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Objective To summarize the clinical characteristics, treatment regimen and clinical outcomes of infantile hepatic hemangioma (IHH) with high-output heart failure (HHF). Methods A retrospective analysis was conducted on 3 IHH infants with concomitant HHF admitted to the Children's Hospital of Chongqing Medical University during October 2020 and October 2023. The characteristics, treatment plans and efficacy were analyzed in the 3 cases. CNKI, WANFANG DATA, Chinese Medical Association Journal Full-text Database, and PubMed databases were retrieved to search domestic and foreign literature concerning the diseases, and the enrolled cases were analyzed and reviewed. Results Among the 3 infants, they were 1 male and 2 females, and aged 1 d, 19 d and 80 d, respectively. The main clinical symptoms were dyspnea and respiratory distress. All 3 patients rapidly progressed to respiratory failure, pulmonary hypertension and heart failure after admission. Diffuse IHH was diagnosed in 2 cases and focal IHH in 1 case. One case of diffuse IHH underwent percutaneous hepatic artery embolization, and the cardiopulmonary function recovered on the day of surgery, and the ventilator was removed. In the other 2 cases, propranolol combined with steroid medication was used, and the estimated right ventricular systolic pressure and E wave to A wave mitral flow ratio (E/A) were the most sensitive indicators in echocardiographic monitoring. There were 24 cases included in literature review, with 4 cases of treatment failure and death, 3 cases of remission, and 17 cases of complete recovery. Conclusion Propranolol combined with steroid medication and percutaneous hepatic artery embolization are effective in treating IHH complicated with HHF. Right ventricular systolic pressure and E/A during drug therapy might be early sensitive marker for the early evaluation of potential therapeutic effects of drugs.

Objective To develop a novel decellularized extracellular matrix (ECM) bioscaffold derived from human cirrhotic liver tissues and construct a 3-dimensional cell culture system using this bioscaffold material. Methods Clinical samples of cirrhotic liver tissues were collected from patients undergoing liver transplantation for hepatic cirrhosis. The cirrhotic liver tissues were cleansed, cut into small tissue blocks (5 mm×5 mm×5 mm), and agitated in deionized water and detergents to obtain decellularized cirrhotic liver scaffold. Human primary human hepatocytes (PHHs) were seeded into the prepared ECM scaffold and cultured continuously for 9 d. Histological studies of the seeded cells were performed to assess the cell engraftment, and qPCR was used to detect the expression of the liver-specific genes in the cultured cells. Results The cirrhotic liver tissue became transparent after decellularization, and HE staining and scanning electron microscopy showed no residual nuclei in the bioscaffold. Residual DNA identification showed that the scaffold material had a residue DNA level less than 10 ng/mg of the tissue. After 9 d of continuous culture in the ECM scaffold, the PHHs showed good engraftment as shown by HE staining; the results of qPCR showed that the cells cultured in this 3D culture system expressed higher levels of liver-specific genes as compared with the cells in conventional 2D culture. Conclusion We successfully construct decellularized ECM bioscaffold derived from human cirrhotic liver tissues and confirmed the feasibility of 3D cell culture using this new bioscaffold material.

Background: The presence of hepatic steatosis (HS) is a crucial histological parameter for evaluating the suitability of liver transplantation. However, to date, no studies have used contrast-enhanced ultrasonography (CEUS) to diagnose and grade HS in brain-dead donors. This study aimed to detect and quantify hepatic microcirculatory perfusion in brain-dead donors using CEUS and to assess the utility of CEUS in the diagnosis and grading of HS., Methods: This prospective study enrolled 88 livers from brain-dead donors (44 with HS and 44 without HS) aged ≥18 years between June 2020 and January 2024. The donors had a mean age of 45.42±9.59 years, and 70 were male (79.5%). CEUS was conducted on the livers of the brain-dead donors 24 h before organ procurement, and time-intensity curves were generated. The main measures included the arrival time, time-to-peak, peak intensity of the hepatic artery (PIHA), peak intensity of the portal vein (PIPV), and peak intensity of the liver parenchyma (PILP), and hepatorenal index (HRI). Logistic regression analyses were used to identify the significant factors associated with HS, and the areas under the curve (AUC) of the receiver operating characteristic curves were used to evaluate diagnostic performance., Results: The PIHA (P<0.001), PIPV (P<0.001), and PILP (P=0.001) were significantly shorter in the steatosis group than the non-steatosis group. The one-way analysis of variance revealed significant decreases in the PIHA (P<0.001), PIPV (P<0.001), and PILP (P<0.001) as HS grades increased. The multivariate regression analysis indicated that the PIHA was an independent factor for both HS [odds ratio (OR) =0.97, 95% confidence interval (CI): 0.94-0.99, P=0.01] and moderate-to-severe HS (OR =0.96, 95% CI: 0.93-0.99, P=0.009). The AUC values of the PIHA and HRI for diagnosing moderate-to-severe HS were 0.88 and 0.69, respectively. The optimal cut-off value of the PIHA for diagnosing moderate-to-severe HS was 173.04, with a sensitivity of 92.9% (13 of 14 livers), specificity of 68.9% (51 of 74 livers), and positive and negative predictive values of 36.1% and 98.1%, respectively., Conclusions: CEUS showed promising results in the diagnosis and grading of HS in brain-dead donors. The PIHA, a CEUS-derived parameter, could serve as a diagnostic tool for moderate-to-severe HS., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://qims.amegroups.com/article/view/10.21037/qims-24-1004/coif). The authors have no conflicts of interest to declare., (2025 AME Publishing Company. All rights reserved.)

Objective: To analyze the incidence trend and establish a model to predict the prognosis of hepatic malignant tumors in children (CHMTs)., Methods: We analyzed the incidence data of CHMTs from 1975 to 2018 from the Surveillance, Epidemiology, and End Results (SEER) database, and evaluated the incidence trends based on different demographic and pathological features. We also analyzed clinicopathologic data from 2000 to 2018 from the SEER database. Univariate and multivariate Cox regression analyses were performed to explore prognostic factors related to overall survival (OS). Then, we established nomograms based on independent predictors and verified them using receiver operating characteristic curves, calibration plots, and decision curve analysis plots., Results: The incidence of CHMTs increased significantly, from 0.1 per 100,000 in 1975 to 0.4 per 100,000 in 2018. Incidences among different races and genders were increasing and converging. The incidence of hepatoblastoma (HB) increased, while that of hepatocellular carcinoma (HCC) was relatively stable. The 1-, 3-, 5-, and 10-year OS rates were 86.2%, 77.5%, 74.2%, and 70.2%, respectively. Being Spanish-Hispanic-Latino, HB, surgery, and systemic therapy were independent predictors of longer OS, whereas regional and distant stages were independent predictors of shorter OS. Nomograms with good predictive ability and clinical utility were established to evaluate the prognosis of children with HB or HCC., Conclusion: The incidence of CHMTs is increasing, especially for HB and in younger children. This study identified independent predictors and developed nomograms that could provide a personalized and accurate prognosis for CHMTs., Competing Interests: None., (AJTR Copyright © 2022.)

Background/aims: The outcome of the Kasai operation remains unsatisfying. This study aims to evaluate the feasibility and effectiveness of primary LDLT on biliary atresia (BA) treatment for infant patients., Methodology: Fifty infant patients with BA who were treated in our center between Jan 2008-Jan 2011 were included. Seventeen of them received LDLT. Another 33 patients received Kasai operation as the first line treatment. All patients had no history of previous abdominal surgery. Records of these patients and the donors for LDLT were retrospectively reviewed., Results: The follow-up ranged from 12-48.5 months; 30 postoperative-day survival of the LDLT patients and Kasai patients were 82.4% and 81.8%, respectively (p=1). One-year survival of the two groups was 82.4% and 60.6% (p=0.200). Jaundice free rate of the patients who survived at least one month after the surgery was 100% vs. 70.4% of the LDLT group and Kasai group, respectively (p=0.035). Main cause of death in LDLT group was hepatic artery thrombosis and multiple organ dysfunction syndrome in the Kasai group., Conclusions: Primary LDLT is a safe and efficient management for infant patients with BA. It may serve as an alternative first line treatment for BA treatment with specific indications.

In this study, we demonstrated with mechanistic evidence that parthenolide, a sesquiterpene lactone, could antagonize paclitaxel-mediated NF-kappaB nuclear translocation and activation by selectively targeting I-kappaB kinase (IKK) activity. We also found that parthenolide could target IKK activity and then inhibit NF-kappaB; this promoted cytochrome c release and activation of caspases 3 and 9. Inhibition of caspase activity blocked the activation of caspase cascade, implying that the observed synergy was related to caspases 3 and 9 activation of parthenolide. In contrast, paclitaxel individually induced apoptosis via a pathway independent of the mitochondrial cytochrome c cascade. Finally, exposure to parthenolide resulted in the inhibition of several NF-kappaB transcript anti-apoptotic proteins such as c-IAP1 and Bcl-xl. These data strengthen the rationale for using parthenolide to decrease the apoptotic threshold via caspase-dependent processes for treatment of non-small cell lung cancer with paclitaxel chemoresistance.