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Hepatic steatosis and fibrosis: Non-invasive assessment

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World Journal of Gastroenterology 2016年第45期22卷 9880-9897页

作者： Rustam N Karanjia mary me crossey I Jane Cox Haddy KS Fye Ramou Njie Robert D Goldin Simon D Taylor-Robinson Liver Unit Division of Digestive Health Department of Surgery and Cancer Imperial College London St Mary’s Campus London W2 1NY United Kingdom Institute of Hepatology London Foundation for Liver Research 111 Coldharbour Lane London SE5 9NT United Kingdom Faculty of Life Sciences and medicine King’s College London London SE5 9NT United Kingdom MRC Gambia Atlantic Road Fajara The Gambia

Chronic liver disease is a major cause of morbidity and mortality worldwide and usually develops over many years, as a result of chronic inflammation and scarring, resulting in end-stage liver disease and its complications. The progression of disease is characterised by ongoing inflammation and consequent fibrosis, although hepatic steatosis is increasingly being recognised as an important pathological feature of disease, rather than being simply an innocent bystander. However, the current gold standard method of quantifying and staging liver disease, histological analysis by liver biopsy, has several limitations and can have associated morbidity and even mortality. Therefore, there is a clear need for safe and noninvasive assessment modalities to determine hepatic steatosis, inflammation and fibrosis. This review covers key mechanisms and the importance of fibrosis and steatosis in the progression of liver disease. We address non-invasive imaging and blood biomarker assessments that can be used as an alternative to information gained on liver biopsy.

关键词： Hepatic steatosis Fibrosis Non-invasive assessment Blood biomarker Ultrasound

Urinary nuclear magnetic resonance spectroscopy of a Bangladeshi cohort with hepatitis-B hepatocellular carcinoma: A biomarker corroboration study

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World Journal of Gastroenterology 2016年第16期22卷 4191-4200页

作者： I Jane Cox Abil E Aliev mary me crossey Mahvish Dawood Mamun Al-Mahtab Sheikh M Akbar Salimur Rahman Antonio Riva Roger Williams Simon D Taylor-Robinson Institute of Hepatology London Foundation for Liver Research Department of Chemistry University College London Division of Digestive Diseases Department of Surgery and Cancer Imperial College London Department of Hepatology Bangabandhu Sheikh Mujib Medical University Department of medical Sciences Toshiba General Hospital

AIM: To establish if a distinct urinary metabolic profile could be identified in Bangladeshi hepatitis-B hepatocellular carcinoma (HCC) patients compared to cirrhosis patients and ***: Urine samples from 42 Bangladeshi patients with HCC (39 patients with hepatitis-B HCC), 47 with cirrhosis on a background of hepatitis B, 46 with chronic hepatitis B, and seven ethnically-matched healthy controls were analyzed using nuclear magnetic resonance (NMR) spectroscopy. A full dietary and medication history was recorded for each subject. The urinary NMR data were analyzed using principal component analysis (PCA) and orthogonal partial least squared discriminant analysis (OPLS-DA) techniques. Differences in relative signal levels of the most discriminatory metabolites identified by PCA and OPLS-DA were compared between subject groups using an independent samples Kruskal-Wallis one-way analysis of variance (ANOVA) test with all pairwise multiple comparisons. Within the patient subgroups, the Mann-Whitney U test was used to compare metabolite levels depending on hepatitis B e-antigen (HBeAg) status and treatment with anti-viral therapy. A Benjamini-Hochberg adjustment was applied to acquire the level of significance for multiple testing, with a declared level of statistical significance of P metabolites that contributed to the discrimination between the subgr

关键词： Urinary metabolic profiling Hepatocellular carcinoma Nuclear magnetic resonance spectroscopy Hepatitis B Bangladesh

Challenges of liver cancer:Future emerging tools in imaging and urinary biomarkers

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World Journal of Hepatology 2015年第26期7卷 2664-2675页

作者： Francesca M Trovato Joshua M Tognarelli mary me crossey Daniela Catalano Simon D Taylor-Robinson Guglielmo M Trovato Dipartimento di medicina Clinica e Sperimentale Scuola di Medicina Università di Catania Department of medicine Imperial College London St Mary’s Campus

Chronic liver disease has become a global health problem as a result of the increasing incidence of viral hepatitis, obesity and alcohol misuse. Over the past three decades, in the United Kingdom alone, deaths from chronic liver disease have increased both in men and in women. Currently, 2.5% of deaths worldwide are attributed to liver disease and projected figures suggest a doubling in hospitalisation and associated mortality by 2020. Chronic liver diseases vary for clinical manifestations and natural history, with some individuals having relatively indolent disease and others with a rapidly progressive course. About 30% of patients affected by hepatitis C has a progressive disease and develop cirrhosis over a 20 years period from the infection, usually 5-10 years after initial medical presentation. The aim of the current therapeutic strategies is preventing the progression from hepatitis to fibrosis and subsequently, cirrhosis. Hepatic steatosis is a risk factor for chronic liver disease and is affecting about the half of patients who abuse alcohol. Moreover non-alcoholic fatty liver disease is part of the metabolic syndrome, associated with obesity, hypertension, type Ⅱ diabetes mellitus and dyslipidaemia, and a subgroup of patients develops non-alcoholic steatohepatitis and fibrosis with subsequent cirrhosis. The strengths and pitfalls of liver biopsy are discussed and a variety of new techniques to assess liver damage from transient elastography to experimental techniques, such as in vitro urinary nuclear magnetic resonance spectroscopy. Some of the techniques and tests described are already suitable for more widespread clinical application, as is the case with ultrasound-based liver diagnostics, but others, such as urinary metabonomics, requires a period of critical evaluation or development to take them from the research arena to clinical practice.

关键词： Virus hepatitis Liver cancer Ultrasound Fibrosis U

WJH 6^(th) Anniversary Special Issues(2): Hepatocellular carcinoma Problem of hepatocellular carcinoma in West Africa

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World Journal of Hepatology 2014年第11期6卷 783-792页

作者： Nimzing G Ladep Olufunmilayo A Lesi Pantong Mark Maud Lemoine Charles Onyekwere mary Afihene mary me crossey Simon D Taylor-Robinson Hepatology Unit Imperial College London St Mary’s Hospital Campus Department of medicine College of Med-icine University of Lagos Department of medicine Jos University Teach-ing Hospital Department of medicine Lagos State Uni-versity College of Medicine/Teaching Hospital Department of medicine Komfo Anokye Teach-ing Hospital

The incidence of hepatocellular carcinoma(HCC) isknown to be high in West Africa with an approximateyearly mortality rate of 200000. Several factors are responsible for this. Early acquisition of risk factors; with vertical or horizontal transmission of hepatitis B(HBV), environmental food contaminants(aflatoxins), poor management of predisposing risk factors and poorlymanaged strategies for health delivery. There has been a low uptake of childhood immunisation for hepatitis B in many West African countries. Owing to late presentations, most sufferers of HCC die within weeks of their diagnosis. Highlighted reasons for the specific disease pattern of HCC in West Africa include:(1) high rate of risk factors;(2) failure to identify at risk populations;(3) lack of effective treatment; and(4) scarce resources for timely diagnosis. This is contrasted to the developed world, which generally has sufficient resources to detect cases early for curative treatment. Provision of palliative care for HCC patients is limited by availability and affordability of potent analgesics. Regional efforts, as well as collaborative networking activities hold promise that could change the epidemiology of HCC in West Africa.

关键词： Liver cancer West Africa Aflatoxin Surveillance Hepatitis B

Maternal Mortality Rates among Im/Migrant Populations in the United States

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Open Journal of Obstetrics and Gynecology 2024年第8期14卷 1161-1175页

作者： Tessa Peredy mary Greenwald Katy Doughty Fachon Fiona Danaher Rashmi Jasrasaria Samantha Truong Annekathryn Goodman University of New England College of Osteopathic Medicine Biddeford ME United States Department of Obstetrics and Gynecology Massachusetts General Hospital Boston Boston MA United States Center for Immigrant Health Massachusetts General Hospital Boston Boston MA United States

Introduction: Maternal mortality rates have more than doubled in the U.S over the last two decades, making it one of the few places in the world where maternal mortality is increasing. Differences in maternal mortality among certain races and ethnicities are known but few studies examine maternal mortality among immigrants. Since immigrants represent 13.7% of the U.S. population, it is essential to examine immigrant subsets to understand maternal mortality among this vulnerable population. methods: A literature search identified 318 articles on maternal mortality and immigrants, with 12 articles from the U.S. The keywords included maternal mortality, United States, migrants, asylum seekers, immigrants, and disparities. Maternal mortality statistics were obtained from the World Health Organization and Center for Disease Control. Results: Studies analyzed in this review found an overall lower maternal mortality rate among immigrant women compared to U.S.-born women, except for Hispanic immigrant women. Black women had the highest maternal mortality rate, regardless of immigration status. Conclusion: Although the literature points to lower maternal mortality among immigrants, the data is still somewhat mixed, making it challenging to draw comprehensive conclusions. Additional research examining maternal mortality among Im/migrants in the U.S. is needed to guide future training among healthcare professionals and policymakers.

关键词： Maternal Mortality Im/Migrant Reproductive Health United States

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肯尼亚的蜜月冒险

空中英语教室（高级版．彭蒙惠英语） 2024年第1期 27-29,46,47页

作者： mary Ann Anderson 不详

22那一刻如梦境般令人着迷。一大群金黄色的狮子在午后的阳光下睡觉、打鼾、慵懒低吟,长长的尾巴互相轻轻拍打。一对来自瑞典的夫妻坐在我身边,我们一同乘坐一辆路虎车在肯尼亚的马赛马拉享受游猎之旅。那位丈夫开始细数那群狮子。

关键词：狮子肯尼亚金黄色

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Dance with you

青年与社会（中） 2011年第6期 24-29页

作者： mary Willam

Take a look at yourself my darling Don＇t ya like what you see Dip your foot in the pool and wonder Is it colder than me Take a look at my arms oh baby See the wounds of my youth There were times when i could not take it Seek the negative truth I love you Like the stars love the sky And they＇re never lonely I love you ＇cause you＇re weak,incomplete and You＇re never phoney I love you Yes i do,yes i do But you＇ll never own me Boy George I never said i＇d be good in bed Take a look at me golden hooker Just you swallow your pride Take a look at me my good looker There＇s a devil inside Never sleep with your windows open Never tell them you cry Never tell them that you feel lonely Coz they＇ll spit in your eye I love you I used to dream of a stream But i need an ocean I love you Falling head over heels With the slightest notion I love you You can stay for a while But don＇t pledge devotion I never said get inside my head I love you I love you i hate you Don＇t mean to frustrate you I love you I love you i hate you Don＇t mean to frustrate you See the queen And his old reminder That you＇ve never been cool Turn your back ＇cause The spite will blind you It＇s incredibly

关键词：穿着时尚服装面料

Molecular Characterization of the Calvin Cycle Enzyme Phosphoribulokinase in the Stramenopile Alga Vaucheria litorea and the Plastid Hosting Mollusc Elysia chlorotica

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Molecular Plant 2009年第6期2卷 1384-1396页

作者： mary E. Rumpho Sirisha Pochareddy Jared M. Worful Elizabeth J. Summer Debashish Bhattacharya Karen N. Pelletreau mary S. Tyler Jungho Lee James R. Manhart Kara M. Soule Department of Biochemistry Microbiology and Molecular Biology 5735 Hitchner Halt University of Maine Orono ME 04469 USA Department of Biology Texas A&M University College Station TX 77843 USA Department of Ecology Evolution and Natural Resources Institute of Marine and Coastal Sciences Rutgers University New Brunswick NJ 08901 USA School of Biology and Ecology University of Maine Orono ME 04469 USA Green Plant Institute #2-202 Bio Valley Seoul National University 103-2 Seodun Gwonseon Suwon Gyeonggi 441-853 Korea Department of Biochemistry and Biophysics Texas A&M University College Station TX 77843 USA

Phosphoribulokinase （PRK）, a nuclear-encoded plastid-localized enzyme unique to the photosynthetic carbon reduction （Calvin） cycle, was cloned and characterized from the stramenopile alga Vaucheria litorea. This alga is the source of plastids for the mollusc （sea slug） Elysia chlorotica which enable the animal to survive for months solely by photoautotrophic CO2 fixation. The 1633-bp V. litorea prk gene was cloned and the coding region, found to be interrupted by four introns, encodes a 405-amino acid protein. This protein contains the typical bipartite target sequence expected of nuclearencoded proteins that are directed to complex （i.e. four membrane-bound） algal plastids. De novo synthesis of PRK and enzyme activity were detected in E. chlorotica in spite of having been starved of V. litorea for several months. Unlike the algal enzyme, PRK in the sea slug did not exhibit redox regulation. Two copies of partial PRK-encoding genes were isolated from both sea slug and aposymbiotic sea slug egg DNA using PCR. Each copy contains the nucleotide region spanning exon 1 and part of exon 2 of V litorea prk, including the bipartite targeting peptide. However, the larger prk fragment also includes intron 1. The exon and intron sequences of prk in E. chlorotica and V/itorea are nearly identical. These data suggest that PRK is differentially regulated in V. litorea and E. chlorotica and at least a portion of the V. litorea nuclear PRK gene is present in sea slugs that have been starved for several months.

关键词： Alga Calvin cycle Elysia chlorotica kleptoplast mollusc phosphoribulokinase photosynthesis plastid redox regulation stramenopile symbiosis Vaucheria litorea.

Hepatocellular carcinoma: Review of disease and tumor biomarkers

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World Journal of Hepatology 2016年第10期8卷 471-484页

作者： Jin Un Kim Mohamed I F Shariff mary M E crossey Maria Gomez-Romero Elaine Holmes I Jane Cox Haddy K S Fye Ramou Njie Simon D Taylor-Robinson Division of Digestive Health Department of Surgery and Cancer Imperial College London Division of Computational medicine Department of Surgery and Cancer Imperial College London the Foundation for Liver Research Institute of Hepatology MRC Gambia

Hepatocellular carcinoma(HCC) is a common malignancy and now the second commonest global cause of cancer death. HCC tumorigenesis is relatively silent and patients experience late symptomatic presentation. As the option for curative treatments is limited to early stage cancers, diagnosis in non-symptomatic individuals is crucial. International guidelines advise regular surveillance of high-risk populations but the current tools lack sufficient sensitivity for early stage tumors on the background of a cirrhotic nodular liver. A number of novel biomarkers have now been suggested in the literature, which may reinforce the current surveillance methods. In addition, recent metabonomic and proteomic discoveries have established specific metabolite expressions in HCC, according to Warburg's phenomenon of altered energy metabolism. With clinical validation, a simple and non-invasive test from the serum or urine may be performed to diagnose HCC, particularly benefiting low resource regions where the burden of HCC is highest.

关键词： Hepatocellular carcinoma Biomarker metabonomics Warburg hypothesis Serum Plasma Urine