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Overview on acute-on-chronic liver failure
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《医学前沿（英文）》 2016年 第10卷 第1期 页码 1-17 doi: 10.1007/s11684-016-0439-x
Liver failure (LF) is defined as severe dysfunction in hepatic synthesis, detoxification, and metabolism induced by various etiologies. Clinical presentation of LF typically includes severe jaundice, coagulation disorder, hepatic encephalopathy, and ascites. LF can be classified into acute LF, acute-on-chronic LF (ACLF), and chronic LF. ACLF has been demonstrated as a distinct syndrome with unique clinical presentation and outcomes. The severity, curability, and reversibility of ACLF have attracted considerable attention. Remarkable developments in ACLF-related conception, diagnostic criteria, pathogenesis, and therapy have been achieved. However, this disease, especially its diagnostic criteria, remains controversial. In this paper, we systemically reviewed the current understanding of ACLF from its definition, etiology, pathophysiology, pathology, and clinical presentation to management by thoroughly comparing important findings between east and west countries, as well as those from other regions. We also discussed the controversies, challenges, and needs for future studies to promote the standardization and optimization of the diagnosis and treatment for ACLF.
关键词： liver failure chronic liver failure acute-on-chronic liver failure diagnosis prognosis treatment
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《医学前沿（英文）》 2014年 第8卷 第2期 页码 250-253 doi: 10.1007/s11684-014-0333-3
The clinical data of a patient with acute-on-chronic liver failure were analyzed retrospectively. The patient has suffered from hepatitis B for 30 years. His liver function deteriorated, yielding Child-Pugh grade C and reaching a model for end-stage liver disease score of 33 points within a short period; this condition was complicated with highly active variceal bleeding and coagulation system failure (PT > 100 s). The patient also presented hepatocellular carcinoma. Comprehensive treatments included effective inhibition of hepatitis B virus replication and intensive care support. Piggyback orthotopic liver transplantation was performed as the final treatment. The patient recovered uneventfully and was discharged after surgery.
关键词： acute-on-chronic liver failure submassive necrosis viral hepatitis B esophageal variceal bleeding liver transplantation
Correlation between viral load and liver cirrhosis in chronic hepatitis B patients
Lili LIU MM , Jiyao WANG MD , Weimin SHE MM ,
《医学前沿（英文）》 2009年 第3卷 第3期 页码 271-276 doi: 10.1007/s11684-009-0054-1
Advances in some common chronic liver diseases
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《医学前沿（英文）》 2014年 第8卷 第2期 页码 127-128 doi: 10.1007/s11684-014-0341-3
Ling Dai, Xiang Gao, Zhihua Ye, Hanmin Li, Xin Yao, Dingbo Lu, Na Wu
《医学前沿（英文）》 2021年 第15卷 第3期 页码 495-505 doi: 10.1007/s11684-020-0790-9
关键词： hepatitis B virus-related liver failure traditional Chinese medicine liver regeneration liver regeneration microenvironment cytokines
《医学前沿（英文）》 2022年 第16卷 第2期 页码 295-305 doi: 10.1007/s11684-021-0857-2
关键词： chronic heart failure trimethylamine-N-oxide flavin monooxygenase 3 single nucleotide polymorphism
Assessment of liver volume variation to evaluate liver function
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《医学前沿（英文）》 2012年 第6卷 第4期 页码 421-427 doi: 10.1007/s11684-012-0223-5
In order to assess the value of liver volumetry in cirrhosis and acute liver failure (ALF) patients, we explored the correlation between hepatic volume and severity of the hepatic diseases. The clinical data of 48 cirrhosis patients with 60 normal controls and 39 ALF patients were collected. Computed tomography-derived liver volume (CTLV) and body surface area (BSA) of normal controls were calculated to get a regression formula for standard liver volume (SLV) and BSA. Then CTLV and SLV of all patients were calculated and grouped by Child-Turcotte-Pugh classification for cirrhosis patients and assigned according to prognosis of ALF patients for further comparison. It turned out that the mean liver volume of the control group was 1 058±337 cm3. SLV was correlated with BSA according to the regression formula. The hepatic volume of cirrhosis patients in Child A, B level was not reduced, but in Child C level it was significantly reduced with the lowest liver volume index (CTLV/SLV). Likewise, in the death group of ALF patients, the volume index was significantly lower than that of the survival group. Based on volumetric study, we proposed an ROC (receiver operating characteristic) analysis to predict the prognosis of ALF patients that CTLV/SLV<83.9% indicates a poor prognosis. In conclusion, the CTLV/SLV ratio, which reflects liver volume variations, correlates well with the liver function and progression of cirrhosis and ALF. It is also a very useful marker for predicting the prognosis of ALF.
关键词： liver volume variation cirrhosis acute liver failure (ALF)
Bioartificial liver devices: Perspectives on the state of the art
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《医学前沿（英文）》 2011年 第5卷 第1期 页码 15-19 doi: 10.1007/s11684-010-0110-x
Acute liver failure remains a significant cause of morbidity and mortality. Bioartificial liver (BAL) devices have been in development for more than 20 years. Such devices aim to temporarily take over the metabolic and excretory functions of the liver until the patients’ own liver has recovered or a donor liver becomes available for transplant. The important issues include the choice of cell materials and the design of the bioreactor. Ideal BAL cell materials should be of good viability and functionality, easy to access, and exclude immunoreactive and tumorigenic cell materials. Unfortunately, the current cells in use in BAL do not meet these requirements. One of the challenges in BAL development is the improvement of current materials; another key point concerning cell materials is the coculture of different cells. The bioreactor is an important component of BAL, because it determines the viability and function of the hepatocytes within it. From the perspective of bioengineering, a successful and clinically effective bioreactor should mimic the structure of the liver and provide an in vivo-like microenvironment for the growth of hepatocytes, thereby maintaining the cells’ viability and function to the maximum extent. One future trend in the development of the bioreactor is to improve the oxygen supply system. Another direction for future research on bioreactors is the application of biomedical materials. In conclusion, BAL is, in principle, an important therapeutic strategy for patients with acute liver failure, and may also be a bridge to liver transplantation. It requires further research and development, however, before it can enter clinical practice.
关键词： acute liver failure bioartificial livers hepatocyte bioreactor
《医学前沿（英文）》 2022年 第16卷 第1期 页码 111-125 doi: 10.1007/s11684-021-0854-5
关键词： COVID-19 chronic hepatitis B liver injury coagulation dysfunction
SHU Ming, PENG Chenghong, CHEN Hao, SHEN Boyong, ZHOU Guangwen, SHEN Chuan, LI Hongwei
《医学前沿（英文）》 2007年 第1卷 第2期 页码 167-172 doi: 10.1007/s11684-007-0031-5
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《医学前沿（英文）》 2016年 第10卷 第3期 页码 356-359 doi: 10.1007/s11684-016-0467-6
Classic constrictive pericarditis (CP) is characterized by fibrous scarring and adhesion of both the visceral pericardium and the parietal pericardium, which leads to restricted cardiac filling. However, diagnosing CP with normal thickness pericardium and without calcification is still a challenge. The predominant cause in the developed world is idiopathic or viral pericarditis， followed by post-cardiac surgery and post-radiation. Tuberculosis still remains a common cause of CP in developing countries. In this report, we describe a rare case of idiopathic localized constrictive visceral pericardium with normal thickness of the parietal pericardium in a middle-aged man. The patient presented with unexplained right heart failure and echocardiography showed moderate bi-atrial enlargement which should be?identified with the restrictive cardiomyopathy.?After 10 months of conservative treatment, the progression of right heart failure was remaining. A pericardiectomy was performed and the patient recovered. This case serves as a reminder to consider CP in patients with unexplained right heart failure, so that timely investigation and treatment can be initiated.
关键词： constrictive pericarditis heart failure pericardiectomy
Severe hepatoxicity caused by aspirin overdose: a case report
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《医学前沿（英文）》 2015年 第9卷 第3期 页码 388-391 doi: 10.1007/s11684-015-0398-7
We report here the rare case of a 61-year-old man with multiple organ dysfunction caused by an aspirin overdose (4 g orally). The patient presented with a fever that reached 39.2 °C, a peptic ulcer, and massive upper gastrointestinal bleeding. His blood test results were as follows: white blood cell count, 1.8×109/L; absolute lymphocytes, 0.4×109/L; absolute neutrophils, 1.2×109/L; and electrolyte disturbances. A computed tomography (CT) scan showed evidence of bilateral inferior pulmonary infection and acute pancreatitis. Thick dark bile with visible floccule was drawn via a percutaneous transhepatic cholangiodrainage (PTCD). Klebsiella pneumoniae was detected in microbiological bile tests. Two years later, the patient died of chronic liver failure.
New perspective on the natural course of chronic HBV infection
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《医学前沿（英文）》 2014年 第8卷 第2期 页码 129-134 doi: 10.1007/s11684-014-0339-x
Chronic hepatitis B virus (HBV) infection is a significant threat to public health and an enormous burden on society. Mechanisms responsible for chronic HBV infection remain poorly understood. A better understanding of the natural course of chronic HBV infection may shed new light on the mechanisms underlying this disease and help in designing new antiviral strategies. Natural course of chronic HBV infection is conventionally viewed as an uninterrupted process that is usually marked by HBV e antigen (HBeAg) seroconversion or characterized by different phases associated with assumed host responses to HBV infection. However, none of these descriptions captures or highlights the core events that determine the natural course of chronic HBV infection. In this review, we briefly present the current knowledge on this subject and explain the significance and implication of events that occur during infection. A pre-core mutant becomes predominant in the viral population following elimination of the wild-type virus in duck hepatitis B virus-chronically infected animals. The coupled events in which first there is viral clearance that clears wild-type virus and then there is the reinfection of wild-type virus cleared livers with mutant virus are highly relevant to understanding of the natural course of chronic HBV infection under both treated and untreated conditions. In our new perspective, a general natural course of chronic HBV infection comprises cycles of viral clearance and reinfection, and such cycles prolong the chronic HBV infection course. Reviewing published data on the natural course of chronic HBV infection can reduce the possibility of missing important points in the initial data interpretation.
关键词： hepatitis B virus chronic HBV infection natural course hepatitis B seroconversion
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《医学前沿（英文）》 2011年 第5卷 第1期 页码 1-7 doi: 10.1007/s11684-010-0105-7
Partial liver transplantation, including reduced-size liver transplantation, split liver transplantation, and living donor liver transplantation, has been developed with several innovative techniques because of donor shortage. Reduced-size liver transplantation is based on Couinaud’s anatomical classification, benefiting children and small adult recipients but failing to relieve the overall donor shortage. Split liver transplantation provides chances to two or even more recipients when only one liver graft is available. The splitting technique must follow stricter anatomical and physiological criteria either ex situ or in situto ensure long-term quality. The first and most important issue involving living donor liver transplantation is donor safety. Before surgery, a series of donor evaluations—including anatomical, liver volume, and liver function evaluations—is indispensable, followed by ethnic agreement. At different recipient conditions, auxiliary liver transplantation and auxiliary partial orthotopic liver transplantation, which employ piggyback techniques, are good alternatives. Partial liver transplantation enriches the practice and knowledge of the transplant society.
关键词： partial liver transplantation reduced-size liver transplantation split liver transplantation living donor liver transplantation
标题 作者 时间 类型 操作
Comprehensive treatment of acute-on-chronic liver failure in a patient with hepatitis B: a case report
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期刊论文
Correlation between viral load and liver cirrhosis in chronic hepatitis B patients
Lili LIU MM , Jiyao WANG MD , Weimin SHE MM ,
期刊论文
The “Traditional Chinese medicine regulating liver regeneration” treatment plan for reducing mortalityof patients with hepatitis B-related liver failure based on real-world clinical data
Ling Dai, Xiang Gao, Zhihua Ye, Hanmin Li, Xin Yao, Dingbo Lu, Na Wu
期刊论文
FMO3--TMAO axis modulates the clinical outcome in chronic heart-failure patients with reduced ejection
期刊论文
Clinical characteristics and risk factors of COVID-19 patients with chronic hepatitis B: a multi-center
期刊论文
Intra-abdominal hypertension is an independent cause of acute renal failure after orthotopic liver transplantation
SHU Ming, PENG Chenghong, CHEN Hao, SHEN Boyong, ZHOU Guangwen, SHEN Chuan, LI Hongwei
期刊论文
A rare chronic constrictive pericarditis with localized adherent visceral pericardium and normal parietal
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期刊论文
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