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文章速递非典型CE1型肝囊型包虫病的诊断及腹腔镜治疗体会 认领
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作者 马志刚 李玉鹏 +1 位作者 孟塬 陈雄 《中华肝胆外科杂志》 CAS CSCD 北大核心 2021年第3期188-191,共4页
目的探讨非典型CE1型肝囊型包虫病的有效诊断方法及腹腔镜手术的临床疗效。方法回顾性分析2018年6月至2019年6月新疆维吾尔自治区人民医院收治的17例非典型CE1型肝囊型包虫患者临床资料,其中男性11例,女性6例,年龄(46.0±21.6)岁,... 目的探讨非典型CE1型肝囊型包虫病的有效诊断方法及腹腔镜手术的临床疗效。方法回顾性分析2018年6月至2019年6月新疆维吾尔自治区人民医院收治的17例非典型CE1型肝囊型包虫患者临床资料,其中男性11例,女性6例,年龄(46.0±21.6)岁,均有畜牧区接触史。术前完善包虫免疫实验、腹部超声、腹部CT检查,行腹腔镜手术治疗,术后采用门诊复查、电话等方式进行随访,随访时间截至2020年6月。对术前不同检查方法诊断情况、手术方式、包虫病复发等指标进行分析。结果17例患者术前肝包虫病血清免疫学检查11例为囊性包虫病阳性,6例阴性。腹部CT诊断结果示17例均为肝囊肿。常规彩色多普勒超声示14例患者为肝囊肿,3例示肝囊性占位,囊型包虫病不除外;更换高频探头后9例患者观察到肝囊性病灶顶部节段双轨征或局部增厚囊壁,诊断为CE1型肝囊型包虫病,8例仍诊断为肝囊肿。17例患者均行腹腔镜手术,术中均明确诊断为肝囊型包虫病,无中转开腹,手术时间(125.0±54.5)min;术中出血量为(150.0±84.5)ml,术后住院时间为(6.5±2.5)d;围手术期无严重并发症或死亡病例,2例术后出现微胆漏,术后5~10 d自行痊愈;术后随访6~12个月,无失访,未见肝脏及腹腔包虫复发。结论在肝脏单囊型病灶的诊治过程中应注意非典型CE1型肝囊型包虫与单纯性肝囊肿的鉴别诊断,腹部螺旋CT、包虫免疫实验、腹部超声有效鉴别率低,易误诊、漏诊,腹部超声高频探头可一定程度提高非典型CE1型肝囊型包虫诊断率。腹腔镜技术既是有效诊断方法也是治疗手段,需根据患者包虫病灶情况选择合理手术方式,腹腔镜手术治疗肝囊型包虫病安全、可行。 展开更多
关键词 肝囊型包虫病 腹腔镜手术治疗 腹部超声 高频探头 肝包虫病 包虫 临床疗效 肝囊肿
Intra-arterial thrombolysis for early hepatic artery thrombosis after liver transplantation 认领
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作者 Ting Li Xiao-Dong Sun +1 位作者 Ying Yu Guo-Yue Lv 《世界临床病例杂志》 SCIE 2021年第7期1592-1599,共8页
BACKGROUND Early hepatic artery thrombosis(E-HAT)is a serious complication after liver transplantation(LT),which often results in graft failure and can lead to patient deaths.Treatments such as re-transplantation and ... BACKGROUND Early hepatic artery thrombosis(E-HAT)is a serious complication after liver transplantation(LT),which often results in graft failure and can lead to patient deaths.Treatments such as re-transplantation and re-anastomosis are conventional therapeutic methods which are restricted by the shortage of donors and the patient’s postoperative intolerance to re-laparotomy.Due to the advances in interventional techniques and thrombolytics,endovascular treatments are increasingly being selected by more and more centers.This study reviews and reports our single-center experience with intra-arterial thrombolysis as the first choice therapy for E-HAT after deceased donor LT.AIM To evaluate the feasibility and reasonability of intra-arterial thrombolysis for EHAT after deceased donor LT.METHODS A total of 147 patients who underwent deceased donor LT were retrospectively reviewed in our hospital between September 2011 and December 2016.Four patients were diagnosed with E-HAT.All of these patients underwent intraarterial thrombolysis with alteplase as the first choice therapy after LT.The method of arterial anastomosis and details of the diagnosis and treatment of EHAT were collated.The long-term prognosis of E-HAT patients was also recorded.The median follow-up period was 26 mo(range:23 to 30 mo).RESULTS The incidence of E-HAT was 2.7%(4/147).E-HAT was considered when Doppler ultrasonography showed no blood flow signals and a definite diagnosis was confirmed by immediate hepatic arterial angiography when complete occlusion of the hepatic artery was observed.The patients were given temporary thrombolytics(mainly alteplase)via a 5-Fr catheter which was placed in the proximal part of the thrombosed hepatic artery followed by continuous alteplase using an infusion pump.Alteplase dose was adjusted according to activated clotting time.The recanalization rate of intra-arterial thrombolysis in our study was 100%(4/4)and no thrombolysis-related mortality was observed.During the follow-up period,patient survival rate was 75%( 展开更多
关键词 Early hepatic artery thrombosis Liver transplantation Intra-arterial thrombolysis THROMBOLYTICS Hepatic arterial angiography PROGNOSIS
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文章速递快速康复护理路径在肝包虫病患者围手术期管理中的应用 认领
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作者 汪晓兰 王红英 +3 位作者 德吉卓玛 黄紫文 于晓玲 吴德全 《中华现代护理杂志》 2021年第4期499-503,共5页
目的探讨快速康复护理路径在肝包虫手术患者术后快速康复中的应用效果。方法采用单纯随机抽样法,选取西藏自治区山南市人民医院2017年11月—2019年2月收治的160例肝包虫手术患者为研究对象,随机分为试验组和对照组,每组80例。对照组患... 目的探讨快速康复护理路径在肝包虫手术患者术后快速康复中的应用效果。方法采用单纯随机抽样法,选取西藏自治区山南市人民医院2017年11月—2019年2月收治的160例肝包虫手术患者为研究对象,随机分为试验组和对照组,每组80例。对照组患者采用普外科常规护理,试验组在常规护理基础上施行快速康复护理路径护理。比较两组患者术后康复指标、疼痛评分和术后并发症情况。结果试验组组患者的首次排气、排便时间为(3.77±3.05)、(23.81±17.29)h,早于对照组的(13.27±8.58)、(37.79±18.23)h,差异有统计学意义(t值分别为4.265、4.975;P<0.01);试验组术后2、4、8、24 h疼痛评分(1.08±1.04)、(1.61±0.85)、(1.13±0.70)、(0.26±0.41)分,低于对照组的(2.41±1.20)、(2.94±0.96)、(2.94±0.96)、(1.33±0.90)分,差异具有统计学意义(t值分别为7.501、9.250、13.650、-8.720;P<0.01)。术后试验组发生肺部感染2例(2.50%),对照组发生13例(16.25%),试验组发生率低于对照组,差异有统计学意义(χ2=8.901,P<0.01)。结论基于快速康复护理路径的标准化护理模式有利于肝包虫病患者术后康复,缩短住院时间,减少术后肺部感染,值得进一步推广。 展开更多
关键词 肝包虫病 围手术期管理 快速康复护理路径 肝包虫手术 单纯随机抽样 术后快速康复 术后肺部感染 排便时间
Molecular pathways of liver regeneration:A comprehensive review 认领
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作者 Yana V Kiseleva Sevak Z Antonyan +3 位作者 Tatyana S Zharikova Kirill A Tupikin Dmitry V Kalinin Yuri O Zharikov 《世界肝病学杂志:英文版(电子版)》 2021年第3期270-290,共21页
The liver is a unique parenchymal organ with a regenerative capacity allowing it to restore up to 70%of its volume.Although knowledge of this phenomenon dates back to Greek mythology(the story of Prometheus),many aspe... The liver is a unique parenchymal organ with a regenerative capacity allowing it to restore up to 70%of its volume.Although knowledge of this phenomenon dates back to Greek mythology(the story of Prometheus),many aspects of liver regeneration are still not understood.A variety of different factors,including inflammatory cytokines,growth factors,and bile acids,promote liver regeneration and control the final size of the organ during typical regeneration,which is performed by mature hepatocytes,and during alternative regeneration,which is performed by recently identified resident stem cells called“hepatic progenitor cells”.Hepatic progenitor cells drive liver regeneration when hepatocytes are unable to restore the liver mass,such as in cases of chronic injury or excessive acute injury.In liver maintenance,the body mass ratio is essential for homeostasis because the liver has numerous functions;therefore,a greater understanding of this process will lead to better control of liver injuries,improved transplantation of small grafts and the discovery of new methods for the treatment of liver diseases.The current review sheds light on the key molecular pathways and cells involved in typical and progenitor-dependent liver mass regeneration after various acute or chronic injuries.Subsequent studies and a better understanding of liver regeneration will lead to the development of new therapeutic methods for liver diseases. 展开更多
关键词 Liver regeneration Molecular pathways Hepatic progenitor cells CYTOKINES Micro ribonucleic acid Partial hepatectomy
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肝包虫囊肿压迫下腔静脉的外科治疗 认领
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作者 张宏伟 吴向未 +3 位作者 张示杰 阿布都瓦依提 孙红 彭心宇 《中华消化外科杂志》 CAS 北大核心 2021年第2期234-239,共6页
目的探讨肝包虫囊肿压迫下腔静脉的外科治疗。方法采用回顾性描述性研究方法。收集2013年5月至2018年5月石河子大学医学院第一附属医院收治的10例肝包虫囊肿压迫下腔静脉病人的临床资料;男7例,女3例;年龄为(46±5)岁,年龄范围为38~5... 目的探讨肝包虫囊肿压迫下腔静脉的外科治疗。方法采用回顾性描述性研究方法。收集2013年5月至2018年5月石河子大学医学院第一附属医院收治的10例肝包虫囊肿压迫下腔静脉病人的临床资料;男7例,女3例;年龄为(46±5)岁,年龄范围为38~51岁。根据术中肝包虫囊肿与下腔静脉的贴合程度以及囊肿完整切除的难易程度,分别行外膜内外囊完整切除术、外膜内外囊次全切除术、外膜内外囊完整切除联合下腔静脉部分切除术。观察指标:(1)手术情况。(2)术后情况。(3)随访情况。采用门诊和电话方式进行随访,于术后3、6、12、24个月门诊随访1次。行彩色多普勒超声检查了解病人肝包虫囊肿复发及下腔静脉栓塞情况。随访终点为术后2年,随访次要终点为肝包虫囊肿复发。随访时间截至2020年5月。正态分布的计量资料以x±s表示。计数资料以绝对数表示。结果(1)手术情况:10例病人均顺利完成手术,7例行外膜内外囊完整切除术,2例行外膜内外囊次全切除术,1例行外膜内外囊完整切除联合下腔静脉部分切除术。10例病人术中无大出血及感染性休克发生。10例病人手术时间为(99±27)min;术中出血量为(99±48)mL。(2)术后情况:10例病人术后2~5 d拔除引流管,无术后出血、术后残腔感染、术后胆瘘发生,无围术期死亡病人,术后住院时间为(7.1±1.8)d。(3)随访情况:10例病人中,9例完成终点随访,随访时间内均无肝包虫囊肿复发及下腔静脉栓塞形成;1例病人于术后12个月,第3次随访失访,此病人术后3、6个月随访未发现肝包虫囊肿复发及下腔静脉栓塞。结论外膜内外囊完整切除术、外膜内外囊次全切除术、外膜内外囊完整切除联合下腔静脉部分切除术均能完整切除肝包虫囊肿。 展开更多
关键词 棘球蚴病 下腔静脉 压迫 手术治疗 治疗效果
肝泡型包虫病特异microRNA的筛选及初步研究 认领
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作者 任宾 樊海宁 +1 位作者 王海久 任利 《临床肝胆病杂志》 CAS 北大核心 2021年第1期135-141,共7页
目的肝泡型包虫病由多房棘球蚴感染造成,通过对肝泡型包虫病患者组织和血浆中差异表达的miRNA进行筛查,寻找肝泡型包虫病新的生物标志物。方法纳入2016年6月—2018年5月在青海大学附属医院确诊的肝泡型包虫病患者,选取2例肝泡型包虫病... 目的肝泡型包虫病由多房棘球蚴感染造成,通过对肝泡型包虫病患者组织和血浆中差异表达的miRNA进行筛查,寻找肝泡型包虫病新的生物标志物。方法纳入2016年6月—2018年5月在青海大学附属医院确诊的肝泡型包虫病患者,选取2例肝泡型包虫病患者的病灶边缘组织和3例临近病灶边缘的正常组织,以及3例肝泡型包虫病患者和3例健康对照者的血浆样本,使用Agilent Human miRNA芯片检测组织和血浆的miRNA表达谱,根据差异倍数(FC>1.2)和P值(P<0.05)筛选差异表达的miRNA,根据差异miRNA的靶基因预测结果,结合文献报道,选择与肝脏疾病相关的血浆miRNA和组织miRNA进行实时荧光定量PCR(qRT-PCR)验证。计量资料2组间比较采用t检验,相关性分析采用Spearman相关分析。结果肝泡型包虫病患者中的microRNA表达谱与健康人相比有显著不同,qRT-PCR验证发现6个microRNA中有3个miRNA(hsa-miR-4644,hsa-miR-136-5p,hsa-miR-483-3p)在肝泡型包虫病患者中显著差异表达(P<0.05)。其中hsa-miR-4644和hsa-miR-483-3p在肝泡型包虫病患者中显著上调表达(P值均<0.05),hsa-miR-136-5p显著下调表达(P<0.05)。通过TargetScan,PITA,microRNAorg数据库对差异miRNA进行靶基因预测,对三个数据库预测到的靶基因取交集,共有137个基因和miRNA之间有靶向关系。差异的hsa-miR-483-3p靶向调控参与人体免疫反应及与肝脏疾病有关的基因(IL-17A,IL-5,CD40LG,TAP2,TNF)。通过GO与KEGG分析发现,hsa-miR-483-3p的靶基因在免疫缺陷(Primary immunodeficiency)信号通路,IL-17信号通路,TNF信号通路中起重要作用。结论肝泡型包虫病有独特的microRNA表达谱,其中hsa-miR-483-3p可作为肝泡型包虫病的一种新的生物学标志物,其调控的靶基因主要参与Primary immunodeficiency信号通路,IL-17信号通路,TNF信号通路。但这些miRNA与肝泡型包虫病之间的调控关系有待进一步验证。 展开更多
关键词 棘球虫幼病 微RNAS 基因表达谱
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Resection of a retrohepatic leiomyosarcoma of the inferior vena cava combined with caudate lobectomy and reconstruction with an allogenic vein 认领
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作者 Xin-Xue Zhang Ji-Qiao Zhu +3 位作者 Hui Zhang Jian-Tao Kou Jun Ma Qiang He 《国际肝胆胰疾病杂志:英文版》 SCIE CAS 2021年第1期80-82,共3页
Primary leiomyosarcoma of the inferior vena cava(IVC)is a rare disease,accounting for 0.5%of soft tissue sarcomas in adults[1].A diversity of therapeutic methods have been applied to treat this type of tumor.The avera... Primary leiomyosarcoma of the inferior vena cava(IVC)is a rare disease,accounting for 0.5%of soft tissue sarcomas in adults[1].A diversity of therapeutic methods have been applied to treat this type of tumor.The average survival time of patients who are not treated is merely 3-4 months[2].The effect of radiotherapy and chemotherapy remains unclear and controversial[3].On the other hand,the en-bloc resection with negative margins may be the only potentially curative treatment and therefore,can contribute to the long-term survival of the patients[4].During the operation,a reconstruction graft for the defected IVC needs to be chosen[5]as the graft-related complications are the surgeons’major concern,which include graft thrombosis and infection[6].Growing evidence has suggested that an allogeneic vein from donation after brain death or cardiac death is a better choice to avoid these complications[7].An allogeneic vein has been reported to be safely used in patients with pancreatic cancer in case of the portal vein and/or superior mesenteric vein invasion[8].A cryopreserved allograft can even be applied in the management of native and prosthetic aortic infections[7].Herein,we present a case of resection of a retrohepatic leiomyosarcoma of the IVC combined with partial caudate lobectomy and reconstruction with an allogeneic vein. 展开更多
关键词 SARCOMA hepatic invasion
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Hepatic isolated ectopic adrenocortical adenoma mimicking metastatic liver tumor 认领
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作者 Jing-Yi Zhang Yan Luo +1 位作者 Fei Liu Bo Li 《国际肝胆胰疾病杂志:英文版》 SCIE CAS 2021年第1期83-86,共4页
A 55-year-old male had surgery for colon cancer in December 2017.A mass was found in the right posterior lobe of his liver in January 2019.There was no previous history of hepatitis,and all tumor markers were within n... A 55-year-old male had surgery for colon cancer in December 2017.A mass was found in the right posterior lobe of his liver in January 2019.There was no previous history of hepatitis,and all tumor markers were within normal ranges.Ultrasound examination found a 2.0×1.7 cm hypoechoic nodule with unclear boundaries and regular shape in hepatic segment VII.Contrast-enhanced ultrasound(CEUS)displayed hyperenhancement in the arterial phase and wash-out in the early portal phase,and the delayed phase was hypoenhanced(Fig.1).Contrast-enhanced computed tomography(CECT)presented a 1.5 cm slightly enhanced hepatic mass in the arterial phase and rim-enhancement in the portal phase(Fig.2 A-C).Magnetic resonance imaging(MRI)showed high intensity on T2W fat-suppressed scan and peripheral hyperintensity on contrast-enhanced T1W portal phase with no uptake of the contrast agent during the delayed phase(Fig.2 D-F),and diffusion weight was restricted in the right posterior upper hepatic segment.Preoperative diagnosis was metastatic carcinoma of the liver. 展开更多
关键词 METASTATIC HEPATIC DIAGNOSIS
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Promotive action of 2-acetylaminofluorene on hepatic precancerous lesions initiated by diethylnitrosamine in rats:Molecular study 认领
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作者 Amany Helmy Hasanin Eman K Habib +1 位作者 Nesreen El Gayar Marwa Matboli 《世界肝病学杂志:英文版(电子版)》 2021年第3期328-342,共15页
BACKGROUND Diethylnitrosamine(DEN)induces hepatic neoplastic lesions over a prolonged period.AIM To investigate the promotive action of 2-acetylaminofluorene(2-AAF)when combined with DEN in order to develop a rat mode... BACKGROUND Diethylnitrosamine(DEN)induces hepatic neoplastic lesions over a prolonged period.AIM To investigate the promotive action of 2-acetylaminofluorene(2-AAF)when combined with DEN in order to develop a rat model for induction of precancerous lesion and investigate the molecular mechanism underlying the activity of 2-AAF.METHODS The pre-precancerous lesions were initiated by intraperitoneal injection of DEN for three weeks consecutively,followed by one intraperitoneal injection of 2-AAF at three different doses(100,200 and 300 mg/kg).Rats were separated into naïve,DEN,DEN+100 mg 2-AAF,DEN+200 mg 2-AAF,and DEN+300 mg 2-AAF groups.Rats were sacrificed after 10 wk and 16 wk.Liver functions,level of alpha-fetoprotein,glutathione S-transferase-P and proliferating cell nuclear antigen staining of liver tissues were performed.The mRNA level of RAB11A,BAX,p53,and Cyclin E and epigenetic regulation by long-noncoding RNA(lncRNA)RP11-513I15.6,miR-1262(microRNA),and miR-1298 were assessed in the sera and liver tissues of the rats.RESULTS 2-AAF administration significantly increased the percent area of the precancerous foci and cell proliferation along with a significant decrease in RAB11A,BAX,and p53 mRNA,and the increase in Cyclin E mRNA was associated with a marked decrease in lncRNA RP11-513I15.6 expression with a significant increase in both miR-1262 and miR-1298.CONCLUSION 2-AFF promoted hepatic precancerous lesions initiated through DEN by decreasing autophagy,apoptosis,and tumor suppression genes,along with increased cell proliferation,in a time-and dose-dependent manner.These actions were mediated under the epigenetic regulation of lncRNA RP11-513I15.6/miR-1262/miR-1298. 展开更多
关键词 Acetylaminofluorene Hepatic precancerous lesion DIETHYLNITROSAMINE AUTOPHAGY APOPTOSIS MicroRNA
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同期联合根治性手术治疗肝肾泡型棘球蚴病10例临床分析 认领
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作者 喀斯木·艾海提 阿卜杜萨拉木·艾尼 +6 位作者 艾斯卡·艾尼娃 冉博 蒋铁民 张瑞青 邵英梅 温浩 吐尔干艾力·阿吉 《中华外科杂志》 CAS 北大核心 2021年第1期59-65,共7页
目的探讨同期联合根治性手术治疗肝肾泡型棘球蚴病(AE)的可行性、安全性和有效性。方法回顾性分析2013年4月至2019年9月在新疆医科大学第一附属医院接受手术治疗的连续10例肝肾AE患者的临床资料,男性8例,女性2例,年龄(42.5±10.3)岁... 目的探讨同期联合根治性手术治疗肝肾泡型棘球蚴病(AE)的可行性、安全性和有效性。方法回顾性分析2013年4月至2019年9月在新疆医科大学第一附属医院接受手术治疗的连续10例肝肾AE患者的临床资料,男性8例,女性2例,年龄(42.5±10.3)岁(范围:27~52岁)。7例曾行姑息性治疗但服药依从性差。10例均存在肝右叶和右肾的联合病灶,2例分别合并肝左外叶和左肾小病灶。病灶体积为(726.4±576.1)cm^(3)(范围:117.0~1998.0 cm^(3))。病灶侵犯右侧膈肌7例、下腔静脉7例、右肾上腺6例、腹壁2例、右侧腰大肌1例、十二指肠1例和右肺下叶2例。采用同期联合根治性手术和血管重建等方法治疗肝肾及邻近器官的AE病灶。半肝及以上肝切除8例,离体肝切除自体肝移植2例,肝部分切除1例;右肾全切除7例,右肾部分切除3例,左肾部分切除1例;清除肝肾外受侵组织器官的病灶,并进行相应修补或重建。结果手术均顺利完成。术后无肝肾功能不全。3例患者出现胸腔积液,经保守治疗后改善;1例出现右肾周围尿漏,置入双“J”管并保守治疗后改善。随访6~81个月,中位随访时间21个月,无死亡病例,无发生肝肾功能不全、急慢性肾病者。1例术后7个月时发生腹壁切口疝,接受腹腔镜疝修补术。随访中无复发,10例患者均获得临床治愈。结论采用同期联合根治性手术治疗复发性或原发性肝肾AE安全可行,可同时有效清除其他邻近器官的病灶。 展开更多
关键词 棘球蚴病 外科手术 同期联合手术 棘球蚴病 棘球蚴病
Congenital hepatic fibrosis in a young boy with congenital hypothyroidism:A case report 认领
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作者 Fang-Fei Xiao Yi-Zhong Wang +2 位作者 Fang Dong Xiao-Lu Li Ting Zhang 《世界临床病例杂志》 SCIE 2021年第6期1475-1482,共8页
BACKGROUND Congenital hepatic fibrosis(CHF)is a rare autosomal recessive disorder characterized by variable degrees of periportal fibrosis and malformation of bile ducts.CHF is generally accompanied by a variety of co... BACKGROUND Congenital hepatic fibrosis(CHF)is a rare autosomal recessive disorder characterized by variable degrees of periportal fibrosis and malformation of bile ducts.CHF is generally accompanied by a variety of conditions or syndromes with other organ involvement.CASE SUMMARY We report a 5-year-4-month-old Chinese boy with congenital hypothyroidism(CH)diagnosed with CHF.The patient was diagnosed with CH by a newborn screening test and has since been taking levothyroxine.He has developed normally without neurocognitive deficits.Abnormal liver function was observed in the patient at the age of 4 years and 11 mo,and elevated levels of liver function indices were persistent for 5 mo.Radiological imaging indicated hepatosplenomegaly without narrowing of the portal vein but dilated splenic vein.A liver biopsy confirmed the pathological features of CHF.Genetic testing revealed two novel homozygous mutations,namely,c.2141-3T>C variant in PKHD1 related to CHF and c.2921G>A(p.R974H)in DUOX2 related to CH.The patient was treated with compound glycyrrhizin tablet,ursodeoxycholic acid,and levothyroxine after diagnosis.The patient achieved a favorable clinical outcome during a follow-up period of over 2 years.CONCLUSION Herein,we report the first case of a Chinese boy with comorbidity of CHF and CH,carrying both PKHD1 gene and DUOX2 gene novel mutations.Liver biopsy and genetic testing should be considered for the diagnosis of coexistent liver disease in CH patients with unexplained abnormal liver function. 展开更多
关键词 Congenital hepatic fibrosis Congenital hypothyroidism Liver biopsy PKHD1 DUOX2 Case report Genetic testing
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Inhibitory effects of oxyresveratrol on ERK and Smad1/2 phosphorylation and HSC activation in preventing carbon tetrachloride-induced rat liver fibrosis 认领
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作者 Guliang Yang Jianfeng Zhan +4 位作者 Yiwen Yang Li Yuan Peilei Wang Chi-Tang Ho Shiming Li 《食品科学与人类健康》 SCIE 2021年第1期6-12,共7页
Oxyresveratrol(ORes,trans-2,4,3′,5′-tetrahydroxy stilbene)naturally exists in mulberry,grapes,peanuts and other plants.It belongs to stilbene polyphenolic family and has an extra hydroxyl group at 2-position compari... Oxyresveratrol(ORes,trans-2,4,3′,5′-tetrahydroxy stilbene)naturally exists in mulberry,grapes,peanuts and other plants.It belongs to stilbene polyphenolic family and has an extra hydroxyl group at 2-position comparing with resveratrol(Res).Hence,ORes has stronger antioxidant activity than resveratrol.In present study,we employed a rat hepatic fibrosis model induced by carbon tetrachloride(CCl_(4))and administrated ORes via gavage feeding to study the protective effects and potential mechanisms of ORes against hepatic fibrosis.We demonstrated that rat liver oxidative damage induced by CCl_(4)was significantly alleviated after ORes feeding.Furthermore,the mRNA transcription levels ofα-smooth muscle actinn(˛-SMA),desmin,and two MMPs(MMP2 and MMP9)were reduced and the expression levels of transforming growth factorβ1(TGF-β1),p-small mother against decapen-taplegic protein(Smad)1/2 and p-extracellular signal-regulated kinases(ERK)1/2 in the liver tissue down-regulated dramatically.In a parallel study with Res,ORes showed more efficacious protective effect than Res against rat liver fibrosis,which is attributed to extended conjugation system due to the extra hydroxyl group at 2-position on ORes making it more electron-rich and susceptible to oxidation than Res.Therefore,dietary consumption of mulberry and other fruits containing ORes may be beneficial in the prevention of liver fibrosis. 展开更多
关键词 OXYRESVERATROL Hepatic fibrosis Oxidative stress TGF-β/Smad/ERK signaling pathway
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Psoraleae induces hepatotoxicity by affecting bile acid balance 认领
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作者 Wei-Ling Pu Bin Yu +3 位作者 An-Hong Wang Ya-Nan Bi Hong Shi Kun Zhou 《亚洲毒理学研究》 2021年第1期15-22,共8页
Buguzhi(Psoraleae fructus),the seed of Psoralea corylifolia Linn,is used to treat osteoporosis,nephritis,vitiligo and other diseases.However,long-term routine or overdose of Psoraleae fructus may lead to hepatotoxicit... Buguzhi(Psoraleae fructus),the seed of Psoralea corylifolia Linn,is used to treat osteoporosis,nephritis,vitiligo and other diseases.However,long-term routine or overdose of Psoraleae fructus may lead to hepatotoxicity and become a major obstacle of its clinical usage.Psoralen was a key active component of Psoraleae fructus,and a main cause of Psoraleae fructus toxicity.This research was to investigate the hepatotoxicity of psoralen and whether it’s related with bile acid imbalance.Methods:C57BL/6 mice were randomly divided into 4 groups(n=10).Psoralen(20 mg/kg,40 mg/kg and 80 mg/kg)was administrated intragastrically once every day and control group with equivalent water until 4 weeks.Results:The results showed that psoralen caused an increase in liver coefficient and the injury of hepatocytes microstructure of mice.It also inhibited cell viability of HepG2 cells.Mice treated with psoralen exerted liver total bile acid increased while serum total bile acid decreased,which indicated that psoralen-induced liver injury may partly associate with cholestasis.For further study of liver transporters,high dose of psoralen inhibited the expression of some important hepatic efflux transporters(including BSEP,p-gp and ABCG5)in vivo and in vitro.Conclusion:We provide evidence for the first time that psoralen may induce cholestatic hepatotoxicity for the bile acid retention by inhibition on bile acid export pumps. 展开更多
关键词 PSORALEN HEPATOTOXICITY Bile acid Hepatic transporter
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Portal hypertension exacerbates intrahepatic portosystemic venous shunt and further induces refractory hepatic encephalopathy: A case report 认领
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作者 Ying-Hao Chang Xiao-Lei Zhou +2 位作者 Dan Jing Zhen Ni Shan-Hong Tang 《世界临床病例杂志》 SCIE 2021年第2期496-501,共6页
BACKGROUND Intrahepatic portosystemic venous shunt(IPSVS)is a rare hepatic disease with different clinical manifestations.Most IPSVS patients with mild shunts are asymptomatic,while the patients with severe shunts pre... BACKGROUND Intrahepatic portosystemic venous shunt(IPSVS)is a rare hepatic disease with different clinical manifestations.Most IPSVS patients with mild shunts are asymptomatic,while the patients with severe shunts present complications such as hepatic encephalopathy.For patients with portal hypertension accompanied by intrahepatic shunt,portal hypertension may lead to hemodynamic changes that may result in exacerbated portal shunt and increased shunt flow.CASE SUMMARY A 57-year-old man,with the medical history of chronic hepatitis B and liver cirrhosis,was admitted to our hospital with abnormal behavior for 10 mo.He had received the esophageal varices ligation and entecavir therapy 1 year ago.Comparing with former examination results,the degree of esophageal varices was significantly reduced,while the right branch of the portal vein was significantly expanded and tortuous.Meanwhile,abdominal ultrasound presented the right posterior branch of portal vein connected with the retrohepatic inferior vena cava.The imaging findings indicated the diagnosis of IPSVS and hepatic encephalopathy.Instead of radiologic interventions or surgical therapies,this patient had only accepted symptomatic treatment.No recurrence of hepatic encephalopathy was observed during 1-year follow-up.CONCLUSION Hemodynamic changes may exacerbate intrahepatic portosystemic shunt.The intervention or surgery should be carefully applied to patients with severe portal hypertension due to the risk of hemorrhage. 展开更多
关键词 Intrahepatic portosystemic venous shunt Portal hypertension Hepatic encephalopathy Esophageal varices Symptomatic treatment Case report HEMODYNAMICS
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剩余肝体积不足的晚期肝泡型包虫外科治疗进展 认领
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作者 杨冲 杨洪吉 +1 位作者 邓绍平 张宇 《中国普通外科杂志》 CAS 北大核心 2021年第1期98-104,共7页
剩余肝体积(RLV)不足是肝切除术后肝功能衰竭和患者死亡的主要原因。肝泡型包虫(HAE)常侵及肝内外重要血管,致使功能肝段的保留极为困难,根治性切除率低。尽管离体肝切除联合自体肝移植术(ERAT)极大拓宽了晚期HAE手术指征,但RLV不足仍... 剩余肝体积(RLV)不足是肝切除术后肝功能衰竭和患者死亡的主要原因。肝泡型包虫(HAE)常侵及肝内外重要血管,致使功能肝段的保留极为困难,根治性切除率低。尽管离体肝切除联合自体肝移植术(ERAT)极大拓宽了晚期HAE手术指征,但RLV不足仍是限制HAE根治性切除的主要因素。近年来,包括分期肝切除、肝静脉支架置入序贯ERAT、辅助性ERAT、联合肝脏离断和门静脉结扎的二步肝切除术(ALPPS)等多种手段已应用于RLV不足晚期HAE的外科治疗,提高了晚期HAE的根治性切除率。笔者对RLV不足的晚期HAE患者外科治疗新进展做一综述。 展开更多
关键词 棘球蚴病 剩余肝体积 肝切除术 肝移植 支架
Comparative study of indocyanine green-R15,Child-Pugh score,and model for end-stage liver disease score for prediction of hepatic encephalopathy after transjugular intrahepatic portosystemic shunt 认领
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作者 Zhong Wang Yi-Fan Wu +5 位作者 Zhen-Dong Yue Hong-Wei Zhao Lei Wang Zhen-Hua Fan Yu Zhang Fu-Quan Liu 《世界胃肠病学杂志:英文版》 SCIE CAS 2021年第5期416-427,共12页
BACKGROUND Hepatic encephalopathy(HE)remains an enormous challenge in patients who undergo transjugular intrahepatic portosystemic shunt(TIPS)implantation.The preoperative indocyanine green retention rate at 15 min(IC... BACKGROUND Hepatic encephalopathy(HE)remains an enormous challenge in patients who undergo transjugular intrahepatic portosystemic shunt(TIPS)implantation.The preoperative indocyanine green retention rate at 15 min(ICG-R15),as one of the liver function assessment tools,has been developed as a prognostic indicator in patients undergoing surgery,but there are limited data on its role in TIPS.AIM To determine whether the ICG-R15 can be used for prediction of post-TIPS HE in decompensated cirrhosis patients with portal hypertension(PHT)and compare the clinical value of ICG-R15,Child-Pugh score(CPS),and model for end-stage liver disease(MELD)score in predicting post-TIPS HE with PHT.METHODS This retrospective study included 195 patients with PHT who underwent elective TIPS at Beijing Shijitan Hospital from January 2018 to June 2019.All patients underwent the ICG-R15 test,CPS evaluation,and MELD scoring 1 wk before TIPS.According to whether they developed HE or not,the patients were divided into two groups:HE group and non-HE group.The prediction of one-year post-TIPS HE by ICG-R15,CPS and MELD score was evaluated by the areas under the receiver operating characteristic curves(AUCs).RESULTS A total of 195 patients with portal hypertension were included and 23%(45/195)of the patients developed post-TIPS HE.The ICG-R15 was identified as an independent predictor of post-TIPS HE.The AUCs for the ICG-R15,CPS,and MELD score for predicting post-TIPS HE were 0.664(95%confidence interval[CI]:0.557-0.743,P=0.0046),0.596(95%CI:0.508-0.679,P=0.087),and 0.641(95%CI:0.554-0.721,P=0.021),respectively.The non-parametric approach(Delong-Delong&Clarke-Pearson)showed that there was statistical significance in pairwise comparison between AUCs of ICG-R15 and MELD score(P=0.0229).CONCLUSION The ICG-R15 has appreciated clinical value for predicting the occurrence of post-TIPS HE and is a choice for evaluating the prognosis of patients undergoing TIPS. 展开更多
关键词 Hepatic encephalopathy Indocyanine green-R15 Child-Pugh score Model for end-stage liver disease score Transjugular intrahepatic portosystemic shunt Portal hypertention
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Role of ammonia in predicting the outcome of patients with acuteon- chronic liver failure 认领
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作者 Stefan Chiriac Carol Stanciu +6 位作者 Camelia Cojocariu Ana-Maria Singeap Catalin Sfarti Tudor Cuciureanu Irina Girleanu Razvan Alexandru Igna Anca Trifan 《世界临床病例杂志》 SCIE 2021年第3期552-564,共13页
BACKGROUND High venous ammonia(VA)values have been proven to be a part of the mechanism of hepatic encephalopathy in patients with liver cirrhosis(LC)as well as acute hepatitis.Moreover,VA has been associated with poo... BACKGROUND High venous ammonia(VA)values have been proven to be a part of the mechanism of hepatic encephalopathy in patients with liver cirrhosis(LC)as well as acute hepatitis.Moreover,VA has been associated with poor prognosis and high mortality in these clinical settings.However,the role of ammonia in acuteon-chronic liver failure(ACLF)has not yet been clearly established.AIM To assess the role of VA in predicting the outcome of cirrhotic patients with ACLF in a tertiary care center.METHODS We performed a retrospective observational study including consecutive patients with LC hospitalized for acute non-elective indications such as ascites,hepatic encephalopathy(HE),upper gastrointestinal bleeding,or bacterial infections that fulfilled the Asian Pacific Association for the Study of the Liver(APASL)criteria for ACLF.The study was conducted in“St.Spiridon”University Hospital,Iasi,Romania,a tertiary care center,between January 2017 and January 2019.The APASL ACLF Research Consortium(AARC)score was calculated and ACLF grade was established accordingly.West-haven classification was used for HE.Statistical analysis was performed using IBM SPSS version 22.0.RESULTS Four hundred and forty-six patients were included,aged 59(50-65)years,57.4%men.Child-Pugh,model for end-stage liver disease(MELD)and AARC scores were 11(10-12),19.13±6.79,and 7(6-8),respectively.66.4%had ACLF grade I,31.2%ACLF grade II,and 2.5%ACLF grade III.HE was diagnosed in 83.9%,34%grade I,37.2%grade II,23.5%grade III,and 5.3%grade IV.Overall mortality was 7.8%.VA was 103(78-148)μmol/L.Receiver operating characteristic analysis showed good accuracy for the prediction of in-hospital mortality for the AARC score[Area under the curve(AUC)=0.886],MELD score(AUC=0.816),VA(AUC=0.812)and a fair accuracy for the Child-Pugh score(AUC=0.799).Subsequently,a cut-off value for the prediction of mortality was identified for VA(152.5μmol/L,sensitivity=0.706,1-specificity=0.190).Univariate analysis found acute kidney injury,severe HE(grade III or IV),VA≥152. 展开更多
关键词 Venous ammonia Hepatic encephalopathy Acute-on-chronic liver failure Asian Pacific Association for the Study of the Liver Acute-on-chronic Liver Failure Research Consortium score CIRRHOSIS Mortality
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Living-donor liver transplantation in Budd-Chiari syndrome with inferior vena cava complete thrombosis:A case report and review of the literature 认领
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作者 Vinicius Rocha-Santos Daniel Reis Waisberg +8 位作者 Rafael Soares Pinheiro Lucas Souto Nacif Rubens Macedo Arantes Liliana Ducatti Rodrigo Bronze Martino Luciana Bertocco Haddad Flavio Henrique Galvao Wellington Andraus Luiz Augusto Carneiro-D'Alburquerque 《世界肝病学杂志:英文版(电子版)》 CAS 2021年第1期151-161,共11页
BACKGROUND Budd-Chiari syndrome(BCS)is a challenging indication for liver transplantation(LT)due to a combination of massive liver,increased bleeding,retroperitoneal fibrosis and frequently presents with stenosis of t... BACKGROUND Budd-Chiari syndrome(BCS)is a challenging indication for liver transplantation(LT)due to a combination of massive liver,increased bleeding,retroperitoneal fibrosis and frequently presents with stenosis of the inferior vena cava(IVC).Occasionally,it may be totally thrombosed,increasing the complexity of the procedure,as it should also be resected.The challenge is even greater when performing living-donor LT as the graft does not contain the retrohepatic IVC;thus,it may be necessary to reconstruct it.CASE SUMMARY A 35-year-old male patient with liver cirrhosis due to BCS and hepatocellular carcinoma beyond the Milan criteria underwent living-donor LT with IVC reconstruction.It was necessary to remove the IVC as its retrohepatic portion was completely thrombosed,up to almost the right atrium.A right-lobe graft was retrieved from his sister,with outflow reconstruction including the right hepatic vein and the branches of segment V and VIII to the middle hepatic vein.Owing to massive subcutaneous collaterals in the abdominal wall,venovenous bypass was implemented before incising the skin.The right atrium was reached via a transdiaphragramatic approach.Hepatectomy was performed en bloc with the retrohepatic vena cava.It was reconstructed with an infra-hepatic vena cava graft obtained from a deceased donor.The patient remains well on outpatient clinic follow-up 25 mo after the procedure,under an anticoagulation protocol with warfarin.CONCLUSION Living-donor LT in BCS with IVC thrombosis is feasible using a meticulous surgical technique and tailored strategies. 展开更多
关键词 Liver transplantation Living donors Budd-Chiari syndrome Hepatic venoocclusive disease Inferior vena cava Case report
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系统免疫炎症指数与肝泡型包虫病患者预后的相关性分析 认领
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作者 陈小彬 袁加琪 +7 位作者 王志鑫 樊海宁 许召君 梅学鹏 王海久 马佳敏 周瀛 侯立朝 《临床肝胆病杂志》 CAS 北大核心 2021年第2期375-379,共5页
目的探讨分析系统免疫炎症指数(SII)与肝泡型包虫病患者预后的相关性分析。方法回顾性分析2015年1月—2018年12月青海大学附属医院肝胆胰外科收治的242例行肝泡型包虫病手术患者的临床资料,计算SII数值。计数资料两组间比较采用χ^2检... 目的探讨分析系统免疫炎症指数(SII)与肝泡型包虫病患者预后的相关性分析。方法回顾性分析2015年1月—2018年12月青海大学附属医院肝胆胰外科收治的242例行肝泡型包虫病手术患者的临床资料,计算SII数值。计数资料两组间比较采用χ^2检验。相关性分析采用Spearman相关分析。应用受试者工作特征曲线(ROC曲线)确定SII的最佳临界值,Kaplan-Meier法绘制生存曲线,对两组患者的总生存时间进行分析,并用log-rank比较两组生存率差异;采用单因素和多因素Cox回归模型分析肝泡型包虫病患者预后的影响因素。结果SII与肝泡型包虫病患者术后病死率呈正相关(r=0.267,P<0.001)。应用ROC曲线确定术前SII的最佳临界值为758.92,将242例患者分为低SII组(SII≤758.92,126例)和高SII组(SII>758.92,n=116例)。低SII组与高SII组肝泡型包虫患者术后1、3、5年生存率分别为98.20%、88.47%、66.10%和90.80%、53.05%、27.40%,低SII组累积生存率>50%,平均生存时间为55.584个月(95%CI:53.550~57.617);高SII组累积生存率<50%,平均生存时间为39.384个月(95%CI:35.070~43.698),中位生存时间为43个月(95%CI:34.694~51.306),低SII组肝泡型包虫病患者生存率明显优于高SII组,两组总体生存率差异有统计学意义(χ^2=46.979,P<0.05)。单因素分析结果显示SII>758.92是肝泡型包虫病患者总体生存时间的影响因素(HR=5.907,95%CI:3.386~10.306,P=0.001);Cox多因素分析显示术前外周血SII是肝泡型包虫病患者总体生存率的独立危险因素(HR=3.507,95%CI:1.911~6.435,P=0.001)。结论术前SII水平与肝泡型包虫病患者预后有明确的相关性,可作为临床评估患者预后的指标,术前外周血SII越高,患者预后越差。 展开更多
关键词 棘球蚴病 系统免疫炎症指数 预后 危险因素
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Evaluation of controlled attenuation parameter in assessing hepatic steatosis in patients with autoimmune liver diseases 认领
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作者 Xi-Xi Ni Min Lian +9 位作者 Hui-Min Wu Xiao-Yun Li Li Sheng Han Bao Qi Miao Xiao Xiao Can-Jie Guo Hai Li Xiong Ma Jing Hua 《世界胃肠病学杂志:英文版》 SCIE CAS 2021年第1期80-91,共12页
BACKGROUND Hepatic steatosis commonly occurs in some chronic liver diseases and may affect disease progression.AIM To investigate the performance of controlled attenuation parameter(CAP)for the diagnosis of hepatic st... BACKGROUND Hepatic steatosis commonly occurs in some chronic liver diseases and may affect disease progression.AIM To investigate the performance of controlled attenuation parameter(CAP)for the diagnosis of hepatic steatosis in patients with autoimmune liver diseases(AILDs).METHODS Patients who were suspected of having AILDs and underwent liver biopsy were consistently enrolled.Liver stiffness measurement(LSM)and CAP were performed by transient elastography.The area under the receiver operating characteristic(AUROC)curve was used to evaluate the performance of CAP for diagnosing hepatic steatosis compared with biopsy.RESULTS Among 190 patients with biopsy-proven hepatic steatosis,69 were diagnosed with autoimmune hepatitis(AIH),18 with primary biliary cholangitis(PBC),and 27 with AIH-PBC overlap syndrome.The AUROCs of CAP for the diagnosis of steatosis in AILDS were 0.878(0.791-0.965)for S1,0.764(0.676-0.853)for S2,and 0.821(0.716-0.926)for S3.The CAP value was significantly related to hepatic steatosis grade(P<0.001).Among 69 patients with AIH,the median CAP score was 205.63±47.36 dB/m for S0,258.41±42.83 dB/m for S1,293.00±37.18 dB/m for S2,and 313.60±27.89 dB/m for S3.Compared with patients with nonalcoholic fatty liver disease(NAFLD)presenting with autoimmune markers,patients with AIH concomitant with NAFLD were much older and had higher serum IgG levels and LSM values.CONCLUSION CAP can be used as a noninvasive diagnostic method to evaluate hepatic steatosis in patients with AILDs.Determination of LSM combined with CAP may help to identify patients with AIH concomitant with NAFLD from those with NAFLD with autoimmune phenomena. 展开更多
关键词 Controlled attenuation parameter Hepatic steatosis Autoimmune liver diseases Nonalcoholic fatty liver disease Liver stiffness measurement Autoimmune hepatitis
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