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Hepatitis B down under:consensus recommendations from the Gastroenterological Society of Australia

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Hepatobiliary Surgery and Nutrition 2023年第5期12卷 768-771页

作者： vignan Manne kris v.kowdley Division of Gastroenterology and Hepatology University of NevadaLas Vegas Kirk Kerkorian School of MedicineLas VegasNVUSA Liver Institute Northwest Washington State University SeattleWAUSA

Chronic hepatitis B(CHB)represents a global public burden with an estimated 296 million people infected worldwide(1).It is a leading cause of morbidity and mortality related to chronic liver disease and hepatocellular carcinoma(HCC)(2-5).The prevalence of CHB can range from populations with low prevalence(valence(>8%).Current recommendations for screening use a prevalence of over 2%as the cutoff to start screening a population(2-5).Australia has a diverse population in which the prevalence of CHB differs between certain subgroups(6,7).

关键词： Chronic hepatitis B(CHB) guidelines Gastroenterological Society of Australia(GESA)

在临床研究中,索磷布韦/维帕他韦用于伴随使用质子泵抑制剂的患者时安全有效

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在临床研究中,索磷布韦/维帕他韦用于伴随使用质子泵抑制剂的患者...

Current perspectives into the evaluation and management of hepatitis B: a review

第十届全国疑难及重症肝病大会

作者： Rafael Esteban Kosh Agarwal Jose Luis Calleja Jean Francois Dufour Steven L.Flamm Stuart C.Gordon Luisa Stamm Liyun Ni Diana Brainard kris v.kowdley Curtis Cooper Juan Antonio Pineda Lluis Castells Maria Buti Sabela Lens UniversityofBarcelona SwedishMedicalCenter GileadSciencesInc. HospitalUniversitarivalld’Hebron GileadSciences Inc. vallD’hebronUniversityHospital NorthwesternUniversityHealthSystem HospitalUniversitarioPuertaDeHierro HospitalUniversitariovirgenDevalme UniversityofBern LiverUnit InternalMedicineDepartmentHospitalUniversitariVallDeHebrón InstituteofLiverStudies King’sCollegeHospitalNHSTrust HenryFordHealthSystem TheOttawaHospital

背景在1期药物相互作用数据可用之前,在有关索磷布韦/维帕他韦(SOF/vEL)的临床试验中禁止伴随使用质子泵抑制剂(PPI)。之后的临床研究允许使用最多20mg的奥美拉唑或等效剂量的药物。本分析评估了接受12周的SOF/vEL治疗并且报告伴随使用...

背景在1期药物相互作用数据可用之前,在有关索磷布韦/维帕他韦(SOF/vEL)的临床试验中禁止伴随使用质子泵抑制剂(PPI)。之后的临床研究允许使用最多20mg的奥美拉唑或等效剂量的药物。本分析评估了接受12周的SOF/vEL治疗并且报告伴随使用PPI的伴有和不伴有代偿期肝硬化的患者的疗效和安全性。

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Hepatobiliary Surgery and Nutrition 2019年第4期8卷 361-369页

作者： vignan Manne Eric Gochanour kris v. kowdley Liver Care Network Swedish Medical Center Seattle WA USA

Hepatitis B is a widespread disease which affects millions of people worldwide. Chronic hepatitis B (CHB) can lead to significant morbidity and mortality due to complications such as cirrhosis and hepatocellular carcinoma. The pathophysiology of hepatitis is critical to diagnosing CHB. Deciding which patients with CHB should be treated is an important decision as treatment can often lead to better outcomes in the appropriate patient population. The nucleos(t)ide analog inhibitors entecavir and tenofovir are currently the mainstay of treatment as they are able to successfully suppress the virus and lead to fewer complications. Novel therapies are currently being developed which may offer a potential cure for this disease in the future.

关键词： Chronic hepatitis B (CHB) hepatocellular carcinoma (HCC) tenofovir entecavir

Mitochondrial DNA from hepatocytes as a ligand for TLR9: Drivers of nonalcoholic steatohepatitis?

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World Journal of Gastroenterology 2016年第31期22卷 6965-6971页

作者： Priya Handa Akhila vemulakonda kris v.kowdley Misael Uribe Nahum Méndez-Sánchez Senior Research Scientist Organ Care Research and Liver Care Network Swedish Medical Center Liver Research Unit Medica Sur Clinic and Foundation

Nonalcoholic fatty liver disease(NAFLD) is the most common liver disease worldwide, affecting approximately one third of the Western world. It consists of a wide spectrum of liver disorders, ranging from fatty liver to nonalcoholic steatohepatitis(NASH), which consists of steatosis, ballooning injury and inflammation. Despite an alarming growth in the statistics surrounding NAFLD, there are as yet no effective therapies for its treatment. Innate immune signaling has been thought to play a significant role in initiating and augmenting hepatic inflammation, contributing to the transition from nonalcoholic fatty liver to NASH. An immune response is triggered by countless signals called damage-associated molecular patterns(DAMPs) elicited by lipid-laden and damaged hepatocytes, which are recognized by pattern recognition receptors(PRRs) on hepatic immune cells to initiate inflammatory signaling. In this editorial, in addition to summarizing innate immune signaling in NAFLD and discussing potential therapies that target innate immune pathways, we have described a recent study that demonstrated that mitochondrial DNA serves as a DAMP activating a hepatic PRR, TLR9, in mice and in the plasma of NASH patients. In addition to identifying a new ligand for TLR9 during NASH progression, the study shows that blocking TLR9 reverses NASH, paving the way for the development of future NASH therapy.

关键词： TLR9 Damage-associated molecular patterns Products of microbial metabolism produced by pathogens Mitochondrial DNA Hepatocytes Nonalcoholic steatohepatitis Nonalcoholic fatty liver disease Inflammation Innate immune signaling Kupffer cells Therapy

Characterization of patients with both alcoholic and nonalcoholic fatty liver disease in a large United States cohort

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World Journal of Hepatology 2019年第10期11卷 710-718页

作者： George Khoudari Amandeep Singh Mazen Noureddin Danielle Fritze Rocio Lopez Imad Asaad Eric Lawitz Fred Poordad kris v.kowdley Naim Alkhouri Department of Hospital Medicine Cleveland Clinic FoundationClevelandOH 44195United States Department of Gastroenterology and Hepatology Cleveland ClinicClevelandOH 44195United States Department of Gastroenterology and Hepatology Cedars Sinai Medical CenterLos AngelesCA 90048United States Department of General Surgery Texas Liver Institute and University of Texas HealthSan AntonioTX 78215United States Department of Quantitative Health Sciences Cleveland ClinicClevelandOH 44195United States Department of Gastroenterology Metro Health SystemClevelandOH 44109United States Texas Liver Institute and University of Texas Health San AntonioTX 78215United States Swedish Liver Care Network Swedish Medical CenterSeattleWA 98122United States

BACKGROUND Nonalcoholic fatty liver disease(NAFLD)is the hepatic manifestation of the metabolic syndrome(MetS)and is characterized by steatosis in the absence of significant alcohol ***,MetS and significant alcohol intake coexist in certain individuals which may lead to the development of *** To assess the clinical characteristics of patients with both alcoholic and NAFLD(BAFLD)in a large cohort in the United *** Adults from the National Health and Nutrition Examination Survey between 2003-2014 were *** was diagnosed based on elevated alanine aminotransferase(ALT)and being overweight or obese in the absence of other liver *** patients met the criteria for NAFLD but also had either MetS or type 2 diabetes and consumed excessive amounts of *** and multivariable analysis were performed to assess differences between NAFLD and BAFLD and to compare severity based on a validated fibrosis score(FIB4 index).RESULTS The prevalence of NAFLD was at 25.9%(95%CI;25.1-26.8)and that of BAFLD was 0.84%(0.67,1.02)which corresponds to an estimated 1.24 million Americans affected by *** to NAFLD,patients with BAFLD were more likely to be male,smokers,have higher ALT,aspartate aminotransferase,triglycerides,and lower platelets;Pve advanced fibrosis[adjusted OR(95%CI)based on FIB4 index>2.67 was 3.2(1.4,7.0),P=0.004].CONCLUSION A significant percentage of the American general population is afflicted by BAFLD and these patients tend to have more advanced liver fibrosis.

关键词： Non-alcoholic fatty liver disease Alcoholic liver disease Fatty liver disease

A flexible ECG patch compatible with NFC RF communication

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npj Flexible Electronics 2020年第1期4卷 126-133页

作者： Mohammad Zulqarnain Stefano Stanzione Steve Smout Myriam Willegems kris Myny Eugenio Cantatore Integrated Circuits Group Eindhoven University of TechnologyEindhovenThe Netherlands Holst Centre/imec EindhovenThe Netherlands imec LeuvenBelgium

With the advent of the internet of things,flexible wearable devices are gaining significant research interest,as they are unobtrusive,comfortable to wear and can support continuous observation of physiological signals,helping to monitor wellness or diagnose *** Indium Gallium Zinc Oxide(a-IGZO)Thin Film Transistors(TFTs)fabricated on flexible substrates are an attractive option to build such bio-signal monitoring systems due to their flexibility,conformability to the human body,and low *** paper presents a flexible electrocardiogram(ECG)patch implemented on foil with self-aligned IGZO TFTs,which is capable to acquire the ECG signals,amplify them and convert them to a sequence of *** analogue frontend has a measured input-referred noise of 8μv_(rms) in the 1-100 Hz *** system achieves experimentally 67.4 dB CMRR,58.9 dB PSRR,and 16.5 MΩinput impedance at 50 Hz while using 1 kHz *** signal from the electrodes is transformed to a 105.9-kb/s Manchester-encoded serial bit stream which could be sent wirelessly to a smart phone via Near Field Communication(NFC)for further *** consumption is 15.4 mW for the digital and 280μW for the analogue *** contribution shows the fundamental steps to demonstrate intelligent plasters for biomedical applications based on flexible electronics providing an NFC-compatible digital output bit stream.

关键词： NFC communication patch

Molecular biology techniques for the surgeon

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World Journal of Surgical Procedures 2012年第2期2卷 5-15页

作者： Gopal kowdley Subramanya Srikantan Kotb Abdelmohsen Myriam Gorospe Javeed Khan Department of Surgery St Agnes Hospital Baltimore MD 21229 United States Laboratory of Molecular Biology and Immunology National Institute on Aging NIH Baltimore MD 21224 United States

New technologies are constantly being introduced into the medical and surgical fields. These technologies come in the form of newer medicines, imaging methods and prognostic tools, among others, and allow clinicians to make more rational and informed decisions on the care of their patients. Many of these technologies utilize advanced techniques which are at the forefront of many research fields and represent a transition of bench advances into the clinical realm. This review will highlight four technologies that are at the forefront in the treatment of oncology patients treated by surgeons on a daily basis. Circulating tumor cells, microarray analysis, proteomic studies and rapid sequencing technologies will be highlighted. These technologies will be reviewed and their potential use in the care o surgical patients will be discussed.

关键词： Methods Molecular diagnostic techniques Medical oncology General surgery MT

QT-GWAS:A novel method for unveiling biosynthetic loci affecting qualitative metabolic traits

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Molecular Plant 2023年第7期16卷 1212-1227页

作者： Marlies Brouckaert Meng Peng RenéHofer lias El Houari Chiarina Darrah veronique Storme Yvan Saeys Ruben vanholme Geert Goeminne vitaliy I.Timokhin John Ralph kris Morreel Wout Boerjan Ghent University Department of Plant Biotechnology and Bioinformatics9000 GhentBelgium vIB Center for Plant Systems Biology 9052 GhentBelgium Ghent University Department of Applied MathematicsComputer Science and Statistics9000 GhentBelgium vIB Center for Inflammation Research 9052 GhentBelgium vIB Metabolomics Core 9052 GhentBelgium Department of Biochemistry and US Department of Energy Great Lakes Bioenergy Research CenterWisconsin Energy InstituteUniversity of Wisconsin-MadisonMadisonWI53706USA Ghent University Department of Applied MathematicsComputer Science and StatisticsGhentBelgium viB Center for Inflammation Research GhentBelgium BioNTech SE MainzRhineland-PalatinateGermany Eunomia Research&Consulting BristolUK vIB Agro-incubator NeveleBelgium Research Institute for Chromatography KortrijkBelgium

Although the plant kingdom provides an enormous diversity of metabolites with potentially beneficial applications for humankind,a large fraction of these metabolites and their biosynthetic pathways remain *** metabolite structures and their biosynthetic pathways is key to gaining biological understanding andto allow metabolic *** orderto retrieve novel biosynthetic genes involved in specialized metabolism,we developed a novel untargeted method designated as qualitative trait GWAs(QT-GWAS)that subjects qualitative metabolic traits to a genome-wide association study,while the conventional metabolite GWAS(mGWAS)mainly considers the quantitative variation of *** a proof of the validity of QT-GWAS,23 and 15of the retrieved associations identified in Arabidopsis thaliana by QTGWAS and mGWAS,respectively,were supported by previous ***,seven genemetabolite associations retrieved by QT-GWAS were confirmed in this study through reverse genetics combined with metabolomics and/or in vitro enzyme *** such,we established that CYTOCHROME P450706A5(CYP706A5)is involved in the biosynthesis of chroman derivatives,UDP-GLYCOSYLTRANSFERASE 76C3(UGT76C3)is able tohexosylate guanine in vitro and in planta,and SULFOTRANSFERASE 202B1(SULT202B1)catalyzes the sulfation of neolignans in ***,our study demonstrates that the untargeted QT-GWAS method can retrieve valid gene-metabolite associations at the level of enzyme-encoding genes,even new associations that cannot be found by the conventional mGwAs,providing a new approach for dissecting qualitative metabolic traits.

关键词： qualitative method proof

Energetic etiologies of acute pancreatitis: A report of five cases

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World Journal of Gastrointestinal Pathophysiology 2015年第4期6卷 243-248页

作者： Artem Shmelev Alain Abdo Sarina Sachdev Urvi Shah Gopal C kowdley Steven C Cunningham The Department of Surgery Saint Agnes Hospital

There are several common causes of acute pancreatitis, principally excessive alcohol intake and gallstones, and there are many rare causes. However, cases of pancreatitis still occur in the absence of any recognizable factors, and these cases of idiopathic pancreatitis suggest the presence of unrecognized etiologies. Five cases of acute pancreatitis in four patients came to attention due to a strong temporal association with exposure to nerve stimulators and energy drinks. Given that these cases of pancreatitis were otherwise unexplained, and given that these exposures were not clearly known to be associated with pancreatitis, we performed a search for precedent cases and for mechanistic bases. No clear precedent cases were found in Pub Med and only scant, weak precedent cases were found in public-health databases. However, there was a coherent body of intriguing literature in support of a mechanistic basis for these exposures playing a role in the etiology of pancreatitis.

关键词： Pancreatitis Energy drinks Transcutaneous electric