检索结果-南通市图书馆

Aliphatic Halogenated Hydrocarbons: Report and Analysis of Liver Injury in 60 Patients

Journal of Clinical and Translational Hepatology 2018年第4期6卷 350-361页

作者： rolf teschke Department of Internal MedicineⅡ Division of Gastroenterology and HepatologyKlinikum HanauHanauAcademic Teaching Hospital of the Medical FacultyGoethe University Frankfurt/MainFrankfurt/MainGermany

Background and Aims:Intoxications by aliphatic halogenated hydrocarbons(AHH),used as effective solvents,are rare and may cause life-threatening liver injury.Patients with acute intoxications by AHH received an innovative treatment.Methods:Analyzed were data of 60 patients intoxicated by AHH,such as dichloromethane(n=3),chloroform(n=2),carbon tetrachloride(n=12),1,2-dichloroethane(n=18),1,1,2-trichloroethane(n=2),trichloroethylene(n=2),tetrachloroethylene(n=13)or mixed AHH chemicals(n=8),who received a new treatment consisting of CO2-induced hyperventilation to accelerate toxin removal via the lungs.Results:Added to the inspiration air at a flow rate of 2-3 Liter min-1,CO2 increased the respiratory volume up to 25-30 Liter min-1,ensuring forced AHH exhalation.This CO2-induced hyperventilation therapy was commonly well tolerated by the 60 patients and lasted for 106.0±10.5 hours.In most cases,initially increased liver test results of aminotransferases normalized quickly under the therapy,and liver histology obtained at completion of the therapy revealed,in the majority of patients,normal findings or fatty changes,and rarely severe single cell necrosis but no confluent liver cell necrosis.Despite therapy,clinical outcome was unfavorable for 4/60 patients(6.7%)of the study cohort,due to single or combined risk factors.These included late initiation of the CO2-induced hyperventilation therapy,intentional intoxication,uptake of high amounts of AHH,concomitant ingestion of overdosed drugs,consumption of high amounts of alcohol,and history of alcohol abuse.Conclusions:For intoxications by AHH,effective therapy approaches including forced hyperventilation to increase toxin removal via the lungs are available and require prompt initiation.

关键词： Aliphatic halogenated hydrocarbons Dichloromethane Chloroform Carbon tetrachloride 1,2-dichloroethane

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Traditional Chinese Medicine and Herb-induced Liver Injury: Comparison with Drug-induced Liver Injury

引用

Journal of Clinical and Translational Hepatology 2018年第1期6卷 57-68页

作者： Jing Jing rolf teschke Medical School of Chinese PLA BeijingChina Integrative Medical Center 302 Military HospitalBeijingChina Department of Internal Medicine II Division of Gastroenterology and HepatologyKlinikum HanauTeaching Hospital of the Medical Faculty of the Goethe UniversityFrankfurt/MainHanau D-63450Germany

Cases of suspected herb-induced liver injury(HILI)caused by herbal Traditional Chinese Medicines(TCMs)and of druginduced liver injury(DILI)are commonly published in the scientific literature worldwide.As opposed to the multiplicity of botanical chemicals in herbal TCM products,which are often mixtures of several herbs,conventional Western drugs contain only a single synthetic chemical.It is therefore of interest to study how HILI by TCM and DILI compare with each other,and to what extent results from each liver injury type can be transferred to the other.China is among the few countries with a large population using synthetic Western drugs as well as herbal TCM.Therefore,China is well suited to studies of liver injury comparing drugs with TCM herbs.Despite some concordance,recent analyses of liver injury cases with verified causality,using the Roussel Uclaf Causality Assessment Method,revealed major differences in HILI caused by TCMs as compared to DILI with respect to the following features:HILI cases are less frequently observed as compared to DILI,have a smaller proportion of females and less unintentional rechallenge events,and present a higher rate of hepatocellular injury features.Since many results were obtained among Chinese residents who had access to and had used Western drugs and TCM herbs,such ethnic homogeneity supports the contention that the observed differences of HILI and DILI in the assessed population are well founded.

关键词： Traditional Chinese medicine(TCM) Herbal TCM hepatotoxicity Herb-induced liver injury(HILI) Roussel Uclaf Causality Assessment Method(RUCAM) Drug-induced liver injury(DILI)

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Traditional Chinese Medicine Induced Liver Injury

引用

Journal of Clinical and Translational Hepatology 2014年第2期2卷 80-94页

作者： rolf teschke Department of Internal Medicine II Division of Gastroenterology and Hepatology Klinikum Hanau Academic Teaching Hospital of the Medical Faculty of the Goethe University Frankfurt/Main Germany

Traditional Chinese Medicine (TCM) is popular around the world and encompasses many different practices with parti-cular emphasis on herbal TCM. Using the PubMed database, a literature search was undertaken to assess the extent herbal TCM products exert rare hepatotoxicity. Analysis of reported cases revealed numerous specified herbal TCM products with potential hepatotoxicity. Among these were An Shu Ling, Bai Fang, Bai Xian Pi, Ban Tu Wan, Bo He, Bo Ye Qing Niu Dan, Bofu Tsu Sho San, Boh Gol Zhee, Cang Er Zi, Chai Hu, Chaso, Chi R Yun, Chuan Lian Zi, Ci Wu Jia, Da Chai Hu Tang, Da Huang, Du Huo, Gan Cao, Ge Gen, Ho Shou Wu, Hu Bohe You, Hu Zhang, Huang Qin, Huang Yao Zi, Hwang Geun Cho, Ji Gu Cao, Ji Ji, Ji Xue Cao, Jiguja, Jin Bu Huan, Jue Ming Zi, Kamishoyosan, Kudzu, Lei Gong Teng, Long Dan Xie Gan Tang, Lu Cha, Ma Huang, Mao Guo Tian Jie Cai, Onshido, Polygonum multiflorum, Qian Li Guang, Ren Shen, Sairei To, Shan Chi, Shen Min, Shi Can, Shi Liu Pi, Shou Wu Pian, Tian Hua Fen, White flood, Wu Bei Zi, Xi Shu, Xiao Chai Hu Tang, Yin Chen Hao, Zexie, Zhen Chu Cao, and various unclassified Chinese herbal mixtures. Causality was firmly established for a number of herbal TCM products by a positive reexposure test result, the liver specific scale of CIOMS (Council for International Organizations of Medical Sciences), or both. Otherwise, the quality of case data was mixed, especially regarding analysis of the herb ingredients because of adulteration with synthetic drugs, contamination with heavy metals, and misidentification. In addition, non-herbal TCM elements derived from Agaricus blazei, Agkistrodon, Antelope, Bombyx, Carp, Fish gallbladder, Phellinus, Scolopendra, Scorpio, and Zaocys are also known or potential hepatotoxins. For some patients, the clinical course was severe, with risks for acute liver failure, liver transplantation requirement, and lethality. In conclusion, the use of few herbal TCM products may rarely be associated with hepatotoxicity in some susceptible individuals, necessitating a stringent

关键词： Traditional Chinese medicine Traditional Chinese herbal medicine Herbal hepatotoxicity Herb induced liver injury Herbs

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Herb-induced Liver Injury in Asia and Current Role of RUCAM for Causality Assessment in 11,160 Published Cases

引用

Journal of Clinical and Translational Hepatology 2020年第2期8卷 200-214页

作者： rolf teschke Yun Zhu Jing Jing Department of Internal Medicine II Division of Gastroenterology and HepatologyKlinikum HanauHanauAcademic Teaching Hospital of the Medical FacultyGoethe University Frankfurt/MainFrankfurt/MainGermany The Fifth Medical Center General Hospital of PLABeijingChina

Herb-induced liver injuries (HILI) by traditional herbal medi-cines are particular challenges in Asian countries, with issues over the best approach to establish causality. The aim of the current analysis was to provide an overview on how causality was assessed in HILI cases from Asian countries and whether the Roussel Uclaf Causality Assessment Method (RUCAM) was the preferred diagnostic algorithm, as shown before in world-wide evaluated cases of drug-induced liver injury (DILI). Using the PubMed database, publications in English language were preferred to allow for reevaluation by peers. Overall 11,160 HILI cases have assessed causality using RUCAM and were published by first authors working in Asian countries. With 21 evaluable reports, most publications came from China's Mainland, with Hong Kong and Taiwan, followed by Korea (n=15), Singapore (n=2), and Japan (n=1), while other Asian countries were not contributory. Most publications provided case and RUCAM data of good quality. For better presentation of future cases, how-ever, the following recommendations are given:(1) preference of prospective study design with use of the updated RUCAM version;(2) clear separation of HILI cohorts from those of other herbal products or DILI;(3) case series for epidemiology stud-ies should contain many essential data, possibly also as supple-mentary material;(4) otherwise, preference of single case reports providing individual case data and RUCAM-based cau-sality gradings, and applying liver test threshold values;and (5) publication in English language journals. In conclusion, China and Korea are top in presenting RUCAM-based HILI cases, other Asian countries are encouraged to follow.

关键词： Liver injury Drug induced liver injury Herb induced liver injury RUCAM

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Drug-and Herb-Induced Liver Injury in Clinical and Translational Hepatology:Causality Assessment Methods, Quo Vadis?

引用

Journal of Clinical and Translational Hepatology 2013年第1期1卷 59-74页

作者： rolf teschke Axel Eickhoff Johannes Schulze Department of Internal Medicine Ⅱ Division of Gastroenterology and Hepatology Klinikum Hanau Academic Teaching Hospital of the Medical Faculty Goethe University Frankfurt/Main Germany Institute of Industrial Environmental and Social Medicine Medical Faculty Goethe University Frankfurt/Main Germany

Drug-induced liver injury (DILI) and herb-induced liver injury (HILI) are typical diseases of clinical and translational hepatology. Their diagnosis is complex and requires an experienced clinician to translate basic science into clinical judgment and identify a valid causality algorithm. To pro-spectively assess causality starting on the day DILI or HILI is suspected, the best approach for physicians is to use the Council for International Organizations of Medical Sciences (CIOMS) scale in its original or preferably its updated version. The CIOMS scale is validated, liver-specific, structured, and quantitative, providing final causality grades based on scores of specific items for individual patients. These items include latency period, decline in liver values after treatment cessa-tion, risk factors, co-medication, alternative diagnoses, hepatotoxicity track record of the suspected product, and unintentional re-exposure. Provided causality is established as probable or highly probable, data of the CIOMS scale with all individual items, a short clinical report, and complete raw data should be transmitted to the regulatory agencies, manufacturers, expert panels, and possibly to the scientific community for further refinement of the causality evaluation in a setting of retrospective expert opinion. Good-quality case data combined with thorough CIOMS-based assessment as a standardized approach should avert subsequent necessity for other complex causality assessment methods that may have inter-rater problems because of poor-quality data. In the future, the CIOMS scale will continue to be the preferred tool to assess causality of DILI and HILI cases and should be used consistently, both prospectively by physicians, and retrospectively for subsequent expert opinion if needed. For comparability and international harmonization, all parties assessing causality in DILI and HILI cases should attempt this standardized approach using the updated CIOMS scale.

关键词： Drug-induced liver injury Drug hepatotoxicity Herb-induced liver injury Herbal hepatotoxicity Causality assessment

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Herbal Traditional Chinese Medicine and suspected liver injury: A prospective study

引用

World Journal of Hepatology 2017年第29期9卷 1141-1157页

作者： Dieter Melchart Stefan Hager Sabine Albrecht Jingzhang Dai Wolfgang Weidenhammer rolf teschke Institute for Complementary and Integrative Medicine University Hospital Zurich and University of Zurich Competence Centre for Complementary Medicine and Naturopathy (Co Co Nat) University Hospital Munich rechts der Isar Technical University of Munich Hospital for Traditional Chinese Medicine Beijing University of Chinese Medicine Department of Internal Medicine Ⅱ Division of Gastroenterology and Hepatology Klinikum Hanau Teaching Hospital of the Medical Faculty of the Goethe University

AIM To analyze liver tests before and following treatment with herbal Traditional Chinese Medicine(TCM) in order to evaluate the frequency of newly detected liver injury.METHODS Patients with normal values of alanine aminotransferase(ALT) as a diagnostic marker for ruling out pre-existing liver disease were enrolled in a prospective study of a safety program carried out at the First German Hospital of TCM from 1994 to 2015. All patients received herbal products, and their ALT values were reassessed 1-3 d prior to discharge. To verify or exclude causality for suspected TCM herbs, the Roussel Uclaf Causality Assessment Method(RUCAM) was used.RESULTS This report presents for the first time liver injury data derived from a prospective, hospital-based and largescale study of 21470 patients who had no liver disease prior to treatment with herbal TCM. Among these, ALT ranged from 1 × to < 5 × upper limit normal(ULN) in 844 patients(3.93%) and suggested mild or moderate liver adaptive abnormalities. However, 26 patients(0.12%) experienced higher ALT values of ≥ 5 × ULN(300.0 ± 172.9 U/L, mean ± SD). Causality for TCM herbs was RUCAM-based probable in 8/26 patients, possible in 16/26, and excluded in 2/26 cases. Bupleuri radix and Scutellariae radix were the two TCM herbs most commonly implicated. CONCLUSION In 26(0.12%) of 21470 patients treated with herbal TCM, liver injury with ALT values of ≥ 5 × ULN was found, which normalized shortly following treatment cessation, also substantiating causality.

关键词： Traditional Chinese Medicine Herbal medicine Liver injury Roussel Uclaf Causality Assessment Method Herb induced liver injury

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Drug and herb induced liver injury: Council for International Organizations of Medical Sciences scale for causality assessment

引用

World Journal of Hepatology 2014年第1期6卷 17-32页

作者： rolf teschke Albrecht Wolff Christian Frenzel Alexander Schwarzenboeck Johannes Schulze Axel Eickhoff Department of Internal Medicine Ⅱ Klinikum Hanau Academic Teaching Hospital of the Medical Faculty of the Goethe University of Frankfurt/Main Department of Internal Medicine Ⅱ Division of Gastroenterology Hepatology and Infectious Diseases Friedrich Schiller University Jena Department of Medicine Ⅰ University Medical Center Hamburg Eppendorf Institute of Industrial Environmental and Social Medicine Medical Faculty Goethe University

Causality assessment of suspected drug induced liver injury(DILI) and herb induced liver injury(HILI) is hampered by the lack of a standardized approach to be used by attending physicians and at various subsequent evaluating levels. The aim of this review was to analyze the suitability of the liver specific Council for International Organizations of Medical Sciences(CIOMS) scale as a standard tool for causality assessment in DILI and HILI cases. PubMed database was searched for the following terms: drug induced liver injury; herb induced liver injury; DILI causality assessment; and HILI causality assessment. The strength of the CIOMS lies in its potential as a standardized scale for DILI and HILI causality assessment. Other advantages include its liver specificity and its validation for hepatotoxicity with excellent sensitivity, specificity and predictive validity, based on cases with a positive reexposure test. This scale allows prospective collection of all relevant data required for a valid causality assessment. It does not require expert knowledge in hepatotoxicity and its results may subsequently be refined. Weaknesses of the CIOMS scale include the limited exclusion of alternative causes and qualitatively graded risk factors. In conclusion, CIOMS appears to be suitable as a standard scale for attending physicians, regulatory agencies, expert panels and other scientists to provide a standardized, reproducible causality assessment in suspected DILI and HILI cases, applicable primarily at all assessing levels involved. 2014 Baishideng Publishing Group Co., Limited. All

关键词： Drug induced liver injury Drug hepatotox-icity Herb induced liver injury Herbal hepatotoxicity Causality assessment

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Herbal hepatotoxicity:Challenges and pitfalls of causality assessment methods

引用

World Journal of Gastroenterology 2013年第19期19卷 2864-2882页

作者： rolf teschke Christian Frenzel Johannes Schulze Axel Eickhoff Division of Gastroenterology and Hepatology Department of Internal Medicine ⅡKlinikum HanauD-63450 HanauGermany Academic Teaching Hospital of the Medical Faculty Johann Wolfgang Goethe-Universit t Frankfurt am MainD-60590 Frankfurt am MainGermany Department of Medicine Ⅰ University Medical Center Hamburg EppendorfD-20246 HamburgGermany nstitute of Industrial Environmental and Social MedicineMedical FacultyJohann Wolfgang GoetheUniversitat Frankfurt am MainD-60590 Frankfurt am MainGermany

The diagnosis of herbal hepatotoxicity or herb induced liver injury(HILI) represents a particular clinical and regulatory challenge with major pitfalls for the causality evaluation.At the day HILI is suspected in a patient,physicians should start assessing the quality of the used herbal product,optimizing the clinical data for completeness,and applying the Council for International Organizations of Medical Sciences(CIOMS) scale for initial causality assessment.This scale is structured,quantitative,liver specific,and validated for hepatotoxicity cases.Its items provide individual scores,which together yield causality levels of highly probable,probable,possible,unlikely,and excluded.After completion by additional information including raw data,this scale with all items should be reported to regulatory agencies and manufacturers for further evaluation.The CIOMS scale is preferred as tool for assessing causality in hepatotoxicity cases,compared to numerous other causality assessment methods,which are inferior on various grounds.Among these disputed methods are the Maria and Victorino scale,an insufficiently qualified,shortened version of the CIOMS scale,as well as various liver unspecific methods such as thead hoc causality approach,the Naranjo scale,the World Health Organization(WHO) method,and the Karch and Lasagna method.An expert panel is required for the Drug Induced Liver Injury Network method,the WHO method,and other approaches based on expert opinion,which provide retrospective analyses with a long delay and thereby prevent a timely assessment of the illness in question by the physician.In conclusion,HILI causality assessment is challenging and is best achieved by the liver specific CIOMS scale,avoiding pitfalls commonly observed with other approaches.

关键词： Herbal hepatotoxicity Herb induced liver injury Herbs Drug hepatotoxicity Drug induced liver injury Causality assessment

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Hepatocellular carcinoma in alcoholic liver disease: mechanistic considerations and clinical facts

引用

Hepatoma Research 2019年第11期5卷 1-16页

Alcoholic hepatocellular carcinoma(AHCC)represents a lethal stage,emerging in the course of severe injurious stages of alcoholic liver disease including cirrhosis.AHCC only affects a few alcohol consumers,certainly not all individuals who consume large amounts of alcohol over a long period of time,suggesting a role of yet unknown genetic risk or protection factors.Most likely,hepatic DNA is ultimately involved,attacked by intermediate products derived from reactive oxygen species(ROS)generated from cytochrome P4502E1 of the NADPH and oxygen dependent microsomal ethanol-oxidizing system whereby ethanol is metabolized.Ethanol and acetaldehyde are activated to procarcinogens,to be promoted to ultimate carcinogens by ROS and causatives for AHCC instead of any other putative chemical contained in alcoholic beverages.Prevention of HCC associated with cirrhosis is best accomplished by early recognition of alcohol abuse at the stage of alcoholic fatty liver rather than alcoholic hepatitis(AH)or alcoholic steatohepatitis(ASH),leading to the advice of consequent abstinence from alcohol.Abstinence early started effectively prevents AHCC development,as opposed to late begin of abstinence that lacks risk reduction.Although drug therapy may partially be effective in AH or ASH,no established drug options are available for a realistic therapy of AHCC.Liver transplantation is controversially discussed and can be considered,but may be an option for only a few patients on a case by case base.In conclusion,AHCC results from a ROS dependent conversion of ethanol and acetaldehyde to procarcinogens as promoters of AHCC.

关键词： Alcohol alcoholic liver disease alcoholic cirrhosis alcoholic hepatocellular carcinoma microsomal ethanol-oxidizing system cytochrome P4502E1 reactive oxygen species carcinogens

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Herbal traditional Chinese medicine and its evidence base in gastrointestinal disorders

引用

World Journal of Gastroenterology 2015年第15期21卷 4466-4490页

作者： rolf teschke Albrecht Wolff Christian Frenzel Axel Eickhoff Johannes Schulze Department of Internal Medicine Ⅱ Division of Gastroenterology and Hepatology Klinikum Hanau Teaching Hospital of the Medical Faculty of the Goethe University Frankfurt/Main Department of Internal Medicine Ⅱ Division of Gastroenterology Hepatology and Infectious DiseasesFriedrich Schiller University Jena Department of Medicine I University Medical Center Hamburg Eppendorf Institute of Industrial Environmental and Social Medicine Medical Faculty of the Goethe University Frankfurt/Main

Herbal traditional Chinese medicine(TCM) is used to treat several ailments, but its efficiency is poorly documented and hence debated, as opposed to modern medicine commonly providinge ffective therapies. The aim of this review article is to present a practical reference guide on the role of herbal TCM in managing gastrointestinal disorders, supported by systematic reviews and evidence based trials. A literature search using herbal TCM combined with terms for gastrointestinal disorders in Pub Med and the Cochrane database identified publications of herbal TCM trials. Results were analyzed for study type, inclusion criteria, and outcome parameters. Quality of placebo controlled, randomized, double-blind clinical trials was poor, mostly neglecting stringent evidence based diagnostic and therapeutic criteria. Accordingly, appropriate Cochrane reviews and meta-analyses were limited and failed to support valid, clinically relevant evidence based efficiency of herbal TCM in gastrointestinal diseases, including gastroesophageal reflux disease, gastric or duodenal ulcer, dyspepsia, irritable bowel syndrome, ulcerative colitis, and Crohn's disease. In conclusion, the use of herbal TCM to treat various diseases has an interesting philosophical background with a long history, but it received increasing skepticism due to the lack of evidence based efficiency as shown by high quality trials; this has now been summarized for gastrointestinal disorders, with TCM not recommended for most gastrointestinal diseases. Future studies should focus on placebo controlled, randomized, double-blind clinical trials, herbal product quality and standard criteria for diagnosis, treatment, outcome, and assessment of adverse herb reactions. This approach will provide figures of risk/benefit profiles that hopefully are positive for at least some treatment modalities of herbal TCM. Proponents of modern herbal TCM best face these promising challenges of pragmaticmodern medicine by bridging the gap between the two medicinal cultures.

关键词： Evidence based trials Traditional Chinesemedicine Herbal traditional Chinese medicine Gastrointestinaldisorders

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

欢迎您,

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

欢迎您,

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：