Group MK received 4 mg.kg-1 ketamine, 0.5 mg.kg-1 midazolam and 0.02 mg.kg-1 atropine and group MKK received 8 mg.kg-1 ketamine, 0.5 mg.kg-1 midazolam and 0.02 mg.kg-1 atropine per rectum. The sedation score at the time of parental separation 30 minutes after drug administration and the response to intravenous cannulation were evaluated on a four-point scale. Respiratory rate, heart rate and arterial oxygen saturation were recorded immediately before parental separation. More patients in group MKK were asleep during separation (62 vs 35%, P <0.05). Fewer patients in group MKK cried during intravenous cannulation (37 vs 68%, P <0.05). Sedation scores were significantly increased at both time points. There was no difference between groups in vital signs at the time of parental separation and no adverse respiratory events occurred during the study period. In cases where a high degree of sedation following premedication in infants and toddlers is desired, the addition of 8 mg.kg-1 ketamine to 0.5 mg.kg-1 midazolam and 0.02 mg.kg-1 atropine administered rectally is more efficacious than 4 mg.kg-1 ketamine.
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Wang YK, Zhu YL, Qiu FM, Zhang T, Chen ZG, Zheng S, Huang J. Activation of Akt and MAPK pathways enhances the tumorigenicity of CD133+ primary colon cancer cells. Carcinogenesis 2010; 31:1376-80. [PMID: 20530554 DOI: 10.1093/carcin/bgq120] [Citation(s) in RCA: 96] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Cancer stem cells (CSCs) play an important role in carcinogenesis, resistance to treatment and may lead to cancer recurrence and metastasis. However, the molecular mechanism of CSC involved in these events needs to be further elucidated. In this study, CD133(+) colon cancer cells were cultured, which showed CSC properties both in vitro and in vivo from metastatic tissue. Upstream molecules in Akt and mitogen-activated protein kinase (MAPK) pathways were preferentially expressed in these CD133(+) cells, as revealed by a global gene chip. The kinase activities of Akt and extracellular signal-regulated kinase (Erk)1/2 were also significantly upregulated in CD133(+) cells. In addition, the clonogenic growth of CD133(+) cell was reduced greatly by inhibiting the activity of Akt and Erk1/2. The results revealed the Akt and MAPK pathways were involved in the tumorigenesis of CD133(+) colon cancer cells, suggesting that molecules in these two pathways might be potential targets in the future therapy.
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Wang Y, Zhang A, Ye Z, Xie H, Zheng S. Bone marrow-derived mesenchymal stem cells inhibit acute rejection of rat liver allografts in association with regulatory T-cell expansion. Transplant Proc 2010; 41:4352-6. [PMID: 20005397 DOI: 10.1016/j.transproceed.2009.08.072] [Citation(s) in RCA: 79] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2009] [Revised: 06/22/2009] [Accepted: 08/17/2009] [Indexed: 12/26/2022]
Abstract
Bone marrow-derived mesenchymal stem cells (MSCs) exhibit immunosuppressive functions in vitro and in vivo. We investigated the immunoregulatory effects of rat MSCs in a model of allogeneic liver transplantation. Brown Norway rats received livers from inbred Lewis rats, and at designated intervals, infusions of MSCs derived from recipient, donor, or third-party rats. Allograft rejection and recipient survival rates were recorded. In particular, changes in circulating regulatory T cells (Tregs) were measured. After administration of MSCs derived from each of the 3 strains, allograft recipients demonstrated markedly longer survival compared with control animals. Histologic analysis revealed significant inhibition of allograft rejection. The MSCs induced generation of CD4+CD25+Foxp3+ Tregs. We concluded that MSCs inhibit acute rejection of allografts after liver transplantation, and propose that the immunoregulatory effects of MSCs are associated with expansion of Tregs.
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Ernst ME, Carter BL, Zheng S, Grimm RH. Meta-analysis of dose-response characteristics of hydrochlorothiazide and chlorthalidone: effects on systolic blood pressure and potassium. Am J Hypertens 2010; 23:440-6. [PMID: 20111008 DOI: 10.1038/ajh.2010.1] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Evidence supporting the benefit of low-dose thiazide-based regimens to reduce cardiovascular events is primarily derived from studies using chlorthalidone, yet low-dose hydrochlorothiazide (HCTZ) (12.5-25 mg) remains more widely prescribed. We sought to describe their comparative dose-response relationships for changes in systolic blood pressure (SBP) and potassium. METHODS PubMed from 1948 to July 2008 was systematically searched to identify clinical trials using either HCTZ or chlorthalidone monotherapies. A total of 108 clinical trials with HCTZ and 29 with chlorthalidone were analyzed. Data were pooled to evaluate the effects on SBP and potassium of both drugs throughout their respective dose-response curves. Equivalence analysis was performed for the clinically recommended low-dose range of 12.5-25 mg, grouped by study duration, using the two one-sided tests procedure described by Schuirmann. RESULTS When evaluated on a milligram-per-milligram basis using pooled data, chlorthalidone generally produces slightly greater reductions in SBP and potassium than HCTZ. In the low-dose range of 12.5-25 mg, equivalence analysis reveals that the reductions in SBP are not equivalent between the two drugs, using upper and lower equivalence bounds of 4 mm Hg. Within the same dosing range, the mean changes in potassium were determined to be equivalent when upper and lower equivalence bounds of 0.29 mEq/l are used. CONCLUSIONS Equivalence analysis using data from several studies suggests that the SBP reductions achieved with HCTZ and chlorthalidone cannot be considered equivalent within the low-dose range currently recommended. However, within this dosing range, reductions in potassium can be considered equivalent.
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Boon N, Carvajal Gallardo E, Zheng S, Eggen E, Dijkstra M, van Roij R. Screening of heterogeneous surfaces: charge renormalization of Janus particles. JOURNAL OF PHYSICS. CONDENSED MATTER : AN INSTITUTE OF PHYSICS JOURNAL 2010; 22:104104. [PMID: 21389438 DOI: 10.1088/0953-8984/22/10/104104] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Nonlinear ionic screening theory for heterogeneously charged spheres is developed in terms of a mode decomposition of the surface charge. A far-field analysis of the resulting electrostatic potential leads to a natural generalization of charge renormalization from purely monopolar to dipolar, quadrupolar, etc, including 'mode couplings'. Our novel scheme is generally applicable to large classes of surface heterogeneities, and is explicitly applied here to Janus spheres with differently charged upper and lower hemispheres, revealing strong renormalization effects for all multipoles.
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Yang H, Mao Y, Yu J, Chen J, He Q, Shou Z, Wu J, Chen Y, Zheng S. Diagnosis of C4d+ Renal Allograft Acute Humoral Rejection by Urine Protein Fingerprint Analysis. J Int Med Res 2010; 38:176-86. [PMID: 20233527 DOI: 10.1177/147323001003800120] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study aimed to develop urine protein fingerprint models for the diagnosis of acute rejection (AR) and complement split product positive (C4d+) acute humoral rejection (AHR) following renal allograft transplantation. Urine samples from 101 renal transplant recipients were analysed by surface-enhanced laser desorption/ionization time-of-flight mass spectrometry combined with bioinformatics. The patients comprised 36 with stable allograft function (stable group), 10 with acute tubular necrosis (ATN) and 55 with AR (20 with C4d- acute cellular rejection [ACR] and 15 with C4d+ AHR). The ATN group was differentiated from the stable group with a sensitivity and specificity of 100% (pattern 1). The stable group was differentiated from the AR group with a specificity of 86.4% and a sensitivity of 85.4% (pattern 2). The C4d- ACR subgroup was differentiated from the C4d+ AHR subgroup with a specificity and sensitivity of 95% and 80%, respectively (pattern 3). It is concluded that urine protein fingerprint analysis can provide a noninvasive tool to diagnose AR and C4d+ AHR.
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Winkler M, Pratschke J, Schulz U, Zheng S, Zhang M, Li W, Lu M, Sgarabotto D, Sganga G, Kaskel P, Chandwani S, Ma L, Petrovic J, Shivaprakash M. Caspofungin for post solid organ transplant invasive fungal disease: results of a retrospective observational study. Transpl Infect Dis 2010; 12:230-7. [PMID: 20070619 PMCID: PMC2904899 DOI: 10.1111/j.1399-3062.2009.00490.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
M. Winkler, J. Pratschke, U. Schulz, S. Zheng, M. Zhang, W. Li, M. Lu, D. Sgarabotto, G. Sganga, P. Kaskel, S. Chandwani, L. Ma, J. Petrovic, M. Shivaprakash. Caspofungin for post solid organ transplant invasive fungal disease: results of a retrospective observational study. Transpl Infect Dis 2010: 12: 230–237. All rights reserved
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Zheng S, Song M, Wu L, Yang S, Shen J, Lu X, Du J, Wang W. China: Public Health Genomics. Public Health Genomics 2010; 13:269-75. [DOI: 10.1159/000240969] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2009] [Accepted: 05/26/2009] [Indexed: 11/19/2022] Open
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Wei H, Li N, Tao Y, Zheng S, Cao W. Mechanical Design and Implementation of a Sociable Companion Robot. ROBOTICS 2010. [DOI: 10.2316/p.2010.703-045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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260
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Xu J, Sun J, Kader A, Lindstrom S, Wiklund F, Hsu F, Johansson J, Zheng S, Isaacs W, Gronberg H. POD-02.09: Estimation of Absolute Risk for Prostate Cancer from Blood DNA. Urology 2009. [DOI: 10.1016/j.urology.2009.07.1203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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261
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Zhong X, Wu B, Pan YJ, Zheng S. Brazilein inhibits survivin protein and mRNA expression and induces apoptosis in hepatocellular carcinoma HepG2 cells. Neoplasma 2009; 56:387-92. [PMID: 19580339 DOI: 10.4149/neo_2009_05_387] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Hepatocellular carcinomas represent the third leading cause of cancer-related deaths worldwide. Survivin, a structurally unique member of the inhibitor of apoptosis protein (IAP) family, is overexpressed in a wide range of malignancies, including hepatocellular carcinoma. Due to its involvement in cancer progression and treatment resistance, survivin is currently undergoing extensive investigation as a novel intervention target to induce apoptosis in cancer cells by phytochemicals or synthetic agents. Brazilein, a compound obtained in a large amount from the dried heartwood of Caesalpinia sappan Linn., which has long been used in traditional medicine in China, has some pharmacological activities. Human hepatocellular carcinoma HepG2 cells were treated with brazilein and analyzed for survivin protein and mRNA levels by Western blotting and real-time RT-PCR, respectively. Brazilein treatment of cells for 48 h at 5 and 10 microg/ml doses resulted in significantly decrease in survivin protein expression. We also observed that brazilein caused a strong decrease in survivin mRNA expression. In other studies, down-regulation of survivin by brazilein was associated with a strong and prominent caspases-9 and -3 activation as well as PARP cleavage. It was also shown that brazilein induced a strong apoptotic cell death, as shown by DNA ladder assay, and growth inhibition of HepG2 cells. Further studies are needed to investigate in vivo effect of brazilein on survivin expression and associated biological effects in hepatocellular carcinoma that could provide useful information for brazilein efficacy in the prevention/intervention of human hepatocellular carcinoma.
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Abstract
e20740 Background: While medical oncology is growing in volume, it is increasingly becoming an outpatient enterprise. Issues leading to hospital admissions in the past are commonly either prevented or managed on an outpatient basis. We sought out trends within our practice on the frequency and reasons for hospital admissions. Methods: Computerized office visit and hospital admissions data were obtained on admissions by physician and year, for Pa. Oncology-Hematology Associates from 2000–2007. A retrospective chart review was also done for one physician from 6/08–12/08 to determine the reasons for admission. Results: While the total number of patients seen per year increased by 40% over the review period from 2000–2007, the relative number of admissions has steadily declined. Adjusting the number of admissions per patients in the practice (since the overall increase in volume partially masks the decline in admission frequency), the reduction in admissions is further evident. The frequency of admissions for the 4 senior oncologists showed a 50% reduction in admissions per patient over the past 8 years. Of 56 admissions reviewed from 6/08–12/08, 20 were related to infections (although only a minority were neutropenic), 13 for symptom management of disease progression, 6 for anemia/bleeding, 3 for bowel obstruction, 3 for non-infectious complications of treatment, and only 1 for chemotherapy administration. Conclusions: Trends in our practice indicate a continued decline in the frequency of admissions per patient. Elective admissions for diagnosis, work-up, and chemotherapy are rare. Improved medications for symptoms related to cancer, its complications and treatment-related toxicities and improvements in palliative care (psychosocial support, communication about prognosis and treatment goals, and end-of-life care) have contributed to decreased admissions. Increasingly, even patients with incurable disease are managed from diagnosis to death entirely as outpatients. Optimizing outpatient management and avoiding admissions in medical oncology has major implications for practice quality, patient quality of life, cost and allocation of health care resources. No significant financial relationships to disclose.
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Tasneem S, Adam F, Minullina I, Pawlikowska M, Hui SK, Zheng S, Miller JL, Hayward CPM. Platelet adhesion to multimerin 1 in vitro: influences of platelet membrane receptors, von Willebrand factor and shear. J Thromb Haemost 2009; 7:685-92. [PMID: 19175495 DOI: 10.1111/j.1538-7836.2009.03284.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Multimerin 1 (MMRN1) is a large, homopolymeric adhesive protein, stored in platelets and endothelium, that when released, binds to activated platelets, endothelial cells and the extracellular matrix. OBJECTIVES The goals of our study were to determine if (i) MMRN1 supports adhesion of resting and/or activated platelets under conditions of blood flow, and (ii) if MMRN1 enhances platelet adhesion to types I and III collagen. PATIENTS/METHODS Platelet adhesion was evaluated using protein-coated microcapillaries, with or without added adhesive proteins and receptor antibodies. Platelets from healthy controls, Glanzmann thrombasthenia (GT) and severe von Willebrand factor (VWF)-deficient donors were tested. RESULTS MMRN1 supported the adhesion of activated, but not resting, washed platelets over a wide range of shear rates. At low shear (150 s(-1)), this adhesion was supported by integrins alphavbeta3 and glycoprotein (GP) Ibalpha but it did not require integrins alphaIIbbeta3 or VWF. At high shear (1500 s(-1)), adhesion to MMRN1 was supported by beta3 integrin-independent mechanisms, involving GPIbalpha and VWF, that did not require platelet activation when VWF was perfused over MMRN1 prior to platelets. MMRN1 bound to types I and III collagen, independent of VWF, however, its enhancing effects on platelet adhesion to collagen at high shear were VWF dependent. CONCLUSIONS MMRN1 supports platelet adhesion by VWF-dependent and -independent mechanisms that vary by flow rate. Additionally, MMRN1 binds to, and enhances, platelet adhesion to collagen. These findings suggest that MMRN1 could function as an adhesive ligand that promotes platelet adhesion at sites of vascular injury.
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Sun J, Xu Z, Bao H, Zheng S. Abstract No. 118: In Vivo Tracking of Magnetic Labeled Bone Marrow Mesenchymal Stem Cells Intravenously Transplanted for Cell Therapy of Acute Renal Failure. J Vasc Interv Radiol 2009. [DOI: 10.1016/j.jvir.2008.12.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Sun J, Xu Z, Lou J, Cai L, Wu C, Zheng S. Abstract No. 199: Usefulness of Soft-Tissue Reconstruction with Angiography/CT Suite Using Flat-Panel Detector Technology in Procedures of Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma. J Vasc Interv Radiol 2009. [DOI: 10.1016/j.jvir.2008.12.189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Li J, Zeng Q, Chen M, Jiang J, Zheng S. Comparison analysis of 1D/2D/3D neutronics modeling for a fusion reactor. FUSION ENGINEERING AND DESIGN 2008. [DOI: 10.1016/j.fusengdes.2008.06.051] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Feng J, Zhang M, Zheng S, Xie P, Ma A. Effects of High Temperature on Multiple Parameters of Broilers In Vitro and In Vivo. Poult Sci 2008; 87:2133-9. [DOI: 10.3382/ps.2007-00358] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Zheng S, Feng X, Qing D, Chen M, Dong J. The tolerance time limits of biliary tracts of liver grafts subjected to warm ischemia and cold preservation: an experimental study in swine. Transplant Proc 2008; 40:1629-34. [PMID: 18589163 DOI: 10.1016/j.transproceed.2008.01.072] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2007] [Accepted: 01/16/2008] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The objective of this study was to investigate the tolerance time limits of liver grafts and biliary tracts with warm ischemia to cold preservation providing experimental data to the prevent primary graft nonfunction and biliary necrosis after orthotopic liver transplantation (OLT). METHODS OLTs were performed in Bama miniature swine. Morphological and functional changes in the liver graft and biliary tracts were investigated after 10 minutes of warm ischemia and various durations of cold preservation. RESULTS When grafts were subjected to 10 minutes of warm ischemia followed by less than 16 hours of cold preservation, all animals survived 1 week; no animal died of biliary necrosis. However, when the cold preservation time exceeded 16 hours, the incidence of biliary necrosis increased significantly (P < .05) with deaths due to bile leaks. As cold preservation persisted, primary graft nonfunction and intraoperative or early postoperative deaths occurred, and all surviving animals developed biliary necrosis. When compared with the group undergoing less than 16 hours of cold preservation, the morphological scores and apoptosis index of epithelial cells of graft bile ducts were significantly increased among the group subjected to more than 16 hours of cold preservation after reperfusion (P < .05), whereas the activity of Na+-K+-ATPase and Ca2+-ATPase of graft bile ducts were reduced significantly (P < .05). Liver function tests showed the concentrations of alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma glutamyl transpeptidase, and alkaline phosphatase (ALP) decreased more slowly among the group undergoing more than 16 hours of cold preservation after operation. CONCLUSIONS We concluded that given 10 minutes of warm ischemia, cold preservation should be less than 16 hours to avoid early biliary necrosis; the corresponding tolerance time limit of the liver to cold preservation was less than 20 hours.
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Zhang A, Xiang J, Zhang M, Zheng S. Primary Hepatic Carcinoid Tumours: Clinical Features with an Emphasis on Carcinoid Syndrome and Recurrence. J Int Med Res 2008; 36:848-59. [PMID: 18652782 DOI: 10.1177/147323000803600428] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
This study sought to determine the clinical profiles and optimal management of primary hepatic carcinoid tumours. The clinical features of nine Chinese patients and 64 patients reported in the English-language literature were characterized. Recurrence rate and survival analysis were performed with the Kaplan–Meier method. The impact of surgical resection and post-operative recurrence on survival was determined by means of the log-rank test. Carcinoid syndrome complicated 10 cases (14%). Sixty-two patients (85%) underwent surgical resection. Actuarial 5-and 10-year survival rates for resected patients were 80% and 75%, respectively. Twelve patients experienced recurrences: the recurrence rate at 5 years post-operatively was 26%. All patients with resectable recurrent disease achieved good long-term survival and no significant relationship was found between recurrence and survival. Owing to the high incidence of recurrence, long-term follow-up is necessary and it is recommended that recurrent cases should be managed with judicious surgical resection.
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Xu W, Chen Y, Zheng S, Zhang S. The application of serum protein fingerprints in the postoperative follow-up of colorectal cancer. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.15044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Luo Y, Zhang A, Huang H, Zheng S. Haemolytic Uraemic Syndrome after Living-donor Liver Transplantation: Is Small-for-size Graft a Potential Risk Factor? J Int Med Res 2008; 36:599-604. [PMID: 18534145 DOI: 10.1177/147323000803600328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Haemolytic uraemic syndrome (HUS) is a rare complication of solid organ transplantation. Immunosuppressive drugs, including cyclosporin A and tacrolimus, have frequently been incriminated. Here we report a case of tacrolimus-induced HUS in a woman with small-for-size syndrome after living-donor liver transplantation. Hypertension, microangiopathic anaemia and end-stage renal failure occurred in the immediate post-transplant period; all other risk factors that might be implicated in the development of HUS were investigated and excluded if no evidence was found. A possible association between small-for-size syndrome, which frequently results in a high blood concentration of tacrolimus post-operatively, and the occurrence of HUS is discussed.
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Zheng S, Luo Y, Wang W, Xiao X. Analysis of the pathomorphology of the intra- and extrahepatic biliary system in biliary atresia. Eur J Pediatr Surg 2008; 18:98-102. [PMID: 18437653 DOI: 10.1055/s-2008-1038360] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Aim of the study was to investigate the pathomorphological changes in the liver and triangular cord of the porta hepatis in biliary atresia and assess the relationship between the degree of differentiation of fibroblasts in the triangular cord of the porta hepatis and the liver fibrosis scores. METHODS From September 2005 to May 2006, 21 patients with biliary atresia (66+/-20 days old) underwent a Kasai procedure. The liver biopsy and the remnant of the porta hepatis were conserved. Five cases with cholestasis syndrome and 10 cases with choledochal cyst were used as a control group. Liver biopsies were performed in the control group. The micro- and ultrastructure of the liver and the remnant of the porta hepatis were assessed in the biliary atresia and the control group. Ultrastructural features were examined by transmission electron microscopy. The semiquantitative differences in liver fibrosis grading between the biliary atresia and the control group was evaluated with a 3-grade staging system. The degree of differentiation of fibroblasts (FB) in the triangular cord of the porta hepatis was assessed as follows: 1) juvenile type: above 50 % FBs were juvenile, 2) senior type: above 50% FBs were senior, 3) median type: between the former 2 types. The differentiation scores of FB in the porta hepatis were assessed in relation to the liver fibrosis score. RESULTS 1) The pathological changes with BA are characterized by inflammation and fibrosis in the hepatic portal area. The fibrosis scores in the biliary atresia group (I: 2 cases, II: 12 cases, III: 7 cases) were significantly higher than in the control group (I: 8 cases, II: 5 cases, III: 2 cases; p=0.01. 2) In the biliary atresia group, the extrahepatic biliary system of all cases showed a triangular cord in the porta hepatis. The triangular cord of porta hepatis was characterized by hyperplasia of canaliculi, atresia or stenosis of the bile ducts, inflammation infiltration, cholestasis, and interstitial fibrosis. 3) The ultrastructural features of BA showed active fibroblasts, a loss of microvilli, dense deposits in the hepatocytes and liver sinusoid, and dilatation of canaliculi. 4) The differentiation scores of FB in the porta hepatis were positively related to the liver fibrosis score (p=0.04). CONCLUSION The main pathological changes of biliary atresia are inflammation and fibrosis in the hepatic portal area. The ultrastructural features of biliary atresia suggested that the differentiation scores of FB in the triangular cord of the porta hepatis were positively related to the liver fibrosis score.
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Jia C, Wang W, Zhu Y, Zheng S. Suprahepatic vena cava manipulative bleeding alleviates hepatic ischemia-reperfusion injury in rats. Dig Liver Dis 2008; 40:285-92. [PMID: 18160354 DOI: 10.1016/j.dld.2007.10.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2007] [Revised: 10/23/2007] [Accepted: 10/25/2007] [Indexed: 12/11/2022]
Abstract
BACKGROUND Little is known about time course and peak level of reactive oxygen species in suprahepatic vena cava after liver ischemia-reperfusion. OBJECTIVE To determine time course and peak level of reactive oxygen species in suprahepatic vena cava after liver ischemia-reperfusion. To focus on the effects of suprahepatic vena cava manipulative bleeding on the hepatic ischemia-reperfusion injury in rat model. METHODS In experiment Part I, blood was taken from suprahepatic vena cava and infrahepatic vena cava for malondialdehyde detection at different time points after reperfusion. Furthermore, we treated the experimental rats in Part II by suprahepatic vena cava manipulative bleeding or infrahepatic vena cava manipulative bleeding at 10 min after reperfusion. RESULTS In experiment Part I, malondialdehyde concentration in suprahepatic vena cava elevated obviously with time and peaked at 10 min after reperfusion. The numbers of accumulated polymorphonuclear neutrophils was significantly increased in ischemia-reperfusion group from 10 min after reperfusion, compared with sham-operated group. In Part II, 2% of body weight suprahepatic vena cava manipulative bleeding with blood transfusion at 10 min after reperfusion significantly decreased circulating malondialdehyde, tumour necrosis factor-alpha, endothelin-1, hyaluronic acid, alanine aminotransferase, aspartate aminotransferase levels and polymorphonuclear neutrophil infiltrations in the liver. The 7-day survival rate of this group was 68.75% (11/16) which was significantly higher than other groups. CONCLUSIONS We provided the first evidence that 2% of body weight suprahepatic vena cava manipulative bleeding with blood transfusion at 10 min after reperfusion significantly prevented liver ischemia-reperfusion injury.
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Gao L, Qian S, Zeng L, Wang R, Wei G, Fan J, Zheng S. An animal model of human cytomegalovirus infection. Transplant Proc 2008; 39:3438-43. [PMID: 18089401 DOI: 10.1016/j.transproceed.2007.06.077] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2006] [Revised: 03/31/2007] [Accepted: 06/21/2007] [Indexed: 11/16/2022]
Abstract
To develop a rat model that allowed in vivo progressive human cytomegalovirus (HCMV) infection, allogeneic liver transplantation was performed across a rat combination of Dark Agouti (DA) to Brown Norway (BN). AD169, a well-characterized laboratory strain of HCMV, was used to establish a rat model of HCMV infection by injection of 0.4 mL (30.0 logTCID50) supernate into the rat peritoneum. Histological and blood specimens were obtained from animals sacrificed at predetermined timepoints. We performed immunohistochemical staining in liver, heart, kidney, spleen, and lung for HCMV immediate-early antigen (IE), lower matrix protein (pp65) detection in peripheral blood leukocytes, and HCMV early antigen (EA) and late antigen (LA). We compared survival rates. Our results showed positive HCMV IE and pp65 antigenemia detected in peripheral blood leukocytes in transplanted recipients from day 1 to day 30. Positive HCMV EA and LA staining cells were only detected in sections 10 days after liver transplantation, namely, in hepatocytes, mononuclear cells, bile duct epithelial cells, and endothelial cells. Successful HCMV replication was due to the combination of liver transplantation and cyclosporine (CsA) immunosuppression. Survival analysis showed no significant differences between the HCMV-infected group and HCMV-uninfected group. This new rat model of HCMV infection may be helpful to understand immune system modulation of HCMV infection.
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Luo J, Qian JH, Yu JK, Zheng S, Xie X, Lu WG. Discovery of altered protein profiles in epithelial ovarian carcinogenesis by SELDI mass spectrometry. EUR J GYNAECOL ONCOL 2008; 29:233-238. [PMID: 18592785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE Identification of proteomic alterations in epithelial ovarian tumorigenesis may facilitate the understanding of progression of this disease. METHODS Specific protein peak patterns were identified in 20 microdissected epithelial ovarian tumors (13 epithelial ovarian cancers (EOCs) and 7 low malignant potential (LMP) tumors), as well as in the matched normal cells. Protein profiles were generated by surface-enhanced laser desorption/ionization time of flight mass spectrometry (SELDI-TOF-MS) from all the different types of cells. RESULTS Among seven protein peaks from EOC cells, six were significantly increased while one was decreased compared with normal cells, and three peaks from LMP cells were markedly increased while one was decreased compared with normal cells. CONCLUSIONS The combination of SELDI and laser capture microdissection (LCM) is effective in finding the key molecules in ovarian tumorigenesis. Further identification of these protein peaks is important and these malignant protein signatures lend themselves to identification of populations at high-risk for EOC and for monitoring response to EOC chemopreventive agents.
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