期刊文献+
共找到91,166篇文章
< 1 2 250 >
每页显示 20 50 100
Organoids of liver diseases: From bench to bedside 预览
1
作者 Li-Jun Wu Zi-Yan Chen +3 位作者 Yi Wang Jun-Gang Zhao Xiao-Zai Xie Gang Chen 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第16期1913-1927,共15页
Understanding the occurrence, development, and treatment of liver diseases is the main goal of hepatopathology research. Liver diseases are not only diverse but also highly heterogeneous among individuals. At present,... Understanding the occurrence, development, and treatment of liver diseases is the main goal of hepatopathology research. Liver diseases are not only diverse but also highly heterogeneous among individuals. At present, research on liver diseases is conducted mainly through cell culture, animal models, pathological specimens, etc. However, these methods cannot fully reveal the pathogenic mechanism and therapeutic characteristics of individualized liver diseases. Recent advances in three-dimensional cell culture technology (organoid culture techniques) include pluripotent stem cells and adult stem cells that are cultured in vitro to form self-organizing properties, making it possible to achieve individualized liver disease research. This review provides a comprehensive overview of the development of liver organoids, the existing and potential applications of liver regenerative medicine, the pathogenesis of liver disease heterogeneity, and drug screening. 展开更多
关键词 ORGANOIDS LIVER DISEASES Individualized research LIVER cancer Threedimensional cell CULTURE LIVER ORGANOIDS
在线阅读 免费下载
Endoscopic ultrasound guided liver biopsy for parenchymal liver disease 预览
2
作者 Aun Raza Shah Muhannad Al-Hanayneh +2 位作者 Monica Chowdhry Mohammad Bilal Shailendra Singh 《世界肝病学杂志:英文版(电子版)》 2019年第4期335-343,共9页
Liver biopsy plays an essential role in the diagnosis, evaluation and management of a vast proportion of liver diseases. Conventionally, percutaneous and transjugular approaches have been used to obtain liver biopsies... Liver biopsy plays an essential role in the diagnosis, evaluation and management of a vast proportion of liver diseases. Conventionally, percutaneous and transjugular approaches have been used to obtain liver biopsies. Endoscopic ultrasound guided liver biopsy (EUS-LB) has emerged as a safe and effective alternate in the past two decades. EUS-LB carries a role in evaluation of both benign and malignant diseases of the liver. It can offer higher resolution imaging of the liver and can detect smaller lesions than computed tomography scan of the abdomen or ultrasound scans with the option for doppler assistance to reduce complications. Current evidence demonstrates the superiority of EUS-LB for a targeted approach of focal lesion and there is also evidence of less sampling variability in heterogeneous parenchymal pathologies. These advantages combined with an improved safety profile had led to the rapid progress in the development of new techniques, equipment and procedures for EUS-LB. W 展开更多
关键词 LIVER BIOPSY ENDOSCOPIC ULTRASOUND ENDOSCOPIC ULTRASOUND GUIDED LIVER BIOPSY LIVER DISEASE
在线阅读 免费下载
Nonalcoholic fatty liver disease prevalence in an Italian cohort of patients with hidradenitis suppurativa: A multi-center retrospective analysis 预览
3
作者 Giovanni Damiani Sebastiano Leone +11 位作者 Kristen Fajgenbaum Nicola L Bragazzi Alessia Pacifico Rosalynn RZ Conic Paolo DM Pigatto Carlo Maiorana Pierpaolo Poli Emilio Berti Maria C Pace Piergiorgio Malagoli Vincenzo Bettoli Marco Fiore 《世界肝病学杂志:英文版(电子版)》 2019年第4期391-401,共11页
BACKGROUND Nonalcoholic fatty liver disease (NAFLD) includes two distinct conditions, with different histologic features and prognosis: non-alcoholic fatty liver (NAFL) and non-alcoholic steatohepatitis (NASH). Furthe... BACKGROUND Nonalcoholic fatty liver disease (NAFLD) includes two distinct conditions, with different histologic features and prognosis: non-alcoholic fatty liver (NAFL) and non-alcoholic steatohepatitis (NASH). Furthermore, NASH is the more aggressive necro-inflammatory form, which may accumulate fibrosis and result in End stage liver disease (ESLD). NAFLD is also linked to systemic inflammatory conditions such as psoriasis. NAFLD is currently the most common cause of ESLD in Western countries, becoming a serious public health concern. Hidradenitis suppurativa (HS) is a systemic inflammatory/autoinflammatory disease of the terminal follicular epithelium of the apocrine gland with a prevalence of 0.05% to 4.10%. Due to its systemic inflammatory behavior several comorbidities were recently associated, however liver ones were scarcely assessed. AIM To evaluate the prevalence and characteristics of NASH/NAFL in HS patients. METHODS This retrospective study is a sub-analysis of a larger study carried out in 4 Italian dermatological centers. In this cohort, there were 83 patients: 51 patients with HS only, 20 patients with HS/NAFL and 12 with HS/NASH. RESULTS Inflammatory comorbidities were present in 3.9% of HS only patients, 25% of HS/NAFL patients and 58.3% of HS/NASH patients (P < 0.001). Similarly, mean Autoinflammatory Disease Damage Index (ADDI) was significantly higher among patients with HS/NASH (5.3 ± 2.2, P < 0.001) compared to patients with HS/NAFL or HS only (2.8 ± 1.6 and 2.6 ± 1.4 respectively). Furthermore, ADDI correlates with IHS4 in HS, HS/NAFL and HS/NASH. Diabetic patients have higher Hurley score than not diabetic ones. Ultrasound examination was significantly different in the three groups. CONCLUSION HS patients displayed a high prevalence of NASH/NAFLD and ultrasound examination should be particularly addressed to patients that display high ADDI scores. 展开更多
关键词 Non-alcoholic steatohepatitis Non-alcoholic FATTY LIVER Nonalcoholic FATTY LIVER DISEASE End stage LIVER DISEASE Hidradenitis suppurativa
在线阅读 免费下载
肝脏T1rho MRI扫描优化及对肝纤维化的诊断价值初探 预览
4
作者 谢双双 李清 +3 位作者 程悦 陈丽华 张莉 沈文 《放射学实践》 北大核心 2019年第1期35-40,共6页
目的:探讨3.0T肝脏T1rho MRI最简自旋锁定时间(SLT)扫描方案及用于诊断肝纤维化的可行性。方法:前瞻性搜集20例正常志愿者(正常组)和20例慢性肝病且临床疑诊为肝纤维化者(肝纤维化组),均行肝脏T1rho MRI扫描。自旋锁定脉冲设定为500 Hz,... 目的:探讨3.0T肝脏T1rho MRI最简自旋锁定时间(SLT)扫描方案及用于诊断肝纤维化的可行性。方法:前瞻性搜集20例正常志愿者(正常组)和20例慢性肝病且临床疑诊为肝纤维化者(肝纤维化组),均行肝脏T1rho MRI扫描。自旋锁定脉冲设定为500 Hz,SLT为1、10、20、30、40和50 ms。扫描结束后分别采用所有6-SLT(1、10、20、30、40和50 ms)和5种简化SLT组合,即最大SLT为40 ms的5-SLT(1、10、20、30、和40 ms)、最大SLT为50 ms的3-SLT(1、10、50 ms;1、20、50 ms;1、30、50 ms;1、40、50 ms),生成T1rho mapping。通过兴趣区(ROI)放置法测量各组合肝脏的T1rho值。采用配对样本t检验比较各简化SLT组合与6-SLT所测肝脏T1rho值的差异;采用Bland-Altman法分析各简化SLT组合与6-SLT所测肝脏T1rho值的一致性。采用ROC曲线分析6-SLT与简化SLT组合对肝纤维化诊断效能的差异。结果:正常组、肝纤维化组6-SLT和5种简化SLT组合所测肝脏T1rho值分别为(44.86±2.65)ms vs(53.01±5.79)ms、(43.07±3.15)ms vs(50.90±5.62)ms、(45.24±2.62)ms vs(53.22±5.25)ms、(45.11±2.53)ms vs(53.85±5.13)ms、(45.11±2.60)ms vs(52.80±5.53)ms和(45.22±2.64)ms vs(53.68±5.78)ms,两组间的差异均有统计学意义(P值均<0.001),用于诊断肝纤维化的曲线下面积(AUC)分别为0.910、0.895、0.910、0.933、0.917和0.923;5种简化SLT组合与6-SLT相比,诊断效能差异均无统计学意义(P值均>0.05)。其中正常组和肝纤维化组最大SLT为50 ms的3-SLT所测肝脏T1rho值与6-SLT差异均无统计学意义(P>0.05),最大SLT为40 ms的5-SLT所测肝脏T1rho值与6-SLT差异有统计学意义(P<0.01)。Bland-Altman分析结果显示所有3-SLT组合与6-SLT差值的散点分布在正常组和肝纤维化组中均较集中,且3-SLT(1、10、50 ms)组合的差值和95%一致性区间最小,分别为-0.37(-2.12~1.37)、-0.2(-3.7-3.3)。结论:3-SLT和5-SLT均能简化6-SLT(1~50 ms)以测量肝脏T1rho值,可用于诊断肝纤维化,且最大SLT为50 ms的3-SLT� 展开更多
关键词 肝脏 肝纤维化 磁共振成像 磁共振T1rho成像 自旋锁定时间
在线阅读 下载PDF
基于肝表面智能自动对位法的超声-CT/MR融合成像的可行性研究 预览
5
作者 曾庆劲 颜荣华 +5 位作者 吴宇轩 龙颖琳 罗丽萍 李凯 许尔蛟 郑荣琴 《中山大学学报(医学版)》 CAS CSCD 北大核心 2019年第1期117-123,共7页
【目的】探讨基于肝表面智能自动对位法的超声-CT/MR融合成像在肝脏局灶性病变定位的可行性及简便性。【方法】采用飞利浦EPIQ7的PercuNav融合成像系统对30例增强CT或MR发现肝内局灶性病变的患者进行超声-CT/MR融合成像检查。同时采用... 【目的】探讨基于肝表面智能自动对位法的超声-CT/MR融合成像在肝脏局灶性病变定位的可行性及简便性。【方法】采用飞利浦EPIQ7的PercuNav融合成像系统对30例增强CT或MR发现肝内局灶性病变的患者进行超声-CT/MR融合成像检查。同时采用系统配置的基于肝表面智能自动对位法(智能法)和常规内定标人工对位法(人工法)进行融合成像配准,比较两种方法的配准成功率、初步配准误差、微调配准次数。【结果】所有30例患者中,智能法和人工法的配准成功率均为96.67%(29/30),且初步配准误差和微调配准次数两种方法之间比较无统计学差异(P >0.05)。进一步分层分析,左肝病例中,人工法的初步配准误差优于智能法,差异有统计学意义(P=0.00),而微调配准次数虽然人工法少于智能法,但两者比较差异无统计学意义(P=0.09);而在右肝病例中,智能法的初步配准误差和微调配准次数均优于人工法,差异有统计学意义(P<0.05)。【结论】基于肝表面智能自动对位法的超声-CT/MR融合成像技术具有较高的配准成功率,可行性较好;相对于常规的内定标人工对位法,对于右肝病灶其融合成像操作过程更为简便高效,有助于降低对操作者融合成像技术经验的依赖性。 展开更多
关键词 肝脏 融合成像 智能对位 超声 肝表面
在线阅读 下载PDF
Crizotinib-induced acute fatal liver failure in an Asian ALK-positive lung adenocarcinoma patient with liver metastasis: A case report 预览
6
作者 Ying Zhang Yan-Yan Xu +2 位作者 Yi Chen Jin-Na Li Ying Wang 《世界临床病例杂志》 2019年第9期1080-1086,共7页
BACKGROUND Crizotinib-induce hepatotoxicity is rare and non-specific, and severe hepatotoxicity can develop into fatal liver failure. Herein, we report a case of fatal crizotinib-induced liver failure in a 37-year-old... BACKGROUND Crizotinib-induce hepatotoxicity is rare and non-specific, and severe hepatotoxicity can develop into fatal liver failure. Herein, we report a case of fatal crizotinib-induced liver failure in a 37-year-old Asian patient. CASE SUMMARY The patient complained of dyspnea and upper abdominal pain for a week in August 2017. He was diagnosed with anaplastic lymphoma kinase- rearranged lung adenocarcinoma combined with multiple distant metastases. Crizotinib was initiated as a first-line treatment at a dosage of 250 mg twice daily. No adverse effects were seen until day 46. On day 55, he was admitted to the hospital with elevated liver enzymes aspartate aminotransferase (AST)(402 IU/L), alanine aminotransferase (ALT)(215 IU/L) and total bilirubin (145 μmol/L) and was diagnosed with crizotinib-induced fulminant liver failure. Despite crizotinib discontinuation and intensive supportive therapy, the level of AST (1075 IU/L), ALT (240 IU/L) and total bilirubin (233 μmol/L) continued to rapidly increase, and he died on day 60. CONCLUSION Physicians should be aware of the potential fatal adverse effects of crizotinib. 展开更多
关键词 FATAL LIVER failure CRIZOTINIB HEPATOTOXICITY LIVER metastases ALK REARRANGEMENT Lung adenocarcinoma Case report
在线阅读 免费下载
Pure three-dimensional laparoscopic full left hepatectomy of a living donor for an adolescent in China
7
作者 Jiu-Lin Song Hong Wu Jia-Yin Yang 《中华医学杂志:英文版》 SCIE CAS CSCD 2019年第2期242-244,共3页
To the Editor:Living donor liver transplantation (LDLT) has expanded the donor pool in countries with low cadaveric organ donation rates.Generally, a left-side liver allograft is sufficient and safe for child and adol... To the Editor:Living donor liver transplantation (LDLT) has expanded the donor pool in countries with low cadaveric organ donation rates.Generally, a left-side liver allograft is sufficient and safe for child and adolescent recipients.[1] For the sake of the donor's cosmetic demands and for early functional rehabilitation, laparoscopic technology has been used in live hepatectomy since 2002.[2] Three-dimensional visualization provides better depth perception and tactile feedback than does conventional two-dimensional laparoscopy.[3] In this report, we presented a case of pure three-dimensional laparoscopic full left live hepatectomy. 展开更多
关键词 LIVING DONOR LIVER transplantation expanded LIVER
Iron and liver fibrosis:Mechanistic and clinical aspects 预览
8
作者 Kosha J Mehta Sebastien Je Farnaud Paul A Sharp 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第5期521-538,共18页
Liver fibrosis is characterised by excessive deposition of extracellular matrix that interrupts normal liver functionality.It is a pathological stage in several untreated chronic liver diseases such as the iron overlo... Liver fibrosis is characterised by excessive deposition of extracellular matrix that interrupts normal liver functionality.It is a pathological stage in several untreated chronic liver diseases such as the iron overload syndrome hereditary haemochromatosis,viral hepatitis,alcoholic liver disease,non-alcoholic fatty liver disease,non-alcoholic steatohepatitis and diabetes.Interestingly,regardless of the aetiology,iron-loading is frequently observed in chronic liver diseases.Excess iron can feed the Fenton reaction to generate unquenchable amounts of free radicals that cause grave cellular and tissue damage and thereby contribute to fibrosis.Moreover,excess iron can induce fibrosis-promoting signals in the parenchymal and non-parenchymal cells,which accelerate disease progression and exacerbate liver pathology.Fibrosis regression is achievable following treatment,but if untreated or unsuccessful,it can progress to the irreversible cirrhotic stage leading to organ failure and hepatocellular carcinoma,where resection or transplantation remain the only curative options.Therefore,understanding the role of iron in liver fibrosis is extremely essential as it can help in formulating iron-related diagnostic,prognostic and treatment strategies.These can be implemented in isolation or in combination with the current approaches to prepone detection,and halt or decelerate fibrosis progression before it reaches the irreparable stage.Thus,this review narrates the role of iron in liver fibrosis.It examines the underlying mechanisms by which excess iron can facilitate fibrotic responses.It describes the role of iron in various clinical pathologies and lastly,highlights the significance and potential of iron-related proteins in the diagnosis and therapeutics of liver fibrosis. 展开更多
关键词 IRON LIVER PATHOLOGIES LIVER FIBROSIS Hepatic stellate cells Cirrhosis
在线阅读 免费下载
肝脏手术缝合技术与缝合材料选择中国专家共识(2018版)
9
作者 中华医学会外科学分会 赵玉沛 +15 位作者 刘连新 蔡建强 曾勇 梁霄 窦科峰 蔡秀军 姜洪池 陈规划 梁力建 李强 梁延波 彭承宏 钦伦秀 张水军 张学文 许戈良 《中国实用外科杂志》 CSCD 北大核心 2019年第1期11-14,共4页
目前,肝脏外科的发展已经从开展和完成半肝切除、右三叶肝切除和尾状叶肝切除等传统观念下难度较大的手术,逐渐转变为如何在保留足够肝脏体积的条件下开展更符合元瘤原则的手术(如静脉入路的解剖性肝切除),以及完成以往无法完成的手术[... 目前,肝脏外科的发展已经从开展和完成半肝切除、右三叶肝切除和尾状叶肝切除等传统观念下难度较大的手术,逐渐转变为如何在保留足够肝脏体积的条件下开展更符合元瘤原则的手术(如静脉入路的解剖性肝切除),以及完成以往无法完成的手术[如联合肝脏分隔和门静脉结扎的二步肝切除术(ALPPS)]等。微创技术在肝切除术中的应用和普及对术中出血控制要求更加严格,创面止血、血管胆管缝合重建也变得更加困难,而规范、科学地完成肝脏血管和胆管的缝合是预防术后大出血和胆漏的重要环节。为指导临床相关工作,中华医学会外科学分会组织国内部分专家,经反复讨论,制定本专家共识。 展开更多
关键词 肝脏 腹腔镜 肝切除 缝合技术 缝合材料
Intestinal permeability after Mediterranean diet and low-fat diet in non-alcoholic fatty liver disease 预览
10
作者 Marco Biolato Fiorella Manca +7 位作者 Giuseppe Marrone Consuelo Cefalo Simona Racco Giacinto A Miggiano Venanzio Valenza Antonio Gasbarrini Luca Miele Antonio Grieco 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第4期509-520,共12页
BACKGROUND In non-alcoholic fatty liver disease(NAFLD),a high-fat or high-fructose diet increases intestinal permeability and promotes derangement of the gut-liver axis.We hypothesize that,diet could be able to modula... BACKGROUND In non-alcoholic fatty liver disease(NAFLD),a high-fat or high-fructose diet increases intestinal permeability and promotes derangement of the gut-liver axis.We hypothesize that,diet could be able to modulate intestinal permeability in patients with NAFLD.AIM To detect diet-induced modification of intestinal permeability in patients with NAFLD undergoing a Mediterranean diet or a low-fat diet.METHODS The current study was a dietary intervention for non-diabetic,patients with biopsy-verified NAFLD and increased transaminases.A crossover design was employed:participants underwent 16 weeks of Mediterranean diet,16 wk of free wash-out,and 16 weeks of low-fat diet.Both diets were hypocaloric and no consumption of supplements was allowed.All patients were followed bimonthly by a dietitian.Evaluations of clinical and metabolic parameters were completed at baseline and at the end of each dietary period.Intestinal permeability was assessed by chromium-51 ethylene diamine tetraacetate excretion testing(51Cr-EDTA).RESULTS Twenty Caucasian patients,90%male,median age 43 years,body mass index(BMI)30.9,with biopsy-verified NAFLD were enrolled.At the end of 16 weeks of a Mediterranean diet,a significant reduction in mean body weight(-5.3±4.1 kg,P=0.003),mean waist circumference(-7.9±4.9 cm,P=0.001),and mean transaminase levels[alanine aminotransferase(ALT)-28.3±11.9 IU/L,P=0.0001;aspartate aminotransferase(AST)-6.4±56.3 IU/L,P=0.01]were observed.These benefits were maintained after 16 wk of wash-out and also after 16 wk of low-fat diet,without further improvements.Fourteen of the 20 patients had intestinal permeability alteration at baseline(mean percentage retention of 51Cr-EDTA=5.4%),but no significant changes in intestinal permeability were observed at the end of the 16 wk of the Mediterranean diet or 16 wk of the low-fat diet.CONCLUSION Mediterranean diet is an effective strategy for treating overweight,visceral obesity and serum transaminase in patients with NAFLD.If the Mediterranean diet can improve intest 展开更多
关键词 LIVER STEATOSIS Gut-liver axis NUTRITION PERSONALIZED medicine VISCERAL obesity
在线阅读 免费下载
Elastography-based screening for esophageal varices in patients with advanced chronic liver disease 预览
11
作者 Rafael Paternostro Thomas Reiberger Theresa Bucsics 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第3期308-329,共22页
Elastography-based liver stiffness measurement(LSM)is a non-invasive tool for estimating liver fibrosis but also provides an estimate for the severity of portal hypertension in patients with advanced chronic liver dis... Elastography-based liver stiffness measurement(LSM)is a non-invasive tool for estimating liver fibrosis but also provides an estimate for the severity of portal hypertension in patients with advanced chronic liver disease(ACLD).The presence of varices and especially of varices needing treatment(VNT)indicates distinct prognostic stages in patients with compensated ACLD(cACLD).The Baveno VI guidelines suggested a simple algorithm based on LSM<20 kPa(by transient elastography,TE)and platelet count>150 G/L for ruling-out VNT in patients with cACLD.These(and other)TE-based LSM cut-offs have been evaluated for VNT screening in different liver disease etiologies.Novel point shear-wave elastography(pSWE)and two-dimensional shear wave elastography(2D-SWE)methodologies for LSM have also been evaluated for their ability to screen for“any”varices and for VNT.Finally,the measurement of spleen stiffness(SSM)by elastography(mainly by pSWE and 2D-SWE)may represent another valuable screening tool for varices.Here,we summarize the current literature on elastography-based prediction of“any”varices and VNT.Finally,we have summarized the published LSM and SSM cut-offs in clinically useful scale cards. 展开更多
关键词 ELASTOGRAPHY LIVER STIFFNESS SPLEEN STIFFNESS Shear wave Magnetic resonance ELASTOGRAPHY VARICES Portal hypertension Cirrhosis ADVANCED chronic LIVER disease
在线阅读 免费下载
不同吸附剂在双重血浆分子吸附系统治疗肝衰竭中的临床研究
12
作者 闫国胜 李丽丽 +2 位作者 姜少利 孟松 吴晨晨 《中华肝脏病杂志》 CAS CSCD 北大核心 2019年第1期51-55,共5页
目的探讨双重血浆分子吸附系统(DPMARS)治疗肝衰竭中不同吸附剂(活性炭与吸附树脂)组合的疗效对比。方法回顾性分析2016年6月至2018年5月郑州市第六人民医院住院的152例肝衰竭患者,分为DPMARS碳罐组77例、DPMARS树脂组75例。比较两组患... 目的探讨双重血浆分子吸附系统(DPMARS)治疗肝衰竭中不同吸附剂(活性炭与吸附树脂)组合的疗效对比。方法回顾性分析2016年6月至2018年5月郑州市第六人民医院住院的152例肝衰竭患者,分为DPMARS碳罐组77例、DPMARS树脂组75例。比较两组患者治疗前、治疗后的肝功能、凝血酶原活动度(PTA)、血白蛋白、肿瘤坏死因子α(TNFα)、白细胞介素6(IL-6)等指标的变化。两组间比较采用两独立样本t检验,疗效比较用χ^2检验。结果治疗后两组患者临床症状均有不同程度的改善,碳罐组好转率为89.6%(69/77),树脂组好转率为90.7%(68/75),差异无统计学意义(χ^2=0.048,P=0.975);两组间不良反应率比较,差异无统计学意义(χ^2=0.235,P=0.995)。与治疗前比较,治疗后碳罐组和树脂组总胆红素(t值分别为3.735,3.728,P值均<0.001)、丙氨酸氨基转移酶(t值分别为5.117、5.203,P值均<0.001)、TNFα(t值分别为3.158、3.094,P值均<0.05)、IL-6(t值分别为3.647、3.559,P值均<0.05)均显著降低,差异有统计学意义。而白蛋白、PTA治疗前后比较,P值均>0.05,差异无统计学意义。结论双重血浆分子吸附系统治疗肝衰竭有效,碳罐或者树脂罐均可与特异性胆红素吸附柱组合成DPMARS应用于临床,且二者疗效差异无统计学意义。 展开更多
关键词 人工 治疗 肝衰竭 双重血浆分子吸附系统 活性炭
Protective action of glutamine in rats with severe acute liver failure 预览
13
作者 Elizangela G Schemitt Renata M Hartmann +4 位作者 Josieli R Colares Francielli Licks Jéferson O Salvi Cláudio A Marroni Norma P Marroni 《世界肝病学杂志:英文版(电子版)》 2019年第3期273-286,共14页
BACKGROUND Severe acute liver failure (SALF) is a rare, but high-mortality, rapidly evolving syndrome that leads to hepatocyte degeneration with impaired liver function. Thioacetamide (TAA) is a known xenobiotic, whic... BACKGROUND Severe acute liver failure (SALF) is a rare, but high-mortality, rapidly evolving syndrome that leads to hepatocyte degeneration with impaired liver function. Thioacetamide (TAA) is a known xenobiotic, which promotes the increase of the formation of reactive oxygen species. Erythroid 2-related factor 2 (Nrf2) activates the antioxidant protection of cells. Studies have evidenced the involvement of inflammatory mediators in conditions of oxidative stress. AIM To evaluate the antioxidant effects of glutamine on Nrf2 activation and NFκB-mediated inflammation in rats with TAA-induced IHAG. METHODS Male Wistar rats (n = 28) were divided into four groups: control, control+glutamine, TAA, and TAA + glutamine. Two TAA doses (400 mg/kg) were administered intraperitoneally, 8 h apart. Glutamine (25 mg/kg) was administered at 30 min, 24 h, and 36 h. At 48 h, blood was collected for liver integrity analysis [aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase (ALP)]. The liver was harvested for histology and assessment of oxidative stress [thiobarbituric acid-reactive substances (TBARS), catalase (CAT), glutathione peroxidase (GPx), glutathione S-transferase (GST), glutathione (GSH), Nrf2, Kelch-like ECH-associated protein 1 (Keap1), NADPH quinone oxidoreductase1 (NQO1), superoxide dismutase (SOD)] and inflammatory process. RESULTS TAA caused disruption of the hepatic parenchyma, with inflammatory infiltration, massive necrosis, and ballooning degeneration. Glutamine mitigated this tissue damage, with visible regeneration of hepatic parenchyma;decreased TBARS (P < 0.001), GSH (P < 0.01), IL-1β, IL6, and TNFα levels (P <0.01) in hepatic tissue;and decreased blood levels of AST, ALT, and ALP (P <0.05). In addition, CAT, GPx, and GST activities were restored in the glutamine group (P <0.01, P <0.01, and P <0.001, respectively vs TAA alone). Glutamine increased expression of Nrf2 (P < 0.05), NQO1, and SOD (P < 0.01), as well as levels of IL-10 (P <0.001), while decreasing expre 展开更多
关键词 THIOACETAMIDE CYTOKINES OXIDATIVE stress INFLAMMATION LIVER failure Chemical and drug induced LIVER injury GLUTAMINE
在线阅读 免费下载
术前肝脏储备功能评估的最新研究进展 预览
14
作者 梁伟强 王猛 《新医学》 2019年第4期229-233,共5页
肝脏储备功能的评估对扩大肝切除术和门静脉栓塞患者至关重要,但尚无任何一种检查方法能够全面准确地评估肝脏储备功能。目前应用于肝脏储备功能评估的各种方法主要包括生物化学指标、临床评分系统(如Child-Pugh和MELD评分等)、动态定... 肝脏储备功能的评估对扩大肝切除术和门静脉栓塞患者至关重要,但尚无任何一种检查方法能够全面准确地评估肝脏储备功能。目前应用于肝脏储备功能评估的各种方法主要包括生物化学指标、临床评分系统(如Child-Pugh和MELD评分等)、动态定量检测肝脏清除功能(如吲哚靛青绿清除试验)、核素显像(如99m锝-半乳糖基人血白蛋白显像和99m锝-甲溴苯宁肝胆特异核素显像等)、CT灌注成像、MRI(如Gd-EOB-DTPA增强MRI)等。该文将综述各种方法的基本原理,并比较各种检查方法的优缺点。 展开更多
关键词 肝脏 储备功能评估 肝功能 核素 磁共振成像
在线阅读 免费下载
基于失效模式与效应分析理论的肝活检组织标本制片质量提升与流程优化模型研究
15
作者 汤鸿 陆忠华 +2 位作者 张熔熔 徐蓉蓉 方凯 《中华肝脏病杂志》 CAS CSCD 北大核心 2019年第3期210-212,共3页
肝活组织检查对肝脏疾病的诊断、疗效判定及预后评估有重要价值,优质稳定的制片,完善高效的流程是前提,但实际影响因素众多,是临床难点之一。现以病理制片中流程缺陷与质量失控的风险因素为出发点,研究失效模式与效应分析进行识别和处理... 肝活组织检查对肝脏疾病的诊断、疗效判定及预后评估有重要价值,优质稳定的制片,完善高效的流程是前提,但实际影响因素众多,是临床难点之一。现以病理制片中流程缺陷与质量失控的风险因素为出发点,研究失效模式与效应分析进行识别和处理,以规避风险及提升质量和效率,构建优化模型。 展开更多
关键词 组织病理学 失效模式与效应分析 肝活检标本 质量控制 流程优化
肝脏储备功能评估方法及临床意义 预览
16
作者 鲁俊玲 王冰洁 张佳光 《海南医学》 CAS 2019年第8期1058-1061,共4页
肝脏是人体维持生命活动的重要器官之一,承担着代谢、合成、解毒、分泌、生物转化及免疫等多种生理功能。肝脏具有巨大的储备功能及再生能力,正常肝脏可耐受切除70%,而不出现明显的生理功能紊乱。若致肝损伤因素损害肝脏超过了肝脏的储... 肝脏是人体维持生命活动的重要器官之一,承担着代谢、合成、解毒、分泌、生物转化及免疫等多种生理功能。肝脏具有巨大的储备功能及再生能力,正常肝脏可耐受切除70%,而不出现明显的生理功能紊乱。若致肝损伤因素损害肝脏超过了肝脏的储备潜能,那么人体健康将受到严重威胁。因此,准确评估肝脏储备功能可为肝脏疾病进展、治疗效果以及预后的判断提供依据。目前,评估肝脏储备功能的方法繁多,各有其优缺点,至今没有哪一种可以单独全面评估肝脏储备功能,本文将针对介绍的各种评估方法的特点作一综述。 展开更多
关键词 肝脏 储备功能 评估 综述 MELD
在线阅读 免费下载
Value of pretransplant albumin-bilirubin score in predicting outcomes after liver transplantation 预览
17
作者 Tao Ma Qing-Shan Li +4 位作者 Yue Wang Bo Wang Zheng Wu Yi Lv Rong-Qian Wu 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第15期1879-1889,共11页
BACKGROUND Due to the significant shortage of organs and the increasing number of candidates on the transplant waiting list, there is an urgent need to identify patients who are most likely to benefit from liver trans... BACKGROUND Due to the significant shortage of organs and the increasing number of candidates on the transplant waiting list, there is an urgent need to identify patients who are most likely to benefit from liver transplantation. The albuminbilirubin (ALBI) grading system was recently developed to identify patients at risk for adverse outcomes after hepatectomy. However, the value of the pretransplant ALBI score in predicting outcomes after liver transplantation has not been assessed. AIM To retrospectively investigate the value of the pretransplant ALBI score in predicting outcomes after liver transplantation. METHODS The clinical data of 272 consecutive adult patients who received donation after cardiac death and underwent liver transplantation at our centre from March 2012 to March 2017 were analysed in the cohort study. After the exclusion of patients who met any of the exclusion criteria, 258 patients remained. The performance of the ALBI score in predicting overall survival and postoperative complications after liver transplantation was evaluated. The optimal cut-off value of preoperative ALBI was calculated according to long-term survival status. The outcomes after liver transplantation, including postoperative complications and survival analysis, were measured.RESULTS The remaining 258 consecutive patients were included in the analysis. The median follow-up time was 17.30 (interquartile range: 8.90-28.98) mo. Death occurred in 35 patients during follow-up. The overall survival rate was 81.0%. The preoperative ALBI score had a significant positive correlation with the overall survival rate after liver transplantation. The calculated cut-off for ALBI scores to predict postoperative survival was -1.48. Patients with an ALBI score >- 1.48 had a significantly lower survival rate than those with an ALBI score ≤-1.48 (73.7% vs 87.6%, P < 0.05), and there were no statistically significant differences in survival rates between patients with a model for end stage liver disease score ≥ 10 and < 10 and different C 展开更多
关键词 Albumin-bilirubin SCORE LIVER transplantation Survival Postoperative complications LIVER TRANSPLANT WAITING list
在线阅读 免费下载
Machine perfusion of the liver:Which is the best technique to mitigate ischaemia-reperfusion injury? 预览
18
作者 Yuri L Boteon Simon C Afford 《世界移植杂志》 2019年第1期14-20,共7页
Longstanding research describes the mechanisms whereby the restoration of blood flow and reoxygenation(reperfusion)aggravates the ischaemic injury caused by a period of anoxia to a donor liver.This phenomenon,called i... Longstanding research describes the mechanisms whereby the restoration of blood flow and reoxygenation(reperfusion)aggravates the ischaemic injury caused by a period of anoxia to a donor liver.This phenomenon,called ischaemia-reperfusion injury(IRI),leads to parenchymal cell death,microcirculatory failure,and inflammatory immune response.Clinically,IRI is the main factor responsible for the occurrence of posttransplant graft dysfunction and ischaemic-type biliary lesions.While extended criteria donor livers are more vulnerable to IRI,their utilisation is required to address the shortfall in donor organs.Thus,the mitigation of IRI should drive the setting of a new benchmark for marginal organ preservation.Herein,strategies incorporating different modalities of machine perfusion of the liver to alleviate IRI are discussed in conjunction with advantages and disadvantages of individual protocols.Techniques leading to reperfusion of the liver during machine perfusion(in situ normothermic regional perfusion and ex situ normothermic machine perfusion)may mitigate IRI by shortening the ischaemic period of the organs.This benefit potentially escalates from the minimum level,obtained following just partial alleviation of the ischaemic period,to the maximum level,which can be potentially achieved with ischaemia-free organ transplantation.Techniques that do not lead to reperfusion of the liver during machine perfusion(hypothermic,subnormothermic,and controlled-oxygenated rewarming)optimise mitochondrial oxidative function and replenish cellular energy stores,thereby lowering reactive oxygen species production as well as the activation of downstream inflammatory pathways during reperfusion.Further mechanistic insights into IRI may guide the development of donor-specific protocols of machine perfusion on the basis of the limitations of individual categories of extended criteria donor organs. 展开更多
关键词 Machine PERFUSION of the LIVER ISCHAEMIA-REPERFUSION injury LIVER transplantation ORGAN PRESERVATION ORGAN RECONDITIONING
在线阅读 免费下载
Pushing the limits of liver surgery for colorectal liver metastases:Current state and future directions 预览
19
作者 Raphael LC Araujo Marcelo M Linhares 《世界胃肠外科杂志:英文版(电子版)》 2019年第2期34-40,共7页
Liver surgery for the treatment of colorectal liver metastases is the standard treatment in a dynamic surgical field with many variables that should be considered in a curative intent scenario.Hepatectomy for colorect... Liver surgery for the treatment of colorectal liver metastases is the standard treatment in a dynamic surgical field with many variables that should be considered in a curative intent scenario.Hepatectomy for colorectal liver metastases has undergone constant changes over the last 30 years,including indications until the need for rescue procedures of recurrent and advanced diseases as well as minimally invasive surgery.These advancements in liver surgery have not only resulted from overall improvements in the surgical field but have also resulted from a better understanding of the biological behavior of the disease,liver regeneration,and homeostasis during and after surgery.Improvements in anesthesiology,intensive care medicine,radiology,and surgical devices have correlated with further advancements of hepatectomies.Moreover,changes are still forthcoming,and both fields of augmented reality and artificial intelligence will likely have future contributions in this field in regard to both diagnoses and the planning of procedures.The aim of this editorial is to emphasize several aspects that have contributed to the paradigm shifts in colorectal liver metastases surgery over the last three decades as well as to discuss the factors concerning patient selection and the technical aspects of liver surgery.Finally,this editorial will highlight the promising new features of this surgery for diagnoses and treatments in this field. 展开更多
关键词 COLORECTAL LIVER METASTASES Cancer HEPATECTOMY LIVER Surgery ONCOLOGY
在线阅读 免费下载
初步探讨艾滋病肝功能损害与肝脏CT表现的关系
20
作者 谢雨恩 廖锦元 王铮 《实用放射学杂志》 CAS 北大核心 2019年第2期224-227,共4页
目的分析艾滋病即获得性免疫缺陷综合征(AIDS)患者肝脏CT表现与肝脏功能酶指标的变化,探讨两者之间的关系。方法 回顾性分析2012年10月至2016年3月进行肝脏MSCT平扫+增强扫描及肝功能生化检查的AIDS患者58例,对其肝脏CT表现、肝功能检... 目的分析艾滋病即获得性免疫缺陷综合征(AIDS)患者肝脏CT表现与肝脏功能酶指标的变化,探讨两者之间的关系。方法 回顾性分析2012年10月至2016年3月进行肝脏MSCT平扫+增强扫描及肝功能生化检查的AIDS患者58例,对其肝脏CT表现、肝功能检验资料进行观察统计分析。结果 按肝脏CT表现分4组:1组为肝实质弥漫性无强化密度减低(20例);2组为肝实质多发大小不等的结节状、片状无强化低密度灶(14例);3组为肝实质多发大小不等结节状、片状有强化低密度灶(15例);4组为肝脏CT平扫+增强未见异常(9例);1组肝脏生化指标异常例数最多,且1组天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)测值均明显高于其他组,差异有统计学意义(P<0.05),1组γ-谷氨酰转肽酶(GGT)测值高于其他组,但差异无统计学意义(P>0.05)。结论AIDS肝功能异常患者肝脏CT表现各异,CT所见以肝脏无强化弥漫性密度减低表现为多见,肝功能损害较明显,对AIDS肝功能损害评价有一定参考意义。 展开更多
关键词 艾滋病 肝脏 肝功能 计算机体层成像
上一页 1 2 250 下一页 到第
使用帮助 返回顶部 意见反馈