Publications by authors named "Dongbo Wu"

15 Publications

  • Page 1 of 1

Correction to: EZH2 promotes the expression of LPA1 by mediating microRNA-139 promoter methylation to accelerate the development of ovarian cancer.

Cancer Cell Int 2021 Oct 19;21(1):551. Epub 2021 Oct 19.

Department of Gynecology, The Maternal and Child Health Hospital of Hunan Province, Changsha, 410000, People's Republic of China.

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http://dx.doi.org/10.1186/s12935-021-02236-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8524913PMC
October 2021

Dopamine receptor D2 antagonization normalizes profibrotic macrophage-endothelial crosstalk in non-alcoholic steatohepatitis.

J Hepatol 2021 Oct 11. Epub 2021 Oct 11.

Key Laboratory of Birth Defects and Related Diseases of Women and Children of MOE, State Key Laboratory of Biotherapy, West China Second University Hospital, Sichuan University, Chengdu, 610064, China. Electronic address:

Background & Aims: Fibrosis in the liver is the main histological determinant of non-alcoholic steatohepatitis (NASH), a disease that parallels the worldwide surge in metabolic syndromes. Currently, there is no effective treatment for liver fibrosis. While Hippo/YAP (Yes-associated protein) signaling is essential for liver regeneration, its aberrant activation frequently leads to fibrosis and tumorigenesis. Unravelling "context-specific" contributions of YAP in liver repair might help selectively bypass fibrosis and preserve the pro-regenerative YAP function in hepatic diseases.

Methods: We used murine liver fibrosis and minipig NASH models, liver biopsies from cirrhotic patients, single-cell RNA sequencing (scRNA-Seq) and a G-protein-coupled receptor (GPCR) ligand screening system.

Results: YAP levels in macrophages are increased in the livers of humans and mice with liver fibrosis. The fibrogenic role of macrophage YAP was evidenced via boosting type I interferon and attenuating liver fibrosis in mice specifically lacking Yap1 in myeloid cells. scRNA-Seq further showed that defecting YAP pathway in macrophages diminished a fibrogenic vascular endothelial cell subset exhibiting pro-fibrotic molecular signatures such as CTGF and VCAM1 expression. To specifically target fibrogenic YAP in macrophages, we utilized a GPCR ligand screening system and identified a dopamine receptor D2 (DRD2) antagonist that selectively blocked YAP in macrophages but not hepatocytes. Genetic and pharmacological targeting of macrophage DRD2 attenuated liver fibrosis. In a large animal (minipig) NASH model recapitulating human pathology, DRD2 antagonist blocked fibrosis and restored hepatic architecture.

Conclusions: DRD2 antagonization selectively targets YAP-dependent fibrogenic crosstalk between macrophages and CTGFVCAM1 endothelial cells, promoting liver regeneration over fibrosis in both rodent and large animal models.

Lay Summary: Fibrosis in the liver is one of the main histological determinants of non-alcoholic steatohepatitis (NASH), a disease paralleling a worldwide surge in metabolic syndromes. Our study demonstrates that myeloid-specific YAP deficiency attenuates liver fibrosis. Dopamine receptor D2 (DRD2) antagonization selectively blocks YAP in macrophages and thwarts liver fibrosis in both rodent and large animal models, showing the potential for the GPCR targeting-based NASH therapies.
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http://dx.doi.org/10.1016/j.jhep.2021.09.032DOI Listing
October 2021

Targeting epigenetically maladapted vascular niche alleviates liver fibrosis in nonalcoholic steatohepatitis.

Sci Transl Med 2021 10 6;13(614):eabd1206. Epub 2021 Oct 6.

Key Laboratory of Birth Defects and Related Diseases of Women and Children of MOE, State Key Laboratory of Biotherapy, West China Second University Hospital, Sichuan University, Chengdu 610041, China.

[Figure: see text].
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http://dx.doi.org/10.1126/scitranslmed.abd1206DOI Listing
October 2021

Significantly Decreased Islet Cell Function is Closely Associated with Hyperglycemia in Chronic Hepatitis B Patients.

Int J Endocrinol 2021 24;2021:1264707. Epub 2021 Aug 24.

Center of Infectious Diseases, Sichuan University West China Hospital, Chengdu, China.

Aim: This study is aimed at the characteristics of glucose metabolism and islet cell function evaluated by the homeostasis model assessment of cell function (HOMA-) value and its risk factors in chronic hepatitis B (CHB) patients.

Method: This cross-sectional study recruited 110 CHB patients (CHB group) and 110 patients without hepatitis B virus (non-HBV group); the groups were matched according to sex, age, and body mass index under the same glucose metabolism status. The risk factors, characteristics, and differences in glucose metabolism and HOMA- values between the two groups were analyzed.

Results: The abnormal glucose metabolism rate was higher in CHB patients with liver cirrhosis (LC) or hepatitis B envelope antigen (HBeAg) (-) status. In addition, under the same glucose metabolism status, the fasting plasma glucose (FPG) levels and 2-hour postprandial plasma glucose (2h-PG) levels in the CHB group were higher, while the HOMA- values were significantly lower and the homeostasis model assessment of insulin resistance (HOMA-IR) value was not higher than that in the non-HBV group (all < 0.0001). Further analyses revealed that the main risk factors for abnormal glucose metabolism were HBeAg (-) status and hepatitis B envelope antibody levels. But HBV serological and virological indicators had no effects on the HOMA- values.

Conclusion: Islet cell function in patients with CHB was compromised, which is closely associated with fasting and postprandial hyperglycemia in chronic hepatitis B patients. Further research should be done to verify the compromised islet cell function and then to investigate the mechanisms behind the effect of hepatitis B virus infection on islet cell function in CHB patients.
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http://dx.doi.org/10.1155/2021/1264707DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8421157PMC
August 2021

Case Report: A Novel Homozygous Variant Identified in a Chinese Patient With Benign Recurrent Intrahepatic Cholestasis-Type 1.

Front Med (Lausanne) 2021 18;8:705489. Epub 2021 Aug 18.

Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, China.

Benign recurrent intrahepatic cholestasis (BRIC) is a rare hereditary cholestatic liver disorder. Accurate diagnosis and timely interventions are important in determining outcomes. Besides clinical and pathologic diagnosis, genetic study of BRIC remains limited. Here, we report a young man enduring recurrent jaundice and severe pruritus for 15 years. The increased level of direct bilirubin was the main biochemical abnormality, and the work-up for common causes of jaundice were unremarkable. Liver biopsy showed extensive cholestasis of hepatocytes in zone 3. The novel homozygous variant including > and was detected on his gene. The patient was finally diagnosed with BRIC-1. His symptoms were relieved, and liver function tests returned to normal after taking ursodeoxycholic acid. This case provides a different perspective to the methodology employed when dealing with cases of jaundice and helping diagnose rare diseases.
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http://dx.doi.org/10.3389/fmed.2021.705489DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8416249PMC
August 2021

EZH2 promotes the expression of LPA1 by mediating microRNA-139 promoter methylation to accelerate the development of ovarian cancer.

Cancer Cell Int 2020 Nov 16;20(1):551. Epub 2020 Nov 16.

Department of Gynecology, The Maternal and Child Health Hospital of Hunan Province, Changsha, 410000, People's Republic of China.

Background: It has been known that ovarian cancer (OC) is a leading cause for women mortality globally. We aimed to analyze the underlying mechanism supporting that enhancer of zeste homolog 2 (EZH2) affected the development of OC via the involvement of microRNA-139 (miR-139)/transforming growth factor beta (TGF-β)/lysophosphatidic acid-1 (LPA1) axis.

Methods: High expression patterns of EZH2 and miR-139 and low LPA1 expression pattern in OC were evaluated using RT-qPCR and immunoblotting, while their correlation was assessed by the Spearman's rank and Pearson's correlation coefficient. Subsequently, dual-luciferase reporter gene assay was applied to validate the binding relationship between miR-139 and LPA1, while H3K27me enrichment was assessed by ChIP assay. After that, the effects of altered expression of EZH2, miR-194, or LPA1 on the cell biological functions and the expression pattern of TGF-related factors were evaluated.

Results: We found that EZH2 repressed the miR-139 expression pattern by recruiting H3K27me3 to promote miR-139 promoter methylation, while silencing of EZH2 suppressed in vitro cancer progression by increasing miR-139. LPA1 was a target of miR-139, and could activate the TGF-β signaling pathway, which hastened the OC progression. miR-139-targeted inhibition of LPA1 and LPA1-activated TGF-β signaling pathway were evidenced to be critical mechanisms underlying the effects of EZH2 on OC cells. Lastly, silencing of EZH2 inhibited the xenograft growth in vivo.

Conclusions: EZH2 could down-regulate miR-139 expression pattern by recruiting H3K27me3 to promote the miR-139 promoter methylation and activate the TGF-β pathway by up-regulating LPA1, which contributed to the progression of OC. The current study may possess potentials for OC treatment.
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http://dx.doi.org/10.1186/s12935-020-01622-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7670614PMC
November 2020

Molecular Biomarkers in Drug-Induced Liver Injury: Challenges and Future Perspectives.

Front Pharmacol 2019 30;10:1667. Epub 2020 Jan 30.

Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, China.

Drug-induced liver injury (DILI) is one among the common adverse drug reactions and the leading causes of drug development attritions, black box warnings, and post-marketing withdrawals. Despite having relatively low clinical incidence, its potentially severe adverse events should be considered in the individual patients due to the high risk of acute liver failure. Although traditional liver parameters have been applied to the diagnosis of DILI, the lack of specific and sensitive biomarkers poses a major limitation, and thus accurate prediction of the subsequent clinical course remains a significant challenge. These drawbacks prompt the investigation and discovery of more effective biomarkers, which could lead to early detection of DILI, and improve its diagnosis and prognosis. Novel promising biomarkers include glutamate dehydrogenase, keratin 18, sorbitol dehydrogenase, glutathione S-transferase, bile acids, cytochrome P450, osteopontin, high mobility group box-1 protein, fatty acid binding protein 1, cadherin 5, miR-122, genetic testing, and omics technologies, among others. Furthermore, several clinical scoring systems have gradually emerged for the diagnosis of DILI including the Roussel Uclaf Causality Assessment Method (RUCAM), Clinical Diagnostic Scale (CDS), and Digestive Disease Week Japan (DDW-J) systems. However, currently their predictive value is limited with certain inherent deficiencies. Thus, perhaps the greatest benefit would be achieved by simultaneously combining the scoring systems and those biomarkers. Herein, we summarized the recent research progress on molecular biomarkers for DILI to improved approaches for its diagnosis and clinical management.
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http://dx.doi.org/10.3389/fphar.2019.01667DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7002317PMC
January 2020

Present and Future Therapies for Chronic Hepatitis B.

Adv Exp Med Biol 2020 ;1179:137-186

Center of Infectious Diseases, Division of Infectious Diseases, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China.

Chronic hepatitis B (CHB) remains the leading cause of liver-related morbidity and mortality across the world. If left untreated, approximately one-third of these patients will progress to severe end-stage liver diseases including liver failure, cirrhosis, and hepatocellular carcinoma (HCC). High level of serum HBV DNA is strongly associated with the development of liver failure, cirrhosis, and HCC. Therefore, antiviral therapy is crucial for the clinical management of CHB. Current antiviral drugs including nucleoside/nucleotide analogues (NAs) and interferon-α (IFN-α) can suppress HBV replication and reduce the progression of liver disease, thus improving the long-term outcomes of CHB patients. This chapter will discuss the standard and optimization antiviral therapies in treatment-naïve and treatment-experienced patients, as well as in the special populations. The up-to-date advances in the development of new anti-HBV agents will be also discussed. With the combination of the current antiviral drugs and the newly developed antiviral agents targeting the different steps of the viral life cycle or the newly developed agents modulating the host immune responses, the ultimate eradication of HBV will be achieved in the future.
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http://dx.doi.org/10.1007/978-981-13-9151-4_6DOI Listing
November 2019

Autologous stem cell transplantation for patients with viral hepatitis-induced liver cirrhosis: a systematic review and meta-analysis.

Eur J Gastroenterol Hepatol 2019 Oct;31(10):1283-1291

Center of Infectious Diseases, West China Hospital of Sichuan University.

Background: Recently, stem cells have been used in the treatment of viral hepatitis-induced liver cirrhosis (LC), and stem cell therapy is showing potential therapeutic effects on liver function improvement. The consensus on effects and safety of stem cell therapy has not been reached, thus it is essential for us to conduct a systematic review and meat-analysis to investigate the efficacy and safety of stem cell therapy for viral hepatitis-induced LC.

Materials And Methods: Medline, Embase, SinoMed and Cochrane Library databases were searched with appropriate keywords through 5 August 2018. We included eight trials involving 467 patients. The pooled weight mean difference (WMD) and 95% confidence interval (CI) were calculated using a fixed or random effects model. Quality assessment and publication bias were also performed. The selected studies were considered for meta-analysis using RevMan V5.3.

Results: Compared with traditional therapy group, autologous stem cell transplantation increased the level of albumin (WMD: 2.47, 95% CI: 1.05-3.90, P < 0.001), but decreased the level of total bilirubin (WMD: -2.26, 95% CI: -3.61 to -0.90, P = 0.001), alanine aminotransferase (WMD: -9.16, 95% CI: -16.47 to -1.85, P = 0.01) and prothrombin time (WMD: -3.02, 95% CI: -4.83 to -1.22, P = 0.001). Clinical symptoms such as edema, fatigue, anorexia and abdominal distention were alleviated. Model for End-Stage Liver Disease and Child-Pugh scores were decreased after stem cell therapy. Whereas, there was no statistically significant difference between two groups regarding aspartate aminotransferase, prothrombin time activity, ascites and pleural fluid. No procedure-related complications were found.

Conclusion: Autologous stem cell transplantation might have beneficial effects on patients with viral hepatitis-induced LC and is relatively safe for these patients. Further high-quality randomized controlled trials are needed.
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http://dx.doi.org/10.1097/MEG.0000000000001455DOI Listing
October 2019

IVIM improves preoperative assessment of microvascular invasion in HCC.

Eur Radiol 2019 Oct 15;29(10):5403-5414. Epub 2019 Mar 15.

Department of Radiology, West China Hospital, Sichuan University, Chengdu, 610041, China.

Purpose: To prospectively evaluate the potential role of intravoxel incoherent motion (IVIM) and conventional radiologic features for preoperative prediction of microvascular invasion (MVI) in patients with hepatocellular carcinoma (HCC).

Methods: Institutional review board approval and written informed consent were obtained for this study. A cohort comprising 115 patients with 135 newly diagnosed HCCs between January 2016 and April 2017 were evaluated. Two radiologists independently reviewed the radiologic features and the apparent diffusion coefficient (ADC), true diffusion coefficient (D), pseudodiffusion coefficient (D*), and pseudodiffusion component fraction (f) were also measured. Interobserver agreement was checked and univariate and multivariate logistic regressions were used for screening the risk factors. Receiver operating characteristics (ROC) curve analyses were performed to evaluate the diagnostic performance.

Results: Features significantly related to MVI of HCC at univariate analysis were reduced ADC (odds ratio, 0.341; 95% CI, 0.211-0.552; p < 0.001), D (odds ratio, 0.141; 95% CI, 0.067-0.299; p < 0.001), and irregular circumferential enhancement (odds ratio, 9.908; 95% CI, 3.776-25.996; p < 0.001). At multivariate analysis, only D value (odds ratio, 0.096; 95% CI, 0.025-0.364; p < 0.001) was the independent risk factor for MVI of HCC. The mean D value for MVI of HCC showed an area under ROC curves of 0.815 (95% CI, 0.740-0.877).

Conclusion: IVIM model-derived D value is superior to ADC measured with mono-exponential model for evaluating the MVI of HCC. Among MR imaging features, tumor margin, enhancement pattern, tumor capsule, and peritumoral enhancement were not predictive for MVI.

Key Points: • Diffusion MRI is useful for non-invasively evaluating the microvascular invasion of hepatocellular carcinoma. • IVIM model is advantageous over mono-exponential model for assessing the microvascular invasion of hepatocellular carcinoma. • Decreased D value was the independent risk factor for predicting MVI of HCC.
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http://dx.doi.org/10.1007/s00330-019-06088-wDOI Listing
October 2019

Quality assessment of clinical practice guidelines for infectious diseases in China.

J Evid Based Med 2018 May 21;11(2):95-100. Epub 2018 Feb 21.

Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu, Sichuan, PR China.

Aim: We aimed to appraise the quality of Chinese Society of Infectious Diseases of China Medical Association clinical practice guidelines (CPGs) for infectious diseases in China.

Methods: We performed the electronic search and hand search on the above-mentioned CPGs for infectious diseases published from January 1997 to October 2017. Each publication was evaluated using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument.

Results: Thirteen guidelines were identified and enrolled for the further evaluation. The median scores of the AGREE II domains across all 13 guidelines were as follows: scope and purpose 73.61% (36.11% to 84.72%), stakeholder involvement 12.50% (8.33% to 20.83%), rigor of development 19.27% (12.50% to 26.04%), clarity of presentation 86.11% (23.61% to 94.44%), applicability 33.33% (26.04% to 50.00%), and editorial independence 8.33% (4.17% to 16.67%). The clarity of presentation domain got the highest score among the six domains. Moreover, when compared the CPGs by the year of publication (2002 to 2006 vs. 2007 to 2017), the quality scores were higher in the CPGs published in the last 10 years than those published before, but with no significant difference.

Conclusions: The quality score of CPGs for infectious diseases in China from January 1997 to October 2017 was moderate, but had significant shortcomings, especially in the stakeholder involvement and editorial independence domains. However, the AGREE II instrument is useful and feasible for appraising the CPGs and should be applied to develop, implement, and promote the CPGs in China.
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http://dx.doi.org/10.1111/jebm.12293DOI Listing
May 2018

Predicting the risk of postoperative liver failure and overall survival using liver and spleen stiffness measurements in patients with hepatocellular carcinoma.

Medicine (Baltimore) 2017 Aug;96(34):e7864

Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China.

Postoperative liver failure (PLF) is the primary cause of morbidity and mortality after hepatic resection for hepatocellular carcinoma (HCC). In this study, we evaluated the efficacy of liver stiffness (LS) and spleen stiffness (SS), as measured by transient elastography (TE), for predicting the risk of PLF and overall survival (OS) in these patients.This prospective cohort study included 54 patients diagnosed with HCC who underwent hepatic resection between March 2013 and March 2014. Preoperative measurement of LS and SS using TE was performed on all patients underwent. The predictivity of LS and SS for PLF was assessed by receiver operating characteristic curve analysis. OS according to LS and SS was analyzed using the Kaplan-Meier method and compared using the log-rank test.PLF developed in seven (12.96%) patients. LS was significantly higher in patients with than in those without PLF (P = .03). The area under the curve of LS for predicting PLF was 0.76 (95% confidence interval, 0.62-0.86; P = .02). However, there was no significant difference in SS between patients with and without PLF (P = .36). Moreover, patients with an LS <16.2 kPa had significantly better OS than those with an LS ≥16.2 kPa (P = .028). No significant difference in OS was observed between patients with an SS of <22.3 and ≥22.3 kPa (P = .378).LS measured by TE can be used to predict the risk of PLF as well as OS in patients with HCC who have undergone hepatic resection. However, SS obtained using TE was not found to be a significant predictor for PLF and OS in our patients.
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http://dx.doi.org/10.1097/MD.0000000000007864DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5572021PMC
August 2017

Controlled attenuation parameter for the detection of hepatic steatosis in patients with chronic hepatitis B.

Infect Dis (Lond) 2016 Sep 31;48(9):670-5. Epub 2016 May 31.

a Center of Infectious Diseases, West China Hospital, Sichuan University , Chengdu , PR China ;

Background: Controlled attenuation parameter (CAP) is a non-invasive method for diagnosing liver steatosis based on vibration-controlled transient elastography. The primary objective of this study was to assess CAP performance and determine the cut-off values for the diagnosis of hepatic steatosis in patients with chronic hepatitis B (CHB) using liver biopsy as a gold standard. The second objective was to apply the cut-off values found in the first cohort to a larger cohort to compare the performance of CAP and ultrasonography.

Methods: Overall, 189 patients with CHB who underwent liver biopsy and CAP detection and 1707 patients with CHB and CAP who underwent abdominal ultrasonography were prospectively enrolled. The performance of CAP for evaluating hepatic steatosis compared with liver biopsy was calculated using the area under the receiver operating characteristic curve (AUROC).

Results: In the 189 patients who underwent liver biopsy, the cut-offs for the CAP with steatosis S ≥ 1, S ≥ 2 and S ≥ 3 were 222 dB/m, 247 dB/m and 274 dB/m, respectively, and the AUROC were 0.88 (95% confidence interval [CI] = 0.82-0.95), 0.92 (95% CI = 0.87-0.97) and 0.94 (95% CI = 0.90-0.99), respectively. After applying the cut-offs above to the 1707 patients, it was found that CAP had a good concordance with abdominal ultrasonography with steatosis grade > S2. On multivariate analysis, body mass index (p < 0.001), triglyceride level (p < 0.001) and fasting glucose level (p = 0.001) were independent risk factors of CAP.

Conclusions: CAP had high diagnostic performance for evaluating hepatic steatosis in patients with CHB and had a good concordance with abdominal ultrasonography.
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http://dx.doi.org/10.3109/23744235.2016.1165860DOI Listing
September 2016

Tenascin-C expression is associated with poor prognosis in hepatocellular carcinoma (HCC) patients and the inflammatory cytokine TNF-α-induced TNC expression promotes migration in HCC cells.

Am J Cancer Res 2015 15;5(2):782-91. Epub 2015 Jan 15.

Center of Infectious Diseases, West China Hospital, Sichuan University Chengdu 610041, China ; Division of Infectious Diseases, State Key Laboratory of Biotherapy, Sichuan University Chengdu 610041, China.

Although tenascin-c (TNC) in inflammatory microenvironment contributes to progression in some tumors, its role in hepatocellular carcinoma (HCC) in metastasis and the mechanism by which TNC expression is regulated in HCC cells are elusive. In this study, we examined TNC expression in 100 HCC tissue samples by immunohistochemistry and compared which between the groups with or without metastasis. TNC expression was higher in metastatic HCC tissues than that in the non-metastatic HCC tissues, which was associated with the Knodell inflammation scores. Importantly, high level of TNC expression was associated with lower survival rate and shorter survival time in the HCC patients. We then investigated the mechanism by which TNC expression is regulated in HCC cells with an in vitro cell culture system. The recombinant TNF-α and conditioned medium from macrophages induced TNC expression at both mRNA and protein levels in HepG2 cells. The induction of TNC expression by conditioned medium from macrophages was suppressed by a TNF-α neutralizing antibody. TNF-α-promoted cell migration was inhibited by a TNC siRNA. In addition, TNF-α-induced TNC expression was blocked by a NF-κB pathway inhibitor. These results suggest that TNF-α in the tumor microenvironment induces TNC expression in HCC cells through the NF-κB pathway, which in turn, promotes HCC cell migration. Thus, TNC may play an important role in promoting HCC metastasis and TNC expression could be a predictive factor for poor prognosis in HCC patients.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4396033PMC
May 2015

Spindle-like abdominal wall-lifting device in gasless laparoscopic surgery in animal experiments.

Minim Invasive Ther Allied Technol 2014 Dec 13;23(6):357-60. Epub 2014 Oct 13.

Department of General Surgery, The People's Hospital of Guangxi Zhuang Autonomous Region , Nanning City, Guangxi Zhuang Autonomous Region , China.

Introduction: CO2 pneumoperitoneum has been used to establish an operation space in laparoscopic surgery. It may have some bad consequences, such as respiratory and circulatory system changes, hypotension and hypoxia in infants and the release of free tumor cells into the abdominal cavity. Gasless laparoscopic technique can avoid these adverse effects. But present gasless laparoscopic techniques have their own disadvantages. The main shortcoming of gasless laparoscopic techniques is inadequate operative space.

Material And Methods: We herein describe a new technique. We used a self-designed spindle-like abdominal wall-lifting device to perform gasless laparoscopic cholecystectomy in seven pigs, recording the operation time, bleeding volume and unexpected occurrences during the operation.

Results: Seven pigs underwent laparoscopic cholecystectomy using this technique with no conversion to open operation. The operation time was between 21 minutes and 65 minutes, with a mean operative time of 42.5 minutes. The range of bleeding volumes was 2 ml to 8 ml, with a mean operative bleeding volume of 4.3 ml. There were no massive hemorrhages, internal organ injuries or other complications during the operation.

Conclusions: These preliminary outcomes indicate that the spindle-like abdominal wall-lifting device is feasible and safe in gasless laparoscopic cholecystectomy, which can provide sufficient exposure of the operative filed.
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http://dx.doi.org/10.3109/13645706.2014.900508DOI Listing
December 2014
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