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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)
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
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
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
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
肠道菌群调控的色氨酸代谢改善了D-Gal/LPS诱导的C57BL/6小鼠急性肝衰竭 Article
郑志鹏, 伍莉, 韩玉秋, 陈俊, 朱帅, 姚圆圆, 王保红, 李兰娟
《工程(英文)》 2022年 第14卷 第7期 页码 134-146 doi: 10.1016/j.eng.2020.12.013
急性肝衰竭(acute liver failure, ALF)发病突然,常常导致死亡。本研究旨在通过多组学的方法,研究肠道菌群在ALF中的综合作用。RNA 测序显示,在Abx干预的ALF小鼠中,肝脏的炎症反应受到抑制,而整体代谢途径上调。此外,AhR靶向干预了影响了经Abx预处理或未经Abx预处理的ALF小鼠的预后,表明AhR通路在一定程度上调节了机体对ALF的易感性。本研究表明,依赖肠道菌群调控的色氨酸代谢可以通过调节AhR的活性,影响宿主对ALF的易感性,为更好地管理ALF提供了一个有前景的靶点。
Clinical analysis of 275 cases of acute drug-induced liver disease
LI Lei, JIANG Wei, WANG Jiyao
《医学前沿(英文)》 2007年 第1卷 第1期 页码 58-61 doi: 10.1007/s11684-007-0012-8
Gut microbial balance and liver transplantation: alteration, management, and prediction
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《医学前沿(英文)》 2018年 第12卷 第2期 页码 123-129 doi: 10.1007/s11684-017-0563-2
Liver transplantation is a conventional treatment for terminal stage liver diseases. However, several complications still hinder the survival rate. Intestinal barrier destruction is widely observed among patients receiving liver transplant and suffering from ischemia–reperfusion or rejection injuries because of the relationship between the intestine and the liver, both in anatomy and function. Importantly, the resulting alteration of gut microbiota aggravates graft dysfunctions during the process. This article reviews the research progress for gut microbial alterations and liver transplantation. Especially, this work also evaluates research on the management of gut microbial alteration and the prediction of possible injuries utilizing microbial alteration during liver transplantation. In addition, we propose possible directions for research on gut microbial alteration during liver transplantation and offer a hypothesis on the utilization of microbial alteration in liver transplantation. The aim is not only to predict perioperative injuries but also to function as a method of treatment or even inhibit the rejection of liver transplantation.
关键词: gut microbial balance liver transplantation ischemia–reperfusion acute rejection
Treatment of infant postrenal acute renal failure following obstruction due to upper urinary calculi
Hui-Xia ZHOU MD, Zhi-Chun FENG MD, Hao MENG MD, Xiao-Guang ZHOU MD, Shuang LI BM, Jun WANG MM, Shi-Xi DAI BM,
《医学前沿(英文)》 2010年 第4卷 第1期 页码 127-130 doi: 10.1007/s11684-010-0009-6
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.
Xiaofang Cui, Benting Ma, Yan Wang, Yan Chen, Chunling Shen, Ying Kuang, Jian Fei, Lungen Lu, Zhugang Wang
《医学前沿(英文)》 2019年 第13卷 第1期 页码 104-111 doi: 10.1007/s11684-017-0568-x
关键词: retinol dehydrogenase 13 carbon tetrachloride acute liver injury Cyp2e1 Spot14
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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
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《医学前沿(英文)》 2018年 第12卷 第3期 页码 262-268 doi: 10.1007/s11684-017-0584-x
γδ T cells display unique developmental, distributional, and functional patterns and can rapidly respond to various insults and contribute to diverse diseases. Different subtypes of γδ T cells are produced in the thymus prior to their migration to peripheral tissues. γδ T cells are enriched in the liver and exhibit liver-specific features. Accumulating evidence reveals that γδ T cells play important roles in liver infection, non-alcoholic fatty liver disease, autoimmune hepatitis, liver fibrosis and cirrhosis, and liver cancer and regeneration. In this study, we review the properties of hepatic γδ T cells and summarize the roles of γδ T cells in liver diseases. We believe that determining the properties and functions of γδ T cells in liver diseases enhances our understanding of the pathogenesis of liver diseases and is useful for the design of novel γδ T cell-based therapeutic regimens for liver diseases.
关键词: γδT cells liver infection non-alcoholic fatty liver disease autoimmune hepatitis liver fibrosis and cirrhosis liver cancer liver regeneration
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《医学前沿(英文)》 2018年 第12卷 第3期 页码 249-261 doi: 10.1007/s11684-018-0622-3
Natural killer T cells are innate-like and tissue-resident lymphocytes, which recognize lipid antigens and are enriched in the liver. Natural killer T cells play important roles in infections, tumors, autoimmune diseases, and metabolic diseases. In this study, we summarize recent findings on biology of natural killer T cells and their roles in hepatitis B virus and hepatitis C virus infection, autoimmune liver diseases, alcoholic liver disease, nonalcoholic fatty liver disease, and hepatocellular carcinoma. Controversial results from previous studies are discussed, and indicate the dynamic alteration in the role of natural killer T cells during the progression of liver diseases, which might be caused by changes in natural killer T subsets, factors skewing cytokine responses, and intercellular crosstalk between natural killer T cells and CD1d-expressing cells or bystander cells.
关键词: natural killer T cells hepatitis B virus and hepatitis C virus infection autoimmune liver diseases alcoholic liver disease nonalcoholic fatty liver disease hepatocellular carcinoma
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
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
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
Clinical analysis of 275 cases of acute drug-induced liver disease
LI Lei, JIANG Wei, WANG Jiyao
期刊论文
Treatment of infant postrenal acute renal failure following obstruction due to upper urinary calculi
Hui-Xia ZHOU MD, Zhi-Chun FENG MD, Hao MENG MD, Xiao-Guang ZHOU MD, Shuang LI BM, Jun WANG MM, Shi-Xi DAI BM,
期刊论文
Rdh13 deficiency weakens carbon tetrachloride-induced liver injury by regulating Spot14 and Cyp2e1 expression
Xiaofang Cui, Benting Ma, Yan Wang, Yan Chen, Chunling Shen, Ying Kuang, Jian Fei, Lungen Lu, Zhugang Wang
期刊论文