Displaying publications 1 - 20 of 421 in total

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  1. Yang P, Chen Y, Huang Z, Xia H, Cheng L, Wu H, et al.
    Elife, 2022 Oct 06;11.
    PMID: 36200862 DOI: 10.7554/eLife.80127
    Despite the importance of innate immunity in invertebrates, the diversity and function of innate immune cells in invertebrates are largely unknown. Using single-cell RNA-seq, we identified prohemocytes, monocytic hemocytes, and granulocytes as the three major cell-types in the white shrimp hemolymph. Our results identified a novel macrophage-like subset called monocytic hemocytes 2 (MH2) defined by the expression of certain marker genes, including Nlrp3 and Casp1. This subtype of shrimp hemocytes is phagocytic and expresses markers that indicate some conservation with mammalian macrophages. Combined, our work resolves the heterogenicity of hemocytes in a very economically important aquatic species and identifies a novel innate immune cell subset that is likely a critical player in the immune responses of shrimp to threatening infectious diseases affecting this industry.
  2. Soh HY, Zhang WB, Yu Y, Zhang R, Chen Y, Gao Y, et al.
    World J Clin Cases, 2023 Mar 16;11(8):1878-1887.
    PMID: 36970007 DOI: 10.12998/wjcc.v11.i8.1878
    BACKGROUND: Sclerosing odontogenic carcinoma is a rare primary intraosseous neoplasm that was featured recently as a single entity in the World Health Organization classification of Head and Neck Tumors 2017, with only 14 cases published to date. The biological characteristics of sclerosing odontogenic carcinoma remain indistinct because of its rarity; however, it appears to be locally aggressive, with no regional or distant metastasis reported to date.

    CASE SUMMARY: We reported a case of sclerosing odontogenic carcinoma of the maxilla in a 62-year-old woman, who presented with an indolent right palatal swelling, which progressively increased in size over 7 years. Right subtotal maxillectomy with surgical margins of approximately 1.5 cm was performed. The patient remained disease free for 4 years following the ablation surgery. Diagnostic workups, treatment, and therapeutic outcomes were discussed.

    CONCLUSION: More cases are needed to further characterize this entity, understand its biological behavior, and justify the treatment protocols. Resection with wide margins of approximately 1.0 to 1.5 cm is proposed, while neck dissection, post-operative radiotherapy, or chemotherapy are deemed unnecessary.

  3. Su H, Kanchanatip E, Wang D, Zheng R, Huang Z, Chen Y, et al.
    Waste Manag, 2020 Feb 01;102:520-527.
    PMID: 31765972 DOI: 10.1016/j.wasman.2019.11.018
    In China, waste sorting practice is not strictly followed, plastics, especially food packaging, are commonly mixed in food waste. Supercritical water gasification (SCWG) of unsorted food waste was conducted in this study, using model unsorted food waste by mixture of pure food waste and plastic. Different operating parameters including reaction temperature, residence time, and feedstock concentration were investigated. Moreover, the effect of three representative food additives namely NaCl, NaHCO3 and Na2CO3 were tested in this work. Finally, comparative analysis about SCWG of unsorted food waste, pure food waste, and plastic was studied. It was found that higher reaction temperature, longer residence time and lower feedstock concentration were advantageous for SCWG of unsorted food waste. Within the range of operating parameters in this study, when the feedstock concentration was 5 wt%, the highest H2 yield (7.69 mol/kg), H2 selectivity (82.11%), total gas yield (17.05 mol/kg), and efficiencies of SCWG (cold gas efficiency, gasification efficiency, carbon gasification efficiency, and hydrogen gasification efficiency) were obtained at 480 °C for 75 min. Also, the addition of food additives with Na+ promoted the SCWG of unsorted food waste. The Na2CO3 showed the best catalytic performance on enhancement of H2 and syngas production. This research demonstrated the positive effect of waste sorting on the SCWG of food waste, and provided novel results and information that help to overcome the problems in the process of food waste treatment and accelerate the industrial application of SCWG technology in the future.
  4. Ge F, Guo R, Liang Y, Chen Y, Shao H, Sung YY, et al.
    Virus Res, 2023 Oct 15;336:199226.
    PMID: 37739268 DOI: 10.1016/j.virusres.2023.199226
    Stutzerimonas stutzeri is an opportunistic pathogenic bacterium belonging to the Gammaproteobacteria, exhibiting wide distribution in the environment and playing significant ecological roles such as nitrogen fixation or pollutant degradation. Despite its ecological importance, only two S. stutzeri phages have been isolated to date. Here, a novel S. stutzeri phage, vB_PstS_ZQG1, was isolated from the surface seawater of Qingdao, China. Transmission electron microscopy analysis indicates that vB_PstS_ZQG1 has a morphology characterized by a long non-contractile tail. The genomic sequence of vB_PstS_ZQG1 contains a linear, double-strand 61,790-bp with the G+C content of 53.24% and encodes 90 putative open reading frames. Two auxiliary metabolic genes encoding TolA protein and nucleotide pyrophosphohydrolase were identified, which are likely involved in host adaptation and phage reproduction. Phylogenetic and comparative genomic analyses demonstrated that vB_PstS_ZQG1 exhibits low similarity with previously isolated phages or uncultured viruses (average nucleotide identity values range from 21.7 to 29.4), suggesting that it represents a novel viral genus by itself, here named as Fuevirus. Biogeographic analysis showed that vB_PstS_ZQG1 was only detected in epipelagic and mesopelagic zone with low abundance. In summary, our findings of the phage vB_PstS_ZQG1 will provide helpful insights for further research on the interactions between S. stutzeri phages and their hosts, and contribute to discovering unknown viral sequences in the metagenomic database.
  5. Chen Y, Guo R, Liang Y, Luo L, Han Y, Wang H, et al.
    Virus Res, 2023 Sep;334:199183.
    PMID: 37499764 DOI: 10.1016/j.virusres.2023.199183
    Stutzerimonas stutzeri is an opportunistic pathogen widely distributed in the environment and displays diverse metabolic capabilities. In this study, a novel lytic S. stutzeri phage, named vB_PstM_ZRG1, was isolated from the seawater in the East China Sea (29°09'N, 123°39'E). vB_PstM_ZRG1 was stable at temperatures ranging from -20°C to 65°C and across a wide range of pH values from 3 to 10. The genome of vB_PstM_ZRG1 was determined to be a double-stranded DNA with a genome size of 52,767 bp, containing 78 putative open reading frames (ORFs). Three auxiliary metabolic genes encoded by phage vB_PstM_ZRG1 were predicted, including Toll/interleukin-1 receptor (TIR) domain, proline-alanine-alanine-arginine (PAAR) protein and SGNH (Ser-Gly-Asn-His) family hydrolase, especially TIR domain is not common in isolated phages. Phylogenic and network analysis showed that vB_PstM_ZRG1 has low similarity to other phage genomes in the GenBank and IMG/VR database, and might represent a novel viral genus, named Elithevirus. Additionally, the distribution map results indicated that vB_PstM_ZRG1 could infect both extreme colds- and warm-type hosts in the marine environment. In summary, our finding provided basic information for further research on the relationship between S. stutzeri and their phages, and expanded our understanding of genomic characteristics, phylogenetic diversity and distribution of Elithevirus.
  6. Zhou H, Liu L, Li R, Qin Y, Fang Q, Balasubramaniam VR, et al.
    Virol J, 2017 08 17;14(1):156.
    PMID: 28814340 DOI: 10.1186/s12985-017-0823-4
    BACKGROUND: Astroviruses (AstVs) have been reported to infect and cause gastroenteritis in most animal species. Human AstVs were regarded the causative agent of viral diarrhea in children. In dogs, little is known about the epidemiology and clinical significance of AstV infection.

    FINDINGS: In this study, we collected and tested 253 rectal swabs from pet dogs; of which 64 samples (25.3%) tested positive for AstVs with diarrhea and 15 more samples (5.9%) also was identified as AstVs, however without any clinical signs. Phylogenetic analysis of 39 partial ORF1b sequences from these samples revealed that they are similar to AstVs, which can be subdivided into three lineages. Interestingly, out of the 39 isolates sequenced, 16 isolates are shown to be in the Mamastrovirus 5/canine astrovirus (CAstV) lineage and the remaining 23 isolates displayed higher similarities with known porcine astrovirus (PoAstV) 5 and 2. Further, analysis of 13 capsid sequences from these isolates showed that they are closely clustered with Chinese or Italy CAstV isolates.

    CONCLUSIONS: The findings indicate that CAstVs commonly circulate in pet dogs, and our sequencing results have shown the genomic diversity of CAstVs leading to increasing number of clusters.

  7. Drummond MF, Augustovski F, Bhattacharyya D, Campbell J, Chaiyakanapruk N, Chen Y, et al.
    Value Health, 2022 Aug;25(8):1257-1267.
    PMID: 35931428 DOI: 10.1016/j.jval.2022.02.006
    Health technology assessment (HTA) has been growing in use over the past 40 years, especially in its impact on decisions regarding the reimbursement, adoption, and use of new drugs, devices, and procedures. In countries or jurisdictions with "pluralistic" healthcare systems, there are multiple payers or sectors, each of which could potentially benefit from HTA. Nevertheless, a single HTA, conducted centrally, may not meet the needs of these different actors, who may have different budgets, current standards of care, populations to serve, or decision-making processes. This article reports on the research conducted by an ISPOR Health Technology Assessment Council Working Group established to examine the specific challenges of conducting and using HTA in countries with pluralistic healthcare systems. The Group used its own knowledge and expertise, supplemented by a narrative literature review and survey of US payers, to identify existing challenges and any initiatives taken to address them. We recommend that countries with pluralistic healthcare systems establish a national focus for HTA, develop a uniform set of HTA methods guidelines, ensure that HTAs are produced in a timely fashion, facilitate the use of HTA in the local setting, and develop a framework to encourage transparency in HTA. These efforts can be enhanced by the development of good practice guidance from ISPOR or similar groups and increased training to facilitate local use of HTA.
  8. Lau YL, Cheong FW, Chin LC, Mahmud R, Chen Y, Fong MY
    Trop Biomed, 2014 Dec;31(4):749-59.
    PMID: 25776601 MyJurnal
    Malaria causes high global mortality and morbidity annually. Plasmodium knowlesi has been recognised as the fifth human Plasmodium sp. and its infection is widely distributed in Southeast Asia. Merozoite surface protein-119 (MSP-119) appears as a potential candidate for malaria blood stage vaccine as it could induce protective immunity. In this study, codon optimized P. knowlesi MSP-119 (pkMSP-119) was expressed and purified in yeast Pichia pastoris expression system. The purified recombinant protein was further evaluated using Western blot assay using knowlesi malaria, non-knowlesi human malaria, non-malarial parasitic infections and healthy serum samples (n = 50). The sensitivity of purified pkMSP-119 towards detection of knowlesi infection was as 28.6% (2/7). pkMSP-119 did not react with all non-malarial parasitic infections and healthy donor sera, yet reacted with some non-knowlesi human malaria sera, therefore lead to a specificity of 86.0% (37/43).
  9. Tan AA, Azman SN, Abdul Rani NR, Kua BC, Sasidharan S, Kiew LV, et al.
    Trop Biomed, 2011 Dec;28(3):620-9.
    PMID: 22433892 MyJurnal
    There is a great diversity of protein samples types and origins, therefore the optimal procedure for each sample type must be determined empirically. In order to obtain a reproducible and complete sample presentation which view as many proteins as possible on the desired 2DE gel, it is critical to perform additional sample preparation steps to improve the quality of the final results, yet without selectively losing the proteins. To address this, we developed a general method that is suitable for diverse sample types based on phenolchloroform extraction method (represented by TRI reagent). This method was found to yield good results when used to analyze human breast cancer cell line (MCF-7), Vibrio cholerae, Cryptocaryon irritans cyst and liver abscess fat tissue. These types represent cell line, bacteria, parasite cyst and pus respectively. For each type of samples, several attempts were made to methodically compare protein isolation methods using TRI-reagent Kit, EasyBlue Kit, PRO-PREP™ Protein Extraction Solution and lysis buffer. The most useful protocol allows the extraction and separation of a wide diversity of protein samples that is reproducible among repeated experiments. Our results demonstrated that the modified TRI-reagent Kit had the highest protein yield as well as the greatest number of total proteins spots count for all type of samples. Distinctive differences in spot patterns were also observed in the 2DE gel of different extraction methods used for each type of sample.
  10. Yap SF, Wong PW, Chen YC, Rosmawati M
    PMID: 12118437
    A retrospective study was carried out to determine the frequency of the pre-core stop codon mutant virus in a group of chronic hepatitis B carriers: 81 cases were considered [33 hepatits B e antigen (HBe) positive and 48 HBe negative]. All of the HBe positive cases had detectable viral DNA by hybridization analysis; in the case of the HBe negative cases, one third had detectable viral DNA by hybridization analysis and two thirds had HBV DNA detectable by polymerase chain reaction (PCR) amplification. Pre-core stop codon mutant detection was carried out on all specimens using allele-specific oligonucleotide hybridization following PCR amplification of the target sequence. The pre-core mutant was detected in 13/33 (39.4%) of HBe positive cases and in 32/48 (66.7%) of HBe negative cases. Sequence analysis was carried out on 8 of the 16 HBe negative specimens that did not carry the pre-core mutant virus to determine the molecular basis for the HBe minus phenotype in these cases: the 1762/1764 TA paired mutation in the second AT rich region of the core promoter was detected in five cases; a start codon mutation was detected in one case. The predominant mutation resulting in the HBe minus phenotype in our isolates was the 1896A pre-core ("pre-core stop codon") mutation; other mutations responsible for the phenotype included the core promoter paired mutation and pre-core start codon mutation. In view of the high frequency of the pre-core mutant virus, sequence analysis was performed to determine the virus genotype on the basis of the nucleotide sequence of codon 15. The sequences of 21 wild type virus (14 HBe positive and 7 HBe negative cases) were examined: 15 were found to be codon 15 CCT variants (71.4%); the frequency in the HBe positive group was 12/14 (85.7%), while that in the HBe negative group was 3/7 (42.9%). The high frequency of the codon 15 CCT variant in association with the frequent occurrence of the pre-core mutant in our isolates concurs with the results of other studies.
  11. Chen YP, Sudderuddin KI
    PMID: 749224
    Toxicity tests carried out on the larvae of A. aegypti and C. quinquefasciatus showed the former to be more tolerant of all insecticides tested, the order of toxicity being temephos greater than DDT greater than DDVP greater than malathion greater than lindane greater than carbaryl; also the second instar larvae of A. aegypti were more susceptible than fourth instar larvae. Enzyme kinetic studies on the total non-specific esterases and CarEs of adults and larvae of both species showed the Km values for total esterases of adult A. aegypti to be 0.333 mM vs 0.233 mM for C. quinquefasciatus; for adult CarEs it was 0.250 mM vs 0.220 mM. For total larval esterases of A. aegypti it was 0.112 mM vs 0.175 mM for C. quinquefasciatus: and for larval CarES it was 0.159 mM vs 0.213 mM respectively. Although some correlation between in vivo toxicity (LD50 values) and in vitro esterase inhibition (I50 values) between species could be discerned, overall correlation could not be established.
  12. Yi X, Yin S, Huang L, Li H, Wang Y, Wang Q, et al.
    Sci Total Environ, 2021 Jun 01;771:144644.
    PMID: 33736175 DOI: 10.1016/j.scitotenv.2020.144644
    Chlorine radical plays an important role in the formation of ozone and secondary aerosols in the troposphere. It is hence important to develop comprehensive emissions inventory of chlorine precursors in order to enhance our understanding of the role of chlorine chemistry in ozone and secondary pollution issues. Based on a bottom-up methodology, this study presents a comprehensive emission inventory for major atomic chlorine precursors in the Yangtze River Delta (YRD) region of China for the year 2017. Four primary chlorine precursors are considered in this study: hydrogen chloride (HCl), fine particulate chloride (Cl-) (Cl- in PM2.5), chlorine gas (Cl2), and hypochlorous acid (HClO) with emissions estimated for twelve source categories. The total emissions of these four species in the YRD region are estimated to be 20,424 t, 15,719 t, 1556 and 9331 t, respectively. The emissions of HCl are substantial, with major emissions from biomass burning and coal combustion, together accounting for 68% of the total HCl emissions. Fine particulate Cl- is mainly emitted from industrial processing, biomass burning and waste incineration. The emissions of Cl2 and HClO are mainly associated with usage of chlorine-containing disinfectants, for example, water treatment, wastewater treatment, and swimming pools. Emissions of each chlorine precursor are spatially allocated based on the characteristics of individual source category. This study provides important basic dataset for further studies with respect to the effects of chlorine chemistry on the formation of air pollution complex in the YRD region.
  13. He Q, Shahabi H, Shirzadi A, Li S, Chen W, Wang N, et al.
    Sci Total Environ, 2019 May 01;663:1-15.
    PMID: 30708212 DOI: 10.1016/j.scitotenv.2019.01.329
    Landslides are major hazards for human activities often causing great damage to human lives and infrastructure. Therefore, the main aim of the present study is to evaluate and compare three machine learning algorithms (MLAs) including Naïve Bayes (NB), radial basis function (RBF) Classifier, and RBF Network for landslide susceptibility mapping (LSM) at Longhai area in China. A total of 14 landslide conditioning factors were obtained from various data sources, then the frequency ratio (FR) and support vector machine (SVM) methods were used for the correlation and selection the most important factors for modelling process, respectively. Subsequently, the resulting three models were validated and compared using some statistical metrics including area under the receiver operating characteristics (AUROC) curve, and Friedman and Wilcoxon signed-rank tests The results indicated that the RBF Classifier model had the highest goodness-of-fit and performance based on the training and validation datasets. The results concluded that the RBF Classifier model outperformed and outclassed (AUROC = 0.881), the NB (AUROC = 0.872) and the RBF Network (AUROC = 0.854) models. The obtained results pointed out that the RBF Classifier model is a promising method for spatial prediction of landslide over the world.
  14. Cui J, Cui J, Peng Y, Yao D, Chan A, Chen Z, et al.
    Sci Total Environ, 2020 Jun 27;744:140558.
    PMID: 32711301 DOI: 10.1016/j.scitotenv.2020.140558
    Fluxes and composition dynamics of atmospheric nitrogen deposition play key roles in better balancing economic development and ecological environment. However, there are some knowledge gaps and difficulties in urban ecosystems, especially for small and medium-sized cities. In this study, both flux and composition (ratio of NH4+-N to NO3--N, RN) of wet-deposited dissolved inorganic nitrogen (DIN, sum of NO3--N and NH4+-N) were estimated and sources were identified at a long-term urban observation station in Tongling, a typical medium-sized city in eastern China during 2010-2016, respectively. Results showed that wet-deposited DIN fluxes were 33.20 and 28.15 kgN ha-1 yr-1 in Tongling city during 2010-2011 and 2015-2016, respectively. Compared to these two periods, both DIN and NO3--N fluxes decreased by 15.2% and 31.8% for a series of NOx abatement measures applied effectively, respectively. At the same time, the NH4+-N flux remained stable and ranged from 19.53 to 20.62 kgN ha-1 yr-1, and the RN increased from 1.7 to 2.2. Seasonally, winds from the southwest and west-southwest with higher frequencies and speeds in spring and summer brought more NH4+-N and DIN wet deposition from an ammonia plant, which could threaten the safety of regional hydrosphere ecosystems. On the whole, the wet-deposited NH4+-N was threatening regional ecosystems of both the hydrosphere and forest. The wet-deposited DIN including NH4+-N in Tongling city stemmed mainly from a combined source of coal combustion and dust from Cu extraction and smelting, ammonia production, and roads. Therefore, production lines should be updated for Cu extraction and smelting industries, thermal power generations and the ammonia plant, old vehicles should be eliminated, and the use of new energy vehicles should be promoted for regional sustainable development and human health in the medium-sized city.
  15. Suyamud B, Chen Y, Quyen DTT, Dong Z, Zhao C, Hu J
    Sci Total Environ, 2024 Jan 10;907:167942.
    PMID: 37863226 DOI: 10.1016/j.scitotenv.2023.167942
    Aquaculture is a highly important and expanding industry in Southeast Asia (SEA). An upcoming problem is the emergence of antibiotic resistant pathogens due to the unchecked use of antibiotics and human clinical practices. This review focused insight into the occurrence of antimicrobial resistance (AMR) and strategies from SEA aquaculture based on the original research publication over the period 2002 to 2023. Amongst the 11 SEA countries, the most AMR report has come from Vietnam, Malaysia, and Thailand, respectively. The AMR found in SEA aquaculture were classified into 17 drug classes. The most reported AMR are aminoglycosides, beta-lactams, (fluoro)quinolones, tetracycline, sulpha group and multi-drug. Beta-lactams, tetracycline, sulpha group are reported in each country with the reported frequencies higher than 40 %. Escherichia coli, Aeromonas and Vibrio are the most widely and frequently reported ARB in SEA aquaculture. Multiple antibiotic resistance (MAR) indexes for the sample containing multiple bacterial isolates were generally low, while the medium numbers of MAR indexes for the typical bacteria species were higher than 0.2 and showed higher MAR levels than the global mean. Most of the detected ARGs are related to beta-lactams, tetracycline, sulpha group, and aminoglycosides. Amongst the beta-lactam resistance genes, blaTEM, and blaSHV are the most frequently detected. Almost all the available information of antibiotics, ARB and ARGs in SEA aquaculture was consistent with the global scale analysis. In addition, factors that contribute to the development and spread of AMR in SEA aquaculture were discussed. Moreover, the national action plan to combat AMR in SEA countries and the available technologies that already applied in the SEA aquaculture are also included in this review. Such findings underline the need for synergistic efforts from scientists, engineers, policy makers, government managers, entrepreneurs, and communities to manage and reduce the burden of AMR in aquaculture of SEA countries.
  16. Lin PA, Chen Y, Chaverra-Rodriguez D, Heu CC, Zainuddin NB, Sidhu JS, et al.
    New Phytol, 2021 04;230(2):793-803.
    PMID: 33459359 DOI: 10.1111/nph.17214
    Herbivore-induced plant volatiles (HIPVs) are widely recognized as an ecologically important defensive response of plants against herbivory. Although the induction of this 'cry for help' has been well documented, only a few studies have investigated the inhibition of HIPVs by herbivores and little is known about whether herbivores have evolved mechanisms to inhibit the release of HIPVs. To examine the role of herbivore effectors in modulating HIPVs and stomatal dynamics, we conducted series of experiments combining pharmacological, surgical, genetic (CRISPR-Cas9) and chemical (GC-MS analysis) approaches. We show that the salivary enzyme, glucose oxidase (GOX), secreted by the caterpillar Helicoverpa zea on leaves, causes stomatal closure in tomato (Solanum lycopersicum) within 5 min, and in both tomato and soybean (Glycine max) for at least 48 h. GOX also inhibits the emission of several HIPVs during feeding by H. zea, including (Z)-3-hexenol, (Z)-jasmone and (Z)-3-hexenyl acetate, which are important airborne signals in plant defenses. Our findings highlight a potential adaptive strategy where an insect herbivore inhibits plant airborne defenses during feeding by exploiting the association between stomatal dynamics and HIPV emission.
  17. Lin KH, Hsu HT, Teng TH, Lin PY, Ko CJ, Hsieh CE, et al.
    Malays J Pathol, 2017 Dec;39(3):289-291.
    PMID: 29279592
    BACKGROUND: Liver regeneration is dependent on the proliferation of hepatocytes. Hepatic progenitor cells are intra-hepatic precursor cells capable of differentiating into hepatocytes or biliary cells. Although liver progenitor cell proliferation during the regenerative process has been observed in animal models of severe liver injury, it has never been observed in vivo in humans because it is unethical to take multiple biopsy specimens for the purpose of studying the proliferation of liver progenitor cells and the roles they play in liver regeneration. Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is a staged procedure for inducing remnant liver hypertrophy so that major hepatectomy can be performed safely. This staged procedure allows for liver biopsy specimens to be taken before and after the liver begins to regenerate.

    CASE PRESENTATION: The liver progenitor cell proliferation is observed in a patient undergoing ALPPS for a metastatic hepatic tumour. Liver biopsy is acquired before and after ALPPS for the calculation of average number of liver progenitor cell under high magnification examination by stain of immunomarkers. This is the first in vivo evidence of growing liver progenitor cells demonstrated in a regenerating human liver.

  18. Huang Q, Zhao G, Chen Y, Wu P, Li S, Peng C, et al.
    J Urol, 2023 Jan;209(1):99-110.
    PMID: 36194169 DOI: 10.1097/JU.0000000000002952
    PURPOSE: We introduce an intrapericardial control technique using a robotic approach in the surgical treatment of renal tumor with level IV inferior vena cava thrombus to decrease the severe complications associated with cardiopulmonary bypass and deep hypothermic circulatory arrest.

    MATERIALS AND METHODS: Eight patients with level IV inferior vena cava thrombi not extending into the atrium underwent transabdominal-transdiaphragmatic robot-assisted inferior vena cava thrombectomy obviating cardiopulmonary bypass/deep hypothermic circulatory arrest (cardiopulmonary bypass-free group) by an expert team comprising urological, hepatobiliary, and cardiovascular surgeons. The central diaphragm tendon and pericardium were transabdominally dissected until the intrapericardial inferior vena cava were exposed and looped proximal to the cranial end of the thrombi under intraoperative ultrasound guidance. As controls, 14 patients who underwent robot-assisted inferior vena cava thrombectomy with cardiopulmonary bypass (cardiopulmonary bypass group) and 25 patients who underwent open thrombectomy with cardiopulmonary bypass/deep hypothermic circulatory arrest (cardiopulmonary bypass/deep hypothermic circulatory arrest group) were included. Clinicopathological, operative, and survival outcomes were retrospectively analyzed.

    RESULTS: Eight robot-assisted inferior vena cava thrombectomies were successfully performed without cardiopulmonary bypass, with 1 open conversion. The median operation time and first porta hepatis occlusion time were shorter, and estimated blood loss was lower in the cardiopulmonary bypass-free group as compared to the cardiopulmonary bypass group (540 vs 586.5 minutes, 16.5 vs 38.5. minutes, and 2,050 vs 3,500 mL, respectively). Severe complications (level IV-V) were also lower in the cardiopulmonary bypass-free group than in cardiopulmonary bypass and cardiopulmonary bypass/deep hypothermic circulatory arrest groups (25% vs 50% vs 40%). Oncologic outcomes were comparable among the 3 groups in short-term follow-up.

    CONCLUSIONS: Pure transabdominal-transdiaphragmatic robot-assisted inferior vena cava thrombectomy without cardiopulmonary bypass/deep hypothermic circulatory arrest represents as an alternative minimally invasive approach for selected level IV inferior vena cava thrombi.

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