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Treatment of portal hypertension

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World Journal of Gastroenterology 2012年第11期18卷 1166-1175页

作者： Khurram Bari Guadalupe garcia-tsao Section of Digestive Diseases Yale University School of MedicineNew HavenCT and VA-Connecticut Healthcare SystemWest HavenCT 06520United States

Portal hypertension is the main complication of cirrhosis and is defined as an hepatic venous pressure gradient （HVPG） of more than 5 mmHg. Clinically significant portal hypertension is defined as HVPG of 10 mmHg or more. Development of gastroesophageal varices and variceal hemorrhage are the most direct consequence of portal hypertension. Over the last decades significant advancements in the field have led to standard treatment options. These clinical recommendations have evolved mostly as a result of *** controlled trials and consensus conferences among experts where existing evidence has been reviewed and future goals for research and practice guidelines have been pro- posed. Management of varices/variceal hemorrhage is based on the clinical stage of portal hypertension. No specific treatment has shown to prevent the formation of varices. Prevention of first variceal hemorrhage depends on the size/characteristics of varices. In patients with small varices and high risk of bleeding, nonselective β-blockers are recommended, while patients with medium/large varices can be treated with either β-blockers or esophageal band ligation. Standard ofcare for acute variceal hemorrhage consists of vasoacrive drugs, endoscopic band ligation and antibiotics prophylaxis. Transjugular intrahepatic portosystemic shunt （TIPS） is reserved for those who fail standard of care or for patients who are likely to fail （＂early TIPS＂）. Prevention of recurrent variceal hemorrhage consists of the combination of β-blockers and endoscopic band ligation.

关键词： Cirrhosis Portal hypertension Varices Varicealhemorrhage Primary prophylaxis Secondary prophylaxis

Harnessing the power of pericytes and hypoxia-inducible factor-1 to modulate stroke outcome

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Neural Regeneration Research 2024年第3期19卷 473-474页

作者： Omolara O.Ogunshola Chih-Chieh tsao Institute of Veterinary Physiology Vetsuisse FacultyUniversity of ZurichZurichSwitzerland

The human brain has exceedingly high metabolic *** cerebral vasculature has the critical task of providing sufficient blood supply to meet this *** sudden interruption of blood flow to the brain,as observed during ischemic stroke,results in acute neurological injury with devastating consequences-a high rate of adult disability and *** stroke is thus a vascular disorder with a dramatic neurological *** is an urgent need for more effective disease management to combat stroke as current treatment paradigms,focusing on vascular recanalization and neuroprotection,have only limited clinical *** accumulating data suggests successful long-term neuroprotection is unlikely to be achievable without a functional microvascular network,strategies that reduce endothelial dysfunction could be ***,very recent evidence highlighted herein suggests protecting the humble pericyte may be a new approach to reaching this goal.

关键词： consequences exceeding herein

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肝硬化的细菌感染：治疗和预防（三）

传染病网络动态 2005年第9期 29-30页

作者： Guadalupe garcia-tsao 姚勤伟（编译）杨月（审校）

2．3．无自发性腹膜炎或胃肠道出血的病人这些病人发生SBP的风险很大程度上依赖于腹水蛋白含量。腹水蛋白含量〉1．0g／dL的病人在2年的随访期中不会发生SBP（因此不需要预防），腹水蛋白很低（〈1．0g／dL）（并且在胃肠道出血期间接... 详细信息

2．3．无自发性腹膜炎或胃肠道出血的病人这些病人发生SBP的风险很大程度上依赖于腹水蛋白含量。腹水蛋白含量〉1．0g／dL的病人在2年的随访期中不会发生SBP（因此不需要预防），腹水蛋白很低（〈1．0g／dL）（并且在胃肠道出血期间接受短期抗生素预防）的病人1年内发生SBP的可能性在20％左右。

关键词：抗生素预防细菌感染肝硬化胃肠道出血治疗自发性腹膜炎腹水蛋白蛋白含量 SBP

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肝硬化的细菌感染：治疗和预防（二）

传染病网络动态 2005年第8期 24-26页

作者： Guadalupe garcia-tsao 姚勤伟（编译）杨月（审校）

在有SBP的病人中，三分之一发生肾功能损害，是这些病人中最重要的死亡预后因素。一项前瞻性的随机化非盲试验比较了头孢噻肟＋白蛋白和仅使用头孢噻肟的治疗效果，结果表明接受白蛋白的病人肾功能损害的发生率明显较低，而且这也和住... 详细信息

在有SBP的病人中，三分之一发生肾功能损害，是这些病人中最重要的死亡预后因素。一项前瞻性的随机化非盲试验比较了头孢噻肟＋白蛋白和仅使用头孢噻肟的治疗效果，结果表明接受白蛋白的病人肾功能损害的发生率明显较低，而且这也和住院死亡率及3个月内死亡率减少有关。蛋白质有增加循环血量的效果，根据经验在诊断时使用1．5g／公斤体重的剂量，

关键词：治疗效果细菌感染肝硬化肾功能损害住院死亡率预防头孢噻肟预后因素循环血量

Empagliflozin reduces brain pathology in Alzheimer's disease and type 2 diabetes

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Neural Regeneration Research 2024年第6期19卷 1189-1190页

作者： Carmen Hierro-Bujalance Monica garcia-Alloza Division of Physiology School of MedicineUniversidad de CadizCadizSpain Instituto de Investigacion e Innovacion en Ciencias Biomedicas de la Provincia de Cadiz(INIBICA) CadizSpain Salus Infirmorum-Universidad de Cadiz CadizSpain

Alzheimer's disease(AD)and type 2 diabetes(T2D):More than 55 million people suffer from dementia,and it is expected that over 150 million people will suffer from this disease by *** is the most common type of dementia and while aging remains the main risk factor to suffer it,previous studies have also shown that metabolic disorders,and T2D specifically,are also major contributors(Wang et al.,2012).

关键词： Alzheimer diabetes

肝硬化自然史和生存预后因子：对118项研究的系统回顾（下）

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传染病网络动态 2006年第11期 17-20页

作者： Gennaro D＇ Amico Guadalupe garcia-tsao Luigi Pagliaro 姚勤伟（编译）杨月（审校）

2．5预后指标在这些研究中一共评价了174项不同的指标。表3列出了根据这些指标在肝硬化的临床和病理生理学中所起作用进行的分组。表4显示，死亡的最常见独立预示因子的指标是Child（-Pugh）评分，在67项研究中引入多冈素分析，其中42项... 详细信息

2．5预后指标在这些研究中一共评价了174项不同的指标。表3列出了根据这些指标在肝硬化的临床和病理生理学中所起作用进行的分组。表4显示，死亡的最常见独立预示因子的指标是Child（-Pugh）评分，在67项研究中引入多冈素分析，其中42项（63％）中5个预示因子最为显著。接下来是Child-Pugh评分的所有组成部分（白蛋白、胆红素、腹水、

关键词：肝硬化系统回顾预后因子自然史独立预示因子病理生理学预后指标 Chi

Oxidative dissolution of Cr(OH)_(3) and mixed Fe-Cr(Ⅲ)phases by aqueous Mn(Ⅲ)-pyrophosphate complex

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Journal of Environmental Sciences 2024年第5期139卷 105-113页

作者： Mismel Ruiz-garcia Jordan Stanberry Giovanna Ballerini Ribeiro Vasileios Anagnostopoulos Department of Chemistry University of Central FloridaOrlando FL 32816USA

The key role of manganese(Mn)in the biogeochemical cycle of trace elements has been of great interest in recent ***,the redox properties of aqueous Mn(Ⅲ)have been studied to a lesser ***(Ⅲ)is not stable in solution by ***,when complexed with inorganic ligands,it has shown potential to oxidize and reduce trace *** the present study,we are exploring the redox characteristics of the complex Mn(Ⅲ)-Pyrophosphate(Mn(Ⅲ)-PP).This complex is stable over a wide range of pH values but requires the ratio of Mn:PP to be less than 1:***,the redox reaction of chromium(Cr(Ⅲ))and Mn(Ⅲ)-PP is investigated.A solid,Cr(OH)_(3),is used as a source of Cr(Ⅲ).For this reaction,environmentally relevant parameters,such as pH,ionic strength,ratio Mn(Ⅲ)/Cr(Ⅲ),and excess of ligand,were *** showed that Mn(Ⅲ)can effectively oxidize Cr(Ⅲ)to Cr(Ⅵ),taking about 15 days for the reaction to *** reaction occurs only under acidic conditions(pH4),and with a low excess of *** initial Mn(Ⅲ)concentration decreases as the Cr(Ⅵ)is produced,and Cr(Ⅵ)can be adsorbed back into the Cr(OH)_(3)surface,limiting the mobility of this toxic *** this adsorption,significant amounts of Cr(VI)are release in the aqueous *** study shows the importance of a mobile species(Mn-PP complex)in the oxidation of Cr(Ⅲ)and the release of Cr(Ⅵ)to the environment.

关键词： Chromium Manganese Pyrophosphate complex Sorption Ionic strength Redox

β-阻断剂对肝硬化患者胃食管静脉曲张的预防作用

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世界核心医学期刊文摘（胃肠病学分册） 2006年第4期2卷 3-4页

作者： Groszmann R.J garcia-tsao G Bosch J. 廖新华 Yale University School of Medicine VA CT Healthcare System Digestive Disease Section/ 111H 950 Campbell AveWest Haven CT 06516 United StatesDr.

BACKGROUND: Nonselective beta-adrenergic blockers decrease portal pressure and prevent variceal hemorrhage. Their effectiveness in preventing varices is unknown. METHODS: We randomly assigned 213 patients with cirrhosis and portal hypertension (minimal hepatic venous pressure gradient [HVPG] of 6 mm Hg) to receive t imolol, a nonselective beta-blocker (108 patients), or placebo (105 patients). The primary end point was the development of gastroesophageal varices or variceal hemorrhage. Endoscopy and HVPG measurements were repeated yearly. RESULTS: During a median follow-up of 54.9 months, the rate of the primary end point did not differ significantly between the timolol group and the placebo group (39 percent and 40 percent, respectively; P = 0.89), nor were there significant differences in the rates of ascites, encephalopathy, liver transplantation, or death. Serious adverse events were more common among patients in the timolol group than among those in the placebo group (18 percent vs. 6 percent, P = 0.006). Varices developed less frequently among patients with a baseline HVPG of less than 10 mm Hg and among those in whom the HVPG decreased by more than 10 percent at one year and more frequently among those in whom the HVPG increased by more than 10 percent at one year. CONCLUSIONS: Nonselective beta-blockers are ineffective in preventing varices in unselected patients with cirrhosis and portal hypertension and are associated with an increased number of adverse events.

关键词： β-阻断剂肝静脉压力梯度门静脉压力终点指标噻吗洛尔死亡发生率安慰剂肝性脑病肝移植内

肝硬化自然史和生存预后因子：对118项研究的系统回顾（上）

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传染病网络动态 2006年第10期 14-18页

作者： Gennaro D’Amico Guadalupe garcia-tsao Luigi Pagliaro 姚勤伟（编译）杨月（审校）

肝移植技术显著地提高了终末期肝硬化患者的生存率和生活质量。但是，因为肝脏供体不足和缺乏对平均寿命的精确预测，仍有很大比例的患者在等待肝移植的过程中死亡。尽管在最近20年提出了很多预测肝硬化患者死亡率的预后模型，但是到目... 详细信息

肝移植技术显著地提高了终末期肝硬化患者的生存率和生活质量。但是，因为肝脏供体不足和缺乏对平均寿命的精确预测，仍有很大比例的患者在等待肝移植的过程中死亡。尽管在最近20年提出了很多预测肝硬化患者死亡率的预后模型，但是到目前为止Child-Pugh记分仍然是临床实践和研究中应用最广泛的一种。

关键词：肝硬化患者系统回顾预后因子自然史肝移植技术等待肝移植生活质量平均寿命