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Frontiers of Medicine 2015年第2期9卷 187-219页

作者： Farhad Sahebjam John M. Vierling Departments of Medicine and Surgery Baylor College of Medicine Baylor-St. Luke's Medical Center Houston TX 77030 USA

Autoimmune hepatitis is a chronic liver disease putatively caused by loss of tolerance to hepatocyte- specific autoantigens. It is characterized by female predilection, elevated aminotransferase levels, autoantibodies, increased y-globulin or IgG levels and biopsy evidence of interface hepatitis. It is currently divided into types 1 and 2, based on expression of autoantibodies. Autoantigenic epitopes have been identified only for the less frequent type 2. Although autoimmune hepatitis occurs in childhood, this review focuses on disease in adults. In the absence of pathognomonic biomarkers, diagnosis requires consideration of clinical, biochemical, serological and histological features, which have been codified into validated diagnostic scoring systems. Since many features also occur in other chronic liver diseases, these scoring systems aid evaluation of the differential diagnosis. New practice guidelines have redefined criteria for remission to include complete biochemical and histological normalization on immunosuppressive therapy. Immunosuppression is most often successful using prednisone or prednisolone and azathioprine; however, the combination of budesonide and azathioprine for non-cirrhotic patients offers distinct advantages. Patients failing standard immunosuppression are candidates for alternative immunosuppressive regimens, yet none of the options has been studied in a randomized, controlled trial. Overlap syndromes with either primary sclerosing cholangitis or primary biliary cirrhosis occur in a minority. Liver transplantation represents a life-saving option for patients presenting with acute liver failure, severely decompensated cirrhosis or hepatocellular carcinoma. Transplant recipients are at risk for recurrent autoimmune hepatitis in the allograft, and de novo disease may occur in patients transplanted for other indications. Patients transplanted for AIH are also at risk for recurrent or de novo inflammatory bowel disease. Progress in our understa

关键词： autoimmune hepatitis autoantibodies diagnosis immunological diseases drug-induced liver injury therapy immunosuppression outcomes hepatocellular carcinoma liver transplantation

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Treatment of stellate ganglion block in diseases:Its role and application prospect

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World Journal of Clinical Cases 2023年第10期11卷 2160-2167页

作者： Jing-Jing Deng Cai-Ling Zhang Dian-Wen Liu Tao Huang Jian Xu Qing-Yan Liu Yue-Nong Zhang Department of Surgery and Anesthesia The Third Affiliated Hospital of Sun Yat-sen University Yuedong HospitalMeizhou 514700Guangdong ProvinceChina Department of Anesthesiology Meizhou Hospital of Traditional Chinese MedicineMeizhou 514700Guangdong ProvinceChina Department of Anesthesiology Shangqiu Maternal and Children Health Care HospitalShangqiu 476000Henan ProvinceChina Department of Anesthesiology Fengshun Hospital of Traditional Chinese MedicineMeizhou 514700Guangdong ProvinceChina

The stellate ganglion(SG),as a type of sympathetic ganglion,consists of the sixth and seventh cervical vertebrae and the first thoracic sympathetic *** block(SGB)is a minimally invasive injection that aims to inject low-concentration local anesthetics to induce a broad sympathetic blocking effect near the *** have been no changes and progress in the clinical application of SGB since the 1830s due to several potential risks,including hematoma from blood vessel injury,hoarseness from recurrent laryngeal nerve injury,and cardiopulmonary *** feasibility and safety of SGB have greatly improved since the appearance of ultrasound-guided *** recent years,SGB has been widely applied in the field of non-anesthesiology sedation,with significant therapeutic effects on pain,immunological diseases,somnipathy,psychological disorders,arrhythmias,and endocrine *** present study reviews the present application of SGB in clinical practice.

关键词： Echocardiography Pain immunological diseases Somnipathy Psychological disorders Arrhythmias Endocrine diseases

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