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COVID-19 and Liver Dysfunction:Current Insights and Emergent Therapeutic Strategies

Journal of Clinical and Translational Hepatology 2020年第1期8卷 18-24页

作者： Gong Feng Kenneth I.Zheng Qin-Qin Yan Rafael S.Rios Giovanni Targher Christopher D.Byrne sven van poucke Wen-Yue Liu Ming-Hua Zheng Xi’an Medical University Xi’anChina NAFLD Research Center Department of Hepatologythe First Affiliated Hospital of Wenzhou Medical UniversityWenzhouChina Section of Endocrinology Diabetes and MetabolismDepartment of MedicineUniversity and Azienda Ospedaliera Universitaria Integrata of VeronaVeronaItaly Southampton National Institute for Health Research Biomedical Research Center University Hospital SouthamptonSouthampton General HospitalSouthamptonUK Ziekenhuis Oost-Limburg Department of AnesthesiologyCritical CareEmergency Medicine and Pain TherapyGenkBelgium Department of Endocrinology the First Affiliated Hospital of Wenzhou Medical UniversityWenzhouChina Institute of Hepatology Wenzhou Medical UniversityWenzhouChina Key Laboratory of Diagnosis and Treatment for The Development of Chronic Liver Disease in Zhejiang Province WenzhouChina

The outbreak of coronavirus disease 2019(COVID-19),caused by the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),has attracted increasing worldwide *** of liver damage or dysfunction(mainly characterized by moderately elevated serum aspartate aminotransferase lev-els)have been reported among patients with ***,it is currently uncertain whether the COVID-19-related liver damage/dysfunction is due mainly to the viral infection per se or other coexisting conditions,such as the use of potentially hepatotoxic drugs and the coexistence of sys-temic inflammatory response,respiratory distress syndrome-induced hypoxia,and multiple organ *** on the current evidence from case reports and case series,this review article focuses on the demographic and clinical characteristics,potential mechanisms,and treatment options for COVID-19-related liver *** review also describes the geo-graphical and demographic distribution of COVID-19-related liver dysfunction,as well as possible underlying mechanisms linking COVID-19 to liver dysfunction,in order to facilitate future drug development,prevention,and control measures for COVID-19.

关键词： COVID-19 Liver dysfunction SARS-CoV-2

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Stratified Platelet-to-lymphocyte Ratio:A Novel Target for Prognostic Prediction of Hepatocellular Carcinoma after Curative Liver Resection

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Journal of Clinical and Translational Hepatology 2017年第1期5卷 35-42页

作者： Gui-Qian Huang Ji-Na Zheng Tian-Tian Zou Yi-Ran Chen Ke-Qing Shi sven van poucke Zhang Cheng Lu-Yi Ruan Ming-Hua Zheng Department of Hepatology Liver Research CenterThe First Affiliated Hospital of Wenzhou Medical UniversityWenzhouChina Renji School of Wenzhou Medical University WenzhouChina School of The First Clinical Medical Sciences Wenzhou Medical UniversityWenzhouChina School of The Second Clinical Medical Sciences Wenzhou Medical UniversityWenzhouChina Institute of Hepatology Wenzhou Medical UniversityWenzhouChina Department of Anesthesiology Intensive CareEmergency Medicine and Pain TherapyZiekenhuis Oost-LimburgGenkBelgium

Background and Aims:Platelet-to-lymphocyte ratio(PLR)has been shown to predict prognosis of *** aimed to evaluate the prognostic value of stratification of PLR in patients after curative liver resection(CLR)for hepatocellular carcinoma(HCC).Methods:A total of 1804 patients who underwent CLR for suspected HCC between January 2007 and January 2014 were screened for the *** of the patients were categorized into equal tertiles according to the number of patients and the distribution of *** significance was determined for overall survival(OS)and was assessed using Kaplan-Meier *** and multi-variate Cox proportional hazard regression analyses were evaluated for association of all independent parameters with disease ***:The optimal cut-off points of preoperative PLR were:(T1)11.98-75.00,(T2)75.00-113.33 and(T3)*** were obvious differences in each PLR tertile with mortality within 36 months of CLR(Plog-rank<0.001).Multivariable analysis suggested that the level of PLR(HR=1.004,95%CI:1.001-1.008,P=0.006),portal vein thrombosis(HR=3.406,95%CI:1.185-9.794,P=0.023),number of nodules(HR=1.810,95%CI:1.345-2.437,P<0.001),Child-Turcotte-Pugh score(HR=1.741,95%CI:1.129-2.684,P=0.012)and microvascular invasion(HR=2.730,95%CI:1.777-4.196,P<0.001)were significant predictors of ***-Meier analysis of overall survival(OS)demonstrated that each PLR tertile showed a progressively worse OS and apparent separation(Plog-rank=0.016).The highest 5-year OS rate following CLR(58%)was revealed in tertile *** contrast,the lowest 5-year OS rate(30%)was revealed in tertile ***:Stratified preoperative PLR could strengthen the predictive power for OS in HCC patients with CLR.

关键词： Platelet-to-lymphocyte ratio Hepatocellular carcinoma Curative liver resection Overall survival

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AME证据系列001--转化医学协会:脓毒症诊断和早期识别的临床实践指南

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临床与病理杂志 2016年第10期36卷 1467-1476页

作者： Zhongheng Zhang Nathan J.Smischney Haibo Zhang sven van poucke Panagiotis Tsirigotis Jordi Rello Patrick M.Honore Win Sen Kuan Juliet June Ray Jiancang Zhou You Shang Yuetian Yu Christian Jung Chiara Robba Fabio Silvio Taccone Pietro Caironi David Grimaldi Stefan Hofer George Dimopoulos Marc Leone Sang-Bum Hong Mabrouk Bahloul Laurent Argaud Won Young Kim Herbert D.Spapen Jose Rodolfo Rocco 张建成(译) 尚游(译) 钟鸣(校) Department of Emergency Medicine Sir Run Run Shaw HospitalZhejiang University School of MedicineHangzhou 310016 Department of Critical Care Medicine Jinhua Hospital of Zhejiang UniversityJinhua Zhejiang 321000 Department of Anesthesiology Mayo ClinicRochesterMNUSA Keenan Research Center for Biomedical Science of St.Michael's Hospital Departments of Anesthesia and PhysiologyInterdepartmental Division of Critical Care MedicineUniversity of TorontoTorontoONCanada Departments of Anesthesiology Critical CareEmergency Medicine and Pain TherapyZiekenhuis Oost-Limburgy GenkBelgium 2nd Department of Internal Medicine Attikcon University HospitalMedical SchoolNational and Kapodistrian University of AthensAthensGreece CIBERES Vall d'Hebron Institut of ResearchUniversitat Autonoma de BarcelonaSpain Universitair Ziekenhuis Brussely Vrije Universiteit Brussel Brussels BrusselsBelgium Emergency Medicine Department National University HospitalNational University Health SystemSingapore and the Department of SurgeryYong Loo Lin School of MedicineNational University of SingaporeSingapore DeWitt Daughtry Family Department of Surgery Jackson Memorial HospitalUniversity of Miami Leonard M.Miller School of MedicineMiamiFLUSA Department of Critical Care Medicine Sir Run Run Shaw HospitalZhejiang University School of MedicineHangzhou 310016 Department of Critical Care Medicine Union HospitalTongji Medical CollegueHuazhong University of Science and TechnologyWuhan 430022 Department of Critical Care Medicine Renji HospitalShanghai Jiao Tong University School of MedicineShanghai 200001 University Hospital Dusseldorf Heinrich-Heine-University DusseldorfMedical FacultyDivision of CardiologyPulmonology and Vascular MedicineDusseldorfGermany Neurosciences Critical Care Unit Addenbrooke's HospitalCambridgeUK Department of Intensive Care Hopital ErasmeUniversite Libre de Bruxelles(ULB)BrusselsBelgium Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti Fondazione IRCCS Ca'Granda-Ospedale

脓毒症是一种由感染引起的异质性疾病,感染触发了一系列复杂的局部或者全身的免疫炎症反应,引起多器官功能衰竭,发病率和病死率显著升高。由于至今仍然没有诊断脓毒症的金标准,所以脓毒症的临床诊断仍是一个难题。因此,脓毒症的临床诊... 详细信息

脓毒症是一种由感染引起的异质性疾病,感染触发了一系列复杂的局部或者全身的免疫炎症反应,引起多器官功能衰竭,发病率和病死率显著升高。由于至今仍然没有诊断脓毒症的金标准,所以脓毒症的临床诊断仍是一个难题。因此,脓毒症的临床诊断需要不断改变来满足临床和研究的要求。然而,尽管有许多新型的生物标记和筛选工具去预测脓毒症发生的风险,但是这些措施的诊断价值和有效性不足以让人满意,并且没有充分的证据去建议临床使用这些新技术。因此,脓毒症的临床诊断标准需要定期更新去适应不断产生的新证据。这篇综述旨在呈现当前脓毒症的诊断和早期识别方面的最新研究证据。临床运用不同的诊断方法的推荐意见依赖于推荐、评价、发展和评估分级体系(Grades of Recommendation Assessment,Development and Evaluation,GRADE),因为大部分的研究是观察性研究,并没有对这些方法进行可靠评估,采用的是两步推理方法。未来需要更多研究来确认或者反驳某一特殊的指标检测,同时应该直接采用相关病人的结果数据。

关键词：脓毒症早期识别诊断

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