检索范围：
排序： 展示方式：
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
Risk factors of prognosis after acute kidney injury in hospitalized patients
null
《医学前沿（英文）》 2017年 第11卷 第3期 页码 393-402 doi: 10.1007/s11684-017-0532-9
The risk factors, especially laboratory indicators, of prognosis after acute kidney injury (AKI) remain unclear. We conducted a retrospective survey of Chinese People’s Liberation Army General Hospital from January 1, 2012 to December 31, 2012 according to the AKI diagnosis standard issued by Kidney Disease Improving Global Outcomes. The epidemiological features and factors influencing hospital mortality and renal function recovery were evaluated through logistic regression analysis. Among 77 662 cases of hospitalized patients, 1387 suffered from AKI. The incidence rate and mortality of AKI were 1.79% and 14.56%, respectively. Multivariate logistic regression analysis revealed that high AKI stage, age greater than 80 years, neoplastic disease, low cardiac output, increased white blood cell count, and decreased platelet count and serum albumin levels were the risk factors affecting the mortality of AKI patients. Conversely, body mass index between 28 and 34.9 was a protective factor. Increased AKI stage, tumor disease, post-cardiopulmonary resuscitation, and RRT were the risk factors of renal function recovery upon discharge. In addition to traditional risk factors, white blood cell count, platelet count, albumin, and BMI were the predictors of the mortality of AKI patients. No laboratory indicators were found to be the risk factors of renal function recovery in AKI patients.
Overview on acute-on-chronic liver failure
null
《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
null
《医学前沿（英文）》 2015年 第9卷 第2期 页码 187-219 doi: 10.1007/s11684-015-0386-y
Autoimmune hepatitis is a chronic liver disease putatively caused by loss of tolerance to hepatocyte-specific autoantigens. It is characterized by female predilection, elevated aminotransferase levels, autoantibodies, increased γ-globulin or IgG levels and biopsy evidence of interface hepatitis. It is currently divided into types 1 and 2, based on expression of autoantibodies. Autoantigenic epitopes have been identified only for the less frequent type 2. Although autoimmune hepatitis occurs in childhood, this review focuses on disease in adults. In the absence of pathognomonic biomarkers, diagnosis requires consideration of clinical, biochemical, serological and histological features, which have been codified into validated diagnostic scoring systems. Since many features also occur in other chronic liver diseases, these scoring systems aid evaluation of the differential diagnosis. New practice guidelines have redefined criteria for remission to include complete biochemical and histological normalization on immunosuppressive therapy. Immunosuppression is most often successful using prednisone or prednisolone and azathioprine; however, the combination of budesonide and azathioprine for non-cirrhotic patients offers distinct advantages. Patients failing standard immunosuppression are candidates for alternative immunosuppressive regimens, yet none of the options has been studied in a randomized, controlled trial. Overlap syndromes with either primary sclerosing cholangitis or primary biliary cirrhosis occur in a minority. Liver transplantation represents a life-saving option for patients presenting with acute liver failure, severely decompensated cirrhosis or hepatocellular carcinoma. Transplant recipients are at risk for recurrent autoimmune hepatitis in the allograft, and de novo disease may occur in patients transplanted for other indications. Patients transplanted for AIH are also at risk for recurrent or de novo inflammatory bowel disease. Progress in our understanding of the immunopathogenesis should lead to identification of specific diagnostic and prognostic biomarkers and new therapeutic strategies.
关键词： autoimmune hepatitis autoantibodies diagnosis immunological diseases drug-induced liver injury therapy immunosuppression outcomes hepatocellular carcinoma liver transplantation
null
《医学前沿（英文）》 2015年 第9卷 第4期 页码 457-467 doi: 10.1007/s11684-015-0417-8
Herbal medicines have recently been recognized as the second most common cause of drug-induced liver injury (DILI) in the United States. However, reliable methods to identify the DILI causality of some herbs, such as Heshouwu (dried root of Polygonum multiflorum), remain lacking. In this study, a total of 12 307 inpatients with liver dysfunction and 147 literature-reported cases of Heshouwu DILI were screened. A general algorithm indicated that only 22.5% (9/40) and 30.6% (45/147) of all hospitalization and literature case reports, respectively, demonstrate the high probability of DILI causality of Heshouwu. By contrast, 95% (19/20) of all cases prospectively investigated by pharmacognosy, phytochemistry, and metabolomic tests exhibited highly probable causality, including a patient who was previously incorrectly attributed and a case that was excluded from Heshouwu causality by pharmacognostic evidence. Toxin (heavy metals, pesticides, and mycotoxins) contamination was also excluded from Heshouwu DILI causality. The objectivity of these screening methods for Heshouwu DILI diagnosis addresses safety concerns regarding stilbene-containing herbal medicines and dietary supplements.
关键词： drug-induced liver injury pharmacognosy metabolomics stilbene Polygonum multiflorum Chinese herbal medicine
null
《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
Assessment of liver volume variation to evaluate liver function
null
《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)
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
Bioartificial liver devices: Perspectives on the state of the art
null
《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
Gut microbial balance and liver transplantation: alteration, management, and prediction
null
《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
吴理茂,李连达,刘红,宁可永,李贻奎
《中国工程科学》 2004年 第6卷 第7期 页码 34-42
研究中药归元方与自体骨髓干细胞移植对急慢性肝损伤的治疗作用。研究方法：用肝脏局部注射乙醇的方法复制急性局限性肝损伤模型，复合因素（CCl4、乙醇、高脂、低蛋白）刺激复制大鼠肝纤维化模型，通过定量组织学、肝功能检查、免疫组化、肝组织羟脯氨酸含量、损伤或纤维区骨髓干细胞观察等综合评价中药、自体骨髓干细胞移植及两者合用的疗效。结果：归元方与自体骨髓干细胞移植可减小肝损伤区域，改善肝功能，使纤维肝组织表达μPA增强，降低血清ALT，AST，PCⅢ，HA和肝组织羟脯氨酸的含量，改善肝组织肝纤维化评分，骨髓干细胞能在肝损伤、肝纤维化形成环境中存活、增殖，并向肝细胞分化，表达肝脏特异的角蛋白CK18。结论：归元方与自体骨髓干细胞移植对急慢性肝损伤有明确的治疗作用，两者合用可优势互补，协同增效。临床上有良好的应用前景。
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
Glucagon-like peptide-2 exhibits protective effect on hepatic ischemia-reperfusion injury in rats
null
《医学前沿（英文）》 2015年 第9卷 第3期 页码 368-373 doi: 10.1007/s11684-015-0403-1
Glucagon-like peptide-2 (GLP-2) has potent anti-inflammatory effects and protects against experimental ischemia/reperfusion (I/R) injury in pulmonary, intestinal, and myocardial tissue. However, its protective abilities against I/R injury in the liver are unknown. We investigated the potential role of GLP-2 pretreatment on hepatic I/R injury in rats. A total of 24 rats were randomly divided into three groups (n = 8). The first group was the control group; the second group was the vehicle-treated hepatic ischemia/reperfusion (HIR, vehicle saline-treated) group; and the third group was the GLP-2 pretreated I/R (GLP2-IR) group. Each rat in the third group was intraperitoneally administered 5 μg GLP-2 for 5 d before the procedure. A portal triad was created to induce ischemia with a vascular atraumatic clamp. After 40 min, the clamp was released to initiate hepatic reperfusion for 6 h. Blood samples and tissue specimens from the liver were obtained. Alanine aminotransferase, aspartate aminotransferase, and total bilirubin levels significantly increased in the saline-treated HIR group (P<0.001), whereas GLP-2 pretreatment significantly decreased their levels (P<0.01). Our data suggested that GLP-2 pretreatment may have a protective effect on liver I/R injury. However, dose-response studies are necessary to determine the most effective dose.
关键词： ischemia/reperfusion liver glucagon-like peptide-2 alanine aminotransferase
利用CES1和DPP-IV的组织残余活性准确评估和追踪特异性肝损伤过程 Article
潘秋莎, 宋培放, 倪振华, 钱星凯, 王安琪, 邹立伟, 刘勇, 王平, 张卫东, 马红, 杨凌
《工程（英文）》 2022年 第19卷 第12期 页码 153-165 doi: 10.1016/j.eng.2021.09.014
准确评估和追踪特异性肝损伤及其进程仍然是当前生物标志物研究中的一大挑战。本研究建立了一种回顾追溯验证方法，用以表征α-萘异硫氰酸酯（ANIT）诱导的特异性肝脏胆管损伤后血清标志物与组织标志物之间的互动关系。研究发现羧酸酯酶1（CES1）作为肝内标志物和二肽基肽酶4（DPP-IV）作为肝外标志物可反映肝脏损伤的不同病理生理状态。CES1 和DPP-IV 水平可甄别肝损伤本身和炎症损伤之间的差异。相比之下，常规血清学标志物碱性磷酸酶（ALP）、丙氨酸转氨酶（ALT）和天冬氨酸转氨酶（AST）在ANIT诱导损伤后血清和组织水平同时升高，胆汁中胆汁酸水平下降，血清中胆汁酸水平升高，肝内组织中胆汁酸水平升高。尽管血清与组织中γ-谷氨酰基转肽酶（γ-GT）升降水平的变化方向相反，但其持续时间远短于CES1，并迅速恢复到正常水平。在上述生物标志物中，只有CES1 能够明确排除炎症干扰下的肝细胞损伤。CES1 还能准确评估熊去氧胆酸（UDCA；单成分药物）和清肺排毒汤（QFPDD；多组分药物）的抗胆汁淤积作用。研究发现QFPDD和UDCA均能减轻ANIT 诱导的肝损伤。UDCA在促进胆汁排泄方面的效果更强，但其抗损伤和抗炎作用相对较弱，而QFPDD在阻断肝脏炎症和修复肝损伤方面更有效。本文数据强调了联合使用CES1（作为肝内肝损伤标志物）和DPP-IV（作为肝外炎症作用标志物）可准确评估和追踪特异性肝损伤，并可区分肝损伤和炎症性肝损伤的差异。
《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
标题 作者 时间 类型 操作
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
Evidence chain-based causality identification in herb-induced liver injury: exemplification of a well-knownliver-restorative herb
null
期刊论文
Comprehensive treatment of acute-on-chronic liver failure in a patient with hepatitis B: a case report
null
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
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
Glucagon-like peptide-2 exhibits protective effect on hepatic ischemia-reperfusion injury in rats
null
期刊论文
京公网安备 11010502051620号
