1.A study on resectable hilar cholangiocarcinoma comparing neoadjuvant therapy combined with liver transplantation versus radical hepatectomy
Jian YANG ; Yan XIE ; Dazhi TIAN ; Xiaoye SUN ; Wentao JIANG ; Zhongyang SHEN
Chinese Journal of Hepatobiliary Surgery 2021;27(4):270-273
Objective:To compare the treatment outcomes of neoadjoint therapy combined with liver transplantation versus radical hepatectomy for patients with surgically resectable hilar cholangiocarcinoma.Methods:A retrospective study was performed on the data of 64 patients with resectable hilar cholangiocarcinoma operated from January 2009 to December 2014 at the Organ Transplantation Department of the First Central Hospital of Tianjin. There were 43 males and 21 females, with an average age of 61.2 years. There were 45 patients who underwent radical hepatectomy in the liver resection group, and 19 patients who underwent combined neoadjuvant therapy (radiotherapy combined with 5-fluorouracil intravenous drip, transcatheter lumen radiotherapy, capecitabine oral administration) and liver transplantation in the liver transplantation group. The recurrence rates and survival rate were compared between groups.Results:The 1, 3 and 5 years cumulative survival rates of the liver transplantation group were 89.5%, 73.7% and 63.2%, respectively, which were significantly better than those of the liver resection group (80.0%, 53.3% and 35.6%) ( P<0.05). The postoperative tumor recurrence rate in the liver transplantation group was 31.6% (6/19), which was significantly lower than that in the liver resection group of 60.0% (27/45) ( P<0.05). Subgroup analysis using postoperative pathological results showed the cumulative survival rates of patients without lymph node metastasis (N 0) and those with negative resection margins (R 0) were not significantly different between groups ( P>0.05). However, for patients with regional lymph node invasion (N 1) and with R 0 resection margin, the cumulative survival rates at 1, 3 and 5 years after liver transplantation were 83.3%, 66.7% and 50.0%, respectively, which were significantly superior to the 64.3%, 28.6% and 14.3% of the liver resection group ( P<0.05). Conclusion:Hepatectomy is recommended for patients with N 0 R 0 resectable hilar cholangiocarcinoma. For patients with hilar cholangiocarcinoma with marginally resectable N 1R 0, neoadjuvant therapy combined with liver transplantation resulted in significantly better long-term overall survival than resection.
2.Identification and Characterization of Two New S-Adenosylmethionine-Dependent Methyltransferase Encoding Genes Suggested Their Involvement in Stipe Elongation of Flammulina velutipes
Qianhui HUANG ; Irum MUKHTAR ; Yelin ZHANG ; Zhongyang WEI ; Xing HAN ; Rongmei HUANG ; Junjie YAN ; Baogui XIE
Mycobiology 2019;47(4):441-448
Two new SAM-dependent methyltransferase encoding genes (fvsmt1 and fvsmt2) were identified from the genome of Flammulina velutipes. In order to make a comprehensive characterization of both genes, we performed in silico analysis of both genes and used qRT-PCR to reveal their expression patterns during the development of F. velutipes. There are 4 and 6 exons with total length of 693 and 978 bp in fvsmt2 and fvsmt1, respectively. The deduced proteins, i.e., FVSMT1 and FVSMT2 contained 325 and 230 amino acids with molecular weight 36297 and 24894 Da, respectively. Both proteins contained a SAM-dependent catalytic domain with signature motifs (I, p-I, II, and III) defining the SAM fold. SAM-dependent catalytic domain is located either in the middle or at the N-terminal of FVSMT2 and FVSMT1, respectively. Alignment and phylogenic analysis showed that FVSMT1 is a homolog to a protein–arginine omega-N-methyltransferase, while FVSMT2 is of cinnamoyl CoA O-methyltransferase type and predicted subcellular locations of these proteins are mitochondria and cytoplasm, respectively. qRT-PCR showed that fvsmt1 and fvsmt2 expression was regulated in different developmental stages. The maximum expression levels of fvsmt1 and fvsmt2 were observed in stipe elongation, while no difference was found in mycelium and pileus. These results positively demonstrate that both the methyltransferase encoding genes are involved in the stipe elongation of F. velutipes.
3.Decreased vitamin D-binding protein level portends poor outcome in acute-on-chronic liver failure caused by hepatitis B virus
Daxian WU ; Qunfang RAO ; Zhongyang XIE ; Xiaoqing ZHU ; Yuanmei CHE ; Jian WU ; Hainv GAO ; Jingyu ZHANG ; Zhouhua HOU ; Xiaoyu CHENG ; Zeyu SUN
Clinical and Molecular Hepatology 2022;28(4):912-925
Background/Aims:
Acute-on-chronic liver failure (ACLF) is a catastrophic illness. Few studies investigated the prognostic value of vitamin D-binding protein (VDBP) for hepatitis B virus (HBV)-related ACLF (HBV-ACLF) resulted in conflicting results.
Methods:
Two prospective HBV-ACLF cohorts (n=287 and n=119) were enrolled to assess and validate the prognostic performance of VDBP.
Results:
VDBP levels in the non-survivors were significantly lower than in the survivors (P<0.001). Multivariate Cox regression demonstrated that VDBP was an independent prognostic factor for HBV-ACLF. The VDBP level at admission gradually decreased as the number of failed organs increased (P<0.001), and it was closely related to coagulation failure. The areas under the receiver operating characteristic curve (AUCs) of the Child-Pugh-VDBP and chronic liver failuresequential organ failure assessment (CLIF–SOFA)-VDBP scores were significantly higher than those of Child-Pugh (P<0.001) and CLIF-SOFA (P=0.0013). The AUCs of model for end-stage liver disease (MELD)-VDBP were significantly higher than those of MELD (P= 0.0384) only in the case of cirrhotic HBV-ACLF patients. Similar results were validated using an external multicenter HBV-ACLF cohort. By longitudinal observation, the VDBP levels gradually increased in survivors (P=0.026) and gradually decreased in non-survivors (P<0.001). Additionally, the VDBP levels were found to be significantly decreased in the deterioration group (P=0.012) and tended to be decreased in the fluctuation group (P=0.055). In contrast, they showed a significant increase in the improvement group (P=0.036).
Conclusions
The VDBP was a promising prognostic biomarker for HBV-ACLF. Sequential measurement of circulating VDBP shows value for the monitoring of ACLF progression.
4.Long-term efficacy and literature review of liver transplant recipients with hepatic myelopathy
Zhaoxian LI ; Yan XIE ; Li ZHANG ; Jisan SUN ; Yanyan SUN ; Xinghui YU ; Zhongyang SHEN ; Wentao JIANG
Chinese Journal of Organ Transplantation 2024;45(1):34-40
Objective:To explore the long-term therapeutic efficacy and outcomes of liver transplantation for patients with hepatic myelopathy (HM).Methods:Retrospective analysis of 24 adult liver transplantation recipients due to HM at First Central Municipal Hospital from January 2006 to October 2022. HM was extensively classified by the severity of lower extremity symptoms, degree of muscle stiffness, capability for independent ambulation and muscle strength. Furthermore, their long-term outcomes were examined. From January 2000 to October 2022, the databases of China National Knowledge Infrastructure (CNKI) , Google Scholar, PubMed and Web of Science were searched with such keywords as "肝性脊髓病and肝移植" "Hepatic Myelopathy and Liver Transplantation" .Results:After liver transplantation, liver functions and blood ammonia normalized and most clinical symptoms improved. During a follow-up period of (12-190) months, 19 patients showed a lowered grade of HC as compared to pre-transplantation. Four cases achieved a complete recovery of extremity function. No change occurred in severity grade for the remaining 5 patients. However, 4 of them experienced varying degrees of improvement in muscle strength and independent walking capability. This review summarized the clinical characteristics and clinical outcomes of 17 patients from both domestic and international sources. Most of them experiences varying degrees of symptomatic improvements after liver transplantation (16 cases).Conclusions:This study has confirmed the effectiveness of liver transplantation for HM and its contribution to the long-term patient recovery.
5.Human menstrual blood-derived stem cells alleviate autoimmune hepatitis via JNK/MAPK signaling pathway in vivo and in vitro.
Fen ZHANG ; Lanlan XIAO ; Ya YANG ; Menghao ZHOU ; Yalei ZHAO ; Zhongyang XIE ; Xiaoxi OUYANG ; Feiyang JI ; Shima TANG ; Lanjuan LI
Frontiers of Medicine 2023;17(3):534-548
Autoimmune hepatitis (AIH) is a severe globally distributed liver disease that could occur at any age. Human menstrual blood-derived stem cells (MenSCs) have shown therapeutic effect in acute lung injury and liver failure. However, their role in the curative effect of AIH remains unclear. Here, a classic AIH mouse model was constructed through intravenous injection with concanavalin A (Con A). MenSCs were intravenously injected while Con A injection in the treatment groups. The results showed that the mortality by Con A injection was significantly decreased by MenSCs treatment and liver function tests and histological analysis were also ameliorated. The results of phosphoproteomic analysis and RNA-seq revealed that MenSCs improved AIH, mainly by apoptosis and c-Jun N-terminal kinase/mitogen-activated protein signaling pathways. Apoptosis analysis demonstrated that the protein expression of cleaved caspase 3 was increased by Con A injection and reduced by MenSCs transplantation, consistent with the TUNEL staining results. An AML12 co-culture system and JNK inhibitor (SP600125) were used to verify the JNK/MAPK and apoptosis signaling pathways. These findings suggested that MenSCs could be a promising strategy for AIH.
Mice
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Animals
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Humans
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Hepatitis, Autoimmune/pathology*
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Signal Transduction
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Disease Models, Animal
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Stem Cells