Imperial College London

Professor Daqing Ma, MD, PhD

Faculty of MedicineDepartment of Surgery & Cancer

Professor of Anaesthesia
 
 
 
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Contact

 

+44 (0)20 3315 8495d.ma Website

 
 
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Assistant

 

Mr Faruq Noormohamed +44 (0)20 3315 8816

 
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Location

 

G3.44Chelsea and Westminster HospitalChelsea and Westminster Campus

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Summary

 

Publications

Publication Type
Year
to

318 results found

Wu L, Zhao H, Weng H, Ma Det al., 2019, Lasting effects of general anesthetics on the brain in the young and elderly: "mixed picture" of neurotoxicity, neuroprotection and cognitive impairment., J Anesth

General anesthetics are commonly used in major surgery. To achieve the depth of anesthesia for surgery, patients are being subjected to a variety of general anesthetics, alone or in combination. It has been long held an illusory concept that the general anesthesia is entirely reversible and that the central nervous system is returned to its pristine state once the anesthetic agent is eliminated from the active site. However, studies indicate that perturbation of the normal functioning of these targets may result in long-lasting desirable or undesirable effects. This review focuses on the impact of general anesthetic exposure to the brain and summarizes the molecular and cellular mechanisms by which general anesthetics may induce long-lasting undesirable effects when exposed at the developing stage of the brain. The vulnerability of aging brain to general anesthetics, specifically in the context of cognitive disorders and Alzheimer's disease pathogeneses are also discussed. Moreover, we will review emerging evidence regarding the neuroprotective property of xenon and anesthetic adjuvant dexmedetomidine in the immature and mature brains. In conclusion, "mixed picture" effects of general anesthetics should be well acknowledged and should be implemented into daily clinical practice for better patient outcome.

JOURNAL ARTICLE

Chen L, Zhao H, Alam A, Mi E, Eguchi S, Yao S, Ma Det al., 2019, Postoperative remote lung injury and its impact on surgical outcome., BMC Anesthesiol, Vol: 19

Postoperative remote lung injury is a complication following various surgeries and is associated with short and long-term mortality and morbidity. The release of proinflammatory cytokines, damage-associated molecular patterns such as high-mobility group box-1, nucleotide-biding oligomerization domain (NOD)-like receptor protein 3 and heat shock protein, and cell death signalling activation, trigger a systemic inflammatory response, which ultimately results in organ injury including lung injury. Except high financial burden, the outcome of patients developing postoperative remote lung injury is often not optimistic. Several risk factors had been classified to predict the occurrence of postoperative remote lung injury, while lung protective ventilation and other strategies may confer protective effect against it. Understanding the pathophysiology of this process will facilitate the design of novel therapeutic strategies and promote better outcomes of surgical patients. This review discusses the cause and pathology underlying postoperative remote lung injury. Risk factors, surgical outcomes and potential preventative/treatment strategies against postoperative remote lung injury are also addressed.

JOURNAL ARTICLE

Dong J, Zeng M, Ji N, Hao S, Zhou Y, Gao Z, Gu H, Zhang L, Ma D, Peng Y, Han Ret al., 2019, Impact of Anesthesia on Long-term Outcomes in Patients With Supratentorial High-grade Glioma Undergoing Tumor Resection: A Retrospective Cohort Study., J Neurosurg Anesthesiol

BACKGROUND: Intravenous and inhalational anesthesia might have different associations with long-term outcome in cancer patients, with reports of adverse effects of inhalation anesthesia. However, the effects of anesthesia in patients with high-grade glioma (HGG) are not known. METHODS: This study investigated 154 patients who received propofol and 140 patients who received sevoflurane for maintenance of anesthesia during HGG tumor resection. The primary outcomes were progression-free survival and overall survival. RESULTS: Median progression-free survival was 10 months (interquartile range [IQR], 6 to 18) versus 11 months (IQR 6 to 20; P=0.674), and median overall survival was 18 months (IQR, 11 to 39) versus 18 months (IQR, 10 to 44; P=0.759) in patients maintained with propofol and sevoflurane, respectively. Higher preoperative Karnofsky performance status and postoperative chemotherapy were associated with a reduced hazard of tumor progression or death, whereas higher age-adjusted Charlson comorbidity index and longer duration of anesthesia were associated with an increased hazard of progression or death. World Health Organization tumor classification IV and incomplete tumor resection were associated with an increased hazard of tumor progression but not death. Anesthesia maintenance with sevoflurane increased the risk of death in patients with Karnofsky performance status <80 compared with propofol (hazard ratio, 1.66; 95% confidence interval, 1.08-2.57; P=0.022). CONCLUSIONS: Compared with maintenance of anesthesia with propofol, sevoflurane did not worsen progression-free or overall survival in patients with HGG undergoing tumor resection. However, propofol might be beneficial in patients with poor preoperative Karnofsky performance status.

JOURNAL ARTICLE

Soni S, O'Dea KP, Tan YY, Cho K, Abe E, Romano R, Cui J, Ma D, Sarathchandra P, Wilson MR, Takata Met al., 2019, ATP redirects cytokine trafficking and promotes novel membrane TNF signaling via microvesicles., FASEB J

Cellular stress or injury induces release of endogenous danger signals such as ATP, which plays a central role in activating immune cells. ATP is essential for the release of nonclassically secreted cytokines such as IL-1β but, paradoxically, has been reported to inhibit the release of classically secreted cytokines such as TNF. Here, we reveal that ATP does switch off soluble TNF (17 kDa) release from LPS-treated macrophages, but rather than inhibiting the entire TNF secretion, ATP packages membrane TNF (26 kDa) within microvesicles (MVs). Secretion of membrane TNF within MVs bypasses the conventional endoplasmic reticulum- and Golgi transport-dependent pathway and is mediated by acid sphingomyelinase. These membrane TNF-carrying MVs are biologically more potent than soluble TNF in vivo, producing significant lung inflammation in mice. Thus, ATP critically alters TNF trafficking and secretion from macrophages, inducing novel unconventional membrane TNF signaling via MVs without direct cell-to-cell contact. These data have crucial implications for this key cytokine, particularly when therapeutically targeting TNF in acute inflammatory diseases.-Soni, S., O'Dea, K. P., Tan, Y. Y., Cho, K., Abe, E., Romano, R., Cui, J., Ma, D., Sarathchandra, P., Wilson, M. R., Takata, M. ATP redirects cytokine trafficking and promotes novel membrane TNF signaling via microvesicles.

JOURNAL ARTICLE

Sun Y-B, Zhao H, Mu D-L, Zhang W, Cui J, Wu L, Alam A, Wang D-X, Ma Det al., 2019, Dexmedetomidine inhibits astrocyte pyroptosis and subsequently protects the brain in in vitro and in vivo models of sepsis., Cell Death Dis, Vol: 10

Sepsis is life-threatening and often leads to acute brain damage. Dexmedetomidine, an α2-adrenoceptor agonist, has been reported to possess neuroprotective effects against various brain injury but underlying mechanisms remain elusive. In this study, in vitro and in vivo models of sepsis were used to explore the effects of dexmedetomidine on the inflammasome activity and its associated glia pyroptosis and neuronal death. In vitro, inflammasome activation and pyroptosis were found in astrocytes following lipopolysaccharide (LPS) exposure. Dexmedetomidine significantly alleviated astrocyte pyroptosis and inhibited histone release induced by LPS. In vivo, LPS treatment in rats promoted caspase-1 immunoreactivity in astrocytes and caused an increase in the release of pro-inflammatory cytokines of IL-1β and IL-18, resulting in neuronal injury, which was attenuated by dexmedetomidine; this neuroprotective effect was abolished by α2-adrenoceptor antagonist atipamezole. Dexmedetomidine significantly reduced the high mortality rate caused by LPS challenge. Our data demonstrated that dexmedetomidine may protect glia cells via reducing pyroptosis and subsequently protect neurons, all of which may preserve brain function and ultimately improve the outcome in sepsis.

JOURNAL ARTICLE

Li T, Chen L, Zhao H, Wu L, Masters J, Han C, Hirota K, Ma Det al., 2019, Both Bupivacaine and Levobupivacaine inhibit colon cancer cell growth but not melanoma cells in vitro, JOURNAL OF ANESTHESIA, Vol: 33, Pages: 17-25, ISSN: 0913-8668

JOURNAL ARTICLE

Perry NJS, Buggy D, Ma D, 2019, Can Anesthesia Influence Cancer Outcomes after Surgery?, JAMA Surgery, ISSN: 2168-6254

JOURNAL ARTICLE

Yu ZY, Geng J, Li ZQ, Sun YB, Wang SL, Masters J, Wang DX, Guo XY, Li M, Ma Det al., 2019, Dexmedetomidine enhances ropivacaine-induced sciatic nerve injury in diabetic rats, BRITISH JOURNAL OF ANAESTHESIA, Vol: 122, Pages: 141-149, ISSN: 0007-0912

JOURNAL ARTICLE

Ning J, Zhao H, Chen B, Mi EZ, Yang Z, Qing W, Lam KWJ, Yi B, Chen Q, Gu J, Ichim T, Bogin V, Lu K, Ma Det al., 2019, Argon Mitigates Impaired Wound Healing Process and Enhances Wound Healing In Vitro and In Vivo, THERANOSTICS, Vol: 9, Pages: 477-490, ISSN: 1838-7640

JOURNAL ARTICLE

Jin Z, Piazza O, Ma D, Scarpati G, De Robertis Eet al., 2019, Xenon anesthesia and beyond: pros and cons., Minerva Anestesiol, Vol: 85, Pages: 83-89

Xenon is a colorless and odorless noble gas, licensed for human use as an anesthetic gas as well as a radiological marker. The MAC of this gas is about 63% but xenon anesthesia is associated with fast recovery of cognitive function and cardiovascular stability. Nevertheless, postoperative nausea and vomiting (PONV) incidence for xenon anesthesia is very high. It has been reported that Xenon has cytoprotective effects that may have therapeutic values in both CNS protection, and in organ graft preservation. Currently, there are few studies about the effect of xenon on ischemia reperfusion injury of transplantable organs and insufficient clinical data upon its effect on intracranial and cerebral perfusion pressure. We shortly review the pros and cons of xenon as an anesthetic agent.

JOURNAL ARTICLE

Alam A, Hana Z, Jin Z, Suen KC, Ma Det al., 2018, Surgery, neuroinflammation and cognitive impairment, EBIOMEDICINE, Vol: 37, Pages: 547-556, ISSN: 2352-3964

JOURNAL ARTICLE

Ma J, Chen Q, Li J, Zhao H, Mi E, Chen Y, Yi B, Ning J, Ma D, Lu K, Gu Jet al., 2018, Dexmedetomidine-Mediated Prevention of Renal Ischemia-Reperfusion Injury Depends in Part on Cholinergic Anti-Inflammatory Mechanisms., Anesth Analg

BACKGROUND: Organ ischemia-reperfusion injury often induces local and systemic inflammatory responses, which in turn worsen organ injury. These inflammatory responses can be regulated by the central nervous system, particularly by the vagal nerve and nicotinic acetylcholine receptors, which are the key components of cholinergic anti-inflammatory pathway. Activation of the cholinergic anti-inflammatory pathway can suppress excessive inflammatory responses and be a potential strategy for prevention of ischemia-reperfusion injury of organs including the kidney. METHODS: Vagal nerve activity, plasma acetylcholine, catecholamine and inflammatory mediators, renal tissue injury, and cell death were measured in mice with bilateral renal ischemia/reperfusion with or without treatment with dexmedetomidine (Dex), an α2-adrenergic receptor agonist. RESULTS: Dex significantly increased the discharge frequency of the cervical vagal nerve by up to 142 Hz (mean) (P < .001), and preserved kidney gross morphology and structure and attenuated cell apoptosis after ischemia-reperfusion. Furthermore, Dex also significantly increased acetylcholine release to 135.8 pmol/L (median) when compared to that (84.7 pmol/L) in the sham group (P < .001) and reduced the levels of several inflammatory mediators induced by renal ischemia/reperfusion. All the effects were abolished by vagotomy, splenectomy, or combinative administration of atipamezole, an α2-adrenergic receptor antagonist. CONCLUSIONS: Our findings suggest that Dex provides renoprotection, at least in part, through anti-inflammatory effects of the parasympathetic nervous system activation in addition to its direct actions on α2-adrenergic receptors.

JOURNAL ARTICLE

Freeman J, Crowley PD, Foley AG, Gallagher HC, Iwasaki M, Ma D, Buggy DJet al., 2018, Effect of Perioperative Lidocaine and Cisplatin on Metastasis in a Murine Model of Breast Cancer Surgery, ANTICANCER RESEARCH, Vol: 38, Pages: 5599-5606, ISSN: 0250-7005

JOURNAL ARTICLE

Liang P, Xu Y, Lan F, Ma D, Li Ket al., 2018, Decreased Cerebral Blood Flow in Mesial Thalamus and Precuneus/PCC during Midazolam Induced Sedation Assessed with ASL, NEUROINFORMATICS, Vol: 16, Pages: 403-410, ISSN: 1539-2791

JOURNAL ARTICLE

Guo Y, Li Y, Zhang Y, Xu X, Zhao A, Zhang J, Li JV, Ma D, Jia W, Jiang Wet al., 2018, Postoperative Delirium Development Associated with Metabolic Alterations Following Hemi-Arthroplasty in Elderly

JOURNAL ARTICLE

Chang E, Wu L, Zhang J, Meng F, Soo CP, Ma Det al., 2018, Case series report on iatrogenic subglottic tracheal stenosis, British-Journal-of-Anaesthesia (BJA) Research Forum, Publisher: ELSEVIER SCI LTD, Pages: E18-E19, ISSN: 0007-0912

CONFERENCE PAPER

Zhang Y, Shan G-J, Zhang Y-X, Cao S-J, Zhu S-N, Li H-J, Ma D, Wang D-Xet al., 2018, Preoperative vitamin D deficiency increases the risk of postoperative cognitive dysfunction: a predefined exploratory sub-analysis, ACTA ANAESTHESIOLOGICA SCANDINAVICA, Vol: 62, Pages: 924-935, ISSN: 0001-5172

JOURNAL ARTICLE

Zhao H, Huang H, Alam A, Chen Q, Suen KC, Cui J, Sun Q, Ologunde R, Zhang W, Lian Q, Ma Det al., 2018, VEGF mitigates histone-induced pyroptosis in the remote liver injury associated with renal allograft ischemia-reperfusion injury in rats, AMERICAN JOURNAL OF TRANSPLANTATION, Vol: 18, Pages: 1890-1903, ISSN: 1600-6135

JOURNAL ARTICLE

Deng C-M, Ding T, Li S, Lei B, Xu M-J, Wang L, Xu S-C, Li X-Y, Ma D, Wang D-Xet al., 2018, Neuraxial Labour Analgesia is Associated with a Reduced Risk of Postpartum Depressive Symptoms: A Multicentre, Prospective Cohort Study

JOURNAL ARTICLE

Zhang D-F, Su X, Meng Z-T, Li H-L, Wang D-X, Li X-Y, Maze M, Ma Det al., 2018, Impact of Dexmedetomidine on Long-term Outcomes After Noncardiac Surgery in Elderly: 3-Year Follow-up of a Randomized Controlled Trial., Ann Surg

OBJECTIVES: The aim was to compare the long-term outcomes of low-dose dexmedetomidine versus placebo in a randomized controlled trial (ChiCTR-TRC-10000802). BACKGROUND: Low-dose dexmedetomidine infusion decreased delirium occurrence within 1 week after surgery in elderly admitted to the intensive care unit (ICU) after noncardiac surgery, but the long-term outcome of this intervention is unknown. METHODS: Patients or their family members were telephone-interviewed for a 3-year follow-up data collection of survival, cognitive function assessed with the modified Telephone Interview for Cognitive Status, and quality of life evaluated with the World Health Organization Quality of Life. RESULTS: Of the 700 patients, 23 (3.3%) were lost at 3-year follow-up. The 3-year overall survival was not statistically different between the dexmedetomidine and placebo groups [114 deaths vs 122/350; hazard ratio (HR) 0.87, 95% confidence interval (CI) 0.68-1.13, P = 0.303]. The survival rates at 6 months, 1 year, and 2 years were significantly higher in the dexmedetomidine than in the placebo group (rate difference of 5.2%, 5.3%, and 6.7% respectively; all P < 0.05). The remaining 98.4% (434/441) 3-year survivors, the dexmedetomidine group, had significantly better cognitive function (mean difference 4.7, 95% CI 3.8-5.6, P < 0.0001) and quality of life (physical domain: 13.6 [10.6-16.6]; psychological domain: 15.2 [12.5-18.0]; social relationship domain: 8.1 [5.5-10.7]; environment domain: 13.3 [10.9-15.7]; all P < 0.0001) than in the placebo group. CONCLUSIONS: For elderly admitted to ICU after noncardiac surgery, low-dose dexmedetomidine infusion did not significantly change 3-year overall survival, but increased survival up to 2 years, and improved cognitive function and quality of life in 3-year survivors.

JOURNAL ARTICLE

Sun Y, Zhao H, Wang D, Ma Det al., 2018, Dexmedetomidine alleviates LPS-induced pyroptosis in astrocytes in vitro, BJA Research Forum, Publisher: ELSEVIER SCI LTD, Pages: E8-E9, ISSN: 0007-0912

CONFERENCE PAPER

Zhao H, Chen Q, Alam A, Cui J, Suen KC, Soo AP, Eguchi S, Gu J, Ma Det al., 2018, The role of osteopontin in the progression of solid organ tumour, CELL DEATH & DISEASE, Vol: 9, ISSN: 2041-4889

JOURNAL ARTICLE

Zac H, Suha A, Azeem A, Daqing Met al., Ketamine: Old Drug but New Use for Neuropathic Pain, Translational Perioperative and Pain Medicine, Vol: 5

JOURNAL ARTICLE

Ciechanowicz S, Zhao H, Chen Q, Cui J, Mi E, Mi E, Lian Q, Ma Det al., 2018, Differential effects of sevoflurane on the metastatic potential and chemosensitivity of non-small-cell lung adenocarcinoma and renal cell carcinoma in vitro, BRITISH JOURNAL OF ANAESTHESIA, Vol: 120, Pages: 368-375, ISSN: 0007-0912

JOURNAL ARTICLE

Zhao H, Alam A, Soo AP, George AJT, Ma Det al., 2018, Ischemia-Reperfusion Injury Reduces Long Term Renal Graft Survival: Mechanism and Beyond, EBIOMEDICINE, Vol: 28, Pages: 31-42, ISSN: 2352-3964

JOURNAL ARTICLE

Wu Y, Wang X-N, Wang N, Han Y, Ma D, Lu Yet al., 2018, Regularity changes of the retinal nerve fiber layer and macular ganglion cell complex in patients with the amnestic mild cognitive impairment, INTERNATIONAL JOURNAL OF NEUROSCIENCE, Vol: 128, Pages: 849-853, ISSN: 0020-7454

JOURNAL ARTICLE

Zhang Y, Li H-J, Wang D-X, Jia H-Q, Sun X-D, Pan L-H, Ye Q-S, Ouyang W, Jia Z, Zhang F-X, Guo Y-Q, Ai Y-Q, Zhao B-J, Yang X-D, Zhang Q-G, Yin N, Tan H-Y, Liu Z-H, Yu J-B, Ma Det al., 2017, Impact of inhalational versus intravenous anaesthesia on early delirium and long-term survival in elderly patients after cancer surgery: study protocol of a multicentre, open-label, and randomised controlled trial, BMJ OPEN, Vol: 7, ISSN: 2044-6055

JOURNAL ARTICLE

Li X, Yang J, Nie X-L, Zhang Y, Li X-Y, Li L-H, Wang D-X, Ma D-Qet al., 2017, Effect of epidural and combined spinal epidural labour analgesia on the occurrence of postpartum depression: amulticentre cohort study, 24th Annual Meeting of the Chinese-Society-of-Anesthesiology, Publisher: OXFORD UNIV PRESS, Pages: E48-E49, ISSN: 0007-0912

CONFERENCE PAPER

Zhao H, Rossaint R, Coburn M, Ma Det al., 2017, The renoprotective properties of xenon and argon in kidney transplantation, EUROPEAN JOURNAL OF ANAESTHESIOLOGY, Vol: 34, Pages: 637-640, ISSN: 0265-0215

JOURNAL ARTICLE

Liu D, Li Z, Zhang X, Zhao L, Jia J, Sun F, Wang Y, Ma D, Wei Wet al., 2017, Assessment of intracranial pressure with ultrasonographic retrobulbar optic nerve sheath diameter measurement, BMC NEUROLOGY, Vol: 17, ISSN: 1471-2377

JOURNAL ARTICLE

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